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Sample records for injection nebulizer din

  1. Measurement of elemental speciation by liquid chromatography -- inductively coupled plasma mass spectrometry (LC-ICP-MS) with the direct injection nebulizer (DIN)

    SciTech Connect

    Shum, Sam

    1993-05-01

    This thesis is divided into 4 parts: elemental speciation, speciation of mercury and lead compounds by microbore column LC-ICP-MS with direct injection nebulization, spatially resolved measurements of size and velocity distributions of aerosol droplets from a direct injection nebulizer, and elemental speciation by anion exchange and size exclusion chromatography with detection by ICP-MS with direct injection nebulization.

  2. A comparison of continuous pneumatic nebulization and flow injection-direct injection nebulization for sample introduction in inductively coupled plasma-mass spectrometry

    SciTech Connect

    Crain, J.S.; Kiely, J.T.

    1995-08-01

    Dilute nitric acid blanks and solutions containing Ni, Cd, Pb, and U (including two laboratory waste samples) were analyzed eighteen times over a two-month period using inductively coupled plasma-mass spectrometry (ICP-MS). Two different sample introduction techniques were employed: flow injection-direct injection nebulization (FI-DIN) and continuous pneumatic nebulization (CPN). Using comparable instrumental measurement procedures, FI-DIN analyses were 33% faster and generated 52% less waste than CPN analyses. Instrumental limits of detection obtained with FI-DIN and CPN were comparable but not equivalent (except in the case of Pb) because of nebulizer-related differences in sensitivity (i.e., signal per unit analyte concentration) and background. Substantial and statistically significant differences were found between FI-DIN and CPN Ni determinations, and in the case of the laboratory waste samples, there were also small but statistically significant differences between Cd determinations. These small (2 to 3%) differences were not related to polyatomic ion interference (e.g., {sup 95}Mo{sup 16}O{sup +}), but in light of the time savings and waste reduction to be realized, they should not preclude the use of FI-DIN in place of CPN for determination of Cd, Pb, U and chemically.

  3. A comparison of continuous pneumatic nebulization and flow injection-direction injection nebulization for sample introduction in inductively coupled plasma-mass spectrometry

    SciTech Connect

    Crain, J.S.; Kiely, J.T.

    1997-08-01

    Samples containing Ni, Cd, Pb, and U were analyzed eighteen times over a two-month period using inductively coupled plasma-mass spectrometry (ICP-MS). Sample introduction was accomplished by either flow injection-direct injection nebulization (FI-DIN) or continuous pneumatic nebulization (CPN). Using comparable instrumental measurement procedures, FI-DIN analyses were 33% faster and generated 52% less waste than CPN analyses. Instrumental limits of detection obtained with FI-DIN and CPN were comparable but not equivalent (except in the case of Pb) because of nebulizer-related differences in sensitivity (i.e., signal per unit analyte concentration) and background. Substantial and statistically significant differences were found between FI-DIN and CPN Ni determinations, and in the case of laboratory waste samples, there were also small but statistically significant differences between Cd determinations. These small (2 to 3%) differences were not related to polyatomic ion interference (e.g., {sup 95}Mo{sup 16}O{sup +}), but in light of the time and waste savings to be realized, they should not preclude the use of FI-DIN in place of CPN for determination of Cd, Pb, U, and similar elements present at trace concentrations.

  4. A direct injection high-efficiency nebulizer for inductively coupled plasma mass spectrometry.

    PubMed

    McLean, J A; Zhang, H; Montaser, A

    1998-03-01

    A simple, relatively low-cost direct injection high-efficiency nebulizer (DIHEN) is introduced for argon inductively coupled plasma (Ar ICP) spectrometry. The DIHEN may be operated at solution uptake rates of 1-100 microL/min. Analytical performance indexes for the DIHEN and fundamental characteristics of the aerosol produced are obtained using an ICP mass spectrometer (ICPMS) and a two-dimensional phase Doppler particle analyzer (2D PDPA), respectively. Results are compared to those obtained with a conventional crossflow pneumatic nebulizer (PN), equipped with a Scott-type spray chamber. Droplet sizes and velocities produced with the DIHEN are smaller than those reported for the direct injection nebulizer (DIN). The DIHEN offers optimal sensitivity at low injector gas flow rates (approximately 0.25 L/min) and high rf power (approximately 1.5 kW). For the 17 elements tested, detection limits (ppt) and sensitivities achieved with the DIHEN (at 85 microL/min) are similar to, or better than, those obtained on the same instrument using the PN (at 1 mL/min). However, because the primary aerosol is injected directly into the plasma, oxide-to-metal ion ratios (MO+/M+) are high, as in the case of the DIN. The utility of the DIHEN for the analysis of small-volume samples is demonstrated by microscale flow injection analysis (muFIA) of Cr bound to human lung DNA. Detection of Cr at the femtogram level is feasible.

  5. Spatially resolved measurements of size and velocity distributions of aerosol droplets from a direct injection nebulizer

    SciTech Connect

    Shum, S.C.K.; Johnson, S.K.; Pang, H.M.; Houk, R.S. )

    1993-05-01

    Aerosol droplet sizes and velocities from a direct injection nebulizer (DIN) are measured with radial and axial spatial resolution by phase Doppler particle analysis (PDPA). The droplets on the central axis of the spray become finer and their size becomes more uniform when [approx]20% methanol is added to the usual aqueous solvent. This could explain why the analyte signal is a maximum at this solvent composition when the DIN is used for inductively coupled plasma-mass spectrometry (ICP-MS). Mean droplet velocities are 12 to 22 m s[sup [minus]1] with standard deviations of [plus minus]4 to [plus minus]7 m s[sup [minus]1]. The outer fringes of the aerosol plume tend to be enriched in large droplets. The Sauter mean diameter (D[sub 3,2]) and velocity of the droplets also vary substantially with axial position in the aerosol plume. 35 refs., 10 figs., 1 tab.

  6. THE DEVELOPMENT OF IODINE BASED IMPINGER SOLUTIONS FOR THE EFFICIENT CAPTURE OF HG USING DIRECT INJECTION NEBULIZATION - INDUCTIVELY COUPLED PLASMA MASS SPECTROMETRY ANALYSIS

    EPA Science Inventory

    Inductively coupled plasma mass spectrometry (ICP/MS) with direct injection nebulization (DIN) was used to evaluate novel impinger solution compositions capable of capturing elemental mercury (Hgo) in EPA Method 5 type sampling. An iodine based impinger solutoin proved to be ver...

  7. THE DEVELOPMENT OF IODINE BASED IMPINGER SOLUTIONS FOR THE EFFICIENT CAPTURE OF HG USING DIRECT INJECTION NEBULIZATION - INDUCTIVELY COUPLED PLASMA MASS SPECTROMETRY ANALYSIS

    EPA Science Inventory

    Inductively coupled plasma mass spectrometry (ICP/MS) with direct injection nebulization (DIN) was used to evaluate novel impinger solution compositions capable of capturing elemental mercury (Hgo) in EPA Method 5 type sampling. An iodine based impinger solutoin proved to be ver...

  8. Evaluation of a direct injection nebulizer interface for flow injection analysis and high performance liquid chromatography with inductively coupled plasma-atomic emission spectroscopic detection

    SciTech Connect

    LaFreniere, K.E.

    1986-06-01

    A direct injection nebulizer (DIN) was designed, developed, and evaluated to determine its potential utilization as an effective interface for flow injection analysis (FIA) and high performance liquid chromatography (HPLC) coupled with inductively coupled plasma-atomic emission spectroscopic detection. The analytical figures of merit for the DIN when used as an interface for FIA-ICP-AES were found to be comparable to or better than those obtained with conventional pneumatic nebulization in terms of limits of detection (LODs), reproducibility, linearity, and interelement effects. Stable plasma operation was maintained for the DIN sample introduction of a variety of pure organic solvents, including acetonitrile, methanol, methylisobutylketone, and pyridine. The HPLC-DIN-ICP-AES facility was specifically applied for the speciation of inorganic and organometallic species contained in synthetic mixtures, vanilla extracts, and a variety of energy-related materials, such as shale oil process water, coal extracts, shale oil, crude oil, and an SRC II. Suggestions for future research are also considered. 227 refs., 44 figs., 15 tabs.

  9. A large bore-direct injection high efficiency nebulizer for inductively coupled plasma spectrometry

    PubMed

    Acon; McLean; Montaser

    2000-04-15

    A large bore-direct injection high efficiency nebulizer (IB-DIHEN) is introduced that is less prone to capillary blockage and optimally operates at low nebulizer gas pressures compared with the conventional DIHEN used for inductively coupled plasma (ICP) spectrometries. The aerosol quality is examined using a two-dimensional phase Doppler particle analyzer (2D PDPA), and analytical figures of merits are acquired by ICP mass spectrometry. Compared with the DIHEN, the LB-DIHEN produces larger droplets, but the velocity distributions and mean droplet velocities are narrower and lower, respectively, providing longer residence times for the droplets in the plasma. High RF power (1500 W), low nebulizer gas flow rates (0.25-0.35 L/min), and low solution uptake rates (80-110 microL/min) are required to operate the LB-DIHEN at optimum conditions for ICPMS. Detection limits and sensitivities measured with the LB-DIHEN are superior to those of a conventional nebulizer-spray chamber combination, but precision is inferior. The performance of the LB-DIHEN is further explored in the determination of trace elements in an herbal extract.

  10. The development of iodine based impinger solutions for the efficient capture of Hg0 using direct injection nebulization-inductively coupled plasma mass spectrometry analysis.

    PubMed

    Hedrick, E; Lee, T G; Biswas, P; Zhuang, Y

    2001-09-15

    Inductively coupled plasma mass spectrometry (ICP/MS) with direct injection nebulization (DIN) was used to evaluate novel impinger solution compositions capable of capturing elemental mercury (Hg0) in EPA Method 5 type sampling. An iodine based impinger solution proved to be very efficient for Hg0 capture and was amenable to direct analysis by DIN-ICP/MS. Hg0 capture efficiency using aqueous iodine (I3-) was comparable to Hg0 capture using acidified potassium permanganate impinger solutions which were analyzed by cold vapor atomic absorption spectrometry (CVAAS), with greater than 98% capture of Hg0 in the first oxidizing impinger. Using DIN-ICP/MS, it was demonstrated for the first time that iodine can be generated just prior to impinger sampling for efficiently oxidizing Hg0 and retaining it in solution as HgI4(2-). Due to the increased interest in Hg speciation from combustion sources and the potential for using DIN-ICP/MS for multiple metals analyses, an impinger sampling train for gaseous Hg speciation and multiple metals analyses using DIN-ICP/MS analyses is presented. The unique feature of such a sampling train is that each impinger solution in the series is amenable to direct analysis by DIN-ICP/MS. A bituminous coal was combusted in a bench scale coal system, and gaseous Hg species (oxidized and elemental) were determined using the proposed impinger train. The DIN-ICP/MS instrumental detection limit was 0.003 ppb, and MDLs ranged from 0.007 to 0.116 microg/L (ppb) in a variety of impinger solutions used for Hg capture.

  11. MICROSCALE FLOW INJECTION AND MICROBORE HIGH-PERFORMANCE LIQUID CHROMATORGRAPHY COUPLED WITH INDUCTIVELY COUPLED PLASMA MASS SPECTROMETRY VIA A HIGH-EFFICIENCY NEBULIZER

    EPA Science Inventory

    A high-effeciency nebulizer has been used for coupling microscale flow injection and microbore high-performance liquid chromatography with inductively coupled plasma mass spectrometry (ICPMS). The microscale flow injection system was configured to minimize band broadening between...

  12. Demountable direct injection high efficiency nebulizer for inductively coupled plasma mass spectrometry

    DOEpatents

    Montaser, Akbar; Westphal, Craig S.; Kahen, Kaveh; Rutkowski, William F.; Acon, Billy W.

    2006-12-05

    A nebulizer adapted for adjusting a position of a capillary tube contained within the nebulizer is provided. The nebulizer includes an elongated tubular shell having a gas input port and a gas output port, a capillary adjustment adapter for displacing the capillary tube in a lateral direction via a rotational force, and a connector for connecting the elongated tubular shell, the capillary adjustment adapter and the capillary tube.

  13. Determination of As, Cd, Pb, and Hg in urine using inductively coupled plasma mass spectrometry with the direct injection high efficiency nebulizer

    NASA Astrophysics Data System (ADS)

    Minnich, Michael G.; Miller, Derek C.; Parsons, Patrick J.

    2008-03-01

    The application of the large-bore direct injection high efficiency nebulizer (LB-DIHEN) for the determination of arsenic (As), cadmium (Cd), lead (Pb), and mercury (Hg) in urine by inductively coupled plasma mass spectrometry (ICP-MS) is described. The LB-DIHEN is compared with the standard method using a concentric pneumatic nebulizer and cyclonic spray chamber. In addition to the toxicological significance of As, Cd, Pb, and Hg, these elements represent a cross-section of analytical issues including spectral interferences (e.g., 40Ar 35Cl + on 75As + and 98Mo 16O + on 114Cd +) and memory effects (Hg). In this study, the low sample consumption of the LB-DIHEN is used to reduce the volume of urine needed for analysis, and to reduce the volume of final diluted sample required for analysis. Eliminating the spray chamber and reducing the dead volume of the nebulizer reduces memory effects, especially for analytes such as Hg. The Dynamic Reaction Cell (DRC) is used in this study to attenuate the background level of ArCl + in spite of the increase in the solvent load and, in turn, the urine matrix (chloride) delivered to the plasma by the LB-DIHEN. This is the first report on coupling the LB-DIHEN to a standard autosampler for unattended sample analysis. The robustness of direct injection nebulization for routine analysis and the issues associated with automation of the sample introduction process are discussed. Although the figures of merit (sensitivity, limit of detection, and precision) determined for both nebulizers are slightly poorer for the LB-DIHEN than for the concentric pneumatic nebulizer, there is not a clinically significant difference between the results for both sample introduction systems. The accuracy of results is assessed using archived urine materials that are circulated by several different proficiency testing (PT) programs and external quality assessment schemes (EQAS). Results obtained using the LB-DIHEN were within the acceptable range

  14. Nebulizer device

    DOEpatents

    Greenspan, Bernard J.; Moss, Owen R.; Schleiffer, Keith E.; Eick, James L.

    1996-01-01

    The present invention constitutes a portable nebulizer capable of producing a finely divided aerosol having uniformly sized droplets. The nebulizer includes a source of fluid such as a capillary tube coupled to a fluid reservoir to which a high voltage is applied in order to generate the aerosol by electrical atomization. The nebulizer further includes a piezoelectric crystal and a mechanism for deforming the crystal so as to generate the required voltage. The nebulizer further includes a means for mechanical positive displacement fluid control for controlling the amount of fluid atomized. By using electrical atomization to generate the aerosol and by piezoelectrically generating the voltage required for atomization, a nebulizer is provided which may be of small size so as to be suitable for hand-held operations, yet is capable of producing measured amounts of finely divided aerosols which are substantially monodispersed.

  15. Evaluation of nebulizer performance within the ICP-MS measurement system for analysis of SRS radiological waste tank simulated solutions

    SciTech Connect

    Jones, V.D.

    1998-12-31

    High level radioactive waste tanks at the Savannah River Site are high in salt content. The average Total Dissolved Solids (TDS) content is approximately 25%. For ICP-MS optimum signal stability and to reduce blockage of nebulizers and sampling orifices, it is usual to limit analyte solutions to a TDS content of nominally < 0.2%. Dilution to this level to reduce the matrix effect may push some analytes of interest below detectable levels. Five commercially available nebulizers were evaluated in a field study as part of the ICP-MS measurement system for their performance in a high salt matrix. The nebulizers surveyed were a meinhard concentric, cross-flow, micro-concentric (MCN), V-groove, and a direct injection nebulizer (DIN). Analytes spiked into non-radioactive diluted salt solutions ranging from nominal 0.25--1.0% TDS were repetitively analyzed with the goal of determining stability of response signal and magnitude of any signal loss/suppression resulting from the diluted salt matrix. The cross-flow nebulizer provided the most stable signal for all salt matrices with the smallest signal loss/suppression due to this matrix. The DIN exhibited a serious lack of tolerance for TDS; possibly due to physical de-tuning of the nebulizer efficiency.

  16. Nebulizer device

    DOEpatents

    Greenspan, Bernard J.; Moss, Owen R.

    1992-01-01

    The present invention constitutes a portable neubulizer capable of producing a finely divided aerosol having uniformly sized droplets. The nebulizer includes a source of fluid such as a capillary tube coupled to a fluid reservoir to which a high voltage is applied in order to generate the aerosol by electrical atomization. The nebulizer further includes a piezoelectric crystal and a mechanism for deforming the crystal so as to generate the required voltage. By using electrical atomization to generate the aerosol and by piezoelectrically generating the voltage required for atomization, a nebulizer is provided which may be of small size so as to be suitable for hand held operations yet is capable of producing measured amounts of finely divided aerosols which are substantially monodispersed.

  17. Rapid determination of zinc and iron in foods by flow-injection analysis with flame atomic-absorption spectrophotometry and slurry nebulization.

    PubMed

    de Andrade, J C; Strong, F C; Martin, N J

    1990-07-01

    A rapid method of determining zinc and iron in food by flame atomic-absorption spectrophotometry with slurry nebulization into an air-acetylene flame has been developed. A V-groove, clog-free Babington-type nebulizer, coupled to a single-line flow-injection analysis (FIA) system, was employed to introduce the slurry into the spray chamber. Under the FIA conditions described, an injection frequency of 120/hr is possible, with negligible carry-over and memory effects. The calibration graphs were obtained by using various concentrations (up to 0.1 g/ml) of white bean homogenate as standards, rather than solutions. The method has been applied to various kinds of foods, including grains, vegetables, fruits and sausage. Homogenization of semi-prepared samples to form slurries took only 4 min. Relative deviations between results by the slurry and solution methods for both elements averaged 2-3%. Detection limits by the slurry method were 0.3 mug/ml Zn and 0.6 mug/ml Fe.

  18. Apparatus for ultrasonic nebulization

    DOEpatents

    Olson, Kenneth W.; Haas, Jr., William J.; Fassel, Velmer A.

    1978-08-29

    An improved apparatus for ultrasonic nebulization of liquid samples or suspensions in which the piezoelectric transducer is protected from chemical attack and erosion. The transducer is protected by being bonded to the inner surface of a glass plate which forms one end wall of a first hollow body provided with apparatus for circulating a fluid for cooling and stabilizing the transducer. The glass plate, which is one-half wavelength in thickness to provide an acoustically coupled outer nebulizing surface, seals an opening in a second hollow body which encloses an aerosol mixing chamber. The second body includes apparatus for delivering the sample solution to the nebulizing surface, a gas inlet for providing a flow of carrier gas for transporting the aerosol of the nebulized sample and an aerosol outlet.

  19. ICP-MS nebulizer performance for analysis of SRS high salt simulated radioactive waste tank solutions ({number_sign}3053)

    SciTech Connect

    Jones, V.D.

    1997-11-01

    High Level Radioactive Waste Tanks at the Savannah River Site are high in salt content. The cross-flow nebulizer provided the most stable signal for all salt matrices with the smallest signal loss/suppression due to this matrix. The DIN exhibited a serious lack of tolerance for TDS; possibly due to physical de-tuning of the nebulizer efficiency.

  20. IMPINGER SOLUTIONS FOR THE EFFICIENT CAPTURE OF GASEOUS MERCURY SPECIES USING DIRECT INJECTION NEBULIZATION INDUCTIVELY COUPLED PLASMA MASS SPECTROMETRY (DIN-ICP/MS) ANALYSIS

    EPA Science Inventory

    Currently there are no EPA reference sampling mehtods that have been promulgated for measuring Hg from coal combustion sources. EPA Method 29 is most commonly applied. The ASTM Ontario Hydro Draft Method for measuring oxidized, elemental, particulate-bound and total Hg is now und...

  1. EVALUATION OF IODINE BASED IMPINGER SOLUTIONS FOR THE EFFICIENT CAPTURE OF HG USING DIRECT INJECTION NEBULIZATION INDUCTIVELY COUPLED PLASMA MASS SPECTROMETRY (DIN-ICP/MS) ANALYSIS

    EPA Science Inventory

    Currently there are no EPA reference sampling methods that have been promulgated for measuring stack emissions of Hg from coal combustion sources, however, EPA Method 29 is most commonly applied. The draft ASTM Ontario Hydro Method for measuring oxidized, elemental, particulate-b...

  2. IMPINGER SOLUTIONS FOR THE EFFICIENT CAPTURE OF GASEOUS MERCURY SPECIES USING DIRECT INJECTION NEBULIZATION INDUCTIVELY COUPLED PLASMA MASS SPECTROMETRY (DIN-ICP/MS) ANALYSIS

    EPA Science Inventory

    Currently there are no EPA reference sampling mehtods that have been promulgated for measuring Hg from coal combustion sources. EPA Method 29 is most commonly applied. The ASTM Ontario Hydro Draft Method for measuring oxidized, elemental, particulate-bound and total Hg is now und...

  3. EVALUATION OF IODINE BASED IMPINGER SOLUTIONS FOR THE EFFICIENT CAPTURE OF HG USING DIRECT INJECTION NEBULIZATION INDUCTIVELY COUPLED PLASMA MASS SPECTROMETRY (DIN-ICP/MS) ANALYSIS

    EPA Science Inventory

    Currently there are no EPA reference sampling methods that have been promulgated for measuring stack emissions of Hg from coal combustion sources, however, EPA Method 29 is most commonly applied. The draft ASTM Ontario Hydro Method for measuring oxidized, elemental, particulate-b...

  4. Formulations and nebulizer performance.

    PubMed

    O'Riordan, Thomas G

    2002-11-01

    To deliver a drug by nebulization, the drug must first be dispersed in a liquid (usually aqueous) medium. After application of a dispersing force (either a jet of gas or ultrasonic waves), the drug particles are contained within the aerosol droplets, which are then inhaled. Some drugs readily dissolve in water, whereas others need a cosolvent such as ethanol or propylene glycol. Some drugs are delivered as suspensions, and the efficiency of nebulizers can be different for solutions and suspensions. Solutions are delivered more efficiently with most devices. In general, conventional ultrasonic nebulizers should not be used to aerosolize suspensions, because of low efficiency. Newer strategies to improve the delivery of non-water-soluble drugs include the use of liposomes and the milling of the drug into very small "nanoparticles." In addition to the active therapeutic ingredient and solvents, drug formulations may include buffers (the solubility of some medications is influenced by pH), stabilizers, and, in the case of multi-dose preparations, antibacterial agents. Though formulations are designed to optimize drug solubility and stability, changes in formulation can also affect inhaled mass, particle size, and treatment time, though the differences between nebulizer brands probably have a greater impact than differences in formulation. Ultrasonic and jet nebulizers may damage protein and other complex agents through heat or shear stress. Additives to multi-dose formulations, especially antimicrobial and chelating agents, may cause adverse events, so there is a trend towards single-use, preservative-free vials.

  5. Nebulization Reflux Concentrator

    NASA Technical Reports Server (NTRS)

    Cofer, Wesley R., III; Collins, V. G.

    1986-01-01

    Nebulization reflux concentrator extracts and concentrates trace quantities of water-soluble gases for subsequent chemical analysis. Hydrophobic membrane and nebulizing nozzles form scrubber for removing trace quantities of soluble gases or other contaminants from atmosphere. Although hydrophobic membrane virtually blocks all transport of droplets, it offers little resistance to gas flow; hence, device permits relatively large volumes of gas scrubbed efficiently with very small volumes of liquid. This means analyzable quantities of contaminants concentrate in extracting solutions in much shorter times than with conventional techniques.

  6. Nebulizer use - slideshow

    MedlinePlus

    ... used to treat asthma, Chronic Obstructive Pulmonary Disease (COPD), and other conditions where inhaled medicines are indicated. Nebulizers deliver a stream of medicated air to the lungs over a period of time. Review Date 4/21/2015 Updated by: Neil K. ...

  7. Direct solution introduction using conventional nebulizers with a short torch for plasma mass spectrometry

    NASA Astrophysics Data System (ADS)

    Westphal, Craig S.; Montaser, Akbar

    2006-06-01

    A new torch, a shortened version of a standard demountable torch, is proposed for facilitating direct injection of liquid samples into an inductively coupled plasma mass spectrometer using conventional and micro-pneumatic nebulizers. The proposed arrangement reduces the cost of the direct injector nebulizer by a factor of 5, typically from 2000 to 400, although a different torch is required. The analytical performance of the high efficiency nebulizer-short torch arrangement is compared to that obtained with the direct injection high efficiency nebulizer interfaced to the conventional torch. Optimum operating conditions for the high efficiency nebulizer-short torch arrangement are generally similar to those of the direct injection high efficiency nebulizer: high RF power (1500 W), low nebulizer gas flow rates (0.09 L/min) and low solution uptake rates (5-85 μL/min). Sensitivity with the high efficiency nebulizer-short torch system at 85 μL/min is improved by a factor of 2.4 on average compared to the direct injection high efficiency nebulizer, while precision values (%RSD) and detection limits are generally comparable or slightly degraded (on average by a factor of 1.7), respectively. Sensitivity is also better at lower solution uptake rates (5 μL/min) by factors ranging from 2 ( 82Se) to 7 ( 59Co) compared to the direct injection high efficiency nebulizer. Additionally, the %RSD values are better at 5 μL/min, ranging from 3.5% to 6.0% for the high efficiency nebulizer-short torch combination compared to 4.7 to 9.1% for the direct injection high efficiency nebulizer. The utility of the high efficiency nebulizer-short torch arrangement is demonstrated through the microscale flow injection analysis of Cr-DNA adducts and the analysis of four certified reference materials (Lyphochek urine metals control, SRM 1515: Apple Leaves, SRM 1570a: Spinach Leaves, SRM 1577b: Bovine Liver). Peak to peak precision values ( N = 3) for the microscale flow injection analysis

  8. Characterization of nebulized buparvaquone nanosuspensions--effect of nebulization technology.

    PubMed

    Hernández-Trejo, Norma; Kayser, Oliver; Steckel, Hartwig; Müller, Rainer H

    2005-01-01

    The poorly soluble drug buparvaquone is proposed as an alternative treatment of Pneumocystis carinii pneumonia (PCP) lung infections. Physically stable nanosuspensions were formulated in order to deliver the drug at the site of infection using nebulization. The aerosolization characteristics of two buparvaquone nanosuspensions were determined with commercial jet and ultrasonic nebulizer devices. Aerosol droplet size distribution was determined with laser diffractometry (LD). Nebulization of the nanosuspensions and dispersion media surfactant solutions produced aerosol droplets diameters in the range from 3 to 5 microm for Respi-jet Kendall, Pari Turbo Boy system and Multisonic nebulizers and particles around 9-10 microm with Omron U1. Fractions of the nanosuspensions from the nebulizer reservoir and of aerosol produced were collected to investigate changes in the size of the drug nanocrystals influenced by the nebulization technology. Comparisons were performed measuring the drug nanocrystals with photon correlation spectroscopy (PCS) and LD of the samples. Drug particle aggregates were detected in the fractions of aerosol collected from jet nebulizers. Nebulizer technology (jet vs. ultrasonic) showed influence on the stability of the drug particle size distribution of buparvaquone nanocrystals during the nebulization time evaluated.

  9. Nebulized therapy. SEPAR year.

    PubMed

    Olveira, Casilda; Muñoz, Ana; Domenech, Adolfo

    2014-12-01

    Inhaled drugs are deposited directly in the respiratory tract. They therefore achieve higher concentrations with faster onset of action and fewer side effects than when used systemically. Nebulized drugs are mainly recommended for patients that require high doses of bronchodilators, when they need to inhale drugs that only exist in this form (antibiotics or dornase alfa) or when they are unable to use other inhalation devices. Technological development in recent years has led to new devices that optimize pulmonary deposits and reduce the time needed for treatment. In this review we focus solely on drugs currently used, or under investigation, for nebulization in adult patients; basically bronchodilators, inhaled steroids, antibiotics, antifungals, mucolytics and others such as anticoagulants, prostanoids and lidocaine. Copyright © 2014 SEPAR. Published by Elsevier Espana. All rights reserved.

  10. Nebulization reflux concentrator

    NASA Technical Reports Server (NTRS)

    Collins, V. G.; Cofer, W. R., III

    1986-01-01

    A nebulization reflux concentrator for removing trace gas contaminants from a sample gas is described. Sample gas from a gas supply is drawn by a suction source into a vessel. The gas enters the vessel through an atomizing nozzle, thereby atomizing and entraining a scrubbing liquid solvent drawn through a siphon tube from a scrubbing liquid reservoir. The gas and entrained liquid rise through a concentrator and impinge upon a solvent phobic filter, whereby purified gas exits through the filter housing and contaminated liquid coalesces on the solvent phobic filter and falls into the reservoir.

  11. [Benefits of nebulized therapy: basic concepts].

    PubMed

    Máiz Carro, Luis; Wagner Struwing, Carolin

    2011-06-01

    The main advantage of nebulized drugs is that they are deposited directly into the respiratory tract and thus higher drug concentrations can be achieved in the bronchial tree and pulmonary bed with fewer adverse effects than when the systemic route is used. The effectiveness of nebulization depends on many factors, including the characteristics of the drug to be nebulized (particle size, form, density, and surface tension), the anatomy of the airways, the patient's inhalation technique and the nebulization system employed, among others. The factors determining the particle size produced by a nebulizer include both the characteristics of the solution and the flow velocity of the nebulization system. The higher the flow velocity, the smaller the aerosol particles. The parameter most widely used to measure aerosolized particle size is the mass median aerodynamic diameter. Particles of between 1 and 5 μm are those with the greatest probability of reaching the site of infection in the bronchial tree and of achieving the desired therapeutic effect. Nebulization systems or apparatus are composed of a nebulization chamber where the liquid to be nebulized is introduced and aerosol and an energy source required to make the nebulizer work are generated. There are three types of nebulization systems: ultrasonic, jet and mesh nebulizers. Of the three, the most effective are mesh nebulizers. These nebulizers are also the most compact, quietest and most rapid, which translates into better patient compliance.

  12. COPD - how to use a nebulizer

    MedlinePlus

    ... With a nebulizer, you will sit with your machine and use a mouthpiece. Medicine goes into your ... mouthpiece and medicine cup. Turn on the nebulizer machine. Place the mouthpiece in your mouth. Keep your ...

  13. Students' Perspectives on Nebulized Drugs and Nebulizer Maintenance.

    PubMed

    Ngai, Kristine; Persico, Amelia L; Brodeur, Michael R

    2017-09-01

    The geriatric population experiences a variety of respiratory concerns including chronic obstructive pulmonary disease, emphysema, asthma, pulmonary hypertension, and lower respiratory infections. Treating these illnesses often requires the use of inhaled therapies that can be delivered through multiple modalities, each of which carries its own pros and cons unique to its use in the geriatric population. Pharmacists have an opportunity to play a role in optimizing the selection of delivery devices and in providing patient and provider education on appropriate use of inhaled therapies. Through patient counseling and correct device selection, patient outcomes can be improved. This paper explores the differences among devices, provides specific information regarding drug mixing for nebulization, provides information regarding cleaning/maintenance of nebulizers, and addresses specific concerns related to geriatric care. It can serve as a reference for pharmacists and student pharmacists as they educate patients and providers.

  14. A Simple and Versatile Nebulizer

    PubMed Central

    Torloni, Maurício

    1962-01-01

    The nebulizer presented in this paper is of simple and rugged construction, permits easy control of cell concentrations, prevents sedimentation of the microorganisms, and permits the cleaning of the suspension needles even during the runs and under aseptic conditions. Fluid consumptions from 10 to 25 ml per hr were obtained with rates of primary air varying from 10 to 25 liters per min. The average diameter of the droplets varied from 1.5 to 2.7 μ. PMID:13921958

  15. Electrostatic charge characteristics of jet nebulized aerosols.

    PubMed

    Kwok, Philip Chi Lip; Trietsch, Sebastiaan J; Kumon, Michiko; Chan, Hak-Kim

    2010-06-01

    Liquid droplets can be spontaneously charged in the absence of applied electric fields by spraying. It has been shown by computational simulation that charges may influence particle deposition in the airways. The electrostatic properties of jet nebulized aerosols and their potential effects on lung deposition have hardly been studied. A modified electrical low pressure impactor (ELPI) was employed to characterize the aerosol charges generated from jet nebulized commercial products. The charge and size measurements were conducted at 50% RH and 22 degrees C with a modified ELPI. Ventolin, Bricanyl, and Atrovent were nebulized using PARI LC Plus jet nebulizers coupled to a DeVilbiss Pulmo-Aide compressor. The aerosols were sampled in 30-sec durations. The drug deposits on the impactor stages were assayed chemically using high-performance liquid chromatography (HPLC). The charges of nebulized deionized water, isotonic saline, and the three commercial products diluted with saline were also measured to analyze the contributions of the major nebule ingredients on charging. No mass assays were performed on these runs. All three commercial nebules generated net negative charges. The magnitude of the charges reduced over the period of nebulization. Ventolin and Bricanyl yielded similar charge profiles. Highly variable charges were produced from deionized water. On the other hand, nebulized saline reproducibly generated net positive charges. Diluted commercial nebules showed charge polarity inversion. The charge profiles of diluted salbutamol and terbutaline solutions resembled those of saline, while the charges from diluted ipratropium solutions fluctuated near neutrality. The charge profiles were shown to be influenced by the concentration and physicochemical properties of the drugs, as well as the history of nebulization. The drugs may have unique isoelectric concentrations in saline at which the nebulized droplets would carry near-zero charges. According to results from

  16. Fabrication of an integrated piezo-electric micro-nebulizer for biochemical sample analysis

    NASA Astrophysics Data System (ADS)

    Pan, C. T.; Shiea, J.; Shen, S. C.

    2007-03-01

    This paper proposes a new micro-nebulizer integrating piezo-electric actuator, micro-nozzle plate, and the cavity of a micro-pump to achieve a high-quality nebulizing effect. With this micro-nebulizer, the size distribution of nebulized droplet particles is finer and more uniform than that of commercial ultrasonic and pneumatic ones. Besides, the system power consumption and volume size are lower and smaller than those of the ultrasonic and pneumatic types. Its whole size is about 18 mm × 32 mm × 35 mm in volume and power consumption is about 1 Watt. The fabrication process of a micro-nozzle plate includes multi-exposure and single develop (MESD), high-hardness nickel-cobalt (Ni-Co) alloy micro-electroplating and high-speed precise microinjection molding. A mold with hardness of Vicker (Hv) 550 is obtained. With such hardness, it endures the high-speed injection molding without deformation. The dimensions of nozzle plates are 4 mm in width, 7 mm in length 8 µm in nozzle-hole diameter and 100 µm in total thickness. The lowest thickness around a nozzle hole is 40 µm. The aspect ratio is about 5. When the working frequency of a piezo-electric micro-nebulizer is set at 16 KHz, a nebulizing rate of 1.8 cc min-1 is obtained. The developed piezo-electric micro-nebulizer at 16 KHz frequency oscillation shows an excellent mass median diameter (MMD or D[4][3]) value of 6.13 µm. This micro-nebulizer is applied to nebulize a test sample of myoglobin into a micro-droplet for the analysis of fused-droplet electrospray ionization (FD-ESI) mass spectrometry. Methyl-alcohol solvents of different consistencies are used to react with myoglobin for FD-ESI mass spectrometry analysis. The result reveals that this developed micro-nebulizer shows a better result of mass spectrometry compared to the commercial ultrasonic and pneumatic ones. This micro-nebulizer is applicable to the FD-ESI mass spectrometry analysis.

  17. Inhaled corticosteroid therapy with nebulized beclometasone dipropionate.

    PubMed

    Nicolini, Gabriele; Cremonesi, Giovanni; Melani, Andrea S

    2010-06-01

    Inhaled corticosteroids (ICS) are the most effective anti-inflammatory agents for the management of chronic persistent asthma and are therefore recommended as first-line antiasthmatic therapy in children and adults. In various settings, the administration of ICS via nebulizer rather than hand-held inhaler (HHI) may have certain advantages, as many patients with HHI fail to use these devices properly or efficiently. In particular, young children, the elderly, the acutely ill, and those with restricted dexterity may be unable to coordinate inhalation with actuation of the device or to generate sufficient inspiratory flow to operate breath-actuated devices effectively. Compliance with nebulized therapy may also be better than that with a pressurized metered-dose inhaler (pMDI) plus spacer. Systematic reviews conclude that there is no significant difference in clinical effects between nebulizers and HHI. Performance and clinical effect of nebulization are influenced by several technical aspects such as the nebulizer-drug combination, nebulizer type, output and lung deposition. Among the currently available ICS, nebulized beclometasone dipropionate (BDP) has been in clinical use for more than 35 years, and has demonstrated marked clinical efficacy and a favorable tolerability profile in children and adults with chronic persistent asthma. The clinical efficacy of nebulized beclometasone is discussed in the present review using data from 13 published studies, which included a total of 1250 patients. Three multicenter, randomized, double-blind studies showed that nebulized BDP is as effective as BDP via pMDI plus spacer in a 2:1 dose ratio. Controlled trials involving 497 adults and children demonstrated similar clinical efficacy between nebulized BDP and either nebulized fluticasone propionate or nebulized budesonide. In all these trials, treatment-related adverse effects were generally uncommon, most were mild-to-moderate in severity, and most were associated with the

  18. New ipratropium formulation to decrease nebulization time.

    PubMed

    Majoral, Caroline; Vecellio, Laurent; Grimbert, Daniel; de Monte, Michèle; le Guellec, Chantal; Ingremeau, Valérie; Minois, Carole; Cordeau, Emeline; Paintaud, Gilles; Steinberg, Anouck; Diot, Patrice

    2007-02-01

    A new anticholinergic aerosol containing 0.5mg ipratropium bromide dissolved in 1mL of solution has been produced with the purpose of decreasing nebulization time for patients compared to the traditional formulation which is twice as voluminal (0.5mg/2mL, Boehringer-Ingelheim, France). The aim of this study was to compare aerosol characteristics (inhaled mass, particle size distribution and nebulization time) of these two formulations of ipratropium bromide, nebulized alone and with terbutaline (5mg/2mL, Astra Zeneca, Sweden), to determine whether the new formulation was equivalent to the old one. Four different jet nebulizers were used: PariLC+, Atomisor NL9M, Sidestream and Mistyneb. Statistical analysis of the results showed that for all types of nebulizer, the inhaled mass of ipratropium bromide 0.5mg/1mL was significantly lower than the inhaled mass of ipratropium bromide 0.5mg/2mL, and that there was no statistical difference between the inhaled mass of ipratropium bromide 0.5mg/1mL+terbutaline 5mg/2mL and the inhaled mass of ipratropium bromide 0.5mg/2mL+terbutaline 5mg/2mL. The study also showed that the new formulation of ipratropium bromide (0.5mg/1mL) mixed with terbutaline allowed a 26% decrease in nebulization time compared to the old formulation (0.5mg/2mL) mixed with terbutaline without changing aerosol characteristics (inhaled mass and particle size distribution). This leads to the conclusion that a 2mL minimum volume is required for nebulization, and that nebulization of ipratropium bromide 0.5mg/1mL alone must be avoided.

  19. Aerosol characterization of nebulized intranasal glucocorticoid formulations.

    PubMed

    Berlinski, A; Waldrep, J C

    2001-01-01

    Inhaled glucocorticoids (GCs) are the mainstay of long-term therapy for asthma. The lack of suitable preparations in the United States has induced clinicians to use intranasal (IN) GC formulations as "nebulizer suspensions" for off-label therapy. However, no data are available regarding aerosol production and characteristics. The aim of this study was to characterize drug outputs and aerodynamic profiles of four nebulized IN GC formulations with further analysis of flunisolide (Flu), and to test the influence of different delivery system/formulation combinations. The aerodynamic profiles and drug outputs were determined by impaction and chemical analysis. The solution output was determined by the gravimetric technique. Triamcinole acetonide (TAA), fluticasone propionate (Flut), beclomethasone dipropionate (Bec), and Flu (550, 500, 840, and 250 microg, respectively) diluted to 4 mL with saline solution were tested with the Sidestream (SID) and Aero-Tech II (AT2) nebulizers. Subsequently, Flu was tested with four additional nebulizers (Pari LC + [PARI] Acorn II, Hudson T Up-draft II, and Raindrop). All the aerosols were heterodisperse and had a particle size range optimal for peripheral airway deposition (1.85 to 3.67 microm). Flu had the highest drug output in the respirable range (22.8 and 20.3 microg/min with the AT and SID, respectively). Flu was 5-11 times more efficiently nebulized than the other formulations tested. No differences were detected in the solution outputs (0.25 to 0.3 mL/min). In subsequent testing of Flu, the PARI, AT, and SID showed the best performances. The LC+ achieved the highest drug and solution output (27.4 microg/min and 0.89 mL/min, respectively). In conclusion, Flu showed the best aerosol performance characteristics. These data do not endorse the off-label utilization of nebulized IN GC, but underscores the importance of in vitro testing before selecting any formulation/nebulizer combinations for clinical use.

  20. Glass frit nebulizer for atomic spectrometry

    USGS Publications Warehouse

    Layman, L.R.

    1982-01-01

    The nebuilizatlon of sample solutions Is a critical step In most flame or plasma atomic spectrometrlc methods. A novel nebulzatlon technique, based on a porous glass frit, has been Investigated. Basic operating parameters and characteristics have been studied to determine how thte new nebulizer may be applied to atomic spectrometrlc methods. The results of preliminary comparisons with pneumatic nebulizers Indicate several notable differences. The frit nebulizer produces a smaller droplet size distribution and has a higher sample transport efficiency. The mean droplet size te approximately 0.1 ??m, and up to 94% of the sample te converted to usable aerosol. The most significant limitations In the performance of the frit nebulizer are the stow sample equMbratton time and the requirement for wash cycles between samples. Loss of solute by surface adsorption and contamination of samples by leaching from the glass were both found to be limitations only In unusual cases. This nebulizer shows great promise where sample volume te limited or where measurements require long nebullzatlon times.

  1. Irritant contact facial dermatitis due to nebulizer therapy.

    PubMed Central

    Eedy, D. J.; Barton, K.; Stanford, C. F.

    1988-01-01

    A case is reported of a patient with long-standing, severe airflow obstruction requiring long-term nebulizer therapy developing a facial dermatitis in the area bounded by the nebulizer mask. The facial dermatitis seems to be the result of the combined irritancy of the nebulizer solutions and moisture, and prophylactic measures are suggested for patients requiring long-term nebulizer therapy. Images Figure 1 PMID:2973007

  2. Diagnostic studies on desolvated aerosols from ultrasonic nebulizers

    NASA Astrophysics Data System (ADS)

    Clifford, Robert H.; Sohal, Preeti; Liu, Huiying; Montaser, Akbar

    1992-08-01

    Dual-beam, light-scattering interferometry was used for simultaneous measurements of particle-size and particle-velocity distributions, size-velocity correlation, particle number density, and volume flux and span of desolvated aerosols. A commercial ultrasonic nebulizer (USN) and a low-cost, humidifier-based USN were used to nebulize pure water, or aqueous solutions containing H 2SO 4, HNO 3, or NaCl. In general, Sauter mean diameter, velocity of droplets, and volume flux of desolvated aerosol were larger when Ar was used as the injector gas instead of He. Sauter mean diameter increased with acid concentration, but it was independent of salt concentration. The velocity of desolvated droplets did not change with analyte concentration or the temperature of the heating tube. Pulsations and clustering of particles were observed for the first time by time-resolved measurements on the aerosol before injection into an inductively coupled plasma. In certain cases, the local number density of the desolvated particles within the clusters and the diameter of the dry particles varied by a factor of ten on a millisecond time scale. The implications of these observations in plasma spectrochemical measurements are discussed.

  3. Nebulized corticosteroids in asthma and COPD. An Italian appraisal.

    PubMed

    Melani, Andrea S

    2012-07-01

    Inhaled corticosteroids (ICSs) are the mainstay of anti-inflammatory treatment in subjects with asthma and COPD. This review evaluates the role of nebulizers as an alternative to inhalers for delivering ICSs in asthma and COPD. I selected 16 randomized, placebo-controlled, blinded, long-term studies, mostly carried out in asthma (n = 14) and COPD. Nebulized budesonide has been demonstrated to be effective and safe in children ages 1-8 years, and, with less evidence, in infants and adults with asthma. Other investigations, with the addition of in vitro and in vivo comparison studies, have shown that nebulized beclomethasone, fluticasone, and flunisolide are effective alternatives to nebulized budesonide in asthma and COPD. Efficient delivery of nebulized ICSs requires that the nebulizer system, the nebulized drug formulation, and the inhaling subject interact properly. The practices of mixing nebulized ICSs with bronchodilators and using nebulized ICSs in acute settings are promising, but require further confirmations, and at present cannot be recommended. I conclude that nebulizers may be considered as an effective alternative to inhalers for delivering ICSs and can be recommended to asthmatic and COPD subjects who are unwilling or unable to use inhalers. Newer formulations could possibly offer a relevant advance for a more efficient nebulization of ICSs.

  4. Residual gravimetric method to measure nebulizer output.

    PubMed

    Vecellio None, Laurent; Grimbert, Daniel; Bordenave, Joelle; Benoit, Guy; Furet, Yves; Fauroux, Brigitte; Boissinot, Eric; De Monte, Michele; Lemarié, Etienne; Diot, Patrice

    2004-01-01

    The aim of this study was to assess a residual gravimetric method based on weighing dry filters to measure the aerosol output of nebulizers. This residual gravimetric method was compared to assay methods based on spectrophotometric measurement of terbutaline (Bricanyl, Astra Zeneca, France), high-performance liquid chromatography (HPLC) measurement of tobramycin (Tobi, Chiron, U.S.A.), and electrochemical measurements of NaF (as defined by the European standard). Two breath-enhanced jet nebulizers, one standard jet nebulizer, and one ultrasonic nebulizer were tested. Output produced by the residual gravimetric method was calculated by weighing the filters both before and after aerosol collection and by filter drying corrected by the proportion of drug contained in total solute mass. Output produced by the electrochemical, spectrophotometric, and HPLC methods was determined after assaying the drug extraction filter. The results demonstrated a strong correlation between the residual gravimetric method (x axis) and assay methods (y axis) in terms of drug mass output (y = 1.00 x -0.02, r(2) = 0.99, n = 27). We conclude that a residual gravimetric method based on dry filters, when validated for a particular agent, is an accurate way of measuring aerosol output.

  5. MDI versus Nebulizers for Acute Asthma

    PubMed Central

    Raissy, Hengameh H.; Kelly, H. William

    2004-01-01

    OBJECTIVE: To evaluate studies comparing metered dose inhalers with holding chambers to nebulizers in the emergency department for the treatment of asthma exacerbation. DATA SOURCE: Primary articles and systematic review provided by the Cochrane Airways Review Group of the Cochrane Library identified by MEDLINE search (1966–February 2004) and through secondary sources. DATA SYNTHESIS: The Cochrane review included 21 randomized clinical trials conducted in hospital emergency departments comparing clinical outcomes following β2 agonist administration via a nebulizer or a metered dose inhaler with holding chamber. Although the relative risk ratio of hospital admission with metered dose inhaler and holding chamber did not differ in children or in adults compared to the nebulizer delivery, none of the individual studies reviewed were powered to detect a difference in the rate of hospital admission. Specific factors in the treatment of acute asthma such as assessment of severity, appropriate outcome selection, appropriate dose selection, and appropriate delivery systems need to be considered to critically evaluate the literature. CONCLUSION: Although available randomized clinical trials suggest equivalency of metered dose inhaler plus holding chambers and nebulized delivery of inhaled β2 agonists, these trials are biased to show no difference in response. There is no data to support the advantage of one method over the other in mild to moderate asthmatic patients either clinically or economically. PMID:23118701

  6. Nebulized Gentamicin as an Alternative to Nebulized Tobramycin for Tracheitis in Pediatric Patients

    PubMed Central

    Martin-McNew, Brittany L.; Lubsch, Lisa M.

    2017-01-01

    OBJECTIVES Tracheitis is an infection of the lower respiratory tract and is defined by the US Centers for Disease Control and Prevention (CDC) based on signs and symptoms with no radiographic evidence of pneumonia. One method of treatment involves the use of tobramycin given by nebulizer. The purpose of this study was to compare the safety and efficacy of nebulized gentamicin with nebulized tobramycin. METHODS This study was conducted in patients under 21 years of age who received greater than or equal to 1 day of gentamicin, 80 mg, or tobramycin, 300 mg, given twice a day by nebulization within the 14-month study period. The primary endpoint was amount of time until the patient no longer met the CDC definition of tracheitis. RESULTS There were 19 patients who presented with 60 separate encounters. The average age of the patients within the gentamicin group was 7.2 and 5 years old within the tobramycin group. The average duration of time for the gentamicin treatment encounters to be free of the CDC definition of tracheitis was 3.36 days compared to 3.17 days with tobramycin. No adverse effects were observed that were attributable to aminoglycoside nebulization. CONCLUSIONS No differences were detected between the safety and efficacy of intravenous gentamicin administered twice a day by nebulizer and that of tobramycin inhalation solution given twice daily in children without cystic fibrosis. PMID:28337076

  7. Nebulization of RNS60, a Physically-Modified Saline, Attenuates the Adoptive Transfer of Experimental Allergic Encephalomyelitis in Mice: Implications for Multiple Sclerosis Therapy.

    PubMed

    Mondal, Susanta; Rangasamy, Suresh B; Ghosh, Supurna; Watson, Richard L; Pahan, Kalipada

    2017-05-01

    Developing a new and effective therapeutic approach against multiple sclerosis (MS) is always an important area of research. RNS60 is a bioactive aqueous solution generated by subjecting normal saline to Taylor-Couette-Poiseuille flow under elevated oxygen pressure. Recently we have demonstrated that RNS60, administered through intraperitoneal injection, ameliorated clinical symptoms and disease progression of experimental allergic encephalomyelitis (EAE), an animal model of MS. Since the intravenous route is not preferred for treating a chronic condition, we tested if nebulization of RNS60 could attenuate the disease process of adoptively-transferred EAE in mice. Although we could not directly image RNS60 after nebulization, nebulized Alexa680 reached spleen, spinal cord and different parts of the brain. Nebulization of RNS60 starting from the acute phase attenuated clinical symptoms of relapsing-remitting EAE in female SJL/J mice. RNS60 nebulization also inhibited perivascular cuffing, maintained the integrity of blood-brain and blood-spinal cord barriers, suppressed inflammation, normalized the expression of myelin genes, and blocked demyelination in the CNS of EAE mice. On the immunomodulatory front, nebulization of RNS60 to EAE mice led to the enrichment of anti-autoimmune regulatory T cells (Tregs) and suppression of autoimmune Th17 cells. Together, these results suggest that nebulization of RNS60 may be used to control aberrant immune responses in MS and other autoimmune disorders.

  8. Reduction of Matrix-Induced Oxide Interferences on Rare Earth Elements and Platinum Using a Desolvating Nebulizer System with Quadrupole Inductively Coupled Plasma Mass Spectrometry

    NASA Astrophysics Data System (ADS)

    Smith, F.

    2013-12-01

    This paper will examine the use of a specialized low-flow desolvating nebulizer system for reduction of oxide mass spectral interferences that can occur in quadrupole inductively coupled plasma mass spectrometry (Q-ICP-MS). This nebulizer system uses an inert low-flow nebulizer (100 microliters/min) coupled to an inert, heated membrane desolvator for efficient water vapor removal before sample aerosol injection to the Q-ICP-MS instrument. Water vapor from conventional nebulizer / spray chamber systems used with Q-ICP-MS can cause numerous mass spectral interferences. One general example is metal oxides formed from the combination of oxygen (from injected water) with sample matrix components. Two specific examples of metal oxide interferences will be investigated with and without membrane desolvation: Ba and Ce oxides on several low-mass rare earth elements (Sm, Eu, and Gd) and Hf oxides on platinum. Rare earth elements are critically important components of modern electronics (ex. magnets, lasers, cell phones, computers) and platinum is a widely used catalyst. Figures of merit for both a conventional nebulizer/spray chamber and the desolvating nebulizer systems will include operating conditions, interference intensities and reduction factors, background equivalent concentrations (BECs), and instrument detection limits (IDLs).

  9. Case study: Training a chimpanzee (Pan troglodytes) to use a nebulizer to aid the treatment of airsacculitis.

    PubMed

    Gresswell, Claire; Goodman, Gidona

    2011-01-01

    Bacterial airsacculitis has been reported in a variety of nonhuman primates, and is widely treated using a combination of surgery and oral antibiotics. This case study details an alternative method of administering antibiotics (via the use of a nebulizer) when the chimpanzee subject developed resistance to all available oral preparations. Training the chimpanzee to use the nebulizer was performed using positive reinforcement techniques (PRT). It took a total of 89 sessions (<7 hr 25 min) to train the chimpanzee to use the nebulizer. The airsacculitis infection was treated using colistin in the nebulizer twice a day for 9 days. Out of 18 potential treatment sessions, full doses were administered on 13 occasions. The final dose of colistin was given via slow brachial intravenous injection under general anesthesia. The infection was successfully treated with colistin. Although there was a training time investment involved, it was felt to be outweighed by the success of the treatment. Also in the likelihood of the infection re-occurring at a later date, the now learnt behavior of using a nebulizer means that future treatment should now be considerably quicker. This is another example of how PRT is a useful tool in the successful welfare and management of captive animals. © 2011 Wiley Periodicals, Inc.

  10. Feedback mechanism for smart nozzles and nebulizers

    DOEpatents

    Montaser, Akbar [Potomac, MD; Jorabchi, Kaveh [Arlington, VA; Kahen, Kaveh [Kleinburg, CA

    2009-01-27

    Nozzles and nebulizers able to produce aerosol with optimum and reproducible quality based on feedback information obtained using laser imaging techniques. Two laser-based imaging techniques based on particle image velocimetry (PTV) and optical patternation map and contrast size and velocity distributions for indirect and direct pneumatic nebulizations in plasma spectrometry. Two pulses from thin laser sheet with known time difference illuminate droplets flow field. Charge coupled device (CCL)) captures scattering of laser light from droplets, providing two instantaneous particle images. Pointwise cross-correlation of corresponding images yields two-dimensional velocity map of aerosol velocity field. For droplet size distribution studies, solution is doped with fluorescent dye and both laser induced florescence (LIF) and Mie scattering images are captured simultaneously by two CCDs with the same field of view. Ratio of LIF/Mie images provides relative droplet size information, then scaled by point calibration method via phase Doppler particle analyzer.

  11. Glass microfabricated nebulizer chip for mass spectrometry.

    PubMed

    Saarela, Ville; Haapala, Markus; Kostiainen, Risto; Kotiaho, Tapio; Franssila, Sami

    2007-05-01

    A microfluidic nebulizer chip for mass spectrometry is presented. It is an all-glass device which consists of fusion bonded Pyrex wafers with embedded flow channels and a nozzle at the chip edge. A platinum heater is located on the wafer backside. Fabrication of the chip is detailed, especially glass deep etching, wafer bonding, and metal patterning. Various process combinations of bonding and metallization have been considered (anodic bonding vs. fusion bonding; heater inside/outside channel; metallization before/after bonding; platinum lift-off vs. etching). The chip vaporizes the liquid sample (0.1-10 microL min(-1)) and mixes it with a nebulizer gas (ca. 100 sccm N2). Operating temperatures can go up to 500 degrees C ensuring efficient vaporization. Thermal insulation of the glass ensures low temperatures at the far end of the chip, enabling easy interconnections.

  12. Stability of albuterol in continuous nebulization.

    PubMed

    Hunter, D A; Yoo, S D; Fox, J L; Michniak, B B

    1998-01-01

    Due to the emergent nature of situations requiring continuous nebulization of albuterol a premixed albuterol solution would provide faster access to the therapy when required. The purpose of this study was to evaluate the stability of albuterol solutions at a concentration (200 micrograms/mL) used in continuous nebulization when stored in various containers of polyvinyl chloride bags, polyolefin bags, polypropylene syringes and tubes and borosilicate glass tubes. Solutions were prepared in triplicate in 0.9% sodium chloride stored under refrigerated and room temperatures for seven days. Samples were removed and analyzed using a stability-indicating high-performance liquid chromatrography assay method. Albuterol was found to be stable (greater than 90% of the initial concentration remaining) for at least seven days in all five types of containers under the conditions tested.

  13. [Disinfection of devices for nebulization: stakes, difficulties, and improvement proposals].

    PubMed

    Reychler, G; Dupont, C; Dubus, J C

    2007-12-01

    Nebulization may transport with the drug some small particles containing microbes. These microbes may be present in all parts of the nebulizer, including the drug solution itself. Depending on the studies, contamination of the nebulizers may reach up to 55% of the devices in patients with cystic fibrosis. That's why using one nebulizer for one patient, using drug sterile ampoules, and having a good hygiene during and after the nebulization are so important. The national disinfection recommendations, usually depending on the type of the nebulizer, are variable from one to another country and are not very well validated. Moreover, the repetitive use of these disinfection techniques on the performances of the nebulizer are neither studied. In daily life, the patients respect these disinfection recommendations in 3 to 98% of the cases. We propose a standardized methodology for evaluating the microbial and functional effects of all disinfectants on the nebulizers. A simple, quick, efficacious, cheap, and without effect on nebulizer performances disinfectant is still waiting.

  14. Pharmacokinetics of nebulized terbinafine in Hispaniolan Amazon parrots (Amazona ventralis).

    PubMed

    Emery, Lee C; Cox, Sherry K; Souza, Marcy J

    2012-09-01

    Aspergillosis is one of the most difficult diseases to treat successfully in avian species. Terbinafine hydrochloride offers numerous potential benefits over traditionally used antifungals for treatment of this disease. Adding nebulized antifungals to treatment strategies is thought to improve clinical outcomes in lung diseases. To determine plasma concentrations of terbinafine after nebulization, 6 adult Hispaniolan Amazon parrots were randomly divided into 2 groups of 3. Each bird was nebulized for 15 minutes with 1 of 2 terbinafine solutions, one made with a crushed tablet and the second with raw drug powder. Blood samples were collected at baseline and at multiple time points up to 720 minutes after completing nebulization. Plasma and nebulization solutions were analyzed by high-performance liquid chromatography. The terbinafine concentration of the solution made with a crushed tablet (0.87 +/- 0.05 mg/mL) was significantly lower than was that made with raw powder (1.02 +/- 0.09 mg/mL). Plasma concentrations of terbinafine did not differ significantly between birds in the 2 groups. Plasma terbinafine concentrations in birds were maintained above in vitro minimum inhibitory concentrations for approximately 1 hour in birds nebulized with the crushed tablet solution and 4 hours in birds nebulized with the raw powder solution. Higher concentrations of solution, longer nebulization periods, or more frequent administration are likely needed to reach therapeutic plasma concentrations of terbinafine for clinically relevant periods in Hispaniolan Amazon parrots.

  15. Nebulized Magnesium Sulfate in Acute Bronchiolitis: A Randomized Controlled Trial.

    PubMed

    Modaresi, Mohammad Reza; Faghihinia, Jamal; Kelishadi, Roya; Reisi, Mohsen; Mirlohi, Shahrokh; Pajhang, Farhad; Sadeghian, Majid

    2015-09-01

    To assess the efficacy of nebulized magnesium sulfate as a bronchodilator in infants hospitalized with acute bronchiolitis. This three-center double masked randomized clinical trial comprised 120 children with moderate to severe bronchiolitis. They were randomly assigned into two groups: the first group was treated with nebulized magnesium sulfate (40 mg/kg) and nebulized epinephrine (0.1 ml/kg) and the second group (control) was treated with nebulized epinephrine (0.1 ml/kg). The primary outcome was the length of hospital stay. The use of oxygen, temperature, oxygen saturation (SPO2), pulse rate (PR), respiratory rate (RR) and respiratory distress assessment instrument (RDAI) score were measured in the beginning of the study and during hospitalization. The mean (SD) age of 120 infants was 5.1(± 2.6) mo and 60% were boys. The length of hospital stay was not different between the two groups (P > 0.01). Use of oxygen supplementation, SPO2 and vital signs were similar in the two groups. Improvement in RDAI score was significantly better in infants treated with nebulized magnesium sulfate than in the other group (P 0.01). Thus, in infants with acute bronchiolitis, the effect of nebulized magnesium sulfate is comparable to nebulized epinephrine. However nebulized magnesium sulfate can improve the clinical score so it may have additive effect to reduce symptoms during hospitalization.

  16. Nebulized Fentanyl in Acute Pain: A Systematic Review.

    PubMed

    Thompson, Joshua P; Thompson, Dennis F

    2016-10-01

    To provide a systematic review of the current role of nebulized fentanyl in acute pain and potentially other conditions. A MEDLINE literature search inclusive of the dates 1946 to May 2016 was performed using the following search terms: fentanyl and administration, inhaled Excerpta Medica was searched from 1980 to May 2016 using the following search terms: exp fentanyl/inhalation drug administration Additionally, Web of Science was searched using the terms fentanyl and pain inclusive of 1945 to May 2016. We utilized the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines to select English language, human primary literature, review articles, and supporting data assessing the efficacy of nebulized fentanyl in acute pain. Seven clinical trials have demonstrated no difference in efficacy between nebulized fentanyl and intravenous (IV) opioids. Few adverse effects were reported; however, the trials were of short duration. Nebulized fentanyl appeared to be a rapid-acting analgesic that does not require IV access. Evidence suggests that nebulized fentanyl is as effective as IV opioids in the treatment of acute pain, with relatively few adverse effects. However, questions remain about the extemporaneous preparation of fentanyl nebulized solution, the variability in nebulization devices, and ensuring consistent drug delivery to distal airways in the clinical setting. The abuse potential of nebulized fentanyl should also be considered. © The Author(s) 2016.

  17. Health resource utilization for inpatients with COPD treated with nebulized arformoterol or nebulized formoterol

    PubMed Central

    Ganapathy, Vaidyanathan; Stensland, Michael D

    2017-01-01

    Objective Arformoterol is the (R,R)-enantiomer of formoterol. Preclinical studies suggest that it is a stronger bronchodilator than the racemic (R,R/S,S)-formoterol; however, its potential clinical advantages have not been demonstrated. This study compared the length of stay (LOS), 30-day readmission rates, and doses of rescue medication administered in hospitalized patients with COPD who were treated with nebulized arformoterol or nebulized formoterol. Methods This retrospective analysis utilized data from Premier, Inc. (Charlotte, NC, USA), the largest nationwide hospital-based administrative database. COPD patients ≥40 years of age were included if they were hospitalized between January 2011 and July 2014, had no asthma diagnoses, and were treated with nebulized arformoterol or nebulized formoterol. LOS was measured from the day the patients initiated the study medication (index day). Rescue medications were defined as short-acting bronchodilators used from the index day onward. Multivariate statistical models included a random effect for hospital and controlled for patient demographics, hospital characteristics, admission characteristics, prior hospitalizations, comorbidities, pre-index service use, and pre-index medication use. Results A total of 7,876 patients received arformoterol, and 3,612 patients received nebulized formoterol. There was no significant difference in 30-day all-cause (arformoterol =11.9%, formoterol =12.1%, odds ratio [OR] =0.981, P=0.82) or COPD-related hospital readmission rates (arformoterol =8.0%, formoterol =8.0%, OR =1.002, P=0.98) after adjusting for covariates. The adjusted mean LOS was significantly shorter for arformoterol-treated vs formoterol-treated patients (4.6 vs 4.9 days, P=0.039), and arformoterol-treated patients used significantly fewer doses of rescue medications vs formoterol-treated patients (5.9 vs 6.6 doses, P=0.006). Conclusion During inpatient stays, treating with arformoterol instead of nebulized formoterol

  18. Identification and validation of nebulized aerosol devices for sputum induction

    PubMed Central

    Davidson, Warren J; Dennis, John; The, Stephanie; Litoski, Belinda; Pieron, Cora; Leigh, Richard

    2014-01-01

    Induced sputum cell count measurement has proven reliability for evaluating airway inflammation in patients with asthma and other airway diseases. Although the use of nebulizer devices for sputum induction is commonplace, they are generally labelled as single-patient devices by the manufacturer and, therefore, cannot be used for multiple patients in large clinical sputum induction programs due to infect ion-control requirements. Accordingly, this study investigated the aerosol characteristics of alternative devices that could be used in such programs. BACKGROUND: Induced sputum cell counts are a noninvasive and reliable method for evaluating the presence, type and degree of airway inflammation in patients with asthma. Currently, standard nebulizer devices used for sputum induction in multiple patients are labelled as single-patient devices by the manufacturer, which conflicts with infection prevention and control requirements. As such, these devices cannot feasibly be used in a clinical sputum induction program. Therefore, there is a need to identify alternative nebulizer devices that are either disposable or labelled for multi-patient use. OBJECTIVE: To apply validated rigorous, scientific testing methods to identify and validate commercially available nebulizer devices appropriate for use in a clinical sputum induction program. METHODS: Measurement of nebulized aerosol output and size for the selected nebulizer designs followed robust International Organization for Standardization methods. Sputum induction using two of these nebulizers was successfully performed on 10 healthy adult subjects. The cytotechnologist performing sputum cell counts was blinded to the type of nebulizer used. RESULTS: The studied nebulizers had variable aerosol outputs. The AeroNeb Solo (Aerogen, Ireland), Omron NE-U17 (Omron, Japan) and EASYneb II (Flaem Nuova, Italy) systems were found to have similar measurements of aerosol size. There was no significant difference in induced sputum

  19. Biopharmaceutical Characterization of Nebulized Antimicrobial Agents in Rats. 4. Aztreonam

    PubMed Central

    Grégoire, Nicolas; Brillault, Julien; Lamarche, Isabelle; Gobin, Patrice; Couet, William

    2016-01-01

    The aim of this study was to determine aztreonam (ATM) membrane permeability using Calu-3 cells and its plasma and pulmonary epithelial lining fluid (ELF) pharmacokinetics in rats after intratracheal nebulization and intravenous administration (15 mg · kg−1). ATM exhibits low Calu-3 permeability (0.07 ± 0.02 × 10−6 cm · s−1), and a high area under the ELF/unbound plasma concentration time curve between 0 and infinity (AUCELF/AUCu,plasma) ratio of 1,069 was observed after nebulization in rats. These results confirm that ATM is a low-permeability molecule and a good candidate for nebulization. PMID:26926626

  20. Biopharmaceutical Characterization of Nebulized Antimicrobial Agents in Rats: 3. Tobramycin

    PubMed Central

    Marchand, Sandrine; Grégoire, Nicolas; Brillault, Julien; Lamarche, Isabelle; Gobin, Patrice

    2015-01-01

    The aim of this study was to determine the biopharmaceutical characteristics of tobramycin (TOB) after nebulization in rats. TOB was administered by intravenous (i.v.) bolus or intratracheal nebulization (3 mg · kg−1), and concentrations were determined in plasma and epithelial lining fluid (ELF) by liquid chromatography-tandem mass spectrometry. The ratio of the TOB concentration in ELF to the plasma area under the curve (AUC) was more than 200 times as high after NEB as after i.v. bolus administration, indicating that TOB nebulization offers a biopharmaceutical advantage over i.v. administration. PMID:26239992

  1. Characterization of aerosols containing Legionella generated upon nebulization.

    PubMed

    Allegra, Séverine; Leclerc, Lara; Massard, Pierre André; Girardot, Françoise; Riffard, Serge; Pourchez, Jérémie

    2016-09-27

    Legionella pneumophila is, by far, the species most frequently associated with Legionnaires' disease (LD). Human infection occurs almost exclusively by aerosol inhalation which places the bacteria in juxtaposition with alveolar macrophages. LD risk management is based on controlling water quality by applying standardized procedures. However, to gain a better understanding of the real risk of exposure, there is a need (i) to investigate under which conditions Legionella may be aerosolized and (ii) to quantify bacterial deposition into the respiratory tract upon nebulization. In this study, we used an original experimental set-up that enables the generation of aerosol particles containing L. pneumophila under various conditions. Using flow cytometry in combination with qPCR and culture, we determined (i) the size of the aerosols and (ii) the concentration of viable Legionella forms that may reach the thoracic region. We determined that the 0.26-2.5 μm aerosol size range represents 7% of initial bacterial suspension. Among the viable forms, 0.7% of initial viable bacterial suspension may reach the pulmonary alveoli. In conclusion, these deposition profiles can be used to standardize the size of inoculum injected in any type of respiratory tract model to obtain new insights into the dose response for LD.

  2. Characterization of aerosols containing Legionella generated upon nebulization

    NASA Astrophysics Data System (ADS)

    Allegra, Séverine; Leclerc, Lara; Massard, Pierre André; Girardot, Françoise; Riffard, Serge; Pourchez, Jérémie

    2016-09-01

    Legionella pneumophila is, by far, the species most frequently associated with Legionnaires’ disease (LD). Human infection occurs almost exclusively by aerosol inhalation which places the bacteria in juxtaposition with alveolar macrophages. LD risk management is based on controlling water quality by applying standardized procedures. However, to gain a better understanding of the real risk of exposure, there is a need (i) to investigate under which conditions Legionella may be aerosolized and (ii) to quantify bacterial deposition into the respiratory tract upon nebulization. In this study, we used an original experimental set-up that enables the generation of aerosol particles containing L. pneumophila under various conditions. Using flow cytometry in combination with qPCR and culture, we determined (i) the size of the aerosols and (ii) the concentration of viable Legionella forms that may reach the thoracic region. We determined that the 0.26–2.5 μm aerosol size range represents 7% of initial bacterial suspension. Among the viable forms, 0.7% of initial viable bacterial suspension may reach the pulmonary alveoli. In conclusion, these deposition profiles can be used to standardize the size of inoculum injected in any type of respiratory tract model to obtain new insights into the dose response for LD.

  3. Characterization of aerosols containing Legionella generated upon nebulization

    PubMed Central

    Allegra, Séverine; Leclerc, Lara; Massard, Pierre André; Girardot, Françoise; Riffard, Serge; Pourchez, Jérémie

    2016-01-01

    Legionella pneumophila is, by far, the species most frequently associated with Legionnaires’ disease (LD). Human infection occurs almost exclusively by aerosol inhalation which places the bacteria in juxtaposition with alveolar macrophages. LD risk management is based on controlling water quality by applying standardized procedures. However, to gain a better understanding of the real risk of exposure, there is a need (i) to investigate under which conditions Legionella may be aerosolized and (ii) to quantify bacterial deposition into the respiratory tract upon nebulization. In this study, we used an original experimental set-up that enables the generation of aerosol particles containing L. pneumophila under various conditions. Using flow cytometry in combination with qPCR and culture, we determined (i) the size of the aerosols and (ii) the concentration of viable Legionella forms that may reach the thoracic region. We determined that the 0.26–2.5 μm aerosol size range represents 7% of initial bacterial suspension. Among the viable forms, 0.7% of initial viable bacterial suspension may reach the pulmonary alveoli. In conclusion, these deposition profiles can be used to standardize the size of inoculum injected in any type of respiratory tract model to obtain new insights into the dose response for LD. PMID:27671446

  4. Concentric micro-nebulizer for direct sample insertion

    DOEpatents

    Fassel, Velmer A.; Rice, Gary W.; Lawrence, Kimberly E.

    1986-03-11

    A concentric micro-nebulizer and method for introducing liquid samples into a plasma established in a plasma torch including a first tube connected to a source of plasma gas. The concentric micro-nebulizer has inner and outer concentric tubes extending upwardly within the torch for connection to a source of nebulizer gas and to a source of liquid solvent and to a source of sample liquid. The inner tube is connected to the source of liquid solvent and to the source of sample liquid and the outer tube is connected to the source of nebulizer gas. The outer tube has an orifice positioned slightly below the plasma when it is established, with the inner and outer tubes forming an annulus therebetween with the annular spacing between the tubes at said orifice being less than about 0.05 mm. The dead volume of the inner tube is less than about 5 microliters.

  5. Measuring nebulizer output. Aerosol production vs gravimetric analysis.

    PubMed

    Tandon, R; McPeck, M; Smaldone, G C

    1997-05-01

    The function of jet nebulizers has been measured traditionally by gravimetric methods, i.e., by weighing nebulizers before and after nebulization. Newer techniques measure aerosol output directly by analyzing aerosolized drug or tracer, i.e., radioactive 99mTc. Because of evaporation, the equivalence of these methods is uncertain. The aim of this study was to determine if the gravimetric method is an accurate measure of aerosol production under different conditions of aerosol generation (i.e., nebulizer type, flow rate, pressure, volume fill, and concentration of solution used to nebulize a drug). In the first phase of the study, we measured the aerosol output of nine commercially available jet nebulizers (AvaNeb; Up-Draft-Hudson RCI; Cirrus-Intersurgical Inc; DeVilbiss 646-DeVilbiss; Powermist-Hospitak, Inc; Respirgard II-Marquest Medical Products; Seamless-Seamless/Dart Respiratory; Salter; Salter Labs; Airlife-Baxter Health Care) run under commonly used conditions (2.5 mL volume fill, 2.0 mL normal saline solvent, 0.5 mL albuterol, flow of 6 L/min, and pressures averaging 15.0 +/- 2.3 [mean +/- SD] pounds per square inch [on the] gauge [psig] provided by a DeVilbiss PulmoAide compressor) with simultaneously measured gravimetrics and filtered radioactivity. Each nebulizer was run to dryness with data acquired every 2 min. The change in the weight of the nebulizer and radioactivity captured on the filter were expressed as percentages of the total in the nebulizer solution. In the second phase of the study, the experiments were repeated using the same nebulizers with a volume fill of 5 mL (diluted to half normal saline solution plus albuterol), flow of 10 L/min, and pressures of 35.6 +/- 8.8 psig. The cumulative (sum of all 2-min runs) weight loss for each individual nebulizer ranged from 25.00 to 64.55% and cumulative aerosol captured varied from 12.63 to 38.76%. While different, the weight loss and aerosol captured were closely correlated (y = -0.62 + 0.62x; r

  6. Concentric micro-nebulizer for direct sample insertion

    DOEpatents

    Fassel, V.A.; Rice, G.W.; Lawrence, K.E.

    1984-03-06

    A concentric micro-nebulizer and method for introducing liquid samples into a plasma established in a plasma torch including a first tube connected to a source of plasma gas. The concentric micro-nebulizer has inner and outer concentric tubes extending upwardly within the torch for connection to a source of nebulizer gas and to a source of liquid solvent and to a source of sample liquid. The inner tube is connected to the source of liquid solvent and to the source of sample liquid and the outer tube is connected to the source of nebulizer gas. The outer tube has an orifice positioned slightly below the plasma when it is established, with the inner and outer tubes forming an annulus therebetween with the annular spacing between the tubes at said orifice being less than about 0.05mm. The dead volume of the inner tube is less than about 5 microliters.

  7. Fabrication of a Babington-type nebulizer for ICP sources

    SciTech Connect

    Wolcott, J.F.; Sobel, C.B.

    1982-11-01

    We describe a method for fabricating a Babington-type nebulizer which can be used for the analysis of clear, dilute solutions, solutions with suspended solids, and solutions containing high percentages of dissolved solids. The forerunner of this nebulizer has previously been described and although it performed satisfactorily, it was relatively difficult to fabricate and orifice sizes were limited by the problems associated with using very small diamond drills. (AIP)

  8. [Salbutamol in asthma treatment: with nebulizer or inhaler?].

    PubMed

    Cavkaytar, Ozlem; Sekerel, Bülent Enis

    2012-01-01

    Breath relieving and protective drugs in asthma treatment are applied through pressurized metered dose inhaler (pMDI), nebulizer or dry powder inhaler. The short acting beta-2 agonist salbutamol used in acute asthma exacerbation is found in the forms of nebule or pMDI in Turkey. Nebule form is used more frequently in emergency services. The aim of this review is to compare these two routes of administration through clinical efficacy, the amount of drug reaching to the lungs and adverse events comprehensively by way of looking through the studies. Additionally effect of different inhalation techniques through chambers, different methods used in cleaning of them and different types of nebulizers, to the efficacy are investigated. As a result, asthma exacerbation can be treated with pMDIs used through holding chambers in emergency room successfully when applied with dosing scheme appropriate for the patient's age, weight and severity of exacerbation (usually 1/4th of nebule dosing) on the contrary to ordinary method of nebulizers.

  9. Nebulized Recombinant Human Tissue Factor Pathway Inhibitor Attenuates Coagulation and Exerts Modest Anti-inflammatory Effects in Rat Models of Lung Injury.

    PubMed

    van den Boogaard, Florry E; Hofstra, Jorrit J; Brands, Xanthe; Levi, Marcel M; Roelofs, Joris J T H; Zaat, Sebastiaan A J; Van't Veer, Cornelis; van der Poll, Tom; Schultz, Marcus J

    2017-04-01

    Critically ill patients are at a constant risk of direct (e.g., by pneumonia) or indirect lung injury (e.g., by sepsis). Excessive alveolar fibrin deposition is a prominent feature of lung injury, undermining pulmonary integrity and function. We examined the effect of local administration of recombinant human tissue factor pathway inhibitor (rh-TFPI), a natural anticoagulant, in two well-established models of lung injury in rats. Rats received intratracheal instillation of Pseudomonas aeruginosa, causing direct lung injury, or they received an intravenous injection of Escherichia coli lipopolysaccharide (LPS), causing indirect lung injury. Rats were randomized to local treatment with rh-TFPI or placebo through repeated nebulization. Challenge with P. aeruginosa or LPS was associated with increased coagulation and decreased fibrinolysis in bronchoalveolar lavage fluid (BALF) and plasma. Rh-TFPI levels in BALF increased after nebulization, whereas plasma rh-TFPI levels remained low and systemic TFPI activity was not affected. Nebulization of rh-TFPI attenuated pulmonary and systemic coagulation in both models, without affecting fibrinolysis. Nebulization of rh-TFPI modestly reduced the inflammatory response and bacterial growth of P. aeruginosa in the alveolar compartment. Local treatment with rh-TFPI does not alter systemic TFPI activity; however, it attenuates both pulmonary and systemic coagulopathy. Furthermore, nebulized rh-TFPI modestly reduces the pulmonary inflammatory response and allows increased bacterial clearance in rats with direct lung injury caused by P. aeruginosa.

  10. Albuterol delivery in an in vitro pediatric ventilator lung model: comparison of jet, ultrasonic, and mesh nebulizers.

    PubMed

    Sidler-Moix, Anne-Laure; Dolci, Ugo; Berger-Gryllaki, Markoulina; Pannatier, André; Cotting, Jacques; Di Paolo, Ermindo R

    2013-02-01

    To determine the influence of nebulizer types and nebulization modes on bronchodilator delivery in a mechanically ventilated pediatric lung model. In vitro, laboratory study. Research laboratory of a university hospital. Using albuterol as a marker, three nebulizer types (jet nebulizer, ultrasonic nebulizer, and vibrating-mesh nebulizer) were tested in three nebulization modes in a nonhumidified bench model mimicking the ventilatory pattern of a 10-kg infant. The amounts of albuterol deposited on the inspiratory filters (inhaled drug) at the end of the endotracheal tube, on the expiratory filters, and remaining in the nebulizers or in the ventilator circuit were determined. Particle size distribution of the nebulizers was also measured. The inhaled drug was 2.8% ± 0.5% for the jet nebulizer, 10.5% ± 2.3% for the ultrasonic nebulizer, and 5.4% ± 2.7% for the vibrating-mesh nebulizer in intermittent nebulization during the inspiratory phase (p < 0.01). The most efficient nebulizer was the vibrating-mesh nebulizer in continuous nebulization (13.3% ± 4.6%, p < 0.01). Depending on the nebulizers, a variable but important part of albuterol was observed as remaining in the nebulizers (jet and ultrasonic nebulizers), or being expired or lost in the ventilator circuit (all nebulizers). Only small particles (range 2.39-2.70 µm) reached the end of the endotracheal tube. Important differences between nebulizer types and nebulization modes were seen for albuterol deposition at the end of the endotracheal tube in an in vitro pediatric ventilator-lung model. New aerosol devices, such as ultrasonic and vibrating-mesh nebulizers, were more efficient than the jet nebulizer.

  11. Biopharmaceutical characterization of nebulized antimicrobial agents in rats: 2. Colistin.

    PubMed

    Gontijo, Aline Vidal Lacerda; Grégoire, Nicolas; Lamarche, Isabelle; Gobin, Patrice; Couet, William; Marchand, Sandrine

    2014-07-01

    The purpose of this study was to investigate the pharmacokinetic properties of colistin following intrapulmonary administration of colistin sulfate in rats. Colistin was infused or delivered in nebulized form at a dose of 0.35 mg/kg of body weight in rats, and plasma drug concentrations were measured for 4 h after administration. Bronchoalveolar lavages (BAL) were also conducted at 0.5, 2, and 4 h after intravenous (i.v.) administration and administration via nebulized drug to estimate epithelial lining fluid (ELF) drug concentrations. Unbound colistin plasma concentrations at distribution equilibrium (2 h postdosing) were almost identical after i.v. infusion and nebulized drug inhalation. ELF drug concentrations were undetectable in BAL samples after i.v. administration, but they were about 1,800 times higher than unbound plasma drug levels at 2 h and 4 h after administration of the nebulized drug. Simultaneous pharmacokinetic modeling of plasma and ELF drug concentrations was performed with a model characterized by a fixed physiological volume of ELF (VELF), a passive diffusion clearance (QELF) between plasma and ELF, and a nonlinear influx transfer from ELF to the central compartment, which was assessed by reducing the nebulized dose of colistin by 10-fold (0.035 mg kg(-1)). The km was estimated to be 133 μg ml(-1), and the Vmax, in-to-Km ratio was equal to 2.5 × 10(-3) liter h(-1) kg(-1), which was 37 times higher than the QELF (6.7 × 10(-5) liter h(-1) kg(-1)). This study showed that with the higher ELF drug concentrations after administration via nebulized aerosol than after intravenous administration, for antibiotics with low permeability such as colistin, nebulization offers a real potential over intravenous administration for the treatment of pulmonary infections.

  12. Biopharmaceutical Characterization of Nebulized Antimicrobial Agents in Rats: 2. Colistin

    PubMed Central

    Gontijo, Aline Vidal Lacerda; Grégoire, Nicolas; Lamarche, Isabelle; Gobin, Patrice; Marchand, Sandrine

    2014-01-01

    The purpose of this study was to investigate the pharmacokinetic properties of colistin following intrapulmonary administration of colistin sulfate in rats. Colistin was infused or delivered in nebulized form at a dose of 0.35 mg/kg of body weight in rats, and plasma drug concentrations were measured for 4 h after administration. Bronchoalveolar lavages (BAL) were also conducted at 0.5, 2, and 4 h after intravenous (i.v.) administration and administration via nebulized drug to estimate epithelial lining fluid (ELF) drug concentrations. Unbound colistin plasma concentrations at distribution equilibrium (2 h postdosing) were almost identical after i.v. infusion and nebulized drug inhalation. ELF drug concentrations were undetectable in BAL samples after i.v. administration, but they were about 1,800 times higher than unbound plasma drug levels at 2 h and 4 h after administration of the nebulized drug. Simultaneous pharmacokinetic modeling of plasma and ELF drug concentrations was performed with a model characterized by a fixed physiological volume of ELF (VELF), a passive diffusion clearance (QELF) between plasma and ELF, and a nonlinear influx transfer from ELF to the central compartment, which was assessed by reducing the nebulized dose of colistin by 10-fold (0.035 mg kg−1). The km was estimated to be 133 μg ml−1, and the Vmax, in-to-Km ratio was equal to 2.5 × 10−3 liter h−1 kg−1, which was 37 times higher than the QELF (6.7 × 10−5 liter h−1 kg−1). This study showed that with the higher ELF drug concentrations after administration via nebulized aerosol than after intravenous administration, for antibiotics with low permeability such as colistin, nebulization offers a real potential over intravenous administration for the treatment of pulmonary infections. PMID:24798284

  13. Physicochemical Characterization of Nebulized Superparamagnetic Iron Oxide Nanoparticles (SPIONs)

    PubMed Central

    Graczyk, Halshka; Bryan, Louise C.; Lewinski, Nastassja; Suarez, Guillaume; Coullerez, Geraldine; Bowen, Paul

    2015-01-01

    Abstract Background: Aerosol-mediated delivery of nano-based therapeutics to the lung has emerged as a promising alternative for treatment and prevention of lung diseases. Superparamagnetic iron oxide nanoparticles (SPIONs) have attracted significant attention for such applications due to their biocompatibility and magnetic properties. However, information is lacking about the characteristics of nebulized SPIONs for use as a therapeutic aerosol. To address this need, we conducted a physicochemical characterization of nebulized Rienso, a SPION-based formulation for intravenous treatment of anemia. Methods: Four different concentrations of SPION suspensions were nebulized with a one-jet nebulizer. Particle size was measured in suspension by transmission electron microscopy (TEM), photon correlation spectroscopy (PCS), and nanoparticle tracking analysis (NTA), and in the aerosol by a scanning mobility particle sizer (SMPS). Results: The average particle size in suspension as measured by TEM, PCS, and NTA was 9±2 nm, 27±7 nm, and 56±10 nm, respectively. The particle size in suspension remained the same before and after the nebulization process. However, after aerosol collection in an impinger, the suspended particle size increased to 159±46 nm as measured by NTA. The aerosol particle concentration increased linearly with increasing suspension concentration, and the aerodynamic diameter remained relatively stable at around 75 nm as measured by SMPS. Conclusions: We demonstrated that the total number and particle size in the aerosol were modulated as a function of the initial concentration in the nebulizer. The data obtained mark the first known independent characterization of nebulized Rienso and, as such, provide critical information on the behavior of Rienso nanoparticles in an aerosol. The data obtained in this study add new knowledge to the existing body of literature on potential applications of SPION suspensions as inhaled aerosol therapeutics. PMID

  14. Physicochemical compatibility of fluticasone-17-propionate nebulizer suspension with ipratropium and albuterol nebulizer solutions

    PubMed Central

    Kamin, Wolfgang; Schwabe, Astrid; Krämer, Irene

    2007-01-01

    The objective of this in-vitro study was to determine whether mixtures of three nebulizable drugs are physicochemically compatible. Drug combinations were prepared by mixing the content of one respule Flutide® forte “ready to use” (fluticasone propionate) with 2 milliliter Atrovent® LS (ipratropium bromide) and 0.5 milliliter Sultanol® inhalation solution (albuterol sulfate). Test suspensions were stored at room temperature and exposed to normal laboratory light for 5 hours. Concentrations of fluticasone-17-propionate, ipratropium bromide, and albuterol sulfate were determined by using stability-indicating high-performance liquid chromatography assays with ultraviolet detection. Physical compatibility was determined by measuring pH and osmolality. Main outcome measures were the drug concentrations of the active components of the mixtures. All drug concentrations retained nearly 100% of the initial drug concentrations after mixing and storage in glass containers at room temperature. Osmolality and pH of the mixtures exhibited no significant changes and no visible changes of the mixtures were detectable over the inspection period. Mixtures of fluticasone propionate, ipratropium bromide, and albuterol sulfate inhalation drug products were shown to be physicochemically compatible over a period of 5 hrs. In order to avoid contamination and microbiological instability, mixing should only take place immediately before administration. Further investigations are needed to determine whether or not drug delivery is affected by mixing the nebulizer suspensions and to ensure that simultaneous nebulization is recommendable. PMID:18268934

  15. Physicochemical compatibility of fluticasone-17- propionate nebulizer suspension with ipratropium and albuterol nebulizer solutions.

    PubMed

    Kamin, Wolfgang; Schwabe, Astrid; Krämer, Irene

    2007-01-01

    The objective of this in-vitro study was to determine whether mixtures of three nebulizable drugs are physicochemically compatible. Drug combinations were prepared by mixing the content of one respule Flutide forte "ready to use" (fluticasone propionate) with 2 milliliter Atrovent LS (ipratropium bromide) and 0.5 milliliter Sultanol inhalation solution (albuterol sulfate). Test suspensions were stored at room temperature and exposed to normal laboratory light for 5 hours. Concentrations of fluticasone- 17-propionate, ipratropium bromide, and albuterol sulfate were determined by using stability-indicating high-performance liquid chromatography assays with ultraviolet detection. Physical compatibility was determined by measuring pH and osmolality. Main outcome measures were the drug concentrations of the active components of the mixtures. All drug concentrations retained nearly 100% of the initial drug concentrations after mixing and storage in glass containers at room temperature. Osmolality and pH of the mixtures exhibited no significant changes and no visible changes of the mixtures were detectable over the inspection period. Mixtures of fluticasone propionate, ipratropium bromide, and albuterol sulfate inhalation drug products were shown to be physicochemically compatible over a period of 5 hrs. In order to avoid contamination and microbiological instability, mixing should only take place immediately before administration. Further investigations are needed to determine whether or not drug delivery is affected by mixing the nebulizer suspensions and to ensure that simultaneous nebulization is recommendable.

  16. Liposomes for drug delivery to the lungs by nebulization.

    PubMed

    Zaru, Marco; Mourtas, Spyridon; Klepetsanis, Pavlos; Fadda, Anna Maria; Antimisiaris, Sophia G

    2007-11-01

    Preparation of drug-loaded freeze-dried (FD) liposomes, designed for delivery to lungs after rehydration/nebulization was investigated. Rifampicin (RIF) incorporating multilamelar (MLV) and dried rehydrated vesicles (DRV); composed of phosphatidylcholine (PC), dipalmitoyloglycero-PC (DPPC) or distearoyloglycero-PC (DSPC), containing or not Cholesterol (Chol), were prepared. Vesicles were characterized for encapsulation efficiency (EE%), size distribution, zeta-potential, stability during freeze drying (FD) and nebulization (nebulization efficiency (NE%) and retention of RIF after nebulization (NER%)). Mucoadhesion and toxicity in A549 cells was measured. RIF EE% was not affected by liposome type but lipid composition was important; Synthetic lipid vesicles (DPPC and DSPC) had higher EE% compared to PC. As Chol increased EE% decreased. Freeze drying (FD) had no effect on EE%, however trehalose decreased EE% possibly due to RIF displacement. NER% was highly affected by lipid composition. Results of NE% and NER% for RIF-loaded liposomes show that DSPC/Chol (2:1) is the best composition for RIF delivery in vesicular form to lungs, by nebulization. Mucoadhesion and A549 cell toxicity studies were in line with this conclusion, however if mucoadhesion is required, improvement may be needed.

  17. Pulmonary monoclonal antibody delivery via a portable microfluidic nebulization platform

    PubMed Central

    Cortez-Jugo, Christina; Qi, Aisha; Rajapaksa, Anushi; Friend, James R.

    2015-01-01

    Nebulizers have considerable advantages over conventional inhalers for pulmonary drug administration, particularly because they do not require coordinated breath actuation to generate and deliver the aerosols. Nevertheless, besides being less amenable to miniaturization and hence portability, some nebulizers are prone to denature macromolecular drugs due to the large forces generated during aerosolization. Here, we demonstrate a novel portable acoustomicrofluidic device capable of nebulizing epidermal growth factor receptor (EGFR) monoclonal antibodies into a fine aerosol mist with a mass median aerodynamic diameter of approximately 1.1 μm, optimal for deep lung deposition via inhalation. The nebulized monoclonal antibodies were tested for their stability, immunoactivity, and pharmacological properties, which confirmed that nebulization did not cause significant degradation of the antibody. In particular, flow cytometry demonstrated that the antigen binding capability of the antibody is retained and able to reduce phosphorylation in cells overexpressing the EGFR, indicating that the aerosols generated by the device were loaded with stable and active monoclonal antibodies. The delivery of antibodies via inhalation, particularly for the treatment of lung cancer, is thus expected to enhance the efficacy of this protein therapeutic by increasing the local concentration where they are needed. PMID:25945147

  18. Comparison of nebulized and sprayed topical anaesthesia for fibreoptic bronchoscopy.

    PubMed

    Keane, D; McNicholas, W T

    1992-10-01

    We compared the efficacy of nebulized (N) and sprayed (S) topical anaesthesia prior to fibreoptic bronchoscopy in a blinded study involving 54 patients aged 57 +/- 26 yrs (mean +/- SD). Cough frequency, recorded on cassette tape, was the index of efficacy. All patients received 100 mg lignocaine sprayed into the pharynx, or nebulized in random order prior to bronchoscopy, and all received intravenous diazepam sedation. Each patient received a further 100 mg of lignocaine solution through the bronchoscope onto the vocal cords and major airways during the procedure. No significant difference was found in overall cough frequency between N and S groups (8.7 +/- 6.9 coughs.min-1 N vs 10.5 +/- 6.0 S), and cough frequency was also similar between N and S during the periods above and below the vocal cords. Furthermore, no differences were found in cough frequency between N and S among smokers, patients with asthma and COPD, and patients who had a biopsy procedure, although a trend was seen in all comparisons towards a lower cough frequency with the nebulized route. Most patients in the S group found the spray unpleasant, whereas only one in the N group complained. We conclude that nebulized and sprayed lignocaine have similar efficacy as topical anaesthetics in fibreoptic bronchoscopy, but patient preference favours the nebulized route.

  19. Nebulization performance of biodegradable sildenafil-loaded nanoparticles using the Aeroneb Pro: formulation aspects and nanoparticle stability to nebulization.

    PubMed

    Beck-Broichsitter, Moritz; Kleimann, Pia; Gessler, Tobias; Seeger, Werner; Kissel, Thomas; Schmehl, Thomas

    2012-01-17

    Polymeric nanoparticles meet the increasing interest for drug delivery applications and hold great promise to improve controlled drug delivery to the lung. Here, we present a series of investigations that were carried out to understand the impact of formulation variables on the nebulization performance of novel biodegradable sildenafil-loaded nanoparticles designed for targeted aerosol therapy of life-threatening pulmonary arterial hypertension. Narrowly distributed poly(D,L-lactide-co-glycolide) nanoparticles (size: ∼200 nm) were prepared by a solvent evaporation technique using poly(vinyl alcohol) (PVA) as stabilizer. The aerodynamic and output characteristics using the Aeroneb Pro nebulizer correlated well with the dynamic viscosity of the employed fluids for nebulization. The nebulization performance was mainly affected by the amount of employed stabilizer, rather than by the applied nanoparticle concentration. Nanoparticles revealed physical stability against forces generated during aerosolization, what is attributed to the adsorbed PVA layer around the nanoparticles. Sildenafil was successfully encapsulated into nanoparticles (encapsulation efficiency: ∼80%). Size, size distribution and sildenafil content of nanoparticles were not affected by nebulization and the in vitro drug release profile demonstrated a sustained sildenafil release over ∼120 min. The current study suggests that the prepared sildenafil-loaded nanoparticles are a promising pharmaceutical for the therapy of pulmonary arterial hypertension.

  20. A review of nebulized drug delivery in COPD

    PubMed Central

    Tashkin, Donald P

    2016-01-01

    Current guidelines recommend inhaled pharmacologic therapy as the preferred route of administration for treating COPD. Bronchodilators (β2-agonists and antimuscarinics) are the mainstay of pharmacologic therapy in patients with COPD, with long-acting agents recommended for patients with moderate to severe symptoms or those who are at a higher risk for COPD exacerbations. Dry powder inhalers and pressurized metered dose inhalers are the most commonly used drug delivery devices, but they may be inadequate in various clinical scenarios (eg, the elderly, the cognitively impaired, and hospitalized patients). As more drugs become available in solution formulations, patients with COPD and their caregivers are becoming increasingly satisfied with nebulized drug delivery, which provides benefits similar to drugs delivered by handheld inhalers in both symptom relief and improved quality of life. This article reviews recent innovations in nebulized drug delivery and the important role of nebulized therapy in the treatment of COPD. PMID:27799757

  1. Dispensing home nebulizers for acute wheezing from the hospital is cost-effective.

    PubMed

    Yamamoto, L G; Okamura, D; Nagamine, J; Boychuk, R B; Halm, B; Lee, E; Yee, L L

    2000-03-01

    The objective was to investigate the use characteristics of home nebulizers and to measure the benefit gained from dispensing home nebulizers (compared with their cost) to patients from the hospital. During the study period, August 28,1996 to May 17,1997, a sample of 232 of the 291 entries from a log of home nebulizers dispensed by the hospital respiratory care department were surveyed over the telephone. Of the 232 study subjects under the age of 21, a telephone interview of a guardian or supervising adult was completed in 106 subjects (46%) a mean of 43 weeks after the home nebulizer was prescribed (47% of the cohort received their home nebulizers from the inpatient service and another 47% were discharged with home nebulizers from the emergency department (ED)). An average of 3.6 estimated additional ED visits and 5.4 office/clinic visits for each patient were prevented by the home nebulizer. The benefit (savings from reduced ED and office visits alone) to cost ratio estimates range from $855:$90 to $1710:$90 or more. The overwhelming majority of the patients felt that the home nebulizer was a good idea, it was easy to use, they had no problems with the nebulizer and they received adequate training for home nebulizer use. Home nebulizers are a cost-effective means of providing home nebulized albuterol for selected outpatients. Hospital inpatient units and EDs which have the ability to dispense a home nebulizer, have an additional therapeutic option available for selected patients who may benefit from it. Medical insurance companies should fully support (ie, pay for) home nebulizers because it is cost effective. If there is any concern about the reliability of the patient to follow-up with their primary physician, the patient's primary physician should be contacted to discuss the feasibility of discharging the patient with a home nebulizer.

  2. Pulmonary Drug Delivery Following Continuous Vibrating Mesh Nebulization and Inspiratory Synchronized Vibrating Mesh Nebulization During Noninvasive Ventilation in Healthy Volunteers.

    PubMed

    Michotte, Jean-Bernard; Staderini, Enrico; Aubriot, Anne-Sophie; Jossen, Emilie; Dugernier, Jonathan; Liistro, Giuseppe; Reychler, Gregory

    2017-07-06

    A breath-synchronized nebulization option that could potentially improve drug delivery during noninvasive positive pressure ventilation (NIPPV) is currently not available on single-limb circuit bilevel ventilators. The aim of this study was to compare urinary excretion of amikacin following aerosol delivery with a vibrating mesh nebulizer coupled to a single-limb circuit bilevel ventilator, using conventional continuous (Conti-Neb) and experimental inspiratory synchronized (Inspi-Neb) nebulization modes. A crossover clinical trial involving 6 noninvasive ventilated healthy volunteers (mean age of 32.3 ± 9.5 y) randomly assigned to both vibrating mesh nebulization modes was conducted: Inspi-Neb delivered aerosol during only the whole inspiratory phase, whereas Conti-Neb delivered aerosol continuously. All subjects inhaled amikacin solution (500 mg/4 mL) during NIPPV using a single-limb bilevel ventilator (inspiratory positive airway pressure: 12 cm H2O, and expiratory positive airway pressure: 5 cm H2O). Pulmonary drug delivery of amikacin following both nebulization modes was compared by urinary excretion of drug for 24 hours post-inhalation. The total daily amount of amikacin excreted in the urine was significantly higher with Inspi-Neb (median: 44.72 mg; interquartile range [IQR]: 40.50-65.13) than with Conti-Neb (median: 40.07 mg; IQR: 31.00-43.73), (p = 0.02). The elimination rate constant of amikacin (indirect measure of the depth of drug penetration into the lungs) was significantly higher with Inspi-Neb (median: 0.137; IQR: 0.113-0.146) than with Conti-Neb (median: 0.116; IQR: 0.105-0.130), (p = 0.02). However, the mean pulmonary drug delivery rate, expressed as the ratio between total daily urinary amount of amikacin and nebulization time, was significantly higher with Conti-Neb (2.03 mg/min) than with Inspi-Neb (1.09 mg/min) (p < 0.01). During NIPPV with a single-limb circuit bilevel ventilator, the use of inspiratory

  3. Baby bottle steam sterilizers for disinfecting home nebulizers inoculated with non-tuberculous mycobacteria.

    PubMed

    Towle, D; Callan, D A; Lamprea, C; Murray, T S

    2016-03-01

    Non-tuberculous mycobacteria (NTMb), present in environmental water sources, can contribute to respiratory infection in patients with chronic pulmonary disease. Contaminated nebulizers are a potential source of respiratory infection. Treatment with baby bottle steam sterilizers disinfects home nebulizers inoculated with bacterial pathogens but whether this method works for disinfection of NTMb is unclear. Baby bottle steam sterilization was compared with vigorous water washing for disinfecting home nebulizers inoculated with NTMb mixed with cystic fibrosis sputum. No NTMb was recovered from any nebulizers after steam treatment whereas viable NTMb grew after water washing, demonstrating that steam sterilization effectively disinfects NTMb-inoculated nebulizers.

  4. Inhaler or Nebulizer: Which One Should My Child Use?

    MedlinePlus

    ... Which One Should My Child Use? KidsHealth > For Parents > Inhaler or Nebulizer: Which One Should My Child Use? Print A A A en español Inhalador o nebulizador: ¿cuál debería usar mi hijo? Some kids who need asthma medicine start out ...

  5. Formulation and nebulization of fluticasone propionate-loaded lipid nanocarriers.

    PubMed

    Umerska, Anita; Mouzouvi, Celia R A; Bigot, André; Saulnier, Patrick

    2015-09-30

    Inhaled fluticasone propionate (FP) is often prescribed as a first-line therapy for the effective management of pulmonary diseases such as asthma. As nanocarriers offer many advantages over other drug delivery systems, this study investigated the suitability of lipid nanocapsules (LNCs) as a carrier for fluticasone propionate, examining the drug-related factors that should be considered in the formulation design and the behaviour of LNCs with different compositions and properties suspended within aerosol droplets under the relatively hostile conditions of nebulization. By adjusting the formulation conditions, particularly the nanocarrier composition, FP was efficiently encapsulated within the LNCs with a yield of up to 97%, and a concentration comparable to commercially available preparations was achieved. Moreover, testing the solubility of the drug in oil and water and determining the oil/water partition coefficient proved to be useful when assessing the encapsulation of the FP in the LNC formulation. Nebulization did not cause the FP to leak from the formulation, and no phase separation was observed after nebulization. LNCs with a diameter of 100 nm containing a smaller amount of surfactant and a larger amount of oil provided a better FP-loading capacity and better stability during nebulization than 30 or 60 nm LNCs. Copyright © 2015 Elsevier B.V. All rights reserved.

  6. Drug output of unvented jet nebulizers as a function of time.

    PubMed

    Diederik, H; Le Brun, P P H; Frijlink, H W; Vitányi, P M B; Weda, M; Barends, D M

    2003-05-12

    Nebulizer drug output rate increases during the nebulization. For unvented jet nebulizers, a physical and mathematical model based on the efficiency of the nebulization process is presented for this phenomenon. Formulas are derived for the cumulative drug output and the drug output rate of the nebulization process. The model is compared with the model proposed by Coates et al. [J. Aerosol. Med. 11 (1998) 101]. Both models are supported by experimental literature data. Both models predict the experimental values well but the proposed model allows more easy prediction of the influence of small changes in the nebulization conditions and the calculation of the cumulative drug output for a related process. From literature data it is shown that the efficiency of an unvented jet nebulization process of diluted aqueous solutions is relatively insensitive to small changes in the concentration as well as to small changes in aspiration flow but is sensitive to the humidity of the compressor gas only.

  7. Comparison of jet and ultrasonic nebulizer pulmonary aerosol deposition during mechanical ventilation.

    PubMed

    Harvey, C J; O'Doherty, M J; Page, C J; Thomas, S H; Nunan, T O; Treacher, D F

    1997-04-01

    Increased delivery of aerosol to a model lung (attached to a mechanical ventilator) has been demonstrated with an ultrasonic nebulizer as compared to a jet nebulizer. This study examined whether the increased aerosol deposition with an ultrasonic nebulizer could also be demonstrated in vivo. Seven patients (6 male and 1 female) were studied during mechanical ventilalion (Siemens Servo 900C, Middlesex, UK) after open heart surgery. Two studies were performed in each patient. In the first study, aerosol was delivered via a Siemens Servo 945 nebulizer system (high setting) driving a System 22 Acorn jet nebulizer (Medic-Aid, Sussex, UK) containing 3 mL (99m)technetium-labelled human serum albumin (99mTc-HSA) (50 microg; activity 74 MBq). In the second study, a DP100 ultrasonic nebulizer (DP Medical, Meylan, France) containing 12 mL 99mTc-HSA (50 microg; activity 185 MBq) was used. Pulmonary deposition was quantified using a gamma camera. The humidification of the circuit and the ventilator settings were kept constant according to the patient's clinical requirements. The total lung aerosol deposition (mean+/-SD), as a percentage of initial nebulizer activity, was greater using the ultrasonic nebulizer than using the jet nebulizer (53+/-1.4 vs 2.3+/-0.9%; p<0.002). The ultrasonic nebulizer was also associated with a reduction in the time required to complete nebulization (9 vs 21 min, respectively) (p<0.0001). Use of the DP100 ultrasonic nebulizer more than doubled lung deposition compared with the System 22 jet nebulizers in mechanically-ventilated patients. Their efficiency, speed of drug delivery, and compatibility with mechanical ventilator circuits make ultrasonic nebulizers potentially attractive for use during mechanical ventilation.

  8. Nebulized racemic epinephrine for extubation of newborn infants.

    PubMed

    Davies, M W; Davis, P G

    2002-01-01

    Following a period of mechanical ventilation, post-extubation upper airway obstruction can occur in newborn infants, especially after prolonged, traumatic or multiple intubations. The subsequent increase in upper airway resistance may lead to respiratory insufficiency and failure of extubation. The vasoconstrictive properties of epinephrine, and its proven efficacy in the treatment of croup in infants, has led to the routine use of inhaled nebulized epinephrine immediately post-extubation in some neonatal units. It is also recommended for neonates with post-extubation tracheal obstruction and stridor in neonatal and respiratory textbooks and reviews. The primary objective was to assess whether nebulized epinephrine administered immediately after extubation in neonates weaned from IPPV decreases the need for subsequent additional respiratory support. Searches were of: MEDLINE from 1966 to September 2000; CINAHL from 1982 to September 2000; Current Contents from 1994 to September 2000; and the Cochrane Controlled Trials Register (Cochrane Library Issue 3, 2000). These searches were updated to September 2001 for this review update. Previous searches up to March 1999 included the Oxford Database of Perinatal Trials, expert informants and journal hand searching mainly in the English language, previous reviews including cross references, abstracts, and conference and symposia proceedings. All randomised and quasi-randomised control trials in which nebulized epinephrine was compared with placebo immediately post-extubation in newborn infants who have been weaned from IPPV and extubated, with regard to clinically important outcomes (i.e. need for additional respiratory support, increase in oxygen requirement, respiratory distress, stridor or the occurrence of side effects). No studies met our criteria for inclusion in this review. No studies were identified which looked at the effect of inhaled nebulized epinephrine on clinically important outcomes in infants being

  9. DINS - Lessons learned and successes achieved

    NASA Astrophysics Data System (ADS)

    Traeger, J.; Quasius, G.

    It is pointed out that the Dormant Inertial Navigation System (DINS) is the first Ring Laser gyro system developed for maneuvering reentry vehicles. The DINS is a pure strapdown system. It provides attitude reference, navigation, and flight control information to the maneuvering reentry vehicle. Two flight tests in which DINS was aboard the Advanced Maneuvering Reentry Vehicle were highly successful. The tests involved the launch of the vehicle by a Minuteman I for a flight from VAFB to Kwajalein. Attention is given to a DINS mission description, a DINS system description, ground test programs, and the flight test program.

  10. Red and nebulous objects in dark clouds - A survey

    NASA Technical Reports Server (NTRS)

    Cohen, M.

    1980-01-01

    A search on the NGS-PO Sky Survey photographs has revealed 150 interesting nebulous and/or red objects, mostly lying in dark clouds and not previously catalogued. Spectral classifications are presented for 55 objects. These indicate a small number of new members of the class of Herbig-Haro objects, a significant number of new T Tauri stars, and a few emission-line hot stars. It is argued that hot, high-mass stars form preferentially in the dense cores of dark clouds. The possible symbiosis of high and low mass stars is considered. A new morphology class is defined for cometary nebulae, in which a star lies on the periphery of a nebulous ring.

  11. Optimization of nebulized delivery of linezolid, daptomycin, and vancomycin aerosol

    PubMed Central

    Zarogoulidis, Paul; Kioumis, Ioannis; Lampaki, Sofia; Organtzis, John; Porpodis, Konstantinos; Spyratos, Dionysios; Pitsiou, Georgia; Petridis, Dimitris; Pataka, Athanasia; Huang, Haidong; Li, Qiang; Yarmus, Lonny; Hohenforst-Schmidt, Wolfgang; Pezirkianidis, Nikolaos; Zarogoulidis, Konstantinos

    2014-01-01

    Background At this time, several antibiotics have been investigated as possibilities for aerosol administration, but local therapy has been found to be more efficient in several diseases. Materials and methods The drugs linezolid (Zyvox), vancomycin (Voncon), and daptomycin (Cubicin) were tested with three jet nebulizers with seven different residual cups and different loadings. Moreover, three ultrasound nebulizers were again tested with these drugs, with different loadings and mouthpiece attachments. Results When drugs are combined with particular cup designs, they significantly lower the droplet size to 1.60 and 1.80 μm, which represents the best combination of Zyvox and cup G and Cubicin and cup D, respectively. Cup design D is suggested as the most effective cup for lowering the droplet size (2.30 μm) when considering a higher loading level (8 mL). Conclusion Modification of current drugs from dry powder to solution is possible, and the residual cup design plays the most important role in droplet size production when the nebulization systems have the same properties. PMID:25143711

  12. Nebulizer and spacer device maintenance in children with asthma.

    PubMed

    Tay, Ee Tein; Needleman, Joshua P; Avner, Jeffrey R

    2009-03-01

    To evaluate inhalation device cleaning practices of children with asthma and its effect on their asthma morbidity. A survey of patients aged 4 to 18 years admitted to an urban pediatric emergency department (ED) with an acute asthma exacerbation. Questions included demographics, asthma history, preference of delivery devices, and frequency of device cleaning. Patients were followed until their disposition from the ED, or until the end of their hospitalization, if admitted. 220 subjects completed the survey. Mean age was 9.2 (+/- 3.9) years-old. One hundred and four (47.3%) patients used both nebulizers and spacer devices, while 18 (8.1%) used spacers only and 98 (44.5%) used nebulizers alone. Seventy-seven (38.1%; 95%CI: 31.7%-45.0%) patients cleaned their nebulizers and 57 (46.7%; 95%CI: 38.1%-55.4%) cleaned their spacer devices after each use as recommended by the Centers for Disease Control. There were no detectable differences in visit admission rate, total number of previous admissions, number of asthma exacerbations per year, and number of ED visits in one year between users who cleaned their devices after every, or every other use, compared to those who cleaned their devices less frequently. Although the majority of patients did not follow accepted guidelines for inhalation device cleaning, further studies are necessary to correlate cleaning practices to patients' clinical outcome.

  13. Nasal high flow nebulization in infants and toddlers: An in vitro and in vivo scintigraphic study.

    PubMed

    Réminiac, François; Vecellio, Laurent; Loughlin, Ronan Mac; Le Pennec, Deborah; Cabrera, Maria; Vourc'h, Nathalie Heuzé; Fink, James B; Ehrmann, Stephan

    2017-03-01

    Aerosol therapy in infants and toddlers is challenging. Nebulization within a nasal high flow (NHF) circuit is attractive. The aim of this study was to quantify aerosol lung deposition when combined with NHF as compared with standard practice. Lung doses were measured scintigraphically after nebulization with jet and mesh nebulizer placed within a NHF circuit in a spontaneously breathing non-human primate model (macaque) and in the anatomical bench SAINT model, respectively representing a full-term newborn and a 9-month-old toddler. In the SAINT model, lung depositions observed with the mesh nebulizer placed in the NHF circuit set at 2 and 4 L/min were 3.3% and 4.2% of the nebulizer charge, respectively, and similar to the 1.70% observed with the control standard facemask jet nebulization (6 L/min flow). In the macaque model, the depositions observed with the mesh nebulizer in the NHF circuit set at 2 and 4 L/min were 0.49% and 0.85%, respectively, also similar to the control measurement (0.71%). Mesh nebulization within a NHF circuit set at 8 L/min and jet nebulization either within a NHF circuit or placed on top of the cannula (NHF set at 2 L/min; total flow of 8 L/min), resulted in a significantly lower lung depositions. Mesh nebulization within a NHF circuit delivering up to 4 L/min gas is likely to be at least as effective than jet nebulization with a facemask in infants and toddlers. Aerosol facemask placement on top of cannulas or jet nebulization within the NHF circuit may be less effective. Pediatr Pulmonol. 2017;52:337-344. © 2016 Wiley Periodicals, Inc.

  14. Inhalation Properties and Stability of Nebulized Naked siRNA Solution for Pulmonary Therapy.

    PubMed

    Tahara, Kohei; Hashimoto, Wakana; Takeuchi, Hirofumi

    2016-01-01

    The use of naked unmodified small interfering RNA (N-siRNA) without vector has previously been investigated as a pulmonary therapy. However, little is known regarding stabilities and aerodynamic particle sizes of N-siRNA-containing droplets; nebulizers have not yet been optimized for N-siRNA solutions. Thus, in this study, we investigated the feasibility of inhaled N-siRNA solutions for pulmonary therapy using nebulization. Various nebulizers and N-siRNA concentrations were assessed in terms of siRNA integrity after nebulization, and inhalation properties including aerodynamic particle size were examined. In comparison with ultrasonic-, air-jet-, and vibrating-mesh nebulizers, N-siRNA integrity was not affected by nebulization. Thus, in further experiments, performances of N-siRNA aerosols with different nebulizers and N-siRNA concentrations were evaluated and screened using an aerodynamic particle sizer (APS) which employed the time-of-flight principle or a cascade impactor. Mean mass aerodynamic diameters of N-siRNA-containing droplets from vibrating-mesh nebulizers tended to decrease with increasing N-siRNA concentrations, reflecting the influence of N-siRNA solutions on surface tension, as indicated by contact angles. These data indicate the utility of APS instruments for investigating the nebulized characteristics of expensive drugs including siRNAs and may facilitate the development of N-siRNA inhalation formulations.

  15. Comparative efficacy of combined nebulized salbutamol with ipratropium bromide and nebulized adrenaline to treat children with acute bronchiolitis.

    PubMed

    Kadir, M A; Mollah, A H; Basak, R; Choudhury, A M; Ahmed, S

    2009-07-01

    As the efficacy of combined nebulized salbutamol & ipratropium bromide as well as L-adrenaline to treat acute bronchiolitis is not well studied among the Bangladeshi infants, this study was carried out to see their efficacy in acute bronchiolitis and to compare their effectiveness. This randomized clinical trial was done among 60 children aged less than 02 years, admitted in the department of Pediatrics, Dhaka Medical College Hospital, during January through December 2005 with acute bronchiolitis. After a quick initial assessment, nebulization were done twice at 6 hours interval with the mentioned drugs, group wise (one group with salbutamol plus ipratropium bromide and other group with L-adrenaline alone) and the outcomes were assessed after 30 minutes of each nebulization in respect to oxygen saturation and clinical modified respiratory distress assessment instrument (MRDAI) scores. The results were analyzed by using SPSS version 10.0 and at a p value of nebulizations by the studied drugs, a significant improvement in respect to oxygen saturation and MRDAI score were noted among the children in both the groups, compared to their baseline status (p=0.000). However, L-adrenaline showed more efficacy (MRDAI, p=0.021; SaO2, p=0.034) than combined Salbutamol & Ipratropium bromide. Both L-adrenaline and combined salbutamol & ipratropium bromide were found effective in acute bronchiolitis but L-adrenaline was found more effective. A large multi-centre clinical trial is recommended.

  16. A modified nebulization modality versus classical ultrasonic nebulization and oxygen-driven nebulization in facilitating airway clearance in patients with acute exacerbation of chronic obstructive pulmonary disease: a randomized controlled trial.

    PubMed

    Luo, Qiaoling; Zheng, Zeguang; Cen, Huihong; Jiang, Mei; Chen, Qin

    2015-07-01

    Ultrasonic nebulization (UN) and oxygen-driven nebulization (ON), two commonly used modalities for nebulization inhalation, are not ideally suitable for patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). A total of 91 patients with AECOPD were randomized to three groups given different nebulization modalities: ON, UN, and ultrasonic nebulization with warming and oxygen (UNWO). The sputum clearance, lung function, changes in physiological measures such as peripheral oxygen saturation (SpO2) and tolerance to these nebulization modalities were recorded and compared among the three groups. The time to the first expectoration was shorter and the sputum volume was larger after UN and UNWO than after ON (both P<0.01). Compared with pre-nebulization, SpO2 significantly increased (P<0.01) and the dyspnea decreased significantly (P<0.05) after UNWO. The SpO2 and dyspnea post-UNWO were significantly better than those post-UN (P<0.01, P<0.05), but not statistically different from those post-ON (both P>0.05). UNWO demonstrated significantly greater comfort and longer duration of nebulization than UN (P<0.01, P<0.05), but no significant differences in these respects from ON (both P>0.05). Forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and peak expiratory flow (PEF) decreased significantly after UNWO (P<0.05, P<0.01, and P<0.01, respectively). UNWO may promote expectoration of sputum with fewer adverse reactions and a higher level of comfort than simple UN and ON. Therefore, it can be used as an adjuvant therapy for AECOPD patients.

  17. Nebulizer performance: AFLM study. Association Française de Lutte contre la Mucoviscidose.

    PubMed

    Faurisson, F; Dessanges, J F; Grimfeld, A; Beaulieu, R; Kitzis, M D; Peytavin, G; Lefebvre, J P; Farinotti, R; Sautegeau, A

    1995-01-01

    This study was conducted by the AFLM order to determine the performance characteristics of 12 commercially available nebulizers (6 ultrasonic and 6 jet) used in the treatment of cystic fibrosis (CF). The nebulizers were connected to a circuit which simulated the ventilation of a CF child and CF adult, and were tested using three drug solutions: tobramycin (T), colistin (C), and amiloride (A). Nebulizer performance was evaluated according to the volume of drug solution delivered in 10 min during the simulated inspiratory phase (VI), drug granulometry (G%), drug concentration modification in the nebulizer reservoir (delta C), and percentage of efficiently aerosolized drug EA%). The ultrasonic devices delivered a significantly higher VI than the jet nebulizers (p < 0.0001) for all three study drug. Ventilation rate did not influence VI. Regarding granulometry, higher percentages of T and A were found to be contained in droplets ranging from 0.5 to 5.0 micron following ultrasonic nebulization. Drug concentration modifications were independent of the nebulizer used but were influenced by drug type; overconcentrations of T and A were observed (delta C = +10.5 +/- 18.6 and +13.4 +/- 8.9%, respectively). On average, the ultrasonic devices achieved a higher EA% than the jet nebulizers (17.3 +/- 6.7 and 9.7 +/- 9.6%, respectively). This study highlights the significant variability in performance of different nebulizer types and empahsizes the importance of accurately testing nebulizers prior to clinical use so that the most efficacious nebulizer/drug combinations may be prescribed.

  18. Diné (Navajo) Ethno- and Archaeoastronomy

    NASA Astrophysics Data System (ADS)

    Chamberlain, Von Del

    The Navajo (Diné) are an Athabascan-speaking people who migrated from the far northwest of America into the desert southwest where they became the largest surviving Native American culture. Three words portray Diné philosophy - beauty, harmony, and balance. Their traditions are rich with astronomical symbolism found in literature, ceremony, iconography, artifacts, rock art, and the sacred landscape. This chapter summarizes Diné astronomical traditions, identification of stars known to be important to the Diné, and how these are depicted on artifacts and rock art.

  19. High-performance flow atomic spectrometry: New nebulization techniques, on-line speciation and on-line sample pretreatment.

    PubMed

    Berndt, H; Yáñez, J

    1996-06-01

    An interface-free combination of HPLC separation techniques and methods for element determination by atomic spectrometry can be achieved by hydraulic high-pressure nebulization (HHPN). With high-temperature HHPN (300 ( degrees )C) super heated liquids can be nebulized providing aerosol yields of up to 90% in flame AAS. This new nebulization method combines the advantages of HHPN and thermospray techniques (very small aerosol droplets, high aerosol yield, nebulization of saturated salt solutions).

  20. The analysis of pneumatic atomization of Newtonian and non-Newtonian fluids for different medical nebulizers.

    PubMed

    Ochowiak, Marek; Matuszak, Magdalena; Włodarczak, Sylwia

    2017-08-01

    The article contains results of the experimental studies on atomization process of inhaled drugs and aqueous solutions of glycerol with aqueous solutions of glycerol polyacrylamide (Rokrysol WF1) in pneumatic nebulizers. In experiments, the different concentration of aqueous solutions of glycerol polyacrylamide have been tested. In addition, the effect of nebulizer design on atomization process has been determined. The one of the main elements of medical pneumatic nebulizer is nebulizer cup. The experiment with this scope is new and is very important from the point of view of aerosol therapy. The results have been obtained by the use of the digital microphotography technique. In order to determine a physicochemical properties of tested liquids, a rheological measurements and measurements of the surface tension were carried out. The differences between characteristics of aerosol for the liquids have been observed. The analysis of the droplets size distributions shows that the different diameters of droplets for Newtonian and non-Newtonian fluids have been formed during atomization in pneumatic nebulizers equipped with different nebulizer cups. The effect of the mouthpiece location on the droplets diameters has been shown. Precise design of nebulizer and nebulizer cups, and also physicochemical properties of atomized liquids are of high importance in order to the effectiveness of drug delivery to patient's respiratory tracts.

  1. A Radiometric Study of Factors Affecting Drug Output of Jet Nebulizers

    PubMed Central

    Mittal, G.; Kumar, N.; Rawat, H.; Chopra, M. K.; Bhatnagar, A.

    2010-01-01

    Jet nebulizers show an unreasonable variation in drug output and nebulization rates that leads to clinical and regulatory problems. Current evaluation methods appear inadequate for the purpose. Our objective was to evaluate Technetium-99m radiometry to study nebulizer parameters and the factors influencing it quantitatively. Drug output, output rate and residual mass and the effect of excipient, temperature, surface tension, air-jet speed, and equipment brand and aging were studied. Though nebulization of radiolabeled drugs followed first-order kinetics, the rates were significantly different; the heaviest drug (Tc-99m colloid) and Tc-99m salbutamol had the least nebulization. Nebulization rate for the first minute was invariably higher than the mean rate signifying the concentration effect of the solute. Drug residue was 35-75%. Drug output of different nebulizer chamber and air compressor brands was different to the extent of 270% and 180% respectively. ‘Aging’ of fluid chamber, cold drug fluid and obstruction in air-jet resulted in significant reduction in output, while addition of 2% saline as excipient did not change the output rate. Addition of ethyl alcohol resulted in a maximum of 260% enhancement (with Tc-99m salbutamol), while further reduction in surface tension was counterproductive irrespective of the drug used. We conclude that radiometry can provide valuable parametric information on the performance of different jet nebulizers. PMID:20582187

  2. History of aerosol therapy: liquid nebulization to MDIs to DPIs.

    PubMed

    Anderson, Paula J

    2005-09-01

    Inhaled therapies have been used since ancient times and may have had their origins with the smoking of datura preparations in India 4,000 years ago. In the late 18th and in the 19th century, earthenware inhalers were popular for the inhalation of air drawn through infusions of plants and other ingredients. Atomizers and nebulizers were developed in the mid-1800s in France and were thought to be an outgrowth of the perfume industry as well as a response to the fashion of inhaling thermal waters at spas. Around the turn of the 20th century, combustible powders and cigarettes containing stramonium were popular for asthma and other lung complaints. Following the discovery of the utility of epinephrine for treating asthma, hand-bulb nebulizers were developed, as well as early compressor nebulizers. The marketing of the first pressurized metered-dose inhaler for epinephrine and isoproterenol, by Riker Laboratories in 1956, was a milestone in the development of inhaled drugs. There have been remarkable advances in the technology of devices and formulations for inhaled drugs in the past 50 years. These have been influenced greatly by scientific developments in several areas: theoretical modeling and indirect measures of lung deposition, particle sizing techniques and in vitro deposition studies, scintigraphic deposition studies, pharmacokinetics and pharmacodynamics, and the 1987 Montreal Protocol, which banned chlorofluorocarbon propellants. We are now in an era of rapid technologic progress in inhaled drug delivery and applications of aerosol science, with the use of the aerosolized route for drugs for systemic therapy and for gene replacement therapy, use of aerosolized antimicrobials and immunosuppressants, and interest in specific targeting of inhaled drugs.

  3. Nebulization associated with bi-level noninvasive ventilation: analysis of pulmonary radioaerosol deposition.

    PubMed

    França, Eduardo E T; Dornelas de Andrade, Armele F; Cabral, Geovanna; Almeida Filho, Paulo; Silva, Kamary C; Galindo Filho, Valdecir C; Marinho, Patrícia E M; Lemos, Andrea; Parreira, Verônica F

    2006-04-01

    Nebulization associated with noninvasive ventilation is used in emergency services and intensive care units. To compare pulmonary radioaerosol deposition during jet nebulization associated to noninvasive ventilation versus spontaneous breathing nebulization; to measure the rate of lung depuration and the correlation between lung deposition, inspiratory flow and tidal volume (V(t)) using scintigraphy. Thirteen healthy volunteers (with normal spirometry), mean age (23.3+/-1.49) years, body mass index 21.2+/-2.3 kg/m(2). Nebulization was performed in spontaneous breathing and associated with bi-level noninvasive ventilation (inspiratory pressure=12 cm H(2)O, expiratory pressure=5 cm H(2)O). The radioaerosol used in the nebulization was technetium (Tc99m) with diethylene triamine penta acetic acid, generated over a period of 9 min in a jet nebulizer. Analysis was performed through scintigraphy. Statistical analysis was performed by analysis of variance (for repeated measures), Bonferroni method, Student's t-test and Person's correlation. There was a decrease in radioaerosol lung deposition with nebulization associated to noninvasive ventilation (mean counts in spontaneous breathing 200,510+11,012 and mean counts in noninvasive ventilation 106,093+2811 (P<0.001). During spontaneous breathing nebulization there was a significant correlation between V(t) and radioaerosol deposition (r=0.565, P<0.05), also between inspiratory flow and radioaerosol deposition in the lungs (r=0.141, P<0.05). However, there was no correlation between V(t) and pulmonary deposition of radioaerosol in bi-level noninvasive ventilation nebulization (r=0.082). During nebulization with noninvasive ventilation in healthy volunteers, there was an increase in V(t) associated to a higher inspiratory flow rate, without resulting in a significant increase in pulmonary radioaerosol deposition.

  4. A retrospective analysis of nebulized versus intravenous fentanyl for renal colic.

    PubMed

    Imamoglu, Melih; Aygun, Ali; Bekar, Omer; Erdem, Erkan; Cicek, Mustafa; Tatli, Ozgur; Karaca, Yunus; Sahin, Aynur; Turkmen, Suha; Turedi, Suleyman

    2017-05-01

    To assess the effectiveness of nebulized fentanyl used for analgesia in renal colic. This research was planned as a randomized, blinded study in which prospectively collected data were analyzed retrospectively to compare nebulized and intravenous (iv) fentanyl therapies. Patients with renal colic with 'moderate' or worse pain on a four-point verbal pain score (VPS) or with pain of 20mm or above on a 100-mm visual analogue score (VAS) at time of presentation were randomized into iv fentanyl (n=62) or nebulized fentanyl (n=53) study groups. Decreases in VAS and VPS scores at 15 and 30min compared to baseline, rescue analgesia requirements and side-effects between the groups were compared. Both iv fentanyl and nebulized fentanyl provided effective analgesia in renal colic patients at the end of 30min. However, iv fentanyl provided more rapid and more effective analgesia than nebulized fentanyl. Patients receiving iv fentanyl had lower rescue analgesia requirements than those receiving nebulized fentanyl (37.1% vs 54.7%), although the difference was not statistically significant (p=0.058). In addition, side-effects were more common in the iv fentanyl group compared to the nebulized fentanyl group (22.1% vs 9.4%), although the difference was also not significant (p=0.058). Nebulized fentanyl provides effective analgesia in patients with renal colic. However, iv fentanyl exhibits more rapid and more powerful analgesic effects than nebulized fentanyl. Nonetheless, due to its ease of use and few potential risks and side-effects the nebulized form can be used as an alternative in renal colic. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Topical airway anesthesia for awake fiberoptic intubation: Comparison between airway nerve blocks and nebulized lignocaine by ultrasonic nebulizer

    PubMed Central

    Gupta, Babita; Kohli, Santvana; Farooque, Kamran; Jalwal, Gopal; Gupta, Deepak; Sinha, Sumit; Chandralekha

    2014-01-01

    Overview: Awake fiberoptic bronchoscope (FOB) guided intubation is the gold standard of airway management in patients with cervical spine injury. It is essential to sufficiently anesthetize the upper airway before the performance of awake FOB guided intubation in order to ensure patient comfort and cooperation. This randomized controlled study was performed to compare two methods of airway anesthesia, namely ultrasonic nebulization of local anesthetic and performance of airway blocks. Materials and Methods: A total of 50 adult patients with cervical spine injury were randomly allocated into two groups. Group L received airway anesthesia through ultrasonic nebulization of 10 ml of 4% lignocaine and Group NB received airway blocks (bilateral superior laryngeal and transtracheal recurrent laryngeal) each with 2 ml of 2% lignocaine and viscous lignocaine gargles. FOB guided orotracheal intubation was then performed. Hemodynamic variables at baseline and during the procedure, patient recall, vocal cord visibility, ease of intubation, coughing/gagging episodes, and signs of lignocaine toxicity were noted. Results: The observations did not reveal any significant differences in demographics or hemodynamic parameters at any time during the study. However, the time taken for intubation was significantly lower in Group NB as compared with the Group L. Group L had an increased number of coughing/gagging episodes as compared with Group NB. Vocal cord visibility and ease of intubation were better in patients who received airway blocks and hence the amount of supplemental lignocaine used was less in this group. Overall patient comfort was better in Group NB with fewer incidences of unpleasant recalls as compared with Group L. Conclusion: Upper airway blocks provide better quality of anesthesia than lignocaine nebulization as assessed by patient recall of procedure, coughing/gagging episodes, ease of intubation, vocal cord visibility, and time taken to intubate. PMID:25538514

  6. Ultrasonic nebulization atmospheric pressure glow discharge - Preliminary study

    NASA Astrophysics Data System (ADS)

    Greda, Krzysztof; Jamroz, Piotr; Pohl, Pawel

    2016-07-01

    Atmospheric pressure glow microdischarge (μAPGD) generated between a small-sized He nozzle jet anode and a flowing liquid cathode was coupled with ultrasonic nebulization (USN) for analytical optical emission spectrometry (OES). The spatial distributions of the emitted spectra from the novel coupled USN-μAPGD system and the conventional μAPGD system were compared. In the μAPGD, the maxima of the intensity distribution profiles of the atomic emission lines Ca, Cd, In, K, Li, Mg, Mn, Na and Sr were observed in the near cathode region, whereas, in the case of the USN-μAPGD, they were shifted towards the anode. In the novel system, the intensities of the analytical lines of the studied metals were boosted from several to 35 times. As compared to the conventional μAPGD-OES with the introduction of analytes through the sputtering and/or the electrospray-like nebulization of the flowing liquid cathode solution, the proposed method with the USN introduction of analytes in the form of a dry aerosol provides improved detectability of the studied metals. The detection limits of metals achieved with the USN-μAPGD-OES method were in the range from 0.08 μg L- 1 for Li to 52 μg L- 1 for Mn.

  7. Effect that an educational program for cystic fibrosis patients and caregivers has on the contamination of home nebulizers*

    PubMed Central

    Zuana, Adriana Della; Garcia, Doroti de Oliveira; Juliani, Regina Célia Turola Passos; da Silva, Luiz Vicente Ribeiro Ferreira

    2014-01-01

    OBJECTIVE: To describe the pathogens found in home nebulizers and in respiratory samples of cystic fibrosis (CF) patients, and to evaluate the effect that a standardized instruction regarding cleaning and disinfection of nebulizers has on the frequency of nebulizer contamination. METHODS: We included 40 CF patients (22 males), all of whom used the same model of nebulizer. The median patient age was 11.2 ± 3.74 years. We collected samples from the nebulizer mouthpiece and cup, using a sterile swab moistened with sterile saline. Respiratory samples were collected by asking patients to expectorate into a sterile container or with oropharyngeal swabs after cough stimulation. Cultures were performed on selective media, and bacteria were identified by classical biochemical tests. Patients received oral and written instructions regarding the cleaning and disinfection of nebulizers. All determinations were repeated an average of two months later. RESULTS: Contamination of the nebulizer (any part) was detected in 23 cases (57.5%). The nebulizer mouthpiece and cup were found to be contaminated in 16 (40.0%) and 19 (47.5%), respectively. After the standardized instruction had been given, there was a significant decrease in the proportion of contaminated nebulizers (43.5%). CONCLUSIONS: In our sample of CF patients, nebulizer contamination was common, indicating the need for improvement in patient practices regarding the cleaning and disinfection of their nebulizers. A one-time educational intervention could have a significant positive impact. PMID:24831395

  8. Characterization of microconcentric nebulizer uptake rates for capillary electrophoresis inductively coupled plasma mass spectrometry

    NASA Astrophysics Data System (ADS)

    Yanes, Enrique G.; Miller-Ihli, Nancy J.

    2003-05-01

    There is demonstrated interest in combining capillary electrophoresis (CE) with inductively coupled plasma mass spectrometry (ICP-MS) for speciation determinations. When self-aspirating nebulizers are used for this application, it is important to offset the suction effect to avoid degradation of the separation. In this study, sample uptake rates for three microconcentric nebulizers of the same model, in combination with a cyclonic spray chamber, were characterized and compared for future utilization in CE-ICP-MS interfaces. The specific model studied was a MicroMist with a nominal uptake rate of 100 μl/min at 1 l/min argon gas flow rate per the manufacturer's specifications. Sample uptake rates at various nebulizer gas flows were measured by aspirating water from a weighed container and calculating the uptake rate in microliter per minute. The nebulizers studied provided good reproducibility from day to day, but a comparison of the different nebulizers reflected a significant difference in performance. A characteristic observed during the study was that uptake rates decreased with increasing nebulizer gas flow. This can be used for sample introduction for CE-ICP-MS. Interestingly, very different performance was observed when comparing the three different nebulizers of the same model. Uptake rates showed strong dependence on argon gas flow rates and the dimensions of the sample uptake tubing.

  9. Vibrating-mesh nebulization of liposomes generated using an ethanol-based proliposome technology.

    PubMed

    Elhissi, Abdelbary; Gill, Hardyal; Ahmed, Waqar; Taylor, Kevin

    2011-06-01

    This is the first study that evaluates the influence of the compartmental design of the micropump Aeroneb Go nebulizer and the viscosity of a proliposome hydration medium on vibrating-mesh aerosolization of liposomes. Ethanol-based proliposomes comprising soya phosphatidylcholine and cholesterol (1:1 mole ratio) were hydrated by using isotonic NaCl (0.9%) or sucrose (9.25%) solutions to generate liposomes that entrapped approximately 61% of the hydrophilic drug, salbutamol sulphate. Liposomes were aerosolized by the nebulizer to a two-stage impinger. For both formulations, the aerosol mass output was higher than the phospholipid output, indicating some accumulation of large liposomes or liposome aggregate within the nebulizer. Using NaCl (0.9%) solution as the dispersion medium, aerosol droplet size was much smaller and aerosol mass and phospholipid outputs were higher. This was attributed to the lower viscosity of the NaCl solution, resulting in a reduced retention of the aerosols in the "trap" of the nebulizer. For the entrapped salbutamol sulphate, although the "fine particle fraction" was relatively high (57.44%), size reduction of the liposomes during nebulization caused marked losses of the drug originally entrapped. Overall, liposomes generated from proliposomes when using this nebulizer showed high nebulization output and small droplet size. However, further work is required to reduce the losses of the originally entrapped drug from liposomes.

  10. Stability and efficacy of synthetic cationic antimicrobial peptides nebulized using high frequency acoustic waves.

    PubMed

    Wang, Ying; Rezk, Amgad R; Khara, Jasmeet Singh; Yeo, Leslie Y; Ee, Pui Lai Rachel

    2016-05-01

    Surface acoustic wave (SAW), a nanometer amplitude electroelastic wave generated and propagated on low-loss piezoelectric substrates (such as LiNbO3), is an extremely efficient solid-fluid energy transfer mechanism. The present study explores the use of SAW nebulization as a solution for effective pulmonary peptide delivery. In vitro deposition characteristics of the nebulized peptides were determined using a Next Generation Cascade Impactor. 70% of the peptide-laden aerosols generated were within a size distribution favorable for deep lung distribution. The integrity of the nebulized peptides was found to be retained, as shown via mass spectrometry. The anti-mycobacterial activity of the nebulized peptides was found to be uncompromised compared with their non-nebulized counterparts, as demonstrated by the minimum inhibition concentration and the colony forming inhibition activity. The peptide concentration and volume recoveries for the SAW nebulizer were significantly higher than 90% and found to be insensitive to variation in the peptide sequences. These results demonstrate the potential of the SAW nebulization platform as an effective delivery system of therapeutic peptides through the respiratory tract to the deep lung.

  11. Determination of nebulizer droplet size distribution: a method based on impactor refrigeration.

    PubMed

    Berg, Elna; Svensson, Jan Olof; Asking, Lars

    2007-01-01

    Size distributions of droplets generated by nebulizers are difficult to determine because of evaporation after aerosolization. We describe a method whereby a Next Generation Pharmaceutical Impactor (NGI; MSP Corporation, Shoreview, MN) is refrigerated at 5 degrees C before connecting it to the nebulizer in order to ensure an environment inside the NGI at close to 100% relative humidity (RH). This, in turn, reduces droplet evaporation between the nebulizer and impaction. The method development was performed with a Pari LC Plus jet nebulizer operated at 2.0 bar, with the NGI set at a flow rate of 15 L/min and with salbutamol 5.0 mg/mL as the test solution. The droplet size distributions were expressed in terms of mass median aerodynamic diameter (MMAD) and geometric standard deviation (GSD). Variation in test conditions showed that the NGI should be cooled for at least 90 min, that nebulization should be started within 5 min after removal from the refrigerator, and that coating of collecting cups to prevent "bouncing" is not necessary. Variation of ambient temperature and humidity had no relevant effect on results. MMAD and GSD results showed that refrigeration of the NGI resulted in droplet size distributions that are likely to reflect those originally delivered at the mouthpiece by the nebulizer. The method was shown to be robust, accurate with recovery of test solutions exceeding 99%, reproducible, and to be suitable for use with a wide range of commercially available nebulizers.

  12. CFD simulation of aerosol delivery to a human lung via surface acoustic wave nebulization.

    PubMed

    Yousefi, Morteza; Pourmehran, Oveis; Gorji-Bandpy, Mofid; Inthavong, Kiao; Yeo, Leslie; Tu, Jiyuan

    2017-07-22

    Administration of drug in the form of particles through inhalation is generally preferable in the treatment of respiratory disorders. Conventional inhalation therapy devices such as inhalers and nebulizers, nevertheless, suffer from low delivery efficiencies, wherein only a small fraction of the inhaled drug reaches the lower respiratory tract. This is primarily because these devices are not able to produce a sufficiently fine drug mist that has aerodynamic diameters on the order of a few microns. This study employs computational fluid dynamics to investigate the transport and deposition of the drug particles produced by a new aerosolization technique driven by surface acoustic waves (SAWs) into an in silico lung model geometrically reconstructed using computed tomography scanning. The particles generated by the SAW are released in different locations in a spacer chamber attached to a lung model extending from the mouth to the 6th generation of the lung bronchial tree. An Eulerian approach is used to solve the Navier-Stokes equations that govern the airflow within the respiratory tract, and a Lagrangian approach is adopted to track the particles, which are assumed to be spherical and inert. Due to the complexity of the lung geometry, the airflow patterns vary as it penetrates deeper into the lung. High inertia particles tend to deposit at locations where the geometry experiences a significant reduction in cross section. Our findings, nevertheless, show that the injection location can influence the delivery efficiency: Injection points close to the spacer centerline result in deeper penetration into the lung. Additionally, we found that the ratio of drug particles entering the right lung is significantly higher than the left lung, independent of the injection location. This is in good agreement with this fact that the most of airflow enters to the right lobes.

  13. Effective pulmonary delivery of an aerosolized plasmid DNA vaccine via surface acoustic wave nebulization

    PubMed Central

    2014-01-01

    Background Pulmonary-delivered gene therapy promises to mitigate vaccine safety issues and reduce the need for needles and skilled personnel to use them. While plasmid DNA (pDNA) offers a rapid route to vaccine production without side effects or reliance on cold chain storage, its delivery to the lung has proved challenging. Conventional methods, including jet and ultrasonic nebulizers, fail to deliver large biomolecules like pDNA intact due to the shear and cavitational stresses present during nebulization. Methods In vitro structural analysis followed by in vivo protein expression studies served in assessing the integrity of the pDNA subjected to surface acoustic wave (SAW) nebulisation. In vivo immunization trials were then carried out in rats using SAW nebulized pDNA (influenza A, human hemagglutinin H1N1) condensate delivered via intratracheal instillation. Finally, in vivo pulmonary vaccinations using pDNA for influenza was nebulized and delivered via a respirator to sheep. Results The SAW nebulizer was effective at generating pDNA aerosols with sizes optimal for deep lung delivery. Successful gene expression was observed in mouse lung epithelial cells, when SAW-nebulized pDNA was delivered to male Swiss mice via intratracheal instillation. Effective systemic and mucosal antibody responses were found in rats via post-nebulized, condensed fluid instillation. Significantly, we demonstrated the suitability of the SAW nebulizer to administer unprotected pDNA encoding an influenza A virus surface glycoprotein to respirated sheep via aerosolized inhalation. Conclusion Given the difficulty of inducing functional antibody responses for DNA vaccination in large animals, we report here the first instance of successful aerosolized inhalation delivery of a pDNA vaccine in a large animal model relevant to human lung development, structure, physiology, and disease, using a novel, low-power (<1 W) surface acoustic wave (SAW) hand-held nebulizer to produce droplets of p

  14. Investigation of Factors Affecting Aerodynamic Performance of Nebulized Nanoemulsion

    PubMed Central

    Kamali, Hosein; Abbasi, Shayan; Amini, Mohammad Ali; Amani, Amir

    2016-01-01

    This work aimed to prepare a nanoemulsion preparation containing budesonide and assess its aerodynamic behavior in comparison with suspension of budesonide. In-vitro aerodynamic performance of the corresponding micellar solution (ie. nanoemulsion preparation without oil) was investigated too. Nanoemulsions of almond oil containing budesonide, as a hydrophobic model drug molecule, were prepared and optimized. Then, the effect of variation of surfactant/co-surfactant concentration on the aerodynamic properties of the nebulized aerosol was studied. The results indicated that the most physically stable formulation makes the smallest aerodynamic size. The concentration of co-surfactant was also shown to be critical in determination of aerodynamic size. Furthermore, the optimized sample, with 3% w/w almond oil, 20% w/w Tween 80+Span 80 and 2% w/w ethanol showed a smaller MMAD in comparison with the commercially available suspension and the micellar solution. PMID:28243265

  15. Effectiveness of nebulized beclomethasone in preventing viral wheezing: an RCT.

    PubMed

    Clavenna, Antonio; Sequi, Marco; Cartabia, Massimo; Fortinguerra, Filomena; Borghi, Marta; Bonati, Maurizio

    2014-03-01

    The goal of this study was to evaluate the effectiveness of nebulized beclomethasone in preventing the recurrence of viral wheezing. The study was designed as a randomized, double-blind, placebo-controlled trial. Outpatient children aged 1 to 5 years with at least 1 episode of viral wheezing in the last 12 months, presenting to any of 40 Italian pediatricians for an upper respiratory tract infection, were randomly allocated to receive beclomethasone 400 μg or placebo twice daily for 10 days. Medications were administered through a nebulizer. A clinical evaluation was performed by the pediatrician at the start and end of the treatment period. A subjective evaluation of symptoms and efficacy of treatment was performed by the parents. The primary endpoint was the incidence of viral wheezing diagnosed by the pediatricians during the 10-day treatment period. A total of 525 children were enrolled in the study, 521 of whom were visited at the end of the treatment period. Wheezing was diagnosed by the pediatricians in 47 children (9.0% [95% confidence interval: 6.7 to 11.3]), with no statistically significant differences between treatment groups (beclomethasone versus placebo relative risk: 0.61 [95% confidence interval: 0.35 to 1.08]).The treatment was considered helpful by 63% of parents (64% in the beclomethasone group vs 61% in the placebo group). In all, 46% of children still had infection symptoms at the end of the treatment period, with no differences between groups. The findings from this study confirm that inhaled steroids are not effective in preventing recurrence of viral wheezing. Moreover, no benefits were found in reducing symptoms of respiratory tract infections.

  16. Saline Nebulization before Gastric Lavage in the Diagnosis of Pulmonary Tuberculosis in Children and Adolescents

    PubMed Central

    Lyrio Peres, Renata; do Prado, Thiago Nascimento; Macedo, Cristina Ribeiro; Palaci, Moisés; Alves Vinhas, Solange; Dietze, Reynaldo; Johnson, John L.; Struchiner, Claúdio Jose

    2010-01-01

    The main objective is to assess whether nebulization before gastric lavage (GL) improves its sensitivity for the diagnosis of childhood tuberculosis (TB). Children and adolescents suspected of pulmonary TB were randomly assigned (1 : 2) to nebulization with hypertonic saline 30 min before GL (Neb group; n = 36) or GL without prior nebulization (controls; n = 68). The proportion of positive GL smears was greater in Neb group than in the control group; however, no statistical significance was observed (36.3% vs. 22.2%; p = 0.4). Inhalation of nebulized hypertonic saline before GL did not improve TB diagnosis in this study. Nevertheless, the validation of our data will require large longitudinal studies. PMID:20207695

  17. Nebulized furosemide for the management of dyspnea: does the evidence support its use?

    PubMed

    Newton, Phillip J; Davidson, Patricia M; Macdonald, Peter; Ollerton, Richard; Krum, Henry

    2008-10-01

    Dyspnea is a common and distressing symptom associated with multiple chronic illnesses and high levels of burden for individuals, their families and health care systems. The subjective nature dyspnea and a poor understanding of pathophysiological mechanisms challenge the clinician in developing management plans. Nebulized furosemide has been identified as a novel approach to dyspnea management. This review summarizes published studies, both clinical and experimental, reporting the use of nebulized furosemide. The search criteria yielded 42 articles published in the period 1988 to 2004. Although nebulized furosemide appeared to have a positive influence on dyspnea and physiological measurements, caution must be taken with the results primarily coming from small-scale clinical trials or observation trials. Despite the limitations of the studies reported, given the range of conditions reporting effectiveness of nebulized furosemide, further investigation of this potential novel treatment of dyspnea is warranted.

  18. The efficacy of nebulized magnesium sulfate alone and in combination with salbutamol in acute asthma.

    PubMed

    Sarhan, Hatem A; El-Garhy, Omar H; Ali, Mohamed A; Youssef, Nouran A

    2016-01-01

    Evaluation of the efficacy of nebulized magnesium sulfate (MgSO4) alone and in combination with salbutamol in acute asthma. A double-blind randomized controlled study was conducted in Chest and Emergency Departments. Thirty patients of acute attack of bronchial asthma were randomized into three groups: MgSO4 nebulization (group A), salbutamol nebulization (group B), and their combination (group C). All patients were monitored before and after nebulization (each 20 minutes) for peak expiratory flow rate (PEFR), respiratory rate (RR), heart rate (HR), blood pressure, pulsus paradoxus, oxygen saturation, clinical examination, and Fischl index. A highly significant improvement in PEFR, PEFR percentage, and Fischl index and significant decrease in RR and HR was observed in all groups. A similar improvement in PEFR was observed in group A and group B (P=0.389). The difference in peak expiratory flow (PEF) improvement was insignificant between group B and group C (P=0.101), while there was a significant difference between group A and group C (P=0.014) in favor of group C. Nebulized MgSO4 alone or combined with salbutamol has a clinically significant bronchodilator effect in acute asthma and leads to clinical improvement, increase in PEFR, reduction in HR, and reduction in RR. The response to nebulized MgSO4 alone (PEFR improvement 54±35.6 L/min, P=0.001) is comparable (P=0.389) to that of nebulized salbutamol (PEFR improvement 67.0±41.9 L/min, P=0.001) and is significantly less than (P=0.014) that of nebulized combination (PEFR improvement 92.0±26.9 L/min, P=0.000).

  19. The efficacy of nebulized magnesium sulfate alone and in combination with salbutamol in acute asthma

    PubMed Central

    Sarhan, Hatem A; EL-Garhy, Omar H; Ali, Mohamed A; Youssef, Nouran A

    2016-01-01

    Objective Evaluation of the efficacy of nebulized magnesium sulfate (MgSO4) alone and in combination with salbutamol in acute asthma. Methods A double-blind randomized controlled study was conducted in Chest and Emergency Departments. Thirty patients of acute attack of bronchial asthma were randomized into three groups: MgSO4 nebulization (group A), salbutamol nebulization (group B), and their combination (group C). All patients were monitored before and after nebulization (each 20 minutes) for peak expiratory flow rate (PEFR), respiratory rate (RR), heart rate (HR), blood pressure, pulsus paradoxus, oxygen saturation, clinical examination, and Fischl index. Results A highly significant improvement in PEFR, PEFR percentage, and Fischl index and significant decrease in RR and HR was observed in all groups. A similar improvement in PEFR was observed in group A and group B (P=0.389). The difference in peak expiratory flow (PEF) improvement was insignificant between group B and group C (P=0.101), while there was a significant difference between group A and group C (P=0.014) in favor of group C. Conclusion Nebulized MgSO4 alone or combined with salbutamol has a clinically significant bronchodilator effect in acute asthma and leads to clinical improvement, increase in PEFR, reduction in HR, and reduction in RR. The response to nebulized MgSO4 alone (PEFR improvement 54±35.6 L/min, P=0.001) is comparable (P=0.389) to that of nebulized salbutamol (PEFR improvement 67.0±41.9 L/min, P=0.001) and is significantly less than (P=0.014) that of nebulized combination (PEFR improvement 92.0±26.9 L/min, P=0.000). PMID:27354766

  20. Bronchoscopy for foreign body aspiration and effects of nebulized albuterol and budesonide combination

    PubMed Central

    Akcora, Bulent; Celikkaya, Mehmet Emin; Ozer, Cahit

    2017-01-01

    Objective: A foreign body aspiration in the tracheobronchial tree is a dangerous medical condition in the childhood period. Although rigid bronchoscopy is a safe procedure, it may cause complications. The aim of this study was to present our bronchoscopy experience and to evaluate the efficacy of pre-operative administration of nebulized albuterol and budesonide combination for reducing intra-operative complications in foreign body aspirated cases. Methods: In this retrospective study our pediatric cases in which a foreign body was removed from tracheobronchial tree in last 8 years were analyzed. After excluding the patients who needed emergent and negative bronchoscopies, the remaining clinically stable 84 patients were compared for the effects of preoperative administration of nebulized albuterol and budesonide combination on bronchoscopy complications. Results: There were 51 boys (60.3%) and 33 girls (39.7%). There were 38 children in the non-nebulized group and 46 children in the nebulized group. We found that the combined albuterol and budesonide nebulization decrease complications such as arterial oxygen desaturation (p<0.05), and bronchospasm (p<0.05) during the bronchoscopic intervention. Conclusion: Preoperative nebulization of albuterol and budesonide combination may decrease perioperative complications of bronchoscopy. PMID:28367177

  1. Global survey on nebulization of antimicrobial agents in mechanically ventilated patients: a call for international guidelines.

    PubMed

    Solé-Lleonart, C; Roberts, J A; Chastre, J; Poulakou, G; Palmer, L B; Blot, S; Felton, T; Bassetti, M; Luyt, C-E; Pereira, J M; Riera, J; Welte, T; Qiu, H; Rouby, J-J; Rello, J

    2016-04-01

    Nebulized antimicrobial agents are increasingly administered for treatment of respiratory infections in mechanically ventilated (MV) patients. A structured online questionnaire assessing the indications, dosages and recent patterns of use for nebulized antimicrobial agents in MV patients was developed. The questionnaire was distributed worldwide and completed by 192 intensive care units. The most common indications for using nebulized antimicrobial agent were ventilator-associated tracheobronchitis (VAT; 58/87), ventilator-associated pneumonia (VAP; 56/87) and management of multidrug-resistant, Gram-negative (67/87) bacilli in the respiratory tract. The most common prescribed nebulized agents were colistin methanesulfonate and sulfate (36/87, 41.3% and 24/87, 27.5%), tobramycin (32/87, 36.7%) and amikacin (23/87, 26.4%). Colistin methanesulfonate, amikacin and tobramycin daily doses for VAP were significantly higher than for VAT (p < 0.05). Combination of parenteral and nebulized antibiotics occurred in 50 (86%) of 58 prescriptions for VAP and 36 (64.2%) of 56 of prescriptions for VAT. The use of nebulized antimicrobial agents in MV patients is common. There is marked heterogeneity in clinical practice, with significantly different in use between patients with VAP and VAT. Randomized controlled clinical trials and international guidance on indications, dosing and antibiotic combinations to improve clinical outcomes are urgently required.

  2. Toward modern inhalational bacteriophage therapy: nebulization of bacteriophages of Burkholderia cepacia complex.

    PubMed

    Golshahi, Laleh; Seed, Kimberley D; Dennis, Jonathan J; Finlay, Warren H

    2008-12-01

    Antibiotic-resistant bacterial infections have renewed interest in finding substitute methods of treatment. The purpose of the present in vitro study was to investigate the possibility of respiratory delivery of a Burkholderia cepacia complex (BCC) bacteriophage by nebulized aerosol administration. Bacteriophages in isotonic saline were aerosolized with Pari LC star and eFlow nebulizers, at titers with mean value (standard deviation) of 2.15 x 10(8) (1.63 x 10(8)) plaque-forming unit (PFU)/mL in 2.5-mL nebulizer fills. The breathing pattern of an adult was simulated using a pulmonary waveform generator. During breath simulation, the size distributions of the nebulized aerosol were measured using phase doppler anemometry (PDA). Efficiency of nebulizer delivery was subsequently determined by collection of aerosol on low resistance filters and measurement of bacteriophage titers. These filter titers were used as input data to a mathematical lung deposition model to predict regional deposition of bacteriophages in the lung and initial bacteriophage titers in the liquid surface layer of each conducting airway generation. The results suggest that BCC bacteriophages can be nebulized successfully within a reasonable delivery time and predicted titers in the lung indicate that this method may hold potential for treatment of bacterial lung infections common among cystic fibrosis patients.

  3. Nebulization of ultradeformable liposomes: the influence of aerosolization mechanism and formulation excipients.

    PubMed

    Elhissi, Abdelbary M A; Giebultowicz, Joanna; Stec, Anna A; Wroczynski, Piotr; Ahmed, Waqar; Alhnan, Mohamed Albed; Phoenix, David; Taylor, Kevin M G

    2012-10-15

    Ultradeformable liposomes are stress-responsive phospholipid vesicles that have been investigated extensively in transdermal delivery. In this study, the suitability of ultradeformable liposomes for pulmonary delivery was investigated. Aerosols of ultradeformable liposomes were generated using air-jet, ultrasonic or vibrating-mesh nebulizers and their stability during aerosol generation was evaluated using salbutamol sulphate as a model hydrophilic drug. Although delivery of ultradeformable liposome aerosols in high fine particle fraction was achievable, the vesicles were very unstable to nebulization so that up to 98% drug losses were demonstrated. Conventional liposomes were relatively less unstable to nebulization. Moreover, ultradeformable liposomes tended to aggregate during nebulization whilst conventional vesicles demonstrated a "size fractionation" behaviour, with smaller liposomes delivered to the lower stage of the impinger and larger vesicles to the upper stage. A release study conducted for 2 h showed that ultradeformable liposomes retained only 30% of the originally entrapped drug, which was increased to 53% by inclusion of cholesterol within the formulations. By contrast, conventional liposomes retained 60-70% of the originally entrapped drug. The differences between ultradeformable liposomes and liposomes were attributed to the presence of ethanol or Tween 80 within the elastic vesicle formulations. Overall, this study demonstrated, contrary to our expectation, that materials included with the aim of making the liposomes more elastic and ultradeformable to enhance delivery from nebulizers were in fact responsible for vesicle instability during nebulization and high leakage rates of the drug. Copyright © 2012 Elsevier B.V. All rights reserved.

  4. Peritoneal Nebulization of Ropivacaine during Laparoscopic Cholecystectomy: Dose Finding and Pharmacokinetic Study

    PubMed Central

    Allegri, Massimo; Ornaghi, Martina; Meghani, Yash; Calcinati, Serena; Lovisari, Federica; Radhakrishnan, Krishnaprabha; Cusato, Maria; Scalia Catenacci, Stefano; Somaini, Marta; Fanelli, Guido; Ingelmo, Pablo

    2017-01-01

    Background. Intraperitoneal nebulization of ropivacaine reduces postoperative pain and morphine consumption after laparoscopic surgery. The aim of this multicenter double-blind randomized controlled trial was to assess the efficacy of different doses and dose-related absorption of ropivacaine when nebulized in the peritoneal cavity during laparoscopic cholecystectomy. Methods. Patients were randomized to receive 50, 100, or 150 mg of ropivacaine 1% by peritoneal nebulization through a nebulizer. Morphine consumption, pain intensity in the abdomen, wound and shoulder, time to unassisted ambulation, discharge time, and adverse effects were collected during the first 48 hours after surgery. The pharmacokinetics of ropivacaine was evaluated using high performance liquid chromatography. Results. Nebulization of 50 mg of ropivacaine had the same effect of 100 or 150 mg in terms of postoperative morphine consumption, shoulder pain, postoperative nausea and vomiting, activity resumption, and hospital discharge timing (>0.05). Plasma concentrations did not reach toxic levels in any patient, and no significant differences were observed between groups (P > 0.05). Conclusions. There is no enhancement in analgesic efficacy with higher doses of nebulized ropivacaine during laparoscopic cholecystectomy. When administered with a microvibration-based aerosol humidification system, the pharmacokinetics of ropivacaine is constant and maintains an adequate safety profile for each dosage tested. PMID:28316464

  5. Influence of inspiratory flow pattern and nebulizer position on aerosol delivery with a vibrating-mesh nebulizer during invasive mechanical ventilation: an in vitro analysis.

    PubMed

    Dugernier, Jonathan; Wittebole, Xavier; Roeseler, Jean; Michotte, Jean-Bernard; Sottiaux, Thierry; Dugernier, Thierry; Laterre, Pierre-François; Reychler, Gregory

    2015-06-01

    Aerosol delivery during invasive mechanical ventilation (IMV) depends on nebulizer type, placement of the nebulizer and ventilator settings. The purpose of this study was to determine the influence of two inspiratory flow patterns on amikacin delivery with a vibrating-mesh nebulizer placed at different positions on an adult lung model of IMV equipped with a proximal flow sensor (PFS). IMV was simulated using a ventilator connected to a lung model through an 8-mm inner-diameter endotracheal tube. The impact of a decelerating and a constant flow pattern on aerosol delivery was evaluated in volume-controlled mode (tidal volume 500 mL, 20 breaths/min, inspiratory time of 1 sec, bias flow of 10 L/min). An amikacin solution (250 mg/3 mL) was nebulized with Aeroneb Solo(®) placed at five positions on the ventilator circuit equipped with a PFS: connected to the endotracheal tube (A), to the Y-piece (B), placed at 15 cm (C) and 45 cm upstream of the Y-piece (D), and placed at 15 cm of the inspiratory outlet of the ventilator (E). The four last positions were also tested without PFS. Deposited doses of amikacin were measured using the gravimetric residual method. Amikacin delivery was significantly reduced with a decelerating inspiratory flow pattern compared to a constant flow (p<0.05). With a constant inspiratory flow pattern, connecting the nebulizer to the endotracheal tube enabled similar deposited doses than these obtained when connecting the nebulizer close to the ventilator. The PFS reduced deposited doses only when the nebulizer was connected to the Y-piece with both flow patterns or placed at 15 cm of the Y-piece with a constant inspiratory flow (p<0.01). Using similar tidal volume and inspiratory time, a constant flow pattern (30 L/min) delivers a higher amount of amikacin through an endotracheal tube compared to a decelerating inspiratory flow pattern (peak inspiratory flow around 60 L/min). The optimal nebulizer position depends on the

  6. Short torch design for direct liquid sample introduction using conventional and micro-nebulizers for plasma spectrometry

    DOEpatents

    Montaser, Akbar; Westphal, Craig S.; Kahen, Kaveh; Rutkowski, William F.

    2008-01-08

    An apparatus and method for providing direct liquid sample introduction using a nebulizer are provided. The apparatus and method include a short torch having an inner tube and an outer tube, and an elongated adapter having a cavity for receiving the nebulizer and positioning a nozzle tip of the nebulizer a predetermined distance from a tip of the outer tube of the short torch. The predetermined distance is preferably about 2-5 mm.

  7. Efficacy and cost comparisons of bronchodilatator administration between metered dose inhalers with disposable spacers and nebulizers for acute asthma treatment.

    PubMed

    Dhuper, Sunil; Chandra, Alpana; Ahmed, Aziz; Bista, Sabin; Moghekar, Ajit; Verma, Rajesh; Chong, Cynthia; Shim, Chang; Cohen, Hillel; Choksi, Sonia

    2011-03-01

    Despite demonstration of equivalent efficacy of beta agonist delivery using a metered dose inhaler (MDI) with spacer vs. nebulizer in asthma patients, use of a nebulizer remains standard practice. We hypothesize that beta agonist delivery with a MDI/disposable spacer combination is an effective and low-cost alternative to nebulizer delivery for acute asthma in an inner-city population. This study was a prospective, randomized, double-blinded, placebo-controlled trial with 60 acute asthma adult patients in two inner-city emergency departments. Subjects (n = 60) received albuterol with either a MDI/spacer combination or nebulizer. The spacer group (n = 29) received albuterol by MDI/spacer followed by placebo nebulization. The nebulizer group (n = 29) received placebo by MDI/spacer followed by albuterol nebulization. Peak flows, symptom scores, and need for rescue bronchodilatator were monitored. Median values were compared with the Kolmogorov-Smirnov test. Patients in the two randomized groups had similar baseline characteristics. The severity of asthma exacerbation, median peak flows, and symptom scores were not significantly different between the two groups. The median (interquartile range) improvement in peak flow was 120 (75-180) L/min vs. 120 (80-155) L/min in the spacer and nebulizer groups, respectively (p = 0.56). The median improvement in the symptom score was 7 (5-9) vs. 7 (4-9) in the spacer and nebulizer groups, respectively (p = 0.78). The median cost of treatment per patient was $10.11 ($10.03-$10.28) vs. $18.26 ($9.88-$22.45) in the spacer and nebulizer groups, respectively (p < 0.001). There is no evidence of superiority of nebulizer to MDI/spacer beta agonist delivery for emergency management of acute asthma in the inner-city adult population. MDI/spacer may be a more economical alternative to nebulizer delivery. Copyright © 2011. Published by Elsevier Inc.

  8. Scintigraphic assessment of radio-aerosol pulmonary deposition with the acapella positive expiratory pressure device and various nebulizer configurations.

    PubMed

    Mesquita, Fabrício O S; Galindo-Filho, Valdecir C; Neto, João Luis F; Galvão, André M; Brandão, Simone C S; Fink, James B; Dornelas-de-Andrade, Armèle

    2014-03-01

    The Acapella device produces high-frequency oscillations and positive expiratory pressure to promote bronchial secretion clearance. Its performance during aerosol delivery has not been described. We evaluated the effect of nebulizer and Acapella configuration on pulmonary deposition of radio-tagged aerosol in healthy subjects. Ten healthy male subjects (mean age 24.4 ± 2.2 y) participated in a crossover study that compared pulmonary delivery of 4 mL of technetium-99m-labeled diethylene triamine penta-acetic acid (25 mCi) and 0.9% saline solution via jet nebulizer. We tested 3 configurations: nebulizer attached to the distal end of the Acapella; nebulizer placed between the mouthpiece and the Acapella; and nebulizer alone (control). With scintigraphy we measured radio-aerosol deposition in 6 lung regions: upper, middle, lower, central, intermediate, and peripheral. Deposition was similar between the right and left lungs, with no significant differences between device configurations. Lung deposition was less with the nebulizer attached to the Acapella than with nebulizer between the mouthpiece and the Acapella (P = .001, for both lungs) or without the Acapella (P = .003 and P = .001 for the right and left lungs, respectively). There was no significant difference between the setup without Acapella and the setup with the nebulizer between the mouthpiece and the Acapella (P = .001, for both lungs). On the vertical axis, deposition was lower with the nebulizer attached to the distal end of the Acapella than with the nebulizer between the mouthpiece and the Acapella (upper region P < .001, middle region P = .001, lower region P = .003), and lower with the nebulizer attached to the distal end of the Acapella than with the setup without Acapella (upper and middle region both P = .001, lower region P = .002), with up to a 3-fold difference in the middle and lower regions. On the central-peripheral axis, deposition was lower with the nebulizer attached to the distal end of

  9. Effect of nebulizer/spray chamber interfaces on simultaneous, axial view inductively coupled plasma optical emission spectrometry for the direct determination of As and Se species separated by ion exchange high-performance liquid chromatography

    NASA Astrophysics Data System (ADS)

    Gettar, Raquel T.; Smichowski, Patricia; Garavaglia, Ricardo N.; Farías, Silvia; Batistoni, Daniel A.

    2005-06-01

    Different nebulizer/expansion chamber combinations were evaluated to assess their performance for sample introduction in the direct coupling with an axial view inductively coupled plasma multielement spectrometer for on-line determination of As and Se species previously separated by ion exchange-high performance liquid chromatography. The column effluents were injected into the plasma without prior derivatization. The instrument operation software was adapted for data acquisition and processing to allow multi-wavelength recording of the transient chromatographic peaks. After optimization of the chromatographic operating conditions, separation of mixtures of inorganic As and Se species, and of inorganic and two organic As species (monomethylarsonic and dimethylarsinic acids), was achieved with excellent resolution. Species discrimination from mixtures of As and Se oxyanions was further improved by the simultaneous element detection at specific analytical wavelengths. Three nebulizers and three spray chambers, employed in seven combinations, were tested as interfaces. Concentric nebulizers associated to a glass cyclonic chamber appear most suitable regarding sensitivity and signal to noise ratio. Measured element detection limits (3 σ) were around 10 ng ml - 1 for all the species considered, making the method a viable alternative to similar procedures that employ volatile hydride generation previous to sample injection into the plasma. Analytical recoveries both for inorganic and organic species ranged between 92 and 107%. The method was demonstrated to be apt for the analysis of surface waters potentially subjected to natural contamination with arsenic.

  10. Facial and ocular deposition of nebulized budesonide: effects of face mask design.

    PubMed

    Harris, Keith W; Smaldone, Gerald C

    2008-02-01

    In vivo case reports and in vitro studies have indicated that aerosol therapy using face masks can result in drug deposition on the face and in the eyes, and that face mask design may affect drug delivery. To test different mask/nebulizer combinations for budesonide, a nebulized steroid used to treat pediatric patients with asthma. Using high-performance liquid chromatography, drug delivery (inhaled mass), facial, and ocular deposition of budesonide aerosols were studied in vitro using a ventilated face facsimile (tidal volume, 50 mL; rate, 25 breaths/min, duty cycle 0.4), a tight-fitting test mask, a standard commercial mask, and a prototype mask designed to optimize delivery by reducing particle inertia. Nebulizer insertion into the mask (front loaded vs bottom loaded) was also tested. Particle size was measured by cascade impaction. Pari LC Plus (PARI Respiratory Equipment; Midlothian, VA) and MistyNeb (Allegiance; McGaw Park, IL) nebulizers were tested. Inhaled mass for tight-fitting and prototype masks was similar (13.2 +/- 1.85% vs 14.4 +/- 0.67% [percentage of nebulizer charge], p = 0.58) and significantly greater than for the commercial mask (3.03 +/- 0.26%, p = 0.005). Mask insertion of nebulizer was a key factor (inhaled mass: front loaded vs bottom loaded, 8.23 +/- 0.18% vs 3.03 +/- 0.26%; p = 0.005). Ocular deposition varied by an order of magnitude and was a strong function of mask design (4.77 +/- 0.24% vs 0.35 +/- 0.05%, p = 0.002, tight fitting vs prototype). Particle sizes (7.3 to 9 microm) were larger than previously reported for budesonide. For pediatric breathing patterns, mask design is a key factor defining budesonide delivery to the lungs, face, and eyes. Front-loaded nebulizer mask combinations are more efficient than bottom-loaded systems.

  11. Surface acoustic wave nebulization facilitating lipid mass spectrometric analysis.

    PubMed

    Yoon, Sung Hwan; Huang, Yue; Edgar, J Scott; Ting, Ying S; Heron, Scott R; Kao, Yuchieh; Li, Yanyan; Masselon, Christophe D; Ernst, Robert K; Goodlett, David R

    2012-08-07

    Surface acoustic wave nebulization (SAWN) is a novel method to transfer nonvolatile analytes directly from the aqueous phase to the gas phase for mass spectrometric analysis. The lower ion energetics of SAWN and its planar nature make it appealing for analytically challenging lipid samples. This challenge is a result of their amphipathic nature, labile nature, and tendency to form aggregates, which readily precipitate clogging capillaries used for electrospray ionization (ESI). Here, we report the use of SAWN to characterize the complex glycolipid, lipid A, which serves as the membrane anchor component of lipopolysaccharide (LPS) and has a pronounced tendency to clog nano-ESI capillaries. We also show that unlike ESI SAWN is capable of ionizing labile phospholipids without fragmentation. Lastly, we compare the ease of use of SAWN to the more conventional infusion-based ESI methods and demonstrate the ability to generate higher order tandem mass spectral data of lipid A for automated structure assignment using our previously reported hierarchical tandem mass spectrometry (HiTMS) algorithm. The ease of generating SAWN-MS(n) data combined with HiTMS interpretation offers the potential for high throughput lipid A structure analysis.

  12. Minimizing variability of cascade impaction measurements in inhalers and nebulizers.

    PubMed

    Bonam, Matthew; Christopher, David; Cipolla, David; Donovan, Brent; Goodwin, David; Holmes, Susan; Lyapustina, Svetlana; Mitchell, Jolyon; Nichols, Steve; Pettersson, Gunilla; Quale, Chris; Rao, Nagaraja; Singh, Dilraj; Tougas, Terrence; Van Oort, Mike; Walther, Bernd; Wyka, Bruce

    2008-01-01

    The purpose of this article is to catalogue in a systematic way the available information about factors that may influence the outcome and variability of cascade impactor (CI) measurements of pharmaceutical aerosols for inhalation, such as those obtained from metered dose inhalers (MDIs), dry powder inhalers (DPIs) or products for nebulization; and to suggest ways to minimize the influence of such factors. To accomplish this task, the authors constructed a cause-and-effect Ishikawa diagram for a CI measurement and considered the influence of each root cause based on industry experience and thorough literature review. The results illustrate the intricate network of underlying causes of CI variability, with the potential for several multi-way statistical interactions. It was also found that significantly more quantitative information exists about impactor-related causes than about operator-derived influences, the contribution of drug assay methodology and product-related causes, suggesting a need for further research in those areas. The understanding and awareness of all these factors should aid in the development of optimized CI methods and appropriate quality control measures for aerodynamic particle size distribution (APSD) of pharmaceutical aerosols, in line with the current regulatory initiatives involving quality-by-design (QbD).

  13. Physical stability and aerosol properties of liposomes delivered using an air-jet nebulizer and a novel micropump device with large mesh apertures.

    PubMed

    Elhissi, A M A; Faizi, M; Naji, W F; Gill, H S; Taylor, K M G

    2007-04-04

    The aerosol properties of liposomes and their physical stability to aerosolization were evaluated using an air-jet nebulizer (Pari LC Plus) and a customized large aperture vibrating-mesh nebulizer (Aeroneb Pro-8microm). Soya phosphatidylcholine: cholesterol (1:1 mole ratio) multilamellar liposomes (MLVs) entrapping salbutamol sulfate were nebulized directly, or after being reduced in size by extrusion through 1 or 0.4microm polycarbonate membrane filters. MLVs were very unstable to jet nebulization and stability was not markedly enhanced when vesicles were extruded before nebulization, such that drug losses from delivered liposomes using the Pari nebulizer were up to 88% (i.e. only 12% retained in liposomes). The Aeroneb Pro-8microm nebulizer was less disruptive to liposomes, completed nebulization in a much shorter time, and produced greater mass output rate than the Pari nebulizer. However, aerosol droplets were larger, total drug and mass outputs were lower and aerosolization performance was dependent on formulation. Vibrating-mesh nebulization was less disruptive to liposomes extruded through the 1microm membranes compared with the non-extruded MLVs, so that the retained entrapment of the drug in the nebulized vesicles was 56% and 37%, respectively. However, extrusion of liposomes to 0.4microm resulted in reduced stability of liposomes to vibrating-mesh nebulization (retained entrapment=41%) which was attributed to the reduced liposome lamellarity and subsequent reduced resistance to nebulization-induced shearing. This study has shown that vibrating-mesh nebulization using the customized large aperture mesh nebulizer (Aeroneb Pro-8microm) had a less disruptive effect on liposomes and produced a higher output rate compared with the Pari LC Plus air-jet nebulizer. On the other hand, the air-jet nebulizer produced higher total mass and drug outputs and smaller aerosol droplets.

  14. Testing and Results of Human Metabolic Simulation Utilizing Ultrasonic Nebulizer Technology for Water Vapor Generation

    NASA Technical Reports Server (NTRS)

    Stubbe, Matthew; Curley, Su

    2010-01-01

    Life support technology must be evaluated thoroughly before ever being implemented into a functioning design. A major concern during that evaluation is safety. The ability to mimic human metabolic loads allows test engineers to evaluate the effectiveness of new technologies without risking injury to any actual humans. The main function of most life support technologies is the removal of carbon dioxide (CO2) and water (H2O) vapor. As such any good human metabolic simulator (HMS) will mimic the human body s ability to produce these items. Introducing CO2 into a test chamber is a very straightforward process with few unknowns so the focus of this particular new HMS design was on the much more complicated process of introducing known quantities of H2O vapor on command. Past iterations of the HMS have utilized steam which is very hard to keep in vapor phase while transporting and injecting into a test chamber. Also steam adds large quantities of heat to any test chamber, well beyond what an actual human does. For the new HMS an alternative approach to water vapor generation was designed utilizing ultrasonic nebulizers as a method for creating water vapor. Ultrasonic technology allows water to be vibrated into extremely tiny pieces (2-5 microns) and evaporate without requiring additional heating. Doing this process inside the test chamber itself allows H2O vapor generation without the unwanted heat and the challenging process of transporting water vapor. This paper presents the design details as well as results of all initial and final acceptance system testing. Testing of the system was performed at a range of known human metabolic rates in both sea-level and reduced pressure environments. This multitude of test points fully defines the systems capabilities as they relate to actual environmental systems testing.

  15. Pharmacokinetics of nebulized and subcutaneously implanted terbinafine in cottonmouths (Agkistrodon piscivorus).

    PubMed

    Kane, L P; Allender, M C; Archer, G; Leister, K; Rzadkowska, M; Boers, K; Souza, M; Cox, S

    2017-04-06

    Ophidiomyces ophiodiicola, the causative agent of snake fungal disease, is proposed as a serious threat to the conservation of several snake populations. The objective of this study was to determine the pharmacokinetic parameters of terbinafine administered through nebulization and a sustained subcutaneous implant as potential treatments of Ophidiomyces in reptiles. Seven adult cottonmouths (Agkistrodon piscivorus) were used in single-dose trials. Each snake was nebulized with terbinafine (2 mg/ml) for 30 min and had blood collected before nebulization and up to 12 hr after nebulization. Following a 5-month washout, the same snakes were administered a subcutaneous implant containing 24.5 mg terbinafine; blood was collected at baseline, 1 day postimplant placement, and then once weekly for 9 weeks. Plasma for both studies was analyzed by high-performance liquid chromatography. The mean plasma concentrations of nebulized terbinafine peaked between 0.5 and 4 hr. The subcutaneously implanted terbinafine reached therapeutic concentrations on day 1 and maintained therapeutic for over 6 weeks. These methods and doses are recommended as potential treatment options for snake fungal disease in reptiles.

  16. Factors to consider when selecting a nebulizer for a new inhaled drug product development program.

    PubMed

    Elphick, Mark; von Hollen, Dirk; Pritchard, John N; Nikander, Kurt; Hardaker, Lucy E A; Hatley, Ross H M

    2015-08-01

    Nebulizers are a common device choice for use when developing a new drug product, but the range of nebulizer devices available can make it difficult to select the right device. Increasingly, companies are only able to promote a drug with the device that was used during the development program; therefore, choosing the best device at an early stage is important in order to achieve commercial success. Selecting a device that is inappropriate for the intended drug can result in poor drug delivery from the nebulizer to the patient, which would have obvious implications for the development program. As device performance varies, it is important to ensure that the most appropriate device is chosen for the intended drug to ensure optimal drug delivery to the patient population. In this review, the types of nebulizer devices available are highlighted, and the factors that should be taken into consideration when selecting the most appropriate device for a new drug are discussed. The review is broadly divided into drug, device, patient and trial characteristics. Efficient nebulizer devices that combine electronic monitoring capabilities as a form of telehealth are likely to provide superior drug delivery to patients and accurate clinical trial data. Their use in adaptive clinical trials may help to vastly reduce the time and costs associated with achieving drug approval.

  17. Sound levels inside incubators and oxygen hoods used with nebulizers and humidifiers.

    PubMed

    Beckham, R W; Mishoe, S C

    1982-01-01

    Degree of hearing loss in the infant is related to high-intensity or high-frequency sound (noise). We measured sound levels of 6 models of pneumatic nebulizers and 8 models of humidifiers at various flowrates, FIO2 settings, and water levels, when they were attached to incubators and oxygen hoods; we also evaluated sound levels from 2 models of ultrasonic nebulizers at various output settings. Among the pneumatic nebulizers, the recommended 58-dbA maximum sound level was exceeded by the Aquapak 621, Ohio Deluxe, and Puritan All-Purpose devices. The Bard Parker, Foregger, and Inspiron pneumatic nebulizers' sound levels were 58 dbA or below except during the dry water-level condition. Among the humidifiers, all produced sound levels below the recommended 58-dbA maximum except the Travenol humidifier; the Bennett Cascade, Conchapak, Foregger, and Hudson humidifiers produced mean sound levels in the 43.0- to 43.5-dbA range. Sound levels increased under all conditions when the devices were used with oxygen hoods. The ultrasonic nebulizers produced low sound levels, but the high-frequency ultrasound they also produce may be undesirable for infants; this question requires further investigation.

  18. Isotope dilution - high efficiency nebulization-ICP-MS: The coupling of accuracy and sensitivity.

    PubMed

    Wildner, H; Wünsch, G

    1996-03-01

    If sample pretreatment, nebulization and method of calibration are suitably adapted to each other the performance of inductively coupled plasma - mass spectrometry ICP-MS can be greatly increased. High accuracy is obtained by high precision and low bias. For a given concentration higher sensitivity means higher count rates and therefore higher precision. Systematic errors are minimized by employing a definitive method of calibration. Increased sensitivity is obtained by introducing higher amounts of sample into the measurement system via high efficiency nebulizers (ultrasonic nebulizer, hydraulic-high pressure nebulizer according to Berndt and concentric high efficiency nebulizer according to Meinhard). Because this means also higher matrix effects a combination of ion chromatographic (IC-TMS) and thermal trace-matrix-separation by aerosol desolvation (T-TMS) is introduced. Isotope dilution (ID) proves to be the calibration most suitable to achieve the highest accuracy. First applications on the analysis of refractory metals (e.g. Ti, V, Nb, Ta) and non-metals (e.g. P, S, As, Se) showed recoveries of 60-105%, an imprecision of the recoveries of 2-50%, but an overall inaccuracy of only 0.1 to 4%.

  19. The efficacy of nebulized salbutamol, magnesium sulfate, and salbutamol/magnesium sulfate combination in moderate bronchiolitis.

    PubMed

    Kose, Mehmet; Ozturk, Mehmet Adnan; Poyrazoğlu, Hakan; Elmas, Tuba; Ekinci, Duygu; Tubas, Filiz; Kurt, Tuba; Goktas, Mehmet Akif

    2014-09-01

    The aim of this paper is to compare the effect of nebulized magnesium sulfate to nebulized salbutamol and salbutamol/magnesium sulfate on successful discharge from the emergency department. A total of 56 infants were included in this double-blinded, prospective study. Infants were grouped according to the nebulized treatment they received: group 1-salbutamol/normal saline, group 2-magnesium sulfate and normal saline, and group 3-salbutamol plus magnesium sulfate. Heart beat, bronchiolitis, clinical severity scores (CSS), and oxygen saturation of the patients were determined before and after nebulization (0, 1, 4 h). The patients were monitored for adverse reactions. Post-treatment mean CSS results were significantly lower than pre-treatment scores in all groups at 4 h with no significant difference within groups. CSS scores were lower in the salbutamol/magnesium sulfate group when compared with the magnesium sulfate and salbutamol groups (3.4 (2.4-4.3), 4.7 (3.8-5.7), 4.0 (3.2-4.3)). CSS were significantly lower than those from the magnesium sulfate group. Nebulized magnesium sulfate plus salbutamol may have additive effects for improving the short-term CSS.

  20. Bioavailability of vitamin B using a small-volume nebulizer ophthalmic drug delivery system.

    PubMed

    Kahn, Monte

    2005-08-01

    To determine the intraocular bioavailability of a novel embodiment for vitamin B(12) delivered to the ocular surface by a piezo-electric ultrasonic nebulizer. The semisolid embodiment contained 0.02% (w/w) vitamin B(12) in 1 g of ointment, which was immiscible and insoluble in 5 mL sterilized warm water. To confirm in vitro functionality, nebulized mist particles of the embodiment were collected and analysed for vitamin B(12) content. The in vivo arm of the study was designed as randomization of 23 patients who were scheduled to undergo cataract surgery in hospital. Fourteen patients were treated with nebulized vitamin B(12), five patients had one drop of 0.02% vitamin B(12) instilled in the conjunctival cul de sac, and four control patients had no medication. Twelve hours after the vitamin was delivered, the patients underwent the cataract procedure and a sample of aqueous humour was collected from each. High performance liquid chromatography was used for detection of vitamin B(12) in all samples. The in vitro analysis of mist particles showed increasing concentrations of vitamin B(12). In the patient tests, analysis of the aqueous humour samples showed that none of the controls or those receiving eye drops had detectable vitamin B(12) in the aqueous humour. However, 4 of 14 in the nebulizer group had vitamin B(12) detected in the aqueous humour in the amount of 10(-7) mol. The small-volume nebulizer system might provide another method of ophthalmic drug delivery.

  1. Safety and efficacy of using high-dose topical and nebulized anesthesia to obtain endobronchial cultures.

    PubMed

    Berger, R; McConnell, J W; Phillips, B; Overman, T L

    1989-02-01

    We evaluated the safety and efficacy of high-dose topical and nebulized airway anesthesia in normal volunteers and in patients undergoing diagnostic fiberoptic bronchoscopy. Lidocaine solution (4 percent) was used for gargling, for spraying the palate and oropharynx with an atomizer, and for nebulization with an air-powered nebulizer (mean total dose, 1,682 mg) and 2 percent lidocaine (Xylocaine) jelly for anesthetizing nasal passages. In six normal subjects and in eight patients, lidocaine blood levels were measured at baseline, after gargling, after spraying, after nebulization, and then at 5, 10, 15, 30, and 60 min; 19 normal subjects and ten patients underwent the same anesthesia protocol but had no blood drawn. Fiberoptic bronchoscopy was performed in 21 normal volunteers and in 18 patients and cultures obtained using the protected specimen brush. Additional endobronchial lidocaine (mean 256 mg) was given to the 18 patients after collecting the microbiology specimens. Peak lidocaine blood levels remained below 6 micrograms/ml in all cases. Cough and discomfort during bronchoscopic examination was absent or minimal in 17 of 21 normal subjects (80 percent) and in 14 of 18 patients (77 percent) and was severe in only one instance (5 percent). There were no related complications. Using only topical and nebulized anesthesia is safe and effective for performing fiberoptic bronchoscopy, especially when bacterial cultures are to be obtained and endobronchial instillation of lidocaine must be avoided.

  2. A preliminary study of painless and effective transdermal botulinum toxin A delivery by jet nebulization for treatment of primary hyperhidrosis

    PubMed Central

    Iannitti, Tommaso; Palmieri, Beniamino; Aspiro, Anna; Di Cerbo, Alessandro

    2014-01-01

    Background Hyperhidrosis is a chronic disease characterized by increased sweat production. Local injections of botulinum toxin A (BTX-A) have been extensively used for treatment of primary hyperhidrosis (idiopathic). The current treatment for this condition involves several intradermal injections, resulting in poor patient compliance due to injection-related pain. Therefore, new protocols, including an improved anesthetic regimen, are required. Aim We designed the present study to determine whether JetPeel™-3, a medical device used for transdermal delivery of drugs by jet nebulization, could be used to deliver lidocaine prior to the standard multiple BTX-A injections or deliver lidocaine together with BTX-A in order to determine the protocol giving better results in terms of procedure-related pain, sweating, and patient satisfaction in subjects affected by primary axillary, palmar or plantar hyperhidrosis. Materials and methods Twenty patients with a visual analog scale (VAS) sweating score ≥ 8 cm were randomized to receive lidocaine 2% (5 mL) delivered by JetPeel™-3 followed by multiple injections of BTX-A (100 units) or lidocaine 2% (5 mL) and BTX-A (50 units) delivered together by JetPeel™-3. Effect of treatment on sweating was measured by VAS (0= minimum sweating; 10= maximum sweating) at 3-month follow-up. Pain induced by the procedure was assessed by VAS (0= minimum pain; 10= maximum pain) immediately after the procedure. Patient satisfaction was assessed at 3-month follow-up using a 5-point scale (1= not at all satisfied; 2= not satisfied; 3= partially satisfied; 4= satisfied; 5= highly satisfied). Results Both treatment modalities reduced sweating at 3-month follow-up, if compared with baseline (all P<0.001). Delivery of lidocaine and BTX-A by JetPeel™-3 resulted in lower procedure-related pain and reduced sweating, if compared with lidocaine delivered by JetPeel™-3 followed by multiple BTX-A injections (all P<0.001). Patient satisfaction with

  3. Lidocaine-based topical anesthetic with disinfectant (LidoDin) versus EMLA for venipuncture: a randomized controlled trial.

    PubMed

    Shavit, Itai; Hadash, Amir; Knaani-Levinz, Hadas; Shachor-Meyouhas, Yael; Kassis, Imad

    2009-10-01

    To examine the efficacy and safety of a new topical anesthetic containing a disinfection ingredient (LidoDin cream) in reducing the pain associated with venipuncture by comparing it with the proven eutectic mixture of lidocaine 2.5% and prilocaine 2.5% (EMLA cream). A single-blind, randomized, controlled trial was conducted on a study population consisting of a convenience sample of patients aged 12 to 16 years who presented at our Emergency Department between November 2007 and April 2008. The Visual Analog Scale (VAS) was used for pain assessment. Before the study, the bactericidal effect of the LidoDin cream on skin flora was tested. Twenty patients were enrolled to each arm of the study. Mean patient age was 13.6 years for the LidoDin group and 14.12 years for the EMLA group (P=0.347). Male patients accounted for 55% of the patients in the LidoDin group, compared with 40% in the EMLA group (P=0.527). Skin reaction scores of the LidoDin group for erythema and edema were not statistically different than those of the EMLA group (P=0.73 and P=0.75, respectively). Patient VAS scores and nurse VAS scores of the LidoDin group were not statistically different than those of the EMLA group (P=0.57 and P=0.93, respectively). This pilot study demonstrated that LidoDin and EMLA seem to be equally safe and effective topical anesthetics for venipuncture. Future studies are planned to determine, if LidoDin reduces the rate of local skin infection in patients treated with multiple daily subcutaneous injections of medications.

  4. Budesonide inhalation suspension: a nebulized corticosteroid for persistent asthma.

    PubMed

    Szefler, Stanley J; Eigen, Howard

    2002-04-01

    Guidelines for managing asthma in pediatric patients published by the American Academy of Allergy, Asthma, and Immunology and the American Academy of Pediatrics recommend the use of inhaled corticosteroids for the management of persistent asthma in infants and young children. When these guidelines were published, pressurized metered-dose inhalers and dry-powder inhalers were the only delivery devices available for inhaled corticosteroids in the United States. These devices can be difficult for young children to use correctly. Furthermore, no inhaled corticosteroid was approved in the United States for the treatment of children younger than 4 years. Budesonide inhalation suspension (Pulmicort Respules; AstraZeneca LP, Wilmington, Del) was developed to meet the medication delivery needs of infants and young children with persistent asthma. Pulmicort Respules is the first inhaled corticosteroid approved for administration by means of a nebulizer and the only inhaled corticosteroid approved in the United States for infants as young as 12 months. Budesonide has been studied extensively worldwide. In the United States the tolerability and efficacy of budesonide inhalation suspension were confirmed in 3 placebo-controlled multicenter trials. These studies demonstrated that both once- and twice-daily dosing of budesonide inhalation suspension (0.25-1 mg) improved pulmonary function and ameliorated asthma symptoms in infants and young children with persistent asthma. Budesonide inhalation suspension was well tolerated, and the incidences of reported adverse events were similar among patients in the budesonide, placebo, and conventional asthma therapy groups. This article reviews the results of these studies, as well as the pharmacokinetics, pharmacodynamics, and clinical use of budesonide inhalation suspension.

  5. A nebulizer chronolog to monitor compliance with inhaler use.

    PubMed

    Tashkin, D P; Rand, C; Nides, M; Simmons, M; Wise, R; Coulson, A H; Li, V; Gong, H

    1991-10-21

    The Lung Health Study is a 10-center 5-year clinical trial sponsored by the National Heart, Lung, and Blood Institute to evaluate the effectiveness of early intervention in chronic obstructive pulmonary disease (COPD). The specific objectives of the trial are to determine whether the accelerated decline in lung function characteristic of COPD and morbidity due to COPD can be reduced by special intervention at a relatively early stage in the evolution of the disease. Special intervention consists of a smoking-cessation program and the use of an inhaled bronchodilator to suppress airway hyperreactivity. The use of the inhaler canister is monitored every 4 months by canister weighing and, at two of the 10 centers, by an electronic recording device, the Nebulizer Chronolog. Among trial participants assigned the latter device, results from the first 4 months of the study indicate that only 52% of trial participants who were uninformed as to the nature of the chronolog used their inhaler at least twice daily as measured by the chronolog, compared with 87% as determined by self-report. Satisfactory or good compliance was achieved by 52% of these subjects as measured by the chronolog compared with 85% as assessed by canister weighing. Eighteen percent of uninformed participants "dumped" their inhalers within a 3-hour time period, contributing to the inaccuracy of canister weights as an indicator of compliance. Feedback of information to the participants from the chronolog improved the level of compliance and eliminated the "dumping" phenomenon. We conclude that, when accurate determinations of compliance are important, as in a drug trial, objective medication monitors should be considered. Electronic monitoring of inhaler use can provide valuable feedback, which encourages improved compliance.

  6. Nebulized antibiotics. An adequate option for treating ventilator-associated respiratory infection?

    PubMed

    Rodríguez, A; Barcenilla, F

    2015-03-01

    Ventilator-associated tracheobronchitis (VAT) is a frequent complication in critical patients. The 90% of those who develop it receive broad-spectrum antibiotic (ATB) treatment, without any strong evidence of its favorable impact. The use of nebulized ATB could be a valid treatment option, to reduce the use of systemic ATB and the pressure of selection on the local flora. Several studies suggest that an adequate nebulization technique can ensure high levels of ATB even in areas of lung consolidation, and to obtain clinical and microbiological cure. New studies are needed to properly assess the impact of treatment with nebulized ATB on the emergence of resistance. Copyright © 2014 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

  7. Characterization of Surface Acoustic Wave Nebulization: Atomization dynamics and resulting droplet size distribution

    NASA Astrophysics Data System (ADS)

    Clark, Alicia; Aliseda, Alberto; Heron, Scott; Huang, Yue; Goodlett, David

    2012-11-01

    High-speed imaging and Phase Doppler Particle Analyzer (PDPA) measurements are used to characterize the size and velocity distributions of micron-sized droplets produced by a surface acoustic wave (SAW) microelectronic nebulizer. The effects of drop composition, electric field amplitude and pulsation frequency, and initial drop volume have been experimentally studied. We observe that the droplets created in pure water are smaller, ~2 μm, and the plume more concentrated near the nebulizer, with small second probability peak for large diameters, ~100 μm. Pure methanol droplets have larger diameters, ~ 5 μm, and lower volume concentration in the nebulizer plume, as corresponds to less efficient atomization process. The influence of fluid viscosity and surface tension will be discussed. Measurements of the velocity distribution show a strong dependency with excitation amplitude and duty factor.

  8. Comparison of Spraying and Nebulized Lidocaine in Patients Undergoing Esophago-Gastro-Duodenoscopy: A Randomized Trial.

    PubMed

    Noitasaeng, Papiroon; Vichitvejpaisal, Phongthara; Kaosombatwattana, Uaypom; Tassanee, Jaiyen; Suwannee, Siriwongsa

    2016-05-01

    Esophago-gastro-duodenoscopy (EGD) was performed under the topical anesthesia of the pharynx. However spraying lidocaine was found to be an annoying maneuver to patients, while nebulized lidocaine appeared to efficiently suppress gags and cough reflexes in airway anesthesia. This study aimed to compare the effectiveness of spraying and nebulized lidocaine for patients undergoing EGD. A total of 110 patients undergoing elective EGD, with a history of neither lidocaine intolerance nor irritable airways due to smoking, chronic obstructive pulmonary disease (COPD), upper respiratory infection, asthma, cardiac and pulmonary diseases and allergy to lidocaine were included. All patients were randomized into two groups: A- where 5 puffs (10 mg/puff) of spraying lidocaine were administered four times at 5-minute intervals, up to a total dose of 200 mg, and B-where 250 mg of nebulized lidocaine was administered via a nebulization kit with an oxygen face mask of 7 LPM for 15 minutes prior to the commencement of EGD. The procedure was performed by the same board-certified endoscopist The co-researcher who was blinded to the lidocaine administration technique assessed the ease of esophageal instrumentation as either difficult, poor; fair or excellent. Both the endoscopist and the patients expressed their satisfaction by using the numerical rating scale. The endoscopist expressed her satisfaction with instrumentation, which showed significant difference between group A and group B as 84.8 ± 8.3 and 79.2 ± 11.2, respectively. The co-researcher also found that group A patients responded to the ease of esophageal instrumentation better than those in group B. However nebulized lidocaine had significant advantages over spraying lidocaine, with better acceptance in patients undergoing EGD. The endoscopist expressed her approval of spraying lidocaine for taking less time to start the procedure, ease for instrumentation, less gag reflex during the procedure, less presence of

  9. Comparison of Numerical Simulations to Experiments for Atomization in a Jet Nebulizer

    PubMed Central

    Lelong, Nicolas; Vecellio, Laurent; Sommer de Gélicourt, Yann; Tanguy, Christian; Diot, Patrice; Junqua-Moullet, Alexandra

    2013-01-01

    The development of jet nebulizers for medical purposes is an important challenge of aerosol therapy. The performance of a nebulizer is characterized by its output rate of droplets with a diameter under 5 µm. However the optimization of this parameter through experiments has reached a plateau. The purpose of this study is to design a numerical model simulating the nebulization process and to compare it with experimental data. Such a model could provide a better understanding of the atomization process and the parameters influencing the nebulizer output. A model based on the Updraft nebulizer (Hudson) was designed with ANSYS Workbench. Boundary conditions were set with experimental data then transient 3D calculations were run on a 4 µm mesh with ANSYS Fluent. Two air flow rate (2 L/min and 8 L/min, limits of the operating range) were considered to account for different turbulence regimes. Numerical and experimental results were compared according to phenomenology and droplet size. The behavior of the liquid was compared to images acquired through shadowgraphy with a CCD Camera. Three experimental methods, laser diffractometry, phase Doppler anemometry (PDA) and shadowgraphy were used to characterize the droplet size distributions. Camera images showed similar patterns as numerical results. Droplet sizes obtained numerically are overestimated in relation to PDA and diffractometry, which only consider spherical droplets. However, at both flow rates, size distributions extracted from numerical image processing were similar to distributions obtained from shadowgraphy image processing. The simulation then provides a good understanding and prediction of the phenomena involved in the fragmentation of droplets over 10 µm. The laws of dynamics apply to droplets down to 1 µm, so we can assume the continuity of the distribution and extrapolate the results for droplets between 1 and 10 µm. So, this model could help predicting nebulizer output with defined geometrical and

  10. Effects of peritoneal ropivacaine nebulization for pain control after laparoscopic gynecologic surgery.

    PubMed

    Somaini, Marta; Brambillasca, Pietro; Ingelmo, Pablo Mauricio; Lovisari, Federica; Catenacci, Stefano Scalia; Rossini, Valeria; Bucciero, Mario; Sahillioglu, Emre; Buda, Alessandro; Signorelli, Mauro; Gili, Mauro; Joshi, Girish; Fumagalli, Roberto; Ferland, Catherine E; Diemunsch, Pierre

    2014-01-01

    To evaluate the effects of peritoneal cold nebulization of ropivacaine on pain control after gynecologic laparoscopy. Evidence obtained from a properly designed, randomized, double-blind, placebo-controlled trial (Canadian Task Force classification I). Tertiary care center. One hundred thirty-five women with American Society of Anesthesiologists disease classified as ASA I-III who were scheduled to undergo operative laparoscopy. Patients were randomized to receive either nebulization of 30 mg ropivacaine before surgery (preoperative group), nebulization of 30 mg ropivacaine after surgery (postoperative group), instillation of 100 mg ropivacaine before surgery (instillation group), or instillation of saline solution (control group). Nebulization was performed using the Aeroneb Pro device. Pain scores, morphine consumption, and ambulation time were collected in the post-anesthesia care unit and at 4, 6, and 24 hours postoperatively. One hundred eighteen patients completed the study. Patients in the preoperative group reported lower pain Numeric Ranking Scale values compared with those in the control group (net difference 2 points; 95% confidence interval [CI], 0.3-3.1 at 4 hours, 1-3 at 6 hours, and 0.7-3 at 24 hours; p = .01) Patients in the preoperative group consumed significantly less morphine than did those in the control group (net difference 7 mg; 95% CI, 0.7-13; p = .02). More patients who received nebulization walked without assistance within 12 hours after awakening than did those in the instillation and control groups (net difference 15%; 95% CI, 6%-24%; p = .001). Cold nebulization of ropivacaine before surgery reduced postoperative pain and morphine consumption and was associated with earlier walking without assistance. Copyright © 2014 AAGL. Published by Elsevier Inc. All rights reserved.

  11. Intraperitoneal ropivacaine nebulization for pain management after laparoscopic cholecystectomy: a comparison with intraperitoneal instillation.

    PubMed

    Bucciero, Mario; Ingelmo, Pablo M; Fumagalli, Roberto; Noll, Eric; Garbagnati, Andrea; Somaini, Marta; Joshi, Girish P; Vitale, Giovanni; Giardini, Vittorio; Diemunsch, Pierre

    2011-11-01

    Studies evaluating intraperitoneal local anesthetic instillation for pain relief after laparoscopic procedures have reported conflicting results. In this randomized, double-blind study we assessed the effects of intraperitoneal local anesthetic nebulization on pain relief after laparoscopic cholecystectomy. Patients undergoing elective laparoscopic cholecystectomy were randomly assigned to receive either instillation of ropivacaine 0.5%, 20 mL after induction of the pneumoperitoneum, or nebulization of ropivacaine 1%, 3 mL before and after surgery. Anesthetic and surgical techniques were standardized. Degree of pain at rest and on deep breathing, incidence of shoulder pain, morphine consumption, unassisted walking time, and postoperative nausea and vomiting were evaluated at 6, 24, and 48 hours after surgery. Of the 60 patients included, 3 exclusions occurred for conversion to open surgery. There were no differences between groups in pain scores or in morphine consumption. No patients in the nebulization group presented significant shoulder pain in comparison with 83% of patients in the instillation group (absolute risk reduction -83, 95% CI -97 to -70, P<0.001). Nineteen (70%) patients receiving nebulization walked without assistance within 12 hours after surgery in comparison with 14 (47%) patients receiving instillation (absolute risk reduction -24, 95% CI -48 to 1, P=0.04). One (3%) patient in the instillation group vomited in comparison with 6 (22%) patients in the nebulization group (absolute risk reduction -19%, 95% CI -36 to -2, P=0.03). Intraperitoneal ropivacaine nebulization was associated with reduced shoulder pain and unassisted walking time but with an increased incidence of postoperative vomiting after laparoscopic cholecystectomy.

  12. Exhaled air and aerosolized droplet dispersion during application of a jet nebulizer.

    PubMed

    Hui, David S; Chow, Benny K; Chu, Leo C Y; Ng, Susanna S; Hall, Stephen D; Gin, Tony; Chan, Matthew T V

    2009-03-01

    As part of our influenza pandemic preparedness, we studied the dispersion distances of exhaled air and aerosolized droplets during application of a jet nebulizer to a human patient simulator (HPS) programmed at normal lung condition and different severities of lung injury. The experiments were conducted in a hospital isolation room with a pressure of - 5 Pa. Airflow was marked with intrapulmonary smoke. The jet nebulizer was driven by air at a constant flow rate of 6 L/min, with the mask reservoir filled with sterile water and attached to the HPS via a nebulizer mask. The exhaled leakage jet plume was revealed by a laser light sheet and images captured by high-definition video. Smoke concentration in the plume was estimated from the light scattered by smoke and droplet particles. The maximum dispersion distance of smoke particles through the nebulizer side vent was 0.45 m lateral to the HPS at normal lung condition (oxygen consumption, 200 mL/min; lung compliance, 70 mL/cm H(2)O), but it increased to 0.54 m in mild lung injury (oxygen consumption, 300 mL/min; lung compliance, 35 mL/cm H(2)O), and beyond 0.8 m in severe lung injury (oxygen consumption, 500 mL/min; lung compliance, 10 mL/cm H(2)O). More extensive leakage through the side vents of the nebulizer mask was noted with more severe lung injury. Health-care workers should take extra protective precaution within at least 0.8 m from patients with febrile respiratory illness of unknown etiology receiving treatment via a jet nebulizer even in an isolation room with negative pressure.

  13. Comparison of numerical simulations to experiments for atomization in a jet nebulizer.

    PubMed

    Lelong, Nicolas; Vecellio, Laurent; Sommer de Gélicourt, Yann; Tanguy, Christian; Diot, Patrice; Junqua-Moullet, Alexandra

    2013-01-01

    The development of jet nebulizers for medical purposes is an important challenge of aerosol therapy. The performance of a nebulizer is characterized by its output rate of droplets with a diameter under 5 µm. However the optimization of this parameter through experiments has reached a plateau. The purpose of this study is to design a numerical model simulating the nebulization process and to compare it with experimental data. Such a model could provide a better understanding of the atomization process and the parameters influencing the nebulizer output. A model based on the Updraft nebulizer (Hudson) was designed with ANSYS Workbench. Boundary conditions were set with experimental data then transient 3D calculations were run on a 4 µm mesh with ANSYS Fluent. Two air flow rate (2 L/min and 8 L/min, limits of the operating range) were considered to account for different turbulence regimes. Numerical and experimental results were compared according to phenomenology and droplet size. The behavior of the liquid was compared to images acquired through shadowgraphy with a CCD Camera. Three experimental methods, laser diffractometry, phase Doppler anemometry (PDA) and shadowgraphy were used to characterize the droplet size distributions. Camera images showed similar patterns as numerical results. Droplet sizes obtained numerically are overestimated in relation to PDA and diffractometry, which only consider spherical droplets. However, at both flow rates, size distributions extracted from numerical image processing were similar to distributions obtained from shadowgraphy image processing. The simulation then provides a good understanding and prediction of the phenomena involved in the fragmentation of droplets over 10 µm. The laws of dynamics apply to droplets down to 1 µm, so we can assume the continuity of the distribution and extrapolate the results for droplets between 1 and 10 µm. So, this model could help predicting nebulizer output with defined geometrical and

  14. Chromosomal locations of three Bacillus subtilis din genes

    SciTech Connect

    Gillespie, K.; Yasbin, R.E.

    1987-07-01

    Previously isolated DNA damage-inducible (din) genes of Bacillus subtilis have been mapped on the bacterial chromosome by bacteriophage PBS1-mediated transduction. The din genes have been localized to three positions on the B. subtilis map. dinA cotransduction with the hisA locus was 80%, while dinC cotransduction with this marker was about 56%. dinB is unlinked to hisA, but its cotransduction with the dal-1 and purB loci was 84 and 22%, respectively.

  15. Biopharmaceutical Characterization of Nebulized Antimicrobial Agents in Rats: 5. Oseltamivir Carboxylate

    PubMed Central

    Galindo Bedor, Danilo Cesar; Lamarche, Isabelle; Laroche, Julian; Pereira de Santana, Davi; Couet, William

    2016-01-01

    The aim of this study was to determine the biopharmaceutical characteristics of oseltamivir carboxylate (OC) after pulmonary delivery. After OC bolus and intratracheal nebulization (NEB) in rats, blood was collected and bronchoalveolar lavages (BALs) were performed. Epithelial lining fluid (ELF) concentrations were estimated from BAL fluid. The area under the curve (AUC) ratio for ELF to plasma was 842 times higher after NEB than after intravenous (i.v.) administration, indicating that OC nebulization offers a biopharmaceutical advantage over i.v. administration. PMID:27297482

  16. Characterization of a human powered nebulizer compressor for resource poor settings.

    PubMed

    Hallberg, Christopher J; Lysaught, Mary Therese; Zmudka, Christopher E; Kopesky, William K; Olson, Lars E

    2014-06-16

    Respiratory disease accounts for three of the ten leading causes of death worldwide. Many of these diseases can be treated and diagnosed using a nebulizer. Nebulizers can also be used to safely and efficiently deliver vaccines. Unfortunately, commercially available nebulizers are not designed for use in regions of the world where lung disease is most prevalent: they are electricity-dependent, cost-prohibitive, and not built to be reliable in harsh operating conditions or under frequent use.To overcome these limitations, the Human Powered Nebulizer compressor (HPN) was developed. The HPN does not require electricity; instead airflow is generated manually through a hand-crank or bicycle-style pedal system. A health care worker or other trained individual operates the device while the patient receives treatment.This study demonstrates functional specifications of the HPN in comparison with a standard commercially available electric jet nebulizer compressor, the DeVilbiss Pulmo-Aide 5650D (Pulmo-Aide). Pressure and flow characteristics were measured with a rotameter and pressure transducer, respectively. Volume nebulized by each compressor was determined by mass, and particle size distribution was determined via laser diffraction. The Hudson RCI Micro Mist nebulizer mouthpiece was used with both compressors. The pressure and flow generated by the HPN and Pulmo-Aide were: 15.17 psi and 10.5 L/min; and 14.65 psi and 11.2 L/min, respectively. The volume of liquid delivered by each was equivalent, 1.097 ± 0.107 mL (mean ± s.e.m., n = 13) for the HPN and 1.092 ± 0.116 mL for the Pulmo-Aide. The average particle size was also equivalent, 5.38 ± 0.040 micrometers (mean ± s.e.m., n = 7) and 5.40 ± 0.025 micrometers, respectively. Based on these characteristics, the HPN's performance is equivalent to a popular commercially available electric nebulizer compressor. The findings presented in this paper, combined with the results of two

  17. Characterization of a human powered nebulizer compressor for resource poor settings

    PubMed Central

    2014-01-01

    Background Respiratory disease accounts for three of the ten leading causes of death worldwide. Many of these diseases can be treated and diagnosed using a nebulizer. Nebulizers can also be used to safely and efficiently deliver vaccines. Unfortunately, commercially available nebulizers are not designed for use in regions of the world where lung disease is most prevalent: they are electricity-dependent, cost-prohibitive, and not built to be reliable in harsh operating conditions or under frequent use. To overcome these limitations, the Human Powered Nebulizer compressor (HPN) was developed. The HPN does not require electricity; instead airflow is generated manually through a hand-crank or bicycle-style pedal system. A health care worker or other trained individual operates the device while the patient receives treatment. This study demonstrates functional specifications of the HPN in comparison with a standard commercially available electric jet nebulizer compressor, the DeVilbiss Pulmo-Aide 5650D (Pulmo-Aide). Methods Pressure and flow characteristics were measured with a rotameter and pressure transducer, respectively. Volume nebulized by each compressor was determined by mass, and particle size distribution was determined via laser diffraction. The Hudson RCI Micro Mist nebulizer mouthpiece was used with both compressors. Results The pressure and flow generated by the HPN and Pulmo-Aide were: 15.17 psi and 10.5 L/min; and 14.65 psi and 11.2 L/min, respectively. The volume of liquid delivered by each was equivalent, 1.097 ± 0.107 mL (mean ± s.e.m., n = 13) for the HPN and 1.092 ± 0.116 mL for the Pulmo-Aide. The average particle size was also equivalent, 5.38 ± 0.040 micrometers (mean ± s.e.m., n = 7) and 5.40 ± 0.025 micrometers, respectively. Conclusions Based on these characteristics, the HPN’s performance is equivalent to a popular commercially available electric nebulizer compressor. The findings presented in

  18. Nebulized Live-Attenuated Influenza Vaccine Provides Protection in Ferrets at a Reduced Dose

    PubMed Central

    Smith, Jennifer Humberd; Papania, Mark; Knaus, Darin; Brooks, Paula; Haas, Debra L.; Mair, Raydel; Barry, James; Tompkins, S. Mark; Tripp, Ralph A.

    2011-01-01

    Live-attenuated influenza vaccine (LAIV) is delivered to vaccine recipients using a nasal spray syringe. LAIV delivered by this method is immunogenic at current doses; however, improvements in nasal delivery might allow for significant dose reduction. We investigated LAIV vaccination in ferrets using a high efficiency nebulizer designed for nasal delivery. LAIV nasal aerosol elicited high levels of serum neutralizing antibodies and protected ferrets from homologous virus challenge at conventional (107 TCID50) and significantly reduced (103 TCID50) doses. Aerosol LAIV also provided a significant level of subtype-specific cross protection. These results demonstrate the dose-sparing potential of nebulizer-based nasal aerosol LAIV delivery. PMID:22075083

  19. Inhalation of Nebulized Perfluorochemical Enhances Recombinant Adenovirus and Adeno-Associated Virus-Mediated Gene Expression in Lung Epithelium

    PubMed Central

    Beckett, Travis; Bonneau, Laura; Howard, Alan; Blanchard, James; Borda, Juan; Weiner, Daniel J.; Wang, Lili; Gao, Guang Ping; Kolls, Jay K.; Bohm, Rudolf; Liggitt, Denny

    2012-01-01

    Abstract Use of perfluorochemical liquids during intratracheal vector administration enhances recombinant adenovirus and adeno-associated virus (AAV)-mediated lung epithelial gene expression. We hypothesized that inhalation of nebulized perfluorochemical vapor would also enhance epithelial gene expression after subsequent intratracheal vector administration. Freely breathing adult C57BL/6 mice were exposed for selected times to nebulized perflubron or sterile saline in a sealed Plexiglas chamber. Recombinant adenoviral vector was administered by transtracheal puncture at selected times afterward and mice were killed 3 days after vector administration to assess transgene expression. Mice tolerated the nebulized perflubron without obvious ill effects. Vector administration 6 hr after nebulized perflubron exposure resulted in an average 540% increase in gene expression in airway and alveolar epithelium, compared with that with vector alone or saline plus vector control (p<0.05). However, vector administration 1 hr, 1 day, or 3 days after perflubron exposure was not different from either nebulized saline with vector or vector alone and a 60-min exposure to nebulized perflubron is required. In parallel pilot studies in macaques, inhalation of nebulized perflubron enhanced recombinant AAV2/5 vector expression throughout the lung. Serial chest radiographs, bronchoalveolar lavages, and results of complete blood counts and serum biochemistries demonstrated no obvious adverse effects of nebulized perflubron. Further, one macaque receiving nebulized perflubron only was monitored for 1 year with no obvious adverse effects of exposure. These results demonstrate that inhalation of nebulized perflubron, a simple, clinically more feasible technique than intratracheal administration of liquid perflubron, safely enhances lung gene expression. PMID:22568624

  20. Determination of low cadmium concentrations in wine by on-line preconcentration in a knotted reactor coupled to an inductively coupled plasma optical emission spectrometer with ultrasonic nebulization.

    PubMed

    Lara, R F; Wuilloud, R G; Salonia, J A; Olsina, R A; Martinez, L D

    2001-12-01

    An on-line cadmium preconcentration and determination system implemented with inductively coupled plasma optical emission spectrometry (ICP-OES) associated to flow injection (FI) with ultrasonic nebulization system (USN) was studied. The cadmium was retained as the cadmium-2-(5-bromo-2-pyridylazo)-5-diethylaminophenol, Cd-(5-Br-PADAP), complex, at pH 9.5. The cadmium complex was removed from the knotted reactor (KR) with 3.0 mol/L nitric acid. A total enhancement factor of 216 was obtained with respect to ICP-OES using pneumatic nebulization (12 for USN and 18 for KR) with a preconcentration time of 60 s. The value of the detection limit for the preconcentration of 5 mL of sample solution was 5 ng/L. The precision for 10 replicate determinations at the 5 microg/L Cd level was 2.9% relative standard deviation (RSD), calculated from the peak heights obtained. The calibration graph using the preconcentration system for cadmium was linear with a correlation coefficient of 0.9998 at levels near the detection limits up to at least 1,000 microg/L. The method was successfully applied to the determination of cadmium in wine samples.

  1. Strategy of DIN-PACS benchmark testing

    NASA Astrophysics Data System (ADS)

    Norton, Gary S.; Lyche, David K.; Richardson, Nancy E.; Thomas, Jerry A.; Romlein, John R.; Cawthon, Michael A.; Lawrence, David P.; Shelton, Philip D.; Parr, Laurence F.; Richardson, Ronald R., Jr.; Johnson, Steven L.

    1998-07-01

    The Digital Imaging Network -- Picture Archive and Communication System (DIN-PACS) procurement is the Department of Defense's (DoD) effort to bring military medical treatment facilities into the twenty-first century with nearly filmless digital radiology departments. The DIN-PACS procurement is unique from most of the previous PACS acquisitions in that the Request for Proposals (RFP) required extensive benchmark testing prior to contract award. The strategy for benchmark testing was a reflection of the DoD's previous PACS and teleradiology experiences. The DIN-PACS Technical Evaluation Panel (TEP) consisted of DoD and civilian radiology professionals with unique clinical and technical PACS expertise. The TEP considered nine items, key functional requirements to the DIN-PACS acquisition: (1) DICOM Conformance, (2) System Storage and Archive, (3) Workstation Performance, (4) Network Performance, (5) Radiology Information System (RIS) functionality, (6) Hospital Information System (HIS)/RIS Interface, (7) Teleradiology, (8) Quality Control, and (9) System Reliability. The development of a benchmark test to properly evaluate these key requirements would require the TEP to make technical, operational, and functional decisions that had not been part of a previous PACS acquisition. Developing test procedures and scenarios that simulated inputs from radiology modalities and outputs to soft copy workstations, film processors, and film printers would be a major undertaking. The goals of the TEP were to fairly assess each vendor's proposed system and to provide an accurate evaluation of each system's capabilities to the source selection authority, so the DoD could purchase a PACS that met the requirements in the RFP.

  2. Ovine progressive pneumonia virus is transmitted more effectively via aerosol nebulization than oral administration

    USDA-ARS?s Scientific Manuscript database

    A new method of experimental infection of ovine progressive pneumonia virus (OPPV), aerosol nebulization (Nb), was compared to intravenous (IV) and oral (PO) methods of experimental infection. Seven month old lambs were given 3.5 × 107 TCID50 of Dubois OPPV LMH19 isolate using IV, PO, or Nb methods ...

  3. Design, fabrication and test of a microfluidic nebulizer chip for desorption electrospray ionization mass spectrometry

    PubMed Central

    Sen, A K; Darabi, J; Knapp, D R

    2009-01-01

    This paper presents design, microfabrication, and test of a microfluidic nebulizer chip for desorption electrospray ionization mass spectrometry (DESI-MS) in proteomic analysis. The microfluidic chip is fabricated using cyclic olefin copolymer (COC) substrates. The fluidic channels are thermally embossed onto a base substrate using a nickel master and then a top substrate is thermally bonded to seal the channels. Carbon ink embossed into the top COC substrate is used to established electrical connection between the external power supply and the liquid in the channel. The microfluidic chip to external capillary connection is fabricated using Nanoport™ interconnection system. Preliminary leakage test was performed to demonstrate the interconnection system is leak-free and pressure test was performed to evaluate the burst pressure. Finally, the nebulizer chip was used to perform DESI-MS for analyzing peptides (BSA and bradykinin) and reserpine on the nanoporous alumina surface. DESI-MS performance of the microfluidic nebulizer chip is compared with that obtained using a conventional DESI nebulizer. PMID:20161284

  4. Efficacy of nebulized liposomal amphotericin B in treatment of experimental pulmonary aspergillosis.

    PubMed

    Gavaldà, Joan; Martín, María-Teresa; López, Pedro; Gomis, Xavier; Ramírez, José-Luís; Rodríguez, Dolors; Len, Oscar; Puigfel, Yolanda; Ruíz, Isabel; Pahissa, Albert

    2005-07-01

    The efficacy of therapeutic aerosolized amphotericin B (AMB) was studied in a steroid-immunosuppressed murine model of invasive pulmonary aspergillosis. Nebulized liposomal AMB can be a valid approach to the treatment of this infection, with subjects showing significantly improved survival relative to that of subjects given intravenous deoxycholate AMB, as well as lower lung weights and pulmonary glucosamine levels.

  5. ULTRASONIC NEBULIZATION AND ARSENIC VALENCE STATE CONSIDERATIONS PRIOR TO DETERMINATION VIA INDUCTIVELY COUPLED PLASMA MASS SPECTROMETRY

    EPA Science Inventory

    An ultrasonic nebulizer (USN) was utilized as a sample introduction device for an inductively coupled plasma mass spectrometer in an attempt to increase the sensitivity for As. The USN produced a valence state response difference for As. The As response was suppressed approximate...

  6. ULTRASONIC NEBULIZATION AND ARSENIC VALENCE STATE CONSIDERATIONS PRIOR TO DETERMINATION VIA INDUCTIVELY COUPLED PLASMA MASS SPECTROMETRY

    EPA Science Inventory

    An ultrasonic nebulizer (USN) was utilized as a sample introduction device for an inductively coupled plasma mass spectrometer in an attempt to increase the sensitivity for As. The USN produced a valence state response difference for As. The As response was suppressed approximate...

  7. Nebulized Isotonic Saline versus Water following a Laryngeal Desiccation Challenge in Classically Trained Sopranos

    ERIC Educational Resources Information Center

    Tanner, Kristine; Roy, Nelson; Merrill, Ray M.; Muntz, Faye; Houtz, Daniel R.; Sauder, Cara; Elstad, Mark; Wright-Costa, Julie

    2010-01-01

    Purpose: To examine the effects of nebulized isotonic saline (IS) versus sterile water (SW) on self-perceived phonatory effort (PPE) and phonation threshold pressure (PTP) following a surface laryngeal dehydration challenge in classically trained sopranos. Method: In a double-blind, within-subject crossover design, 34 sopranos breathed dry air…

  8. Nebulized sodium cromoglycate in young asthmatic children. Double-blind trial.

    PubMed Central

    Hiller, E J; Milner, A D; Lenney, W

    1977-01-01

    Seventeen asthmatic children under 5 years of age took part in a double-blind controlled trial of nebulized sodium cromoglycate solution. Daily symptom scores kept by the parents showed improvement in 11 children during active treatment, and a significant improvement in scores for cough by day and night was obtained for the group as a whole. PMID:413493

  9. The Effects of Three Nebulized Osmotic Agents in the Dry Larynx

    ERIC Educational Resources Information Center

    Tanner, Kristine; Roy, Nelson; Merrill, Ray M.; Elstad, Mark

    2007-01-01

    Purpose: This investigation examined the effects of nebulized hypertonic saline, isotonic saline (IS), and sterile (hypotonic) water on phonation threshold pressure (PTP) and self-perceived phonatory effort (PPE) following a surface laryngeal dehydration challenge. Method: In a double-blind, randomized experimental trial, 60 vocally healthy women…

  10. Nebulized Fentanyl for Dyspnea in a Hospice Patient with True Allergy to Morphine and Hydromorphone.

    PubMed

    Wahler, Robert G; Smith, David B; Mulcahy, Kimberly B

    2017-03-01

    An 86-year-old white female was admitted to hospice care with lung cancer. Even with optimal medical management, she suffered from dyspnea and required opioid therapy. However, the patient had a true morphine and hydromorphone allergy. She was administered nebulized fentanyl for symptomatic relief of dyspnea with good effect and she did not experience any allergic response.

  11. Effects of Temperature and Humidity on Laser Diffraction Measurements to Jet Nebulizer and Comparison with NGI.

    PubMed

    Song, Xinghan; Hu, Junhua; Zhan, Shuyao; Zhang, Rui; Tan, Wen

    2016-04-01

    Laser diffraction (LD) and next generation impactor (NGI) are commonly used for the evaluation of inhaled drug formulations. In this study, the effect of temperature and humidity on the assessment of the nebulizer particle size distribution (PSD) by LD was investigated, and the consistency between NGI and LD measurements was evaluated. There was an increase in particle size with higher temperature or lower humidity. The particle population with a diameter less than 1 μm was significant at a temperature of 5°C or at relative humidity >90%; however, the same particle population became undetectable when temperature increased to 39°C or at relative humidity of 30-45%. The results of the NGI and LD measurements of aerosol generated from three types of jet nebulizers were compared. A poor correlation between the NGI and LD measurements was observed for PARI LC (2.2 μm) (R (2) = 0.893) and PARI LC (2.9 μm) (R (2) = 0.878), while a relatively good correlation (R (2) = 0.977) was observed for the largest particle size nebulizer (PARI TIA (8.6 μm)). We conclude that the ambient environment and the nebulizer have significant impacts on the performance and consistency between these instruments. These factors should be controlled in the evaluation of inhaled aerosol drug formulations when these instruments are used individually or in combination.

  12. Promoting adherence to nebulized therapy in cystic fibrosis: poster development and a qualitative exploration of adherence

    PubMed Central

    Jones, Stephen; Babiker, Nathan; Gardner, Emma; Royle, Jane; Curley, Rachael; Hoo, Zhe Hui; Wildman, Martin J

    2015-01-01

    Background Cystic fibrosis (CF) health care professionals recognize the need to motivate people with CF to adhere to nebulizer treatments, yet little is known about how best to achieve this. We aimed to produce motivational posters to support nebulizer adherence by using social marketing involving people with CF in the development of those posters. Methods The Sheffield CF multidisciplinary team produced preliminary ideas that were elaborated upon with semi-structured interviews among people with CF to explore barriers and facilitators to the use of nebulized therapy. Initial themes and poster designs were refined using an online focus group to finalize the poster designs. Results People with CF preferred aspirational posters describing what could be achieved through adherence in contrast to posters that highlighted the adverse consequences of nonadherence. A total of 14 posters were produced through this process. Conclusion People with CF can be engaged to develop promotional material to support adherence, providing a unique perspective differing from that of the CF multidisciplinary team. Further research is needed to evaluate the effectiveness of these posters to support nebulizer adherence. PMID:26346635

  13. In vitro characterization of nebulizer delivery of liposomal amphotericin B aerosols.

    PubMed

    Alexander, Barbara D; Winkler, Thomas P; Shi, Shuai; Dodds Ashley, Elizabeth S; Hickey, Anthony J

    2011-01-01

    Pharmaceutical aerosols have the potential to prevent pulmonary infectious diseases. Liposomal amphotericin B (LAMB, Ambisome, Astellas Pharma US, Deerfield, IL, USA) is approved as an intravenous infusion for empiric treatment of presumed fungal infections in neutropenic, febrile patients, as well as patients infected with Aspergillus, Cryptococcus, and other fungal pathogens. In this study, four different nebulizers were tested for their ability to deliver LAMB in aerodynamic droplet-size ranges relevant to lung deposition by an inertial sampling technique Mass median aerodynamic diameter (MMAD) and fine particle fraction percent <3.3 μm (FPF(3.3)) and <5.8 μm (FPF(5.8)) were determined by cascade impaction during a 2 min sampling period for each of three trials of all nebulizers. The MMADs for all nebulizers ranged from 1.72 ± 0.11 μm to 2.89 ± 0.12 μm; FPF(3.3) and FPF(5.8) were approximately 80% and 90%, respectively. Although all nebulizers appear acceptable for delivery of LAMB, the Pari LC Star and the Aeroeclipse II were considered the best in terms of delivery of aerosol efficiently and the proportion suitable for lung deposition. Additional research on pulmonary delivery and clinical tolerability is warranted.

  14. Nebulized Isotonic Saline versus Water following a Laryngeal Desiccation Challenge in Classically Trained Sopranos

    ERIC Educational Resources Information Center

    Tanner, Kristine; Roy, Nelson; Merrill, Ray M.; Muntz, Faye; Houtz, Daniel R.; Sauder, Cara; Elstad, Mark; Wright-Costa, Julie

    2010-01-01

    Purpose: To examine the effects of nebulized isotonic saline (IS) versus sterile water (SW) on self-perceived phonatory effort (PPE) and phonation threshold pressure (PTP) following a surface laryngeal dehydration challenge in classically trained sopranos. Method: In a double-blind, within-subject crossover design, 34 sopranos breathed dry air…

  15. Spacers versus nebulizers in treatment of acute asthma - a prospective randomized study in preschool children.

    PubMed

    Mitselou, Niki; Hedlin, Gunilla; Hederos, Carl-Axel

    2016-12-01

    To compare administration of bronchodilators by nebulizers with delivery by metered dose inhalers (MDIs) with spacers and to evaluate the clinical effect of the treatment of acute asthma in preschool children. A prospective randomized clinical trial in a pediatric emergency department (PED). Preschool children who were admitted for virus induced wheezing or acute asthma exacerbation were randomly allocated to receive bronchodilator treatment by nebulizer or by metered dose inhaler. The accompanying parents completed a questionnaire. The length of stay in the PED and the hospitalization rate were similar and no difference was seen in the parents' view of ease of use and device acceptance. Baseline data were similar for both groups apart from the family history of asthma and atopic disease that was greater in the nebulizer group. No significant differences were seen in heart rate, respiratory rate and oxygen saturation at baseline and after the treatment. According to the parents 40% of the participants had asthma diagnosis though up to 66% had some kind of asthma medication. Our data suggests that MDIs with spacers are at least as effective as nebulizers in the delivery of beta agonists to treat preschool children with virus induced wheezing or acute exacerbations of asthma in the PED. Parents may underestimate the gravity of their children's asthma. It is mandatory to provide adequate information to the staff and parents in order to treat pediatric acute asthma successfully.

  16. Nebulizers or pressurized metered-dose inhalers in the treatment of asthma exacerbations.

    PubMed

    Radzik, Daniele; Peroni, Diego G; Pescollderungg, Lydia; Piacentini, Giorgio L; Chatzimichail, Atanasio; Boner, Attilio L

    2005-01-01

    The use of inhaled beta2-agonists delivered by a metered-dose inhaler (MDI) with a holding chamber (spacer) actually is considered the best treatment for childhood acute asthma. However, its use in daily practice still seems rather limited. The aim of this study was to investigate, using a questionnaire, the use of a nebulizer or MDI as the first-line method for delivering inhaled beta2-agonists in children with acute asthma. A questionnaire was developed and distributed to 22 pediatric departments and to 131 family pediatricians (FPs) in northeast Italy. We showed that in the hospitals the episodes of acute asthma usually were treated with bronchodilators administered by wet nebulization (95.45%). This was the case also for FPs (70.9%). However, 29.1% of FPs usually advised the use of an MDI/holding chamber to children with acute asthma. Despite the established efficacy of inhaled beta2-agonists administrated with an MDI compared with wet nebulization in acute asthma, this practice still is rather limited. The use of wet nebulization was more evident in hospital settings compared with community medicine. Emergency room visits may represent a missed opportunity to promote an effective method of delivering bronchodilators in childhood asthma.

  17. The effect of additional aeration of liquid on the atomization process for a pneumatic nebulizer.

    PubMed

    Ochowiak, M; Matuszak, M

    2017-01-15

    At this paper the effect of aeration on the droplet size distribution of the aerosol have been analyzed. The atomization process was carried out using a pneumatic nebulizer which was equipped with a modified nebulizer cup. This modified nebulizer cup was combined with an additional source of gas bubbles. The measurements of the droplet sizes obtained by the use of the digital microphotography method and analyzed by Image-Pro Plus software. The analysis of the experimental studies proved that an increase in the flow rates of additional gas leads to the increase in the number of small droplets and the decrease of the number of drops of large diameter. Additionally, the mean droplet diameter decreases with the increase of the flow rate of aeration gas. A correlation equation was proposed, which describes the relationship between the mean diameter of droplet and the volumetric flow rate of additional gas. The increase in the bubble volume discharging through a single orifice causes the increase of the flow rate of aeration gas. The modifications of construction of atomizer lead to the better effectiveness of nebulization. Copyright © 2016 Elsevier B.V. All rights reserved.

  18. The Effects of Three Nebulized Osmotic Agents in the Dry Larynx

    ERIC Educational Resources Information Center

    Tanner, Kristine; Roy, Nelson; Merrill, Ray M.; Elstad, Mark

    2007-01-01

    Purpose: This investigation examined the effects of nebulized hypertonic saline, isotonic saline (IS), and sterile (hypotonic) water on phonation threshold pressure (PTP) and self-perceived phonatory effort (PPE) following a surface laryngeal dehydration challenge. Method: In a double-blind, randomized experimental trial, 60 vocally healthy women…

  19. Delivery of albuterol and ipratropium bromide from two nebulizer systems in chronic stable asthma. Efficacy and pulmonary deposition

    SciTech Connect

    Johnson, M.A.; Newman, S.P.; Bloom, R.; Talaee, N.; Clarke, S.W.

    1989-07-01

    Bronchodilator responses to both nebulized albuterol (salbutamol) and ipratropium bromide and aerosol delivery to the tracheobronchial tree have been assessed in eight patients with chronic stable asthma (mean baseline FEV1, 50 percent; reversibility greater than 20 percent). Two commercially available nebulizer systems were used, namely, a Turret nebulizer operated at a compressed gas flow rate of 12 L/min (droplet MMD, 3.3 mu) and an Inspiron nebulizer driven at 6 L/min (MMD, 7.7 mu). Albuterol was given as doses of 250 micrograms, 250 micrograms, 500 micrograms, and 1,000 micrograms (cumulative dose, 2 mg) and ipratropium bromide as doses of 50 micrograms, 50 micrograms, 100 micrograms, and 200 micrograms (cumulative dose, 400 micrograms) at intervals of 35 minutes. For albuterol, bronchodilatation was significantly (p less than 0.05) greater at all dosage levels with the Turret. For ipratropium, bronchodilatation was similar for both nebulizers. Measurements of aerosol deposition using /sup 99m/Tc-labelled pentetic acid (diethylenetriamine pentaacetic acid; DTPA) showed that 9.1 +/- 1.1 percent and 2.7 +/- 0.2 percent of the dose reached the lungs during nebulization to dryness for Turret and Inspiron, respectively (p less than 0.01); distribution within the lungs was similar for the two aerosols. Selection of nebulizer apparatus can influence delivery of aerosol and subsequent bronchodilator response to albuterol in patients with chronic stable asthma but is less important for aerosol delivery of ipratropium bromide in these patients.

  20. In vitro evaluation of positive expiratory pressure devices attached to nebulizers.

    PubMed

    Berlinski, Ariel

    2014-02-01

    Patients with cystic fibrosis perform airway clearance techniques and receive nebulized medications on a regular basis. Some positive expiratory pressure (PEP) devices allow concomitant administration of aerosol. I hypothesized that this practice alters the aerosol characteristics and patient dose. I compared the aerosol characteristics and patient dose of nebulized albuterol from 2 types of nebulizer, alone and when connected to different PEP and vibratory PEP devices. Three units of a continuous-output nebulizer (Up-Draft II Opti-Neb) and 3 units of a breath-enhanced nebulizer (LC Plus) were tested alone and connected to PEP devices (Acapella Choice, Acapella Duet, and EzPAP for Up-Draft II Opti-Neb, and Pari PEP at 2 different settings, and Pari PEP S system with the LC Plus). Aerosol characteristics were evaluated with a cooled cascade impaction technique. The nebulizers were loaded with 2.5 mg/3 mL albuterol solution and operated for 4 min at 6 L/min (wall air). Patient dose was evaluated with simulated breathing patterns for a child, small adult, and large adult. Albuterol was assayed via spectrophotometry. Connecting the LC Plus to the PEP devices did not change the aerosol characteristics or patient dose. Connecting the Up-Draft II Opti-Neb to the PEP devices significantly reduced the mass median aerodynamic diameter, from 4.13 μm to 3.72 μm with EzPAP (P = .02), 1.24 μm with Acapella Choice (P < .001), and 1.22 μm with Acapella Duet (P < .001). The total amount of albuterol captured by the impactor decreased when connected to either Acapella Choice (65%) or Acapella Duet (69%), with 17-25% retained in the PEP devices. Patient dose decreased by 76% and 84% when connected to Acapella Choice and Acapella Duet, respectively. Concomitant use of nebulizer and PEP or vibratory PEP devices that obstruct the aerosol pathway significantly decrease the aerosol particle size and the patient dose.

  1. Impact of atomization technique on the stability and transport efficiency of nebulized liposomes harboring different surface characteristics.

    PubMed

    Lehofer, Bernhard; Bloder, Florian; Jain, Pritesh P; Marsh, Leigh M; Leitinger, Gerd; Olschewski, Horst; Leber, Regina; Olschewski, Andrea; Prassl, Ruth

    2014-11-01

    The objective of this study was to evaluate the impact of nebulization on liposomes with specific surface characteristics by applying three commercially available inhaler systems (air-jet, ultrasonic and vibrating-mesh). Conventional liposome formulations composed of phosphatidylcholine and cholesterol were compared to sterically stabilized PEGylated liposomes and cationic polymer coated liposomes.Liposomes of similar size (between 140 and 165 nm in diameter with polydispersity indices <0.1) were prepared by dry lipid film rehydration followed by size extrusion. Their stability upon nebulization was determined in terms of size, polydispersity index and leakage using a fluorescence quenching system. The transport efficiencies of the nebulizer devices and the influences of both salt and liposomes on the droplet size distribution of the aerosol were investigated. While the droplet size of the aerosol decreased with increasing salt concentration the liposomes had no influence on the droplet size distribution. The output of the nebulizers in terms of liposomal transport efficiencies differed significantly among the nebulizer principles (20–100%, p < 0.05), with the vibrating-mesh nebulizers being the most effective. The integrity of the conventional liposomes was almost unaffected by the atomization process, while polymer coated and especially positively charged liposomes showed enhanced leakage. The release rates for the hydrophilic model drug system were highest for the vibrating-mesh nebulizers regardless of the surface characteristics of the liposomes (increasing from 10% to 20% and 50% for the conventional, PEGylated and positively charged formulations, respectively). In view of surface modified liposomes our data suggest that drug delivery via nebulization necessitates the finding of a compromise between nebulizer efficiency, formulation stability and drug release profile to accomplish the development of tailored formulations suitable for advanced inhalation

  2. Effect of two administration routes of Shenmai Injection () on pulmonary gas exchange function after tourniquet-induced ischemia-reperfusion.

    PubMed

    Jin, Jian-Guo; Shen, Hai-Jian; Shan, Yuan-Lu; Chen, Lei; Zhao, Xi-Yue; Wang, Liang-Rong; Lin, Li-Na

    2017-01-01

    To compare the effect between nebulized and intravenous administration of Shenmai Injection () on pulmonary gas exchange function of patients following tourniquet-induced lower limb ischemia-reperfusion. Thirty-eight patients scheduled for lower extremity surgery were randomized into three groups using the closed envelop method: Shenmai Injection was administered 30 min before tourniquet inflflation by nebulization [0.6 mL/kg in 10 mL normal saline (NS)] in the nebulization group or by intravenous drip (0.6 mL/kg dissolved in 250 mL of 10% glucose) in the intravenous drip group, and equal volume of NS was given intravenously in the NS group; 15 in each group. Arterial blood gases were analyzed, serum levels of malonaldehyde (MDA) and interleukine-6 (IL-6) and interleukine-8 (IL-8) were determined using the method of thiobarbituric acid reaction and enzyme-linked immuno sorbent assay respectively just before tourniquet inflflation (T0), and at 0.5 h (T1), 2 h (T2), 6 h (T3) after tourniquet deflflation. Compared with baselines at T0, MDA levels signifificantly increased at T2, T3 in the NS group and at T3 in the nebulization group, and IL-6 and IL-8 levels were signifificantly increased at T2, T3 in NS, the intravenous drip and the nebulization groups (P <0.05). Arterial pressure of oxygen (PaO2) at T3 was decreased, while alveolararterial oxygen tension showed difference (PA-aDO2) at T3 in the NS group; RI at T3 in both intravenous drip and the nebulization groups were enhanced (P <0.05). Compared with the NS group, MDA and IL-8 levels at T2, T3, IL-6 at T3 in the intravenous drip group, and IL-8 at T3 in the nebulization group were all remarkably increased (P <0.05). Additionally, MDA level at T3 in the nebulization group was higher than that in the intravenous drip group (P <0.05). Intravenous administration of Shenmai Injection provided a better protective effect than nebulization in mitigating pulmonary gas exchange dysfunction in patients following tourniquet

  3. Production of Inhalable Submicrometer Aerosols from Conventional Mesh Nebulizers for Improved Respiratory Drug Delivery

    PubMed Central

    Longest, P. Worth; Spence, Benjamin M.; Holbrook, Landon T.; Mossi, Karla M.; Son, Yoen-Ju; Hindle, Michael

    2012-01-01

    Submicrometer and nanoparticle aerosols may significantly improve the delivery efficiency, dissolution characteristics, and bioavailability of inhaled pharmaceuticals. The objective of this study was to explore the formation of submicrometer and nanometer aerosols from mesh nebulizers suitable for respiratory drug delivery using experiments and computational fluid dynamics (CFD) modeling. Mesh nebulizers were coupled with add-on devices to promote aerosol drying and the formation of submicrometer particles, as well as to control the inhaled aerosol temperature and relative humidity. Cascade impaction experiments were used to determine the initial mass median aerodynamic diameters of 0.1% albuterol aerosols produced by the AeroNeb commercial (4.69 μm) and lab (3.90 μm) nebulizers and to validate the CFD model in terms of droplet evaporation. Through an appropriate selection of flow rates, nebulizers, and model drug concentrations, submicrometer and nanometer aerosols could be formed with the three devices considered. Based on CFD simulations, a wire heated design was shown to overheat the airstream producing unsafe conditions for inhalation if the aerosol was not uniformly distributed in the tube cross-section or if the nebulizer stopped producing droplets. In comparison, a counter-flow heated design provided sufficient thermal energy to produce submicrometer particles, but also automatically limited the maximum aerosol outlet temperature based on the physics of heat transfer. With the counter-flow design, submicrometer aerosols were produced at flow rates of 5, 15, and 30 LPM, which may be suitable for various forms of oral and nasal aerosol delivery. Thermodynamic conditions of the aerosol stream exiting the counter-flow design were found be in a range of 21-45 °C with relative humidity greater than 40% in some cases, which was considered safe for direct inhalation and advantageous for condensational growth delivery. PMID:22707794

  4. Production of Inhalable Submicrometer Aerosols from Conventional Mesh Nebulizers for Improved Respiratory Drug Delivery.

    PubMed

    Longest, P Worth; Spence, Benjamin M; Holbrook, Landon T; Mossi, Karla M; Son, Yoen-Ju; Hindle, Michael

    2012-09-01

    Submicrometer and nanoparticle aerosols may significantly improve the delivery efficiency, dissolution characteristics, and bioavailability of inhaled pharmaceuticals. The objective of this study was to explore the formation of submicrometer and nanometer aerosols from mesh nebulizers suitable for respiratory drug delivery using experiments and computational fluid dynamics (CFD) modeling. Mesh nebulizers were coupled with add-on devices to promote aerosol drying and the formation of submicrometer particles, as well as to control the inhaled aerosol temperature and relative humidity. Cascade impaction experiments were used to determine the initial mass median aerodynamic diameters of 0.1% albuterol aerosols produced by the AeroNeb commercial (4.69 μm) and lab (3.90 μm) nebulizers and to validate the CFD model in terms of droplet evaporation. Through an appropriate selection of flow rates, nebulizers, and model drug concentrations, submicrometer and nanometer aerosols could be formed with the three devices considered. Based on CFD simulations, a wire heated design was shown to overheat the airstream producing unsafe conditions for inhalation if the aerosol was not uniformly distributed in the tube cross-section or if the nebulizer stopped producing droplets. In comparison, a counter-flow heated design provided sufficient thermal energy to produce submicrometer particles, but also automatically limited the maximum aerosol outlet temperature based on the physics of heat transfer. With the counter-flow design, submicrometer aerosols were produced at flow rates of 5, 15, and 30 LPM, which may be suitable for various forms of oral and nasal aerosol delivery. Thermodynamic conditions of the aerosol stream exiting the counter-flow design were found be in a range of 21-45 °C with relative humidity greater than 40% in some cases, which was considered safe for direct inhalation and advantageous for condensational growth delivery.

  5. Nebulized magnesium for moderate and severe pediatric asthma: A randomized trial.

    PubMed

    Alansari, Khalid; Ahmed, Wessam; Davidson, Bruce L; Alamri, Mohamed; Zakaria, Ibrahim; Alrifaai, Mahomud

    2015-12-01

    Intravenous magnesium sulfate, a rescue therapy added to bronchodilator and systemic steroid therapy for moderate and severe asthma, is uncommonly administered. We hypothesized that nebulized magnesium would confer benefit without undue risk. Patients aged 2 to 14 y with moderate and severe asthma (PRAM severity score ≥ 4) admitted to infirmary/observation unit care were randomized double-blind on admission to receive 800 mg nebulized magnesium or normal saline placebo after all received intensive therapy with combined nebulized albuterol-ipratropium and intravenous methylprednisolone. Time to medical readiness for discharge was the primary outcome; sample size was chosen to detect a 15% absolute improvement. Improvement over time in PRAM severity score and other secondary outcomes were compared for the overall group and severe asthma subset. One hundred and ninety-one magnesium sulfates and 174 placebo patients met criteria for analysis. The groups were similar with mean baseline PRAM scores >7. Blinded active therapy significantly increased blood magnesium level 2 hr post-treatment completion compared to placebo, 0.85 vs 0.82 mmol/L, P = 0.001. There were no important adverse effects. Accelerated failure time analysis showed a non-significantly shortened time to medical readiness for discharge of 14% favoring the magnesium sulfate group, OR = 1.14, 95% CI 0.93 to 1.40, P = 0.20. Mean times until readiness for discharge were 14.7 hr [SD 9.7] versus 15.6 hr [SD 11.3] for the investigational and placebo groups, respectively, P = 0.41. Adding nebulized magnesium to combined nebulized bronchodilator and systemic steroid therapy failed to significantly shorten time to discharge of pediatric patients with moderate or severe asthma. © 2015 Wiley Periodicals, Inc.

  6. Concept analysis of Diné Hózhó: a Diné wellness philosophy.

    PubMed

    Kahn-John, Michelle

    2010-01-01

    American Indian Alaska Native people of the United States face challenges in attaining physical, mental, spiritual, and environmental health. This article presents a concept analysis of Diné Hózhó, a complex and misunderstood wellness concept the Diné (Navajo) strive to attain. Findings from a literature review are presented to explore anthropological definitions and uses of the concept Hózhó. The method of concept analysis of Walker and Avant is utilized, model cases are presented. Recommendations for application in nursing practice are presented.

  7. Selection of dinB Alleles Suppressing Survival Loss upon dinB Overexpression in Escherichia coli

    PubMed Central

    Benson, Ryan W.; Cafarelli, Tiziana M.; Rands, Thomas J.; Lin, Ida

    2014-01-01

    Escherichia coli strains overproducing DinB undergo survival loss; however, the mechanisms regulating this phenotype are poorly understood. Here we report a genetic selection revealing DinB residues essential to effect this loss-of-survival phenotype. The selection uses strains carrying both an antimutator allele of DNA polymerase III (Pol III) α-subunit (dnaE915) and either chromosomal or plasmid-borne dinB alleles. We hypothesized that dnaE915 cells would respond to DinB overproduction differently from dnaE+ cells because the dnaE915 allele is known to have an altered genetic interaction with dinB+ compared to its interaction with dnaE+. Notably, we observe a loss-of-survival phenotype in dnaE915 strains with either a chromosomal catalytically inactive dinB(D103N) allele or a low-copy-number plasmid-borne dinB+ upon DNA damage treatment. Furthermore, we find that the loss-of-survival phenotype occurs independently of DNA damage treatment in a dnaE915 strain expressing the catalytically inactive dinB(D103N) allele from a low-copy-number plasmid. The selective pressure imposed resulted in suppressor mutations that eliminated growth defects. The dinB intragenic mutations examined were either base pair substitutions or those that we inferred to be loss of function (i.e., deletions and insertions). Further analyses of selected novel dinB alleles, generated by single-base-pair substitutions in the dnaE915 strain, indicated that these no longer effect loss of survival upon overproduction in dnaE+ strains. These mutations are mapped to specific areas of DinB; this permits us to gain insights into the mechanisms underlying the DinB-mediated overproduction loss-of-survival phenotype. PMID:24914188

  8. Determination of trace elements on polysilicates by ID-ICP-MS with ultrasonic nebulization/membrane desolvation

    SciTech Connect

    Bonchin-Cleland, S.; Olivares, J.A.; Miller, G.G.; Gallegos, L.; Dawson, H.J.

    1996-06-01

    This work investigates the performance of an ID-ICP-MS (isotope dilution-inductively coupled plasma mass spectrometry) system with USN/MD (ultrasonic nebulization/membrane desolvation) sample introduction for the determination of trace metal impurities in polysilicon.

  9. Nebulized albuterol delivery in a model of spontaneously breathing children with tracheostomy.

    PubMed

    Berlinski, Ariel

    2013-12-01

    Nebulized therapy is commonly used in spontaneously breathing tracheostomized patients, despite a lack of recommended devices and techniques. I compared albuterol dose delivered to a model of spontaneously breathing children with tracheostomy, using different nebulizers, tracheostomy tube sizes, inhalation techniques, and breathing patterns. A tracheostomy model was connected in series to a breathing simulator, with a filter interposed. I simulated the breathing patterns of a 16-month-old child and 12-year-old child, and tested tracheostomy tubes with internal diameters of 3.5 mm and 5.5 mm. Albuterol nebulizer solution (2.5 mg/3 mL) was used. A breath-enhanced nebulizer (Pari LC Plus), a breath-actuated nebulizer (AeroEclipse), and a nebulizer that continuously delivers aerosol (Up-Draft II Opti-Neb) were operated for 5 min at 6 L/min with wall air. The Up-Draft II was tested with T-piece and mask interfaces, with an extension tube, and with and without assisted breathing (every breath and every other breath). The amount of albuterol delivered was analyzed via spectrophotometry. Particle size distribution was measured with a cascade impactor. The Pari LC Plus was more efficient than the Up-Draft II or AeroEclipse. Assisted breathing with the Up-Draft II with extension increased albuterol delivery with every other breath (second best device/configuration), being superior to every breath technique. Adding an extension tube increased delivered albuterol. T-piece was more efficient than mask. Breathing patterns with larger tidal volume increased albuterol delivery. Tracheostomy size had less impact on drug delivery. Mass median aerodynamic diameter decreased by 48-74% when passing through the tracheostomy tubes, and 0.8% of the nominal dose was deposited in the tracheostomy tube. Albuterol delivery in a model of spontaneously breathing children with tracheostomy is influenced by type of device and configuration, use of assisted breathing, breathing pattern, and

  10. Nebulized and oral thiol derivatives for pulmonary disease in cystic fibrosis.

    PubMed

    Nash, Edward F; Stephenson, Anne; Ratjen, Felix; Tullis, Elizabeth

    2009-01-21

    Cystic fibrosis is an inherited condition resulting in thickened, sticky respiratory secretions. Respiratory failure, due to recurrent pulmonary infection and inflammation, is the most common cause of mortality. Muco-active therapies (e.g. dornase alfa and nebulized hypertonic saline) may decrease sputum viscosity, increase airway clearance of sputum, reduce infection and inflammation and improve lung function. Thiol derivatives, either oral or nebulized, have shown benefit in other respiratory diseases. Their mode of action is likely to differ according to the route of administration. There are several thiol derivatives, and it is unclear which of these may be beneficial in cystic fibrosis. To evaluate the efficacy and safety of nebulized and oral thiol derivatives in people with cystic fibrosis. We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Trials Register, comprising references identified from comprehensive electronic database searches, hand searches of relevant journals, abstract books and conference proceedings.Most recent search: November 2008. Randomized and quasi-randomized controlled trials comparing nebulized or oral thiol derivatives to placebo or another thiol derivative in people with cystic fibrosis. The authors independently assessed trials for inclusion, analysed methodological quality and extracted data. Searches identified 18 trials; eight (seven older than 10 years) (234 participants) are included. Three trials of nebulized thiol derivatives were identified (one compared 20% n-acetylcysteine to 2% n-acetylcysteine; another compared sodium-2-mercaptoethane sulphonate to 7% hypertonic saline; and another compared glutathione to 4% hypertonic saline). Although generally well-tolerated with no significant adverse effects, there was no evidence of significant clinical benefit in our primary outcomes in participants receiving these treatments.Five studies of oral thiol derivatives were identified. Three studies compared n

  11. Nebulized and oral thiol derivatives for pulmonary disease in cystic fibrosis.

    PubMed

    Tam, Julian; Nash, Edward F; Ratjen, Felix; Tullis, Elizabeth; Stephenson, Anne

    2013-07-12

    Cystic fibrosis is an inherited condition resulting in thickened, sticky respiratory secretions. Respiratory failure, due to recurrent pulmonary infection and inflammation, is the most common cause of mortality. Muco-active therapies (e.g. dornase alfa and nebulized hypertonic saline) may decrease sputum viscosity, increase airway clearance of sputum, reduce infection and inflammation and improve lung function. Thiol derivatives, either oral or nebulized, have shown benefit in other respiratory diseases. Their mode of action is likely to differ according to the route of administration. There are several thiol derivatives, and it is unclear which of these may be beneficial in cystic fibrosis. To evaluate the efficacy and safety of nebulized and oral thiol derivatives in people with cystic fibrosis. We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Trials Register, comprising references identified from comprehensive electronic database searches, hand searches of relevant journals, abstract books and conference proceedings.Most recent search: 13 June 2013.We also conducted a PubMed search on 26 February 2013 for relevant published articles. Randomized and quasi-randomized controlled trials comparing nebulized or oral thiol derivatives to placebo or another thiol derivative in people with cystic fibrosis. The authors independently assessed trials for inclusion, analysed risk of bias and extracted data. Searches identified 23 trials; nine trials (255 participants) are included, of these seven trials are more than 10 years old. Three trials of nebulized thiol derivatives were identified (one compared 20% N-acetylcysteine to 2% N-acetylcysteine; another compared sodium-2-mercaptoethane sulphonate to 7% hypertonic saline; and another compared glutathione to 4% hypertonic saline). Although generally well-tolerated with no significant adverse effects, there was no evidence of significant clinical benefit in our primary outcomes in participants receiving

  12. Etanercept Injection

    MedlinePlus

    ... injection comes as a solution (liquid) in a prefilled syringe and an automatic injection device, and as a ... etanercept injection.If your medication comes in a prefilled syringe or automatic injection device, use each syringe or ...

  13. Improvement on droplet production rate of ultrasonic - nebulizer in spray pyrolysis process

    NASA Astrophysics Data System (ADS)

    Panatarani, Camellia; Demen, Tuti Aryati; Men, Liu Kin; Maulana, Dwindra Wilham; Hidayat, Darmawan; Joni, I. Made

    2013-09-01

    Atomization is an important part in Spray Pyrolysis (SP) process which is applied to synthesize submicron or nano sized particles or to deposit thin film. Ultrasonic Nebulizer (UN) is usually use in SP due to its homogeneous droplets production with size between 1-5 μm. The drawback of the UN is low droplets production rate. In this research, we successfully developed a Digital Ultrasonic Nebulizer (DUN) with high droplets production rate using two ultrasonic traducers with applied frequency of 2.4 MHz. The result of DUN atomization was improved 4-6 fold compare to the conventional UN. The DUN also has an additional digital features such as pushbutton, LCD and microcontroller which is allow to set duration and applied voltage.

  14. Collison nebulizer as a new soft ionization source for mass spectrometry

    NASA Astrophysics Data System (ADS)

    Pervukhin, V. V.; Sheven', D. G.; Kolomiets, Yu. N.

    2016-08-01

    We have proposed that a Collison-type nebulizer be used as an ionization source for mass spectrometry with ionization under atmospheric pressure. This source does not require the use of electric voltage, radioactive sources, heaters, or liquid pumps. It has been shown that the number of ions produced by the 63Ni radioactive source is three to four times larger than the number of ions produced by acoustic ionization sources. We have considered the possibility of using a Collison-type nebulizer in combination with a vortex focusing system as an ion source for extractive ionization of compounds under atmospheric pressure. The ionization of volatile substances in crossflows of a charged aerosol and an analyte (for model compounds of the amine class, viz., diethylaniline, triamylamine, and cocaine) has been investigated. It has been shown that the limit of detecting cocaine vapor by this method is on the level of 4.6 × 10-14 g/cm3.

  15. Production of amorphous nanoparticles by supersonic spray-drying with a microfluidic nebulator

    NASA Astrophysics Data System (ADS)

    Amstad, Esther; Gopinadhan, Manesh; Holtze, Christian; Osuji, Chinedum O.; Brenner, Michael P.; Spaepen, Frans; Weitz, David A.

    2015-08-01

    Amorphous nanoparticles (a-NPs) have physicochemical properties distinctly different from those of the corresponding bulk crystals; for example, their solubility is much higher. However, many materials have a high propensity to crystallize and are difficult to formulate in an amorphous structure without stabilizers. We fabricated a microfluidic nebulator that can produce amorphous NPs from a wide range of materials, even including pure table salt (NaCl). By using supersonic air flow, the nebulator produces drops that are so small that they dry before crystal nuclei can form. The small size of the resulting spray-dried a-NPs limits the probability of crystal nucleation in any given particle during storage. The kinetic stability of the a-NPs—on the order of months—is advantageous for hydrophobic drug molecules.

  16. Online Standard Additions Technique for La-ICP-MS Using a Desolvating Nebulizer System

    NASA Astrophysics Data System (ADS)

    Roy, J.; Asogan, D.; Moody, S.; Clarke, D.

    2014-12-01

    Historically, quantification with laser ablation inductively coupled plasma mass spectrometry (LA-ICP-MS) has been limited to the ability to matrix match both standards and samples. This can prove problematic when a particular matrix matched standard is not readily available. Liquid standard addition has been shown1-4 as an alternative technique for quantification that does not require matrix matching; however, further fundamental study is needed especially considering the different mass flow rates delivered to the plasma from traditional pneumatic nebulizers and laser ablation itself. In this work, the authors combine a specialized low-flow desolvating nebulizer system with LA-ICP-MS. This nebulizer system efficiently removes water vapour, thereby significantly reducing oxide based mass spectral interferences. For the instrument setup, the output from the laser is combined with the dried aerosol from the nebulizer system prior to entering the ICP-MS source. By using two sources of dry aerosol, mixing efficiency is improved whilst minimising plasma power lost to solvent (water vapour) processing. The method was applied to both USGS Green River Shale and an Arkansas Womble Shale. The results showed a number of elements that were correctly quantified using the technique as compared to reference values. References Gunther, D., Cousin, H., Magyar, B., Leopold, I., J. Anal. Atom. Spectrom., 1997, 12, 165 - 170. Leach, J.J., Allen, L. A., Aeschliman, D.B., Houk, R.S., Anal. Chem., 1999, 71, 440 - 445. O'Conner, C.J.P., Sharp, B.L, Evans, P.J., Anal. Atom. Spectrom., 2006, 21, 556. Yang, C.K., Chi, P.H., Lin, Y.C., Sun, Y.C., Yang, M.H., Talanta, 2010, 80, 1222 - 1227.

  17. Biopharmaceutical Characterization of Nebulized Antimicrobial Agents in Rats: 1. Ciprofloxacin, Moxifloxacin, and Grepafloxacin

    PubMed Central

    Gontijo, Aline Vidal Lacerda; Brillault, Julien; Grégoire, Nicolas; Lamarche, Isabelle; Gobin, Patrice; Marchand, Sandrine

    2014-01-01

    The aim of this study was to evaluate the biopharmaceutical characteristics of three fluoroquinolones (FQs), ciprofloxacin (CIP), moxifloxacin (MXF), and grepafloxacin (GRX), after delivery via a nebulized aerosol to rats. Bronchoalveolar lavages (BAL) were conducted 0.5, 2, 4, and 6 h after FQ intravenous administration and nebulized aerosol delivery to estimate epithelial lining fluid (ELF) drug concentrations. Plasma drug concentrations were also measured, and profiles of drug concentrations versus time after intravenous administration and nebulized aerosol delivery were virtually superimposable, attesting for rapid and complete systemic absorption of FQs. ELF drug concentrations were systematically higher than corresponding plasma drug concentrations, whatever the route of administration, and average ELF-to-unbound plasma drug concentration ratios post-distribution equilibrium did not change significantly between the ways of administration and were equal: 4.0 ± 5.3 for CIP, 12.6 ± 7.3 for MXF, and 19.1 ± 10.5 for GRX (means ± standard deviations). The impact of macrophage lysis on estimated ELF drug concentrations was significant for GRX but reduced for MXF and CIP; therefore, simultaneous pharmacokinetic modeling of plasma and ELF drug concentrations was only performed for the latter two drugs. The model was characterized by a fixed volume of ELF (VELF), passive diffusion clearance (QELF), and active efflux clearance (CLout) between plasma and ELF, indicating active efflux transport systems. In conclusion, this study demonstrates that ELF drug concentrations of these three FQs are several times higher than plasma drug concentrations, probably due to the presence of efflux transporters at the pulmonary barrier level, but no biopharmaceutical advantage of FQ nebulization was observed compared with intravenous administration. PMID:24798283

  18. Biopharmaceutical characterization of nebulized antimicrobial agents in rats: 1. Ciprofloxacin, moxifloxacin, and grepafloxacin.

    PubMed

    Gontijo, Aline Vidal Lacerda; Brillault, Julien; Grégoire, Nicolas; Lamarche, Isabelle; Gobin, Patrice; Couet, William; Marchand, Sandrine

    2014-07-01

    The aim of this study was to evaluate the biopharmaceutical characteristics of three fluoroquinolones (FQs), ciprofloxacin (CIP), moxifloxacin (MXF), and grepafloxacin (GRX), after delivery via a nebulized aerosol to rats. Bronchoalveolar lavages (BAL) were conducted 0.5, 2, 4, and 6 h after FQ intravenous administration and nebulized aerosol delivery to estimate epithelial lining fluid (ELF) drug concentrations. Plasma drug concentrations were also measured, and profiles of drug concentrations versus time after intravenous administration and nebulized aerosol delivery were virtually superimposable, attesting for rapid and complete systemic absorption of FQs. ELF drug concentrations were systematically higher than corresponding plasma drug concentrations, whatever the route of administration, and average ELF-to-unbound plasma drug concentration ratios post-distribution equilibrium did not change significantly between the ways of administration and were equal: 4.0 ± 5.3 for CIP, 12.6 ± 7.3 for MXF, and 19.1 ± 10.5 for GRX (means ± standard deviations). The impact of macrophage lysis on estimated ELF drug concentrations was significant for GRX but reduced for MXF and CIP; therefore, simultaneous pharmacokinetic modeling of plasma and ELF drug concentrations was only performed for the latter two drugs. The model was characterized by a fixed volume of ELF (VELF), passive diffusion clearance (QELF), and active efflux clearance (CLout) between plasma and ELF, indicating active efflux transport systems. In conclusion, this study demonstrates that ELF drug concentrations of these three FQs are several times higher than plasma drug concentrations, probably due to the presence of efflux transporters at the pulmonary barrier level, but no biopharmaceutical advantage of FQ nebulization was observed compared with intravenous administration.

  19. Evaluation effects of nebulized gentamicin in exacerbation of chronic obstructive lung disease

    PubMed Central

    Soltaninejad, Forogh; Kheiri, Soleiman; Habibian, Roya; Amra, Arshia; Asgari-Savadjani, Shahin

    2016-01-01

    Background: Chronic obstructive pulmonary disease (COPD) is a major cause of chronic morbidity and mortality throughout the world. Exacerbation of COPD has negative effect on quality of life. Therapeutic effect of nebulized antibiotics in pulmonary infections has been reported previously. Hence, we evaluated the effect of nebulized gentamicin in acute exacerbation of COPD (AECOPD). Materials and Methods: In this clinical trial study, 86 hospitalized patients with AECOPD were divided into two groups for using nebulized gentamicin twice daily (case group) and placebo (control group) for 5 days in addition to standard treatment. On admission and on the 6th day, respiratory rate (RR), white blood cell (WBC), spirometry, and SPO2 (arterial O2 saturation by pulse oxymetry) were measured in groups. The severity of dyspnea was evaluated by the Medical Research Council scale. Results: In both groups, changes of SpO2, RR, forced an expiratory volume of first second (FEV1), and forced vital capacity (FVC) were significant during the times of intervention (P < 0.05). However, changes of FEV1 and FVC were significantly different between two groups (P < 0.05). So that increments of FEV1 and FVC were higher in the case group than control group. WBC decreased significantly in the case group (P < 0.05) compared to control group. There was no significant difference between groups in severity of dyspnea after intervention (P > 0.05). Conclusion: Treatment with Nebulized Gentamicin in AECOPD exacerbation resulted in further improvement of FVC and FEV1 on the 6th day. PMID:27904601

  20. The effects of three nebulized osmotic agents in the dry larynx.

    PubMed

    Tanner, Kristine; Roy, Nelson; Merrill, Ray M; Elstad, Mark

    2007-06-01

    This investigation examined the effects of nebulized hypertonic saline, isotonic saline (IS), and sterile (hypotonic) water on phonation threshold pressure (PTP) and self-perceived phonatory effort (PPE) following a surface laryngeal dehydration challenge. In a double-blind, randomized experimental trial, 60 vocally healthy women (n = 15 per group) underwent a laryngeal desiccation challenge involving oral breathing for 15 min using medical-grade dry air (RH<1%). Three of the four groups then received nebulized isotonic saline (0.9% NaCl), hypertonic saline (7% NaCl), or sterile (hypotonic) water, respectively; the 4th group served as a nontreatment control. PTP and PPE were estimated for high-pitched productions at baseline, immediately postdesiccation, and at 5, 20, 35, and 50 min postnebulization. PTP increased significantly for all groups following the desiccation challenge. PTP values were, on average, 0.5 cm H(2)O greater immediately postdesiccation versus baseline. In contrast, PTP values did not change significantly following the administration of nebulized treatments, although a temporary trend toward a reduction in PTP was observed for the IS group. Unexpectedly, PPE ratings decreased significantly after the desiccation challenge. In general, PPE ratings were poorly correlated with PTP measures. A laryngeal desiccation challenge (i.e., temporary exposure to extremely low relative humidity while breathing transorally) significantly increased PTP. Although interesting trends emerged, none of the nebulized treatments significantly enhanced recovery from the negative effects of desiccation on PTP. In light of very low correlations between PTP and PPE, serious questions are raised regarding presumed associations between these measures.

  1. The effect of prehospital nebulized naloxone on suspected heroin-induced bronchospasm.

    PubMed

    Tataris, Katie L; Weber, Joseph M; Stein-Spencer, Leslee; Aks, Steven E

    2013-04-01

    Snorting or smoking heroin is a known trigger of acute asthma exacerbation. Heroin abuse may be a risk factor for more severe asthma exacerbations and intubation. Heroin and other opioids provoke pulmonary bronchoconstriction. Naloxone may play a role in decreasing opioid-induced bronchospasm. There are no known clinical cases describing the effect of naloxone on opioid-induced bronchospasm. This is an observational study in which nebulized naloxone was administered to patients with suspected heroin-induced bronchospasm. Patients with spontaneous respirations were administered 2 mg of naloxone with 3 mL of normal saline by nebulization. We describe a case series of administrations for suspected heroin-induced bronchospasm. We reviewed 21 administrations of nebulized naloxone to patients with suspected heroin-induced bronchospasm. Of these, 19 patients had a clinical response to treatment documented. Thirteen patients displayed clinical improvement (68%), 4 patients had no improvement (21%), and 2 patients worsened (10%). Of the 2 patients who had clinical decline, none required intubation. Of the patients who improved, 1 patient received only nebulized naloxone and 1 patient received naloxone and albuterol together. Seven patients showed clinical improvement after the administration of albuterol, atrovent, and naloxone together as a combination. Four patients showed additional improvement when the naloxone was administered after the albuterol and atrovent combination. Naloxone may play a role in reducing acute opioid-induced bronchoconstriction, either alone or in combination with albuterol. Future controlled studies should be conducted to determine if the addition of naloxone to standard treatment improves bronchospasm without causing adverse effects. Copyright © 2013 Elsevier Inc. All rights reserved.

  2. Effects of nebulized sodium cromoglycate on adult patients with severe refractory asthma.

    PubMed

    Sano, Yasuyuki; Adachi, Mitsuru; Kiuchi, Takahiro; Miyamoto, Terumasa

    2006-03-01

    Many patients with severe refractory asthma, which is insufficiently controlled by additional high-dose of inhaled corticosteroids, require oral corticosteroids and/or immunosuppressant. Clinicians should seek for suitable medications, for its' chronic use may induce high risk of side effects. The purpose of this study was to evaluate the efficacy and safety of nebulized sodium cromoglycate (3-4 times/day) in adult severe asthmatic patients with poorly controlled asthmatic symptoms, despite treatments with high-dose inhaled corticosteroids. Adult patients with severe asthma (n=251) were enrolled in a randomized clinical trial at 30 medical centers in Japan. Isotonic saline was used as placebo. The study was conducted for 10 weeks; with initial 2 weeks of observation followed by 8 weeks of treatments. Efficacy was primarily evaluated based on improvements in morning peak expiratory flow after treatment. All patients who applied inhalation of nebulized sodium cromoglycate (SCG group) or saline (Controls) were treated with high-dose of inhaled corticosteroids (median of beclomethasone dipropionate equivalent dose: 1600 microg/days) and second-line control therapy including oral corticosteroids. There was no significant difference in morning peak expiratory flow between SCG group and controls. However, when patients were stratified into atopic and non-atopic groups, morning peak expiratory flow had significantly improved in the atopic SCG group compared to atopic Controls. Additional inhalation of nebulized sodium cromoglycate with inhaled corticosteroids is effective even in patients with severe atopic asthma. This finding shows that nebulized sodium cromoglycate is expected to be new second-line therapeutic option in severe asthma.

  3. Nebulized Adrenaline in the Postoperative Management of Brachycephalic Obstructive Airway Syndrome in a Pug.

    PubMed

    Ellis, Jenny; Leece, Elizabeth Ann

    Brachycephalic obstructive airway syndrome is a common problem in certain breeds, and may necessitate surgical procedures, such as rhinoplasty, palatoplasty, laryngeal sacculectomy, and/or arytenoid laryngoplasty, to improve the quality of life. However, laryngeal edema may necessitate the use of temporary tracheostomy tubes postoperatively to maintain a patent airway. This case demonstrates that administration of nebulized adrenaline in the immediate postoperative period where upper airway obstruction is life threatening can be used to reduce edema, therefore avoiding the need for tracheostomy.

  4. Electrolyte type and nozzle composition affect the process of vibrating-membrane nebulization.

    PubMed

    Beck-Broichsitter, Moritz; Oesterheld, Nina

    2017-10-01

    The size of airborne particles determines their deposition pattern within the lungs and therefore, the efficacy of inhalation therapy. The present study analyzed factors affecting liquid atomization performed by vibrating-membrane technology. First, the process of vibrating-membrane nebulization (eFlow®rapid and Aeroneb® Pro) was challenged with numerous inorganic salts and active pharmaceutical ingredients. All investigated samples caused a sigmoidal decrease in aerosol droplet size upon an increase in concentration. Calculated dose-effect curve characteristics (i.e., half maximal effective sample concentration inducing a halfway drop of the droplet size) indicated distinct molar "potency" amongst the utilized samples with respect to generation of "adequate" inhalation aerosols. Second, the employed solvent (aqueous vs. organic) was shown to amplify the electrolyte effect on vibrating-membrane technology (i.e., dose-effect curve characteristics and overall aerosol droplet size). Third, besides the sample and solvent type, the nozzle composition (diverse metal and polymer coatings) induced a strong impact on the current mode of nebulization. Here, coating materials were identified, which necessitated higher and lower electrolyte concentrations in order to decrease the aerosol droplet size in comparable manner to plain nebulizer membranes. Thus, depending on the employed sample type and concentration, solvent and nozzle composition, a delivery of "inadequate" or "adequate" aerosols for inhalation purpose was observed. Overall, the current observations could be used to compile suggestions for the rational design of aerosol formulations and nebulizer devices meeting the specific requirements for successful inhalation therapy. Copyright © 2017 Elsevier B.V. All rights reserved.

  5. Effect of magnesium sulfate nebulization on the incidence of postoperative sore throat

    PubMed Central

    Yadav, Monu; Chalumuru, Nitish; Gopinath, Ramachandran

    2016-01-01

    Background and Aims: Postoperative sore throat (POST) is a well-recognized complication after general anesthesia (GA). Numerous nonpharmacological and pharmacological measures have been used for attenuating POST with variable success. The present study was conducted to compare the efficiency of preoperative nebulization of normal saline and magnesium sulfate in reducing the incidence of POST following GA. Materials and Methods: Following institutional ethical committee approval and written informed consent, a prospective randomized double-blinded study was conducted in 100 cases divided into two equal groups. Patients included in the study were of either gender belonging to American Society of Anesthesiologist (ASA) status 1 or 2 undergoing elective surgery of approximately 2 h or more duration requiring tracheal intubation. Patients in Group A are nebulized with 3 ml of normal saline and the patients in Group B are nebulized with 3 ml of 225 mg isotonic nebulized magnesium sulfate for 15 min, 5 min before induction of anesthesia. The incidence of POST at rest and on swallowing and any undue complaints at 0, 2, 4, and 24 h in the postoperative period are evaluated. Results: There is no significant difference in POST at rest during 0th, 2nd and 4th h between normal saline and MgSO4. Significant difference is seen at 24th h, where MgSO4 lessens POST. There is no significant difference in POST on swallowing during 0th and 2nd h between normal saline and MgSO4. Significant difference is seen at 4th h, where MgSO4 has been shown to lessen POST. Conclusions: MgSO4 significantly reduces the incidence of POST compared to normal saline. PMID:27275043

  6. Development of a liposome-based formulation for vitamin K1 nebulization on the skin

    PubMed Central

    Campani, Virginia; Marchese, Dario; Pitaro, Maria Teresa; Pitaro, Michele; Grieco, Paolo; De Rosa, Giuseppe

    2014-01-01

    Vitamin K1 (VK1) is a very lipophilic and photosensitive molecule contained in some vegetables. Recently, the use of VK1 on the skin has been proposed for different pharmaceutical or cosmeceutical applications. In this study, an innovative strategy for the administration of VK1 on the skin was proposed. In particular, to overcome the drawbacks associated with a VK1-containing fatty ointment available on the market, an aqueous formulation suitable to be administered by nebulization was developed. The use of liposomes encapsulating VK1 enabled issues due to the lipophilicity of VK1 to be overcome. Thus, different liposomal formulations, with different VK1 concentrations, were prepared and characterized in terms of size, zeta potential, VK1 encapsulation into liposomes, and stability of the formulations during storage. After a first phase of screening, the selected formulation was tested by a portable device for nebulization. No alteration of the vesicle characteristics following the liposome supply through the nebulizer was found. Finally, permeation studies were carried out on pig-excised skin in Franz cells and the newly developed formulation was compared to a marketed VK1-containing ointment. In this test, an enhanced VK1 accumulation into the skin was found when using nebulized liposomes. In conclusion, in order to administer VK1 on the skin, the newly developed formulation could be a valid alternative to the products available on the market today. In particular, the use of liposomes could facilitate the multiple administrations per day by aerosol, but also increase, compared to a semi-solid preparation, the accumulation of VK1 into the epidermis and dermis. PMID:24748792

  7. Clinical use of nebulized budesonide inhalation suspension in a child with asthma.

    PubMed

    Skoner, D P; Angelini, B L; Friday, G; Gentile, D

    1999-10-01

    Childhood asthma contributes to significant morbidity among patients and significantly impacts the quality of life and daily routines of their caregivers. The parents or caregivers assume responsibility for tasks that children are too young to perform; this often includes daily administration of controller medications and nightly administration of reliever medications. Most young children do not have the coordination or understanding to effectively use pressurized metered-dose inhalers or inhalation-driven devices; thus nebulizer therapy often is preferred for children younger than 4 years of age. Budesonide inhalation suspension will be the first inhaled corticosteroid available for children younger than 4 years of age and the first inhaled corticosteroid for delivery by nebulization in the United States. This is a case report of a 3-year-old boy who received budesonide inhalation suspension as part of several double-blind and open-label studies evaluating the drug. Before study entry, the boy was experiencing more breakthrough wheezing episodes at night than the parents were used to, resulting in an increase in nighttime awakenings that required nebulizer therapy. These nighttime awakenings had a substantial impact on the quality of life of the entire family and interfered with the parents' ability to function at work. Even though they wanted to have more children, this situation discouraged them from doing so. Budesonide inhalation suspension improved overall asthma control and was well tolerated. The boy had a decrease in nighttime symptoms and an increase in both height and weight percentiles for his age. Importantly, use of budesonide inhalation suspension in this boy eased the management of severe asthma and improved the quality of life of the entire family. The parents subsequently decided to have a second child. Budesonide inhalation suspension represents a major breakthrough for infants and young children by providing a formulation that, on approval, can

  8. Use of nebulized budesonide in two critical patients with hydrocarbon intoxication.

    PubMed

    Gurkan, Fuat; Bosnak, Mehmet

    2005-01-01

    Reports of acute naphtha (a petroleum distillate) intoxication, particularly those containing treatment and toxicological data, are poorly verified in the literature. Systemic steroids have not usually been advised for routine management, but no previous studies have been reported on the effects of corticosteroid inhalations. In this study, two critical pediatric patients with chemical pneumonia due to naphtha ingestion have been reported who were effectively managed with nebulized budesonide.

  9. An evaluation of different steam disinfection protocols for cystic fibrosis nebulizers.

    PubMed

    Hohenwarter, K; Prammer, W; Aichinger, W; Reychler, G

    2016-01-01

    Contamination is a key element in cystic fibrosis. For this reason, nebulizer hygiene is an important, but complex and time-consuming task for cystic fibrosis patients. The aim of this study was to compare different steam disinfection and drying protocols. One hundred nebulizer parts were inoculated with cystic fibrosis-related bacteria in high concentrations (Burkholderia multivorans 3.9 × 10(10)/ml, Staphylococcus aureus 8.9 × 10(8/)ml and Pseudomonas aeruginosa 2.1 × 10(9)/ml). Tubes with Mycobacterium abscessus complex were additionally tested. Six steam disinfectors were compared. Different methods of drying were examined. All tested bacteria were efficiently killed by the different steam disinfectors tested. The risk of contamination depended on the method of drying. Steam disinfection is a safe disinfection method. It is better to leave the nebulizers wet after steam disinfection than to manipulate them by active drying, which seems to be a source of recontamination. Copyright © 2015 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved.

  10. [Difference of lung deposition rate of disodium cromoglycate (DSCG) among three kinds of electric nebulizer].

    PubMed

    Murayama, N; Kameda, M; Takamatsu, I; Inoue, T; Doi, S; Toyoshima, K

    1996-01-01

    We examined the lung deposition rate of DSCG with three kinds of electric nebulizer (NE-U03, Pari-Master, Nisshou) on 5 pediatrician skilled with inhalation therapy (31-54 years of age). Excretion of DSCG for 4 hours after inhalation in urine were highest in NE-U03 group, second in Pari-Master group and least in Nisshou group. And then we studied bronchodilating effect of sulbutamol on 18 children (7-17 years of age) with acute exacerbation of bronchial asthma with NE-U03 and Pari-Master. Asthmatic symptom score, SaO2 and pulmonary function were examined before and after inhalation. The delta %FVC, delta %FEV1.0, delta %PEF, delta %V50 and delta %V25 using NE-U03 were 10.3%, 19.1%, 25.5%, 32.5%, and 29.3% in NE-U03 group and 10.6%, 15.9%, 24.1%, 25.4% and 21.3% in Pari-Master group. The data of pulmonary obstraction in NE-03 group were better than that in Pari-Master group. From our data it is obvious that 3 kinds of electric nebulizers have different efficacy in regard to the lung deposition dose of inhaled drugs. When we compare the efficacy of drugs. When we compare the efficacy of drugs for nebulizer inhalation therapy, we should use the drug dose attained to lung and not nominal drug dose in principle.

  11. Effect of formulation on the stability and aerosol performance of a nebulized antibody

    PubMed Central

    Respaud, Renaud; Marchand, Denis; Parent, Christelle; Pelat, Thibaut; Thullier, Philippe; Tournamille, Jean-François; Viaud-Massuard, Marie-Claude; Diot, Patrice; Si-Tahar, Mustapha; Vecellio, Laurent; Heuzé-Vourc’h, Nathalie

    2014-01-01

    Most monoclonal antibodies (mAbs) are administered to patients intravenously to ensure high bioavailability as rapidly as possible. The airways, however, are an attractive delivery route for mAbs for the treatment of lung diseases, making it possible to increase their concentration in the target organ while limiting their systemic passage. Several challenges must be overcome for translation into clinical practice. For example, the drug and device must be paired for the efficient and reliable deposition of a pharmacologically active and safe mAb in the lung region of interest. Mesh nebulizers appear to be the most effective aerosol-producing devices for delivering large amounts of biopharmaceutical while limiting protein instability during nebulization. We used metrological and analytic methods to analyze the effect of both antibody concentration and surfactant addition on aerosol performance and antibody integrity. These two factors had a limited effect on aerosol performance, but affected antibody aggregation. The addition of surfactants to antibody formulations at concentrations appropriate for lung administration markedly reduced the formation of medium or large aggregates, as shown by dynamic light scattering and fluorescence microscopy. Aggregation was also dependent on the type of mesh nebulizer, highlighting the need to optimize drug and device together. PMID:25517319

  12. Effect of formulation on the stability and aerosol performance of a nebulized antibody.

    PubMed

    Respaud, Renaud; Marchand, Denis; Parent, Christelle; Pelat, Thibaut; Thullier, Philippe; Tournamille, Jean-François; Viaud-Massuard, Marie-Claude; Diot, Patrice; Si-Tahar, Mustapha; Vecellio, Laurent; Heuzé-Vourc'h, Nathalie

    2014-01-01

    Most monoclonal antibodies (mAbs) are administered to patients intravenously to ensure high bioavailability as rapidly as possible. The airways, however, are an attractive delivery route for mAbs for the treatment of lung diseases, making it possible to increase their concentration in the target organ while limiting their systemic passage. Several challenges must be overcome for translation into clinical practice. For example, the drug and device must be paired for the efficient and reliable deposition of a pharmacologically active and safe mAb in the lung region of interest. Mesh nebulizers appear to be the most effective aerosol-producing devices for delivering large amounts of biopharmaceutical while limiting protein instability during nebulization. We used metrological and analytic methods to analyze the effect of both antibody concentration and surfactant addition on aerosol performance and antibody integrity. These two factors had a limited effect on aerosol performance, but affected antibody aggregation. The addition of surfactants to antibody formulations at concentrations appropriate for lung administration markedly reduced the formation of medium or large aggregates, as shown by dynamic light scattering and fluorescence microscopy. Aggregation was also dependent on the type of mesh nebulizer, highlighting the need to optimize drug and device together.

  13. Epinephrine Improves the Efficacy of Nebulized Hypertonic Saline in Moderate Bronchiolitis: A Randomised Clinical Trial.

    PubMed

    Flores-González, J Carlos; Matamala-Morillo, Miguel A; Rodríguez-Campoy, Patricia; Pérez-Guerrero, Juan J; Serrano-Moyano, Belén; Comino-Vazquez, Paloma; Palma-Zambrano, Encarnación; Bulo-Concellón, Rocio; Santos-Sánchez, Vanessa; Lechuga-Sancho, Alfonso M

    2015-01-01

    There is no evidence that the epinephrine-3% hypertonic saline combination is more effective than 3% hypertonic saline alone for treating infants hospitalized with acute bronchiolitis. We evaluated the efficacy of nebulized epinephrine in 3% hypertonic saline. We performed a randomized, double-blind, placebo-controlled clinical trial in 208 infants hospitalized with acute moderate bronchiolitis. Infants were randomly assigned to receive nebulized 3% hypertonic saline with either 3 mL of epinephrine or 3 mL of placebo, administered every four hours. The primary outcome measure was the length of hospital stay. A total of 185 infants were analyzed: 94 in the epinephrine plus 3% hypertonic saline group and 91 in the placebo plus 3% hypertonic saline group. Baseline demographic and clinical characteristics were similar in both groups. Length of hospital stay was significantly reduced in the epinephrine group as compared with the placebo group (3.94 ±1.88 days vs. 4.82 ±2.30 days, P = 0.011). Disease severity also decreased significantly earlier in the epinephrine group (P = 0.029 and P = 0.036 on days 3 and 5, respectively). In our setting, nebulized epinephrine in 3% hypertonic saline significantly shortens hospital stay in hospitalized infants with acute moderate bronchiolitis compared to 3% hypertonic saline alone, and improves the clinical scores of severity from the third day of treatment, but not before. EudraCT 2009-016042-57.

  14. [Efficacy and safety of nebulized L-epinephrine associated with dexamethasone in postintubation laringitis

    PubMed

    Fernandes, I C; Fernandes, J C; Cordeiro, A; Hsin, S H; Bousso, A; Ejzenberg, B; Okay, Y

    2001-01-01

    OBJECTIVE: To assess the efficacy and safety of the use of nebulized L-epinephrine associated with dexamethasone in postintubation laryngitis. METHODS: We carried out a prospective, randomized, double-blind, placebo controlled study with two cohorts of patients with postintubation laryngitis graded 3 to 6 by Downes-Raphaelly score during two years. Our population was divided into two groups: A and B; both groups received intravenous dexamethasone and two doses of nebulized saline; however, only group B received L-epinephrine. The efficacy was assessed by Downes-Raphaelly score. The side effects of L-epinephrine were evaluated according to the occurrence of cardiac arrhythmia, increased blood pressure, and average heart rate of group B in comparison to group A. RESULTS: Twenty-two patients were included in group A (average score = 4.8) and 19 in group B (average score = 5.2). During treatment, 3 patients in group A presented a score of 8 and were reintubated. This group also showed higher mean clinical scores than group B during the first two hours of the protocol; these results were not statistically significant. No side effects were observed due to epinephrine. The gas blood measurements were adequate in both groups, but better in the control group. CONCLUSIONS: We did not observe increased efficacy for the treatment of postintubation laryngitis when nebulized L-epinephrine was used simultaneously with intravenous dexamethasone. Some indicators, however, did present a favorable trend when combined therapy was used and should be submitted to further evaluation.

  15. Enhancement of pneumatic nebulization efficiency through application of an electric field.

    PubMed

    Savage, R N; Hieftje, G M

    1978-10-01

    A technique is described for reducing the size of aerosol droplets produced by a pneumatic nebulizer of the kind commonly used in flame or plasma spectrometry. The technique involves the application of an electric field to the tip of the nebulizer, resulting in an induced surface charge on the liquid being nebulized. In turn, the surface charge reduces the liquid's surface tension and results in the generation of a finer aerosol. In this study, the effect of the electric field is quantified in terms of the spatial dispersion and size distribution of aerosol droplets formed in the presence and absence of the field. Droplet size distributions, obtained using the MgO impression technique and analyzed using log-normal and upper-limit functions, reveal a 63% decrease in the volume mean droplet diameter in the field's presence. As a result, this system is expected to be useful in both flame and plasma spectrometry, where reduced droplet size can yield improved precision and freedom from interferences.

  16. Epinephrine Improves the Efficacy of Nebulized Hypertonic Saline in Moderate Bronchiolitis: A Randomised Clinical Trial

    PubMed Central

    Comino-Vazquez, Paloma; Palma-Zambrano, Encarnación; Bulo-Concellón, Rocio; Santos-Sánchez, Vanessa

    2015-01-01

    Background and Aims There is no evidence that the epinephrine-3% hypertonic saline combination is more effective than 3% hypertonic saline alone for treating infants hospitalized with acute bronchiolitis. We evaluated the efficacy of nebulized epinephrine in 3% hypertonic saline. Patients and Methods We performed a randomized, double-blind, placebo-controlled clinical trial in 208 infants hospitalized with acute moderate bronchiolitis. Infants were randomly assigned to receive nebulized 3% hypertonic saline with either 3 mL of epinephrine or 3 mL of placebo, administered every four hours. The primary outcome measure was the length of hospital stay. Results A total of 185 infants were analyzed: 94 in the epinephrine plus 3% hypertonic saline group and 91 in the placebo plus 3% hypertonic saline group. Baseline demographic and clinical characteristics were similar in both groups. Length of hospital stay was significantly reduced in the epinephrine group as compared with the placebo group (3.94 ±1.88 days vs. 4.82 ±2.30 days, P = 0.011). Disease severity also decreased significantly earlier in the epinephrine group (P = 0.029 and P = 0.036 on days 3 and 5, respectively). Conclusions In our setting, nebulized epinephrine in 3% hypertonic saline significantly shortens hospital stay in hospitalized infants with acute moderate bronchiolitis compared to 3% hypertonic saline alone, and improves the clinical scores of severity from the third day of treatment, but not before. Trial Registration EudraCT 2009-016042-57 PMID:26575036

  17. Effects of nebulized nitroprusside on pulmonary and systemic hemodynamics during pulmonary hypertension in piglets.

    PubMed

    Meadow, W; Rudinsky, B; Bell, A; Hipps, R

    1998-08-01

    We tested the effects of nebulized nitroprusside (Neb-NP) on pulmonary and systemic hemodynamics during pulmonary hypertension induced by hypoxia or group B streptococci infusion in piglets. Twenty-three anesthetized and mechanically ventilated piglets received Neb-NP under four experimental conditions: 1) normoxia; 2) 15 and 60 min of pulmonary hypertension induced by hypoxia; 3) after pretreatment with dipyridamole; 4) pulmonary hypertension induced by infusion of group B streptococci. In addition, Neb-NP was contrasted to nebulization of tolazoline. During hypoxia-induced pulmonary hypertension, Neb-NP significantly reduced pulmonary artery pressure [PAP; -8.4+/-0.9 (SEM) mm Hg] and pulmonary vascular resistance (-25+/-2.1%) (both p < 0.001), whereas neither systemic arterial pressure nor cardiac output changed significantly. Selective pulmonary vasodilation began within 2 min of the onset of Neb-NP, and did not wane over 1 h. In contrast, within 5 min after Neb-NP was discontinued while hypoxia persisted, PAP rose significantly. Pretreatment with dipyridamole did not enhance the pulmonary vasodilation induced by Neb-NP, but did reduce systemic arterial pressure. Nebulized tolazoline did not reduce PAP significantly, but did lower systemic arterial pressure. Selective pulmonary vasodilation induced by Neb-NP was significantly smaller during group B streptococci-induced versus hypoxia-induced pulmonary hypertension. In sum, Neb-NP produced prompt, significant, selective reduction of PAP in piglets with pulmonary hypertension. Cautious extrapolation of these findings to selected clinical conditions in human infants may be warranted.

  18. Effect of ultrasonic nebulization on arterial oxygen saturation in chronic obstructive pulmonary disease.

    PubMed

    Flick, M R; Moody, L E; Block, A J

    1977-03-01

    Twenty patients with mild to severe chronic obstructive pulmonary disease received ultrasonic nebulization to assess the danger of short-term changes in blood gas levels during this therapy. The status of arterial oxygenation was monitored during 20 minutes of therapy and for 20 minutes following therapy. In nine patients with periodic studies of arterial blood, the mean change in arterial oxygen pressure from base line was a decrease of 0.8 mm Hg at ten minutes into therapy, 2.8 mm Hg at the conclusion of therapy, and 2.9 mm Hg 20 minutes after therapy. In all 20 patients, ear oximetric studies showed only a small mean change at ten minutes into therapy, at the end of therapy, and at 20 minutes after therapy. Changes in the status of arterial oxygenation during and after therapy with ultrasonic nebulization in a group of patients with chronic obstructive pulmonary disease are generally small and of no statistical and limited clinical significance; however, alarming falls in arterial oxygenation can occur and cannot be predicted by base-line testing of pulmonary function or studies of arterial blood. It would be prudent to monitor patients with chronic obstructive pulmonary disease during therapy with ultrasonic nebulization or to withhold therapy altogether.

  19. Efficiency of a New Mesh-Type Nebulizer (NE-SM1 NEPLUS) for Intrapulmonary Delivery of Ipratropium Bromide in Surgical Patients.

    PubMed

    Lee, Yong-Hun; Kwon, Gu-Youn; Park, Do-Yang; Bang, Ji-Yeon; Jang, Dong-Min; Lee, Soo-Han; Lee, Eun-Kyung; Choi, Byung-Moon; Noh, Gyu-Jeong

    2016-04-01

    This study was aimed to evaluate the efficiency of a new mesh-type nebulizer for the intrapulmonary delivery of ipratropium bromide in surgical patients under mechanical ventilation. A total of 20 patients were randomly allocated to receive 0.5 mg ipratropium bromide using either a control (Pariboy SX, Pari, Co., Starnberg, Germany, n = 10) or test (NE-SM1 NEPLUS, KTMED INC., Seoul, Korea, n = 10) nebulizer during general anaesthesia. Ipratropium bromide was nebulized continuously for 20 min. in each group. Plasma concentrations of ipratropium bromide were obtained from blood samples at preset intervals. Non-compartmental analysis of ipratropium bromide was performed to compare the efficiency of pulmonary drug delivery in both nebulizers. Population pharmacokinetic analysis of ipratropium bromide was performed. Additionally, the noise level during the nebulizer operation and the aerosol particle size for each device were measured. The dose-normalized AUC(last) was 0.10 min/L for both nebulizers. The pharmacokinetics of nebulized ipratropium bromide can be described best by a one-compartment model with first-order absorption. The apparent volume of distribution and metabolic clearance were 1340 L and 6.78 L/min, respectively. Type of nebulizer was a significant covariate for absorption rate constant. The equivalent sound level and median aerosol particle diameter were 35.0 dB and 4.52 μm for the test nebulizer, and 60.2 dB and 3.85 μm for the control nebulizer, respectively. From the standpoint of the dose-normalized AUC(last) , a new vibrating mesh-type nebulizer shows similar performance in the intrapulmonary delivery of ipratropium bromide to that of a jet-type nebulizer in surgical patients.

  20. Effect of mask dead space and occlusion of mask holes on delivery of nebulized albuterol.

    PubMed

    Berlinski, Ariel

    2014-08-01

    Infants and children with respiratory conditions are often prescribed bronchodilators. Face masks are used to facilitate the administration of nebulized therapy in patients unable to use a mouthpiece. Masks incorporate holes into their design, and their occlusion during aerosol delivery has been a common practice. Masks are available in different sizes and different dead volumes. The aim of this study was to compare the effect of different degrees of occlusion of the mask holes and different mask dead space on the amount of nebulized albuterol available at the mouth opening in a model of a spontaneously breathing child. A breathing simulator mimicking infant (tidal volume [VT] = 50 mL, breathing frequency = 30 breaths/min, inspiratory-expiratory ratio [I:E] = 1:3), child (VT = 155 mL, breathing frequency = 25 breaths/min, I:E = 1:2), and adult (VT = 500 mL, breathing frequency = 15 breaths/min, I:E = 1:2) breathing patterns was connected to a collection filter hidden behind a face plate. A pediatric size mask and an adult size mask connected to a continuous output jet nebulizer were sealed to the face plate. Three nebulizers were loaded with albuterol sulfate (2.5 mg/3 mL) and operated with 6 L/min compressed air for 5 min. Experiments were repeated with different degrees of occlusion (0%, 50%, and 90%). Albuterol was extracted from the filter and measured with a spectrophotometer at 276 nm. Occlusion of the holes in the large mask did not increase the amount of albuterol in any of the breathing patterns. The amount of albuterol captured at the mouth opening did not change when the small mask was switched to the large mask, except with the breathing pattern of a child, and when the holes in the mask were 50% occluded (P = .02). Neither decreasing the dead space of the mask nor occluding the mask holes increased the amount of nebulized albuterol captured at the mouth opening.

  1. Dynamics of aerosol size during inhalation: hygroscopic growth of commercial nebulizer formulations.

    PubMed

    Haddrell, Allen E; Davies, James F; Miles, Rachael E H; Reid, Jonathan P; Dailey, Lea Ann; Murnane, Darragh

    2014-03-10

    The size of aerosol particles prior to, and during, inhalation influences the site of deposition within the lung. As such, a detailed understanding of the hygroscopic growth of an aerosol during inhalation is necessary to accurately model the deposited dose. In the first part of this study, it is demonstrated that the aerosol produced by a nebulizer, depending on the airflows rates, may experience a (predictable) wide range of relative humidity prior to inhalation and undergo dramatic changes in both size and solute concentration. A series of sensitive single aerosol analysis techniques are then used to make measurements of the relative humidity dependent thermodynamic equilibrium properties of aerosol generated from four common nebulizer formulations. Measurements are also reported of the kinetics of mass transport during the evaporation or condensation of water from the aerosol. Combined, these measurements allow accurate prediction of the temporal response of the aerosol size prior to and during inhalation. Specifically, we compare aerosol composed of pure saline (150 mM sodium chloride solution in ultrapure water) with two commercially available nebulizer products containing relatively low compound doses: Breath®, consisting of a simple salbutamol sulfate solution (5 mg/2.5 mL; 1.7 mM) in saline, and Flixotide® Nebules, consisting of a more complex stabilized fluticasone propionate suspension (0.25 mg/mL; 0.5 mM in saline. A mimic of the commercial product Tobi© (60 mg/mL tobramycin and 2.25 mg/mL NaCl, pH 5.5-6.5) is also studied, which was prepared in house. In all cases, the presence of the pharmaceutical was shown to have a profound effect on the magnitude, and in some cases the rate, of the mass flux of water to and from the aerosol as compared to saline. These findings provide physical chemical evidence supporting observations from human inhalation studies, and suggest that using the growth dynamics of a pure saline aerosol in a lung inhalation model

  2. Capturing the efficiency of vibrating mesh nebulizers: minimizing upper airway deposition.

    PubMed

    Sagalla, Rex B; Smaldone, Gerald C

    2014-10-01

    Vibrating mesh devices are portable nebulizer systems with reported high efficiency. Losses occur during expiration, and particle size distributions vary. We describe an aerosol chamber designed to capture and condition aerosols from a typical vibrating mesh nebulizer, the Omron U22. The goal was to improve inhaled mass (IM) and respirable fraction (RF) and shorten treatment time. With test solutions of radiolabeled saline, we characterized the Omron U22 (three examples) vibrating mesh nebulizer measuring aerosol output with different breathing patterns, with and without manual breath synchronization. Particle size distributions were measured by cascade impaction as a "standing cloud" and during ventilation with a piston respirator. IM (percentage of nebulizer charge), respirable mass (RM), particle size distribution, and breathing time were measured with and without use of the chamber. Breathing patterns were designed to simulate tidal breathing with a "COPD" (chronic obstructive pulmonary disease) pattern (450 mL, rate 15, duty cycle 0.35) and "slow and deep" breathing for maximal lung deposition (1,500 mL, rate 5, duty cycle 0.70). Patterns of deposition were confirmed in a human volunteer using a gamma camera. IM was significantly affected by breathing pattern and averaged 30.0±2.91% and 53.9±7.99% for COPD and slow and deep patterns, respectively. With the chamber, IM was less sensitive to breathing pattern (57.4±6.97%, 57.9±4.69%, respectively). Particle size distributions varied widely between devices and were markedly affected by both ventilating the device and addition of the chamber. With the chamber, RF and RM increased, and differences in particle size distributions between individual devices were minimized. Compared with breath synchronization, treatment time was reduced. Gamma camera images revealed reduced upper airway deposition consistent with predictions from in vitro cascade distributions. Our prototype chamber allowed for capture and

  3. Efficacy and safety of nebulized morphine given at 2 different doses compared to IV titrated morphine in trauma pain.

    PubMed

    Grissa, Mohamed Habib; Boubaker, Hamdi; Zorgati, Asma; Beltaïef, Kaouthar; Zhani, Wafa; Msolli, Mohamed Amine; Bzeouich, Nasri; Bouida, Wahid; Boukef, Riadh; Nouira, Semir

    2015-11-01

    Our aim was to compare the efficacy and safety of intravenous (IV) titrated morphine with nebulized morphine given at 2 different doses in severe traumatic pain. In a prospective, randomized, controlled double-blind study, we included 300 patients with severe traumatic pain. They were assigned to 3 groups: Neb10 group received 1 nebulization of 10-mg morphine; Neb20 group received 1 nebulization of 20-mg morphine, repeated every 10 minutes with a maximum of 3 nebulizations; and the IV morphine group received 2-mg IV morphine repeated every 5 minutes until pain relief. Visual analog scale was monitored at baseline, 5, 10, 15, 20, 25, 30, and 60 minutes after the start of drug administration. Treatment success was defined by the percentage of patients in whom visual analog scale decreased greater than or equal to 50% of its baseline value. When this end point was not reached, rescue morphine was administered. Pain resolution time was defined by the elapsed time between the start of the protocol and the reach of treatment success criteria. Success rate was significantly better at 97% (95% confidence interval [CI], 93-100) for Neb20 group compared to Neb10 group (81% [95% CI, 73-89]) and IV morphine group (79% [95% CI, 67-84]). The lowest resolution time was observed in Neb20 group (20 minutes [95% CI, 18-21]). Side effects were minor and significantly lower in both nebulization groups compared to IV morphine group. Nebulized morphine using boluses of 10 mg has similar efficacy and better safety than IV titrated morphine in patients with severe posttraumatic pain. Increasing nebulized boluses to 20 mg increases the effectiveness without increasing side effects. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. Ernst Rüdin: Hitler's Racial Hygiene Mastermind.

    PubMed

    Joseph, Jay; Wetzel, Norbert A

    2013-01-01

    Ernst Rüdin (1874-1952) was the founder of psychiatric genetics and was also a founder of the German racial hygiene movement. Throughout his long career he played a major role in promoting eugenic ideas and policies in Germany, including helping formulate the 1933 Nazi eugenic sterilization law and other governmental policies directed against the alleged carriers of genetic defects. In the 1940s Rüdin supported the killing of children and mental patients under a Nazi program euphemistically called "Euthanasia." The authors document these crimes and discuss their implications, and also present translations of two publications Rüdin co-authored in 1938 showing his strong support for Hitler and his policies. The authors also document what they see as revisionist historical accounts by leading psychiatric genetic authors. They outline three categories of contemporary psychiatric genetic accounts of Rüdin and his work: (A) those who write about German psychiatric genetics in the Nazi period, but either fail to mention Rüdin at all, or cast him in a favorable light; (B) those who acknowledge that Rüdin helped promote eugenic sterilization and/or may have worked with the Nazis, but generally paint a positive picture of Rüdin's research and fail to mention his participation in the "euthanasia" killing program; and (C) those who have written that Rüdin committed and supported unspeakable atrocities. The authors conclude by calling on the leaders of psychiatric genetics to produce a detailed and complete account of their field's history, including all of the documented crimes committed by Rüdin and his associates.

  5. Pegfilgrastim Injection

    MedlinePlus

    Pegfilgrastim comes as a solution (liquid) in prefilled injection syringes and in a pre-filled automatic injection device (On-body Injector) to inject subcutaneously (under the skin). If you are using pegfilgrastim to ...

  6. Cabazitaxel Injection

    MedlinePlus

    ... injection is used along with prednisone to treat prostate cancer (cancer of a male reproductive organ) that has ... cabazitaxel injection is usually used in men with prostate cancer. If used by pregnant women, cabazitaxel injection can ...

  7. Ondansetron Injection

    MedlinePlus

    Zofran® Injection ... Ondansetron injection is used to prevent nausea and vomiting caused by cancer chemotherapy and surgery. Ondansetron is in a ... medications: or any of the ingredients in ondansetron injection. Ask your pharmacist for a list of the ...

  8. Effect of Nebulized Morphine on Dyspnea of Mustard Gas-Exposed Patients: A Double-Blind Randomized Clinical Trial Study

    PubMed Central

    Shohrati, Majid; Ghanei, Mostafa; Harandi, Asghar Amini; Foroghi, Soniya; Harandi, Ali Amini

    2012-01-01

    Background. Dyspnea is one of the main complaints in a group of COPD patients due to exposure to sulfur mustard (SM) and is refractory to conventional therapies. We designed this study to evaluate effectiveness of nebulized morphine in such patients. Materials and Methods. In a double-blind clinical trial study, 40 patients with documented history of exposure to SM were allocated to two groups: group 1 who received 1 mg morphine sulfate diluted by 4 cc normal saline 0.5% using nebulizer once daily for 5 days and group 2 serving as control who received normal saline as placebo. They were visited by pulmonologist 7 times per day to check symptoms and signs and adverse events. Different parameters including patient-scored peak expiratory flow using pick flow meter, visual analogue scale (VAS) for dyspnea, global quality of life and cough, and number of respiratory rate, night time awaking for dyspnea and cough have been assessed. Results. The scores of VAS for dyspnea, cough and quality of life and also respiratory rate, heart rate, and night time awaking due to dyspnea and night time awaking due to cough improved significantly after morphine nebulization without any major adverse events. Also pick expiratory flow has been improved significantly after nebulization in each day. Conclusion. Our results showed the clinical benefit of nebulized morphine on respiratory complaints of patients due to exposure to SM without significant side effects. PMID:22530119

  9. A randomized, controlled trial of nebulized 5% hypertonic saline and mixed 5% hypertonic saline with epinephrine in bronchiolitis.

    PubMed

    Tinsa, Faten; Abdelkafi, Sana; Bel Haj, Imen; Hamouda, Samia; Brini, Ines; Zouari, Bechir; Boussetta, Khadija

    2014-11-01

    Bronchiolitis is a public health problem in the word and in Tunisia. Nebulized hypertonic saline seems to have some benefits in bronchiolitis. The aim of this study is to evaluate the efficacy of nebulized 5% hypertonic saline alone or mixed with epinephrine in bronchiolitis as measured by improvement in clinical score, oxygen saturation or reduction in duration of hospitalization. This prospective, double blind, placebo controlled, randomized clinical trial was performed at Children's Hospital of Tunis from February 2012 to Mars 2012. A total of 94 patients less than 12 months of age with diagnosis of moderately severe bronchiolitis were enrolled and assigned to receive 5% nebulized hypertonic saline, mixed 5% hypertonic saline with standard epinephrine 0,1% or normal saline (placebo) at admission and every 4 hours during hospitalization. There were no significant difference between nebulized 5% hypertonic saline, mixed 5% hypertonic saline with epinephrine or normal saline at baseline, T30 min, T60 min, and T120 min after start study in Wang severity score, oxygen saturation in room air, rate respiratory and heart rate. There was no difference in duration of hospitalization. Nebulized 5% hypertonic saline or mixed 5% hypertonic saline with epinephrine are safety but does not appear effective in treating moderately ill infants with the first acute bronchiolitis.

  10. Impact of lyoprotectants for the stabilization of biodegradable nanoparticles on the performance of air-jet, ultrasonic, and vibrating-mesh nebulizers.

    PubMed

    Beck-Broichsitter, Moritz; Kleimann, Pia; Schmehl, Thomas; Betz, Thomas; Bakowsky, Udo; Kissel, Thomas; Seeger, Werner

    2012-10-01

    Strategies for further advancements in pulmonary drug delivery include the application of colloidal carriers. Freeze-drying in the presence of lyoprotectants is a valuable approach to improve long-term stability of biodegradable nanoparticles, but possibly constrains aerosol generation after powder rehydration, when employing traditional nebulizers. Here, we investigated the impact of lyoprotectants on both output and aerodynamic performance of air-jet, ultrasonic, and vibrating-mesh nebulization. Additionally, changes in formulation temperature and concentration were monitored, to estimate physicochemical alterations of formulations during nebulization. The stability of poly(d,l-lactide-co-glycolide) nanoparticles was maintained for lyoprotectant/nanoparticle ratios above 5/1. All nebulized formulations displayed suitable output and aerodynamic characteristics for peripheral lung deposition. Air-jet- and ultrasonic nebulization was associated with considerable temperature (~10°C) and concentration changes (up to 156%) of the reservoir fluid, which consequently, caused significant shifting of surface tension and viscosity. By contrast, vibrating-mesh nebulization caused marginal temperature increase (~5°C) with no apparent signs of concentration. Thus, the changing surface tension and viscosity were fitted employing Eötvös' rule and the Andrade equation (R(2)>0.98), allowing to predict the physicochemical properties of each formulation for prolonged nebulization periods. In particular, vibrating-mesh nebulization seems to be promising for aerosol application of rehydrated freeze-dried biodegradable nanoparticles to the respiratory tract. Copyright © 2012 Elsevier B.V. All rights reserved.

  11. Postoperative Analgesia after Laparoscopic Ovarian Cyst Resection: Double-blind Multicenter Randomized Control Trial Comparing Intraperitoneal Nebulization and Peritoneal Instillation of Ropivacaine.

    PubMed

    Scalia Catenacci, Stefano; Lovisari, Federica; Peng, Shuo; Allegri, Massimo; Somaini, Marta; Ghislanzoni, Luca; Greco, Massimiliano; Rossini, Valeria; D'Andrea, Luca; Buda, Alessandro; Signorelli, Mauro; Pellegrino, Antonio; Sportiello, Debora; Bugada, Dario; Ingelmo, Pablo M

    2015-01-01

    To compare the effects of local anesthetic intraperitoneal nebulization with intraperitoneal instillation during laparoscopic ovarian cystectomy on postoperative morphine consumption and pain. Multicenter, randomized, case-control trial. Canadian Task Force Classification I. University hospitals in Italy. One hundred forty patients scheduled for laparoscopic ovarian cystectomy. Patients were randomized to receive either nebulization of ropivacaine 150 mg before surgery or instillation of ropivacaine 150 mg before surgery. Nebulization was performed using the Aeroneb Pro device (Aerogen, Galway, Ireland). One hundred forty patients were enrolled, and 123 completed the study. There was no difference between the 2 groups in average morphine consumption (7.3 ± 7.5 mg in the nebulization group vs 9.2 ± 7.2 mg in the instillation group; p = .17). Eighty-two percent of patients in the nebulization group required morphine compared with 96% in the instillation group (p < .05). Patients receiving nebulization had a lower dynamic Numeric Ranking Scale compared with those in the instillation group in the postanesthesia care unit postanesthesia care unit and 4 hours after surgery (p < .05). Ten patients (15%) in the nebulization group experienced shivering in the postanesthesia care unit compared with 2 patients (4%) in the instillation group (p = .035). Nebulization of ropivacaine prevents the use of morphine in a significant proportion of patients, reduced postoperative pain during the first hours after surgery, and was associated with a higher incidence of postoperative shivering when compared with instillation. Copyright © 2015 AAGL. Published by Elsevier Inc. All rights reserved.

  12. Nebulizing conditions of pneumatic electrospray ionization significantly influence electrolyte effects on compound measurement.

    PubMed

    Niu, Wei; Zhu, Xiaohong; Yu, Ke; Li, Li; Sun, Yan; Li, Chuan

    2012-03-01

    Composition of mobile phase can greatly influence the success of electrospray ionization (ESI)-interfaced liquid chromatography-mass spectrometry analysis. To investigate the relationship between formic-acid-based modification of mobile phase and ESI nebulizing conditions, an API 4000 ESI source and a TSQ Quantum one were compared under the same chromatographic conditions. Ginkgo terpene lactones and flavonols were measured in plasma, which involved using ascorbic acid to circumvent cross-interference between the analytes. ESI responses to using formic acid included changes in signal intensity, matrix effect, and upper limit of quantification. Significant disparities in the responses were observed between the two ESI sources, suggesting that the use of electrolyte modifier in liquid chromatography mobile phase and the pneumatic nebulization for ESI should be properly balanced to accomplish optimal ESI-based analysis. The distribution of unpaired ions toward the surface of the initial droplet was assumed to be an important step in the pneumatic ESI process. When using the electrolyte in mobile phase, a too fast droplet reduction by rapid-heating-assisted pneumatic nebulization could negatively decrease the time available for the unpaired ions to migrate from droplet interior to its surface. Ascorbic acid was identified as a major interfering substance for the bioanalytical assay; the interference mechanism might be associated with hindering the unpaired analyte ions from distributing toward the droplet surface rather than outcompeting the analyte ions for the limited excess charge on droplets surface. The current work extends the knowledge base of pneumatic ESI, which has implication for optimal use of the ESI-interfaced liquid chromatography-mass spectrometry technique. Copyright © 2012 John Wiley & Sons, Ltd.

  13. Individualized supervised resistance training during nebulization in adults with cystic fibrosis.

    PubMed

    Shaw, Ina; Kinsey, Janine E; Richards, Roxanne; Shaw, Brandon S

    2016-01-01

    Since dyspnea limits exercise adherence and intensity in cystic fibrosis (CF) patients, engaging in resistance training (RT), which causes less dyspnea than other exercise modalities, while using nebulizers could not only overcome this barrier, but also enhance long-term adaptations to treatment. The objective of this study was to examine the effects of RT during nebulization on spirometry, anthropometry, chest wall excursion, respiratory muscle strength and health-related quality of life (HRQOL). Fourteen male and female CF patients were assigned to a four-week, 20-minute, 5-day per week proof-of-concept RT group (RTG) (n=7) or non-exercising control group (CON) (n=7), with 3 CON patients later dropping out of the study. Patients performed whole body exercises for 3 sets of 10 reps using resistance bands, since such bands have previously demonstrated a greater effect on functional exercise capacity than conventional RT in lung patients. The RTG displayed significant (p≤0.05) increases in FEV1, FEV1/FVC, latissimusdorsi strength, pectoralis major clavicular portion strength, pectoralis major sternocostal portion strength and emotional and digestion HRQOL domains, while decreasing pectoralis minor strength on the left and social, body image and respiration HRQOL domains. This small scale proof-of-concept investigation demonstrates the multiple and simultaneous benefits of RT during nebulization in CF patients. The improvements in pulmonary measures are particularly promising especially since this study only made use of a four-week experimental period. This study provides an important alternative, time-saving treatment for the CF patient that does not add to the treatment burden of CF patients.

  14. NEBULIZED HYPERTONIC SALINE ATTENUATES ACUTE LUNG INJURY FOLLOWING TRAUMA AND HEMORRHAGIC SHOCK

    PubMed Central

    Wohlauer, M.; Moore, E.E.; Silliman, C.C.; Fragoso, M.; Gamboni, F.; Harr, J.; Accurso, F.; Wright, F.; Haenel, J.; Fullerton, D.; Banerjee, A.

    2012-01-01

    Objective We hypothesized that aerosolized inhaled HTS given at the onset of resuscitation will decrease acute lung injury (ALI) following hemorrhagic shock by inhibiting the release of epithelial derived pro-inflammatory mediators. Design Animal study Setting Animal care facility procedure room in a medical center. Subjects Adult male Sprague-Dawley rats. Interventions Rats underwent hemorrhagic shock followed by 2 hrs of resuscitation and one hour of observation. In the study group, nebulized HTS was delivered at the end of the shock period and after 1 hr and 2 hr of resuscitation. Measurements and Main Results Shock provoked ALI, which was attenuated with inhaled HTS (1.56 ± 0.2 vs. 0.95 ± 0.3 mg protein/ml BALF, Shock vs. Shock +HTS, p<0.01). Nebulized HTS reduced inflammation (CINC-1 accumulation in BAL fluid 5999 ± 1267 vs. 3342 ± 859 pg/ml, Shock vs. Shock +HTS, p=0.006). Additionally, nebulized HTS inhibited MMP-13 accumulation in the BALF (1513 ± 337 pg/ml BALF vs. 230 ± 19 pg/ml, Shock vs. Shock + HTS, p=0.009) and pretreatment with an MMP-13 inhibitor was sufficient to attenuate postinjury ALI (1.42 ± 0.09 vs. 0.77 ± 0.23 mg/ml BAL protein, Shock vs. Shock + MMP-13 Inhibitor CL-82198, p=0.002). Conclusion Inhaled hypertonic saline attenuates postshock acute lung injury by exerting an anti-inflammatory effect on the pulmonary epithelium, suggesting a new clinical strategy to treat ALI/ARDS. PMID:22732292

  15. Nebulized lidocaine blunts airway hyper-responsiveness in experimental feline asthma.

    PubMed

    Nafe, Laura A; Guntur, Vamsi P; Dodam, John R; Lee-Fowler, Tekla M; Cohn, Leah A; Reinero, Carol R

    2013-08-01

    Nebulized lidocaine may be a corticosteroid-sparing drug in human asthmatics, reducing airway resistance and peripheral blood eosinophilia. We hypothesized that inhaled lidocaine would be safe in healthy and experimentally asthmatic cats, diminishing airflow limitation and eosinophilic airway inflammation in the latter population. Healthy (n = 5) and experimentally asthmatic (n = 9) research cats were administered 2 weeks of nebulized lidocaine (2 mg/kg q8h) or placebo (saline) followed by a 2-week washout and crossover to the alternate treatment. Cats were anesthetized to measure the response to inhaled methacholine (MCh) after each treatment. Placebo and doubling doses of methacholine (0.0625-32.0000 mg/ml) were delivered and results were expressed as the concentration of MCh increasing baseline airway resistance by 200% (EC200Raw). Bronchoalveolar lavage was performed after each treatment and eosinophil numbers quantified. Bronchoalveolar lavage fluid (BALF) % eosinophils and EC200Raw within groups after each treatment were compared using a paired t-test (P <0.05 significant). No adverse effects were noted. In healthy cats, lidocaine did not significantly alter BALF eosinophilia or the EC200Raw. There was no difference in %BALF eosinophils in asthmatic cats treated with lidocaine (36±10%) or placebo (33 ± 6%). However, lidocaine increased the EC200Raw compared with placebo 10 ± 2 versus 5 ± 1 mg/ml; P = 0.043). Chronic nebulized lidocaine was well-tolerated in all cats, and lidocaine did not induce airway inflammation or airway hyper-responsiveness in healthy cats. Lidocaine decreased airway response to MCh in asthmatic cats without reducing airway eosinophilia, making it unsuitable for monotherapy. However, lidocaine may serve as a novel adjunctive therapy in feline asthmatics with beneficial effects on airflow obstruction.

  16. Nebulized ketamine decreases incidence and severity of post-operative sore throat

    PubMed Central

    Ahuja, Vanita; Mitra, Sukanya; Sarna, Rashi

    2015-01-01

    Background and Aims: Post-operative sore throat (POST) occurs in 21-65% of patients. Ketamine used earlier as gargle for reducing POST has limitations. The aim of this study was to see if nebulised ketamine reduces POST. Methods: We conducted a prospective, randomised, placebo-control, and double-blind controlled trial. After written informed consent, 100 patients belonging to American Society of Anaesthesiologists physical status I-II in the age group 20-60 years, of either sex undergoing surgery under general anaesthesia (GA) were enrolled. Patients were randomised into two groups; group saline (S) received saline nebulisation 5.0 ml and group ketamine (K) received ketamine 50 mg (1.0 ml) with 4.0 ml of saline nebulisation for 15 min. GA was induced 10 min after completion of nebulisation in the patients. The POST and haemodynamic monitoring were done pre-nebulization, pre-induction, on reaching post-anaesthesia care unit, and at 2, 4, 6, 8, 12 and 24 h post-operatively. POST was graded on a four-point scale (0-3). Results: The overall incidence of POST was 33%; 23 patients (46%) in saline and 10 patients (20%) in ketamine group experienced POST (Fisher's exact P = 0.01). The use of ketamine nebulization attenuated POST at 2 h and 4 h post-operatively (P < 0.05). The primary outcome was incidence of POST at 4 h; 13 patients in group S versus 4 patients in group K (P = 0.03) experienced POST at 4 h. The moderate sore throat occurred in 6 patients in group S and none in group K at 2 h, post-operatively (P = 0.02). Conclusion: Ketamine nebulization significantly attenuated the incidence and severity of POST, especially in the early post-operative period, with no adverse effects. PMID:25684812

  17. Individualized supervised resistance training during nebulization in adults with cystic fibrosis

    PubMed Central

    Shaw, Ina; Kinsey, Janine E.; Richards, Roxanne; Shaw, Brandon S.

    2016-01-01

    Background & Objective: Since dyspnea limits exercise adherence and intensity in cystic fibrosis (CF) patients, engaging in resistance training (RT), which causes less dyspnea than other exercise modalities, while using nebulizers could not only overcome this barrier, but also enhance long-term adaptations to treatment. The objective of this study was to examine the effects of RT during nebulization on spirometry, anthropometry, chest wall excursion, respiratory muscle strength and health-related quality of life (HRQOL). Methods: Fourteen male and female CF patients were assigned to a four-week, 20-minute, 5-day per week proof-of-concept RT group (RTG) (n=7) or non-exercising control group (CON) (n=7), with 3 CON patients later dropping out of the study. Patients performed whole body exercises for 3 sets of 10 reps using resistance bands, since such bands have previously demonstrated a greater effect on functional exercise capacity than conventional RT in lung patients. Results: The RTG displayed significant (p≤0.05) increases in FEV1, FEV1/FVC, latissimusdorsi strength, pectoralis major clavicular portion strength, pectoralis major sternocostal portion strength and emotional and digestion HRQOL domains, while decreasing pectoralis minor strength on the left and social, body image and respiration HRQOL domains. Conclusion: This small scale proof-of-concept investigation demonstrates the multiple and simultaneous benefits of RT during nebulization in CF patients. The improvements in pulmonary measures are particularly promising especially since this study only made use of a four-week experimental period. This study provides an important alternative, time-saving treatment for the CF patient that does not add to the treatment burden of CF patients. PMID:27882012

  18. Nebulized hypertonic saline for bronchiolitis in the emergency department: a randomized clinical trial.

    PubMed

    Florin, Todd A; Shaw, Kathy N; Kittick, Marlena; Yakscoe, Stephen; Zorc, Joseph J

    2014-07-01

    Acute bronchiolitis is the most frequent lower respiratory tract infection in infants, yet there are no effective therapies available. Current evidence is unclear about the role of hypertonic saline (HS) for the acute treatment of bronchiolitis. To determine whether nebulized 3% HS compared with normal saline (NS) improves respiratory distress in infants with bronchiolitis not responding to standard treatments in the emergency department. A randomized clinical trial with blinding of investigators, health care providers, and parents was conducted at a single urban pediatric ED. The participants included children aged 2 to less than 24 months with their first episode of bronchiolitis and a Respiratory Distress Assessment Instrument score of 4 to 15 after nasal suctioning and a trial of nebulized albuterol. Patients were randomized to receive either nebulized 3% HS (HS group) or NS (NS group). The primary outcome was change in respiratory distress at 1 hour after the intervention, as measured by the Respiratory Assessment Change Score (a decrease indicates improvement). Secondary outcomes included vital signs, oxygen saturation, hospitalization, physician clinical impression, parental assessment, and adverse events. The 31 patients enrolled in each treatment arm had similar baseline demographic and clinical characteristics. At 1 hour after the intervention, the HS group demonstrated significantly less improvement in the median Respiratory Assessment Change Score compared with the NS group (HS, -1 [interquartile range, -5 to 1] vs. NS, -5 [interquartile range, -6 to -2]; P = .01). There were no significant differences in heart rate, oxygen saturation, hospitalization rate, or other outcomes. There were no adverse events. Infants with bronchiolitis and persistent respiratory distress after standard treatment in the emergency department had less improvement after receiving 3% HS compared with those who received NS. Based on these results and the existing evidence

  19. Formulation, Characterization and Pulmonary Deposition of Nebulized Celecoxib Encapsulated Nanostructured Lipid Carriers

    PubMed Central

    Patlolla, Ram R.; Chougule, Mahavir; Patel, Apurva R.; Jackson, Tanise; Tata, Prasad NV; Singh, Mandip

    2010-01-01

    The aim of the current study was to encapsulate celecoxib (Cxb) in the Nanostructured Lipid Carrier (Cxb-NLC) nanoparticles and evaluate the lung disposition of nanoparticles following nebulization in Balb/c mice. Cxb-NLC nanoparticles were prepared with Cxb, Compritol, Miglyol and sodium taurocholate using high-pressure homogenization. Cxb-NLC nanoparticles were characterized for physical and aerosol properties. In-vitro cytotoxicity studies were performed with A549 cells. The lung deposition and pharmacokinetic parameters of Cxb-NLC and Cxb solution (Cxb-Soln) formulations were determined using Inexpose™ system and Pari LC star jet nebulizer. The particle size and entrapment efficiency of Cxb-NLC formulation were 217 ± 20 nm and > 90%, respectively. The Cxb-NLC released the drug in controlled fashion, and in vitro aersolization of Cxb-NLC formulation showed FPF of 75.6 ± 4.6 %, MMAD of 1.6 ±0.13 μm and GSD of 1.2 ± 0.21. Cxb-NLC showed dose and time dependent cytotoxicity against A549 cells. Nebulization of Cxb-NLC demonstrated 4 fold higher AUCt/D in lung tissues compared to Cxb-Soln. The systemic clearance of Cxb-NLC was slower (0.93 L/h) compared to Cxb-Soln (20.03 L/h). Cxb encapsulated NLC were found to be stable and aerodynamic properties were within the respirable limits. Aerosolization of Cxb-NLC improved the Cxb pulmonary bioavailability compared to solution formulation which will potentially lead to better patient compliance with minimal dosing intervals. PMID:20153385

  20. Technical note: Air compared to nitrogen as nebulizing and drying gases for electrospray ionization mass spectrometry.

    PubMed

    Mielczarek, P; Silberring, J; Smoluch, M

    2016-01-01

    In the present study we tested the application of compressed air instead of pure nitrogen as the nebulizing and drying gas, and its influence on the quality of electrospray ionization (ESI) mass spectra. The intensities of the signals corresponding to protonated molecules were significantly (twice) higher when air was used. Inspection of signal-to-noise (S/N) ratios revealed that, in both cases, sensitivity was comparable. A higher ion abundance after the application of compressed air was followed by a higher background. Another potential risk of using air in the ESI source is the possibility for sample oxidation due to the presence of oxygen. To test this, we selected five easily oxidizing compounds to verify their susceptibility to oxidation. In particular, the presence of methionine was of interest. For all the compounds studied, no oxidation was observed. Amodiaquine oxidizes spontaneously in water solutions and its oxidized form can be detected a few hours after preparation. Direct comparison of the spectra where nitrogen was used with the corresponding spectra obtained when air was applied did not show significant differences. The only distinction was slightly different patterns of adducts when air was used. The difference concerns acetonitrile, which forms higher signals when air is the nebulizing gas. It is also important that the replacement of nitrogen with air does not affect quantitative data. The prepared calibration curves also visualize an intensity twice as high (independent of concentration within tested range) of the signal where air was applied. We have used our system continuously for three months with air as the nebulizing and drying gas and have not noticed any unexpected signal deterioration caused by additional source contamination from the air. Moreover, compressed air is much cheaper and easily available using oil-free compressors or pumps.

  1. Nebulized ketamine decreases incidence and severity of post-operative sore throat.

    PubMed

    Ahuja, Vanita; Mitra, Sukanya; Sarna, Rashi

    2015-01-01

    Post-operative sore throat (POST) occurs in 21-65% of patients. Ketamine used earlier as gargle for reducing POST has limitations. The aim of this study was to see if nebulised ketamine reduces POST. We conducted a prospective, randomised, placebo-control, and double-blind controlled trial. After written informed consent, 100 patients belonging to American Society of Anaesthesiologists physical status I-II in the age group 20-60 years, of either sex undergoing surgery under general anaesthesia (GA) were enrolled. Patients were randomised into two groups; group saline (S) received saline nebulisation 5.0 ml and group ketamine (K) received ketamine 50 mg (1.0 ml) with 4.0 ml of saline nebulisation for 15 min. GA was induced 10 min after completion of nebulisation in the patients. The POST and haemodynamic monitoring were done pre-nebulization, pre-induction, on reaching post-anaesthesia care unit, and at 2, 4, 6, 8, 12 and 24 h post-operatively. POST was graded on a four-point scale (0-3). The overall incidence of POST was 33%; 23 patients (46%) in saline and 10 patients (20%) in ketamine group experienced POST (Fisher's exact P = 0.01). The use of ketamine nebulization attenuated POST at 2 h and 4 h post-operatively (P < 0.05). The primary outcome was incidence of POST at 4 h; 13 patients in group S versus 4 patients in group K (P = 0.03) experienced POST at 4 h. The moderate sore throat occurred in 6 patients in group S and none in group K at 2 h, post-operatively (P = 0.02). Ketamine nebulization significantly attenuated the incidence and severity of POST, especially in the early post-operative period, with no adverse effects.

  2. Nebulized liposomal gadobenate dimeglumine contrast formulation for magnetic resonance imaging of larynx and trachea

    PubMed Central

    Wei, Xiaohui; Wu, Huawei; Lu, Qing; Xu, Jianrong; Xu, Yuhong

    2011-01-01

    Background To develop a lipid-stabilized contrast formulation containing gadobenate dimeglumine for clear visualization of the mucosal surfaces of the larynx and trachea for early diagnosis of disease by magnetic resonance imaging. Methods The contrast formulation was prepared by loading gadobenate dimeglumine into egg phosphotidylcholine, cholesterol, and sterylamine nanoliposomes using the dehydration-rehydration method. The liposomal contrast formulation was ultrasonically nebulized, and the deposition and coating pattern on explanted pig laryngeal and tracheal segments was examined by inductively coupled plasma atomic emission spectroscopy. The sizes of the nebulized droplets were characterized by photon correlation spectroscopy. The contrast-enhanced mucosal surface images of the larynx and trachea were obtained in a 3.0T magnetic resonance scanner using a T1-weighted spectral presaturation inversion recovery sequence. Results Various cationic liposome formulations were compared for their stabilization effects on the droplets containing gadobenate dimeglumine. The liposomes composed of egg phosphotidylcholine, cholesterol, and sterylamine in a molar ratio of 1:1:1 were found to enable the most efficient nebulization and the resulting droplet sizes were narrowly distributed. They also resulted in the most even coating on the laryngeal and tracheal lumen surfaces and produced significant contrast enhancement along the mucosal surface. Such contrast enhancement could help clearer visualization of several disease states, such as intraluminal protrusions, submucosal nodules, and craters. Conclusion This lipid-stabilized magnetic resonance imaging contrast formulation may be useful for improving mucosal surface visualization and early diagnosis of disease originating in the mucosal surfaces of the larynx and trachea. PMID:22267923

  3. Three-phase plasma arc atomic-emission spectrometric analysis of environmental samples using an ultrasonic nebulizer.

    PubMed

    Ghatass, Zekry F; Roston, Gamal D; Mohamed, Moustafa M

    2003-06-01

    Combination of an ultrasonic nebulizer and plasma excitation sources for spectrochemical analysis offers desirable features of low detection limits, high sample throughput, wide dynamic range of operation, acceptable precision and accuracy, and simultaneous quantitative analytical capabilities. Moreover, the ultrasonic nebulizer does not require sample preconcentration. Recently we have developed a three-phase plasma arc (TPPA) for atomic emission spectrochemical analysis. In the present work, to increase the analytical utility of the three-phase plasma system, an ultrasonic nebulizer was used for sample introduction. The effects of the argon gas flow rate, current, excitation temperature have been studied. The analytical calibration curves are obtained for Ca, Cr, Fe, Mg and Mn, and detection limits have been calculated. The present technique is used to determine the concentration of the elements Ca, Cr, Fe, Mg and Mn in airborne samples.

  4. Determination of Rare Earth Elements in Green River Shale By Inductively Coupled Plasma Mass Spectrometry Using a Desolvating Nebulizer System

    NASA Astrophysics Data System (ADS)

    Smith, F.; Clarke, D.; Moody, S.

    2014-12-01

    In this work, inductively coupled plasma mass spectrometry (ICP-MS) is applied to a geological sample for the determination of rare earth elements (REEs) using a specialized nebulizer system. The low flow desolvating nebulizer has been shown to decrease metal oxide formation which leads to a reduction in mass spectral interferences. Traditional nebulizers and spray chambers may be suitable for similar sample types, but reduction of water vapor loading to the plasma can improve REE detection limits for quadrupole-based ICP-MS. The Green River formation holds the largest oil shale deposits in the world and understanding the elemental composition of these samples is important in its study. A certified reference material, USGS Green River Shale (SGR-1), was microwave digested prior to analysis, and recoveries of REEs compared to historical values are discussed.

  5. Ground deformation monitoring using RADARSAT-2 DInSAR-MSBAS at the Aquistore CO2 storage site in Saskatchewan (Canada)

    NASA Astrophysics Data System (ADS)

    Czarnogorska, M.; Samsonov, S.; White, D.

    2014-11-01

    The research objectives of the Aquistore CO2 storage project are to design, adapt, and test non-seismic monitoring methods for measurement, and verification of CO2 storage, and to integrate data to determine subsurface fluid distributions, pressure changes and associated surface deformation. Aquistore site is located near Estevan in Southern Saskatchewan on the South flank of the Souris River and west of the Boundary Dam Power Station and the historical part of Estevan coal mine in southeastern Saskatchewan, Canada. Several monitoring techniques were employed in the study area including advanced satellite Differential Interferometric Synthetic Aperture Radar (DInSAR) technique, GPS, tiltmeters and piezometers. The targeted CO2 injection zones are within the Winnipeg and Deadwood formations located at > 3000 m depth. An array of monitoring techniques was employed in the study area including advanced satellite Differential Interferometric Synthetic Aperture Radar (DInSAR) with established corner reflectors, GPS, tiltmeters and piezometers stations. We used airborne LIDAR data for topographic phase estimation, and DInSAR product geocoding. Ground deformation maps have been calculated using Multidimensional Small Baseline Subset (MSBAS) methodology from 134 RADARSAT-2 images, from five different beams, acquired during 20120612-20140706. We computed and interpreted nine time series for selected places. MSBAS results indicate slow ground deformation up to 1 cm/year not related to CO2 injection but caused by various natural and anthropogenic causes.

  6. Nebulized hypertonic saline and recombinant human DNase in the treatment of pulmonary atelectasis in newborns.

    PubMed

    Dilmen, Ugur; Karagol, Belma Saygili; Oguz, Serife Suna

    2011-06-01

    The aim of this study was to compare and evaluate the efficacy of nebulized 3% hypertonic saline (HS) and recombinant human DNase (rhDNase) treatment for resolution of persistent atelectasis in newborns. Forty newborns (38 preterms) who did not respond to conventional treatment were enrolled to receive either nebulized 3% HS solution (n = 20) or rhDNase (n = 20) between September 2007 and March 2008. Clinical parameters, oxygen saturation and radiological response (chest X-ray scoring) were analyzed before and after administration of 3% HS or rhDNase. The patients of the nebulized 3% HS solution group improved better chest X-ray scores parameters than the patients of the rhDNase group: chest X-ray scores were 5.1 ± 1.9 vs 4.8 ± 1.7 before treatment and 1.0 ± 0.8 vs 2.1 ± 1.4 after treatment (P < 0.001). Resolution time of atelectasis did not differ between the two groups after whole treatment but the percentage of atelectasis resolution after 3 days treatment were 90% (18/20) in the 3% HS group and 70% (14/20) in the rhDNase group. The patients in the 3% HS group improved better also in clinical parameters in comparison to the rhDNase treatment. The difference of oxygen saturation before and after the treatment was 4.6 ± 0.8 in 3% HS group in comparison to 2.6 ± 0.1 in the rhDNase group (P < 0.05). All serum sodium levels were normal in two groups before and after the treatment modalities. This is the first study on the usefulness of nebulized 3% hypertonic saline solution in treating newborns with pulmonary atelectasis. In addition, 3% HS solution was a more effective therapeutic option on the basis of clinical and radiological improvement compared to rhDNase treatment in newborns with pulmonary atelectasis. © 2011 The Authors. Pediatrics International © 2011 Japan Pediatric Society.

  7. Management of plastic bronchitis with nebulized tissue plasminogen activator: another brick in the wall.

    PubMed

    Colaneri, Massimo; Quarti, Andrea; Pozzi, Marco; Gasparini, Stefano; Carloni, Ines; de Benedictis, Fernando Maria

    2014-02-13

    Plastic bronchitis is a rare complication of a variety of respiratory diseases and congenital heart disease surgery, particularly Fontan procedure. Bronchial casts with rubber-like consistency develop acutely and may cause severe life-threatening respiratory distress. The management of plastic bronchitis is yet not well defined. Early intermittent, self-administered nebulization of tissue plasminogen activator was found to be effective in preventing deterioration of acute respiratory symptoms in a patient with primary ciliary dyskinesia and recurrent cast formation. Further investigation into new therapeutic strategies for this devastating disease is advocated.

  8. Use of nebulized adrenaline to aid expulsion of intra-nasal foreign bodies in children.

    PubMed

    Douglas, A R

    1996-06-01

    Foreign bodies in the noses of children may often be expelled by simple nose blowing. Success of this manoeuvre depends on how firmly the object is lodged, and on the co-operation and skill of the child. Attempts at direct removal using instruments frequently result in the patient becoming distressed and resort to general anaesthesia is sometimes required. This short communication describes a series of cases in which nebulized adrenaline helped loosen firmly impacted foreign bodies, thereby facilitating removal, minimizing upset for the child, and avoiding anaesthetic risk.

  9. Ibandronate Injection

    MedlinePlus

    Boniva® Injection ... Ibandronate injection is used to treat osteoporosis (a condition in which the bones become thin and weak and break ... Ibandronate injection comes as a solution (liquid) to be injected into a vein by a doctor or nurse in ...

  10. Leuprolide Injection

    MedlinePlus

    Leuprolide injection comes as a long-acting suspension (Lupron) that is injected intramuscularly (into a muscle) by a doctor or nurse in a medical ... Depot-4 month, Lupron Depot-6 Month). Leuprolide injection also comes as a long-acting suspension (Eligard) that is injected subcutaneously (just under ...

  11. Parallel path nebulizer: Critical parameters for use with microseparation techniques combined with inductively coupled plasma mass spectrometry

    NASA Astrophysics Data System (ADS)

    Yanes, Enrique G.; Miller-Ihli, Nancy J.

    2005-04-01

    Four different, low flow parallel path Mira Mist CE nebulizers were evaluated and compared in support of an ongoing project related to the use of microseparation techniques interfaced to inductively coupled plasma mass spectrometry for the quantification of cobalamin species (Vitamin B12). For the characterization of the different Mira Mist CE nebulizers, the nebulizer orientation as well as the effect of methanol on analytical response was the focus of the study. The position of the gas outlet on the nebulizer which consistently provided the maximum signal was when it was rotated to the 11 o'clock position when the nebulizer is viewed end-on. With this orientation the increased signal may be explained by the fact that the cone angle of the aerosol is such that the largest percentage of the aerosol is directed to the center of the spray chamber and consequently into the plasma. To characterize the nebulizer's performance, the signal response of a multielement solution containing elements with a variety of ionization potentials was used. The selection of elements with varying ionization energies and degrees of ionization was essential for a better understanding of observed increases in signal enhancement when methanol was used. Two different phenomena contribute to signal enhancement when using methanol: the first is improved transport efficiency and the second is the "carbon enhancement effect". The net result was that as much as a 30-fold increase in signal was observed for As and Mg when using a make-up solution of 20% methanol at a 15 μL/min flow rate which is equivalent to a net volume of 3 μL/min of pure methanol.

  12. Virucidal Efficacy of a Hydrogen Peroxide Nebulization Against Murine Norovirus and Feline Calicivirus, Two Surrogates of Human Norovirus.

    PubMed

    Zonta, William; Mauroy, Axel; Farnir, Frederic; Thiry, Etienne

    2016-12-01

    Human noroviruses (HuNoV) are amongst the leading causes of acute non-bacterial gastroenteritis in humans and can be transmitted via person-to-person contact, via contact with contaminated surfaces or by consumption of contaminated food. Contaminated surfaces in healthcare settings contribute to the transmission of viruses. No-touch automated room disinfection systems might prevent such a spread of contamination and thus their virucidal effect needs to be evaluated. The aim of this study was to assess the efficacy of a nebulization system spraying hydrogen peroxide on two main surrogates of HuNoV, namely murine norovirus (MNV) and feline calicivirus (FCV). The viruses were dried on cover glasses and on stainless steel discs and exposed to nebulization. The number of infectious viral particles and genomic copies before and after the nebulization was compared. The efficacy in reducing infectivity of both surrogates was demonstrated. For the infectious viral titre of MNV and FCV, a log10 reduction factor ≥4.84 and 4.85 was observed after nebulization, respectively, for tests on cover glasses and ≥3.90 and 5.30, respectively, for tests on stainless steel discs. Only low reductions in genomic copy numbers were observed for both surrogates. The nebulization of hydrogen peroxide showed a clear virucidal effect on both HuNoV surrogates, MNV and FCV, on two different carriers and the use of nebulization should be promoted in complementarity with conventional disinfection methods in healthcare settings and food processing facilities to reduce viral load and spread of contamination.

  13. Aerodynamic characteristics of nebulized terbutaline sulphate using the Andersen Cascade Impactor compared to the Next Generation Impactor.

    PubMed

    Abdelrahim, Mohamed E

    2011-04-01

    Characterization of the aerosol emitted from nebulizers is determined using the Next Generation Impactor (NGI). The Andersen Cascade Impactor (ACI) was previously used but the limitation of high flow rate used decreased its uses. We have investigated the use of ACI with different operational conditions compared to the NGI methodology. NGI was operated at a flow rate of 15 L min⁻¹ after cooling at 5°C for 90 min. ACI was operated using flow rates 15 and 28.3 L min⁻¹ at room (ROOM) temperature and after cooling at 5 °C for 60 min (COLD). ACI was also operated using a flow rate 15 L min⁻¹ through the nebulizer T-piece with a flow rate 28.3 L min⁻¹ through ACI (15 Mix) using the mixing valve at ROOM and COLD. Two nebulizer systems, the Sidestream (SIDE) and the Aeroneb Pro (AERO) were used to nebulize terbutaline sulphate respiratory solution. Overall there was a highly significant difference (P < 0.001) between different ACI operating conditions for FPF and MMAD of both nebulizer systems. The ACI at higher flow rate increased the evaporation effect whilst cooling minimized evaporation of both nebulizer systems. Hence cooling and using slow flow rate minimizes evaporation effects with ACI. The ACI 15COLD results were similar to that of NGI. That supports the use of ACI at inhalation flow rate 15 L min⁻¹ without fear of domination of gravity on ACI stages.

  14. [Metered-dose inhalers with home-made spacers versus nebulizers to treat moderate wheezing attacks in children].

    PubMed

    Vilarinho, Liana Consuelo Santana; Cardeal Mendes, Carlos Maurício; de Freitas Souza, Leda Solano

    2003-01-01

    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. 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 microg/3 kg in the spacer group, and 250 microg/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. 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 microg/3 kg with the spacer, and 250 microg/3 kg with the nebulizer) were shown to be clinically equivalent. Treatment cost was significantly lower in the spacer group, as was the time to prepare and deliver the drug. Parental satisfaction was similar for both inhaler devices. The home-made spacer with a metered-dose inhaler is a cost-effective alternative to a jet nebulizer in the delivery of salbutamol to children with moderate wheezing attacks.

  15. Levalbuterol nebulizer solution: is it worth five times the cost of albuterol?

    PubMed

    Asmus, M J; Hendeles, L

    2000-02-01

    Albuterol is a 50:50 mixture of R-albuterol, the active enantiomer, and S-albuterol, which appears to be inactive in humans. The Food and Drug Administration recently approved levalbuterol, the pure R-isomer, as a preservative-free nebulizer solution. Published studies indicate that it is neither safer nor more effective than an equimolar dose of racemic albuterol (levalbuterol 1.25 mg = albuterol 2.5 mg). However, these studies were conducted in patients with stable asthma (at the top of the dose-response curve), whereas a nebulized bronchodilator most likely would be used by patients with an acute exacerbation. Because such patients, in the hospital setting, often require higher doses of albuterol, the manufacturer's recommended dose of levalbuterol is likely to be too low for rescue therapy. Levalbuterol may cost as much as 5 times more than racemic albuterol, depending on purchase method. We conclude that levalbuterol offers no advantage over albuterol but is likely to be more costly.

  16. Ultrasonic Nebulizer Assisted LIBS: a Promising Metal Elements Detection Method for Aqueous Sample Analysis

    NASA Astrophysics Data System (ADS)

    Zhong, Shilei; Zheng, Ronger; Lu, Yuan; Cheng, Kai; Xiu, Junshan

    2015-11-01

    A newly developed approach for trace metal elements detection for aqueous samples analysis is presented in this paper. The idea of this approach is to improve ablation efficiency by transforming the liquid sample into a dense cloud of droplets using an ultrasonic nebulizer. The resulting droplets are then subjected to analysis by laser induced breakdown spectroscopy (LIBS). A purpose-built ultrasonic nebulizer assisted LIBS (UN-LIBS) system has been applied to the analysis of aqueous samples at trace levels of concentration. Experimental investigations of solution samples were carried out with various dissolved trace metal elements (Mn, Zn, Cu, Pb, Fe, Mg and Na) using this approach. The characteristics of UN-LIBS signal of the elements were investigated regarding the lifetime and S/B ratio and the calibration curves for trace metal elements analyses. The obtained LODs are comparable or much better than the LODS of the reported signal enhancement approaches when the laser pulse energy was as low as 30 mJ. The good linearity of calibration curves and the low LODs shows the potential ability of this method for metal elements analysis application. The density of the electrons was calculated by measuring the Stark width of the line of Hα. The possible mechanism of the LIBS signal enhancement of this approach was briefly discussed. supported by National Natural Science Foundation of China (No. 11104153)

  17. Golimumab Injection

    MedlinePlus

    ... body and causes pain, swelling, and damage) including: rheumatoid arthritis (condition in which the body attacks its own ... doctor.If golimumab injection is used to treat rheumatoid arthritis, it may also be injected intravenously (into a ...

  18. Adalimumab Injection

    MedlinePlus

    ... causes pain, swelling, and damage) including the following: rheumatoid arthritis (a condition in which the body attacks its ... If you are using adalimumab injection to treat rheumatoid arthritis, your doctor may tell you to inject the ...

  19. Ipilimumab Injection

    MedlinePlus

    ... are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while receiving ipilimumab injection, call your doctor. Ipilimumab injection may cause your baby to be born too early or to die before birth.

  20. Teniposide Injection

    MedlinePlus

    ... in men. You should not become pregnant or breast-feed while you are receiving teniposide injection. If you or your partner become pregnant while receiving teniposide injection, call your doctor. Teniposide may harm the fetus.

  1. Dexrazoxane Injection

    MedlinePlus

    ... Dexrazoxane injection (Zinecard) is used to prevent or decrease heart damage caused by doxorubicin in women who ... with doxorubicin. Dexrazoxane injection (Totect) is used to decrease damage to the skin and tissues that may ...

  2. Colistimethate Injection

    MedlinePlus

    ... is used to treat certain infections caused by bacteria. Colistimethate injection is in a class of medications called antibiotics. It works by killing bacteria.Antibiotics such as colistimethate injection will not work ...

  3. Chloramphenicol Injection

    MedlinePlus

    ... treat certain types of serious infections caused by bacteria when other antibiotics cannot be used. Chloramphenicol injection ... antibiotics. It works by stopping the growth of bacteria..Antibiotics such as chloramphenicol injection will not work ...

  4. Natalizumab Injection

    MedlinePlus

    ... your condition. Keep all appointments to receive natalizumab injection even if you feel well. ... tests to check your body's response to natalizumab injection.It is important ... you are taking, as well as any products such as vitamins, minerals, or ...

  5. Methylnaltrexone Injection

    MedlinePlus

    ... taking opioid medications, you should stop using methylnaltrexone injection as well.You should stop taking other laxative medications when you start using methylnaltrexone injection. However, be sure to let your doctor know ...

  6. Triptorelin Injection

    MedlinePlus

    ... used to treat the symptoms associated with advanced prostate cancer. Triptorelin injection (Triptodur) is used to treat central ... a medical office or clinic. When used for prostate cancer, an injection of 3.75 mg of triptorelin ( ...

  7. Degarelix Injection

    MedlinePlus

    Degarelix injection is used to treat advanced prostate cancer (cancer that begins in the prostate [a male reproductive gland]). Degarelix injection is in a class of medications called gonadotropin-releasing hormone (GnRH) ...

  8. Medroxyprogesterone Injection

    MedlinePlus

    ... Medroxyprogesterone injection is a very effective method of birth control but does not prevent the spread of human ... you have been using a different method of birth control and are switching to medroxyprogesterone injection, your doctor ...

  9. Dolasetron Injection

    MedlinePlus

    ... treat nausea and vomiting that may occur after surgery. Dolasetron injection should not be used to prevent ... a single injection just before the end of surgery or as soon as nausea or vomiting occurs. ...

  10. Levoleucovorin Injection

    MedlinePlus

    Levoleucovorin injection is used to prevent harmful effects of methotrexate (Rheumatrex, Trexall) when methotrexate is used to to treat certain types of cancer. Levoleucovorin injection is also used to treat people ...

  11. Etelcalcetide Injection

    MedlinePlus

    Etelcalcetide injection is used to treat secondary hyperparathyroidism (condition in which the body produces too much parathyroid ... blood when the kidneys are not working properly.) Etelcalcetide injection is in a class of medications called ...

  12. Dupilumab Injection

    MedlinePlus

    ... injection is used to treat the symptoms of eczema (atopic dermatitis; a skin disease that causes the ... use other medications for their condition or whose eczema has not responded to other medications. Dupilumab injection ...

  13. Methylprednisolone Injection

    MedlinePlus

    ... allergic reactions. Methylprednisolone injection is used in the management of multiple sclerosis (a disease in which the ... laboratory test, tell your doctor and the laboratory personnel that you are using methylprednisolone injection.If you ...

  14. Clindamycin Injection

    MedlinePlus

    ... your treatment with clindamycin injection or during the first several months after your treatment is finished: watery or bloody stools, diarrhea, stomach cramps, or fever.Talk to your doctor about the risks of receiving clindamycin injection.

  15. Obinutuzumab Injection

    MedlinePlus

    Obinutuzumab injection is used with chlorambucil (Leukeran) to treat chronic lymphocytic leukemia (CLL; a type of cancer of the white blood cells). Obinutuzumab injection is in a class of medications called ...

  16. Ferumoxytol Injection

    MedlinePlus

    Ferumoxytol injection is used to treat iron-deficiency anemia (a lower than normal number of red blood ... and may cause the kidneys to stop working). Ferumoxytol injection is in a class of medications called ...

  17. Pralatrexate Injection

    MedlinePlus

    Pralatrexate injection is used to treat peripheral T-cell lymphoma (PTCL; a form of cancer that begins in a ... come back after treatment with other medications. Pralatrexate injection has not been shown to help people who ...

  18. Cyanocobalamin Injection

    MedlinePlus

    Cyanocobalamin injection is used to treat and prevent a lack of vitamin B12 that may be caused by any ... organs) and permanent damage to the nerves. Cyanocobalamin injection also may be given as a test to ...

  19. Paclitaxel Injection

    MedlinePlus

    Paclitaxel injection manufactured with human albumin is used to treat breast cancer that has not improved or that has come back after treatment with other medications. Paclitaxel injection manufactured with polyoxyethylated castor oil is used to ...

  20. Peramivir Injection

    MedlinePlus

    Peramivir injection is used to treat some types of influenza infection ('flu') in people who have had symptoms of ... flu for no longer than 2 days. Peramivir injection is in a class of medications called neuraminidase ...

  1. Cefotetan Injection

    MedlinePlus

    Cefotetan injection is used to treat infections of the lungs, skin, bones, joints, stomach area, blood, female reproductive organs, and urinary tract. Cefotetan injection is also used before surgery to prevent infections. ...

  2. Mipomersen Injection

    MedlinePlus

    Mipomersen injection is used to decrease levels of cholesterol and other fatty substances in the blood in people who ... that removes LDL from the blood), but mipomersen injection should not be used along with this treatment. ...

  3. Romiplostim Injection

    MedlinePlus

    Romiplostim injection is used to increase the number of platelets (cells that help the blood to clot) in order ... low number of platelets in the blood). Romiplostim injection should only be used in people who cannot ...

  4. Hydrocortisone Injection

    MedlinePlus

    Hydrocortisone injection is used to treat symptoms of low corticosteroid levels (lack of certain substances that are usually produced ... also used to treat severe allergic reactions. Hydrocortisone injection is used in the management of multiple sclerosis ( ...

  5. Palivizumab Injection

    MedlinePlus

    Palivizumab injection is used to help prevent respiratory syncytial virus (RSV; common virus that can cause serious lung infections) ... or have certain heart or lung diseases. Palivizumab injection is not used to treat the symptoms of ...

  6. Naltrexone Injection

    MedlinePlus

    Naltrexone injection is used along with counseling and social support to help people who have stopped drinking large amounts of alcohol to avoid drinking again. Naltrexone injection is also used along with counseling and social ...

  7. Tesamorelin Injection

    MedlinePlus

    Tesamorelin injection is used to decrease the amount of extra fat in the stomach area in adults with human ... fat in certain areas of the body). Tesamorelin injection is not used to help with weight loss. ...

  8. Tigecycline Injection

    MedlinePlus

    Tigecycline injection used to treat certain serious infections including community acquired pneumonia (a lung infection that developed in a ... area between the chest and the waist). Tigecycline injection should not be used to treat pneumonia that ...

  9. Eculizumab Injection

    MedlinePlus

    Eculizumab injection is used to treat paroxysmal nocturnal hemoglobinuria (PNH: a type of anemia in which too many red ... oxygen to all parts of the body). Eculizumab injection is also used to treat atypical hemolytic uremic ...

  10. Pembrolizumab Injection

    MedlinePlus

    Pembrolizumab injection is used to treat melanoma (a type of skin cancer) that cannot be treated with surgery or ... spread to other parts of the body. Pembrolizumab injection is also used to treat a certain type ...

  11. Oxacillin Injection

    MedlinePlus

    ... is used to treat infections caused by certain bacteria. Oxacillin injection is in a class of medications called penicillins. It works by killing bacteria.Antibiotics such as oxacillin injection will not work ...

  12. Cefoxitin Injection

    MedlinePlus

    ... injection is used to treat infections caused by bacteria including pneumonia and other lower respiratory tract (lung) ... medications called cephamycin antibiotics. It works by killing bacteria.Antibiotics such as cefoxitin injection will not work ...

  13. Nafcillin Injection

    MedlinePlus

    ... to treat infections caused by certain types of bacteria. Nafcillin injection is in a class of medications called penicillins. It works by killing bacteria.Antibiotics such as nafcillin injection will not work ...

  14. Doripenem Injection

    MedlinePlus

    ... tract, kidney, and abdomen that are caused by bacteria. Doripenem injection is not approved by the Food ... medications called carbapenem antibiotics. It works by killing bacteria.Antibiotics such as doripenem injection will not work ...

  15. [Ernst Rüdin: distinguished scientist, radical racial hygienist].

    PubMed

    Roelcke, V

    2012-03-01

    Ernst Rüdin (1874–1952) was one of the founders of psychiatric genetics. From 1931 until 1945, he was Director of the German Institute for Psychiatric Research (Deutsche Forschungsanstalt für Psychiatrie, DFA) and from 1935 until 1945 President of the German Association of Neurologists and Psychiatrists. The historical knowledge on Rüdin is reconsidered, using new sources, and with a focus on Rüdin’s involvement in the Nazi program of patient killings („euthanasia"). It is documented that (1) it is a misconception to interpret psychiatric genetics as „instrumentalised" by the Nazi regime; (2) Rüdin belonged to the group of psychiatric perpetrators who worked to give the Nazi selection policies scientific authority; (3) Rüdin knew early on about the patient killings and refused to support others in their efforts to stop them; and (4) the research in the context of the patient killings carried out by Julius Deussen, a member of Rüdin’s team at the DFA, was initiated and actively supported by Rüdin, and co-financed by the DFA.

  16. Selected parameters affecting characterization of nebulized aqueous solutions by inertial impaction and comparison with phase-Doppler analysis.

    PubMed

    Dunbar, C A; Hickey, A J

    1999-09-01

    The objective of this study was to evaluate selected parameters affecting the characterization of air-jet nebulized aqueous solutions by inertial impaction. Parameters affecting characterization of the droplet size distribution by inertial impaction were considered to be nebulizer T-piece connecting tube length, solute concentration, droplet charge accumulation, sample time and marker concentration. Parametric effects on nebulizer output characteristics were evaluated using a fractional factorial design. Response factors were defined as mass median aerodynamic diameter (MMAD), relative span factor (Delta), fine particle mass and delivery rate of solute. Connecting tube length, grounding the impaction stages and marker concentration did not significantly affect the response factors (0.05). Mass median aerodynamic diameter (MMAD) and delivery rate of solute were significantly affected by solute concentration (p<0.05). Fine particle mass was significantly affected by the interaction between solute concentration and sampling time. Droplets attained an equilibrium size with an MMAD=1.0 microm, Delta=2.12 (0.9% solute) and MMAD=1.7 microm, Delta=2.00 (9. 0% solute) before the exit of the nebulizer T-piece. The droplet size distributions obtained by inertial impaction were compared with data obtained by phase-Doppler analysis.

  17. Nebulized solid lipid nanoparticles for the potential treatment of pulmonary hypertension via targeted delivery of phosphodiesterase-5-inhibitor.

    PubMed

    Makled, Shaimaa; Nafee, Noha; Boraie, Nabila

    2017-01-30

    Phosphodiesterase type 5 (PDE-5) inhibitors - among which sildenafil citrate (SC) - play a primary role in the treatment of pulmonary hypertension (PH). Yet, SC can be only administered orally or parenterally with lot of risks. Targeted delivery of SC to the lungs via inhalation/nebulization is mandatory. In this study, solid lipid nanoparticles (SLNs) loaded with SC were prepared and characterized in terms of colloidal, morphological and thermal properties. The amount of drug loaded and its release behavior were estimated as a function of formulation variables. The potential of lipid nanocarriers to retain their properties following nebulization and autoclaving was investigated. In addition, toxicity aspects of plain and loaded SLNs on A549 cells were studied with respect to concentration. Spherical SLNs in the size range (100-250nm) were obtained. Particles ensured high encapsulation efficiency (88-100%) and sustained release of the payload over 24h. Cell-based viability experiments revealed a concentration-dependant toxicity for both plain and loaded SLNs recording an IC50 of 516 and 384μg/mL, respectively. Nebulization with jet nebulizer and sterilization via autoclaving affected neither the colloidal stability of SLNs nor the drug entrapment, proving their potential as pulmonary delivery system. Interaction of SLNs with mucin was a function of the emulsifier coating layer. Results yet seeking clinical evidence - might give promises of new therapy for PH of higher safety, better performance and higher patient compliance. Copyright © 2016 Elsevier B.V. All rights reserved.

  18. Implementation of a Policy Change: Replacement of Nebulizers by Spacers for the Treatment of Asthma in Children.

    PubMed

    Breuer, Oded; Shoseyov, David; Kerem, Eitan; Brooks, Rebecca

    2015-07-01

    Treatment using inhaled bronchodilators for asthma with a metered dose inhaler attached to a spacer device (MDI+S) was shown to be as efficient as nebulizers. Nevertheless, nebulizers remain the treatment of choice in most hospitals. To implement a policy change to improve asthma treatment in pediatric wards and the pediatric emergency department. The study was performed in the emergency department and pediatric wards of a university medical center. The study group comprised all children admitted with a diagnosis of asthma necessitating treatment. The medical and nursing staff of both the pediatric emergency department and the pediatric wards was trained how to use metered dose inhalers attached to spacers on a regular basis in asthmatic pediatric patients. At a preset date nebulizers were replaced by spacers and their use was monitored by the supervising physician. Salbutamol was administered by a metered dose inhaler (100 μg/puff) attached to a spacer device. The number of puffs was determined by severity of disease according to GINA recommendations. After 2 years the outcome and cost analysis were examined. During 3 years since the initial policy change 92.5%, patients were treated with spacers throughout their hospital stay (emergency department and pediatric ward). Costs were reduced by an estimated 63%. In view of its many advantages, replacing nebulizers by MDI+S for the treatment of acute asthma.is, feasible, if performed in collaboration with the staff, hospital authority and patients.

  19. Cidofovir Injection

    MedlinePlus

    ... in babies whose mothers received cidofovir injection during pregnancy. You should not use cidofovir injection while you are pregnant or plan to become pregnant unless your doctor decides that this is the best treatment for your condition.Cidofovir injection has caused tumors ...

  20. Albiglutide Injection

    MedlinePlus

    ... blood) when other medications did not control levels well enough. Albiglutide injection is not used to treat type 1 diabetes ( ... does not cure it. Continue to use albiglutide injection even if you feel well. Do not stop using albiglutide injection without talking ...

  1. Nalbuphine Injection

    MedlinePlus

    ... Your doctor may adjust your dose of nalbuphine injection during your treatment, depending on how well your pain is controlled and on the side effects that you experience. Talk to your doctor about how you are feeling ... nalbuphine injection.You may receive nalbuphine injection in a hospital, ...

  2. Liraglutide Injection

    MedlinePlus

    ... blood) when other medications did not control levels well enough. Liraglutide injection (Victoza) is not used to treat type 1 ... does not cure it. Continue to use liraglutide injection even if you feel well. Do not stop using liraglutide injection without talking ...

  3. Meperidine Injection

    MedlinePlus

    ... Your doctor may adjust your dose of meperidine injection during your treatment, depending on how well your pain is controlled and on the side effects that you experience. Talk to your doctor about how you are feeling ... meperidine injection.If you have used meperidine injection for longer ...

  4. Dulaglutide Injection

    MedlinePlus

    ... blood) when other medications did not control levels well enough. Dulaglutide injection is not used to treat type 1 diabetes ( ... does not cure it. Continue to use dulaglutide injection even if you feel well. Do not stop using dulaglutide injection without talking ...

  5. Morphine Injection

    MedlinePlus

    ... Your doctor may adjust your dose of morphine injection during your treatment, depending on how well your pain is controlled and on the side effects that you experience. Talk to your doctor about how you are feeling ... with morphine injection.If you have used morphine injection for longer ...

  6. Busulfan Injection

    MedlinePlus

    Busulfex® Injection ... Busulfan injection is used to treat a certain type of chronic myelogenous leukemia (CML; a type of cancer of ... of 16 doses) before bone marrow transplant.Busulfan injection may cause seizures during therapy with the medication. ...

  7. Preventive nebulization of mucolytic agents and bronchodilating drugs in invasively ventilated intensive care unit patients (NEBULAE): study protocol for a randomized controlled trial.

    PubMed

    van der Hoeven, Sophia M; Binnekade, Jan M; de Borgie, Corianne A J M; Bosch, Frank H; Endeman, Henrik; Horn, Janneke; Juffermans, Nicole P; van der Meer, Nardo J M; Merkus, Maruschka P; Moeniralam, Hazra S; van Silfhout, Bart; Slabbekoorn, Mathilde; Stilma, Willemke; Wijnhoven, Jan Willem; Schultz, Marcus J; Paulus, Frederique

    2015-09-02

    Preventive nebulization of mucolytic agents and bronchodilating drugs is a strategy aimed at the prevention of sputum plugging, and therefore atelectasis and pneumonia, in intubated and ventilated intensive care unit (ICU) patients. The present trial aims to compare a strategy using the preventive nebulization of acetylcysteine and salbutamol with nebulization on indication in intubated and ventilated ICU patients. The preventive nebulization of mucolytic agents and bronchodilating drugs in invasively ventilated intensive care unit patients (NEBULAE) trial is a national multicenter open-label, two-armed, randomized controlled non-inferiority trial in the Netherlands. Nine hundred and fifty intubated and ventilated ICU patients with an anticipated duration of invasive ventilation of more than 24 hours will be randomly assigned to receive either a strategy consisting of preventive nebulization of acetylcysteine and salbutamol or a strategy consisting of nebulization of acetylcysteine and/or salbutamol on indication. The primary endpoint is the number of ventilator-free days and surviving on day 28. Secondary endpoints include ICU and hospital length of stay, ICU and hospital mortality, the occurrence of predefined pulmonary complications (acute respiratory distress syndrome, pneumonia, large atelectasis and pneumothorax), and the occurrence of predefined side effects of the intervention. Related healthcare costs will be estimated in a cost-benefit and budget-impact analysis. The NEBULAE trial is the first randomized controlled trial powered to investigate whether preventive nebulization of acetylcysteine and salbutamol shortens the duration of ventilation in critically ill patients. NCT02159196, registered on 6 June 2014.

  8. Variability in delivered dose and respirable delivered dose from nebulizers: are current regulatory testing guidelines sufficient to produce meaningful information?

    PubMed Central

    Hatley, Ross HM; Byrne, Sarah M

    2017-01-01

    Background To improve convenience to patients, there have been advances in the operation of nebulizers, resulting in fast treatment times and less drug lost to the environment. However, limited attention has been paid to the effects of these developments on the delivered dose (DD) and respirable delivered dose (RDD). Published pharmacopoeia and ISO testing guidelines for adult-use testing utilize a single breathing pattern, which may not be sufficient to enable effective comparisons between the devices. Materials and methods The DD of 5 mg of salbutamol sulfate into adult breathing patterns with inhalation:exhalation (I:E) ratios between 1:1 and 1:4 was determined. Droplet size was determined by laser diffraction and RDD calculated. Nine different nebulizer brands with different modes of operation (conventional, venturi, breath-enhanced, mesh, and breath-activated) were tested. Results Between the non-breath-activated nebulizers, a 2.5-fold difference in DD (~750–1,900 µg salbutamol) was found; with RDD, there was a more than fourfold difference (~210–980 µg). With increasing time spent on exhalation, there were progressive reductions in DD and RDD, with the RDD at an I:E ratio of 1:4 being as little as 40% of the dose with the 1:1 I:E ratio. The DD and RDD from the breath-activated mesh nebulizer were independent of the I:E ratio, and for the breath-activated jet nebulizer, there was less than 20% change in RDD between the I:E ratios of 1:1 and 1:4. Conclusion Comparing nebulizers using the I:E ratio recommended in the guidelines does not predict relative performance between the devices at other ratios. There was significant variance in DD or RDD between different brands of non-breath-activated nebulizer. In future, consideration should be given to revision of the test protocols included in the guidelines, to reflect more accurately the potential therapeutic dose that is delivered to a realistic spectrum of breathing patterns. PMID:28203110

  9. Does nebulized lidocaine reduce the pain and distress of nasogastric tube insertion in young children? A randomized, double-blind, placebo-controlled trial.

    PubMed

    Babl, Franz E; Goldfinch, Christopher; Mandrawa, Christine; Crellin, Dianne; O'Sullivan, Ronan; Donath, Susan

    2009-06-01

    Nasogastric tube insertion is a common procedure in children that is very painful and distressing. Although nebulized lidocaine has been shown to be effective in reducing the pain and discomfort of nasogastric tube insertion in adults, there have been no similar studies in children. We set out to investigate the role of nebulized lidocaine in reducing pain and distress of nasogastric tube insertion in young children. We conducted a randomized, double-blind, placebo-controlled trial of nebulized 2% lidocaine at 4 mg/kg versus saline placebo during nasogastric tube insertion at a tertiary urban pediatric emergency department. Patients were eligible if they were aged from 1 to 5 years with no comorbid disease and a clinical indication for a nasogastric tube. Nebulization occurred for 5 minutes, 5 minutes before nasogastric tube insertion. Video recordings before, during, and after the procedure were rated using the Face, Legs, Activity, Cry, and Consolability (FLACC) pain and distress assessment tool (primary outcome measure) and pain and distress visual analog scale scores (secondary outcome measures). Difficulty of insertion and adverse events were also assessed. Eighteen participants were nebulized with 2% lidocaine and 18 participants with normal saline. Nebulization was found to be highly distressing. FLACC scores during nasogastric tube insertion were very high in both groups. There was a trend in the post-nasogastric tube insertion period toward lower FLACC scores in the lidocaine group. Visual analog scale scores for this postinsertion period were significantly lower in the lidocaine arm for pain and distress. There were no significant differences between groups in terms of difficulty of insertion and the number of minor adverse events. The study was terminated early because of the distress and treatment delay associated with nebulization. Nasogastric tube insertion results in very high FLACC scores irrespective of lidocaine use. Nebulized lidocaine cannot be

  10. Scintigraphic Assessment of Deposition of Radiolabeled Fluticasone Delivered from a Nebulizer and Metered Dose Inhaler in 10 Healthy Dogs.

    PubMed

    Chow, K E; Tyrrell, D; Yang, M; Abraham, L A; Anderson, G A; Mansfield, C S

    2017-09-29

    Aerosolized medications increasingly being are used to treat respiratory diseases in dogs. No previous studies assessing respiratory tract deposition of radiolabeled aerosols have been performed in conscious dogs. Assess respiratory tract deposition of radiolabeled, inhalant corticosteroid (fluticasone propionate labeled with (99m) Tc) delivered from a nebulizer and metered dose inhaler (MDI) to healthy dogs. Ten healthy Foxhounds. Prospective, randomized, cross-over pilot study. Initial inhalation method (nebulizer or MDI) was randomly assigned. Treatments were crossed over after a 7-day washout period. Treatments initially were performed using sedation. Dogs were imaged using 2-dimensional planar scintigraphy, with respiratory tract deposition quantified by manual region-of-interest analysis. Deposition calculated as percentage of delivered dose. Six of 10 dogs were randomly selected and reassessed without sedation. Inhalation method had significant effect on respiratory tract deposition (P = 0.027). Higher deposition was achieved by nebulization with mean deposition of 4.2% (standard deviation [SD], 1.4%; range, 1.9-6.1%); whereas MDI treatment achieved a mean of 2.3% (SD, 1.4%; range, 0.2-4.2%). Nebulization achieved higher respiratory tract deposition than MDI in 7 of 10 dogs. No statistical difference (P = 0.68) was found between mean respiratory tract deposition achieved in dogs when unsedated (3.8%; SD, 1.5%) or sedated (3.6%; SD, 1.7%). Study confirms respiratory tract deposition of inhalant medications delivered from a nebulizer and MDI in healthy dogs, breathing tidally with and without sedation. Respiratory tract deposition in these dogs was low compared to reported deposition in adult humans, but similar to reported deposition in children. Copyright © 2017 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

  11. Albuterol delivery in a neonatal ventilated lung model: Nebulization versus chlorofluorocarbon- and hydrofluoroalkane-pressurized metered dose inhalers.

    PubMed

    Lugo, R A; Kenney, J K; Keenan, J; Salyer, J W; Ballard, J; Ward, R M

    2001-03-01

    The aim of this study was to compare albuterol delivery in a neonatal ventilated lung model, using three delivery methods: 1) jet nebulizer; 2) chlorofluorocarbon-pressurized metered dose inhaler (CFC-MDI) actuated into an ACE(R) spacer; and 3) hydrofluoroalkane-pressurized MDI (HFA-MDI) actuated into an ACE(R) spacer. The bench model consisted of a mechanically ventilated infant test lung with ventilator settings to simulate a very low birth weight neonate with moderate lung disease. Albuterol solution (0.5%) was nebulized at the humidifier and temperature port, 125 cm and 30 cm from the Y-piece, respectively. Albuterol metered dose inhalers (MDIs) were actuated into an ACE(R) spacer that was tested in two positions: 1) inline between the endotracheal (ET) tube and the Y-piece; and 2) attached to the ET tube and administered by manual ventilation. Albuterol was collected on a filter at the distal end of the ET tube and was quantitatively analyzed by high performance liquid chromatography. Albuterol delivery by CFC-MDI (position 1, 4.8 +/- 1.0%, vs. position 2, 3.8 +/- 1.6%, P > 0.05) and HFA-MDI (position 1, 5.7 +/- 1.6%, vs. position 2, 5.5 +/- 2.4%, P > 0.05) were significantly greater than delivery by nebulization at 30 cm (0.16 +/- 0.07%) and 125 cm (0.15 +/- 0.03%) from the Y-piece (P < 0.001). A single actuation of albuterol MDI delivered the equivalent of nebulizing 2.5-3.7 mg of albuterol solution. We conclude that albuterol administered by MDI and ACE(R) spacer resulted in more efficient delivery than by nebulization in this mechanically ventilated neonatal lung model. There was no significant difference in drug delivery between CFC-MDI and HFA-MDI; nor did the placement of the spacer significantly affect drug delivery.

  12. A simple approach to predict the stability of phospholipid vesicles to nebulization without performing aerosolization studies.

    PubMed

    Subramanian, Sneha; Khan, Iftikhar; Korale, Oshadie; Alhnan, Mohamed Albed; Ahmed, Waqar; Najlah, Mohammad; Taylor, Kevin M G; Elhissi, Abdelbary

    2016-04-11

    Membrane extrusion was investigated for predicting the stability of soya phosphatidylcholine liposomes and surfactosomes (Tween 80-enriched liposomes) to nebulization. Formulations were prepared with or without cholesterol, and salbutamol sulfate (SBS) or beclometasone dipropionate (BDP) were incorporated as model hydrophilic or hydrophobic drugs respectively. Formulations were extruded through 5, 2, 1 and 0.4 μm polycarbonate membrane filters to study the influence of membrane pore size on drug retention by the vesicles. Surfactosomes were found to be very leaky to SBS, such that even without extrusion greater than 50% of the originally entrapped drug was lost; these losses were minimized by the inclusion of cholesterol. The smaller the membrane pore size, the greater the leakage of SBS; hence only around 10% were retained in cholesterol-free surfactosomes extruded through 0.4 μm filters. To study the influence of vesicle size on SBS retained entrapment, an excessive extrusion protocol was proposed (51 extrusion cycles through 1 μm filters) to compare the stability of freshly prepared vesicles (i.e. unextruded; median size approx. 4.5-6.5 μm) with those previously extruded through 1 μm pores. Cholesterol was essential for minimizing losses from liposomes, whilst for surfactosomes size reduction prior to extrusion was the only way to minimize SBS losses which reached up to 93.40% of the originally entrapped drug when no cholesterol was included. When extrusion was applied to BDP-loaded vesicles, greater proportions of the drug were retained in the vesicles compared to SBS. Even with extrusion through 0.4 μm, BDP retention was around 50-60% with little effect of formulation. Excessive extrusion showed BDP retention using small liposomes (1 μm) to be as high as 71-87%, compared to 50-66% for freshly prepared vesicles. The findings, based on extrusion, were compared to studies of vesicle stability to nebulization, published by a range of investigators. It was

  13. Screening method for determination of high levels of cadmium, lead, and copper in foods by polarized Zeeman atomic absorption spectrometry using discrete nebulization technique.

    PubMed

    Saito, I; Oshima, H; Kawamura, N; Yamada, M

    1988-01-01

    A screening method for determination of cadmium, lead, and copper in foods was developed. The sample (1-3 g) is digested with HNO3-H2SO4-HClO4 in a centrifuge tube attached to a straight glass tube that prevents loss of HNO3 by volatilization. After digestion, potassium iodide, H2SO4, and MIBK (4-methyl 2-pentanone) are added, and the metals are extracted with MIBK as metal iodides. The MIBK solution is injected and the metals are determined by flame polarized Zeeman atomic absorption spectrometry using a discrete nebulization technique. Recoveries of metals from fortified milk powder, unpolished rice, fish, beef, peanut butter, apple, and cabbage were satisfactory. The analytical results for NBS Oyster Tissue and NIES Pepperbush, Chlorella, and Mussel agreed with certified or reference values except lead in Pepperbush. The limits of quantitation for cadmium, lead, and copper were 0.01, 0.09, and 0.02 ppm, respectively. This method is simple and safe for routine analysis of high levels of cadmium, lead, and copper in foods.

  14. Ultrasonic nebulization extraction coupled with headspace single-drop microextraction of volatile and semivolatile compounds from the seed of Cuminum cyminum L.

    PubMed

    Zhang, Huihui; Shi, Yuhua; Wei, Shigang; Wang, Yinghua; Zhang, Hanqi

    2011-08-15

    Ultrasonic nebulization extraction (UNE) coupled with headspace single-drop microextraction (HS-SDME) was developed. In the UNE process, the analytes were transferred from the aqueous phase to the gas phase. Then the analytes were transferred from the gas phase to the solvent phase by the carrier gas and extracted and enriched with suspended microdrop solvent. Finally, the microdrop solvent injected into GC-MS system. The parameters affecting extraction performance, such as type of suspended solvent, microdrop volume, flow rate of carrier gas, temperature of extraction vessel and extraction time were investigated and optimized. The proposed method can be applied for the extraction and enrichment of the volatile and semivolatile compounds simultaneously. The extraction efficiency of the proposed method was compared with that of ultrasonic extraction (UE) and UE-HS-SDME. Compared with UE-HS-SDME, the contents of constituents in the extract obtained by the proposed method were closer to those obtained by hydrodistillation (HD), which is a standard extraction method.

  15. Growth of hematite by using ultrasonic nebulizer pyrolysis for use in a photoelectrochemical electrode

    NASA Astrophysics Data System (ADS)

    Ha, Jin-Wook; Ryu, Hyukhyun; Lee, Sang-Jin; Lee, Won-Jae

    2017-04-01

    In this study, a hematite photoelectrode was grown on a fluorine-doped tin-oxide substrate by using the ultrasonic nebulizer pyrolysis method. We analyzed the morphological, structural, optical, electrical, and photoelectrochemical properties of hematite samples grown at different temperatures. Field emission scanning electron microscopy, X-ray diffraction, ultraviolet-visible spectroscopy and electrochemical impedance spectroscopy with a 3-electrode potentiostat, were used to characterize hematite. The hematite sample grown at 300 °C had the highest crystallinity and the largest excited minority carrier density. Consequently, the hematite grown at 300 °C had the highest photocurrent density of 0.39 mA/cm2 at 0.55 V (vs. saturated calomel electrode (Sat. 3.3 M KCl)).

  16. Preliminary characterization of a low-powered microwave induced flame plasma for direct organic solvent nebulization

    SciTech Connect

    Ng, Kin C.; Bucay, Phil

    2011-12-15

    A low powered (<90 W) microwave-induced plasma has been generated at atmospheric pressure by using a Beenakker cavity, a laboratory constructed torch, and a gas mixture of argon (400 ml/min), hydrogen (100 ml/min), and air (130 ml/min). This plasma has an excitation temperature of 3300-3500 K, electron number density of 7 x 10{sup 14} cm{sup -3}, and easily accepts direct methanol and ethanol introduction with a 1 ml/min solution nebulization rate. Detection limits (3{sigma}) obtained from the atomic emission signals of Li, Sr, and Cr in water are 15, 120, and 290 ng/ml, respectively. Similarly, detection limits for the metals in methanol are 15, 120, and 260 ng/ml, respectively, and in ethanol they are 25, 360, and 330 ng/ml, respectively. The linear dynamic range is greater than three orders of magnitude.

  17. An empirical method to cluster objective nebulizer adherence data among adults with cystic fibrosis

    PubMed Central

    Hoo, Zhe H; Campbell, Michael J; Curley, Rachael; Wildman, Martin J

    2017-01-01

    Background The purpose of using preventative inhaled treatments in cystic fibrosis is to improve health outcomes. Therefore, understanding the relationship between adherence to treatment and health outcome is crucial. Temporal variability, as well as absolute magnitude of adherence affects health outcomes, and there is likely to be a threshold effect in the relationship between adherence and outcomes. We therefore propose a pragmatic algorithm-based clustering method of objective nebulizer adherence data to better understand this relationship, and potentially, to guide clinical decisions. Methods to cluster adherence data This clustering method consists of three related steps. The first step is to split adherence data for the previous 12 months into four 3-monthly sections. The second step is to calculate mean adherence for each section and to score the section based on mean adherence. The third step is to aggregate the individual scores to determine the final cluster (“cluster 1” = very low adherence; “cluster 2” = low adherence; “cluster 3” = moderate adherence; “cluster 4” = high adherence), and taking into account adherence trend as represented by sequential individual scores. The individual scores should be displayed along with the final cluster for clinicians to fully understand the adherence data. Three illustrative cases We present three cases to illustrate the use of the proposed clustering method. Conclusion This pragmatic clustering method can deal with adherence data of variable duration (ie, can be used even if 12 months’ worth of data are unavailable) and can cluster adherence data in real time. Empirical support for some of the clustering parameters is not yet available, but the suggested classifications provide a structure to investigate parameters in future prospective datasets in which there are accurate measurements of nebulizer adherence and health outcomes. PMID:28392678

  18. Nanomaterial size distribution analysis via liquid nebulization coupled with ion mobility spectrometry (LN-IMS).

    PubMed

    Jeon, Seongho; Oberreit, Derek R; Van Schooneveld, Gary; Hogan, Christopher J

    2016-02-21

    We apply liquid nebulization (LN) in series with ion mobility spectrometry (IMS, using a differential mobility analyzer coupled to a condensation particle counter) to measure the size distribution functions (the number concentration per unit log diameter) of gold nanospheres in the 5-30 nm range, 70 nm × 11.7 nm gold nanorods, and albumin proteins originally in aqueous suspensions. In prior studies, IMS measurements have only been carried out for colloidal nanoparticles in this size range using electrosprays for aerosolization, as traditional nebulizers produce supermicrometer droplets which leave residue particles from non-volatile species. Residue particles mask the size distribution of the particles of interest. Uniquely, the LN employed in this study uses both online dilution (with dilution factors of up to 10(4)) with ultra-high purity water and a ball-impactor to remove droplets larger than 500 nm in diameter. This combination enables hydrosol-to-aerosol conversion preserving the size and morphology of particles, and also enables higher non-volatile residue tolerance than electrospray based aerosolization. Through LN-IMS measurements we show that the size distribution functions of narrowly distributed but similarly sized particles can be distinguished from one another, which is not possible with Nanoparticle Tracking Analysis in the sub-30 nm size range. Through comparison to electron microscopy measurements, we find that the size distribution functions inferred via LN-IMS measurements correspond to the particle sizes coated by surfactants, i.e. as they persist in colloidal suspensions. Finally, we show that the gas phase particle concentrations inferred from IMS size distribution functions are functions of only of the liquid phase particle concentration, and are independent of particle size, shape, and chemical composition. Therefore LN-IMS enables characterization of the size, yield, and polydispersity of sub-30 nm particles.

  19. [Nebulized colistin versus tobramycin in the treatment of chronic Pseudomonas colonization in cystic fibrosis patients].

    PubMed

    Quintana-Gallego, Esther; Lopez-Campos, Jose Luis; Calero, Carmen; Dapena, Francisco Javier

    2014-01-21

    To compare the efficacy, safety and treatment satisfaction with inhaled colistin versus tobramycin in the cure of chronic Pseudomonas colonization in cystic fibrosis patients. A quasi-experimental open paired data trial in which patients with cystic fibrosis and chronic colonization by Pseudomonas aeruginosa were included. Patients performed 2 periods of 6 consecutive months of nebulized antibiotics: inhaled tobramycin at a dose of 300 mg/12 h (Pari LC Plus(®)) and colistimethate (I-neb(®)) at a dose of 1 MIU twice a day. Visits were made monthly and at the beginning and the end of each period; we evaluated the body mass index, lung function, number of exacerbations and sputum microbiology. Patient satisfaction was assessed with 2 questionnaires of satisfaction on the treatment and the inhalation devices. A group of 25 patients (8 men and 6 under 14 years) with a mean age of 21.4 (7.2) years and 59.8 (21.1) % of forced expiratory volume in one second (FEV1) were included. During the second period, clinical benefits were obtained in terms of lung function with an FEV1 gain of 5% at 6 months of treatment and reducing the number of exacerbations (1.84 [1.2] vs 0.8 [0.8]; P=.001). The questionnaire score was higher in period 2. Colistimethate sodium administered through the misting system I-neb(®) provides clinical benefits in terms of exacerbations and improvement of lung function and patient satisfaction for the nebulized antibiotic treatment. Copyright © 2012 Elsevier España, S.L. All rights reserved.

  20. Study of nebulization delivery of aerosolized fluorescent microspheres to the avian respiratory tract

    PubMed Central

    Tell, Lisa A.; Stephens, Kimberly; Teague, Stephen V.; Pinkerton, Kent E.; Raabe, Otto G.

    2015-01-01

    SUMMARY This study investigated the delivery of an aerosol of monodisperse microspheres to the respiratory tract of birds following aerosol exposure. Adult domestic pigeons (Columbia livia domestica; n=5 birds per timed treatment) were exposed to an aerosol of fluorescent 1.0 μm diameter carboxylate microspheres for 0.5, 1, 2 or 4 hr. During the aerosolization period, the birds were free standing in a plexiglass treatment chamber, and the aerosol was delivered using a commercial nebulizer. Immediately following aerosol exposure the birds were euthanized and the carcasses were intravenously infused with a modified paraformaldehyde/gluteraldehyde fixative. Evaluation of microsphere distribution was performed using a stereoscopic microscope with an epifluorescent module. The results from this study revealed that the amount of aerosolized particles delivered using a commercial nebulizer was proportional to exposure periods. Aerosol exposure periods of 0.5 h or 1 h did not result in a readily observable distribution of 1.0 μm fluorescent microspheres to the cranial thoracic, caudal thoracic, or abdominal air sac membranes. This was partly attributed to the relatively low concentration of the individual monodisperse microspheres in the aerosolized suspension. The 2 and 4 hr exposure periods resulted in readily observable deposition of the 1.0 μm fluorescent microspheres in the cranial thoracic, caudal thoracic, or abdominal air sac membranes with the 4 hr exposure period resulting in the greatest number of particles on the membrane surfaces. For each of the exposure periods there was individual animal variation regarding the distribution and relative number of spheres deposited. This study demonstrates the widespread deposition of particles that had an aerodynamic equivalent diameter of approximately 1 μm and provides a better understanding of particle deposition efficiency within the respiratory system following aerosol exposure in birds. PMID:22856198

  1. Study of nebulization delivery of aerosolized fluorescent microspheres to the avian respiratory tract.

    PubMed

    Tell, Lisa A; Stephens, Kimberly; Teague, Stephen V; Pinkerton, Kent E; Raabe, Otto G

    2012-06-01

    This study investigated the delivery of an aerosol of monodisperse microspheres to the respiratory tract of birds following aerosol exposure. Adult domestic pigeons (Columbia livia domestica, n = 5 birds per timed treatment) were exposed to an aerosol of fluorescent 1.0 microm diameter carboxylate microspheres for 0.5, 1, 2, or 4 hr. During the aerosolization period, the birds were free-standing in a plexiglass treatment chamber and the aerosol was delivered using a commercial nebulizer. Immediately following aerosol exposure, the birds were euthanatized and the carcasses were intravenously infused with a modified paraformaldehyde/gluteraldehyde fixative. Evaluation of microsphere distribution was performed using a stereoscopic microscope with an epifluorescent module. The results from this study revealed that the amount of aerosolized particles delivered using a commercial nebulizer was proportional to exposure periods. Aerosol exposure periods of 0.5 hr or 1 hr did not result in a readily observable distribution of 1.0 microm fluorescent microspheres to the cranial thoracic, caudal thoracic, or abdominal air sac membranes. This was partly attributed to the relatively low concentration of the individual monodisperse microspheres in the aerosolized suspension. The 2- and 4-hr exposure periods resulted in readily observable deposition of the 1.0 mirom fluorescent microspheres in the cranial thoracic, caudal thoracic, or abdominal air sac membranes, with the 4-hr exposure period resulting in the greatest number of particles on the membrane surfaces. For each of the exposure periods, there was individual animal variation regarding the distribution and relative number of spheres deposited. This study demonstrates the widespread deposition of particles that had an aerodynamic equivalent diameter of approximately 1 microm and provides a better understanding of particle deposition efficiency within the respiratory system following aerosol exposure in birds.

  2. Experimental induction of malignant catarrhal fever in pigs with ovine herpesvirus 2 by intranasal nebulization.

    PubMed

    Li, Hong; Brooking, Angela; Cunha, Cristina W; Highland, Margaret A; O'Toole, Donal; Knowles, Donald P; Taus, Naomi S

    2012-10-12

    Malignant catarrhal fever (MCF), a frequently fatal herpesviral disease primarily of ruminant species, has been sporadically reported in pigs. All cases of naturally occurring porcine MCF reported to date have been linked to ovine herpesvirus 2 (OvHV-2), a gammaherpesvirus in the genus Macavirus carried by sheep. Experimental induction of MCF by aerosolization of the virus in nasal secretions collected from infected sheep has been successful in bison, cattle and rabbits. The goals of this study were to determine the susceptibility of pigs to MCF following experimental intranasal inoculation of OvHV-2, and to characterize the disease. Twelve pigs in four groups were nebulized with 10(5), 10(6), 10(7), or 10(8) DNA copies of OvHV-2 from sheep nasal secretions. Three control pigs were nebulized with nasal secretions from uninfected sheep. Three additional pigs were inoculated intravenously with 10(7) DNA copies of OvHV-2 to evaluate this route of infection with cell-free virus. Seven of twelve intranasally challenged pigs became infected with OvHV-2. Five of these seven, all in higher dose groups, developed MCF. Lesions resembled those reported in natural cases of porcine MCF. The most striking and consistent histological lesions were in trachea, lung, kidney and brain. These comprised mucopurulent tracheitis, interstitial pneumonia, necrotizing arteritis-periarteritis, and nonpurulent meningoencephalitis. No infection was established in the intravenously challenged or control groups. The study showed that MCF can be experimentally induced in pigs by aerosol challenge using sheep nasal secretions containing OvHV-2. Domestic pigs are a natural clinically susceptible host for sheep-associated MCF. They represent a useful, cost-effective model for MCF research. Published by Elsevier B.V.

  3. A randomized, clinical trial comparing the efficacy of continuous nebulized albuterol (15 mg) versus continuous nebulized albuterol (15 mg) plus ipratropium bromide (2 mg) for the treatment of acute asthma.

    PubMed

    Salo, David; Tuel, Mark; Lavery, Robert F; Reischel, Ulrich; Lebowitz, Jeff; Moore, Terry

    2006-11-01

    Multiple studies have examined adding nebulized ipratropium bromide to intermittent albuterol for the treatment of acute asthma. Although continuous nebulized treatments in themselves offer benefits; few data exist regarding the efficacy of adding ipratropium bromide to a continuous nebulized system. To compare continuous nebulized albuterol alone (A) vs. albuterol and ipratropium bromide (AI) in adult Emergency Department (ED) patients with acute asthma, a prospective, randomized, double-blind, controlled clinical trial was conducted on a convenience sample of patients (IRB approved). The setting was an urban ED. Consenting patients > 18 years of age with peak expiratory flow rates (PEFR) < 70% predicted, between October 15 and December 28, 1999, were randomized to albuterol (7.5 mg/h) + ipratropium bromide (1.0 mg/h), or albuterol alone via continuous nebulization using the Hope Nebulizer (B&B Technologies Inc., Orangevale, CA) for 2 h. Main outcome measures were changed in mean improvement at 60 and 120 min PEFR compared to baseline (time 0). Secondary measures were admission rates. Data were analyzed using appropriate parametric and non-parametric tests (p < 0.05 statistically significant). Sixty-two patients (30 women) completed enrollment: 32 in (AI) and (30) in (A). Four (A) and 2 (AI) patients are without 120 min data: 3 (A) and 1 (AI) were discharged after 60 min, whereas one each (A) and (AI) worsened and were admitted before 120 min. There were no statistically significant differences between treatment groups in age, sex, predicted or initial PEFR. Thirteen (19.4%) patients were admitted. There was no statistically significant difference in improvement of mean PEFR at 60 min or 120 min compared to baseline, between groups, using repeated measures analysis of variance. Mean improvement in PEFR at 60 min compared to baseline (time 0): (A) = 93.2 L/min (95% confidence interval [CI] 64.5-121.8), (AI) = 86.6 L/min (95% CI 58.9-114.3); mean improvement in PEFR

  4. Dinámica de objetos transplutonianos: resultados preliminares

    NASA Astrophysics Data System (ADS)

    Fernández, S.; Brizuela, H.; Roig, F.; Varela, O.

    Se presentan los resultados de una integración numérica de las ecuaciones de movimiento para objetos transplutonianos. Se han calculado los tiempos de Lyapunov para esos objetos y se analiza el comportamiento dinámico de los mismos.

  5. A COMPARISON OF URINARY ARSENIC SPECIATION VIA DIRECT NEBULIZATION AND ON-LINE PHOTOOXIDATION-HYDRIDE GENERATION WITH DETECTION BY INDUCTIVELY COUPLED PLASMA MASS SPECTROMETRY

    EPA Science Inventory

    Arsenic speciation continues to be important in assessing human and environmental exposure risk. Urinary arsenic analysis provides information on recent arsenic exposure. In this study, two sample introduction pathways: direct nebulization (DN) and hydride generation (HG) were ut...

  6. A COMPARISON OF URINARY ARSENIC SPECIATION VIA DIRECT NEBULIZATION AND ON-LINE PHOTOOXIDATION-HYDRIDE GENERATION WITH DETECTION BY INDUCTIVELY COUPLED PLASMA MASS SPECTROMETRY

    EPA Science Inventory

    Arsenic speciation continues to be important in assessing human and environmental exposure risk. Urinary arsenic analysis provides information on recent arsenic exposure. In this study, two sample introduction pathways: direct nebulization (DN) and hydride generation (HG) were ut...

  7. Hydromorphone Injection

    MedlinePlus

    ... Your doctor may adjust your dose of hydromorphone injection during your treatment, depending on how well your pain is controlled and on the side ... to have pain after you finish the hydromorphone injection, call your doctor.It ... you are taking, as well as any products such as vitamins, minerals, or ...

  8. Ixabepilone Injection

    MedlinePlus

    ... doctor will order laboratory tests to see how well your liver is working before and during your treatment. If the tests show that you have liver problems, your doctor will probably not give you ixabepilone injection and capecitabine (Xeloda). Treatment with both ixabepilone injection ...

  9. Romidepsin Injection

    MedlinePlus

    ... group of cancers of the immune system that first appear as skin rashes) in people who have already been treated with at least one other medication given by mouth or by injection. Romidepsin injection is in a class of medications called histone deacetylase (HDAC) inhibitors. It ...

  10. Nusinersen Injection

    MedlinePlus

    Nusinersen injection is used for the treatment of spinal muscular atrophy (an inherited condition that reduces muscle strength and movement). Nusinersen injection is in a class of medications called antisense ... a certain protein necessary for the muscles and nerves to work normally.

  11. Musculoskeletal Injection

    PubMed Central

    Wittich, Christopher M.; Ficalora, Robert D.; Mason, Thomas G.; Beckman, Thomas J.

    2009-01-01

    Patients commonly present to primary care physicians with musculoskeletal symptoms. Clinicians certified in internal medicine must be knowledgeable about the diagnosis and management of musculoskeletal diseases, yet they often receive inadequate postgraduate training on this topic. The musculoskeletal problems most frequently encountered in our busy injection practice involve, in decreasing order, the knees, trochanteric bursae, and glenohumeral joints. This article reviews the clinical presentations of these problems. It also discusses musculoskeletal injections for these problems in terms of medications, indications, injection technique, and supporting evidence from the literature. Experience with joint injection and the pharmacological principles described in this article should allow primary care physicians to become comfortable and proficient with musculoskeletal injections. PMID:19720781

  12. Dual-beam, light-scattering interferometry for simultaneous measurements of droplet-size and velocity distributions of aerosols from commonly used nebulizers

    SciTech Connect

    Clifford, R.H.; Ishii, I.; Montaser, A. ); Meyer, G.A. )

    1990-02-15

    Dual-beam, light-scattering interferometry is introduced for simultaneous measurement of droplet-size and droplet-velocity distributions. The technique was tested in the characterization of tertiary aerosols produced by five nebulization systems (a pneumatic, an ultrasonic, and three frit-type nebulizers) used in inductively coupled plasma spectrometry. In general, the Sauter mean diameter (D{sub 3,2}) of tertiary aerosol produced by frit-type nebulizer was smaller than those of ultrasonic and pneumatic nebulizers. At higher injector gas flow, D{sub 3,2} was reduced for the pneumatic nebulizer but was increased for the ultrasonic nebulizer. At the same injector gas flow rate, droplets move slightly faster if helium is used as injector gas instead of argon. For all practical purposes, the D{sub 3,2} values measured for tertiary aerosol with dual-beam, light-scattering interferometry are comparable to the same data obtained by laser Fraunhofer diffraction. Compared to laser Fraunhofer diffraction, the proposed technique possesses two unique advantages. First, droplet velocity distribution can be measured. Second, spatially resolved information on droplet-size and velocity distributions may be obtained directly and rapidly.

  13. Interfacing low-energy SAW nebulization with Liquid Chromatography-Mass Spectrometry for the analysis of biological samples

    PubMed Central

    Tveen-Jensen, Karina; Gesellchen, Frank; Wilson, Rab; Spickett, Corinne M.; Cooper, Jonathan M.; Pitt, Andrew R.

    2015-01-01

    Soft ionization methods for the introduction of labile biomolecules into a mass spectrometer are of fundamental importance to biomolecular analysis. Previously, electrospray ionization (ESI) and matrix assisted laser desorption-ionization (MALDI) have been the main ionization methods used. Surface acoustic wave nebulization (SAWN) is a new technique that has been demonstrated to deposit less energy into ions upon ion formation and transfer for detection than other methods for sample introduction into a mass spectrometer (MS). Here we report the optimization and use of SAWN as a nebulization technique for the introduction of samples from a low flow of liquid, and the interfacing of SAWN with liquid chromatographic separation (LC) for the analysis of a protein digest. This demonstrates that SAWN can be a viable, low-energy alternative to ESI for the LC-MS analysis of proteomic samples. PMID:25978651

  14. Unilateral pupillary mydriasis from nebulized ipratropium bromide: A false sign of brain herniation in the intensive care unit.

    PubMed

    Chaudhry, Priyanka; Friedman, Deborah I; Yu, Wengui

    2014-03-01

    Although there are many causes of anisocoria in the intensive care setting, the development of unilateral mydriasis in patients with intracranial hemorrhage or tumor is a neurological emergency, as it may herald the onset of uncal herniation. We describe two patients with a hemiparesis from neurosurgical disorder who subsequently developed a fixed and dilated pupil. The pupillary abnormality was caused by nebulized ipratropium bromide in both cases, and resolved when the medication was discontinued. Nebulized ipratropium may leak from the mask into ipsilateral eye and cause mydriasis in patients with facial weakness. This benign cause of anisocoria in the intensive care setting is distinguished from uncal herniation by the laterality of neurologic findings, and lack of mental status change, ptosis, and extraocular movement impairment.

  15. Interfacing low-energy SAW nebulization with Liquid Chromatography-Mass Spectrometry for the analysis of biological samples.

    PubMed

    Tveen-Jensen, Karina; Gesellchen, Frank; Wilson, Rab; Spickett, Corinne M; Cooper, Jonathan M; Pitt, Andrew R

    2015-05-15

    Soft ionization methods for the introduction of labile biomolecules into a mass spectrometer are of fundamental importance to biomolecular analysis. Previously, electrospray ionization (ESI) and matrix assisted laser desorption-ionization (MALDI) have been the main ionization methods used. Surface acoustic wave nebulization (SAWN) is a new technique that has been demonstrated to deposit less energy into ions upon ion formation and transfer for detection than other methods for sample introduction into a mass spectrometer (MS). Here we report the optimization and use of SAWN as a nebulization technique for the introduction of samples from a low flow of liquid, and the interfacing of SAWN with liquid chromatographic separation (LC) for the analysis of a protein digest. This demonstrates that SAWN can be a viable, low-energy alternative to ESI for the LC-MS analysis of proteomic samples.

  16. Intravenous versus nebulized ceftazidime in ventilated piglets with and without experimental bronchopneumonia: comparative effects of helium and nitrogen.

    PubMed

    Tonnellier, Marc; Ferrari, Fabio; Goldstein, Ivan; Sartorius, Alfonso; Marquette, Charles-Hugo; Rouby, Jean-Jacques

    2005-05-01

    Lung deposition of intravenous cephalosporins is low. The lung deposition of equivalent doses of ceftazidime administered either intravenously or by ultrasonic nebulization using either nitrogen-oxygen or helium-oxygen as the carrying gas of the aerosol was compared in ventilated piglets with and without experimental bronchopneumonia. Five piglets with noninfected lungs and 5 piglets with Pseudomonas aeruginosa experimental bronchopneumonia received 33 mg/kg ceftazidime intravenously. Ten piglets with noninfected lungs and 10 others with experimental P. aeruginosa bronchopneumonia received 50 mg/kg ceftazidime by ultrasonic nebulization. In each group, the ventilator was operated in half of the animals with a 65%/35% helium-oxygen or nitrogen-oxygen mixture. Animals were killed, and multiple lung specimens were sampled for measuring ceftazidime lung tissue concentrations by high-performance liquid chromatography. As compared with intravenous administration, nebulization of ceftazidime significantly increased lung tissue concentrations (17 +/- 13 vs. 383 +/- 84 microg/g in noninfected piglets and 10 +/- 3 vs. 129 +/- 108 microg/g in piglets with experimental bronchopneumonia; P < 0.001). The use of a 65%/35% helium-oxygen mixture induced a 33% additional increase in lung tissue concentrations in noninfected piglets (576 +/- 141 microg/g; P < 0.001) and no significant change in infected piglets (111 +/- 104 microg/g). Nebulization of ceftazidime induced a 5- to 30-fold increase in lung tissue concentrations as compared with intravenous administration. Using a helium-oxygen mixture as the carrying gas of the aerosol induced a substantial additional increase in lung deposition in noninfected piglets but not in piglets with experimental bronchopneumonia.

  17. Comparison of Initial Response of Nebulized Salbutamol and Adrenaline in Infants and young Children Admitted with Acute Bronchiolitis.

    PubMed

    Adhikari, S; Thapa, P; Rao, K S; Bk, G

    2016-01-01

    Background Acute bronchiolitis is common cause of hospitalization in infants and young children. There are widespread variations in the diagnosis and management. Despite the use of bronchodilators for decades, there is lack of consensus for the benefit of one above another. Objective To compare initial response of nebulized adrenaline and salbutamol. Method Children aged two months to two years admitted with acute bronchiolitis in the department of Paediatrics of Manipal teaching hospital, Pokhara, Nepal, from 1st March 2014 to 28th February 2015 were enrolled. Patients fulfilling inclusion criteria received either adrenaline or salbutamol nebulization. Data were collected in a predesigned proforma. Respiratory distress assessment instrument (RDAI) scores were considered primary outcome measure and respiratory rate at 48 hours, duration of hospital stay, requirement of supplemental oxygen and intravenous fluid were considered secondary outcome measure. Result A total of 40 patients were enrolled in each study group. Mean RDAI scores at admission was in 9.75 with (CI- 9.01, 10.49) in adrenaline and 9.77 (CI- 9.05, 10.50) in salbutamol group. There was gradual decline in mean RDAI scores in both the groups over 48 hours to 4.15 (CI- 3.57,4.73) and 4.13 (CI- 3.69,4.56) in adrenaline and salbutamol group respectively. Hospital stay was 5.32 days in adrenaline and 5.68 days in salbutamol group. Patients nebulized with adrenaline required oxygen for 33.30 hours compared with 36.45 hours in salbutamol. Intravenous fluid duration was also less in adrenaline group compared to salbutamol group (33.15 vs 37.80 hours). Conclusion Patients of acute bronchiolitis nebulized with either salbutamol or adrenaline experienced similar decline in RDAI scores in the first 48 hours. Duration of supplementary oxygen and intravenous fluid was less in adrenaline group compared with salbutamol group.

  18. An Experimental Investigation of the Performance of a Collison Nebulizer Generating H1N1 Influenza Aerosols

    DTIC Science & Technology

    2015-04-04

    bacteria , fungi, atmospheric environmental pollu- tants and pulmonary drug particles suspended in air or another gas.[1] Their generation has numerous...metabolic injury to bacteria and viruses during extended periods of aerosolization from a Collison nebulizer. [1424] Whereas delivery from six-jet...time. Materials and methods H1N1 influenza H1N1 influenza A/PR/8/34 VR-1469 ( ATCC VR-95) virus was propagated in embryonic chicken eggs and titred using

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

    PubMed

    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.

  20. Effect of partial liquid ventilation and nebulized perfluorocarbon on CT lung density distribution: randomized controlled study of experimental lung injury.

    PubMed

    Kelly, K P; Stenson, B J; Drummond, G B

    2005-05-01

    Perfluorocarbon (PFC) liquid can improve gas exchange in acute lung injury. How PFC aerosol is distributed in the lung is unknown. We induced lung injury in rabbits with saline lavage, followed by mechanical ventilation in the supine position. The animals were divided into three groups: a control group, a group treated with partial liquid ventilation and a group given nebulized perfluorocarbon (PF 5080). We made CT image slices of the excised lungs. In the apical, middle and caudal slices we defined three regions of interest, from anterior to posterior, and noted the mean attenuation of each area. We also studied two rabbits which had not received lung injury or mechanical ventilation. Group means were different between the normal rabbits and all three study groups. There was a difference between the control and partial liquid ventilation groups, and between the partial liquid ventilation and nebulized groups, but no difference between the nebulized and control groups. Within each treatment group, there was no regional difference in the distribution of density. PF 5080 is not deposited in large amounts by aerosol. Less PFC was found in the lungs after partial liquid ventilation than expected. Within treatment groups, lung densities indicate less gravitational and regional differences than found in other studies.

  1. Comparison of Usefulness of Ketamine and Magnesium Sulfate Nebulizations for Attenuating Postoperative Sore Throat, Hoarseness of Voice, and Cough.

    PubMed

    Rajan, Sunil; Malayil, George Jacob; Varghese, Rekha; Kumar, Lakshmi

    2017-01-01

    Postoperative sore throat (POST) is a complication that is unresolved in patients undergoing endotracheal intubation. To compare the effects of ketamine and magnesium sulfate nebulizations in two strengths, on the incidence and severity of POST, hoarseness, and cough. Sixty surgical patients undergoing elective abdominal and lower limb surgeries under combined epidural and general anesthesia were included in this prospective, randomized, double-blinded study. Patients in each group were nebulized with the respective study drug 15 min prior to the surgery, i.e., ketamine in Group K, magnesium sulfate 250 mg, and 500 mg in Group M1 and Group M2, respectively, and normal saline as control in Group C. A standardized anesthesia protocol was followed for all patients. After extubation, the patients were asked to grade POST, hoarseness, and cough at 0, 2, 4, 12, and 24 h. One-way analysis of variance, Chi-square test, Fisher's exact test, paired t-tests, and Wilcoxon's signed-rank test as applicable. Ketamine and magnesium sulfate 500 mg demonstrated a statistically significant decrease in POST at 0, 2, and 4 h, and postoperative hoarseness at 0 h. There was decrease in the incidence and severity of sore throat, hoarseness, and cough at all periods in the study groups as compared with control. Nebulization with ketamine 50 mg and magnesium sulfate 500 mg, 15 min before induction of general anesthesia and intubation, reduce the incidence and severity of POST and hoarseness of voice.

  2. [Prevention of infections in patients with lymphoproliferative syndromes and myeloma by nebulization of an IgA concentrate].

    PubMed

    Bezares, R; Murro, H; Díaz, A; Cavagnaro, F; Caviglia, D; Santomé, J

    1997-06-01

    Infection of the upper respiratory tract is a major cause of morbidity and mortality in patients with lymphoproliferative syndromes and multiple myeloma. Nebulizations with IgA tested in a randomized double blind trial to evaluate its efficacy to prevent respiratory infections in patients with lymphoproliferative syndromes and multiple myeloma. Forty nine patients were evaluated (chronic lymphocytic leukaemia, 22; multiple myeloma, 11; lymphoma, 8; HCL, 6; Waldenström and lymphoepiteliod tymoma, 1 patient each) were randomized to receive nebulizations every 12 hours during 3 months of IgA or placebo. Seven infectious episodes (4 respiratory tract infections) in 25 IgA treated patients and 25 episodes (16 respiratory tract infections) in 24 control patients were recorded (p <0.0002). Eighteen patients belonging to the treated group remained free of infections against only 5 from the control group (p < 0.001). No difference related to the grade of infections was observed between groups. The arithmetic media for the first infection observed in each group was 45.6 +/- 22.0 days for the IgA treated and 28.6 +/- 17.5 days for the placebo (p < 0.025). According to this study, IgA nebulization therapy was useful to prevent respiratory tract infections and also delay the onset of infection in patients with lymphoproliferative syndromes and myeloma.

  3. Experimental nebulization of American bison (Bison bison) with low doses of ovine herpesvirus 2 from sheep nasal secretions.

    PubMed

    Gailbreath, Katherine L; O'Toole, Donal; Taus, Naomi S; Knowles, Donald P; Oaks, J Lindsay; Li, Hong

    2010-07-14

    Malignant catarrhal fever (MCF), caused by ovine herpesvirus 2 (OvHV-2), is an important cause of mortality in ranched American bison and domestic cattle in North America. Previous studies showed that bison can be infected by intranasal nebulization with sheep nasal secretions containing OvHV-2 and provided preliminary information on viral doses required for infection and disease progression. The goals of this study were to establish optimal minimal infectious and minimal lethal doses of OvHV-2 by the intranasal route in bison, evaluate the influence of dose on incubation period and other clinical parameters and determine if bison seropositive for antibody against MCF-group viruses are resistant to developing MCF after intranasal challenge. In this study, the minimal infectious dose and minimal lethal dose overlap, suggesting that experimental production of subclinically infected bison is impractical. Dose is inversely related to both incubation period and the period between nebulization and first detection of >1000 OvHV-2 DNA copies/500 ng total DNA in peripheral blood leukocytes. Interestingly, all of the bison seropositive for anti-MCF-group viral antibody prior to inoculation died of MCF after nebulization. We conclude that previous exposure to an MCF-group virus does not necessarily provide resistance to OvHV-2-induced MCF in bison.

  4. Abaloparatide Injection

    MedlinePlus

    ... of a natural human hormone called parathyroid hormone (PTH). It works by causing the body to build ... container.You should know that abaloparatide injection may cause dizziness, lightheadedness, and fainting when you get up ...

  5. Sumatriptan Injection

    MedlinePlus

    ... accompanied by nausea and sensitivity to sound and light). Sumatriptan injection is also used to treat the ... children. Store it at room temperature, away from light, excess heat, and moisture (not in the bathroom). ...

  6. Certolizumab Injection

    MedlinePlus

    ... has not improved when treated with other medications, rheumatoid arthritis (a condition in which the body attacks its ... continues. When certolizumab injection is used to treat rheumatoid arthritis, it is usually given every other week and ...

  7. Acyclovir Injection

    MedlinePlus

    ... chickenpox in the past) in people with weak immune systems. It is also used to treat first-time ... from time to time) in people with normal immune systems. Acyclovir injection is used to treat herpes simplex ...

  8. Doxercalciferol Injection

    MedlinePlus

    Doxercalciferol injection is used to treat secondary hyperparathyroidism (a condition in which the body produces too much parathyroid hormone [PTH; a natural substance needed to control the amount of calcium in ...

  9. Evolocumab Injection

    MedlinePlus

    ... how to inject this medication.Remove the prefilled syringe or prefilled autoinjector from the refrigerator and allow it to ... before using it. Do not warm the prefilled syringe or prefilled autoinjector in hot water, microwave, or place in ...

  10. Ixekizumab Injection

    MedlinePlus

    ... as a as a solution (liquid) in a prefilled syringe, and as a prefilled autoinjector to inject subcutaneously ( ... dispose of the puncture-resistant container.Remove the prefilled syringe or autoinjector from the refrigerator. Place it on ...

  11. Alirocumab Injection

    MedlinePlus

    ... how to inject this medication.Remove the prefilled syringe or prefilled dosing pen from the refrigerator and allow it ... hours or longer. Do not put the prefilled syringe or prefilled dosing pen back in the refrigerator after it ...

  12. Daclizumab Injection

    MedlinePlus

    Daclizumab comes as a solution (liquid) in a prefilled syringe to inject subcutaneously (under the skin). It is ... or tattooed.Never reuse or share needles or prefilled syringes of medication. Throw away used syringes in a ...

  13. Sarilumab Injection

    MedlinePlus

    ... receive any vaccines. You should not receive any vaccinations while you are using sarilumab injection without talking ... pregnant, tellyour doctor before the baby receives any vaccinations.if you are having surgery, including dental surgery, ...

  14. Zidovudine Injection

    MedlinePlus

    ... zidovudine injection does not cure HIV, it may decrease your chance of developing acquired immunodeficiency syndrome (AIDS) ... sex and making other life-style changes may decrease the risk of transmitting (spreading) the HIV virus ...

  15. Rasburicase Injection

    MedlinePlus

    ... as tumors break down) in people with certain types of cancer who are being treated with chemotherapy medications. Rasburicase injection is in a class of medications called enzymes. It works by breaking down uric acid so ...

  16. Haloperidol Injection

    MedlinePlus

    ... release injection are used to treat schizophrenia (a mental illness that causes disturbed or unusual thinking, loss of ... medications); medications for anxiety, depression, irritable bowel disease, mental illness, motion sickness, Parkinson's disease, seizures, ulcers, or urinary ...

  17. Risperidone Injection

    MedlinePlus

    ... acting) injection is used to treat schizophrenia (a mental illness that causes disturbed or unusual thinking, loss of ... ropinirole (Requip); medications for anxiety, blood pressure, or mental illness; medications for seizures such as carbamazepine (Carbatrol, Epitol, ...

  18. Thiotepa Injection

    MedlinePlus

    ... that begins in the female reproductive organs where eggs are formed), breast, and bladder cancer. It is ... comes as a powder to be mixed with liquid to be injected intravenously (into a vein) by ...

  19. Methotrexate Injection

    MedlinePlus

    ... Methotrexate injection is also used to treat severe psoriasis (a skin disease in which red, scaly patches ... slowing the growth of cancer cells. Methotrexate treats psoriasis by slowing the growth of skin cells to ...

  20. Cefazolin Injection

    MedlinePlus

    ... is used to treat certain infections caused by bacteria including skin, bone, joint, genital, blood, heart valve, ... medications called cephalosporin antibiotics. It works by killing bacteria.Antibiotics such as cefazolin injection will not work ...

  1. Trastuzumab Injection

    MedlinePlus

    ... completed for up to 52 weeks. When trastuzumab injection is used to treat stomach cancer, it is usually given once every 3 weeks. The length of your treatment depends on how well your body responds to the medication and the ...

  2. Bendamustine Injection

    MedlinePlus

    ... leukemia (CLL; a type of cancer of the white blood cells). Bendamustine injection is also used to treat a ... NHL: cancer that begins in a type of white blood cell that normally fights infection) that is slow spreading, ...

  3. Palonosetron Injection

    MedlinePlus

    ... that may occur several days after receiving certain chemotherapy medications. Palonosetron injection is in a class of medications called 5-HT3 receptor antagonists. It works by blocking the action of serotonin, a natural ...

  4. Doxycycline Injection

    MedlinePlus

    ... injection is in a class of medications called tetracycline antibiotics. It works by killing bacteria that cause ... are allergic to doxycycline, minocycline (Dynacin, Minocin, Solodyn), tetracycline (Achromycin V), any other medications, or any of ...

  5. Dexamethasone Injection

    MedlinePlus

    ... severe allergic reactions. It is used in the management of certain types of edema (fluid retention and ... needed for normal body functioning) and in the management of certain types of shock. Dexamethasone injection is ...

  6. Levofloxacin Injection

    MedlinePlus

    ... infections. Levofloxacin injection is also used to prevent anthrax (a serious infection that may be spread on ... in people who may have been exposed to anthrax germs in the air and treat and prevent ...

  7. Omalizumab Injection

    MedlinePlus

    ... steroids. Omalizumab is also used to treat chronic hives without a known cause that cannot successfully be ... is not used to treat other forms of hives or allergic conditions. Omalizumab injection is in a ...

  8. Plerixafor Injection

    MedlinePlus

    ... used along with a granulocyte-colony stimulating factor (G-CSF) medication such as filgrastim (Neupogen) or pegfilgrastim ( ... injection will begin after you have received a G-CSF medication once a day for 4 days, ...

  9. Avelumab Injection

    MedlinePlus

    ... doctor or nurse in a medical facility or infusion center. It is usually given once every 2 ... Avelumab injection may cause serious reactions during the infusion of the medication. You may be given other ...

  10. Alemtuzumab Injection

    MedlinePlus

    ... injection, the medication is usually given three times weekly on alternate days (usually Monday, Wednesday, and Friday) ... that you eat foods that are rich in iron such as meats, leafy green vegetables, and fortified ...

  11. Dinutuximab Injection

    MedlinePlus

    ... treat neuroblastoma (a cancer that begins in nerve cells) in children who have responded to other treatments. Dinutuximab injection is in a class of medications called monoclonal antibodies. It works by killing cancer cells.

  12. Cyclosporine Injection

    MedlinePlus

    ... transplanted organ by the immune system of the person receiving the organ) in people who have received kidney, liver, and heart transplants. Cyclosporine injection should only be used to treat people who are unable to take cyclosporine by mouth. ...

  13. Denosumab Injection

    MedlinePlus

    ... menstrual periods), who have an increased risk for fractures (broken bones) or who cannot take or did ... receiving certain treatments that increase their risk for fractures. Denosumab injection (Xgeva) is used to reduce fractures ...

  14. Epinephrine Injection

    MedlinePlus

    ... emergency medical treatment to treat life-threatening allergic reactions caused by insect bites or stings, foods, medications, ... at the first sign of a serious allergic reaction. Use epinephrine injection exactly as directed; do not ...

  15. Aflibercept Injection

    MedlinePlus

    ... injection is used to treat wet age-related macular degeneration (AMD; an ongoing disease of the eye that ... that leads to blurry vision and vision loss), diabetic macular edema (an eye disease caused by diabetes that can ...

  16. Fondaparinux Injection

    MedlinePlus

    ... the leg), which can lead to pulmonary embolism (PE; a blood clot in the lung), in people ... with warfarin (Coumadin, Jantoven) to treat DVT or PE. Fondaparinux injection is in a class of medications ...

  17. Panitumumab Injection

    MedlinePlus

    ... as a solution (liquid) to be given by infusion (injected into a vein). It is usually given ... doctor or nurse in a doctor's office or infusion center. Panitumumab is usually given once every 2 ...

  18. Topotecan Injection

    MedlinePlus

    ... organs where eggs are formed) and small cell lung cancer (a type of cancer that begins in the ... topotecan injection is used to treat ovarian or lung cancer, it is usually given once a day for ...

  19. Gemcitabine Injection

    MedlinePlus

    ... with surgery. Gemcitabine is also used to treat cancer of the pancreas that has spread to other parts of the ... 4 weeks. When gemcitabine is used to treat cancer of pancreas it may be injected once every week. The ...

  20. Lacosamide Injection

    MedlinePlus

    ... with other medications to control certain types of seizures in people who cannot take oral medications. Lacosamide ... If you suddenly stop using lacosamide injection, your seizures may happen more often. Your doctor will probably ...

  1. Pegloticase Injection

    MedlinePlus

    ... doctor if you have glucose-6-phosphate dehydrogenase (G6PD) deficiency (an inherited blood disease). Your doctor may test you for G6PD deficiency before you start to receive pegloticase injection. If ...

  2. Ibritumomab Injection

    MedlinePlus

    ... is in a class of medications called monoclonal antibodies with radioisotopes. It works by attaching to cancer ... you receive ibritumomab injection, your body may develop antibodies (substances in the blood that help the immune ...

  3. Oxytocin Injection

    MedlinePlus

    Oxytocin injection is used to begin or improve contractions during labor. Oxytocin also is used to reduce bleeding after childbirth. ... other medications or procedures to end a pregnancy. Oxytocin is in a class of medications called oxytocic ...

  4. Edaravone Injection

    MedlinePlus

    Edaravone injection is used to treat amyotrophic lateral sclerosis (ALS, Lou Gehrig's disease; a condition in which the nerves that control muscle movement slowly die, causing the muscles to shrink and ...

  5. Pentamidine Injection

    MedlinePlus

    Pentamidine injection is used to treat pneumonia caused by a fungus called Pneumocystis carinii. It is in a class of medications called antiprotozoals. It works by stopping the growth of protozoa that can cause pneumonia.

  6. Diphenhydramine Injection

    MedlinePlus

    ... or along with other medications to control abnormal movements in people who have Parkinsonian syndrome (a disorder of the nervous system that causes difficulties with movement, muscle control, and balance). Diphenhydramine injection should not ...

  7. Docetaxel Injection

    MedlinePlus

    ... allergic to docetaxel injection or drugs made with polysorbate 80, an ingredient found in some medications. Ask ... if a medication you are allergic to contains polysorbate 80. If you experience any of the following ...

  8. Octreotide Injection

    MedlinePlus

    ... hormone (a natural substance) produced by people with acromegaly (condition in which the body produces too much ... Octreotide long-acting injection is used to control acromegaly, carcinoid tumors, and VIP-omas in people who ...

  9. Vedolizumab Injection

    MedlinePlus

    ... injection may cause serious allergic reactions during an infusion and for several hours afterward. A doctor or ... of the following symptoms during or after your infusion: rash; itching; swelling of the face, eyes, mouth, ...

  10. Granisetron Injection

    MedlinePlus

    ... that may occur after surgery. Granisetron extended-release (long-acting) injection is used with other medications to prevent nausea and vomiting caused by cancer chemotherapy that may occur immediately ...

  11. Fluconazole Injection

    MedlinePlus

    ... injection is used to treat fungal infections, including yeast infections of the mouth, throat, esophagus (tube leading ... by fungus. Fluconazole is also used to prevent yeast infections in patients who are likely to become ...

  12. Intravitreal injection

    MedlinePlus

    ... You may have this procedure if you have: Macular degeneration : An eye disorder that slowly destroys sharp, central ... injection References American Academy of Ophthalmology. Age-related macular degeneration PPP - updated 2015. Aao.org web site. Updated ...

  13. Ciprofloxacin Injection

    MedlinePlus

    ... is used to treat certain infections caused by bacteria such as pneumonia; and infections of the skin, ... of antibiotics called fluoroquinolones. It works by killing bacteria that cause infections.Antibiotics such as ciprofloxacin injection ...

  14. Tobramycin Injection

    MedlinePlus

    ... treat certain serious infections that are caused by bacteria such as meningitis (infection of the membranes that ... medications called aminoglycoside antibiotics. It works by killing bacteria.Antibiotics such as tobramycin injection will not work ...

  15. Ceftriaxone Injection

    MedlinePlus

    ... is used to treat certain infections caused by bacteria such as gonorrhea (a sexually transmitted disease), pelvic ... medications called cephalosporin antibiotics. It works by killing bacteria.Antibiotics such as ceftriaxone injection will not work ...

  16. Moxifloxacin Injection

    MedlinePlus

    ... is used to treat certain infections caused by bacteria such as pneumonia; ; and , skin, and abdominal (stomach ... antibiotics called fluoroquinolones. It works by killing the bacteria that cause infections.Antibiotics such as moxifloxacin injection ...

  17. Daptomycin Injection

    MedlinePlus

    ... in adults or serious skin infections caused by bacteria in adults and children 1 year of age ... called cyclic lipopeptide antibiotics. It works by killing bacteria.Antibiotics such as daptomycin injection will not work ...

  18. Amikacin Injection

    MedlinePlus

    ... treat certain serious infections that are caused by bacteria such as meningitis (infection of the membranes that ... medications called aminoglycoside antibiotics. It works by killing bacteria.Antibiotics such as amikacin injection will not work ...

  19. Meropenem Injection

    MedlinePlus

    ... skin and abdominal (stomach area) infections caused by bacteria and meningitis (infection of the membranes that surround ... of medications called antibiotics. It works by killing bacteria that cause infection.Antibiotics such as meropenem injection ...

  20. Cefepime Injection

    MedlinePlus

    ... is used to treat certain infections caused by bacteria including pneumonia, and skin, urinary tract, and kidney ... medications called cephalosporin antibiotics. It works by killing bacteria.Antibiotics such as cefepime injection will not work ...

  1. Ertapenem Injection

    MedlinePlus

    ... abdominal (stomach area) infections, that are caused by bacteria. It is also used for the prevention of ... medications called carbapenem antibiotics. It works by killing bacteria.Antibiotics such as ertapenem injection will not work ...

  2. Aztreonam Injection

    MedlinePlus

    ... to treat certain infections that are caused by bacteria, including respiratory tract (including pneumonia and bronchitis), urinary ... abdominal (stomach area) infections, that are caused by bacteria. Aztreonam injection also may be used before, during, ...

  3. Ceftaroline Injection

    MedlinePlus

    ... infections and pneumonia (lung infection) caused by certain bacteria. Ceftaroline is in a class of medications called cephalosporin antibiotics. It works by killing bacteria.Antibiotics such as ceftaroline injection will not work ...

  4. Cefotaxime Injection

    MedlinePlus

    ... is used to treat certain infections caused by bacteria including pneumonia and other lower respiratory tract (lung) ... medications called cephalosporin antibiotics. It works by killing bacteria.Antibiotics such as cefotaxime injection will not work ...

  5. Cefuroxime Injection

    MedlinePlus

    ... is used to treat certain infections caused by bacteria including pneumonia and other lower respiratory tract (lung) ... medications called cephalosporin antibiotics. It works by killing bacteria.Antibiotics such as cefuroxime injection will not work ...

  6. Ampicillin Injection

    MedlinePlus

    ... to treat certain infections that are caused by bacteria such as meningitis (infection of the membranes that ... of medications called penicillins. It works by killing bacteria.Antibiotics such as ampicillin injection will not work ...

  7. Gentamicin Injection

    MedlinePlus

    ... treat certain serious infections that are caused by bacteria such as meningitis (infection of the membranes that ... medications called aminoglycoside antibiotics. It works by killing bacteria.Antibiotics such as gentamicin injection will not work ...

  8. MEDICAL INJECTION

    NASA Image and Video Library

    1963-06-10

    S62-08371 (1962) --- The automatic medical injectors carried on the Mercury-Atlas 9 flight. The injectors provide the astronaut with injection tubes of Tigan, for preventing motion sickness and Demerol, for relieving pain. The tubes encased in the block are stowed in the astronauts survival kit. The single injection tubes are placed in a pocket of the astronauts spacesuit. Photo credit: NASA

  9. Characterization of three mycobacterial DinB (DNA polymerase IV) paralogs highlights DinB2 as naturally adept at ribonucleotide incorporation

    PubMed Central

    Ordonez, Heather; Uson, Maria Loressa; Shuman, Stewart

    2014-01-01

    This study unveils Mycobacterium smegmatis DinB2 as the founder of a clade of Y-family DNA polymerase that is naturally adept at incorporating ribonucleotides by virtue of a leucine in lieu of a canonical aromatic steric gate. DinB2 efficiently scavenges limiting dNTP and rNTP substrates in the presence of manganese. DinB2's sugar selectivity factor, gauged by rates of manganese-dependent dNMP versus rNMP addition, is 2.7- to 3.8-fold. DinB2 embeds ribonucleotides during DNA synthesis when rCTP and dCTP are at equimolar concentration. DinB2 can incorporate at least 16 consecutive ribonucleotides. In magnesium, DinB2 has a 26- to 78-fold lower affinity for rNTPs than dNTPs, but only a 2.6- to 6-fold differential in rates of deoxy versus ribo addition (kpol). Two other M. smegmatis Y-family polymerases, DinB1 and DinB3, are characterized here as template-dependent DNA polymerases that discriminate strongly against ribonucleotides, a property that, in the case of DinB1, correlates with its aromatic steric gate side chain. We speculate that the unique ability of DinB2 to utilize rNTPs might allow for DNA repair with a ‘ribo patch’ when dNTPs are limiting. Phylogenetic analysis reveals DinB2-like polymerases, with leucine, isoleucine or valine steric gates, in many taxa of the phylum Actinobacteria. PMID:25200080

  10. Injection overview

    SciTech Connect

    Prestwich, S.

    1983-12-01

    The test program was initiated at the Raft River Geothermal Field in southern Idaho in September 1982. A series of eight short-term injection and backflow tests, followed by a long-term injection test, were conducted on one well in the field. Tracers were added during injection and monitored during backflow as well. The principal objective was to determine if tracers could be effectively used as a means to assess reservoir characteristics in a one-well test. The test program resulted in a unique data set which shows promise as a means to improve understanding of the reservoir characteristics. In December 1982, an RFP was issued to obtain an industrial partner to obtain follow-on data on the injection/backflow technique in a second field, and to study any alternate advanced concepts for injection testing which the industrial community might recommend. The East Mesa Geothermal Field was selected for the second test series. Two wells were utilized for testing, and a series of ten tests were conducted in July and August 1983, aimed principally at further evaluation of the injection/backflow technique.

  11. Nebulized C1-Esterase Inhibitor does not Reduce Pulmonary Complement Activation in Rats with Severe Streptococcus Pneumoniae Pneumonia.

    PubMed

    de Beer, Friso; Lagrand, Wim; Glas, Gerie J; Beurskens, Charlotte J P; van Mierlo, Gerard; Wouters, Diana; Zeerleder, Sacha; Roelofs, Joris J T H; Juffermans, Nicole P; Horn, Janneke; Schultz, Marcus J

    2016-12-01

    Complement activation plays an important role in the pathogenesis of pneumonia. We hypothesized that inhibition of the complement system in the lungs by repeated treatment with nebulized plasma-derived human C1-esterase inhibitor reduces pulmonary complement activation and subsequently attenuates lung injury and lung inflammation. This was investigated in a rat model of severe Streptococcus pneumoniae pneumonia. Rats were intra-tracheally challenged with S. pneumoniae to induce pneumonia. Nebulized C1-esterase inhibitor or saline (control animals) was repeatedly administered to rats, 30 min before induction of pneumonia and every 6 h thereafter. Rats were sacrificed 20 or 40 h after inoculation with bacteria. Brochoalveolar lavage fluid and lung tissue were obtained for measuring levels of complement activation (C4b/c), lung injury and inflammation. Induction of pneumonia was associated with pulmonary complement activation (C4b/c at 20 h 1.24 % [0.56-2.59] and at 40 h 2.08 % [0.98-5.12], compared to 0.50 % [0.07-0.59] and 0.03 % [0.03-0.03] in the healthy control animals). The functional fraction of C1-INH was detectable in BALF, but no effect was found on pulmonary complement activation (C4b/c at 20 h 0.73 % [0.16-1.93] and at 40 h 2.38 % [0.54-4.19]). Twenty hours after inoculation, nebulized C1-esterase inhibitor treatment reduced total histology score, but this effect was no longer seen at 40 h. Nebulized C1-esterase inhibitor did not affect other markers of lung injury or lung inflammation. In this negative experimental animal study, severe S. pneumoniae pneumonia in rats is associated with pulmonary complement activation. Repeated treatment with nebulized C1-esterase inhibitor, although successfully delivered to the lungs, does not affect pulmonary complement activation, lung inflammation or lung injury.

  12. Effect of nebulized budesonide on respiratory mechanics and oxygenation in acute lung injury/acute respiratory distress syndrome: Randomized controlled study

    PubMed Central

    Mohamed, Hatem Saber; Meguid, Mona Mohamed Abdel

    2017-01-01

    Background: We tested the hypothesis that nebulized budesonide would improve lung mechanics and oxygenation in patients with early acute lung injury (ALI) and/or acute respiratory distress syndrome (ARDS) during protective mechanical ventilation strategy without adversely affecting systemic hemodynamics. Methods: Patients with ALI/ARDS were included and assigned into two groups; budesonide group (30 cases) in whom 1 mg–2 ml budesonide suspension was nebulized through the endotracheal tube and control group (30 cases) in whom 2 ml saline (placebo) were nebulized instead of budesonide. This regimen was repeated every 12 h for three successive days alongside with constant ventilator settings in both groups. Hemodynamics, airway pressures, and PaO2/FiO2 were measured throughout the study period (72 h) with either nebulized budesonide or saline. Furthermore, tumor necrosis factor-alpha (TNF-α), interleukin-1 beta (IL-1β), and interleukin-6 (IL-6) were analyzed serologically as markers of inflammation at pre- and post-nebulization sessions. Results: We found a significant difference between the two groups regarding PaO2/FiO2 (P = 0.023), peak (P = 0.021), and plateau (P = 0.032) airway pressures. Furthermore, TNF-α, IL-1β, and IL-6 were significantly reduced after budesonide nebulizations. No significant difference was found between the two groups regarding hemodynamic variables. Conclusion: Nebulized budesonide improved oxygenation, peak, and plateau airway pressures and significantly reduced inflammatory markers (TNF-α, IL-1β and IL-6) without affecting hemodynamics. Trial Registry: Australian New Zealand Clinical Trial Registry (ANZCTR) at the number: ACTRN12615000373572. PMID:28217046

  13. Nebulized hypertonic saline treatment reduces both rate and duration of hospitalization for acute bronchiolitis in infants: an updated meta-analysis.

    PubMed

    Chen, Yen-Ju; Lee, Wen-Li; Wang, Chuang-Ming; Chou, Hsin-Hsu

    2014-12-01

    Nebulized hypertonic saline (HS) treatment reduced the length of hospitalization in infants with acute bronchiolitis in a previous meta-analysis. However, there was no reduction in the admission rate. We hypothesized that nebulized HS treatment might significantly decrease both the duration and the rate of hospitalization if more randomized controlled trials (RCTs) were included. We searched MEDLINE, PubMed, CINAHL, and the Cochrane Central Register of Controlled Trials (CENTRAL) without a language restriction. A meta-analysis was performed based on the efficacy of nebulized HS treatment in infants with acute bronchiolitis. We used weighted mean difference (WMD) and risk ratio as effect size metrics. Eleven studies were identified that enrolled 1070 infants. Nebulized HS treatment significantly decreased the duration and rate of hospitalization compared with nebulized normal saline (NS) [duration of hospitalization: WMD = -0.96, 95% confidence interval (CI) = -1.38 to -0.54, p < 0.001; rate of hospitalization: risk ratio = 0.59, 95% CI = 0.37-0.93, p = 0.02]. Furthermore, nebulized HS treatment had a beneficial effect in reducing the clinical severity (CS) score of acute bronchiolitis infants post-treatment (Day 1: WMD = -0.77, 95% CI = -1.30 to -0.24, p = 0.005; Day 2: WMD = -0.85, 95% CI = -1.30 to -0.39, p < 0.001; Day 3: WMD = -1.14, 95% CI = -1.69 to -0.58, p < 0.001). There was no decrease in the rate of readmission (risk ratio = 1.08, 95% CI = 0.68-1.73, p = 0.74). Nebulized HS treatment significantly decreased both the rate and the duration of hospitalization. Due to the efficacy and cost-effectiveness, HS should be considered for the treatment of acute bronchiolitis in infants. Copyright © 2014. Published by Elsevier B.V.

  14. Nebulizers vs metered-dose inhalers with spacers for bronchodilator therapy to treat wheezing in children aged 2 to 24 months in a pediatric emergency department.

    PubMed

    Delgado, Annette; Chou, Katherine J; Silver, Ellen Johnson; Crain, Ellen F

    2003-01-01

    To determine if administration of albuterol by a metered-dose inhaler with a spacer device is as efficacious as administration of albuterol by nebulizer to treat wheezing in children aged 2 years and younger. Double-blind, randomized, placebo-controlled clinical trial. Pediatric emergency department. From a convenience sample of wheezing children aged 2 to 24 months, 85 patients were enrolled in the nebulizer group and 83 in the spacer group. The nebulizer group received a placebo metered-dose inhaler with a spacer followed by nebulized albuterol. The spacer group received albuterol by a metered-dose inhaler with a spacer followed by nebulized isotonic sodium chloride solution. Treatments were given every 20 minutes by a single investigator blinded to group assignment. The primary outcome was admission rate. Pulmonary Index score and oxygen saturation were measured initially and 10 minutes after each treatment. The nebulizer group had a significantly higher mean (SD) initial Pulmonary Index score compared with the spacer group (7.6 [2.5] vs 6.6 [2.0]; P =.002). With the initial Pulmonary Index score controlled, children in the spacer group were admitted less (5% vs 20%; P =.05). Analyses also revealed an interaction between group and initial Pulmonary Index score; lower admission rates in the spacer group were found primarily in children having a more severe asthma exacerbation. Our data suggest that metered-dose inhalers with spacers may be as efficacious as nebulizers for the emergency department treatment of wheezing in children aged 2 years or younger.

  15. Nebulization of nanoparticulate amorphous or crystalline tacrolimus--single-dose pharmacokinetics study in mice.

    PubMed

    Sinswat, Prapasri; Overhoff, Kirk A; McConville, Jason T; Johnston, Keith P; Williams, Robert O

    2008-08-01

    Developing a pulmonary composition of tacrolimus (TAC) provides direct access to the graft in lung transplant offering the possibility of high drug levels. The objective of this study was to investigate the physicochemical and pharmacokinetic characteristics of the nanostructured aggregates containing amorphous or crystalline nanoparticles of TAC produced by ultra-rapid freezing (URF). TAC and lactose (1:1 ratio; URF-TAC:LAC) and TAC alone (URF-TAC) were investigated for pulmonary delivery and compared to unprocessed TAC. X-ray diffraction (XRD) results indicated that URF-TAC was crystalline, whereas URF-TAC:LAC was amorphous. In vitro results revealed the superior physiochemical characteristics of both URF formulations compared to unprocessed TAC. The surface area of URF processed TAC was higher (25-29 m2/g) than that of the unprocessed TAC (0.53 m2/g) and subsequently enhanced dissolution rates. In addition, URF-TAC:LAC displayed the ability to supersaturate in the dissolution media to about 11 times the crystalline equilibrium solubility. Similar aerodynamic particle sizes of 2-3 microm, and fine particle fraction between 70% and 75% were found in both formulations. The local and systemic pharmacokinetic studies in mice showed similar AUC(0-24), higher Cmax, and lower Tmax for the URF-TAC:LAC compared to the URF-TAC. Nanostructured aggregates containing amorphous or crystalline nanoparticles of TAC were demonstrated to be effectively delivered via nebulization, with similar in vitro and in vivo performances.

  16. Synthesis of Carbon Nano Materials Originated from Waste Cooking Oil Using a Nebulized Spray Pyrolysis

    NASA Astrophysics Data System (ADS)

    Arie, A. A.; Hadisaputra, L.; Susanti, R. F.; Devianto, H.; Halim, M.; Enggar, R.; Lee, J. K.

    2017-07-01

    Synthesis of nanocarbon on snake fruit-peel’s activated carbon from waste cooking oil palm was conducted by a nebulized spray pyrolysis process (NSP) by varying the processing temperature from 650 to 750 °C. Ferrocene was used as a catalyst with constant concentration of 0.015 g/ml of carbon source. The structure of nanocarbon was studied by using scanning electron microscope (SEM),x-ray diffraction (XRD), surface area analyzer and Raman spectroscopy. SEM results showed that the structures of carbon products was in the the form of carbon nanopsheres (CNS). XRD and Raman analysis confirmed the CNS structure. The carbon producs were then tested as electrode’s materials for lithium ion capacitors (LIC) by cyclic voltammetry (CV) instruments. From the CV results the specific capacitance was estimated as 79.57 F / g at a scan rate of 0.1 mV / s and voltage range from 2.5 - 4 V. This study shows that the nano carbons synthesized from the waste cooking oil can be used as prospective electrode materials for LIC.

  17. Pneumatic nebulization gas-solid extraction of triazine herbicides in vegetable.

    PubMed

    Li, Na; Jin, Haiyan; Nian, Li; Wang, Yeqiang; Lei, Lei; Zhang, Rui; Zhang, Hanqi; Yu, Yong

    2013-08-23

    The pneumatic nebulization gas-solid extraction (PN-GSE) high-performance liquid chromatography (HPLC) was developed and applied to the extraction, separation and determination of triazine herbicides in vegetables. The herbicides were ultrasonically extracted from vegetables with 70% methanol in water. Then the extract was introduced to PN-GSE system to further clean-up. The experimental parameters, including type and concentration of extraction solvent, ratio of solvent to sample, pH value of sample solution and PN-GSE solution, extraction time, temperature, type of sorbent, flow rate of carrier gas, pumping rate of gas, and kind and volume of elution solvent, were investigated and optimized. The limits of detection for seven herbicides range from 0.59 to 1.05μg/kg. The recoveries of the herbicides are in the range of 86.2-110.6% and relative standard deviations are equal or less than 7.51%, when the present method was applied to the analysis of spiked samples. The present method was applied to the analysis of real samples and the results were satisfactory.

  18. Effect of nebulized eucalyptus on contamination of microbial plaque of endotracheal tube in ventilated patients

    PubMed Central

    Amini, Nazanin; Rezaei, Korosh; Yazdannik, Ahmadreza

    2016-01-01

    Background: Formation of biofilm and bacterial colonization within the endotracheal tube (ETT) are significant sources of airway contamination and play a role in the development of ventilator-associated pneumonia (VAP). This study was conducted to examine the effect of nebulized eucalyptus (NE) on bacterial colonization of ETT biofilm. Materials and Methods: We performed a randomized clinical trial in three intensive care units (ICUs) of an educational hospital. Seventy intubated patients were selected and randomly divided into intervention (n = 35) and control (n = 35) groups. The intervention group received 4 ml (5%) of eucalyptus in 6 ml normal saline every 8 h. The placebo group received only 10 ml of normal saline in the same way. On extubation, the interior of the tube was immediately sampled using a sterile swab for standard microbiological analysis. Chi-square and Fisher's exact tests were used for statistical analysis in SPSS. P values less than 0.05 were considered statistically significant. Results: In both samples, Klebsiella pneumoniae and Acinetobacter baumannii were the most frequently isolated bacteria. In the control group, heavy colonization was greater than in the intervention group (P = 0.002). The frequency of isolation of K. pneumoniae in the intervention group was lower than in the control group (P < 0.001). However, there was no difference between the two groups in other isolated bacteria. Conclusions: NE can reduce microbial contamination of the endotracheal tube biofilm in ventilated patients. Moreover, K. pneumoniae was the most sensitive to NE. PMID:27095990

  19. Numerical simulation of air flow and medical-aerosol distribution in an innovative nebulizer hood.

    PubMed

    Shakked, Tal; Katoshevski, David; Broday, David M; Amirav, Israel

    2005-01-01

    The use of a hood to administer therapeutic aerosols to wheezy infants has many advantages and was found as efficient as administration using a mask. The aim of the present study is to investigate numerically the airflow induced drug dispersion inside the hood. Drug droplet dispersion is examined with respect to three breathing phases: inspiration, expiration, and apnea. The governing equations describing the airflow and the trajectories of drug droplets were solved using the FLUENT 6.1 Computational Fluid Dynamics (CFD) software package. The geometry and mesh were generated with the GAMBIT package. The velocity field of the air and the trajectories of drug droplets inside the funnel--the tube that delivers the drug from the nebulizer to the infant's mouth--and close to its exit are robust and do not show any appreciable differences among the three breathing phases studied. However, in other parts of the hood, air velocity, and particle motion largely depend on the infant's breathing and physiological state. The efficiency of drug delivery to the mouth during inspiration is found to be as high as 84%, whereas it is much smaller in the other two (common) breathing phases examined. Our results may be utilized to improve the hood design and to increase its efficacy for administration of aerosolized medications to infants.

  20. Low positive end-expiratory pressure does not exacerbate nebulized-acid lung injury in dogs.

    PubMed

    Pellett, Andrew A; Welsh, David A; deBoisblanc, Bennett P; Lipscomb, Gary; Johnson, Royce W; Lord, Kevin C; Levitzky, Michael G

    2005-03-01

    It is not clear if low end-expiratory pressures contribute to ventilator-induced lung injury in large animals. We sought to determine whether ventilation with a low level of positive end-expiratory pressure (PEEP) worsens preexisting permeability lung injury in dogs. Lung injury was initiated in 20 mongrel dogs by ventilating with nebulized 3N hydrochloric acid until a lower inflection point (LIP) appeared on the respiratory system pressure-volume loop. One group of 10 dogs was then ventilated for 4 hours with PEEP set below the LIP (low PEEP), whereas the remaining group of dogs was ventilated for the same time period with similar tidal volumes but with PEEP set above the LIP (high PEEP). We found histologic evidence of reduced alveolar volumes in the low-PEEP animals. However, there were no differences in neutrophil infiltration, lung lobe weights, pulmonary capillary hemorrhage or congestion, or arterial endothelin-1 concentration between the 2 protocol groups. In conclusion, we were unable to demonstrate that ventilation with PEEP set below the LIP exacerbates hydrochloric acid-induced lung injury in dogs.

  1. Synthesis of kerosene based nanocarbons by a nebulized spray pyrolysis method

    SciTech Connect

    Widjaja, Ongky Arie, Arenst Andreas; Halim, Martin; Lee, Joong Kee

    2016-04-19

    In this work, kerosene oil based nanocarbons were synthesized by a nebulized spray pyrolysis method. This method was conducted at temperature of 700°C under a nitrogen inert atmospheric condition. Activated carbon and ferrocene were used as substrate and catalyst, respectively. Initially, ferrocene was dissolved in the oil with fixed concentration of 0.02 g/ml. The pyrolysis reaction was carried out by varying the operating time of 15, 30 and 45 minutes. The main aim of this work was to investigate the effect of varying the operation time on the morphology and structural characteristics of as-prepared carbon products. The morphology and structural characteristics of synthesized nanocarbons were examined by Scanning Electron Microscope (SEM), Transmission Electron Microscopy (TEM), and Raman Spectroscopy, respectively. SEM and TEM observations showed that nano carbons were formed as agglomerated carbon nanospheres (CNSs) and graphene for all variation of operating time. Furthermore, it was observed that the size of agglomerated CNSs was proportional with the operating time from 15 to 45 minutes. Raman analysis showed that the ratio between graphite like and disorder carbon structure (I{sub G}/I{sub D})of carbon samples increased from operating time of 15 to 30 minutes, however the ratio decreased from 30 minutes to 45 minutes.

  2. Surface acoustic wave nebulization device with dual interdigitated transducers improves SAWN-MS performance.

    PubMed

    Huang, Yue; Heron, Scott R; Clark, Alicia M; Edgar, J Scott; Yoon, Sung Hwan; Kilgour, David P A; Turecek, Frantisek; Aliseda, Alberto; Goodlett, David R

    2016-06-01

    We compared mass spectrometric (MS) performance of surface acoustic wave nebulization (SAWN) generated by a single interdigitated transducer (IDT) designed to produce a progressive wave (PW) to one with a dual IDT that can in theory generate standing waves (SW). Given that devices using dual IDTs had been shown to produce fewer large size droplets on average, we hypothesized they would improve MS performance by improving the efficiency of desolvation. Indeed, the SW-SAWN chip provided an improved limit of detection of 1 femtomole of peptide placed on chip making it 100× more sensitive than the PW design. However, as measured by high-speed image recording and phase Doppler particle analyzer measurements, there was only a 26% increase in the small diameter (1-10 µm) droplets produced from the new device, precluding a conclusion that the decrease in droplet size was solely responsible for the improvement in MS signal/noise. Given that the dual IDT design produced a more instantaneous plume than the PW design, the more likely contributor to improved MS signal/noise was concluded to be a higher ion flux entering the mass spectrometer for the dual IDT designs. Notably, the dual IDT device allowed production of much higher quality protein mass spectra up to about 20 kDa, compared with the single IDT device. Copyright © 2016 John Wiley & Sons, Ltd.

  3. Performance of the vibrating membrane aerosol generation device: Aeroneb Micropump Nebulizer.

    PubMed

    Zhang, Guifang; David, Anand; Wiedmann, Timothy Scott

    2007-01-01

    The output and particle size distribution of several series of aqueous solutions were measured to define quantitatively the practical limits of the solution properties acceptable for aerosol production by the aeroneb micropump nebulizer. Aerosol output measurements were made gravimetrically and the particle size distributions were obtained by laser diffractometry. Solution properties were obtained from the literature by interpolation of the best-fit curve of the property plotted as a function of composition. For nonionic solutes, addition of sodium chloride dramatically increased the output rate and also decreased the droplet size at low solute concentrations. Increasing viscosity also caused a significant decrease in output. Cesium chloride displayed increased output rate with concentration due to the rising density. Based on calculations with the number of apertures and oscillatory frequency, low output rates appeared to be a consequence of apertures failing to produce a droplet with each oscillation. Overall, ionic strength, density, surface tension, and viscosity affected the output rate in a manner that can be now empirically predicted.

  4. Slurry nebulization for the analysis of gypsum and cement by inductively coupled plasma spectrometry.

    PubMed

    McCrindle, Robert I; Marjanovic, Ljiljana

    2002-12-01

    The usual form of presentation for a sample to be analyzed by an inductively coupled plasma-optical emission spectrometer is in the form of a liquid. For the analysis of solids, this involves a dissolution step and in the case of complex matrices this may be long and difficult. Should it be possible to analyse the sample without prior dissolution, then the problems associated with obtaining a solution would be resolved. A method for analyzing samples is to make use of slurry nebulization. Samples with complex matrices, such as cement and gypsum were selected and analysed as in the form of a slurry. Using different concentrations of a certified reference materials, calibration curves were obtained, from which the unknown samples could be determined directly. Use of aqueous solutions for calibration was also investigated. The method was evaluated using other reference materials or results obtained by an independent laboratory using different technique for the analysis. The slurry method was found to be accurate and precise.

  5. The cough response to ultrasonically nebulized distilled water in heart-lung transplantation patients

    SciTech Connect

    Higenbottam, T.; Jackson, M.; Woolman, P.; Lowry, R.; Wallwork, J.

    1989-07-01

    As a result of clinical heart-lung transplantation, the lungs are denervated below the level of the tracheal anastomosis. It has been questioned whether afferent vagal reinnervation occurs after surgery. Here we report the cough frequency, during inhalation of ultrasonically nebulized distilled water, of 15 heart-lung transplant patients studied 6 wk to 36 months after surgery. They were compared with 15 normal subjects of a similar age and sex. The distribution of the aerosol was studied in five normal subjects using /sup 99m/technetium diethylene triamine pentaacetate (/sup 99m/Tc-DTPA) in saline. In seven patients, the sensitivity of the laryngeal mucosa to instilled distilled water (0.2 ml) was tested at the time of fiberoptic bronchoscopy by recording the cough response. Ten percent of the aerosol was deposited onto the larynx and trachea, 56% on the central airways, and 34% in the periphery of the lung. The cough response to the aerosol was strikingly diminished in the patients compared with normal subjects (p less than 0.001), but all seven patients coughed when distilled water was instilled onto the larynx. As expected, the laryngeal mucosa of heart-lung transplant patients remains sensitive to distilled water. However, the diminished coughing when the distilled water is distributed by aerosol to the central airways supports the view that vagal afferent nerves do not reinnervate the lungs after heart-lung transplantation, up to 36 months after surgery.

  6. Determination of trace elements in heroin by inductively coupled plasma atomic emission spectrometry using ultrasonic nebulization

    NASA Astrophysics Data System (ADS)

    Budič, Bojan; Klemenc, Sonja

    2000-06-01

    A method for the determination of Al, Ba, Ca, Cu, Fe, K, Mg, Mn, Na, Ni, P, S, Sr and Zn in heroin samples by ICP-AES using ultrasonic nebulization is described. The samples were microwave digested with HNO 3. To improve the detection limits and minimise the matrix interferences the experimental parameters were optimised by variation of the operating power, carrier gas flow rate and observation height above the load coil. Optimum operating conditions for most of the analytes were at operating power 1550 W, carrier gas flow rate between 0.8 and 1.0 l min -1 and observation height between 10 and 12 mm above load coil. The limits of detection were below 0.5 μg g -1 (dry mass) for most of the elements investigated. The analytical recoveries of spiked samples were in the range between 94 and 103% and precision was on average better than 6%. The analysis of heroin samples shows that the method is simple, rapid and capable of providing accurate results for all the analytes investigated with the exception of nickel which was below the limit of detection in the analyzed samples.

  7. Synthesis of kerosene based nanocarbons by a nebulized spray pyrolysis method

    NASA Astrophysics Data System (ADS)

    Widjaja, Ongky; Arie, Arenst Andreas; Halim, Martin; Lee, Joong Kee

    2016-04-01

    In this work, kerosene oil based nanocarbons were synthesized by a nebulized spray pyrolysis method. This method was conducted at temperature of 700°C under a nitrogen inert atmospheric condition. Activated carbon and ferrocene were used as substrate and catalyst, respectively. Initially, ferrocene was dissolved in the oil with fixed concentration of 0.02 g/ml. The pyrolysis reaction was carried out by varying the operating time of 15, 30 and 45 minutes. The main aim of this work was to investigate the effect of varying the operation time on the morphology and structural characteristics of as-prepared carbon products. The morphology and structural characteristics of synthesized nanocarbons were examined by Scanning Electron Microscope (SEM), Transmission Electron Microscopy (TEM), and Raman Spectroscopy, respectively. SEM and TEM observations showed that nano carbons were formed as agglomerated carbon nanospheres (CNSs) and graphene for all variation of operating time. Furthermore, it was observed that the size of agglomerated CNSs was proportional with the operating time from 15 to 45 minutes. Raman analysis showed that the ratio between graphite like and disorder carbon structure (IG/ID)of carbon samples increased from operating time of 15 to 30 minutes, however the ratio decreased from 30 minutes to 45 minutes.

  8. Use of Nebulized Antimicrobials for the Treatment of Respiratory Infections in Invasively Mechanically Ventilated Adults: A Position Paper from the European Society of Clinical Microbiology and Infectious Diseases.

    PubMed

    Rello, Jordi; Solé-Lleonart, Candela; Rouby, Jean-Jacques; Chastre, Jean; Blot, Stijn; Poulakou, Garyfallia; Luyt, Charles-Edouard; Riera, Jordi; Palmer, Lucy B; Pereira, Jose M; Felton, Tim; Dhanani, Jayesh; Bassetti, Matteo; Welte, Tobias; Roberts, Jason A

    2017-04-13

    With an established role in cystic fibrosis and bronchiectasis, nebulized antibiotics are increasingly being used to treat respiratory infections in critically ill invasively mechanically ventilated adult patients. Although there is limited evidence describing their efficacy and safety, in an era of need for new strategies to enhance antibiotic effectiveness because of a shortage of new agents and increases in antibiotic resistance, the potential of nebulization of antibiotics to optimize therapy is considered of high interest, particularly in patients infected with multidrug-resistant (MDR) pathogens. This Position Paper of the European Society of Clinical Microbiology and Infectious Diseases provides recommendations based on the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology regarding the use of nebulized antibiotics in invasively mechanically ventilated adults, based on a systematic review and meta-analysis of the existing literature (last search July 2016). Overall, the panel recommends to avoid use of nebulized antibiotics in clinical practice, due to a weak level of evidence of their efficacy and the high potential for underestimated risks of adverse events (particularly, respiratory complications). Higher quality evidence is urgently needed to inform clinical practice. Priorities of future research are detailed in the second part of the Position Paper as a guidance for researchers in this field. In particular, the panel identified an urgent need for randomized clinical trials of nebulized antibiotic therapy as part of a substitution approach to treatment of pneumonia due to MDR pathogens.

  9. Ganciclovir Injection

    MedlinePlus

    ... tests to check your body's response to ganciclovir injection.It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or ...

  10. Pertuzumab Injection

    MedlinePlus

    ... tests to check your body's response to pertuzumab injection.It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or ...

  11. Mitoxantrone Injection

    MedlinePlus

    ... to the treatment.If you are using mitoxantrone injection for MS, you should know that it controls MS but does not cure it. Continue to receive treatments even if you feel well. Talk to your doctor if you no longer ...

  12. Olaratumab Injection

    MedlinePlus

    ... your pharmacist any questions you have about olaratumab injection.It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or ...

  13. Reslizumab Injection

    MedlinePlus

    ... the infusion or for a short period of time after the infusion has finished.You will receive each injection of reslizumab in a doctor's office or medical facility. You will stay in the office for some time after you receive the medication so your doctor ...

  14. Teduglutide Injection

    MedlinePlus

    ... syndrome in people who need additional nutrition or fluids from intravenous (IV) therapy. Teduglutide injection is in a class of medications called glucagon-like peptide-2 (GLP-2) analogs. It works by improving the absorption of fluids and nutrients in the intestines.

  15. Pegaptanib Injection

    MedlinePlus

    ... if you have or have ever had diabetes, high blood pressure, a heart attack, or a stroke.tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while using pegaptanib injection, ...

  16. Nebulized anti-IL-13 monoclonal antibody Fab' fragment reduces allergen-induced asthma.

    PubMed

    Hacha, Jonathan; Tomlinson, Kate; Maertens, Ludovic; Paulissen, Geneviève; Rocks, Natacha; Foidart, Jean-Michel; Noel, Agnès; Palframan, Roger; Gueders, Maud; Cataldo, Didier D

    2012-11-01

    IL-13 is a prototypic T helper type 2 cytokine and a central mediator of the complex cascade of events leading to asthmatic phenotype. Indeed, IL-13 plays key roles in IgE synthesis, bronchial hyperresponsiveness, mucus hypersecretion, subepithelial fibrosis, and eosinophil infiltration. We assessed the potential efficacy of inhaled anti-IL-13 monoclonal antibody Fab' fragment on allergen-induced airway inflammation, hyperresponsiveness, and remodeling in an experimental model of allergic asthma. Anti-IL-13 Fab' was administered to mice as a liquid aerosol generated by inExpose inhalation system in a tower allowing a nose-only exposure. BALB/c mice were treated by PBS, anti-IL-13 Fab', or A33 Fab' fragment and subjected to ovalbumin exposure for 1 and 5 weeks (short-term and long-term protocols). Our data demonstrate a significant antiasthma effect after nebulization of anti-IL-13 Fab' in a model of asthma driven by allergen exposure as compared with saline and nonimmune Fab fragments. In short- and long-term protocols, administration of the anti-IL-13 Fab' by inhalation significantly decreased bronchial responsiveness to methacholine, bronchoalveolar lavage fluid eosinophilia, inflammatory cell infiltration in lung tissue, and many features of airway remodeling. Levels of proinflammatory mediators and matrix metalloprotease were significantly lower in lung parenchyma of mice treated with anti-IL-13 Fab'. These data demonstrate that an inhaled anti-IL-13 Fab' significantly reduces airway inflammation, hyperresponsiveness, and remodeling. Specific neutralization of IL-13 in the lungs using an inhaled anti-IL-13 Fab' could represent a novel and effective therapy for the treatment of asthma.

  17. Liquid Nebulization-Ion Mobility Spectrometry Based Quantification of Nanoparticle-Protein Conjugate Formation.

    PubMed

    Jeon, Seongho; Oberreit, Derek R; Van Schooneveld, Gary; Hogan, Christopher J

    2016-08-02

    Despite the importance of examining the formation of nanoparticle-protein conjugates, there is a dearth of routine techniques for nanoparticle-protein conjugate characterization. The most prominent change to a nanoparticle population upon conjugate formation is a shift in the nanoparticle size distribution function. However, commonly employed dynamic light scattering based approaches for size distribution characterization are ineffective for nonmonodisperse samples, and further they are relatively insensitive to size shifts of only several nanometers, which are common during conjugate formation. Conversely, gas phase ion mobility spectrometry (IMS) techniques can be used to reliably examine polydisperse samples, and are sensitive to ∼1 nm size distribution function shifts; the challenge with IMS is to convert nanoparticle-protein conjugates to aerosol particles without bringing about nonspecific aggregation or conjugate formation. Except in limited circumstances, electrospray based aerosolization has proven difficult to apply for this purpose. Here we show that via liquid nebulization (LN) with online, high-flow-rate dilution (with dilution factors up to 10 000) it is possible to aerosolize nanoparticle-protein conjugates, enabling IMS measurements of their conjugate size distribution functions. We specifically employ the LN-IMS system to examine bovine serum albumin binding to gold nanoparticles. Inferred maximum protein surface coverages (∼0.025 nm(-2)) from measurements are shown to be in excellent agreement with reported values for gold from quartz crystal microbalance measurements. It is also shown that LN-IMS measurements can be used to detect size distribution function shifts on the order of 1 nm, even in circumstances where the size distribution function itself has a standard deviation of ∼5 nm. In total, the reported measurements suggest that LN-IMS is a potentially simple and robust technique for nanoparticle-protein conjugate characterization.

  18. Methods of analysis by the U.S. Geological Survey National Water Quality Laboratory; use of a modified ultrasonic nebulizer for the analysis of low ionic-strength water by inductively coupled optical emission spectrometry

    USGS Publications Warehouse

    Harris, Carl M.; Litteral, Charles J.; Damrau, Donna L.

    1997-01-01

    The U.S. Geological Survey National Water Quality Laboratory has developed a method for the determination of dissolved calcium, iron, magnesium, manganese, silica, and sodium using a modified ultrasonic nebulizer sample-introduction system to an inductively coupled plasma-optical emission spectrometer. The nebulizer's spray chamber has been modified to avoid carryover and memory effects common in some conventional ultrasonic designs. The modified ultrasonic nebulizer is equipped with a high-speed rinse cycle to remove previously analyzed samples from the spray chamber without excessive flush times. This new rinse cycle decreases sample washout times by reducing carryover and memory effects from salt or analytes in previously analyzed samples by as much as 45 percent. Plasma instability has been reduced by repositioning the argon carrier gas inlet on the spray chamber and by directly pumping waste from the chamber, instead of from open drain traps, thereby maintaining constant pressure to the plasma. The ultrasonic nebulizer improves signal intensities, which are 8 to 16 times greater than for a conventional cross-flow pneumatic nebulizer, without being sensitive to clogging from salt buildup as in cross-flow nebulizers. Detection limits for the ultrasonic nebulizer are 4 to 18 times less than detection limits achievable using a cross-flow pneumatic nebulizer, with equivalent sample analysis time.

  19. Nebulized water cooling of the canopy affects leaf temperature, berry composition and wine quality of Sauvignon blanc.

    PubMed

    Paciello, Pericle; Mencarelli, Fabio; Palliotti, Alberto; Ceccantoni, Brunella; Thibon, Cécile; Darriet, Philippe; Pasquini, Massimiliano; Bellincontro, Andrea

    2017-03-01

    The present paper details a new technique based on spraying nebulized water on vine canopy to counteract the negative impact of the current wave of hot summers with temperatures above 30 °C, which usually determine negative effects on vine yield, grape composition and wine quality. The automatized spraying system was able to maintain air temperature at below 30 °C (the threshold temperature to start spraying) for all of August 2013, when in the canopy of uncooled vines the temperature was as high as 36 °C. The maintenance of temperature below 30 °C reduced leaf stress linked to high temperature and irradiance regimes as highlighted by the decrease of H2 O2 content and catalase activity in the leaves. A higher amount of total polyphenols and organic acids and lower sugars characterized the grapes of cooled vines. Wine from these grapes had a higher content of some volatile thiols like 3-sulfanylhexanol (3SH) and 3-sulfanylhexylacetate (3SHA), and lower content of 4-methyl-4-sulfanylpentan-2-one (4MSP). Under conditions of high temperature and irradiance regimes, water nebulization on the vine canopy can represent a valid solution to reduce and/or avoid oxidative stress and associated effects in the leaves, ensure a regular berry ripening and maintain high wine quality. The consumption of water during nebulization was acceptable, being 180 L ha(-1) min(-1) , which lasted an average of about 1 min to reduce the temperature below the threshold value of 30 °C. A total of 85-90 hL (from 0.8 to 0.9 mm) of water per hectare per day was required. © 2016 Society of Chemical Industry. © 2016 Society of Chemical Industry.

  20. Protective effect of levodropropizine against cough induced by inhalation of nebulized distilled water in patients with obstructive lung disease.

    PubMed

    Bariffi, F; Tranfa, C; Vatrella, A; Ponticiello, A

    1992-01-01

    Levodropropizine is a recently developed, peripherally active antitussive agent which is widely used in clinical practice. In order to obtain further information on the spectrum of activity of this compound in experimental clinical models, a double-blind controlled study was carried out to evaluate the potential effect of the drug against cough and bronchoconstriction induced by inhalation of an ultrasonically nebulized solution of distilled water in patients with obstructive lung disease. Twenty patients were randomly divided into two groups, which received levodropropizine (60 mg t.i.d.) or placebo respectively for 7 consecutive days. Parameters evaluated at baseline and on the last day of treatment included (i) results of respiratory function tests (FEV1, IVC, FVC, TIFF, PEF, MEF75, MEF50, MEF25) performed before the stimulation test with nebulized water; (ii) total number of coughs during a 2-hour period after the stimulation test; (iii) bronchial responsiveness, quantified by calculating the volume of nebulized water required to induce a 20% reduction of FEV1 below the basal level. At pretreatment, the tussive response was very similar in the two groups. A significant decrease in number of coughs (from 34.4 +/- 8.4 at baseline to 15.6 +/- 4.9 post-treatment, p less than 0.01) was observed after administration of levodropropizine, whereas placebo treatment produced no significant effect (number of coughs: 29.6 +/- 4.9 at baseline vs 24.8 +/- 9.6 post-treatment, N.S.). Bronchial responsiveness decreased significantly (compared to baseline) in both treatment groups, without any significant difference between drug and placebo. Respiratory function tests were not significantly affected by either treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

  1. Particle transport in a He-microchip plasma atomic emission system with an ultrasonic nebulizer for aqueous sample introduction

    NASA Astrophysics Data System (ADS)

    Oh, Joosuck; Lim, H. B.

    2008-11-01

    The transport efficiency of dried particles generated from an ultrasonic nebulizer (USN) was studied to improve the analytical performance of a lab-made, He-microchip plasma system, in which a quartz tube (~ 1 mm i.d.) was positioned inside the central channel of a poly(dimethylsiloxane) (PDMS) polymer chip. The polymer microchip plasma has the advantages of low cost, small size, easy handling and design, and self-ignition with long stabilization (> 24 h). However, direct introduction of aqueous solution into the microplasma for the detection of metals remains problematic due to plasma instability. In addition, the much smaller size of the system can cause signal suppression due to low transport efficiency. Therefore, knowledge of particle transport efficiency in this microplasma system is required to enhance the sensitivity and stability. The weight of transported particles in the range of 0.02 to 10 mg m - 3 was measured using a piezobalance with a precision of 0.4-17.8%, depending on the operating conditions. The significant effects of the USN operating conditions and the physical properties of the tubing, namely, length, inner diameter and surface characteristics, on the number of particles transported from the nebulizer to the microplasma were studied. When selected metals, such as Na, Mg and Pb, at a concentration of 5 mg L - 1 were nebulized, transported particles were obtained with a mass range of 0.5-5 mg m - 3 , depending on atomic weights. For application of the He-rf-microplasma, the atomic emission system was optimized by changing both the radio frequency (rf) power (60-200 W) and cooling temperature of the USN (- 12-9 °C). The limits of detection obtained for K, Na and Cu were 0.26, 0.22, and 0.28 mg L - 1 , respectively. These results confirmed the suitable stability and sensitivity of the He-rf-PDMS microchip plasma for application as an atomization source.

  2. Evaluation of the Target Inhalation Mode (TIM) Breathing Maneuver in Simulated Nebulizer Therapy in Patients with Cystic Fibrosis

    PubMed Central

    Prince, Ivan; Dixon, Emma; Agent, Penny; Pryor, Jennifer; Hodson, Margaret

    2010-01-01

    Abstract Background Adaptive Aerosol Delivery (AAD) systems provide efficient drug delivery and improved lung deposition over conventional nebulizers by combining real-time analyses of patient breathing patterns and precisely timed aerosol delivery. Delivery and deposition are further enhanced by breathing techniques involving slow, deep inhalations. Methods This exploratory study assessed the acceptability of slow, deep inhalations in 20 patients with cystic fibrosis (CF) during up to eight simulated nebulizer treatments with the I-neb AAD System. The breathing maneuver, Target Inhalation Mode (TIM) breathing, involved the lengthening of the patient's inhalation time over successive breaths with guidance from auditory and tactile (vibratory) feedback from the device. Results At the end of the first treatment, most patients felt that the instructions were easy to understand (90%) and that the vibratory feedback was pleasant (65%). Half of the patients found the procedure to be comfortable. At the end of the final treatment, most patients felt that the breathing maneuver was easy to understand (90%) and use (80%), but that the duration of the breath was too long (100%). Logged data revealed that 90% of patients were able to comply with the breathing maneuver. The two patients unable to comply had a forced vital capacity of <1.75 L. The average treatment time decreased from 288.4 to 141.6 sec during the first and final treatments, respectively. Conclusions This study provides preliminary evidence of the acceptability of the TIM breathing maneuver in patients with CF and their ability to perform repeated TIM breathing during simulated nebulizer therapy with the I-neb AAD System. PMID:20373907

  3. Nebulized oil-in-water nanoemulsion mists for pulmonary delivery: development, physico-chemical characterization and in vitro evaluation.

    PubMed

    Nesamony, Jerry; Shah, Ishan S; Kalra, Ashish; Jung, Rose

    2014-09-01

    This study presents novel nanostructured oil-in-water (o/w) mists based on self-nanoemulsifying (SNE) mixtures capable of delivering poorly water-soluble drugs into the lungs. Formulation development of an o/w nanoemulsion (NE) capable of being nebulized for pulmonary delivery of poorly water-soluble drugs. SNE mixtures were prepared and evaluated using Tween 80 and Cremophor RH 40 as surfactants; Transcutol P, Capryol 90 and PEG 400 as cosurfactants; and Labrafac Lipophile Wl 1349 (a medium-chain triglyceride) as an oil. Liquid NEs were analyzed by light scattering, zeta potential, transmission electron microscopy (TEM) and in vitro drug release studies. The aqueous NE was nebulized and assessed by light scattering and TEM. The formulation was aseptically filtered and the sterility validated. In vitro cytotoxicity of the formulations was tested in NIH 3T3 cells. The capability of the formulation to deliver a poorly water-soluble drug was determined using ibuprofen. Ibuprofen was found to be stable in the NEs. The formulations were neutrally charged with a droplet size of about 20 nm. TEM images displayed 100 nm oil droplets. The aseptic filtration method produced sterile NE. The nebulized mist revealed properties ideal for pulmonary delivery. The biocompatible aerosol has a nanostructure consisting of several oil nanodroplets enclosed within each water drop. Solubility and in vitro drug release studies showed successful incorporation and release of ibuprofen. The developed formulation could be used as an inhalation for delivering material possessing poor water solubility into the lungs.

  4. Comparison of Usefulness of Ketamine and Magnesium Sulfate Nebulizations for Attenuating Postoperative Sore Throat, Hoarseness of Voice, and Cough

    PubMed Central

    Rajan, Sunil; Malayil, George Jacob; Varghese, Rekha; Kumar, Lakshmi

    2017-01-01

    Context: Postoperative sore throat (POST) is a complication that is unresolved in patients undergoing endotracheal intubation. Aim: To compare the effects of ketamine and magnesium sulfate nebulizations in two strengths, on the incidence and severity of POST, hoarseness, and cough. Settings and Design: Sixty surgical patients undergoing elective abdominal and lower limb surgeries under combined epidural and general anesthesia were included in this prospective, randomized, double-blinded study. Subjects and Methods: Patients in each group were nebulized with the respective study drug 15 min prior to the surgery, i.e., ketamine in Group K, magnesium sulfate 250 mg, and 500 mg in Group M1 and Group M2, respectively, and normal saline as control in Group C. A standardized anesthesia protocol was followed for all patients. After extubation, the patients were asked to grade POST, hoarseness, and cough at 0, 2, 4, 12, and 24 h. Statistical Analysis Used: One-way analysis of variance, Chi-square test, Fisher's exact test, paired t-tests, and Wilcoxon's signed-rank test as applicable. Results: Ketamine and magnesium sulfate 500 mg demonstrated a statistically significant decrease in POST at 0, 2, and 4 h, and postoperative hoarseness at 0 h. There was decrease in the incidence and severity of sore throat, hoarseness, and cough at all periods in the study groups as compared with control. Conclusion: Nebulization with ketamine 50 mg and magnesium sulfate 500 mg, 15 min before induction of general anesthesia and intubation, reduce the incidence and severity of POST and hoarseness of voice. PMID:28663608

  5. Salbutamol via metered-dose inhaler with spacer versus nebulization for acute treatment of pediatric asthma in the emergency department.

    PubMed

    Benito-Fernández, Javier; González-Balenciaga, María; Capapé-Zache, Susana; Vázquez-Ronco, Miguel A; Mintegi-Raso, Santiago

    2004-10-01

    To assess the effectiveness of salbutamol delivered via a metered-dose inhaler with spacer versus a nebulizer for acute asthma treatment in the pediatric emergency department. All consecutive children younger than 14 years old who required treatment of acute asthma exacerbation in the emergency department during May 2002 (prospective cohort, n = 321) and May 2001(retrospective cohort, n = 259) were included. Inhaled salbutamol was administered by metered-dose inhaler with a spacer (and a face mask in children younger than 2 years old) in the prospective cohort and by nebulizer in the retrospective cohort. There were no significant differences between the two cohorts in the mean (+/-SD) age (44.50 +/- 38.64 vs. 48.37 +/- 43.55 months) and asthma treatment, arterial oxygen saturation (96.34 +/- 2.12% vs. 96.19 +/- 6.32%), and heart rate (123.71 +/- 23.63 vs. 129.41 +/- 34.55 beats/min) before emergency department consultation. The number of doses of inhaled bronchodilators was also similar (1.42 +/- 1.01 vs. 1.45 +/- 0.98) as well as the number of children that required a stay in the observation unit, admission to the hospital, or returned for medical care. The overall mean length of stay in the emergency department was slightly shorter in the prospective cohort (82 +/- 48 vs. 89 +/- 52 minutes). The administration of bronchodilators using a metered-dose inhaler with spacer is an effective alternative to nebulizers for the treatment of children with acute asthma exacerbations in the emergency department.

  6. Doctor Shoja-ad-Din Sheikholeslamzadeh and his Achievements

    PubMed Central

    Afshar, Ahmadreza; Ziaei, Majid Eyvaz; Ahmadi, Aziz

    2015-01-01

    Doctor Shoja-ad-Din Sheikholeslamzadeh (also known as Dr. Sheikh) (1931-2014) was an outstanding orthopedic surgeon. He is credited for the establishment of the Iranian Association of Rehabilitation, Shafa Yahyaian Hospital as an Orthopedic and Rehabilitation Center, the Social Welfare Organization, Iran's emergency dispatch center (115) and many other major projects that led to the upgrading of health care services in Iran. He also served as the Minister of Social Welfare and Minister of Health and Welfare before the Islamic revolution. The history of modern health care management and modern orthopedic surgery in Iran are indebted to the great leadership and executive abilities of Dr. Sheikh. PMID:25692161

  7. Subcutaneous (SQ) injections

    MedlinePlus

    SQ injections; Sub-Q injections; Diabetes subcutaneous injection; Insulin subcutaneous injection ... NIH. Giving a subcutaneous injection . Rockville, MD. National ... of Health and Human Services NIH publications; 2015. Available ...

  8. Comparison of fluticasone propionate with budesonide administered via nebulizer: a randomized controlled trial in patients with severe persistent asthma

    PubMed Central

    Chen, Ping; Liu, Chuntao; Kang, Jian; Xiao, Wei; Chen, Zhengxian; Tang, Huaping; Du, Xin; Liu, Cindy; Luo, Linda

    2017-01-01

    Background This study compared the efficacy and safety of fluticasone propionate (FP) inhalation n solution with budesonide (BUD) suspension for inhalation administered via nebulizer, in Chinese adult patients with severe, persistent asthma. Methods This was a multicenter, randomized, active-controlled, single-blind, parallel-group study, conducted at 26 clinical sites in China. Participants were randomized 1:1 to FP nebules 1 mg twice daily or BUD 2 mg twice daily via nebulizer for 12 weeks. Results A total of 317 adult patients were randomized. The primary endpoint was mean change in morning peak expiratory flow (PEF) over weeks 1–12 from baseline, and analyzed in the ITT (n=315) and PP populations (n=283). Week 12 PEF increase from baseline was 26.7 L/min (14.1%) and 28.0 L/min (15.3%) in the ITT population, and 29.1 L/min (15.7%) and 30.1 L/min (16.2%) in the PP population, in the FP and BUD groups, respectively; all improvements were of clinical significance. Lower limits of the two-sided 95% CIs for the least squares (LS) mean treatment difference (FP minus BUD) were −12.19 L/min (ITT) and −12.95 L/min (PP), both above the pre-specified non-inferiority criteria −12.00 L/min and not clinically meaningful. There was no significant difference in the week 12 mean FEV1 increase between the FP and BUD groups (0.237 L/16.79% vs. 0.236 L/17.73%). Lower limits of the 95% CIs for LS mean treatment difference in morning PEF change from baseline over weeks 1–4 in a post hoc analysis were −10.41 and −11.96 L/min in the ITT and PP populations respectively; both above −12.00 L/min. A review of safety data indicated that rates of AEs, SAEs, and drug-related AEs were similar between two groups. Conclusions The 12-week treatment of FP inhalation solution administered via nebulizer is safe and effectively for treating severe, persistent asthma in Chinese patients over 12 week. PMID:28275486

  9. Humidity control of an incubator using the microcontroller-based active humidifier system employing an ultrasonic nebulizer.

    PubMed

    Güler, I; Burunkaya, M

    2002-01-01

    Relative humidity levels of an incubator were measured and controlled. An ultrasonic nebulizer system as an active humidifier was used to humidify the incubator environment. An integrated circuit-type humidity sensor was used to measure the humidity level of the incubator environment. Measurement and control processes were achieved by a PIC microcontroller. The high-performance and high-speed PIC provided the flexibility of the system. The developed system can be used effectively for the intensive care of newborns and/or premature babies. Since the humidifier generates an aerosol in ambient conditions, it is possible to provide the high relative humidity level for therapeutic and diagnostic purposes in medicine.

  10. Add-on treatment with nebulized hypertonic saline in a child with plastic bronchitis after the Glenn procedure.

    PubMed

    Lis, Grzegorz; Cichocka-Jarosz, Ewa; Jedynak-Wasowicz, Urszula; Glowacka, Edyta

    2014-01-01

    Plastic bronchitis (PB), although a rare cause of airway obstruction, has mortality rates up to 50% in children after Fontan-type cardiac surgery. We present the case of an 18-month-old female patient with PB following pneumonia. At 6 months of age, the patient underwent the Glenn procedure due to functionally univentricular heart. Fiberoptic bronchoscopy revealed complete blockage of the left bronchus by mucoid casts. Pharmacotherapy consisted of glucocorticosteroids, azithromycin, and enalapril maleate. The child also received nebulized 3% NaCl solution, which proved to be beneficial. In children submitted to Fontan-type procedures, physicians must be alert for PB, which can be triggered by respiratory tract infection.

  11. Inhalation and deposition of nebulized sodium cromoglycate in two different particle size distributions in children with asthma.

    PubMed

    Nerbrink, O L; Lindström, M; Meurling, L; Svartengren, M

    2002-11-01

    The relative deposition of two inhaled droplet size distributions of sodium cromoglycate produced by a Hudson Updraft II nebulizer was evaluated, using a setup modified from the proposed Comité Européen Normalisé (CEN) standard prEN 13544-1. The modified setup comprised an Andersen 296 impactor and a Spira Electro 2 dosimeter. The setup was characterized prior to use in children with sodium cromoglycate (SCG) and sodium fluoride as tracer aerosol. The main in vivo study was designed to allow nine children with a mean age of 10 years to inhale SCG aerosol at two different relative humidities (RH), a high RH (> 90%) and a low RH (13%), which in turn resulted in two different droplet size distributions. The nebulizer/dosimeter was set to provide 1-sec nebulization during 50 inhalations. Throughout the exposures, the children were instructed to inhale in a consistent manner with target tidal volumes (0.5 L) and inhalation flows (0.4 L/sec). Blood samples were taken at predefined time intervals, and the area under the curve (AUC) was calculated. A lung deposition program, TGLD2, was used to calculate the expected deposition, using the droplet sizes and inhalation parameters obtained during in vivo exposures. The in vivo monitoring of droplet size distribution during the exposure showed that the low, intermediate (room air), and high RHs gave a mean droplet size distribution with a mass median aerosol diameter (MMAD) of 1.2, 1.7, and 2.0 microm, respectively. The average tidal volume over all exposures was 0.51 +/- 0.12 L. The total deposition fraction was 33.4% of the estimated nebulizer output. A correlation was found between tidal volume and the calculated deposited fraction. The results indicate that there is a difference in total deposition, depending on the size of the droplet size distribution, with the larger droplet size distribution (MMAD, 2.0 microm) having a higher total deposition than the smaller droplet size distribution (MMAD, 1.2 microm). The

  12. Effect of Nebulized Hypertonic Saline Treatment in Emergency Departments on the Hospitalization Rate for Acute Bronchiolitis: A Randomized Clinical Trial.

    PubMed

    Angoulvant, François; Bellêttre, Xavier; Milcent, Karen; Teglas, Jean-Paul; Claudet, Isabelle; Le Guen, Christèle Gras; de Pontual, Loïc; Minodier, Philippe; Dubos, François; Brouard, Jacques; Soussan-Banini, Valérie; Degas-Bussiere, Vanessa; Gatin, Amélie; Schweitzer, Cyril; Epaud, Ralph; Ryckewaert, Amélie; Cros, Pierrick; Marot, Yves; Flahaut, Philippe; Saunier, Pascal; Babe, Philippe; Patteau, Géraldine; Delebarre, Mathilde; Titomanlio, Luigi; Vrignaud, Bénédicte; Trieu, Thanh-Van; Tahir, Abdelilah; Regnard, Delphine; Micheau, Pascale; Charara, Oussama; Henry, Simon; Ploin, Dominique; Panjo, Henri; Vabret, Astrid; Bouyer, Jean; Gajdos, Vincent

    2017-08-07

    Acute bronchiolitis is the leading cause of hospitalization among infants. Previous studies, underpowered to examine hospital admission, have found a limited benefit of nebulized hypertonic saline (HS) treatment in the pediatric emergency department (ED). To examine whether HS nebulization treatment would decrease the hospital admission rate among infants with a first episode of acute bronchiolitis. The Efficacy of 3% Hypertonic Saline in Acute Viral Bronchiolitis (GUERANDE) study was a multicenter, double-blind randomized clinical trial on 2 parallel groups conducted during 2 bronchiolitis seasons (October through March) from October 15, 2012, through April 15, 2014, at 24 French pediatric EDs. Among the 2445 infants (6 weeks to 12 months of age) assessed for inclusion, 777 with a first episode of acute bronchiolitis with respiratory distress and no chronic medical condition were included. Two 20-minute nebulization treatments of 4 mL of HS, 3%, or 4 mL of normal saline (NS), 0.9%, given 20 minutes apart. Hospital admission rate in the 24 hours after enrollment. Of the 777 infants included in the study (median age, 3 months; interquartile range, 2-5 months; 468 [60.2%] male), 385 (49.5%) were randomized to the HS group and 387 (49.8%) to the NS group (5 patients did not receive treatment). By 24 hours, 185 of 385 infants (48.1%) in the HS group were admitted compared with 202 of 387 infants (52.2%) in the NS group. The risk difference for hospitalizations was not significant according to the mixed-effects regression model (adjusted risk difference, -3.2%; 95% CI, -8.7% to 2.2%; P = .25). The mean (SD) Respiratory Distress Assessment Instrument score improvement was greater in the HS group (-3.1 [3.2]) than in the NS group (-2.4 [3.3]) (adjusted difference, -0.7; 95% CI, -1.2 to -0.2; P = .006) and similarly for the Respiratory Assessment Change Score. Mild adverse events, such as worsening of cough, occurred more frequently among children in the HS group

  13. Use of a parallel path nebulizer for capillary-based microseparation techniques coupled with an inductively coupled plasma mass spectrometer for speciation measurements

    NASA Astrophysics Data System (ADS)

    Yanes, Enrique G.; Miller-Ihli, Nancy J.

    2004-06-01

    A low flow, parallel path Mira Mist CE nebulizer designed for capillary electrophoresis (CE) was evaluated as a function of make-up solution flow rate, composition, and concentration, as well as the nebulizer gas flow rate. This research was conducted in support of a project related to the separation and quantification of cobalamin (vitamin B-12) species using microseparation techniques combined with inductively coupled plasma mass spectrometry (ICP-MS) detection. As such, Co signals were monitored during the nebulizer characterization process. Transient effects in the ICP were studied to evaluate the suitability of using gradients for microseparations and the benefit of using methanol for the make-up solution was demonstrated. Co signal response changed significantly as a function of changing methanol concentrations of the make-up solution and maximum signal enhancement was seen at 20% methanol with a 15 μl/min flow rate. Evaluation of the effect of changing the nebulizer gas flow rates showed that argon flows from 0.8 to 1.2 l/min were equally effective. The Mira Mist CE parallel path nebulizer was then evaluated for interfacing capillary microseparation techniques including capillary electrophoresis (CE) and micro high performance liquid chromatography (μHPLC) to inductively coupled plasma mass spectrometry (ICP-MS). A mixture of four cobalamin species standards (cyanocobalamin, hydroxocobalamin, methylcobalamin, and 5' deoxyadenosylcobalamin) and the corrinoid analogue cobinamide dicyanide were successfully separated using both CE-ICP-MS and μHPLC-ICP-MS using the parallel path nebulizer with a make-up solution containing 20% methanol with a flow rate of 15 μl/min.

  14. Attenuation of the hemodynamic response to laryngoscopy and tracheal intubation with fentanyl, lignocaine nebulization, and a combination of both: A randomized controlled trial

    PubMed Central

    Kumar, Abhyuday; Seth, Anita; Prakash, Smita; Deganwa, Mangilal; Gogia, Anoop Raj

    2016-01-01

    Background: The present study was undertaken to compare and evaluate the efficacy of intravenous (IV) fentanyl and lignocaine airway nebulization and a combination of both in attenuating the hemodynamic response to laryngoscopy and tracheal intubation. Materials and Methods: Ninety-six patients of either sex aged between 18 and 65 years of age, belonging to the American Society of Anesthesiologists (ASA) health status Classes I and II, undergoing elective surgery requiring general anesthesia with endotracheal intubation were included in the study. Patients were randomly divided into three groups. Group F received IV fentanyl 2 μg/kg, Group L received nebulization with 3 mg/kg of 4% lignocaine, and Group FL received both nebulization with 3 mg/kg of 4% lignocaine and IV fentanyl 2 μg/kg before intubation. Hemodynamic parameters were noted before and immediately after induction, 1 min after intubation, and every minute after intubation for 10 min. Results: Hemodynamic response to laryngoscopy and intubation was not completely abolished in any of the groups. Nebulized lignocaine was least effective in attenuating hemodynamic response to intubation, and hemodynamic parameters were significantly high after intubation as compared to other groups. Fentanyl alone or in combination with nebulized lignocaine was most effective, and Group F and Group FL were comparable. The maximum increase in mean blood pressure after intubation from baseline in Groups F, L, and FL was 7.4%, 14.6%, and 5.4%, respectively. Conclusion: In our study, IV fentanyl 2 μg/kg administered 5 min before induction was found to be the most effective in attenuating the hemodynamic response. There was no advantage to the use of nebulized lignocaine in attenuating the hemodynamic response to laryngoscopy and intubation. PMID:27746569

  15. Nebulized fluticasone propionate, a viable alternative to systemic route in the management of childhood moderate asthma attack: A double-blind, double-dummy study.

    PubMed

    Demirca, Beyza Poplata; Cagan, Hasret; Kiykim, Ayca; Arig, Ulku; Arpa, Medeni; Tulunay, Aysin; Ozen, Ahmet; Karakoc-Aydiner, Elif; Baris, Safa; Barlan, I B

    2015-09-01

    In this study, we compared the clinical and immunological efficacy of nebulized corticosteroid (CS) to systemic route during treatment of moderate asthma attack in children. In this randomized, placebo-controlled, double-blind, double-dummy, prospective study, 81 children aged 12 months to 16 years experiencing asthma attack randomized into two treatment groups to receive, either; nebulized fluticasone propionate (n = 39, 2000 mcg/day) or oral methylprednisolone (n = 41, 1 mg/kg/day). Pulmonary index scores (PIS) were assessed at admission and at 1st, 4th, 8th, 12th, 24th, 48th hours, as well as, on day 7 and peak expiratory flow (PEF) at baseline and at the 7th day. Daily symptom and medication scores were recorded for all subjects. Immunological studies included phytohemagglutinin induced peripheral blood mononuclear cells culture supernatant for cytokine responses and CD4(+) CD25(+) FOXP3(+) T regulatory cell (T reg) percentage at baseline and day 7. The changes in PIS and PEF were similar in both treatment groups, with a significant improvement in both values at the 7th day, when compared to baseline. In both groups, significant reductions in symptom and medication scores were observed during the treatment period with no significant difference between the groups. At day 7 of intervention, phytohemagglutinin induced IL-4 level was significantly decreased only in the nebulized group compared to baseline (p = 0.01). Evaluation of cytokine responses by means of fold increase (stimulated (S)/unstimulated (US) ratio) revealed a significant reduction in IL-4, IL-5 and IL-17 only in nebulized group (p = 0.01, 0.01, 0.02; respectively). The fold increase value of IL-5 was significantly lower at 7th day in nebulized group when compared to systemic one (p = 0.02). At 7th day, although in both treatment groups the percentage of T reg cells was suppressed, it remained significantly higher in the nebule one when compared to systemic route (p = 0.04). In the management of

  16. Efficacy and safety of glycopyrrolate/eFlow(®) CS (nebulized glycopyrrolate) in moderate-to-very-severe COPD: Results from the glycopyrrolate for obstructive lung disease via electronic nebulizer (GOLDEN) 3 and 4 randomized controlled trials.

    PubMed

    Kerwin, Edward; Donohue, James F; Goodin, Thomas; Tosiello, Robert; Wheeler, Alistair; Ferguson, Gary T

    2017-07-19

    SUN-101 is a combination of glycopyrrolate delivered through an innovative, electronic nebulizer, intended for the treatment of patients with COPD. The objective of this study was to assess the efficacy and safety of this new drug device combination. Replicate Phase III randomized, double-blind, placebo-controlled studies were conducted to evaluate the efficacy and safety of glycopyrrolate solution administered by an investigational eFlow(®) Closed System (eFlow(®) CS) nebulizer in subjects with moderate-to-very-severe COPD, including those with continued background use of a long-acting beta2-agonist ± inhaled corticosteroid and/or history of cardiovascular (CV) disease. Subjects were randomized in a 1:1:1 ratio to receive placebo or glycopyrrolate (25 μg or 50 μg twice daily [BID]) for 12 weeks. The primary efficacy endpoint was the change from baseline in trough forced expiratory volume in 1 s (FEV1) at Week 12 compared with placebo. Secondary endpoints included change from baseline in forced vital capacity (FVC) after 12 weeks, change from baseline in health status measured by St George's Respiratory Questionnaire (SGRQ) at 12 weeks/end of study (EOS), and change in rescue medication use, as well as change from baseline in FEV1 area under the curve from 0 to 12 h after 12 weeks in the GOLDEN 3 sub-study. Daytime and night-time symptoms were recorded using an electronic diary. Safety was monitored throughout the study, including major adverse cardiovascular events. A total of 653 subjects were randomized in GOLDEN 3 and 641 in GOLDEN 4. Treatment with glycopyrrolate 25 μg BID and 50 μg BID resulted in statistically significant and clinically important changes from baseline in trough FEV1 compared with placebo at Week 12 (GOLDEN 3: 0.105 L and 0.126 L; p ≤ 0.0001; GOLDEN 4: 0.084 L and 0.082 L; p ≤ 0.0001). Nebulized glycopyrrolate 25 μg BID and 50 μg BID also resulted in improvements in FVC change from baseline versus placebo at

  17. The effect of nebulized magnesium sulfate in the treatment of moderate to severe asthma attacks: a randomized clinical trial.

    PubMed

    Hossein, Shaker; Pegah, Akhavan; Davood, Farsi; Said, Abbasi; Babak, Mahshidfar; Mani, Mofidi; Mahdi, Rezai; Peyman, Hafezimoghadam

    2016-05-01

    Thirty percent of people with asthma do not respond to standard treatment, and complementary therapies are needed. The objective of this study was to investigate the impact of inhaled magnesium sulfate on the treatment response in emergency department (ED) patients with moderate to severe attacks of asthma. This study is a randomized controlled trial, enrolling patients with moderate to severe asthma in the ED. Subjects allocated to the study group were treated with the standard, plus 3 ml of 260 mmol/L solution of magnesium sulfate every 20 to 60 minutes. The control group was treated with nebulized saline as a placebo in addition to standard protocol. The study results included admission rate and changes in peak expiratory flow rate (PEFR) (primary outcomes) as well as dyspnea severity score, respiratory rate and peripheral oxygen saturation. A total of 50 patients were enrolled (25 allocated to the study group and 25 to the control group). The study group as compared to the control group had significantly more improvement in the intensity of dyspnea, PEFR and Spo2 20, 40 and 60 minutes after intervention. In the control group, 11 patients (44%) required admission as compared to 18 (72%) in the control group (P=.02). Adding nebulized magnesium sulfate to standard therapy in patients with moderate to severe asthma attacks leads to greater and faster improvement in PEFR, respiratory rate, oxygen saturation and respiratory rate. It also reduces hospitalization rates in this patient population. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. An efficient compressive sensing based PS-DInSAR method for surface deformation estimation

    NASA Astrophysics Data System (ADS)

    Li, J. T.; Xu, H. P.; Shan, L.; Liu, W.; Chen, G. Z.

    2016-11-01

    Permanent scatterers differential interferometric synthetic aperture radar (PS-DInSAR) is a technique for detecting surface micro-deformation, with an accuracy at the centimeter to millimeter level. However, its performance is limited by the number of SAR images available (normally more than 20 are needed). Compressive sensing (CS) has been proven to be an effective signal recovery method with only a very limited number of measurements. Applying CS to PS-DInSAR, a novel CS-PS-DInSAR method is proposed to estimate the deformation with fewer SAR images. By analyzing the PS-DInSAR process in detail, first the sparsity representation of deformation velocity difference is obtained; then, the mathematical model of CS-PS-DInSAR is derived and the restricted isometry property (RIP) of the measurement matrix is discussed to validate the proposed CS-PS-DInSAR in theory. The implementation of CS-PS-DInSAR is achieved by employing basis pursuit algorithms to estimate the deformation velocity. With the proposed method, DInSAR deformation estimation can be achieved by a much smaller number of SAR images, as demonstrated by simulation results.

  19. Direct liquid sample introduction for flow injection analysis and liquid chromatography with inductively coupled argon plasma spectrometric detection

    SciTech Connect

    Lawrence, K.E.; Rice, G.W.; Fassel, V.A.

    1984-02-01

    The coupling of flow injection analysis (FIA) or high-performance liquid chromatography (HPLC) techniques to inductively coupled plasma atomic emission spectrometry (ICP-AES) offers new and attractive approaches for the determination of elemental concentrations in a wide variety of sample matrices. One of the most attractive features that FIA offers is a rapid and precise means of automating sample introduction into an ICP for simultaneous, multielement analysis at the trace, minor, and major constituent level with minimal sample consumption. The utilization of the ICP as a detector for HPLC retains most of the advantages of FIA-ICP, while providing the analyst with a powerful and versatile means of compound separation. This added dimension becomes particularly important when metal speciation is of primary interest, rather than total metal content. To date, the coupling of FIA and HPLC to the ICP has only been accomplished using conventional cross-flow, concentric, or Babington-type pneumatic nebulizers. Limits of detection under these conditions have generally been observed to be poorer when compared to conventional continuous sample flow conditions. These limitations have been attributed to the large dead-volume and the sample losses associated with conventional nebulizers and band broadening of eluents from FIA transfer tubing or HPLC columns prior to entering the nebulizer unit. In an effort to resolve these difficulties, a microconcentric nebulizer has been developed which is inserted directly into the tip of a conventional sample introduction tube of an ICP torch. Preliminary data on the potential utility of direct liquid sample introduction into the ICP are presented. 12 references, 6 figures, 1 table.

  20. A ΔdinB mutation that sensitizes Escherichia coli to the lethal effects of UV- and X-radiation.

    PubMed

    Lee, Mei-Chong W; Franco, Magdalena; Vargas, Doris M; Hudman, Deborah A; White, Steven J; Fowler, Robert G; Sargentini, Neil J

    2014-01-01

    The DinB (PolIV) protein of Escherichia coli participates in several cellular functions. We investigated a dinB mutation, Δ(dinB-yafN)883(::kan) [referred to as ΔdinB883], which strongly sensitized E. coli cells to both UV- and X-radiation killing. Earlier reports indicated dinB mutations had no obvious effect on UV radiation sensitivity which we confirmed by showing that normal UV radiation sensitivity is conferred by the ΔdinB749 allele. Compared to a wild-type strain, the ΔdinB883 mutant was most sensitive (160-fold) in early to mid-logarithmic growth phase and much less sensitive (twofold) in late log or stationary phases, thus showing a growth phase-dependence for UV radiation sensitivity. This sensitizing effect of ΔdinB883 is assumed to be completely dependent upon the presence of UmuDC protein; since the ΔdinB883 mutation did not sensitize the ΔumuDC strain to UV radiation killing throughout log phase and early stationary phase growth. The DNA damage checkpoint activity of UmuDC was clearly affected by ΔdinB883 as shown by testing a umuC104 ΔdinB883 double-mutant. The sensitivities of the ΔumuDC strain and the ΔdinB883 ΔumuDC double-mutant strain were significantly greater than for the ΔdinB883 strain, suggesting that the ΔdinB883 allele only partially suppresses UmuDC activity. The ΔdinB883 mutation partially sensitized (fivefold) uvrA and uvrB strains to UV radiation, but did not sensitize a ΔrecA strain. A comparison of the DNA sequences of the ΔdinB883 allele with the sequences of the Δ(dinB-yafN)882(::kan) and ΔdinB749 alleles, which do not sensitize cells to UV radiation, revealed ΔdinB883 is likely a "gain-of-function" mutation. The ΔdinB883 allele encodes the first 54 amino acids of wild-type DinB followed by 29 predicted residues resulting from the continuation of the dinB reading frame into an adjacent insertion fragment. The resulting polypeptide is proposed to interfere directly or indirectly with UmuDC function(s) involved

  1. A ΔdinB mutation that sensitizes Escherichia coli to the lethal effects of UV and X-radiation

    PubMed Central

    Lee, Mei-Chong W.; Franco, Magdalena; Vargas, Doris M.; Hudman, Deborah A.; White, Steven J.; Fowler, Robert G.; Sargentini, Neil J.

    2014-01-01

    The DinB (PolIV) protein of Escherichia coli participates in several cellular functions. We investigated a dinB mutation, Δ(dinB-yafN)883(::kan) [referred to as ΔdinB883], which strongly sensitized E. coli cells to both UV- and X-radiation killing. Earlier reports indicated dinB mutations had no obvious effect on UV radiation sensitivity which we confirmed by showing that normal UV radiation sensitivity is conferred by the ΔdinB749 allele. Compared to a wild-type strain, the ΔdinB883 mutant was most sensitive (160-fold) in early to mid-logarithmic growth phase and much less sensitive (twofold) in late log or stationary phases, thus showing a growth phase-dependence for UV radiation sensitivity. This sensitizing effect of ΔdinB883 is assumed to be completely dependent upon the presence of UmuDC protein; since the ΔdinB883 mutation did not sensitize the ΔumuDC strain to UV radiation killing throughout log phase and early stationary phase growth. The DNA damage checkpoint activity of UmuDC was clearly affected by ΔdinB883 as shown by testing a umuC104 ΔdinB883 double-mutant. The sensitivities of the ΔumuDC strain and the ΔdinB883 ΔumuDC double-mutant strain were significantly greater than for the ΔdinB883 strain, suggesting that the ΔdinB883 allele only partially suppresses UmuDC activity. The ΔdinB883 mutation partially sensitized (fivefold) uvrA and uvrB strains to UV radiation, but did not sensitize a ΔrecA strain. A comparison of the DNA sequences of the ΔdinB883 allele with the sequences of the Δ(dinB-yafN)882(::kan) and ΔdinB749 alleles, which do not sensitize cells to UV radiation, revealed ΔdinB883 is likely a “gain-of-function” mutation. The ΔdinB883 allele encodes the first 54 amino acids of wild-type DinB followed by 29 predicted residues resulting from the continuation of the dinB reading frame into an adjacent insertion fragment. The resulting polypeptide is proposed to interfere directly or indirectly with UmuDC function

  2. Mycobacterium smegmatis DinB2 misincorporates deoxyribonucleotides and ribonucleotides during templated synthesis and lesion bypass

    PubMed Central

    Ordonez, Heather; Shuman, Stewart

    2014-01-01

    Mycobacterium smegmatis DinB2 is the founder of a clade of Y-family DNA polymerase that is naturally adept at utilizing rNTPs or dNTPs as substrates. Here we investigate the fidelity and lesion bypass capacity of DinB2. We report that DinB2 is an unfaithful DNA and RNA polymerase with a distinctive signature for misincorporation of dNMPs, rNMPs and oxoguanine nucleotides during templated synthesis in vitro. DinB2 has a broader mutagenic spectrum with manganese than magnesium, though low ratios of manganese to magnesium suffice to switch DinB2 to its more mutagenic mode. DinB2 discrimination against incorrect dNTPs in magnesium is primarily at the level of substrate binding affinity, rather than kpol. DinB2 can incorporate any dNMP or rNMP opposite oxo-dG in the template strand with manganese as cofactor, with a kinetic preference for synthesis of an A:oxo-dG Hoogsteen pair. With magnesium, DinB2 is adept at synthesizing A:oxo-dG or C:oxo-dG pairs. DinB2 effectively incorporates deoxyribonucleotides, but not ribonucleotides, opposite an abasic site, with kinetic preference for dATP as the substrate. We speculate that DinB2 might contribute to mycobacterial mutagenesis, oxidative stress and quiescence, and discuss the genetic challenges to linking the polymerase biochemistry to an in vivo phenotype. PMID:25352547

  3. Development and validation of a stability-indicating high-performance liquid chromatography method for the simultaneous determination of albuterol, budesonide, and ipratropium bromide in compounded nebulizer solutions.

    PubMed

    Blewett, Anthony J; Varma, Deepti; Gilles, Tiffany; Butcher, Rashidi; Jacob, Jaini; Amazan, Jean; Jansen, Susan A

    2011-01-01

    In recent years, there has been a large increase in the use of pharmaceutical compounding to prepare medications that are not commercially available. The treatment of asthma typically includes the use of albuterol (ALB), ipratropium bromide (IPB), and/or budesonide (BUD) nebulizer solutions. There is currently no commercially available nebulizer solution containing all three of these compounds, and patients must rely on often-unregulated compounding. There is a distinct need for methodologies that can be used to analyze compounded formulations to ensure patient safety. We report an HPLC-UV method to separate and quantitate ALB, IPB, and BUD in nebulizer solutions. The method used a gradient elution to achieve separation via an RP C18 column. The method was validated, showed good selectivity, and was linear over several orders of magnitude. The method was applied to the analysis of nebulizer solutions and determination of their storage stability. Significant ALB-dependent degradation occurred within 5 h in solutions formulated with the free base of ALB, while those containing the sulfate salt of ALB produced no degradation. Alkali solutions can cause base-catalyzed hydrolysis of IPB and degradation of BUD. Compounded formulations containing ALB need to include an acid to control pH and prevent degradation.

  4. The Effects of Smartphone-based Nebulizer Therapy Education on Parents' Knowledge and Confidence of Performance in Caring for Children with Respiratory Disease.

    PubMed

    Lee, Jung Min; Kim, Shin-Jeong; Min, Hae Young

    This study aimed to identify the effects of smartphone-based nebulizer therapy education on the knowledge and confidence of parents while performing care for their children with respiratory disease. This quasi-experimental study employed a pretest-posttest design using a nonequivalent control group. Data were collected from children's parents who had not used nebulizer therapy for their children previously. Both the groups were given nebulizer therapy education using the same content but different learning methods. The experimental group (n=36) was taught using smartphones, while the control group (n=36) was taught using verbal and paper-based methods. The data were analyzed using the Chi Square test, repeated measures analysis of variance, and t-test. The mean scores on knowledge improvement (F=100.949, p<0.001) and confidence in performing care (t=-6.959, p<0.001) were significantly higher for the experimental group as compared to the control group. Further, the scores on satisfaction with the learning method were significantly higher for the experimental group as compared to the control group (t=-5.819, p<0.001). Our results suggest that smartphone-based education on nebulizer therapy might be effective in improving parents' knowledge and confidence in performing care for their children. This study suggests that smartphone-based education needs to be considered as an effective educational intervention in providing nursing support for parents of children with respiratory disease. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. [Metered-dose inhaler with spacer vs nebulization for severe and potentially severe acute asthma treatment in the pediatric emergency department].

    PubMed

    Sannier, N; Timsit, S; Cojocaru, B; Leis, A; Wille, C; Garel, D; Bocquet, N; Chéron, G

    2006-03-01

    To compare treatment with beta 2 agonist delivered either by a spacer device or a nebulizer in children with severe or potentially severe acute asthma. In this randomized trial, children 4 to 15 years, cared for in the emergency department for severe or potentially severe acute asthma, received 6 times either nebulizations of salbutamol (0.15mg/kg) or puffs of a beta 2 agonist (salbutamol 50 microg/kg or terbutaline 125 microg/kg). The primary outcome was the hospitalization rate. Secondary outcomes included percentage improvement in Bishop score, in PEF, SaO(2), respiratory and heart rates, side effects, length of stay and relapses 10 and 30 days later. Groups did not differ for baseline data. There were no significant differences between the 2 groups (nebulizer N=40, spacer N=39) for baseline characteristics before emergency department consultation except for length of acute asthma in the spacer group. Clinical evolution after treatment, hospitalization rate, relapse were similar including the more severe subgroup. In the spacer group, tachycardia was less frequent (P<0.02). The overall length of stay in the emergency department was significantly shorter (148+/-20 vs 108+/-13 min, P<10(-9)). The administration of beta 2 agonist using a metered-dose inhaler with spacer is an effective alternative to nebulizers for the treatment of children with severe or potentially severe acute asthma in the emergency department. Time gained can be used for asthma education.

  6. Determination of metals in lubricating oils by flame atomic absorption spectrometry using a single-bore high-pressure pneumatic nebulizer.

    PubMed

    Mora, J; Todolí, J L; Sempere, F J; Canals, A; Hernandis, V

    2000-12-01

    The behaviour of a single-bore high-pressure pneumatic nebulizer (SBHPPN) as a tool for the analysis of lubricating oils by flame atomic absorption spectrometry (FAAS) was investigated. The effects of the sample oil content [from 10% to 100% (w/w) oil in 4-methylpentan-2-one, IBMK] and the carrier nature (IBMK and methanol) on the characteristics of the aerosols generated, on the analyte transport efficiency and on the analytical figures of merit in FAAS were studied. A pneumatic concentric nebulizer (PCN) was used for comparison. Increasing the oil content increases the viscosity of the sample. With the PCN this gives rise to coarser aerosols, making it impossible to nebulize samples with an oil content higher than 70% (w/w). Using the SBHPPN, the viscosity of the sample scarcely affects the characteristics of the primary aerosols. Hence, the SBHPPN is able, by using the appropriate carrier, to nebulize pure lubricating oils. Among the carriers tested, IBMK is the most advisable because it is fully miscible with all the oil samples. The SBHPPN provides higher sensitivities and lower limits of detection than the PCN. Compared with a method based on organic dilution, the use of the SBHPPN for the direct analysis of lubricating oils by FAAS makes it possible, in addition to increasing the analysis throughput, to detect elements at lower concentrations. Moreover, the SBHPPN provides similar results to those obtained using a previous acid digestion step.

  7. Flame AAS/flame AES for trace determination in fresh and used lubricating oils with sample introduction by hydraulic high-pressure nebulization.

    PubMed

    Berndt, H; Schaldach, G; Kägler, S H

    1996-04-01

    In hydraulic high-pressure nebulization (HHPN) an aerosol is produced by means of an HPLC-pump and a special nebulization nozzle, applying a pressure of about 200 bar. This spray technique has been employed for sample introduction of mineral oil samples in flame atomic absorption/flame emission spectrometry. The determination of the trace elements Al, Cr, Cu, Fe, K, Na, Ni, Pb, Si and V has been investigated. Viscosity hardly acts upon the sensitivity of the determination, thereby avoiding a time consuming dilution of oil samples. By means of two interconnecting sampling valves a calibration method based on the standard addition technique can be performed which is both simple and easy to carry out. In samples of used oils, results for Cu and Pb equalled those of XRF-analysis. Regarding Fe traces, data obtained from AAS and XRF measurement correlate. In comparison with sample uptake by pneumatic nebulization, which is restricted to diluted oil samples, detection limits decrease by a factor of 2 to 4, indicating the dilution required in pneumatic nebulization.

  8. CAPILLARY ELECTROPHORESIS COUPLED ON-LINE WITH INDUCTIVELY COUPLED PLASMA MASS SPECTROMETRY FOR ELEMENTAL SPECIATION

    EPA Science Inventory

    A novel interface to connect a capillary electrophoresis (CE) system with an inductively coupled plasma mass spectrometric (ICPMS) detector is reported here. The interface was built using a direct injection nebulizer (DIN) system. In this interface, the CE capillary was placed co...

  9. CAPILLARY ELECTROPHORESIS COUPLED ON-LINE WITH INDUCTIVELY COUPLED PLASMA MASS SPECTROMETRY FOR ELEMENTAL SPECIATION

    EPA Science Inventory

    A novel interface to connect a capillary electrophoresis (CE) system with an inductively coupled plasma mass spectrometric (ICPMS) detector is reported here. The interface was built using a direct injection nebulizer (DIN) system. In this interface, the CE capillary was placed co...

  10. A comparison between the Dutch and American-English digits-in-noise (DIN) tests in normal-hearing listeners.

    PubMed

    Smits, Cas; Watson, Charles S; Kidd, Gary R; Moore, David R; Goverts, S Theo

    2016-01-01

    The Dutch digits-in-noise test (NL DIN) and the American-English version (US DIN) are speech-in-noise tests for diagnostic and clinical usage. The present study investigated differences between NL DIN and US DIN speech reception thresholds (SRTs) for a group of native Dutch-speaking listeners. In experiment 1, a repeated-measures design was used to compare SRTs for the NL DIN and US DIN in steady-state noise and interrupted noise for monaural, diotic, and dichotic listening conditions. In experiment 2, a subset of these conditions with additional speech material (i.e. US DIN triplets without inter-digit coarticulation/prosody) was used. Experiment 1 was conducted with 16 normal-hearing Dutch students. Experiment 2 was conducted with nine different students. No significant differences between SRTs measured with the NL DIN and US DIN were found in steady-state noise. In interrupted noise the US DIN SRTs were significantly better in monaural and diotic listening conditions. Experiment 2 demonstrated that these better SRTs cannot be explained by the combined effect of inter-digit coarticulation and prosody in the American-English triplets. The NL DIN and US DIN are highly comparable and valuable tests for measuring auditory speech recognition abilities. These tests promote across-language comparisons of results.

  11. Measuring Black Carbon Concentrations in Liquid Samples Using the Single Particle Soot Photometer: Addressing Black Carbon Losses During Sample Storage and Nebulization

    NASA Astrophysics Data System (ADS)

    Menking, J. A.; Kaspari, S.; Jenkins, M.

    2011-12-01

    Black Carbon (BC), an aerosol created from the incomplete combustion of fossil and bio-fuels, is the second largest contributor to global warming next to CO2. BC deposited on snow and ice reduces the surface albedo, accelerating seasonal snowmelt and glacier retreat and influencing the regional water cycle and climate (Hansen and Nazarenko, 2004). BC emissions and its post-depositional spatial distribution in snow and ice are a large uncertainty in climate change analyses, thus measurements of global BC concentrations in liquid samples of snow and ice are desirable. The Single Particle Soot Photometer (SP2) is a relatively new method for measuring BC concentrations in liquid samples with promising advantages over other commonly used methods, namely that measurements require smaller sample volumes and are not affected by the presence of other absorbing particles. Despite potential advantages over traditional methods, total BC in liquid samples cannot be quantified because of methodological uncertainties. Preliminary tests show BC losses related to (1) nebulization and (2) changes to the sample during storage. BC in storage may adhere to the vial walls, resulting in BC losses. Particles containing BC may also agglomerate to form large particles with sizes outside of the SP2 detection range (80-650nm). Further losses are indicated in a comparison of polydisperse Aquadag (BC standard) particle size distributions between the ultrasonic nebulizer and a collision-type atomizer, which shows a loss of particles > ~500nm associated with the Cetac U-5000AT+ ultrasonic nebulizer. Larger particles may not be nebulized because of inefficiencies related to the ultrasonic transducer plate, and/or highly charged particles may adhere to the glass within the nebulizer, also resulting in BC losses. The purpose of this study was to determine the methods of storage and nebulization that maximize the amount of BC delivered to the SP2 inlet. Storage and sample parameters tested include

  12. Provocative dose of methacholine causing a 20% drop in FEV1 should be used to interpret methacholine challenge tests with modern nebulizers.

    PubMed

    Dell, Sharon D; Bola, Sundeep S; Foty, Richard G; Marshall, Laura C; Nelligan, Kathleen A; Coates, Allan L

    2015-03-01

    The American Thoracic Society guidelines (1999) for methacholine challenge tests (MCTs) using the 2-minute tidal breathing protocol were developed for the now-obsolete English-Wright (EW) nebulizer. In addition, the guideline recommendation to use the provocative concentration of methacholine causing a 20% drop in FEV1 (PC20) rather than the provocative dose of methacholine causing a 20% drop in FEV1 (PD20) for determining the level of bronchial hyperresponsiveness has been challenged. To determine if cumulative dose or concentration of methacholine delivered to the airways is the determinant for airway responsiveness and to validate use of the AeroEclipse* II BAN (Aero; Trudell Medical International, London, ON, Canada) nebulizer compared with use of the reference standard EW nebulizer. Subjects with asthma (10-18 yr old) participated in randomized, controlled cross-over experiments comparing four MCT protocols using standard methacholine concentrations, but varying: (1) methacholine starting concentration (testing for cumulative effect); (2) nebulizer (EW versus Aero); and (3) inhalation time. PD20 was calculated using nebulizer output rate, inhalation time, and preceding doses delivered. ANOVA analyses were used to compare geometric means of PC20 and PD20 between protocols. A total of 32 subjects (17 male) participated. PC20 differed when starting concentration varied (0.46 vs. 0.80 mg/ml; P<0.0001), whereas PD20 did not (0.06 vs. 0.08 mg). PC20 differed with the EW versus the Aero nebulzer with 30-second inhalation (1.19 vs. 0.43 mg/ml; P=0.0006) and the EW versus the Aero nebulizer with 20-second inhalation (1.91 vs. 0.89 mg/ml; P=0.0027), whereas PD20 did not (0.07 vs. 0.06 mg and 0.11 vs. 0.09 mg, respectively). In MCTs, the cumulative dose (PD20), not the PC20, determines bronchial responsiveness. Modern nebulizers may be used for the test if clinical interpretation is based on PD20. Clinical trial registered with www.clinicaltrials.gov (NCT01288482).

  13. Analytical evaluation of nebulizers for the introduction of acetic acid extracts aiming at the determination of trace elements by inductively coupled plasma mass spectrometry

    NASA Astrophysics Data System (ADS)

    de Gois, Jefferson S.; Maranhão, Tatiane de A.; Oliveira, Fernando J. S.; Frescura, Vera L. A.; Curtius, Adilson J.; Borges, Daniel L. G.

    2012-11-01

    Most of the official procedures aiming at classification of solid waste toxicity take into account metal solubility and bioavailability by means of extraction experiments using acetic acid solutions. Hence, the aim of this work was to investigate and optimize conditions to suppress the effect of acetic acid on the determination of trace elements using inductively coupled plasma mass spectrometry. The performance of four nebulizers (cross-flow (CFN), ultrasonic (USN), Meinhard (MN) and MicroMist (MMN)) were compared as to their efficiency in minimizing spectral and non-spectral effects on the determination of Ag, As, Ba, Cd, Cr, Hg, Pb and Se, with the ultimate goal to analyze acetic acid extracts obtained from solid waste residues. Operating conditions (desolvation temperatures for USN, RF power and nebulizer gas flow rates) were optimized individually for each nebulizer and for all analytes maintained in 0.14 mol L- 1 HNO3 solutions and in solutions prepared with acetic acid and acetic acid + NaOH, adjusted to pH 2.88 and 4.93, respectively. Pronounced non-spectral interferences for 75As and 82Se were observed in the presence of acetic acid for CF and MN, although to a less extent also for MMN and USN. Signal increase for blank solutions measured at m/z 208 (208Pb) for CFN and MN, 107 (107Ag) for USN and MN coupled to a cyclonic chamber and, m/z 82 (82Se) for USN was observed, indicating an increased risk of spectral interference upon an increase in the concentration of acetic acid. Signal increase at specific m/z ratios, however, was not significant when the MMN was used, with the exception of m/z 52 (52Cr) in acetic acid solutions, arising from the formation of 40Ar12C+. This same effect was noticed for all nebulizers, although at noticeably different intensities. A signal stability study was performed, demonstrating that variations in the analytical signal were within a 20% range for all analytes, with the exception of Hg, after continuous aspiration for 70 min

  14. Impact of airborne particle size, acoustic airflow and breathing pattern on delivery of nebulized antibiotic into the maxillary sinuses using a realistic human nasal replica.

    PubMed

    Leclerc, Lara; Pourchez, Jérémie; Aubert, Gérald; Leguellec, Sandrine; Vecellio, Laurent; Cottier, Michèle; Durand, Marc

    2014-09-01

    Improvement of clinical outcome in patients with sinuses disorders involves targeting delivery of nebulized drug into the maxillary sinuses. We investigated the impact of nebulization conditions (with and without 100 Hz acoustic airflow), particle size (9.9 μm, 2.8 μm, 550 nm and 230 nm) and breathing pattern (nasal vs. no nasal breathing) on enhancement of aerosol delivery into the sinuses using a realistic nasal replica developed by our team. After segmentation of the airways by means of high-resolution computed tomography scans, a well-characterized nasal replica was created using a rapid prototyping technology. A total of 168 intrasinus aerosol depositions were performed with changes of aerosol particle size and breathing patterns under different nebulization conditions using gentamicin as a marker. The results demonstrate that the fraction of aerosol deposited in the maxillary sinuses is enhanced by use of submicrometric aerosols, e.g. 8.155 ± 1.476 mg/L of gentamicin in the left maxillary sinus for the 2.8 μm particles vs. 2.056 ± 0.0474 for the 550 nm particles. Utilization of 100-Hz acoustic airflow nebulization also produced a 2- to 3-fold increase in drug deposition in the maxillary sinuses (e.g. 8.155 ± 1.476 vs. 3.990 ± 1.690 for the 2.8 μm particles). Our study clearly shows that optimum deposition was achieved using submicrometric particles and 100-Hz acoustic airflow nebulization with no nasal breathing. It is hoped that our new respiratory nasal replica will greatly facilitate the development of more effective delivery systems in the future.

  15. Development of nano alpha-ketoglutarate nebulization formulation and its pharmacokinetic and safety evaluation in healthy human volunteers for cyanide poisoning.

    PubMed

    Sultana, Shaheen; Singh, Thakuri; Ahmad, Farhan Jalees; Bhatnagar, Aseem; Mittal, Gaurav

    2011-05-01

    Development of nano alpha-ketoglutarate (A-KG) nebulization formulation for neutralization of inhaled cyanide ion toxicity. Objectives of the present study were to (a) develop a novel A-KG nebulization formulation against cyanide poisoning, particularly hydrogen cyanide gas (b) validate its respiratory fraction in vitro and in vivo, and (c) create its pharmacokinetic data in human volunteers. The formulation was optimized on the basis of particle size of aerosolized droplets after nebulization in 6 volunteers. Gamma scintigraphy was used to quantify total and regional lung deposition of nebulized A-KG after radiolabeling it with Technetium-99m. The formulation was optimized using 30% ethanol-saline with particle size in the range of 300-500 nm. In vitro and in vivo studies showed that drug nebulization resulted in a significant respirable fraction of 65 ± 0.6% with whole lung deposition of 13 ± 1%. Human pharmacokinetic data was derived in 6 healthy human volunteers with peak serum concentration (C(max)) of 39 ± 3 μg/ml, while the area under curve (AUC) after inhalation was 376 ± 23 μg × h/ml indicating that the drug was rapidly and completely absorbed when targeted directly to lungs. Significant lung deposition of A-KG was achieved with the developed formulation. The formulation appears to have several advantages, including the potential of neutralizing inhaled CN(-) ions in the lungs themselves. It is a safe and efficacious procedure, suitable for hospital or ambulance use in accidental cyanide poisoning cases, or as a preventive approach for fire-rescue teams. Copyright © 2011 Elsevier B.V. All rights reserved.

  16. Laryngeal Desiccation Challenge and Nebulized Isotonic Saline in Healthy Male Singers and Nonsingers: Effects on Acoustic, Aerodynamic, and Self-Perceived Effort and Dryness Measures.

    PubMed

    Tanner, Kristine; Fujiki, Robert B; Dromey, Christopher; Merrill, Ray M; Robb, Whitney; Kendall, Katherine A; Hopkin, J Arden; Channell, Ron W; Sivasankar, M Preeti

    2016-11-01

    This study examined the effects of a laryngeal desiccation challenge and nebulized isotonic saline on voice production in young, healthy male singers and nonsingers. This is a prospective, double-blind, within-subjects experimental design. Participants included 10 male university-trained singers and 10 age-matched nonsingers (mean age, 21.8 years; range, 18-26 years) who underwent a 30-minute oral breathing laryngeal desiccation challenge using medical grade dry air (<1% relative humidity) on two occasions in consecutive weeks. After the challenge, participants received either 3 mL or 9 mL of nebulized isotonic saline (0.9% Na(+)Cl(-)); order of administration was counterbalanced. Phonation threshold pressure (PTP), the cepstral spectral index of dysphonia (CSID) for sustained vowels and connected speech, and self-perceived vocal effort, mouth dryness, and throat dryness were measured at each recording (baseline, after challenge, and at 5, 35, and 65 minutes after treatment). Self-perceived effort and dryness measures increased (worsened) after desiccation challenge and decreased (improved) after nebulized treatment (P < 0.05). No consistent changes were observed for PTP or CSID over time. Overall, singers demonstrated significantly lower vocal effort and CSID as compared with nonsingers. Young, vocally healthy men may not experience physiologic changes in voice production associated with laryngeal desiccation and nebulized saline treatments; however, self-reported increases in vocal effort which are associated with dryness symptoms might improve with nebulized treatments. Future hydration research should consider age and sex variables. Copyright © 2016 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  17. Does nebulized epinephrine improve the efficacy of hypertonic saline solution in the treatment of hospitalized moderate acute bronchiolitis? A double blind, randomized clinical trial.

    PubMed

    Flores-González, Jose Carlos; Dominguez-Coronel, Maria Teresa; Matamala Morillo, Miguel Angel; Aragón Ramírez, Miriam; García Ortega, Rosa María; Dávila Corrales, Francisco Javier; García Palacios, Maria Victoria; Perez Guerrero, Juan Jesus; García García, Laura; Lechuga Sancho, Alfonso María

    2016-04-01

    Nebulized 3% hypertonic saline solution (HSS 3%) has proven to reduce hospital stay in infants with acute bronchiolitis, as compared with nebulized physiological saline solutions. There are no studies assessing the effectiveness of nebulized epinephrine in patients treated with HSS 3%. The aim of this study was to compare the length of stay (LOS) in hospitalized patients treated with HSS 3% with placebo vs. HSS 3% with epinephrine. Secondarily we aimed to assess the effectiveness and safety of both treatments. We performed a prospective, randomized, double-blind, parallel-group study, including infants hospitalized for moderate acute bronchiolitis. Both groups received standard life support and were randomly treated with nebulized HSS 3% (7 mL) with either placebo 3 mL or epinephrine 3 mL. Nebulizations were initially administered every four hours and this interval was modified according to the patient's response. Sixty-four infants were included, 32 patients in each group. No statistically significant differences were found between the two groups (P=0.948) in length of stay, disease severity, SatO2, respiratory rate or heart rate. On the third day of hospitalization, severity and respiratory rate in the HSS 3%+E presented a non statistically significant trend to an earlier improvement, (P=0.063 and P=0.096 repectively). No adverse events occurred. Four patients (two from each group) required transfer to the pediatric intensive care unit. With a third of the final estimated sample, we find a trend to an earlier clinical recovery in the epinephrine group, even though no statistical significant differences in LOS were found. The study needs to be continued until the total sample is recruited.

  18. Magnesium nebulization utilization in management of pediatric asthma (MagNUM PA) trial: study protocol for a randomized controlled trial.

    PubMed

    Schuh, Suzanne; Sweeney, Judy; Freedman, Stephen B; Coates, Allan L; Johnson, David W; Thompson, Graham; Gravel, Jocelyn; Ducharme, Francine M; Zemek, Roger; Plint, Amy C; Beer, Darcy; Klassen, Terry; Curtis, Sarah; Black, Karen; Nicksy, Darcy; Willan, Andrew R

    2016-05-24

    Up to 30 % of children with acute asthma are refractory to initial therapy, and 84 % of this subpopulation needs hospitalization. Finding safe, noninvasive, and effective strategies to treat this high-risk group would substantially decrease hospitalizations, healthcare costs, and the psycho-social burden of the disease. Whereas intravenous magnesium (Mg) is effective in severe refractory asthma, its use is sporadic due to safety concerns, with the main treatment goal being to prevent intensive care unit admission. In contrast, nebulized Mg is noninvasive, allows higher pulmonary drug concentrations, and has a much higher safety potential due to the lower rate of systemic delivery. Previous studies of inhaled Mg show disparate results due to the use of unknown/inefficient delivery methods and other methodological flaws. The study is a randomized double-blind controlled trial in seven Canadian pediatric Emergency Departments (two-center pilot 2011 to 2014, Canada-wide November 2014 to December 2017). The trial will include 816 otherwise healthy children who are 2 to 17 years old, having had at least one previous wheezing episode, have received systemic corticosteroids, and have a Pediatric Respiratory Assessment Measure (PRAM) ≥ 5 points after three salbutamol and ipratropium treatments for a current acute asthma exacerbation. Eligible consenting children will receive three experimental treatments of nebulized salbutamol with either 600 mg of Mg sulfate or placebo 20 min apart, using an Aeroneb Go nebulizer, which has been shown to maximize pulmonary delivery while maintaining safety. The primary outcome is hospitalization within 24 h of the start of the experimental therapy for persistent respiratory distress or supplemental oxygen. Secondary outcomes include all-cause hospitalization within 24 h, PRAM, vital signs, number of bronchodilator treatments by 240 min, and the association between the difference in the primary outcome between the groups, age

  19. Modelling of the evaporation behaviour of particulate material for slurry nebulization inductively coupled plasma atomic emission spectrometry

    NASA Astrophysics Data System (ADS)

    Merten, D.; Heitland, P.; Broekaert, J. A. C.

    1997-11-01

    This paper is an electronic publication in Spectrochimica Acta Electronica (SAE), the electronic section of Spectrochimica Acta, Part B (SAB). This hardcopy text, comprising the main body and an appendix, is accompanied by a disk with programs, data files and a brief manual. The main body discusses purpose, design principle and usage of the computer software for modelling the evaporation behaviour of particles in inductively coupled plasma atomic emission spectrometry (ICP-AES). Computer software has been developed in FORTRAN 77 language in order to simulate the evaporation behaviour of particles of refractory materials such as encountered in the analysis of advanced ceramic powders by slurry nebulization inductively coupled argon plasma atomic spectrometry. The program simulates the evaporation of single particles in the inductively coupled plasma and also enable it to calculate on the base of a given particle size distribution the evaporation behaviour of all the particles contained in a sample. In a so-called "intensity concept", the intensity is calculated as a function of the observation height in order to determine recovery rates for slurries compared with aqueous solutions. This yields a quick insight whether a calibration with aqueous solutions can be used for analysis of slurries of a given powder by slurry nebulization ICP-AES and also is a help in determining the optimal parameters for analyses of powders by means of slurry nebulization ICP-AES. Applications for the evaporation of Al 2O 3 and SiC powders document the usefulness of the model for the case of a 1.5 kW argon ICP of which the temperature at 8 mm above the load coil has been determined to be 6100 K. The model predicts the maximum particle size for SiC and Al 2O 3 that can be transported (10-15 μm) and evaporated for a given efficiency under given experimental conditions. For both Al 2O 3 and SiC, two ceramic powders of different grain size were investigated. The median particle sizes cover

  20. Relative lung deposition of salbutamol following inhalation from a spacer and a Sidestream jet nebulizer following an acute exacerbation.

    PubMed

    Mazhar, Syed H R; Ismail, Nahlah E; Newton, Duncan A G; Chrystyn, Henry

    2008-03-01

    What is already known about this subject. Studies have shown that a large volume spacer attached to a metered dose inhaler provides similar bronchodilator effects to nebulized dosing during the management of patients following an acute exacerbation. Due to the high doses used, these effects could be measured at the top of the dose-response relationship and the response limited due to the patient's exacerbation. Although clinical end-points are the gold standard to show comparability, some indication of similar lung deposition is useful to consolidate any claims. What this study adds. The urinary pharmacokinetic method we have used postinhalation provides an index of lung deposition for inhalation methods that can be incorporated into the routine management of patients with an acute exacerbation. This is the first study to identify and compare lung deposition and systemic delivery for inhalation methods within the setting of the routine management of asthma and chronic obstructive pulmonary disease patients following hospitalization due to an acute exacerbation. The study highlights the comparability of the doses for the two inhalation methods evaluated with respect to lung deposition, systemic delivery and bronchodilator response. Studies comparing inhalation methods in acute exacerbations have not assessed lung deposition. Five 100-mug salbutamol doses were inhaled from a metered dose inhaler plus spacer (MDI + SP) and 5 mg was nebulized (NEB) following acute exacerbation hospitalization. Urinary salbutamol excretion was determined at 30 min (USAL0.5) and over 24 h (USAL24) postinhalation together with forced expiratory volume in 1 s (FEV(1)). The USAL0.5 mean ratio (90% confidence interval) post MDI + SP and NEB [n = 19 asthma, 11 chronic obstructive pulmonary disease (COPD)] was 1.01 (0.81, 1.26). USAL24 was less (P < 0.001) following MDI + SP, whereas FEV(1) was similar. Only a small difference between asthmatics and COPD patients was observed for the MDI + SP

  1. Treatment of acute severe asthma with inhaled albuterol delivered via jet nebulizer, metered dose inhaler with spacer, or dry powder.

    PubMed

    Raimondi, A C; Schottlender, J; Lombardi, D; Molfino, N A

    1997-07-01

    Despite the increasing use of dry powder formulations in the ambulatory setting, there is a paucity of information on the efficacy of this therapeutic modality to treat acute severe asthma. In addition, studies that compared wet nebulization vs metered dose inhalers formulated with chlorofluorocarbon (CFCMDI) attached to holding chambers have yielded discrepant results. Thus, it is unclear which of the three delivery systems would elicit a superior bronchodilator response, particularly in patients with life-threatening asthma. In a prospective, randomized open design, we studied the response to inhaled albuterol (salbutamol) in 27 adult asthmatics presenting to the emergency department (ED) with an FEV1 <30% predicted. Subjects were treated with one of the following regimens (nine subjects in each group): group A, mean (SD) baseline FEV1 of 0.7 (0.2) L, received albuterol solution, 5 mg, via a nebulizer (Puritan-Bennett Raindrop; Lawrenceville, Ga) impelled with oxygen (O2) at 8 L/min; group B, baseline FEV1 of 0.6 (0.15) L, received albuterol, 400 microg, via a CFCMDI attached to a 145-mL valved aerosol holding chamber (Aerochamber; Trudell Medical; London, ON); and group C, baseline FEV1 of 0.6 (0.17) L, received albuterol powder, 400 microg, by another means (Rotahaler; Glaxo; Research Triangle Park, NC). All groups received the respective treatments on arrival in the ED, every 30 min during the first 2 h, and then hourly until the sixth hour. Clinical parameters and FEV1 were recorded on ED admission and 15 min after each dose of albuterol. At the time of ED admission, all patients also received continuous O2 and one dose of I.V. steroids (dexamethasone, 8 mg). The total dose of inhaled albuterol administered during the 6-h treatment was 45 mg of nebulized solution in group A and 3,600 microg of albuterol aerosol and dry powder in groups B and C, respectively. No significant differences were found in the population demographics, baseline FEV1, and arterial

  2. Dose Accuracy and Injection Force of Different Insulin Glargine Pens

    PubMed Central

    Friedrichs, Arnd; Bohnet, Janine; Korger, Volker; Adler, Steffen; Schubert-Zsilavecz, Manfred; Abdel-Tawab, Mona

    2013-01-01

    Background Dose accuracy and injection force, representing key parameters of insulin pens, were determined for three pens delivering insulin glargine-based copies, Pen Royale (WR) and DispoPen (WD) for Glaritus® (Wockhardt) and GanLee Pen (GL) for Basalin® (Gan & Lee), compared with pens of the originator, ClikSTAR® (CS) and S o l o S TA R® (SS) for Lantus® (Sanofi) . Methods Using the weighing procedure recommended by DIN EN ISO 11608–1:2000, dose accuracy was evaluated based on nonrandomized delivery of low (5 U), mid (30 U), and high (60 U) dosage levels. Injection force was measured by dispensing the maximum dose of insulin (60 U for the GL, WR, and WD; 80 U for the SS and CS) at dose speeds of 6 and 10 U/s. Results All tested pens delivered comparable average doses within the DIN EN ISO 11608–1:2000 limits at all dosage levels. The GL revealed a higher coefficient of variation (CV) at 5 U, and the WR and WD had higher CVs at all dosage levels compared with the CS and SS. Injection force was higher for the WR, WD, and GL compared with the CS and SS at both dose speeds. In contrast to the CS and SS with an end-of-content feature, doses exceeding the remaining insulin could be dialed with the WR, GL, and WD and, apparently, dispensed with the WD. Conclusions All pens fulfilled the dose accuracy requirements defined by DIN EN ISO 11608–1:2000 standards at all three dosage levels, with the WR, WD, and GL showing higher dosage variability and injection force compared with the SS and CS. Thus, the devices that deliver insulin glargine copies show different performance characteristics compared with the originator. J Diabetes Sci Technol 2013;7(5):1346–1353 PMID:24124963

  3. Dose accuracy and injection force of different insulin glargine pens.

    PubMed

    Friedrichs, Arnd; Bohnet, Janine; Korger, Volker; Adler, Steffen; Schubert-Zsilavecz, Manfred; Abdel-Tawab, Mona

    2013-09-01

    Dose accuracy and injection force, representing key parameters of insulin pens, were determined for three pens delivering insulin glargine-based copies, Pen Royale (WR) and DispoPen (WD) for Glaritus® (Wockhardt) and GanLee Pen (GL) for Basalin® (Gan & Lee), compared with pens of the originator, ClikSTAR® (CS) and SoloSTAR® (SS) for Lantus® (Sanofi). Using the weighing procedure recommended by DIN EN ISO 11608-1:2000, dose accuracy was evaluated based on nonrandomized delivery of low (5 U), mid (30 U), and high (60 U) dosage levels. Injection force was measured by dispensing the maximum dose of insulin (60 U for the GL, WR, and WD; 80 U for the SS and CS) at dose speeds of 6 and 10 U/s. All tested pens delivered comparable average doses within the DIN EN ISO 11608-1:2000 limits at all dosage levels. The GL revealed a higher coefficient of variation (CV) at 5 U, and the WR and WD had higher CVs at all dosage levels compared with the CS and SS. Injection force was higher for the WR, WD, and GL compared with the CS and SS at both dose speeds. In contrast to the CS and SS with an end-of-content feature, doses exceeding the remaining insulin could be dialed with the WR, GL, and WD and, apparently, dispensed with the WD. All pens fulfilled the dose accuracy requirements defined by DIN EN ISO 11608-1:2000 standards at all three dosage levels, with the WR, WD, and GL showing higher dosage variability and injection force compared with the SS and CS. Thus, the devices that deliver insulin glargine copies show different performance characteristics compared with the originator. © 2013 Diabetes Technology Society.

  4. High resolution, high precision, simultaneous measurements of δD and δ18O using a CRDS analyzer with an ultrasonic nebulizer sample preparation module.

    NASA Astrophysics Data System (ADS)

    Gkinis, Vasileios; Morrie, Valerie; Jones, Tyler; Vaughn, Bruce; White, James

    2013-04-01

    The recent advent of commercial Cavity Ring Down Spectroscopy (CRDS) has initiated the development of numerous new Continuous Flow Analysis (CFA) methods for high resolution, high precision measurements of greenhouse gas concentrations and isotopic ratios of water from ice cores. Depending on the sample preparation method and the calibration schemes applied, these new systems have proved to be precise, accurate and extremely versatile, allowing for high quality measurements performed in the field. However there are still challenges to be addressed. Measurements need to be accurately calibrated with respect to international standards (SMOW - SLAP in the case of water). A proper characterization of the precision and the accuracy of a system is another task that needs to be performed. Apparent sample diffusion affects the produced signals in ways that are unique not only to different systems but also to different implementations of the same system, reducing the resolution that can be obtained. Parameters such as melt rate, sample flow, cavity volume and the method of sample preparation can significantly alter the performance of the analytical method. These effects can be accurately characterized with a series of experiments and consequently corrected for using spectral filtering techniques. Last but not least, proper monitoring of the melting process is necessary in order to assign an ice core depth scale on the data produced. In this work we present an integrated system for high resolution, high precision water isotopic analysis from a continuously melted ice core sample, using a commercial CRDS analyzer (Picarro L2130 -i) . The system utilizes an ultrasonic concentric nebulizer in order to achieve complete fractionation free vaporization of the continuous flow water sample. An adjacent home made calibration module allows for the injection of local standards accurately characterized with respect to the SMOW - SLAP scale. The system has been used for the high

  5. Effect of terfenadine on pulmonary function, histamine release, and bronchial challenges with nebulized water and cold-air hyperventilation.

    PubMed

    Townley, R G; Hopp, R J; Bewtra, A K; Nabe, M

    1989-11-01

    To assess the effectiveness of terfenadine on bronchoconstriction in asthmatics, 12 asthmatic patients between the ages of 19 and 43 were challenged with ultrasonically nebulized distilled water (UNDW) and treated with terfenadine, 120 or 240 mg, or placebo in a three-way crossover double-blind study. A similar study of 12 asthmatics (nine from the UNDW trial) was performed using cold-air hyperventilation challenge (CAHC). In vitro analyses were also made of samples from ten mild asthmatics to determine the effect of terfenadine on basophil histamine release. Terfenadine, 240 mg, showed significant (P = .012) benefit over placebo in improving pulmonary function after UNDW challenge. Modest but significant (P less than .05) bronchodilator benefits were also demonstrated by terfenadine, 240 and 120 mg, after CAHC. Finally, the in vitro study showed significant inhibition by terfenadine of anti-IgE-induced histamine release from human basophils.

  6. Add-on treatment with nebulized hypertonic saline in a child with plastic bronchitis after the Glenn procedure*, **

    PubMed Central

    Lis, Grzegorz; Cichocka-Jarosz, Ewa; Jedynak-Wasowicz, Urszula; Glowacka, Edyta

    2014-01-01

    Plastic bronchitis (PB), although a rare cause of airway obstruction, has mortality rates up to 50% in children after Fontan-type cardiac surgery. We present the case of an 18-month-old female patient with PB following pneumonia. At 6 months of age, the patient underwent the Glenn procedure due to functionally univentricular heart. Fiberoptic bronchoscopy revealed complete blockage of the left bronchus by mucoid casts. Pharmacotherapy consisted of glucocorticosteroids, azithromycin, and enalapril maleate. The child also received nebulized 3% NaCl solution, which proved to be beneficial. In children submitted to Fontan-type procedures, physicians must be alert for PB, which can be triggered by respiratory tract infection. PMID:24626275

  7. Aerosolization of two strains (ice+ and ice-) of Pseudomonas syringae in a Collison nebulizer at different temperatures

    NASA Astrophysics Data System (ADS)

    Pietsch, Renee; David, Ray; Marr, Linsey; Vinatzer, Boris; Schmale, David

    2015-04-01

    The aerosolization of microorganisms from aquatic environments is understudied. In this study, an ice nucleation active (ice+) strain and a non-ice nucleation active (ice-) strain of the bacterium Pseudomonas syringae were aerosolized from aqueous suspensions under artificial laboratory conditions using a Collison nebulizer. The aerosolization of P. syringae was not influenced by water temperatures between 5° and 30°C. In general, the culturability (viability) of P. syringae in aerosols increased with temperature between 5 and 30°C. The ice+ strain was aerosolized in greater numbers than the ice- strain at all temperatures studied, suggesting a possible connection between the ice nucleation phenotype and aerosol production. Together, our results suggest that P. syringae has the potential to be aerosolized from natural aquatic environments, such as streams, rivers, ponds, and lakes; known reservoirs of P. syringae. Future work is needed to elucidate the mechanisms of aerosolization of P. syringae from natural aquatic systems.

  8. An in-vitro assessment of a NanoCrystal beclomethasone dipropionate colloidal dispersion via ultrasonic nebulization.

    PubMed

    Ostrander, K D; Bosch, H W; Bondanza, D M

    1999-11-01

    Short duration ultrasonic nebulization of a concentrated NanoCrystal colloidal dispersion of beclomethasone dipropionate demonstrated an increased respirable fraction and decreased throat deposition when evaluated in an Andersen 8-stage cascade impactor in comparison to the commercially available propellant-based product Vanceril. An aqueous-based 1.25% w/w colloidal dispersion of beclomethasone dipropionate when aerosolized via an Omron NE-U03 ultrasonic nebulizer generated a respirable drug dose from 22.6 to 39.4 micrograms per 2 s actuation period, compared to 12.8 micrograms for a single actuation of Vanceril. When viewed as a percentage of the emitted dose (through the actuator or mouthpiece), the respirable fraction ranged from 56 to 72% for the nanocrystalline formulation versus 36% for the propellant system. In addition, the throat deposition as seen in the induction port was 9-10% of the emitted dose for the novel suspension, as compared to 53% for the commercial product. Thus, when used with the device outlined herein, a nanocrystalline colloidal suspension of beclomethasone dipropionate affords greater potential drug delivery to the conductive airways of the lung in both quantity and as a percent of emitted dose. Additionally, lower potential throat deposition values were observed which may retard the development of undesirable side effects, such as candidiasis, when compared to a propellant based delivery system. Lastly, the ability to atomize aqueous-based nanocrystalline colloidal dispersions represents an environmentally sound alternative to the current chlorofluorocarbon (CFC)-based products and may avoid the technical difficulties of reformulating with chlorine-free propellants.

  9. The combination of nebulized sodium cromoglycate and salbutamol in the treatment of moderate-to-severe asthma in children.

    PubMed

    Furusho, Kenshi; Nishikawa, Kiyoshi; Sasaki, Sei; Akasaka, Toru; Arita, Masahiko; Edwards, Alan

    2002-06-01

    The aim of this multi-centre prospective study was to evaluate the efficacy, tolerability, and safety of the combination of sodium cromoglycate (SCG) and salbutamol (administered as a nebulized solution), compared to SCG alone and salbutamol alone, in the management of severe, intractable asthma in childhood. The study was an open, randomized, cross-over trial of 12 weeks' duration in children with moderate-to-severe intractable asthma. All treatments were administered twice daily by powered nebulizer. The primary outcome measure was the change in asthma severity, as measured by the mean asthma score during the last 2 weeks of a baseline period and the last 2 weeks of each treatment. Secondary outcome measure was the patient's opinion of the effectiveness of treatment. The change in asthma scores from baseline values were significantly greater with the combination treatment compared to each component administered separately. The mean difference in asthma score between the combination and salbutamol was: -7.5; 95% CI, -11.70 to -3.29 (p < 0.0001). The mean difference between the combination and SCG was: -8.53; 95% CI, -14.03 to -3.25 (p < 0.0001). Patients were also significantly in favor of combination treatment (p < 0.001 vs. salbutamol; p < 0.01 vs. SCG). Two patients reported adverse effects. We concluded that regular twice-daily inhalation of a combination of SCG and salbutamol gave better control of symptoms than previous treatments in patients with severe, intractable asthma. Few adverse effects with this therapy suggest that it is extremely useful, safe, and effective.

  10. Quantification aspects of constant pressure (ultra) high pressure liquid chromatography using mass-sensitive detectors with a nebulizing interface.

    PubMed

    Verstraeten, M; Broeckhoven, K; Lynen, F; Choikhet, K; Landt, K; Dittmann, M; Witt, K; Sandra, P; Desmet, G

    2013-01-25

    The present contribution investigates the quantitation aspects of mass-sensitive detectors with nebulizing interface (ESI-MSD, ELSD, CAD) in the constant pressure gradient elution mode. In this operation mode, the pressure is controlled and maintained at a set value and the liquid flow rate will vary according to the inverse mobile phase viscosity. As the pressure is continuously kept at the allowable maximum during the entire gradient run, the average liquid flow rate is higher compared to that in the conventional constant flow rate operation mode, thus shortening the analysis time. The following three mass-sensitive detectors were investigated: mass spectrometry detector (MS), evaporative light scattering detector (ELSD) and charged aerosol detector (CAD) and a wide variety of samples (phenones, polyaromatic hydrocarbons, wine, cocoa butter) has been considered. It was found that the nebulizing efficiency of the LC-interfaces of the three detectors under consideration changes with the increasing liquid flow rate. For the MS, the increasing flow rate leads to a lower peak area whereas for the ELSD the peak area increases compared to the constant flow rate mode. The peak area obtained with a CAD is rather insensitive to the liquid flow rate. The reproducibility of the peak area remains similar in both modes, although variation in system permeability compromises the 'long-term' reproducibility. This problem can however be overcome by running a flow rate program with an optimized flow rate and composition profile obtained from the constant pressure mode. In this case, the quantification remains reproducibile, despite any occuring variations of the system permeability. Furthermore, the same fragmentation pattern (MS) has been found in the constant pressure mode compared to the customary constant flow rate mode.

  11. Aerosol Delivery with Two Nebulizers Through High-Flow Nasal Cannula: A Randomized Cross-Over Single-Photon Emission Computed Tomography-Computed Tomography Study.

    PubMed

    Dugernier, Jonathan; Hesse, Michel; Jumetz, Thibaud; Bialais, Emilie; Roeseler, Jean; Depoortere, Virginie; Michotte, Jean-Bernard; Wittebole, Xavier; Ehrmann, Stephan; Laterre, Pierre-François; Jamar, François; Reychler, Gregory

    2017-10-01

    High-flow nasal cannula use is developing in ICUs. The aim of this study was to compare aerosol efficiency by using two nebulizers through a high-flow nasal cannula: the most commonly used jet nebulizer (JN) and a more efficient vibrating-mesh nebulizer (VN). Aerosol delivery of diethylenetriaminepentaacetic acid labeled with technetium-99m (4 mCi/4 mL) to the lungs by using a VN (Aerogen Solo(®); Aerogen Ltd., Galway, Ireland) and a constant-output JN (Opti-Mist Plus Nebulizer(®); ConvaTec, Bridgewater, NJ) through a high-flow nasal cannula (Optiflow(®); Fisher & Paykel, New Zealand) was compared in six healthy subjects. Flow rate was set at 30 L/min through the heated humidified circuit. Pulmonary and extrapulmonary deposition was measured by single-photon emission computed tomography combined with a low-dose computed tomographic scan and by planar scintigraphy. Lung deposition was only 3.6 (2.1-4.4) and 1 (0.7-2)% of the nominal dose with the VN and the JN, respectively (p < 0.05). The JN showed higher retained doses than the VN. However, both nebulizers were associated with substantial deposition in the single limb circuit, the humidification chamber, and the nasal cannula [58.2 (51.6-61.6)% of the nominal dose with the VN versus 19.2 (15.8-22.9)% of the nominal dose with the JN, p < 0.05] and in the upper respiratory tract [17.6 (13.4-27.9)% of the nominal dose with the VN and 8.6 (6.0-11.0)% of the nominal dose with the JN, p < 0.05], especially in the nasal cavity. In the specific conditions of the study, pulmonary drug delivery through the high-flow nasal cannula is about 1%-4% of the initial amount of drugs placed in the nebulizer, despite the higher efficiency of the VN as compared with the JN.

  12. Comparison of the effects of nebulized terbutaline with or without intravenous betamethasone on exhaled nitric oxide in children with acute asthma attack.

    PubMed

    Lee, Ming Yung; Tsai, Yi Giien; Yang, Kuender D; Hung, Chih Hsing

    2006-02-01

    Exhaled nitric oxide (eNO), a non-invasive marker that reflects the degree of airway inflammation, may be useful for assessing the response to anti-inflammatory treatment of asthma. The purpose of this randomized prospective study was to compare the effect of a nebulized terbutaline plus a single intravenous dose of betamethasone at baseline followed by a second of terbutaline at 6 h with the effect of the same protocol of nebulized terbutaline alone on airway inflammation of acute asthmatic children as demonstrated by eNO levels. Children visiting the emergency department due to acute asthma attack were recruited. All enrolled patients had fluorescent assay-proven hypersensitivity to Dermatophagoides pteronyssinus. Patients were randomized to receive either nebulized terbutaline plus intravenous betamethasone (experimental group, n = 11) or nebulized terbutaline alone (control group, n = 11) at baseline followed by a second dose of nebulized terbutaline alone 6 h later. Exhaled NO concentrations were significantly reduced in the experimental group at 7 h (40.25 +/- 12.43 vs 28.88 +/- 18.02 ppb; p = 0.005) and 12 h (40.25 +/- 12.43 vs 30.11 +/- 18.16 ppb; p = 0.007) after treatment. The eNO level in the experimental group was also reduced at 7 h (28.88 +/- 18.02 vs 38.12 +/- 16.50 ppb; p = 0.034) and 12 h (30.11 +/- 18.16 vs 39.36 +/- 17.63 ppb; p = 0.035) compared to the control group. The change of eNO concentration was correlated to the change of peak expiratory flow rate (PEFR) [r = -0.678; p = 0.022] and pulmonary index scores (r = 0.606; p = 0.048) at 7 h after treatment in the betamethasone group. Nebulized terbutaline given at baseline and 6 h later was significantly more effective in improving PEFR and asthmatic symptoms (pulmonary index scores) for at least 12 h when the initial dose was administered in combination with intravenous betamethasone.

  13. Feasibility study of a gadolinium-loaded DIN-based liquid scintillator

    NASA Astrophysics Data System (ADS)

    Song, Sook Hyung; Joo, Kyung Kwang; So, Sun Heang; Yeo, In Sung

    2013-09-01

    DIN (di-isopropylnaphthalene) has a high flashpoint and can be used as a base solvent in liquid scintillators. It reduces safety concerns to humans and the environment. (PPO, 3 g/ ℓ) and (bis-MSB, 30 mg/ ℓ) were dissolved to formulate a DIN-based liquid scintillator (LS). A gadolinium (Gd) complex with carboxylic acid was synthesized using a neutralized chemical reaction. Then, 0.1% Gd was loaded into the LS. This Gd-loaded DIN-based LS using a solvent-solvent extraction method is the first attempt at a LS. In this study, we investigated the physical and the optical properties of this LS, and we will summarize all the characteristics of the Gd-loaded DIN-based LS.

  14. Manufacturing of microcomponents in a research institute under DIN EN ISO 9001

    NASA Astrophysics Data System (ADS)

    Maas, Dieter; Karl, Bernhard; Saile, Volker; Schulz, Joachim

    2000-08-01

    The Institute for Microstructure Technology at Forschungszentrum Karlsruhe has implemented a rigorous quality management system and was certified according to the DIN ISO EN 9001 standard in January 2000.

  15. Discrimination against major groove adducts by Y-family polymerases of the DinB subfamily.

    PubMed

    Walsh, Jason M; Ippoliti, Paul J; Ronayne, Erin A; Rozners, Eriks; Beuning, Penny J

    2013-09-01

    Y-family DNA polymerases bypass DNA adducts in a process known as translesion synthesis (TLS). Y-family polymerases make contacts with the minor groove side of the DNA substrate at the nascent base pair. The Y-family polymerases also contact the DNA major groove via the unique little finger domain, but they generally lack contacts with the major groove at the nascent base pair. Escherichia coli DinB efficiently and accurately copies certain minor groove guanosine adducts. In contrast, we previously showed that the presence in the DNA template of the major groove-modified base 1,3-diaza-2-oxophenothiazine (tC) inhibits the activity of E. coli DinB. Even when the DNA primer is extended up to three nucleotides beyond the site of the tC analog, DinB activity is strongly inhibited. These findings prompted us to investigate discrimination against other major groove modifications by DinB and its orthologs. We chose a set of pyrimidines and purines with modifications in the major groove and determined the activity of DinB and several orthologs with these substrates. DinB, human pol kappa, and Sulfolobus solfataricus Dpo4 show differing specificities for the major groove adducts pyrrolo-dC, dP, N(6)-furfuryl-dA, and etheno-dA. In general, DinB was least efficient for bypass of all of these major groove adducts, whereas Dpo4 was most efficient. DinB activity was essentially completely inhibited by the presence of etheno-dA, while pol kappa activity was strongly inhibited. All three of these DNA polymerases were able to bypass N(6)-furfuryl-dA with modest efficiency, with DinB being the least efficient. We also determined that the R35A variant of DinB enhances bypass of N(6)-furfuryl-dA but not etheno-dA. In sum, we find that whereas DinB is specific for bypass of minor groove adducts, it is specifically inhibited by major groove DNA modifications.

  16. Dinámica de planetas extrasolares resonantes

    NASA Astrophysics Data System (ADS)

    Beauge, C.

    Actualmente se han detectado 117 planetas alrededor de estrellas de Secuencia Principal, incluyendo 12 sistemas planetarios, cada uno con dos o tres miembros. De estos últimos, ocho poseen planetas en órbitas próximas y sus perturbaciones gravitacionales se convierten en un factor fundamental para la estabilidad orbital del sistema. Todos se encuentran en configuraciones resonantes, desde la conmensurabilidad de movimientos 2/1 de Gliese 876, hasta la resonancia secular de Ups And. En esta presentación analizamos varios aspectos de la dinámica resonante de los planetas extrasolares, incluyendo la existencia de soluciones de equilibrio, construcción de modelos analógicos y métodos para la determinación de masas individuales. También discutimos por qué las resonancias son tan frecuentes en estos sistemas, comparado con nuestro propio Sistema Solar. Por último, intentamos relacionar estos modelos con la hipótesis de migración planetaria, buscando límites en su extensión y en los posibles mecanismos que le dieron origen.

  17. Mutually exclusive RNA secondary structures regulate translation initiation of DinQ in Escherichia coli.

    PubMed

    Kristiansen, Knut I; Weel-Sneve, Ragnhild; Booth, James A; Bjørås, Magnar

    2016-11-01

    Protein translation can be affected by changes in the secondary structure of mRNA. The dinQ gene in Escherichia coli encodes a primary transcript (+1) that is inert to translation. Ribonucleolytic removal of the 44 first nucleotides converts the +1 transcript into a translationally active form, but the mechanism behind this structural change is unknown. Here we present experimental evidence for a mechanism where alternative RNA secondary structures in the two dinQ mRNA variants affect translation initiation by mediating opening or closing of the ribosome binding sequence. This structural switch is determined by alternative interactions of four sequence elements within the dinQ mRNA and also by the agrB antisense RNA. Additionally, the structural conformation of +1 dinQ suggests a locking mechanism comprised of an RNA stem that both stabilizes and prevents translation initiation from the full-length dinQ transcript. BLAST search and multiple sequence alignments define a new family of dinQ-like genes widespread in Enterobacteriaceae with close RNA sequence similarities in their 5' untranslated regions. Thus, it appears that a whole new family of genes is regulated by the same mechanism of alternative secondary RNA structures. © 2016 Kristiansen et al.; Published by Cold Spring Harbor Laboratory Press for the RNA Society.

  18. The Escherichia coli SOS gene dinF protects against oxidative stress and bile salts.

    PubMed

    Rodríguez-Beltrán, Jerónimo; Rodríguez-Rojas, Alexandro; Guelfo, Javier R; Couce, Alejandro; Blázquez, Jesús

    2012-01-01

    DNA is constantly damaged by physical and chemical factors, including reactive oxygen species (ROS), such as superoxide radical (O(2)(-)), hydrogen peroxide (H(2)O(2)) and hydroxyl radical (•OH). Specific mechanisms to protect and repair DNA lesions produced by ROS have been developed in living beings. In Escherichia coli the SOS system, an inducible response activated to rescue cells from severe DNA damage, is a network that regulates the expression of more than 40 genes in response to this damage, many of them playing important roles in DNA damage tolerance mechanisms. Although the function of most of these genes has been elucidated, the activity of some others, such as dinF, remains unknown. The DinF deduced polypeptide sequence shows a high homology with membrane proteins of the multidrug and toxic compound extrusion (MATE) family. We describe here that expression of dinF protects against bile salts, probably by decreasing the effects of ROS, which is consistent with the observed decrease in H(2)O(2)-killing and protein carbonylation. These results, together with its ability to decrease the level of intracellular ROS, suggests that DinF can detoxify, either direct or indirectly, oxidizing molecules that can damage DNA and proteins from both the bacterial metabolism and the environment. Although the exact mechanism of DinF activity remains to be identified, we describe for the first time a role for dinF.

  19. The response of two different dosages of beclometasone dipropionate suspension for nebulization versus a standard dose of beclometasone dipropionate via a metered-dose inhaler on bronchoprovocation testing in adults with asthma.

    PubMed

    Bousquet, J; Meziane, H; Chanez, P; Mueser, M; Umile, A

    2003-02-01

    The objective of this double-blind, randomized, placebo-controlled, parallel-group study was to compare the pharmacodynamic effects and safety of beclometasone dipropionate (BDP) given by nebulization or metered-dose inhalation in adult patients with asthma. Following a 1-week run-in period, 40 patients, aged 18-60 years, with intermittent bronchial asthma were randomized to one of four treatment groups for 3 weeks (n = 10 in each group): beclometasone dipropionate (BDP) suspension for nebulization 1,600 microg day(-1) b.i.d. via a nebulizer, BDP suspension for nebulization 3,200 microg day(-1) b.i.d. via a nebulizer, BDP 800 microg day(-1) b.i.d. via a metered-dose inhaler (MDI) plus spacer, or placebo. At study end, comparable effects were reported for all active treatment groups on the primary pharmacodynamic endpoint of FEV1 in response to methacholine bronchial provocation testing, with a statistically significant improvement shown in the BDP 3,200 microg day(-1) suspension for nebulization group compared with pre-treatment for other parameters, including FEV1 and peak expiratory flow rates. All treatments were comparable. All treatments were equally well tolerated. No significant effects on cortisol levels were reported in any of the treatment groups.

  20. Darbepoetin Alfa Injection

    MedlinePlus

    ... to inject it.Darbepoetin alfa injection comes in prefilled syringes and in vials to be used with disposable ... solution before injecting it. Be sure that the prefilled syringe or vial is labeled with the correct name ...