Maternal asthma medication use during pregnancy and risk of congenital heart defects
ConclusionWe did not observe statistically significant associations between the reported use of asthma medications during pregnancy and most specific types of CHDs. Despite limitations in our inability to evaluate asthma status and severity, our study suggests that maternal asthma medication use does not substantially, if at all, increase the risk of CHDs. Birth Defects Research (Part A), 2015. © 2015 Wiley Periodicals, Inc. (Source: Birth Defects Research Part A: Clinical and Molecular Teratology)
Source: Birth Defects Research Part A: Clinical and Molecular Teratology - September 1, 2015 Category: Perinatology & Neonatology Authors: Alissa R. Van Zutphen, Erin M. Bell, Marilyn L. Browne, Shao Lin, Angela E. Lin, Charlotte M. Druschel, Tags: Original Research Article Source Type: research

The metabolomics of asthma control: a promising link between genetics and disease
The objective is to identify novel genetic and biochemical predictors of asthma control using an integrative “omics” approach. We generated lipidomic data by liquid chromatography tandem mass spectrometry (LC‐MS), ­ using plasma samples from 20 individuals with asthma. The outcome of i nterest was a binary indicator of asthma control defined by the use of albuterol inhalers in the preceding week. We integrated metabolomic data with genome‐wide genotype, gene expression, and methylation data of this cohort to identify genomic and molecular indicators of asthma control. A Conditio nal Gaussian Bayesian Ne...
Source: Immunity, Inflammation and Disease - August 27, 2015 Category: Allergy & Immunology Authors: Michael J. McGeachie, Amber Dahlin, Weiliang Qiu, Damien C. Croteau ‐Chonka, Jessica Savage, Ann Chen Wu, Emily S. Wan, Joanne E. Sordillo, Amal Al‐Garawi, Fernando D. Martinez, Robert C. Strunk, Robert F. Lemanske, Andrew H. Liu, Benjami Tags: Original Research Source Type: research

Albuterol Delivery via Facial and Tracheostomy Route in a Model of a Spontaneously Breathing Child.
Abstract BACKGROUND: Some pediatric patients receiving therapeutic aerosols undergo tracheostomy, and others who are tracheostomized continue requiring inhaled therapies upon decannulation. It is unknown whether a dose adjustment is required. Different devices are available for facial and tracheostomy delivery, and in some instances, the assisted technique is used. We hypothesized that the change from face mask to tracheostomy would result in a decrease in the lung dose. METHODS: A breathing simulator connected in series to a filter holder and an anatomically correct head model of a child was used. The drug c...
Source: Respiratory Care - August 18, 2015 Category: Respiratory Medicine Authors: Cooper B, Berlinski A Tags: Respir Care Source Type: research

Lactic acidosis and diastolic hypotension after intermittent albuterol nebulization in a pediatric patient
We describe a case of 13-year-old female with intermittent asthma who developed lactic acidosis and diastolic hypotension after receiving intermittent albuterol nebulizer treatment. She presented to the emergency department (ED) with sudden onset of shortness of breath and chest pain. She received two albuterol nebulizer treatments at home without symptomatic relief. She was treated in the ED with intermittent albuterol nebulizer treatment for a total of 22.5 mg over the next 5 hours. A decrease in diastolic blood pressure from 60 mmHg to 40 mmHg was noted after the treatment. Blood lactate level was 5.9 mmol/L. She recove...
Source: Respiratory Medicine Case Reports - August 16, 2015 Category: Respiratory Medicine Source Type: research

Production of Highly Charged Pharmaceutical Aerosols Using a New Aerosol Induction Charger
Conclusions The combination of the aerosol induction charger and predictive correlations will allow for the practical generation and control of charged submicrometer aerosols for targeting deposition within the lungs. (Source: Pharmaceutical Research)
Source: Pharmaceutical Research - August 7, 2015 Category: Drugs & Pharmacology Source Type: research

The effect of caffeine and albuterol on body composition and metabolic rate.
CONCLUSIONS: In rats, albuterol with caffeine produced significantly greater increases in lean body mass and reductions in fat mass without changes in food intake after 4-8 weeks of treatment. Since caffeine and albuterol are approved for the treatment of asthma in children and adolescents at the doses tested and change body composition without changing food intake, this combination may deserve further exploration for use in treating pediatric obesity. PMID: 26239482 [PubMed - as supplied by publisher] (Source: Obesity)
Source: Obesity - August 4, 2015 Category: Eating Disorders and Weight Management Authors: Liu AG, Arceneaux KP, Chu JT, Jacob G, Schreiber AL, Tipton RC, Yu Y, Johnson WD, Greenway FL, Primeaux SD Tags: Obesity (Silver Spring) Source Type: research

Accelerated Idioventricular Rhythm in a Child With Status Asthmaticus
We present the case of a 4-year-old boy who was admitted to our hospital in status asthmaticus and found to have a wide complex rhythm while being treated with inhaled albuterol and intravenous methylprednisolone. This rhythm was diagnosed as accelerated idioventricular rhythm (AIVR), which carries a benign prognosis. It resolved as the medications used to treat his asthma exacerbation were weaned. There was no ventricular ectopy seen on a 24-hour Holter monitor performed 3 months after his hospitalization, suggesting that the AIVR was related to the medications the patient was receiving at the time. This case suggests tha...
Source: PEDIATRICS - July 31, 2015 Category: Pediatrics Authors: Beach, C., Marcuccio, E., Beerman, L., Arora, G. Tags: Pulmonology, Asthma, Cardiology, Cardiovascular Disorders Case Report Source Type: research

Clindamycin-induced hypersensitivity reaction
We report the case of a 46-year-old female who experienced anaphylaxis after a dose of intravenous (IV) clindamycin. Following treatment with methylprednisolone, epinephrine, diphenhydramine, and albuterol, the patient stabilized. The patient’s score on the Naranjo’s algorithm was 8 (probable); a score of 9 (definite) limited only by absence of drug re-challenge. To our knowledge, this is the first report of a clindamycin-induced anaphylaxis where the patient was not exposed to any other agent that may have triggered the response, the first case in the United States, and only the third documented case in th...
Source: Infection - July 28, 2015 Category: Infectious Diseases Source Type: research

The Case Files: Serious and Unusual Reaction to Naloxone Administration
By Anthony Congeni, Alex Fox, MD, & Andrew King, MD Naloxone is given routinely in the hospital and prehospital setting without much concern for significant morbidity. Many providers are unaware of its potential complications, including pulmonary edema, and may be caught off guard when respiratory distress occurs in an awake patient who was previously rescued with naloxone. The use of naloxone is now common in anesthesiology and emergency medicine for patients with concern for opiate toxicity. Its use, however, is not without occasional morbidity, particularly cardiopulmonary complications including pulmonary edema. ...
Source: The Case Files - July 14, 2015 Category: Emergency Medicine Tags: Blog Posts Source Type: research

Serious and Unusual Reaction to Naloxone Administration
By Anthony Congeni, Alex Fox, MD, & Andrew King, MDNaloxone is given routinely in the hospital and prehospital setting without much concern for significant morbidity. Many providers are unaware of its potential complications, including pulmonary edema, and may be caught off guard when respiratory distress occurs in an awake patient who was previously rescued with naloxone.The use of naloxone is now common in anesthesiology and emergency medicine for patients with concern for opiate toxicity. Its use, however, is not without occasional morbidity, particularly cardiopulmonary complications including pulmonary edema. (J T...
Source: The Case Files - July 14, 2015 Category: Emergency Medicine Tags: Blog Posts Source Type: research

Rapidly Progressive Nonuremic Calciphylaxis in Setting of Warfarin
A 63-year-old African American woman presented with multiple painful, violaceous, nodules on her lower extremities for the preceding three weeks. Her past medical history was notable for mechanical aortic valve replacement seven years prior, asthma, type 2 diabetes mellitus, congestive heart failure, hyperlipidemia, hypertension and obesity. Her home medications included warfarin, longstanding low-dose prednisone for severe asthma, calcium, atorvastatin, glipizide, metformin, insulin, ipratropium-albuterol, montelukast, omalizumab, losartan, metoprolol, torsemide, and omeprazole. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - July 8, 2015 Category: Journals (General) Authors: Gordon H. Bae, Vinod E. Nambudiri, Daniel Q. Bach, John Danziger, Beverly Faulkner-Jones, Colm McMahon, Susan J. Huang Tags: Images in Dermatology Source Type: research

Rapidly Progressive Nonuremic Calciphylaxis in the Setting of Warfarin
A 63-year-old African American woman presented with multiple painful, violaceous nodules on her lower extremities for the preceding 3 weeks. Her past medical history was notable for mechanical aortic valve replacement 7 years prior, asthma, type 2 diabetes mellitus, congestive heart failure, hyperlipidemia, hypertension, and obesity. Her home medications included warfarin, longstanding low-dose prednisone for severe asthma, calcium, atorvastatin, glipizide, metformin, insulin, ipratropium-albuterol, montelukast, omalizumab, losartan, metoprolol, torsemide, and omeprazole. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - July 8, 2015 Category: Journals (General) Authors: Gordon H. Bae, Vinod E. Nambudiri, Daniel Q. Bach, John Danziger, Beverly Faulkner-Jones, Colm McMahon, Susan J. Huang Tags: Images in dermatology Source Type: research

Albuterol inhalation increases FeNO level in steroid ‐naive asthmatics but not COPD patients with reversibility
This study aimed to investigate whether airway obstruction could interfere with real FENO levels and if different FeNO changes after albuterol inhalation could assist in distinguishing asthma from chronic obstructive pulmonary disease (COPD). MethodsFeNO and spirometry measurements were performed before and after albuterol inhalation in the following three patient groups: 30 steroid‐naive asthmatics, 25 asthmatics inhaling corticosteroids/long‐acting β(2)‐adrenergic agonists for at least 1 month and 20 COPD patients. Bronchodilator test (BDT) results were positive in all patients enrolled. The correlations among...
Source: The Clinical Respiratory Journal - July 8, 2015 Category: Respiratory Medicine Authors: Haijin Zhao, Rui Li, Yanhua LV, Hangming Dong, Lihong Yao, Yue Wu, Guanhua Xiao, Shaoxi Cai Tags: ORIGINAL ARTICLE Source Type: research

Recalcitrant Supraventricular Tachycardia: Occult Albuterol Toxicity Due to a Factitious Disorder
We report a case of a factitious disorder presenting with recurrent episodes of supraventricular tachycardia (SVT). (Source: The Journal of Emergency Medicine)
Source: The Journal of Emergency Medicine - July 7, 2015 Category: Emergency Medicine Authors: Brandon K. Wills, Constance Kwan, Michael Bailey, Leigh Johnson, Nicholas Allan Tags: Selected Topics: Toxicology Source Type: research

Albuterol inhalation increases FeNO level in steroid‐naive asthmatics but not COPD patients with reversibility
This study aimed to investigate whether airway obstruction could interfere with real FENO levels and if different FeNO changes after albuterol inhalation could assist in distinguishing asthma from chronic obstructive pulmonary disease (COPD). Methods: FeNO and spirometry measurements were performed before and after albuterol inhalation in the following three patient groups: 30 steroid‐naive asthmatics, 25 asthmatics inhaling corticosteroids/long‐acting β(2)‐adrenergic agonists for at least one month, and 20 COPD patients. Bronchodilator test (BDT) results were positive in all patients enrolled. The correlations ...
Source: The Clinical Respiratory Journal - June 16, 2015 Category: Respiratory Medicine Authors: Haijin Zhao, Rui Li, Yanhua LV, Hangming Dong, Lihong Yao, Yue Wu, Guanhua Xiao, Shaoxi Cai Tags: Original Article Source Type: research

Albuterol inhalation increases FeNO level in steroid-naive asthmatics but not COPD patients with reversibility.
This study aimed to investigate whether airway obstruction could interfere with real FENO levels and if different FeNO changes after albuterol inhalation could assist in distinguishing asthma from chronic obstructive pulmonary disease (COPD). METHODS: FeNO and spirometry measurements were performed before and after albuterol inhalation in the following three patient groups: 30 steroid-naive asthmatics, 25 asthmatics inhaling corticosteroids/long-acting β(2)-adrenergic agonists for at least one month, and 20 COPD patients. Bronchodilator test (BDT) results were positive in all patients enrolled. The correlations a...
Source: Respiratory Care - June 16, 2015 Category: Respiratory Medicine Authors: Zhao H, Li R, Lv Y, Dong H, Yao L, Wu Y, Xiao G, Cai S Tags: Clin Respir J Source Type: research

Retropharyngeal Air and Pneumomediastinum: A Rare Complication of Influnenza A and Asthma in an Adult
A 27 year old female presented to our suburban emergency department (ED) complaining of shortness of breath, neck fullness, and right sided chest pain worsening over the past two days. The patient is a known asthmatic who was poorly controlled on her home regimen of an albuterol MDI. She was seen the day before at an urgent care facility and given a diagnosis of community acquired pneumonia and was started on a steroid taper, albuterol nebulizers, and clarithromycin. On initial presentation in the ED she was noted to be in severe respiratory distress, utilizing accessory muscles and sitting in the tripod position. (Source:...
Source: The American Journal of Emergency Medicine - June 13, 2015 Category: Emergency Medicine Authors: Matthew Niehaus, Allison Rusgo, Kevin Roth, Jeanne L. Jacoby Tags: Case Report Source Type: research

Assessing the Response to Inhaled Albuterol by Monitoring Patient Effort-Related Trends With a Servo-I Ventilator in Neurally Adjusted Ventilatory Assist Mode: A Case Presentation.
This article presents a case study that chronicles the care of an infant with chronic lung disease treated with albuterol. An innovative form of ventilation with monitoring of the electrical activity of the diaphragm with a special sensor-embedded catheter is used to assess the effectiveness of albuterol administration. PURPOSE: This case study presents the monitoring of the effectiveness of albuterol in an infant with chronic lung disease measuring the electrical activity of the diaphragm catheter (Edi) and the various monitoring systems on the Servo-i ventilator in Neurally Adjusted Ventilatory Assist (NAVA) Mode. ...
Source: Advances in Neonatal Care - June 1, 2015 Category: Nursing Authors: Snow TM, Brinck MJ Tags: Adv Neonatal Care Source Type: research

Quantification of Aerosol Hydrofluoroalkane HFA‐134a Elimination in the Exhaled Human Breath Following Inhaled Corticosteroids Administration
This study demonstrates, for the first time, that breath HFA‐134a levels can be used to assess inhaler medication compliance. It may also be used to evaluate how effectively the medicine is delivered. Clin Trans Sci 2015; Volume #: 1–6 (Source: Clinical and Translational Science)
Source: Clinical and Translational Science - June 1, 2015 Category: Biomedical Science Authors: Hye‐Won Shin, Barbara Barletta, Leila Yoonessi, Simone Meinardi, Szu‐Yun Leu, Shlomit Radom‐Aizik, Inderpal Randhawa, Eliezer Nussbaum, Donald R. Blake, Dan M. Cooper Tags: Article Source Type: research

Clinical outcomes and treatment cost comparison of levalbuterol versus albuterol in hospitalized adults with chronic obstructive pulmonary disease or asthma.
CONCLUSION: Clinical outcomes were similar with the use of levalbuterol versus albuterol for exacerbations of COPD or asthma. On average, patients receiving levalbuterol had longer and more costly hospital stays. PMID: 26025994 [PubMed - in process] (Source: American Journal of Health-System Pharmacy : AJHP)
Source: American Journal of Health-System Pharmacy : AJHP - May 31, 2015 Category: Drugs & Pharmacology Authors: Brunetti L, Poiani G, Dhanaliwala F, Poppiti K, Kang H, Suh DC Tags: Am J Health Syst Pharm Source Type: research

Moderate Intensity Exercise Mediates Comparable Increases In Exhaled Chloride As Albuterol In Individuals With Cystic Fibrosis
Despite the demonstrated advantageous systemic changes in response to regular exercise for individuals with cystic fibrosis (CF), exercise is still viewed as an elective rather than a vital component of therapy, and it is likely that these benefits extend to and are partially mediated by exercise-induced changes in ion regulation. (Source: Respiratory Medicine CME)
Source: Respiratory Medicine CME - May 23, 2015 Category: Respiratory Medicine Authors: Courtney M. Wheatley, Sarah E. Baker, Mary A. Morgan, Marina G. Martinez, Bo Liu, Steven M. Rowe, Wayne J. Morgan, Eric C. Wong, Stephen R. Karpen, Eric M. Snyder Source Type: research

A case of pediatric Steven-Johnson Syndrome associated with albuterol consumption.
We describe a case of Steven-Johnson Syndrome (SJS) associated with albuterol exposure in a 6-year-old male. A possible contributing role of albuterol in SJS occurrence in the present case is strongly suggested by the temporal relationship between the event and the initiation of drug therapy as well as by the positive rechallenge. To the best of our knowledge, albuterol had not been previously associated with SJS in medical literature. It can be therefore possible that physicians, pediatricians in particular, probably not aware of the possible risk of albuterol-induced SJS, might underestimate skin reactions in children ta...
Source: International Immunopharmacology - May 13, 2015 Category: Allergy & Immunology Authors: Maggini V, Lombardi N, Lenti MC, Masi S, Trapani S, Pugi A, Mugelli A, Vannacci A Tags: Int Immunopharmacol Source Type: research

Effect of Tidal Volume and Nebulizer Type and Position on Albuterol Delivery in a Pediatric Model of Mechanical Ventilation.
Abstract BACKGROUND: Optimization of factors affecting aerosol delivery during mechanical ventilation in the pediatric population is important. We hypothesized that increasing the tidal volume (VT), using a vibrating mesh nebulizer, and placing the nebulizer at the ventilator would increase lung dose/delivery efficiency. METHODS: Continuous-output jet and vibrating mesh nebulizers loaded with albuterol (2.5 mg/3 mL) were compared when placed before the Y-piece and at the ventilator. The model consisted of a ventilator operated in pressure-regulated volume control ventilation mode at a breathing frequency of 2...
Source: Respiratory Care - May 12, 2015 Category: Respiratory Medicine Authors: Berlinski A, Willis JR Tags: Respir Care Source Type: research

On Chlorofluorocarbon Bans and Inhaled Albuterol Prices
The competing concerns and interests of both individuals and society must be considered when establishing regulatory policy. In 2008, the US Food and Drug Administration (FDA) banned albuterol inhalers containing chlorofluorocarbons. This decision was questioned at the time because the chlorofluorocarbons emitted from inhalers have an insignificant effect on ozone and because of the anticipated costs of transitioning to hydrofluoroalkane inhalers for patients with respiratory disease. With the ban, generically manufactured chlorofluorocarbon inhalers were discontinued, leaving only branded hydrofluoroalkane inhalers availa...
Source: JAMA Internal Medicine - May 11, 2015 Category: Internal Medicine Source Type: research

Impact of Chlorofluorocarbon Ban on Albuterol Inhaler Use for Asthma
Using private insurance data from 2004 to 2010, this study investigates the effect of the chlorofluorocarbon ban on out-of-pocket costs and utilization of albuterol inhalers among individuals with asthma. See the Editor’s Note by Ross and the Perspective by Redberg. (Source: JAMA Internal Medicine)
Source: JAMA Internal Medicine - May 11, 2015 Category: Internal Medicine Source Type: research

Not Breathing Easier With FDA’s Ban on Chloroflurocarbons in Inhalers
I recently experienced firsthand the impact of the US Food and Drug Administration’s (FDA) ban on chlorofluorocarbons as described by Jena et al. My daughter was home for vacation from college and needed to fill a prescription for an albuterol inhaler (Ventolin). I went to the pharmacy to pick it up, and when the pharmacist handed me the prescription, he said it would be $59. (Source: JAMA Internal Medicine)
Source: JAMA Internal Medicine - May 11, 2015 Category: Internal Medicine Source Type: research

Pharmacologic Agents That Promote Airway Clearance in Hospitalized Subjects: A Systematic Review.
Abstract Pharmacologic agents to promote mucus clearance may reduce the sequelae of obstructive secretions. We systematically reviewed comparative studies of pharmacologic agents for mucus clearance in hospitalized or postoperative subjects without cystic fibrosis and over 12 months of age. We searched MEDLINE and other databases from January 1970 to July 2014 to identify relevant literature. Two reviewers independently assessed each study against predetermined inclusion/exclusion criteria. Two reviewers also independently extracted data regarding subject and intervention characteristics and outcomes and assigned ...
Source: Respiratory Care - May 5, 2015 Category: Respiratory Medicine Authors: Sathe NA, Krishnaswami S, Andrews J, Ficzere C, McPheeters ML Tags: Respir Care Source Type: research

Reply
We appreciate the comments from Villanueva et al1 on our counterintuitive finding: the more knowledge a caregiver is able to demonstrate related to asthma, the more likely the child is to be readmitted.2 This finding raises an important question: what to do when a child is admitted for asthma and the caregiver can recite the signs and symptoms of exacerbation, describe the differences between albuterol and controllers, and appropriately describe when to administer medication? (Source: The Journal of Pediatrics)
Source: The Journal of Pediatrics - April 30, 2015 Category: Pediatrics Authors: Katherine A. Auger, Robert S. Kahn, Matthew M. Davis, Jeffrey M. Simmons Tags: Letter to the Editor Source Type: research

Comparison of Aerosol Delivery by Face Mask and Tracheostomy Collar.
Abstract BACKGROUND: The purpose of this study was to compare the performance of a tracheostomy collar, Wright mask, and aerosol mask attached to a jet nebulizer in facilitating aerosolized medication delivery to the lungs. We also compared albuterol delivery with open versus closed fenestration and determined the effect of inspiratory-expiratory ratio (I:E) on aerosol delivery. METHODS: Albuterol (2.5 mg/3 mL) was administered to an in vitro model consisting of an adult teaching mannequin extrathoracic and upper airway with stoma intubated with an 8-mm fenestrated tracheostomy tube. The cuff was deflated. A ...
Source: Respiratory Care - April 28, 2015 Category: Respiratory Medicine Authors: Bugis AA, Sheard MM, Fink JB, Harwood RJ, Ari A Tags: Respir Care Source Type: research

Congenital myasthenic syndrome (CMS) caused by novel mutation in LRP4. Phenotypic heterogeneity and defects in neuromuscular transmission (NMT) identified in a second kinship (P2.021)
CONCLUSIONS: (1) The identified LRP4 mutation disrupts agrin-MuSK-LRP4 signaling, results in poorly developed and degenerating EPs, and impairs multiple parameters of NMT. (2) LRP4-CMS can show marked intrafamilial heterogeneity, can be severely disabling, but can be mitigated by albuterol. Study Supported by: NIH, Mayo CIM.Disclosure: Dr. Selcen has nothing to disclose. Dr. Shen has nothing to disclose. Dr. Ohkawara has nothing to disclose. Dr. McEvoy has nothing to disclose. Dr. Ohno has nothing to disclose. Dr. Engel has nothing to disclose. (Source: Neurology)
Source: Neurology - April 8, 2015 Category: Neurology Authors: Selcen, D., Shen, X., Ohkawara, B., McEvoy, K., Ohno, K., Engel, A. Tags: Neuromuscular Disease: Genetics and Outcomes Source Type: research

Outdoor air pollution and health effects in urban children with moderate to severe asthma
Abstract Particulate matter less than 2.5 μm in diameter (PM2.5) is associated with asthma morbidity. Recent studies have begun examining the role of various constituents of PM2.5, their potential sources, and their effects on health. We examine their role in asthmatic children. Thirty-six children 6–14 years with moderate/severe asthma from inner city areas in New York City were studied for 2-week periods (summer and winter) using diaries and lung function. Outdoor data, including PM10, PM2.5, elements, elemental/organic carbon, and criteria gases (NO2, SO2, and O3) were collected at two sites....
Source: Air Quality, Atmosphere and Health - April 7, 2015 Category: Environmental Health Source Type: research

Effect of airway acidosis and alkalosis on airway vascular smooth muscle responsiveness to albuterol
Background: In vitro and animal experiments have shown that the transport and signaling of β2-adrenergic agonists are pH-sensitive. Inhaled albuterol, a hydrophilic β2-adrenergic agonist, is widely used for the treatment of obstructive airway diseases. Acute exacerbations of obstructive airway diseases can be associated with changes in ventilation leading to either respiratory acidosis or alkalosis thereby affecting albuterol responsiveness in the airway. The purpose of this study was to determine if airway pH has an effect on albuterol-induced vasodilation in the airway. Methods: Ten healthy volunteers performed...
Source: BMC Clinical Pharmacology - April 2, 2015 Category: Drugs & Pharmacology Authors: Jose CancadoEliana MendesJohana AranaGabor HorvathMaria MonzonMatthias SalatheAdam Wanner Source Type: research

42-Year-Old Man With Asthma Symptoms and Recurrent Bronchitis
A 42-year-old man from southern Iowa presented to our institution for evaluation of symptoms of asthma and recurrent bronchitis. The patient’s body mass index was 17.0, and he had never smoked. Since high school, he had had a persistent, productive cough. Asthma had been diagnosed years previously, and over the years, multiple medications were prescribed including fluticasone/salmeterol HFA, montelukast, albuterol, other inhaled glucocorticoids, and ipratropium/albuterol nebulization. The medications were minimally effective at controlling respiratory symptoms. (Source: Mayo Clinic Proceedings)
Source: Mayo Clinic Proceedings - April 1, 2015 Category: Internal Medicine Authors: Benjamin R. Griffin, Christopher R. Stephenson, Mark E. Wylam Tags: Residents’ clinic Source Type: research

Markers of Differential Response to Inhaled Corticosteroid Treatment Among Children With Mild Persistent Asthma
Conclusions Children with mild persistent asthma who have markers of atopic asthma or who have greater asthma burden may obtain greater benefit from beclomethasone therapy. Additional study is needed to confirm whether these markers can guide individualized therapy. (Source: The Journal of Allergy and Clinical Immunology: In Practice)
Source: The Journal of Allergy and Clinical Immunology: In Practice - March 15, 2015 Category: Allergy & Immunology Source Type: research

Diastolic hypotension in pediatric patients with asthma receiving continuous albuterol
Journal of Asthma, Ahead of Print. (Source: Journal of Asthma)
Source: Journal of Asthma - March 4, 2015 Category: Respiratory Medicine Tags: article Source Type: research

Does Active Dissemination of Evidence Result in Faster Knowledge Transfer Than Passive Diffusion?: An Analysis of Trends of the Management of Pediatric Asthma and Croup in US Emergency Departments From 1995 to 2009
Conclusions: During a 15-year period, knowledge transfer by passive diffusion or active guideline dissemination resulted in similar trends of corticosteroid use for the management of pediatric asthma and croup. (Source: Pediatric Emergency Care)
Source: Pediatric Emergency Care - March 1, 2015 Category: Emergency Medicine Tags: Original Articles Source Type: research

The metabolomics of asthma control: a promising link between genetics and disease
The objective is to identify novel genetic and biochemical predictors of asthma control using an integrative “omics” approach. We generated lipidomic data by liquid chromatography tandem mass spectrometry (LC‐MS), ­ using plasma samples from 20 individuals with asthma. The outcome of interest was a binary indicator of asthma control defined by the use of albuterol inhalers in the preceding week. We integrated metabolomic data with genome‐wide genotype, gene expression, and methylation data of this cohort to identify genomic and molecular indicators of asthma control. A Conditional Gaussian Bayesian Netw...
Source: Immunity, Inflammation and Disease - March 1, 2015 Category: Allergy & Immunology Authors: Michael J. McGeachie, Amber Dahlin, Weiliang Qiu, Damien C. Croteau‐Chonka, Jessica Savage, Ann Chen Wu, Emily S. Wan, Joanne E. Sordillo, Amal Al‐Garawi, Fernando D. Martinez, Robert C. Strunk, Robert F. Lemanske, Andrew H. Liu, Benjamin A. Raby, Sco Tags: Original Research Source Type: research

Effect of High-Dose Continuous Albuterol Nebulization on Clinical Variables in Children With Status Asthmaticus*
We examined the effect of high-dose (75 or 150 mg/hr) albuterol on clinical variables in children with status asthmaticus. Design: Retrospective analysis of inpatient medical records and prospectively collected computerized PICU respiratory therapy database. Setting: Twenty-five-bed multidisciplinary PICU in a tertiary care children’s hospital. Patients: Children admitted to the PICU between January 2006 and December 2007 with status asthmaticus receiving high-dose continuous albuterol nebulization. (Those with cerebral palsy, cardiac pathology, and ventilator dependence were excluded.) Interventions: Chart review fo...
Source: Pediatric Critical Care Medicine - February 1, 2015 Category: Pediatrics Tags: Online Clinical Investigations Source Type: research

A 41-year-old woman with shortness of breath and history of rash and recurrent laryngeal edema.
Abstract A 41-year-old Hispanic woman with a 20 pack-year smoking history presented with worsening shortness of breath on exertion that gradually started 2 years ago, then significantly deteriorated over the last 4 months. She was diagnosed with COPD 2 months prior to her presentation and started on treatment with fluticasone propionate and albuterol. Her medical history was relevant for undifferentiated connective tissue disorder diagnosed 5 years prior due to a positive antinuclear antibody test, arthralgia, recurrent urticarial skin rash, peripheral neuropathy, abdominal pain, and diffuse body swelling. She was...
Source: Chest - February 1, 2015 Category: Respiratory Medicine Authors: Ataya A, Faruqi I, Salgado JC Tags: Chest Source Type: research

Acute Effect of an Inhaled Glucocorticosteroid on Albuterol-induced Bronchodilation in Patients with Moderately Severe Asthma.
Abstract RATIONALE: We have previously shown that in asthmatics a single dose of an inhaled glucocorticosteroid (ICS) acutely potentiates inhaled albuterol-induced airway vascular smooth muscle relaxation through a non-genomic action. An effect on airway smooth muscle was not seen, presumably because the patients had normal lung function. The purpose of the present study was to conduct a similar study in asthmatics with airflow obstruction to determine if an ICS could acutely also potentiate albuterol-induced airway smooth muscle relaxation in them. METHODS: In 15 adult asthmatics (mean±SE baseline FEV...
Source: Chest - January 22, 2015 Category: Respiratory Medicine Authors: Mendes ES, Cadet L, Arana J, Wanner A Tags: Chest Source Type: research

Long-acting muscarinic antagonist use in adults with asthma: real-life prescribing and outcomes of add-on therapy with tiotropium bromide
David Price,1,2 Alan Kaplan,3 Rupert Jones,4 Daryl Freeman,5 Anne Burden,2 Shuna Gould,2 Julie von Ziegenweidt,2 Muzammil Ali,2 Christine King,2 Mike Thomas6 1Academic Centre of Primary Care, University of Aberdeen, Aberdeen, 2Research in Real-Life, Cambridge, UK; 3Family Physician Airways Group of Canada, Richmond Hill, ON, Canada; 4Centre for Clinical Trials and Health Research, Plymouth University, Plymouth, 5Norfolk Community Health and Care NHS Trust, Norwich, 6Primary Care Research, University of Southhampton, Southhampton, UK Background: Randomized controlled trials indicate that addition of a long-acting muscarinic...
Source: Journal of Asthma and Allergy - January 14, 2015 Category: Allergy & Immunology Tags: Journal of Asthma and Allergy Source Type: research

In Vitro Evaluation of Aerosols Delivered via the Nasal Route.
CONCLUSIONS: Careful pairing of the aerosol generator and interface is very important during transnasal aerosol delivery. PMID: 25587167 [PubMed - as supplied by publisher] (Source: Respiratory Care)
Source: Respiratory Care - January 13, 2015 Category: Respiratory Medicine Authors: El Taoum KK, Xi J, Kim JW, Berlinski A Tags: Respir Care Source Type: research

A Comparison of Metered-Dose Inhaled Albuterol Versus Endotracheal Liquid Bolus Albuterol for the Treatment of Bronchoconstriction.
Abstract INTRODUCTION: Aerosolized albuterol delivery is a mainstay treatment for bronchoconstriction; however, almost no data exist that evaluate the clinical outcome of instillation of an endotracheal liquid bolus (ELB) of a bronchodilator directly into the airway. METHODS: This randomized trial sought to evaluate the efficacy of albuterol lavage via artificial airway with accompanied patient positioning. Subjects receiving mechanical ventilation for acute respiratory failure with clinical manifestations of bronchoconstriction were assigned to initially receive either traditional albuterol via metered-dose ...
Source: Respiratory Care - January 13, 2015 Category: Respiratory Medicine Authors: Johnston DA, Gilmore TW, Gosselin KP Tags: Respir Care Source Type: research

No differences? Aerosol characteristics of 9 jet nebulisers tested in vitro
ConclusionIn vitro aerosol performance of the 9 tested nebulisers differs considerably. Nebulisers with a high RDDR ensure most likely the best effective intrapulmonary deposition within a short time, which is relevant for adherence. (Source: European Respiratory Journal)
Source: European Respiratory Journal - December 23, 2014 Category: Respiratory Medicine Authors: Walz-Jung, H., Kamin, W., Kramer, I. Tags: 1.6 General Practice and Primary Care Source Type: research

Multidrug resistant acinetobacter baumannii in ventilator associated pneumonia: Prevalence and predictors of mortality
Conclusions: Identification of prognostic factors of mortality would be a reliable tool for early detection and guiding empirical therapy. (Source: European Respiratory Journal)
Source: European Respiratory Journal - December 23, 2014 Category: Respiratory Medicine Authors: Almomani, B., Al-Gharaibeh, R., Al-Mahasneh, F., Samrah, S. Tags: 2.1 Acute Critical Care Source Type: research

Sealed-lips instruction for pressurised metered dose inhalers (pMDIs) - A critical step?
Background: pMDI inserts include the mouthpiece instruction: close around/hold firmly between the lips. The perfect seal for laboratory testing may not, however, be representative of patient use.Aim: To determine gap-effects on salbutamol delivery from low (LR) and high resistance (HR), and breath-actuated (BA)/training pMDIs.Methods: Sealed and 0.18cm2gap adapters, and modified actuators to mimic low and high pMDI resistances were made. The four combinations were tested with Ventolin® Evohaler® (+standard actuator=Control), using a Next Generation Impactor™ operated to pharmacopoeial standard. The effect of ...
Source: European Respiratory Journal - December 23, 2014 Category: Respiratory Medicine Authors: Sanders, M., Bruin, R., Tran, C. Tags: 1.6 General Practice and Primary Care Source Type: research

Metered-dose inhaler albuterol: Evaluation of efficacy and safety of increasing doses in children with acute wheezing
ConclusionsBoth dosage regimens showed similar efficacy and safety in this study. (Source: European Respiratory Journal)
Source: European Respiratory Journal - December 23, 2014 Category: Respiratory Medicine Authors: Pereira Muchao, F., Miguita e Souza, J., Conceicao Cavalcante Torres, H., Batista de Lalibera, I., Schvartsman, C., Carlos Rodrigues, J., Ribeiro Ferreira da Silva Filho, L. V. Tags: 7.2 Paediatric Asthma and Allergy Source Type: research

Lung recruitment maneuver with and without nebulized albuterol for acute lung injury
Conclusion: nebulised albuterol improved oxygenation but not alveolar fluid clearance when combined with lung recruitment in ALI or ARDS. (Source: European Respiratory Journal)
Source: European Respiratory Journal - December 23, 2014 Category: Respiratory Medicine Authors: Badawy, M., Asida, S. Tags: 2.1 Acute Critical Care Source Type: research

Effects Of Exercise Intensity Compared To Albuterol In Individuals With Cystic Fibrosis
Although exercise is a vital component of the therapy prescribed to individuals with cystic fibrosis (CF), it is not a priority due to a finite amount of treatment time and the view that exercise is not as beneficial as pharmacological treatments by many individuals with CF. We sought to compare the therapeutic benefits of exercise and their prescribed bronchodilator albuterol. (Source: Respiratory Medicine CME)
Source: Respiratory Medicine CME - December 17, 2014 Category: Respiratory Medicine Authors: Courtney M. Wheatley, Sarah E. Baker, Mary A. Morgan, Marina G. Martinez, Wayne J. Morgan, Eric C. Wong, Stephen R. Karpen, Eric M. Snyder Source Type: research