Recognizing and Tackling Inhaler Technique Decay in Asthma and Chronic Obstructive Pulmonary Disesase (COPD) Clinical Practice.

A poor inhaler technique continues to represent a substantial barrier to effective asthma and chronic obstructive pulmonary disease management. It can result in perceived lack of treatment effectiveness even with apparent adherence to a prescribed regimen of inhaled maintenance therapies, potentially resulting in an unnecessary change or escalation of treatment. Many patients are not trained to inhaler mastery in real-world practice; furthermore, even where mastery is initially achieved, an ongoing assessment and education are seldom maintained.

Implant experience with an implantable hemodynamic monitor for the management of symptomatic heart failure.

Introduction: Management of congestive heart failure is a serious public health problem. The use of implantable hemodynamic monitors (IHMs) may assist in this management by providing continuous ambulatory filling pressure status for optimal volume management.

Methods And Results: The Chronicle system includes an implanted monitor, a pressure sensor lead with passive fixation, an external pressure reference (EPR), and data retrieval and viewing components.

Differences in tachyarrhythmia detection and implantable cardioverter defibrillator therapy by primary or secondary prevention indication in cardiac resynchronization therapy patients.

Introduction: Although numerous trials have shown benefit of implantable cardioverter defibrillators (ICDs) for either primary or secondary prevention, no trial has prospectively enrolled patients from both indications and analyzed ICD utilization between groups.

Methods And Results: We performed a retrospective review of MIRACLE ICD, a randomized, prospective double-blind trial of cardiac resynchronization therapy (CRT) in the ICD population. Both secondary prevention (N = 563) and primary prevention patients (N = 415) were enrolled.