Purpose: Correct use of inhaler devices is fundamental to effective asthma management but represents an important challenge for patients. The correct inhalation manoeuvre differs markedly for different inhaler types. The objective of this study was to compare outcomes for patients prescribed the same inhaler device versus mixed device types for asthma controller and reliever therapy.
Methods: This retrospective observational study identified patients with asthma (ages 4-80 years) in a large primary care database who were prescribed an inhaled corticosteroid (ICS) for the first time. We compared outcomes for patients prescribed the same breath-actuated inhaler (BAI) for ICS controller and salbutamol reliever versus mixed devices (BAI for controller and pressurised metered-dose inhaler [pMDI] for reliever). The 2-year study included 1 baseline year before the ICS prescription (to identify and correct for confounding factors) and 1 outcome year. Endpoints were asthma control (defined as no hospital attendance for asthma, oral corticosteroids, or antibiotics for lower respiratory tract infection) and severe exacerbations (hospitalisation or oral corticosteroids for asthma).
Results: Patients prescribed the same device (n=3,428) were significantly more likely to achieve asthma control (adjusted odds ratio, 1.15; 95% confidence interval [CI], 1.02-1.28) and recorded significantly lower severe exacerbation rates (adjusted rate ratio, 0.79; 95% CI, 0.68-0.93) than those prescribed mixed devices (n=5,452).
Conclusions: These findings suggest that, when possible, the same device should be prescribed for both ICS and reliever therapy when patients are initiating ICS.
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http://dx.doi.org/10.4168/aair.2012.4.4.184 | DOI Listing |
Eur J Clin Pharmacol
December 2024
Department of Pharmacy, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.
Purpose: Voriconazole (VRC) is recommended for the prevention and treatment of invasive fungal infections in children undergoing hematopoietic stem cell transplantation (HSCT). It demonstrates nonlinear pharmacokinetics (PK) and exhibits substantial inter- and intraindividual variability. Phenytoin sodium (PHT) and methylprednisolone (MP) are commonly used in the early stages of HSCT to prevent epilepsy and graft-versus-host disease.
View Article and Find Full Text PDFFront Neurosci
December 2024
Brain, Body and Cognition Research Group, Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, Elsene, Belgium.
Background: Implicit motor sequence learning (IMSL) is a cognitive function that allows us to execute multiple movements in a specific sequential order and plays a crucial role in our daily functional activities. Although the role of the basal ganglia network in IMSL is well-established, the exact involvement of the cerebellar network is less clear.
Aim: Here, we aimed to address this issue by investigating the effects of cerebellar transcranial direct-current stimulation (tDCS) on IMSL.
Digit Health
December 2024
Pediatric Department, Faculty of Nursing, Khonkaen University, Khonkaen, Thailand.
Objective: This study aims to evaluate the effectiveness of digital health interventions compared to standard care in promoting exclusive breastfeeding (EBF) among postpartum women in low-and middle-income countries (LMICs).
Methods: The PRISMA guidelines of reporting were followed for the searching of four databases and screening following eligibility criteria: articles presenting digital health interventions, conducted as randomized control trials (RCTs), quasi-experimental, or mixed-method studies, reporting on EBF duration and early initiation of breastfeeding, and published in the English language were included.
Results: Of 1595 articles screened, only 10 published between 2013 and 2023 met the criteria.
World J Pediatr Congenit Heart Surg
December 2024
Penn State Hershey Pediatric Cardiovascular Research Center, Penn State College of Medicine, Hershey, PA, USA.
Background: The study objective was to determine the impact of cardiopulmonary bypass perfusion modalities on cerebral hemodynamics and clinical outcomes in congenital cardiac surgery patients stratified by acyanotic versus cyanotic heart disease.
Methods: A total of 159 pediatric (age <18 years) cardiac surgery patients were prospectively randomized to pulsatile or nonpulsatile cardiopulmonary bypass and stratified by type of congenital heart disease: acyanotic versus cyanotic. Intraoperative cerebral gaseous microemboli counts and middle cerebral artery pulsatility index were assessed.
J Clin Nurs
December 2024
Division of Medical Law and Ethics, Department of Medical Humanities and Social Sciences, Yonsei University College of Medicine, Seoul, Republic of Korea.
Aims: To identify the characteristics and compare the codes of ethics enacted by the Korean Nursing Association and International Council of Nurses.
Design: A mixed-method collective case study.
Methods: This study adopted interpretive approaches comprising case definition and selection, data collection, analysis and interpretation.
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