ABSTRACT
OBJECTIVE: To evaluate which way of topical drug application would result in a better deposition pattern after FESS. MATERIAL AND METHODS: We compared the deposition pattern of a nasal steroid after application with a metered pump spray or inhalation using the Pari sinus device. Visualization was achieved via colouring using 1% Sodium-fluorescein solution. All patients had a well healed sinus system with an endoscopically wide open access after FESS. We looked for the deposition with Blue-light-endoscopy directly after application and after washing out using a nasal douche. Analysis was performed blinded by two independent experienced sinus surgeons via representative single shots. RESULTS: Data of 11 patients revealed, that deposition after metered pump spray application was superior than after inhalation for all localisations. By far most part of the drug was deposited in the anterior nasal cavity, followed by the head of the middle turbinate, ethmoid. Small amounts reached the maxillary sinus, the anterior wall of the sphenoid sinus, the olfactory cleft and the entrance to the frontal sinus. The frontal sinus itself was not reached in any case. Washing out led to a decrease of deposition intensity, in some cases to a better distribution into the maxillary and sphenoid sinus and frontal recess. CONCLUSIONS: Postoperative deposition of topical nasal steroids after FESS is insufficient. We need better methods and devices to optimize efficacy of topical treatment.
Subject(s)
Adrenal Cortex Hormones/administration & dosage , Metered Dose Inhalers , Nasal Polyps/surgery , Postoperative Care , Pulse Therapy, Drug/instrumentation , Sinusitis/surgery , Adrenal Cortex Hormones/pharmacokinetics , Aerosols , Algorithms , Biological Availability , Chronic Disease , Endoscopy , Fluorescein , Humans , Nasal Polyps/drug therapy , Sinusitis/drug therapy , Video RecordingABSTRACT
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Subject(s)
Humans , Ataxia Telangiectasia/complications , Ataxia Telangiectasia/diagnosis , Ataxia Telangiectasia/radiotherapy , Pulse Therapy, Drug/methods , Pulse Therapy, Drug/trends , Ataxia Telangiectasia/physiopathology , Ataxia Telangiectasia , Pulse Therapy, Drug/instrumentationABSTRACT
O relato de caso descrito tem um início agudo e uma evolução fatal em poucos dias, apesar do suporte clínico e terapêutico instituído em centro de terapia intensiva. Hemorragia alveolar difusa que evolui para insuficiência respiratória e renal agudas exige exclusão dos principais diagnósticos diferenciais cabíveis e início precoce da terapêutica
Subject(s)
Humans , Female , Aged , Antibodies, Antineutrophil Cytoplasmic/pharmacology , Antibodies, Antineutrophil Cytoplasmic/physiology , Antibodies, Antineutrophil Cytoplasmic , Glomerulonephritis/complications , Glomerulonephritis/mortality , Pulse Therapy, Drug/instrumentation , Pulse Therapy, Drug/trends , Heart Failure/complications , Heart Failure/mortality , Respiratory Insufficiency/complications , Respiratory Insufficiency/mortalityABSTRACT
In 26 patients, we evaluated a novel pulsed nasal delivery system for nitric oxide (NO) that, in the short term, was as effective as continuous delivery for decreasing pulmonary artery pressure and pulmonary vascular resistance. In 2 patients, NO delivered in the home using this pulsing system was well tolerated for up to 2 years. The long-term safety, efficacy, and acceptability of NO delivered in the home remains to be studied.
Subject(s)
Hemodynamics/drug effects , Home Nursing/methods , Hypertension, Pulmonary/drug therapy , Hypertension, Pulmonary/physiopathology , Nitric Oxide/administration & dosage , Vasodilator Agents/administration & dosage , Administration, Inhalation , Administration, Intranasal , Adolescent , Adult , Child , Child, Preschool , Female , Follow-Up Studies , Humans , Male , Pulse Therapy, Drug/instrumentation , Pulse Therapy, Drug/methods , Time , Treatment OutcomeABSTRACT
Remote controlled release of agents in the alimentary tract is an important task of gastroenterology and pharmacy. We investigated two different methods of drug release by heating locally restricted parts in medical capsules: hysteresis losses of magnetite powder and eddy current losses of metals in alternating magnetic fields. The comparison of our experimental results with theoretically derived expectations show that both methods are suitable techniques if special technical conditions are met. In order to demonstrate the feasibility of simple constructions, we used a gelatin capsule, consisting of two parts which were kept together by a belt of wax and a small copper coil. This capsule was placed in water and the belt was heated in an alternating magnetic field until melting and releasing a test fluid after about 60 s.