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Author: World Health Organization Publisher: World Health Organization ISBN: 924006785X Category : Medical Languages : en Pages : 14
Book Description
The World Health Organization (WHO) has now developed a target product profile (TPP) for the minimal and optimal characteristics of an aerosolized surfactant that can be used for neonates with respiratory distress syndrome (RDS) in low- and middle-income countries (LMICs). The purpose of the TPP is to guide product developers about key test characteristics and performance specifications that will meet the needs of end users in LMICs. It describes the minimal and optimal characteristics of an aerosolized surfactant for treatment of RDS in newborns in LMICs. The intended target audience is doctors, nurses, pharmacists, administrators, procurement officers, program managers, policy makers, members of academic organizations who care for preterm neonates.
Author: World Health Organization Publisher: World Health Organization ISBN: 924006785X Category : Medical Languages : en Pages : 14
Book Description
The World Health Organization (WHO) has now developed a target product profile (TPP) for the minimal and optimal characteristics of an aerosolized surfactant that can be used for neonates with respiratory distress syndrome (RDS) in low- and middle-income countries (LMICs). The purpose of the TPP is to guide product developers about key test characteristics and performance specifications that will meet the needs of end users in LMICs. It describes the minimal and optimal characteristics of an aerosolized surfactant for treatment of RDS in newborns in LMICs. The intended target audience is doctors, nurses, pharmacists, administrators, procurement officers, program managers, policy makers, members of academic organizations who care for preterm neonates.
Author: Susan Boc Publisher: ISBN: Category : Languages : en Pages : 283
Book Description
The overall aim of this research project was to develop surfactant dry powder formulations and devices for efficient delivery of aerosol formulations to infants using the excipient enhanced growth (EEG) approach. Use of novel formulations and inline delivery devices would allow for more efficient treatment of infants suffering from neonatal respiratory distress syndrome and bronchiolitis. A dry powder aerosol formulation has been developed using the commercial product, Survanta ® (beractant) and EEG technology to produce micrometer-sized hygroscopic particles. Spray drying and formulation parameters were initially determined with dipalmitoylphosphatidylcholine (DPPC, the dominant phospholipid in pulmonary surfactant), which produced primary particles 1 mm in size with a mass median aerodynamic diameter of 1-2 mm. Investigation of dry powder dispersion enhancers and alcohol concentration on the effect of powder aerosol characteristics were performed with the Survanta-EEG formulation. The optimal formulation consisted of Survanta®, mannitol and sodium chloride as hygroscopic excipients, and leucine as the dry powder dispersion enhancer, prepared in 20% v/v ethanol/water. The powders produced primary particles of 1 mm with>50% of the particles less than 1 mm. The presence of surfactant proteins and surface activity were demonstrated with the Survanta-EEG formulation following processing. A novel containment unit dry powder inhaler (DPI) was designed for delivery of the surfactant-EEG formulation using a low volume of dispersion air. Studies explored optimization of air entrainment pathway, inlet hole pattern, delivery tube internal diameter and length. With 3-10 mg fill masses of spray dried surfactant powder, the DPI enabled delivery of>2 mg using one 3-mL actuation of dispersion air. Overall, it was possible to deliver>85% of the loaded fill mass using three actuations. Nebulized aerosol formulations are characterized with low delivered doses. Using a novel mixer-heater delivery system, the highest estimated percent lung dose achieved during realistic in vitro testing of a Survanta-EEG formulation aerosolized with a commercial mesh nebulizer was when nebulization was synchronized with inhalation of the breathing profile. Design changes to the mixer-heater system eliminated the need for synchronization, achieving an estimated percent lung dose of 31% of the nominal, an improvement compared with existing systems that achieve approximately
Author: Peter C. Rimensberger Publisher: Springer ISBN: 3642012191 Category : Medical Languages : en Pages : 1584
Book Description
Written by outstanding authorities from all over the world, this comprehensive new textbook on pediatric and neonatal ventilation puts the focus on the effective delivery of respiratory support to children, infants and newborns. In the early chapters, developmental issues concerning the respiratory system are considered, physiological and mechanical principles are introduced and airway management and conventional and alternative ventilation techniques are discussed. Thereafter, the rational use of mechanical ventilation in various pediatric and neonatal pathologies is explained, with the emphasis on a practical step-by-step approach. Respiratory monitoring and safety issues in ventilated patients are considered in detail, and many other topics of interest to the bedside clinician are covered, including the ethics of withdrawal of respiratory support and educational issues. Throughout, the text is complemented by numerous illustrations and key information is clearly summarized in tables and lists.
Author: Stavros Kassinos Publisher: Academic Press ISBN: 0128149744 Category : Business & Economics Languages : en Pages : 438
Book Description
Inhaled medicines are widely used to treat pulmonary and systemic diseases. The efficacy and safety of these medicines can be influenced by the deposited fraction, the regional deposition pattern within the lungs and by post-depositional events such as drug dissolution, absorption and clearance from the lungs. Optimizing performance of treatments thus requires that we understand and are able to quantify these product and drug attributes. Inhaled Medicines: Optimizing Development through Integration of In Silico, In Vitro and In Vivo Approaches explores the current state of the art with respect to inhalation drug delivery, technologies available to assess product performance, and novel in silico methods now available to link in vitro product performance to clinical performance. Recent developments in the latter field, especially the prospect of integration of three-dimensional Computational Fluid Particle Methods (3D-CFPD) with physiologically based pharmacokinetic (PBPK models), unlocks the potential for in silico population studies that can help inform and optimize treatment and product development strategies. In this highly multidisciplinary field, where progress occurs at the intersection of several disciplines of engineering and science, this work aims to integrate current knowledge and understanding and to articulate a clear vision for future developments. ? Considers the healthcare needs driving the field, and where inhaled drugs could have the maximum impact ? Gives a concise account of the state of the art in key areas and technologies such as device and formulation technologies, clinically relevant in vitro performance assessment, medical imaging, as well as in silico modelling and simulation ? Articulates how the combination of in vitro product performance data, medical imaging and simulations technologies in the framework of large scale in silico pre-clinical trials could revolutionize the field ? Provides systematic and thorough referencing to sources offering a more-in-depth analysis of technical issues
Author: Publisher: World Health Organization ISBN: 9241545879 Category : Childbirth Languages : en Pages : 393
Book Description
The emphasis of the manual is on rapid assessment and decision making. The clinical action steps are based on clinical assessment with limited reliance on laboratory or other tests and most are possible in a variety of clinical settings.
Author: United States. Public Health Service. Office of the Surgeon General Publisher: ISBN: Category : Government publications Languages : en Pages : 728
Book Description
This report considers the biological and behavioral mechanisms that may underlie the pathogenicity of tobacco smoke. Many Surgeon General's reports have considered research findings on mechanisms in assessing the biological plausibility of associations observed in epidemiologic studies. Mechanisms of disease are important because they may provide plausibility, which is one of the guideline criteria for assessing evidence on causation. This report specifically reviews the evidence on the potential mechanisms by which smoking causes diseases and considers whether a mechanism is likely to be operative in the production of human disease by tobacco smoke. This evidence is relevant to understanding how smoking causes disease, to identifying those who may be particularly susceptible, and to assessing the potential risks of tobacco products.
Author: Robert Kliegman Publisher: Elsevier Health Sciences ISBN: 0323761755 Category : Medical Languages : en Pages : 1355
Book Description
Patients don't present with a disease; they present with symptoms. Using a practical, symptom-based organization, Nelson Pediatric Symptom-Based Diagnosis: Common Diseases and their Mimics, 2nd Edition, offers authoritative guidance on differential diagnosis and treatment of diseases and disorders in children and adolescents, and covers the symptoms you're likely to see in practice, their mimics, and uncommon disorders. Drs. Robert M. Kliegman, Heather Toth, Brett J. Bordini, and Donald Basel walk you through what to consider and how to proceed when faced with common symptoms such as cough, fever, headache, autistic-like behaviors, chronic pain, chest pain, gait disturbances, and much more. - Begins with a presenting symptom and leads you through differential diagnosis and a concise review of treatment recommendations. - Contains more than a dozen new topics including Disease Mimics: An Approach to Undiagnosed Diseases, Autistic-like Behaviors, Shock, Hypertension, Neurocognitive and Developmental Regression, Chronic Pain, Hypertonicity, Movement Disorders, Hypermobility, and more. - Features a new focus on symptoms of rarer diseases that are mimics of more common diseases. - Offers a user-friendly approach to Altered Mental Status such as coma and other CNS disorders, with numerous clinically useful tables and figures to guide clinical decision making in various care settings. - Uses a highly templated format for easy reference and quick answers to clinical questions, with the same consistent presentation in each chapter: History, Physical Examination, Diagnosis (including laboratory tests), Imaging, Diagnosis, and Treatment. - Includes numerous full-color illustrations, algorithms, tables, and "red flags" to aid differential diagnosis. - Serves as an ideal companion to Nelson Textbook of Pediatrics, 21st Edition. Content in this book is referenced and linked electronically to the larger text, providing easy access to full background and evidence-based treatment and management content when you own both references.
Author: David C. Shelledy Publisher: Jones & Bartlett Learning ISBN: 128420622X Category : Medical Languages : en Pages : 793
Book Description
Respiratory Care: Patient Assessment and Care Plan Development, Second Edition describes the purpose of patient assessment and then guides the reader through the process of reviewing existing data in the medical record
Author: World Health Organization
Author: World Health Organization
Author: Susan Boc
Author: Peter C. Rimensberger
Author: Stavros Kassinos
Author: 
Author: United States. Public Health Service. Office of the Surgeon General
Author: 
Author: 
Author: Robert Kliegman
Author: David C. Shelledy