From: Craig Abud [craig@nichemedical.ccsend.com] on behalf of Craig Abud
[craig@nichemedical.com.au]
Sent: Sunday, 17 May 2009 8:50 AM
To: Craig Abud
Subject: Niche News - July 2008(V2)
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Niche News |
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Welcome to Niche Medical's Customer Newsletter. This newsletter is designed to inform our customers of the
latest information on our products and services. We aim to include
information on best practice, continuing education, equipment operation and
clinical updates. This newsletter currently goes out to over 800 health care
professionals (nurses, doctors, physiotherapists, educators and scientists)
working in the field of Respiratory Medicine. Please note that we highly
value your input and feedback. Please send all feedback to Craig Abud -
simply reply to this email. Our goal is to provide you with valuable information in a format
that fits into your busy schedule. If for any reason you do not wish to
receive this newsletter in the future, simply click on the opt-out button
below. Please feel free to pass this newsletter onto those who may find it
valuable. There is a forward email icon located at the bottom of this
newsletter. Craig Abud Niche Medical
AUTHORS: Kate M. Hardaker1, Paola T. Espinel1, Adriana M. Cortés1, Helen
K. Reddel1, Brett G. Toelle1, Adrian Barnett2, Gail Williams3, Guy B. Marks1 STUDY CENTRE: 1. Woolcock Institute of Medical Research, Sydney, NSW 2050, 2.
Institute of Health and Biomedical Innovation; Queensland University of
Technology, Kelvin Grove, QLD, 4059, 3. School of Population Health,
University of Queensland, Herston, QLD 4006. BACKGROUND:
AIM: To compare the accuracy of stored electronic PEF data and
written diary records in an epidemiological study of Australian children. METHODS: Participants:
Recruitment:
Electronic Peak Flow:
Written Diary:
Analysis:
RESULTS:
CONCLUSION: These findings imply that missing and discordant data is common
when study participants are asked to record PEF results onto paper diaries.
Errors increase with duration of monitoring. Acknowledgements: Supported by: Australian
Research Council and National Environment Protection Council of Australia Click here to view the
Full Abstract on our website.............
In this edition of Niche News we present an independent study
comparing the clinical efficacy of the LiteAire disposable spacer to a
nebuliser in the treatment of acute asthma in adult patients admitted to a
New York Hospital Emergency Department. This study shows that beta agonist delivery via MDI with the
LiteAire disposable spacer for the management of acute asthma is as
efficacious as nebulizer delivery. This is a very relevant and important clinical comparison
especially when we consider that with the exception of Children's Hospitals
the use of nebulisers remains the mainstay of clinical practice for
bronchodilator administration in the treatment of acute asthma and COPD in
the majority of Australian Hospitals. We do however recognise that spacer usage and spacer advocacy is
common practice in respiratory outpatient clinics, pulmonary function
laboratories, community health and increasingly so in respiratory and medical
wards. Following the release of the new TGA Guidelines (1) in July 2007
prohibiting the reprocessing of single patient-use items (including single
patient-use spacers i.e. Volumatic spacer etc) there has been a gradual shift
in practice towards the utilisation of the recently introduced disposable
spacers and autoclavable spacers. The LiteAire disposable spacer is a viable alternative and has
significant advantages over the newly introduced Large Plastic Disposable
Spacers as follows:
The LiteAire disposable spacer also has significant advantages
over the newly introduced Autoclavable Spacers as follows:
For a complimentary evaluation of the LiteAire disposable spacer
in your healthcare facility simply reply to this email or telephone our
office on 1300 136 855. References: (1). Update on the regulation of the re-manufacture of single
use medical devices - October 2006 - TGA Website 2008. (2). Laboratory usage habits and delivered salbutamol dose of
spacers available in Australia and New Zealand - Presented by Graham Hall,
Respiratory Medicine, Princess Margaret Hospital and School of Paediatric and
Child Health, University of Western Australia at the TSANZ Conference in
Melbourne, April 2008.
Authors: Sunil Dhuper MD, Alpana Chandra MD, Aziz Ahmed MD, Sabin Bista
MD, Ajit Moghekar MD, Rajesh Verma MD, Cynthia Chong MD, Chang Shim MD,
Hillel Cohen Dr. PH, Sonia Choksi MD Study Centre: Coney Island Hospital: 2601 Ocean Parkway, Brooklyn, NY, USA,
11235 Background: Despite demonstration of equivalent efficacy of beta agonist
delivery using MDI with spacer versus nebulizer in asthma patients, use of
nebulizer remains the standard of practice. We hypothesize that beta agonist delivery with MDI/ disposable
spacer (LiteAire) combination is as effective and low cost alternative than
nebulizer delivery for acute asthma. Methods: Prospective, randomized, double blinded, placebo controlled
trial in the emergency department (ED) in 60 acute asthma patients. Subjects were randomized to receive albuterol with MDI/spacer
combination or nebulizer. The spacer group (N=29) received albuterol by MDI
using LiteAire followed by placebo nebulization. The nebulizer group (N=29) received placebo by MDI using
LiteAire followed by albuterol nebulization. Peak flows, symptom scores and
need for rescue bronchodilator were monitored. Results: Patients in the two randomized groups had similar baseline
characteristics. The severity of asthma exacerbation, median peak flows, and
symptom scores were not significantly different between the two groups. The median improvement in peak flow was 120(75,180)L/min versus
120(80,155)L/min in the LiteAire and nebulizer groups, respectively (p=
0.56). The median improvement in the symptom score was 7 (5,9) versus 7(4,9)
in the LiteAire and nebulizer groups, respectively (p= 0.78). Conclusion: Beta agonist delivery with MDI /spacer combination for
management of acute asthma is an equally efficacious and more economical
alternative to nebulizer delivery. Note: The Full Article has been accepted for publication in The
Journal of Emergency Medicine. Click here to view the
Full Abstract on our website.............
Authors: Sunil Dhuper MD, Sanjay Arora MD, Aziz Ahmed MD, Alpana Chandra
MD ,Cynthia Chong MD, Chang Shim MD, Hillel W. Cohen Dr. PH, Scott Foss,
Sonia Choksi MD. Study Centre: North Central Bronx Hospital, 3424 Kossuth Avenue, Bronx, New
York 10467. An Affiliate of The Albert Einstein College of Medicine Introduction: Despite tremendous variability in the number of MDI actuations
(2-12) used in studies comparing beta agonist delivery via MDI/spacer and one
unit dose ampule with a nebulizer, there is increasing literature support
based on clinical trials for the use of 6 MDI actuations. Materials and Methods: To determine the total dose output, a test device was attached
to a USP throat model feeding into a filter connected to a Michigan
Instrument Dual Test Lung System. Particle size was determined using an
Andersen 8-Stage Cascade Impactor (ACI) with USP throat. Results: The total dose output was found to be 175.9±27.0 micrograms for
6 actuations of albuterol delivered to a LiteAire Spacer via MDI versus
219.8±13.6 micrograms for a Misty Max 10 with T-piece. The percent respirable fraction (defined as the total mass on
plates # 3-7 indicating a size range of 4.7- 0.4 microns) was found to be
90.26±1.51% for LiteAire and 81.68±0.66% for the Misty Max 10 (p Discussion: This study demonstrates that using the breath simulation
technique there is no significant difference in the total dose output using 6
actuations of albuterol MDI spacer versus 1 unit dose of nebulizer albuterol.
Even though the difference in the respirable fraction between
the two modes of delivery using ACI was significant, there was no difference
in the total dose output in the effective respirable dose calculated using
the breath simulation studies. We also determined that the total dose deposition using ACI with
the two modes of delivery was not significantly different and well in line
with the method using the breath simulated techniques. Conclusion: When conducting a clinical efficacy study comparing MDI/Spacer
and one unit dose of albuterol delivered via nebulization, we recommend using
6 albuterol MDI actuations with spacer as the in vitro dose outputs with the
two modes are comparable. Click here to view the
Full Abstract on our website.............
The new software allows you to save 8 pre and 8 post bronchodilator
results (including all curves) in the EasyOne spirometer and these results
can then be reviewed and the tests re-ranked (if required) at the completion
of the testing session via the new EasyWare software. This upgrade is available (compatible) only for EasyOne
spirometers with Serial Number 50500 and above. You will find the Serial
Number on the base of the EasyOne spirometer. Should you wish to have your EasyOne spirometer and EasyWare
software upgraded free of charge then please contact Niche Medical on
telephone: 1300 136 855 or simply reply to this email. Note: You need to own a previous version of the EasyWare software to
qualify for a free EasyWare software upgrade or alternatively you can
purchase the new EasyWare software. Quick Tip: Whilst on the subject of the EasyOne
spirometer I will take this opportunity to answer one of the most commonly
asked questions we receive. Question: When using the EasyOne spirometer
(stand-alone - without a computer) how do I get back to the main menu to do
another test without having to turn off the EasyOne spirometer? Answer: Hold down the "0" Key (which
is also the Escape Key) until you hear a beep and this will take you back to
the previous menu. Depending upon where you are in the menu you may need to
repeat this step once or twice until you are back in the main menu which
begins with "Perform Test" . Click here for
information on the new EasyWare software (this is a 6MB file)
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email: craig@nichemedical.com.au phone: 1300 136 855 |
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