The patients’ inhalation flow pattern is one of the significant determinants for clinical performance of inhalation therapy. However, the development of inhalation flow meters for various inhalation devices has been unable to keep up with the increasing number of newly launched inhalation devices. In the present study, we developed simple attachment orifices for the inhalation flow pattern monitoring system, which are suitable for all commercial inhalers, and investigated the efficacy of the system on the clinical inhalation instruction for patients co-prescribed dry powder inhaler (DPI) and soft mist inhaler (SMI). First, we constructed simple attachment orifices that were adjusted for 13 commercial inhalers, and examined the correlation between orifice and inhalation device. Second, the inhalation flow patterns (peak inspiratory flow rate, PIFR; inhalation duration time, DT) of patients prescribed a combination of DPI and SMI were monitored before and after inhalation instruction. The inhalation resistance of commercial inhalers are listed in the following order; Twincaps® > Handihaler® > Swinghaler® = Clickhaler® > Twisthaler® > Turbuhaler® > Jenuair® > Diskus® = Ellipta® > Diskhaler® > Breezhaler® > Respimat® = pMDI. The pressure drop via orifice was significantly correlated with that via the commercial inhaler. For the confirmation, all participants achieved the DPI criterion of PIFR. On the other hand, 4 participants (6 clinical visits) of 10 experimented participants could not achieve the essential criterion of DT (> 1.5 sec) for SMI, but all participants improved their duration time after inhalation instruction by pharmacists (P<0.05). In the present study, we successfully developed simple attachment orifice suitable for 13 commercial inhalation devices. These data suggested that our simple attachment orifices for the inhalation flow pattern monitoring system can detect patients with inadequate inhalation patterns via SMI.
ABSTRACT. A 3 year-old female Japanese Black cattle was diagnosed as diabetes mellitus (DM). Hyperglycemia (295 mg/dl), increase of serum fructosamine (487 µmol/l), elevated glycosylated hemoglobin A1 (GHbA1; 10.9%), low concentration of serum insulin (< 1.0 µU/ ml), increased serum glucagon (399 pg/ml), and glucose intolerance (glucose disappearance rate; k=0.53) were noted. On the histopathologic findings in pancreas, insulitis with infiltration of mononuclear cells was found. This case suggests that serum fructosamine and GHbA1 are available parameters for understanding of pathophysiological conditions of bovine DM.-KEY WORDS: bovine diabetes mellitus, fructosamine, glycosylated hemoglobin.J. Vet. Med. Sci. 61(8): 965-966, 1999 of 0.4 g/kg of glucose. Blood glucose levels were measured at 0,5,10, 20, 30, 45, 60, 90, and 120 min after injection of glucose. As the glucose disapperance rate (k) and half time (T 1/2) were 0.53 and 130 min, respectively, indicating glucose intolerance (age matched clinically healthy control cattle
Today, well over 160,000 patients undergo dialysis throughout Japan. The number of patients who are newly required to receive it is increasing year by year. Given that situation, our hospital has annually held a seminar since October 1994 for patients with renal diseases. The purpose is to slow the deterioration of renal function and to delay the introduction of dialysis by encouraging the patients to acquire a habit of taking high calory, low protein food.This seminar must have help the patients get more knowledgeable about morbidity and learn the benefit of low protein rice-based diet. Now that three years have passed since the opening of the course, we reviewed the outcome, comparing the effects of old and new restrict diets.A difference began to appear 9-2 months after the lst seminar between the seminar participants and the non-participants (control group) who received guidance only at the outpatient ward. The average rate of decrease in the serum creatine level of those participants who eated lowprotein rice was 0.029 and that of those participants who did not eat the restricted food was 0.166 (p <0.05), compared with 0.262 in the control group. We concluded that the difference is ascribable to the effect of the seminar. We would like to contribute to the well-being of the patients by enriching the content of the seminar and continuing to hold it.
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