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Medical Management for Rhinosinusitis
Published in John C Watkinson, Raymond W Clarke, Louise Jayne Clark, Adam J Donne, R James A England, Hisham M Mehanna, Gerald William McGarry, Sean Carrie, Basic Sciences Endocrine Surgery Rhinology, 2018
The delivery device is important, with aerosol sprays achieving poor penetration beyond the anterior third of the nose. The most effective delivery devices are the positive pressure, high-volume irrigation bottles or Neti pots, which can penetrate all sinuses in a post-operative patient following wide sinus surgery or frontosphenoethmoidectomy (Figure 97.3).49
Allergy and Asthma
Published in Hilary McClafferty, Integrative Pediatrics, 2017
Although many complementary approaches are available, few have been well studied, especially in children (Hon et al. 2015). A typical example is nasal saline irrigation, which is widely used yet has few supporting studies in children. One study of its use by Jeffe et al. has documented good tolerance and compliance with saline irrigation in 61 children ranging in age from less than 5 years to 18 years, despite initial parental skepticism that the child would accept the treatment (Jeffe et al. 2012). Nasal irrigation can be done with a variety of commercially available devices, such as a neti pot (Ragab et al. 2015).
Nasal saline irrigation: prescribing habits and attitudes of physicians and pharmacists
Published in Scandinavian Journal of Primary Health Care, 2021
Jesse Tapiala, Antti Hyvärinen, Sanna Toppila-Salmi, Eero Suihko, Elina Penttilä
In summary, the most popular method for NSI was a Neti pot (n = 477; 80.7%) filled with an isotonic solution (n = 440; 73.9%) that was 30–40 degrees Celsius (n = 417; 70.1%). Hypertonic (n = 18; 3.0%) or hypotonic (n = 11; 1.8%) solutions were rarely administered and the rest did not instruct the tonicity (n = 126; 21.2%). Volumes of 51–100 ml (n = 72; 12.2%) and 101–200 ml (n = 83; 14.0%) were recommended the most, while the majority gave no recommendation at all (n = 316; 53.4%). Many of the respondents recommended homemade solutions (n = 483; 81.2%) as opposed to purchasing ready-to-use nasal solutions from pharmacies (n = 325; 54.6%). Irrigations were most instructed as a daily (n = 222; 37.8%) or twice-a-day (n = 277; 47.2%) therapy. Regular irrigations were recommended by 77 (12.9%) of the respondents, while the rest (n = 518; 87.1%) opted for a short-term usage (mean: 6.52 days, SD = 3.9, min = 1 day and max = 30 days). There was no significant difference in the length of the recommended use between pharmacists and physicians.
α-Irradiation setup for primary human cell cultures
Published in International Journal of Radiation Biology, 2020
Andreas Maier, Julia Wiedemann, Julia Anna Adrian, Maximilian Dornhecker, Andreas Zipf, Wilma Kraft-Weyrather, Gerhard Kraft, Sandra Richter, Nico Teuscher, Claudia Fournier
We could successfully show that the presented α-irradiation setup is suitable for irradiation of primary human cells. It meets all requirements necessary for a homogenous and reproducible irradiation with α-particles even at low doses. Energy and LET of α-particles emitted by the 241Am-source are similar to α-particles from 222Rn decay. The distance from the α-source and the sample is only 2.7 mm, resulting in minimal energy loss. A mechanical shutter insures a precise exposure time. The opening time of the shutter is only in the order of 1% of usual irradiation times, and thus negligible for experimental design. The capability of our setup is comparable to the setup described by Beaton et al. (2011), but facilitates a faster irradiation with a higher precision due to the integrated automatic shutter system. The irradiation setups described in Dahle et al. (2011), Esposito et al. (2009) and Neti et al. (2004) are comparable to our system. One major difference in these three setups is the use of a helium-flushed irradiator housing to reduce the energy loss of the α-particles, making the exchange of samples more complicated than in our setup. Compared to the work of Neti et al. (2004) and Dahle et al. (2011), our experiment did not include a collimator, as we wanted to avoid scattering at the walls of the collimator. Nevertheless, the technical characteristics of these setups are similar to ours, but for irradiation in our facility, we developed a system most suitable for our research purposes.
Naegleria fowleri: diagnosis, treatment options and pathogenesis
Published in Expert Opinion on Orphan Drugs, 2019
Mohammad Ridwane Mungroo, Naveed Ahmed Khan, Ruqaiyyah Siddiqui
Primary amoebic meningoencephalitis patients are known to come in contact with warm water via activities such as bathing, swimming, the use of neti pots, and more recently performing ritual ablution [3]. The susceptible demography is mostly immunocompetent children and young adults, likely due to their exposure to outdoor water-related activities. Primary amoebic meningoencephalitis has a rapid course of disease and death usually occurs within a matter of days. Primary amoebic meningoencephalitis also leads to multiple complications such as hydrocephalus and residual neurological deficits. The currently available treatment is intravenous with Amphotericin B, coupled with adjunctive regimens such as rifampin and the azoles. However, these antimicrobials have severe systemic adverse effects such as nephrotoxicity, as they are administered intravenously. Their pharmacodynamics are also hampered by the fact that systemic administration takes time to reach and penetrate target organs as well as high selectivity of the blood-brain barrier ensure poor penetration of drug to reach the target site in the CNS to kill the residing parasite effectively [51]. Several drugs are used for the treatment of N. fowleri, including amphotericin B, miltefosine, fluconazole, azithromycin, rokitamycin, rifampin, chlorpromazine, dexamethasone, and corifungin. Table 2 shows some drugs that are used for the treatment of PAM. Below are some of the drugs that are currently used in the treatment of N. fowleri infection.