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  1. Article: A path to successful patient outcomes through aerosol drug delivery to children: a narrative review.

    Ari, Arzu

    Annals of translational medicine

    2021  Volume 9, Issue 7, Page(s) 593

    Abstract: Although using aerosolized medications is a mainstay of treatment in children with asthma and other respiratory diseases, there are many issues in terms of device and interface selection, delivery technique and dosing, as well as patient and parental ... ...

    Abstract Although using aerosolized medications is a mainstay of treatment in children with asthma and other respiratory diseases, there are many issues in terms of device and interface selection, delivery technique and dosing, as well as patient and parental education that have not changed for half a century. Also, due to many aerosol devices and interfaces available on the market and the broad range of patient characteristics and requirements, providing effective aerosol therapy to children becomes a challenge. While aerosol delivery devices are equally effective, if they are age-appropriate and used correctly, the majority of aerosol devices require multiple steps to be used efficiently. Unfortunately, many children with pulmonary diseases have problems with the correct delivery technique and do not gain therapeutic benefits from therapy that result in poor disease management and increased healthcare costs. Therefore, the purpose of this paper is to review the current knowledge on aerosol delivery devices used in children and guide clinicians on the optimum device- and interface-selection, delivery technique, and dosing in this patient population. Strategies on how to deliver aerosolized medications in crying and distressed children and how to educate parents on aerosol therapy and promote patient adherence to prescribed medications are also provided. Future directions of aerosol therapy in children should focus on these issues and implement policies and clinical practices that highlight the potential solutions to these problems.
    Language English
    Publishing date 2021-05-24
    Publishing country China
    Document type Journal Article ; Review
    ZDB-ID 2893931-1
    ISSN 2305-5847 ; 2305-5839
    ISSN (online) 2305-5847
    ISSN 2305-5839
    DOI 10.21037/atm-20-1682
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Use of aerosolised medications at home for COVID-19.

    Ari, Arzu

    The Lancet. Respiratory medicine

    2020  Volume 8, Issue 8, Page(s) 754–756

    MeSH term(s) Administration, Inhalation ; Adrenal Cortex Hormones/administration & dosage ; Aerosols ; Betacoronavirus ; COVID-19 ; Coronavirus Infections/drug therapy ; Coronavirus Infections/virology ; Home Care Services ; Humans ; Nebulizers and Vaporizers ; Pandemics ; Pneumonia, Viral/drug therapy ; Pneumonia, Viral/virology ; Respiratory System Agents/administration & dosage ; SARS-CoV-2
    Chemical Substances Adrenal Cortex Hormones ; Aerosols ; Respiratory System Agents
    Keywords covid19
    Language English
    Publishing date 2020-06-22
    Publishing country England
    Document type Journal Article
    ZDB-ID 2686754-0
    ISSN 2213-2619 ; 2213-2600
    ISSN (online) 2213-2619
    ISSN 2213-2600
    DOI 10.1016/S2213-2600(20)30270-8
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: PROMOTING SAFE AND EFFECTIVE USE OF AEROSOL DEVICES IN COVID-19:RISKS AND SUGGESTIONS FOR VIRAL TRANSMISSION.

    Ari, Arzu

    Expert opinion on drug delivery

    2020  Volume 17, Issue 11, Page(s) 1509–1513

    MeSH term(s) Aerosols ; Betacoronavirus ; COVID-19 ; Coronavirus Infections ; Humans ; Nebulizers and Vaporizers ; Pandemics ; Pneumonia, Viral ; SARS-CoV-2
    Chemical Substances Aerosols
    Keywords covid19
    Language English
    Publishing date 2020-09-10
    Publishing country England
    Document type Editorial ; Comment
    ZDB-ID 2167286-6
    ISSN 1744-7593 ; 1742-5247
    ISSN (online) 1744-7593
    ISSN 1742-5247
    DOI 10.1080/17425247.2020.1811225
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Practical strategies for a safe and effective delivery of aerosolized medications to patients with COVID-19.

    Ari, Arzu

    Respiratory medicine

    2020  Volume 167, Page(s) 105987

    Abstract: The COVID-19, the disease caused by a novel coronavirus and named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has spread rapidly across the globe. It has caused outbreaks of illness due to person-to-person transmission of the virus ... ...

    Abstract The COVID-19, the disease caused by a novel coronavirus and named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has spread rapidly across the globe. It has caused outbreaks of illness due to person-to-person transmission of the virus mainly via close contacts and droplets produced by an infected person's cough or sneeze. Exhaled droplets from infected patients with COVID-19 can be inhaled into the lungs and leads to respiratory illness such as pneumonia and acute respiratory distress syndrome. Although aerosol therapy is a mainstay procedure used to treat pulmonary diseases at home and healthcare settings, it has a potential for fugitive emissions during therapy due to the generation of aerosols and droplets as a source of respiratory pathogens. Delivering aerosolized medications to patients with COVID-19 can aggravate the spread of the novel coronavirus. This has been a real concern for caregivers and healthcare professionals who are susceptible to unintended inhalation of fugitive emissions during therapy. Due to a scarcity of information in this area of clinical practice, the purpose of this paper is to explain how to deliver aerosolized medications to mild-, sub-intensive, and intensive-care patients with COVID-19 and how to protect staff from exposure to exhaled droplets during aerosol therapy.
    MeSH term(s) Administration, Inhalation ; Aerosols/administration & dosage ; Betacoronavirus/isolation & purification ; COVID-19 ; Coronavirus Infections/drug therapy ; Coronavirus Infections/epidemiology ; Drug Delivery Systems/methods ; Drug Delivery Systems/standards ; Humans ; Infection Control/methods ; Nebulizers and Vaporizers ; Pandemics ; Pneumonia, Viral/drug therapy ; Pneumonia, Viral/epidemiology ; SARS-CoV-2
    Chemical Substances Aerosols
    Keywords covid19
    Language English
    Publishing date 2020-04-21
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 1003348-8
    ISSN 1532-3064 ; 0954-6111
    ISSN (online) 1532-3064
    ISSN 0954-6111
    DOI 10.1016/j.rmed.2020.105987
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Evaluating dry powder inhalers: From in vitro studies to mobile health technologies.

    Ari, Arzu / Alhamad, Bshayer Ramadan

    Respiratory medicine

    2023  Volume 215, Page(s) 107281

    Abstract: Dry powder inhalers (DPIs) are essential in treating patients with pulmonary diseases. Since DPIs were introduced in the 1960s, a remarkable improvement has been made in their technology, dose delivery, efficiency, reproducibility, stability, and ... ...

    Abstract Dry powder inhalers (DPIs) are essential in treating patients with pulmonary diseases. Since DPIs were introduced in the 1960s, a remarkable improvement has been made in their technology, dose delivery, efficiency, reproducibility, stability, and performance based on safety and efficacy. While there are many DPIs on the market and several more under development, it is vital to evaluate the performance of DPIs for effective aerosol drug delivery to patients with respiratory disorders. Their performance evaluation includes the physicochemical properties of the drug powder formulation, metering system, device design, dose preparation, inhalation technique, and patient-device integration. The purpose of this paper is to review current literature evaluating DPIs through in vitro studies, computational fluid models, and in vivo/clinical studies. We will also explain how mobile health applications are used to monitor and evaluate patients' adherence to prescribed medications.
    MeSH term(s) Humans ; Dry Powder Inhalers ; Reproducibility of Results ; Aerosols ; Drug Delivery Systems ; Powders ; Technology ; Administration, Inhalation
    Chemical Substances Aerosols ; Powders
    Language English
    Publishing date 2023-05-25
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 1003348-8
    ISSN 1532-3064 ; 0954-6111
    ISSN (online) 1532-3064
    ISSN 0954-6111
    DOI 10.1016/j.rmed.2023.107281
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Impact of Program Components on Perceived Organizational Support in Respiratory Care Education.

    Ari, Arzu / Wang, Tiankai / Hudgins, Abbey M

    Respiratory care

    2024  Volume 69, Issue 2, Page(s) 210–217

    Abstract: Background: Perceived organizational support has been linked to employee commitment and job satisfaction. Understanding the effects of perceived organizational support on employees allows leaders to improve employees' performance and the success of ... ...

    Abstract Background: Perceived organizational support has been linked to employee commitment and job satisfaction. Understanding the effects of perceived organizational support on employees allows leaders to improve employees' performance and the success of their organizations. The purpose of this study was to identify the perceived organizational support across different respiratory care education programs in the United States.
    Methods: All chairs and program directors of bachelor's of science and master's of science degree respiratory care education programs in the United States were surveyed (
    Results: A total of 67 respondents responded to the perceived organizational support survey; a 69% response rate. They were satisfied with their job and committed to their institutions. They also reported that faculty salaries were equitable relative to the national average, and their institutions encouraged teamwork among faculty. The respondents' titles, total years of administrative experience, students' scores on the national credentialing therapist multiple choice examination (TMC), and institutions that offer both bachelor's of science and master's of science degree programs had a direct relationship with perceived organizational support in respiratory care education programs. Age and sex were inversely related to perceived organizational support. A topic modeling analysis based on the respondents' opinions about perceived organizational support showed that the respondents frequently mentioned the words support, institution, budget, year, nursing, and experience. The respondents emphasized the importance of support, institution marketing, their years of experience, and the program budget. They also mentioned that nursing programs overshadowed respiratory care education programs at their institutions.
    Conclusions: Age, sex, job title, years of administrative experience, students' TMC scores, and the type of programs offered impacted perceived organizational support by respiratory care directors. Student-, program- and participant-related factors can be used to improve perceived organizational support in respiratory care education.
    MeSH term(s) Humans ; United States ; Students ; Faculty ; Surveys and Questionnaires ; Multivariate Analysis
    Language English
    Publishing date 2024-01-24
    Publishing country United States
    Document type Journal Article
    ZDB-ID 603252-7
    ISSN 1943-3654 ; 0098-9142 ; 0020-1324
    ISSN (online) 1943-3654
    ISSN 0098-9142 ; 0020-1324
    DOI 10.4187/respcare.11225
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Use of aerosolised medications at home for COVID-19

    Ari, Arzu

    The Lancet Respiratory Medicine

    2020  Volume 8, Issue 8, Page(s) 754–756

    Keywords Pulmonary and Respiratory Medicine ; covid19
    Language English
    Publisher Elsevier BV
    Publishing country us
    Document type Article ; Online
    ZDB-ID 2686754-0
    ISSN 2213-2619 ; 2213-2600
    ISSN (online) 2213-2619
    ISSN 2213-2600
    DOI 10.1016/s2213-2600(20)30270-8
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  8. Article ; Online: How to optimize aerosol drug delivery during noninvasive ventilation

    Arzu Ari

    Eurasian Journal of Pulmonology, Vol 21, Iss 1, Pp 1-

    What to use, how to use it, and why?

    2019  Volume 8

    Abstract: Much evidence supports the use of non-invasive ventilation (NIV) in patients who have acute and chronic respiratory failure and aerosolized medications are increasingly used in this patient population. Successful application of aerosol therapy during NIV ...

    Abstract Much evidence supports the use of non-invasive ventilation (NIV) in patients who have acute and chronic respiratory failure and aerosolized medications are increasingly used in this patient population. Successful application of aerosol therapy during NIV depends on the effectiveness of the drug deposition in the lungs. Previous evidence showed that many factors impact aerosol delivery to patients receiving NIV. Those factors include mode of ventilation, ventilator parameters, type of ventilator circuit, the position of the aerosol device, the location of leak port, type of exhalation valve, humidity, enhanced condensational growth, type of aerosol device, and interface as well as delivery technique. The purpose of this paper is to review the available evidence related to aerosol therapy during NIV and provide recommendations to optimize aerosol drug delivery to patients receiving NIV.
    Keywords Aerosols ; metered-dose inhalers ; nebulizers ; noninvasive ventilation and drugs ; Internal medicine ; RC31-1245
    Subject code 610
    Language English
    Publishing date 2019-01-01T00:00:00Z
    Publisher Wolters Kluwer Medknow Publications
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  9. Article ; Online: Effect of nebulizer type, delivery interface, and flow rate on aerosol drug delivery to spontaneously breathing pediatric and infant lung models.

    Ari, Arzu

    Pediatric pulmonology

    2019  Volume 54, Issue 11, Page(s) 1735–1741

    Abstract: Background: Different types of nebulizers, interfaces, and flow rates are used to deliver aerosolized medications to children. The purpose of this study was to determine the effect of nebulizer type, delivery interface, and flow rate on aerosol drug ... ...

    Abstract Background: Different types of nebulizers, interfaces, and flow rates are used to deliver aerosolized medications to children. The purpose of this study was to determine the effect of nebulizer type, delivery interface, and flow rate on aerosol drug delivery to spontaneously breathing pediatric and infant lung models.
    Methodology: A teaching mannequin was attached to a sinusoidal pump via a collecting filter at the bronchi to simulate a spontaneously breathing child (Vt: 250 mL, RR: 20 bpm and Ti: 1 second) and infant (Vt = 100 mL, RR = 30 bpm, Ti: 0.7 seconds). Albuterol sulfate was nebulized with jet (Misty Max 10; Cardinal Health) and mesh (Aerogen Solo; Aerogen) nebulizers using a low-flow nasal cannula (LFNC; Hudson), a high-flow nasal cannula (HFNC; Fisher & Paykel), face mask (FM; Hudson), and mouthpiece (MP; Cardinal Health). While all interfaces were used in the pediatric study, only LFNC, HFNC, and FM were tested in the infant study. The mesh nebulizer was tested at 2, 4, and 6 L/min with LFNC, 4 and 6 L/min with HFNC, and 6 L/min with FM and MP. The jet nebulizer was operated at 6 and 8 L/min with FM and 6 L/min with LFNC, HFNC, and MP (n = 5). The drug was eluted from the filter and analyzed by spectrophotometry. Factorial analysis of variance and post hoc comparisons were used for data analysis. P < .05 was considered statistically significant.
    Results: Delivery efficiency of mesh nebulizers is two to fourfold more than jet nebulizers used with HFNC, FM, and MP. No statistical difference was found between jet and mesh nebulizers used with LFNC in infants (P = .643) and pediatrics (P = .255). Aerosol delivery with MP was the best compared to other interfaces used in pediatrics (P < .05). As the second-best interface in aerosol drug delivery, the delivery efficiency of FM was greater than HFNC (P = .0001) and LFNC (P = .0001). Increasing flow rate with LFNC and HFNC decreased aerosol delivery with the mesh nebulizer in both infants and pediatrics.
    Conclusion: The type of nebulizer, delivery interface, and flow rate used in the treatment of children affect aerosol drug delivery.
    MeSH term(s) Administration, Inhalation ; Aerosols ; Albuterol/administration & dosage ; Bronchodilator Agents/administration & dosage ; Child ; Equipment Design ; Humans ; Infant ; Lung/metabolism ; Manikins ; Models, Biological ; Nebulizers and Vaporizers
    Chemical Substances Aerosols ; Bronchodilator Agents ; Albuterol (QF8SVZ843E)
    Language English
    Publishing date 2019-07-16
    Publishing country United States
    Document type Journal Article
    ZDB-ID 632784-9
    ISSN 1099-0496 ; 8755-6863
    ISSN (online) 1099-0496
    ISSN 8755-6863
    DOI 10.1002/ppul.24449
    Database MEDical Literature Analysis and Retrieval System OnLINE

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