Browsing by Author "Mohsen, Marwa"

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    Effects of Fill Volume and Humidification on Aerosol Delivery During Single-Limb Noninvasive Ventilation
    (DAEDALUS ENTERPRISES INC., 2018) Saeed, Haitham; Mohsen, Marwa; Eldin, Abeer Salah; Elberry, Ahmed A.; Hussein, Raghda R. S.; Rabea, Hoda; Abdelrahim, Mohamed E. A.; https://t.ly/2rA2d
    BACKGROUND: The aim of this work was to determine the effect of nil volume and humidification change on aerosol delivery during single-limb noninvasive ventilation (NIV). METHODS: Four groups were recruited, each consisting of 12 subjects (6 females) with COPD receiving NIV. Groups 1 and 3 received inhaled salbutamol with a vibrating mesh nebulizer, and Groups 2 and 4 received inhaled salbutamol with a jet nebulizer. The in vivo study was carried out on days 1 and 3. In groups 1 and 2, 2 fill-volumes were delivered to each subject; 1 mL 5,000 mu g/mL salbutamol respirable solution used as it is or diluted to a total of 2 mL using normal saline. In groups 3 and 4, 1 mL 5,000 mu g/mL salbutamol respirable solution diluted to 2 mL total volume using normal saline was delivered to each subject with and without humidification. Unchanged salbutamol in urine at 30 min (USAL0.5) and in pooled urine at 24 h (USAL24) was determined. On day 2, the ex vivo study was carried out on subjects using the same experimental setting with a filter placed proximal to their face mask for collection of total inhaled dose of salbutamol (aerosol emitted). RESULTS: The vibrating mesh nebulizer delivered higher USAL0.5, USAL24, and aerosol emitted compared to the jet nebulizer at all fill volumes and humidification conditions (P < .001). Increasing till volume from 1 mL to 2 mL resulted in a significant increase in USAL0.5, USAL24, and aerosol emitted from the jet nebulizer (P < .05) with an insignificant effect on the vibrating mesh nebulizer. A 2-mL fill volume with the jet nebulizer delivered USAL24 and aerosol emitted comparable to those of 1 mL with the vibrating mesh nebulizer with significantly longer nebulization times (P < .001). Humidification had an insignificant effect on aerosol delivery. CONCLUSIONS: Increasing the fill volume of a jet nebulizer is essential to increase the amount of inhaled medication reaching a subject. In contrast, there is no need to increase rill volumes when using a vibrating mesh nebulizer. There is no need to switch off the humidifier while delivering aerosol through a single-limb NIV circuit.
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    A New Clinical Utility for Tubular Markers to Identify Kidney Responders to Saxagliptin Treatment in Adults With Diabetic Nephropathy
    (Elsevier, 2022-04) Mohsen, Marwa; .Elberry, Ahmed A; Rabea, Alaa Mohamed; Khalil, Doaa Mahmoud; Abdelrahim, Mohamed E.A; Hussein, Raghda R. S
    Objectives: In recent clinical studies, saxagliptin exhibited nephroprotective potential by lowering albuminuria. In this study, we aimed to determine whether these kidney effects of saxagliptin were mediated by changes in markers of kidney tubular damage, including urinary neutrophil gelatinase-associated protein (uNGAL) and liver-type fatty acidebinding protein (uL-FABP).& nbsp;Methods: Our study included 80 patients with type 2 diabetes, hypertension and mild to moderate diabetic kidney disease (DKD) with prevalent albuminuria. Patients were either randomly assigned to saxagliptin as add-on therapy or remained unchanged on their stable antidiabetic therapy as a control arm.& nbsp;Results: Saxagliptin significantly reduced uNGAL with a median change of-25.4% (interquartile range [IQR],-35.6% to-12.2%) compared with the control group (median change,-0.91%; IQR,-12% to 11.88%; p < 0.001) after 3 months. Similarly, patients given saxagliptin had a highly significant reduction in uL-FABP (median change,-24.4%; IQR,-30.5% to-15.1%) compared with controls (median change,-3.8%; IQR-10% to 12.5%; p < 0.001). Median estimated glomerular filtration rate (eGFR) values after 3 months in the saxagliptin arm were significantly higher (76.5 mL/min per 1.73 m(2); IQR, 70 to 92.75 mL/min per 1.73 m(2)) in the low-risk uNGAL group compared with controls (59.8 mL/min per 1.73 m(2); IQR, 51 to 76.2 mL/min per 1.73 m(2); p=0.002). Also, higher-although not significantly-posttreatment eGFR levels were observed in patients with low risk of uL-FABP (73 mL/min per 1.73 m(2); IQR, 58 to 91.3 mL/min per 1.73 m(2)) compared with controls (57.3 mL/min per 1.73 m(2); IQR, 49.5 to 72.6 mL/min per 1.73 m(2); p=0.06). No significant increase was observed in high-risk patients for either marker when compared with controls.& nbsp;Conclusions: The albuminuria-lowering effect of saxagliptin may be due to inhibition of kidney tubular damage. Use of tubular markers may be a promising approach to identifying kidney responders to gliptins.(C) 2021 Canadian Diabetes Association