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Elderly persons (≥75 years) on aspirin-based antiplatelet therapy without routine proton-pump inhibitor (PPI) use have a higher long-term risk of major bleeding, in particular upper gastrointestinal (GI) bleeding which is often more disabling or fatal than in younger persons, according to the OXVASC* study.
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Upcoming expiratory pressure device may help reduce infection in cystic fibrosis

Roshini Claire Anthony
6 months ago

An upcoming disposable positive expiratory pressure (PEP) device for individuals with cystic fibrosis may lessen the occurrence of infections and subsequently, reduce antibiotic use and medical consultations, said researchers from the University of Limerick, Ireland.

“[The new PEP device, SoloPEP] provides the same therapeutic effect as existing devices but eliminates the risk of infection because it is not used repeatedly over a long period of time and does not require cleaning,” said Professor Colum Dunne, Foundation Chair and Director of Research at the University of Limerick’s Graduate Entry Medical School, and co-principal investigator of the device.

Patients requiring PEP devices are taught how to use and clean the devices, and if proper cleaning instructions are not followed, the devices can become contaminated with bacteria, said Dunne.

“Noncompliance with cleaning happens as patients do not see it as necessary, they forget, or they simply do not have the time. The net effect is that patients who have presented with infections can be treated successfully with antibiotics, only to have the same infection recur as they breathe in the same problematic bacteria from their own poorly cleaned devices,” he said, noting that the new device will eliminate this risk.

According to Dunne, SoloPEP is an innovation involving a novel engineering mechanism that as per currently available PEP devices, “involves the patient exhaling against a fixed-orifice resistor or a threshold resistor, generating preset pressures”, an action which helps dislodge trapped mucus secretions and moves them towards larger airways to enable expulsion. [Hippokratia 2008;12:211-220] However, the SoloPEP device is smaller and due to its disposability, does not require cleaning, thus improving convenience, said Dunne.

Behind the development of the product is a multidisciplinary team including microbiologists, medical device engineers, and respiratory physicians who treat both adult and paediatric respiratory illness. Creation of this device was a multistep process which involved auditing bacterial outbreaks and detecting previously undetected bacteria in the nasal sinuses, said Dunne. The researchers also observed patients’ practices and discussed with them the challenges faced in using PEP devices.  

“This is a prime example of where patients and their carers provided the stimulus for innovation,” said Dunne. Products such as ours will help reduce antimicrobial use, reduce hospital stays, reduce numbers presenting at GPs and emergency rooms, and improve at-risk patients’ quality of life overall,” said Dunne.

The University of Limerick has recently received funding to develop the device which is expected to be on the market within 2 years and will be suitable for both adults and children.

From L-R: Prof Deirdre McGrath (respiratory consultant), Prof Colum Dunne (director of research), and Dr Leonard O' Sullivan (senior lecturer, design ergonomics)

From L-R: Prof Deirdre McGrath (respiratory consultant), Prof Colum Dunne (director of research), and Dr Leonard O' Sullivan (senior lecturer, design ergonomics)

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Most Read Articles
2 years ago
A study on participants from the Women's Health Initiative showed the dissociation between calcium/vitamin D supplementation and reduction in menopausal symptoms.
one year ago
Dr Lesley Braun, Blackmores Institute Director, is interviewed and answers some critical questions on complementary medicine, its evolution, its benefits and its present and future roles alongside mainstream medicine.
Pearl Toh, 12 days ago
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Pearl Toh, 2 months ago
Celecoxib is preferred over naproxen when added to proton-pump inhibitor (PPI) for preventing recurrent upper gastrointestinal (GI) bleeding in patients at high risk of both GI and cardiovascular (CV) events, who require concomitant aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs), according to the CONCERN* study.