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#32743 - 11/26/09 08:56 AM Re: Clinical utility of Exhaled Nitric Oxide [Re: nitric oxide]
nitric oxide Offline
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Registered: 07/07/09
Posts: 58

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#32787 - 12/02/09 12:55 PM Re: Clinical utility of Exhaled Nitric Oxide [Re: nitric oxide]
nitric oxide Offline
Member

Registered: 07/07/09
Posts: 58
Hey All,

Outcomes using exhaled nitric oxide measurements as an
adjunct to primary care asthma management

In a recent study, the feasibility of obtaining FENO
measurements in primary care has been confirmed.13 Here, we evaluated the utility of using FENO levels in an unselected population of patients with a diagnosis of asthma in a primary care setting. The aims were two-fold: firstly, to assess whether an open FENO-based protocol similar to, but less resourceintensive than those used in previous randomised controlled trials could be applied in the primary care setting, and what the impact on asthma outcomes would be; and secondly, to evaluate the practical issues associated with using and interpreting FENO levels in a nurse-led asthma clinic.

FENO was measured according to current guidelines using a
NIOX MINO electrochemical analyser or a NIOX
chemiluminescence analyser (both Aerocrine, Solna, Sweden).The latter was available at the Research Unit, 5km. from the Health Centre, but was used only when there was technical failure of the NIOX MINO. To validate FENO results, the sensors from the NIOX MINO device were tested against a calibrated standard, and where appropriate, a correction factor was applied to take account of signal drift.

Source: Primary Care Respiratory Journal


Edited by nitric oxide (12/02/09 01:02 PM)

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#32804 - 12/03/09 11:17 AM Re: Clinical utility of Exhaled Nitric Oxide [Re: nitric oxide]
Marcus Offline
Member

Registered: 07/28/09
Posts: 50
Hey Nitric,

Your recent post was really interesting. It seems that the NIOX MINO Analyser had frequent technical failures and significant sensor inaccuracy issues causing the researcher to apply a manual correction factor and/or rely on the expensive NIOX lab instrument as a backup.

Do we have any other devices to measure FENO?

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#32843 - 12/07/09 08:10 AM Re: Clinical utility of Exhaled Nitric Oxide [Re: Marcus]
nitric oxide Offline
Member

Registered: 07/07/09
Posts: 58
Hey Marcus,

I researched on the same and came across a device called Insight eNo system which helps in asthma care by detecting trace amounts of nitric oxide molecules in a single human breath utilizing a proprietary technology.

Hope you find the information useful.

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#32869 - 12/09/09 12:12 PM Re: Clinical utility of Exhaled Nitric Oxide [Re: nitric oxide]
nitric oxide Offline
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Registered: 07/07/09
Posts: 58

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#32877 - 12/10/09 10:17 AM Re: Clinical utility of Exhaled Nitric Oxide [Re: redewenur]
nitric oxide Offline
Member

Registered: 07/07/09
Posts: 58
Originally Posted By: redewenur
"Since 1991, however, measurement of in vivo NO production in humans have been proven to be technically feasible by means of ex vivo manoeuvres, i.e. by sampling the exhaled breath and analysing it for NO content using a chemiluminescent NO analyser"

http://www.erj.ersjournals.com/cgi/reprint/12/5/1005.pdf

Chemiluminescence is what makes the glow worm glow, but in that case it's called bioluminescence.




Hey redewenur,

Referring to your previous post dated 14th July, chemiluminescent analyzer has been used to measure exhaled nitric oxide. Recently I have come across an excerpt from Primary Care Respiratory Journal (2009), which states that FENO was measured according to current guidelines using a NIOX MINO electrochemical analyzer or a NIOX chemiluminescence analyzer (both Aerocrine, Solna, Sweden). The latter was available at the Research Unit, 5km. from the Health Centre, but was used only when there was technical failure of the NIOX MINO. It seems that the NIOX MINO Analyzer had frequent technical failures and significant sensor inaccuracy issues causing the researcher to apply a manual correction factor and/or rely on the expensive NIOX lab instrument as a backup.

Doesn't these devices sounds cumbersome to use it? Any information about it.


Edited by nitric oxide (12/10/09 10:20 AM)

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#32906 - 12/14/09 09:55 AM Re: Clinical utility of Exhaled Nitric Oxide [Re: Amaranth Rose II]
Marcus Offline
Member

Registered: 07/28/09
Posts: 50
Hey Amarnath,

Recently nitric oxide has posted information about the technical failure in the eNO monitoring device NIOX MINO. He has also posted excerpt from the Medical Journal Primary Care Respiratory Journal (2009)regarding the same.

Is it true? Any comments on this. It will be helpful for me since I'm studying the effects of asthma on children.

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#32907 - 12/14/09 10:05 AM Re: Clinical utility of Exhaled Nitric Oxide [Re: Marcus]
Amaranth Rose II Offline

Superstar

Registered: 12/16/06
Posts: 962
Loc: Southeast Nebraska, USA
I'm not an expert on asthma. And I wouldn't take the word on anyone on the net unless I personally knew them well. I suggest you contact the authors of the study in question and get the word right straight from the horse's mouth, so to speak.
_________________________
If you don't care for reality, just wait a while; another will be along shortly. --A Rose


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#32918 - 12/15/09 08:33 AM Re: Clinical utility of Exhaled Nitric Oxide [Re: Amaranth Rose II]
Marcus Offline
Member

Registered: 07/28/09
Posts: 50
Thanks Amarnath.


Edited by Marcus (12/15/09 09:04 AM)

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#32945 - 12/16/09 01:11 PM Re: Clinical utility of Exhaled Nitric Oxide [Re: Marcus]
nitric oxide Offline
Member

Registered: 07/07/09
Posts: 58
Hey All,

Came across this link on web.Just take a look at it.

http://www.healthcentral.com/asthma/c/907259/97668/exhaled-treatment

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#33003 - 12/18/09 10:12 AM Re: Clinical utility of Exhaled Nitric Oxide [Re: nitric oxide]
nitric oxide Offline
Member

Registered: 07/07/09
Posts: 58
Hey Marcus,

Came across this link on web. It has explanations on the Outcomes of using exhaled nitric oxide measurements and also about the technical failure of the eNO monitoring device NIOX MINO. Take a look at it.

http://www.thepcrj.org/journ/view_article.php?article_id=667

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#33063 - 12/22/09 11:43 AM Re: Clinical utility of Exhaled Nitric Oxide [Re: nitric oxide]
Marcus Offline
Member

Registered: 07/28/09
Posts: 50
Hey All,

Came across this link on web. Just take a look at it.


http://bx.businessweek.com/health-20/out...32218ad12db87f/

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#33077 - 12/24/09 12:04 PM Re: Clinical utility of Exhaled Nitric Oxide [Re: Marcus]
Zephir Offline
Superstar

Registered: 07/01/08
Posts: 498

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#33110 - 12/28/09 11:06 AM Re: Clinical utility of Exhaled Nitric Oxide [Re: Zephir]
nitric oxide Offline
Member

Registered: 07/07/09
Posts: 58
Hi Zephir,

Thanks for the link.It was very informative and helpful.
Are you doing any study or research on nitric oxide?


Edited by nitric oxide (12/28/09 11:09 AM)

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#33113 - 12/29/09 11:23 AM Re: Clinical utility of Exhaled Nitric Oxide [Re: nitric oxide]
Marcus Offline
Member

Registered: 07/28/09
Posts: 50

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#33134 - 12/31/09 05:47 AM Re: Clinical utility of Exhaled Nitric Oxide [Re: nitric oxide]
mamuntarekul
Unregistered


Exhaled nitric oxide has been studied since 1991 and several studies have shown it to be powerful tool in management of asthma. The American Thoracic Society (ATS) and European Respiratory Society (ERS) have jointly published guidelines for the standardized measurement of eNO.1 Recent asthma guidelines (NHLBI) indicate the positive role of inflammation measurements, of which eNO is the most clinically viable.

The clinical utility of measuring eNO include:

1. Selecting and Titrating Medication

Exhaled nitric oxide has been shown to predict the likelihood of a steroid response more consistently than spirometry or bronchodilator response.2 Use of eNO to direct inhaled steroid therapy was shown to reduce dosage while maintaining asthma control.3

2. Monitoring Compliance

An elevated eNO is suggestive of inadequate anti-inflammatory therapy either from an insufficient dose or due to patient non-compliance.4 Reduction of exhaled NO levels after the start of therapy can reassure a physician that the treatment regime is being followed, and can demonstrate to the patient the physiological change that the therapy could achieve if properly followed.5

3. Predicting Exacerbation and Loss of Control

The ability to predict a worsening of symptoms is the most exciting clinical application of eNO measurement. Exhaled nitric oxide is a better predictor over FEV1 of both asthma control, loss of control and worsening of asthma.6 Elevated eNO measured at a clinic visit indicates increased risk of an exacerbation occurring within the next two weeks.7 Pediatric studies have found that an eNO level above 47 ppb predicts loss of control when inhaled steroids are reduced or withdrawn.8 A rise in eNO among patients who cease steroid therapy is predictive of an upcoming relapse.9 A home monitoring study showed that frequent eNO measurements may have predictive power for impending instability of asthma.





definition stakeholder [u]- newborn baby doll[/u]


Edited by mamuntarekul (12/31/09 05:49 AM)

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#33137 - 12/31/09 09:19 AM Re: Clinical utility of Exhaled Nitric Oxide [Re: ]
nitric oxide Offline
Member

Registered: 07/07/09
Posts: 58
Hey mamuntarekul,

This post has already been posted by me. Can you share some useful information about nitric oxide?

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#33138 - 12/31/09 09:21 AM Re: Clinical utility of Exhaled Nitric Oxide [Re: nitric oxide]
nitric oxide Offline
Member

Registered: 07/07/09
Posts: 58
Hey All,

Caffeine decreases exhaled nitric oxide

http://thorax.bmj.com/content/57/4/361.abstract

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#33167 - 01/05/10 08:50 AM Re: Clinical utility of Exhaled Nitric Oxide [Re: nitric oxide]
Marcus Offline
Member

Registered: 07/28/09
Posts: 50

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#33174 - 01/06/10 10:19 AM Re: Clinical utility of Exhaled Nitric Oxide [Re: Marcus]
nitric oxide Offline
Member

Registered: 07/07/09
Posts: 58
Hey Marcus,

Thanks for the link. Found it interesting. Came across this link on web. Just take a look at it.

http://olby.net/2010/01/clinical-utility...nt-and-control/

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