Spacer inhalation technique and deposition of extrafine aerosol in asthmatic children.

The aim of the present study was to measure airway, oropharyngeal and gastrointestinal deposition of (99m)Tc-labelled hydrofluoroalkane-beclomethasone dipropionate after inhalation via a pressurised metered-dose inhaler and spacer (Aerochamber Plus) in asthmatic children. A group of 24 children (aged 5-17 yrs) with mild asthma inhaled the labelled drug. A total of 12 children took five tidal breaths after each actuation (tidal group). The other 12 children used a slow maximal inhalation followed by a 5 - 10-s breath-hold (breath-hold group). Simultaneous anterior and posterior planar gamma-scintigraphic scans (120-s acquisition) were recorded. For the tidal group, mean+/-sd lung deposition (% ex-actuator, attenuation corrected) was 35.4+/-18.3, 47.5+/-13.0 and 54.9+/-11.2 in patients aged 5-7 (n = 4), 8-10 (n = 4) and 11-17 yrs (n = 4), respectively. Oropharyngeal and gastrointestinal deposition was 24.0+/-10.5, 10.3+/-4.4 and 10.1+/-6.2. With the breath-hold technique, lung deposition was 58.1+/-6.7, 56.6+/-5.2 and 58.4+/-9.2. Oropharyngeal and gastrointestinal deposition was 12.9+/-3.2, 20.1+/-9.5 and 20.8+/-8.8. Inhalation of the extrafine formulation with the breath-hold technique showed significantly improved lung deposition compared with tidal breathing across all ages. Oropharyngeal and gastrointestinal deposition was markedly decreased, regardless of which inhalation technique was applied, compared with a previous paediatric study using the same formulation delivered via a breath-actuated metered-dose inhaler.

Readability levels of patient education material on the World Wide Web.

BACKGROUND: Patient education is an important component of family practice. Pamphlets, verbal instructions, and physicians' self-created materials have been the most common resources for patient education. Today, however, the popularity of the World Wide Web (Web) as a ready source of educational materials is increasing. The reading skills required by a patient to understand that information has not been determined. The objective of our study was to assess the readability of medical information on the Web that is specifically intended for patients. METHODS: An investigator downloaded 50 sequential samples of patient education material from the Web. This information was then evaluated for readability using the Flesch reading score and Flesch-Kinkaid reading level. RESULTS: On average, the patient information from the Web in our sample is written at a 10th grade, 2nd month reading level. Previous studies have shown that this readability level is not comprehensible to the majority of patients. CONCLUSIONS: Much of the medical information targeted for the general public on the Web is written at a reading level higher than is easily understood by much of the patient population.