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European Review For Medical and... 2015Cardioceuticals are nutritional supplements that contain all the essential nutrients including vitamins, minerals, omega-3-fatty acids and other antioxidants like... (Review)
Review
Cardioceuticals are nutritional supplements that contain all the essential nutrients including vitamins, minerals, omega-3-fatty acids and other antioxidants like a-lipoic acid and coenzyme Q10 in the right proportion that provide all round protection to the heart by reducing the most common risks associated with the cardiovascular disease including high low-density lipoprotein cholesterol and triglyceride levels and factors that contribute to coagulation of blood. Omega-3 fatty acids have been shown to significantly reduce the risk for sudden death caused by cardiac arrhythmias and all-cause mortality in patients with known coronary heart disease. Omega-3 fatty acids are also used to treat hyperlipidemia and hypertension. There are no significant drug interactions with omega-3 fatty acids. The American Heart Association recommends consumption of two servings of fish per week for persons with no history of coronary heart disease and at least one serving of fish daily for those with known coronary heart disease. Approximately 1 g/day of eicosapentaenoic acid plus docosahexaenoic acid is recommended for cardio protection. Higher dosages of omega-3 fatty acids are required to reduce elevated triglyceride levels (2-4 g/day). Modest decreases in blood pressure occur with significantly higher dosages of omega-3 fatty acids.
Topics: American Heart Association; Animals; Cardiovascular Diseases; Dietary Supplements; Docosahexaenoic Acids; Eicosapentaenoic Acid; Fatty Acids, Omega-3; Humans; Lipoproteins, LDL; Male; Randomized Controlled Trials as Topic; United States
PubMed: 25720716
DOI: No ID Found -
American Family Physician May 2019Drug interactions are common in the primary care setting and are usually predictable. Identifying the most important and clinically relevant drug interactions in primary... (Review)
Review
Drug interactions are common in the primary care setting and are usually predictable. Identifying the most important and clinically relevant drug interactions in primary care is essential to patient safety. Strategies for reducing the risk of drug-drug interactions include minimizing the number of drugs prescribed, re-evaluating therapy on a regular basis, considering nonpharmacologic options, monitoring for signs and symptoms of toxicity or effectiveness, adjusting dosages of medications when indicated, and adjusting administration times. Inhibition or induction of cytochrome P450 drug metabolizing isoenzymes is the most common mechanism by which clinically important drug interactions occur. The antimicrobials most likely to affect the international normalized ratio significantly in patients receiving warfarin are trimethoprim/sulfamethoxazole, metronidazole, and fluconazole. An empiric warfarin dosage reduction of 30% to 50% upon initiation of amiodarone therapy is recommended. In patients receiving amiodarone, limit dosages of simvastatin to 20 mg per day and lovastatin to 40 mg per day. Beta blockers should be tapered and discontinued several days before clonidine withdrawal to reduce the risk of rebound hypertension. Spironolactone dosages should be limited to 25 mg daily when coadministered with potassium supplements. Avoid prescribing opioid cough medicines for patients receiving benzodiazepines or other central nervous system depressants, including alcohol. Physicians should consider consultation with a clinical pharmacist when clinical circumstances require the use of drugs with interaction potential.
Topics: Drug Interactions; Drug Monitoring; Humans; Polypharmacy; Primary Health Care; Risk Factors
PubMed: 31038898
DOI: No ID Found -
Clinical Medicine (London, England) Jun 2016
Review
Topics: Humans; Acne Vulgaris; Dermatologic Agents; Isotretinoin; Recurrence; Treatment Outcome
PubMed: 27252338
DOI: 10.7861/clinmedicine.16-3-s34 -
Journal of the American Chemical Society Apr 2017The divergent synthesis of two series of borazino-doped polyphenylenes, in which one or more aryl units are replaced by borazine rings, is reported for the first time,...
The divergent synthesis of two series of borazino-doped polyphenylenes, in which one or more aryl units are replaced by borazine rings, is reported for the first time, taking advantage of the decarbonylative [4 + 2] Diels-Alder cycloaddition reaction between ethynyl and tetraphenylcyclopentadienone derivatives. Because of the possibility of functionalizing the borazine core with different groups on the aryl substituents at the N and B atoms of the borazino core, we have prepared borazino-doped polyphenylenes featuring different doping dosages and orientations. To achieve this, two molecular modules were prepared: a core and a branching unit. Depending on the chemical natures of the central aromatic module and the reactive group, each covalent combination of the modules yields one exclusive doping pattern. By means of this approach, three- and hexa-branched hybrid polyphenylenes featuring controlled orientations and dosages of the doping BN rings have been prepared. Detailed photophysical investigations showed that as the doping dosage is increased, the strong luminescent signal is progressively reduced. This suggests that the presence of the BN rings engages additional deactivation pathways, possibly involving excited states with an increasing charge-separated character that are restricted in the full-carbon analogues. Notably, a strong effect of the orientational doping on the fluorescence quantum yield was observed for those hybrid polyphenylene structures featuring low doping dosages. Finally, we showed that Cu-catalyzed 1,3-dipolar cycloaddition is also chemically compatible with the BN core, further endorsing the inorganic benzene as a versatile aromatic scaffold for engineering of molecular materials with tailored and exploitable optoelectronic properties.
PubMed: 28276248
DOI: 10.1021/jacs.7b01477 -
Endocrinology and Metabolism Clinics of... Mar 2019This article presents an overview of the use of radioactive iodine (131-I) in the treatment of patients with differentiated thyroid cancer. Topics reviewed include... (Review)
Review
This article presents an overview of the use of radioactive iodine (131-I) in the treatment of patients with differentiated thyroid cancer. Topics reviewed include definitions; staging; the 2 principal methods for selection of 131-I dosage; the indications for ablation, adjuvant treatment, and treatment; the recommendations for the use of 131-I contained in the guidelines of the American Thyroid Association and the Society of Nuclear Medicine and Molecular Imaging; the dosage recommendations and selection of dosage approach for 131-I by these organizations; the use of recombinant human thyrotropin for radioiodine ablation, adjuvant therapy, or treatment; and the MedStar Washington Hospital Center approach.
Topics: Humans; Iodine Radioisotopes; Thyroid Neoplasms
PubMed: 30717901
DOI: 10.1016/j.ecl.2018.11.005 -
Herz Sep 2016The effects of alcohol on induction of arrhythmias is dose-dependent, independent of preexisting cardiovascular diseases or heart failure and can affect otherwise... (Review)
Review
The effects of alcohol on induction of arrhythmias is dose-dependent, independent of preexisting cardiovascular diseases or heart failure and can affect otherwise healthy subjects. While the probability of atrial fibrillation increases with the alcohol dosage, events of sudden cardiac death are less frequent with low and moderate consumption but occur more often in heavy drinkers with alcoholic cardiomyopathy. Men are first affected at higher dosages of alcohol but women can suffer from arrhythmias at lower dosages. Thromboembolisms and ischemic stroke can occur less often at lower dosages of alcohol; however, hemorrhagic stroke and subarachnoid hemorrhage are increased with higher alcohol dosages. Recognizable protective mechanisms of alcohol with respect to cardiovascular diseases only occur with lower amounts of alcohol of less than 10 g per day. Underlying mechanisms explain these controversial effects. Specific therapeutic options for alcohol-related arrhythmias apart from abstinence from alcohol consumption are not known.
Topics: Alcohol Drinking; Arrhythmias, Cardiac; Cardiomyopathy, Alcoholic; Causality; Comorbidity; Dose-Response Relationship, Drug; Ethanol; Humans; Incidence; Risk Factors; Survival Rate
PubMed: 27582366
DOI: 10.1007/s00059-016-4463-z -
The Journal of Antimicrobial... Nov 2023The new definitions of antimicrobial susceptibility categories proposed by EUCAST in 2020 require the definition of standard and high dosages of antibiotic. For...
BACKGROUND
The new definitions of antimicrobial susceptibility categories proposed by EUCAST in 2020 require the definition of standard and high dosages of antibiotic. For injectable β-lactams, standard and high dosages have been proposed for short-infusion regimens only.
OBJECTIVES
To evaluate dosages for β-lactams administered by prolonged infusion (PI) and continuous infusion (CI).
METHODS
Monte Carlo simulations were performed for seven injectable β-lactams: aztreonam, cefepime, cefotaxime, cefoxitin, ceftazidime, piperacillin and temocillin. Various dosage regimens based on short infusion, PI or CI were simulated in virtual patients. Pharmacokinetic (PK) profiles and PTAs were obtained based on reference population PK models, as well as PK/pharmacodynamic targets and MIC breakpoints proposed by EUCAST. Alternative dosage regimens associated with PTA values similar to those of recommended dosages up to the breakpoints were considered acceptable.
RESULTS
Adequate PTAs were confirmed for most EUCAST short-infusion dosage regimens. A total of 9 standard and 14 high dosages based on PI (3 to 4 h) or CI were identified as alternatives. For cefepime and aztreonam, only PI and CI regimens could achieve acceptable PTAs for infections caused by Pseudomonas spp.: 2 g q8h as PI of 4 h or 6 g/24 h CI for cefepime; 2 g q6h as PI of 3 h or 6 g/24 h CI for aztreonam.
CONCLUSIONS
These alternative standard and high dosage regimens are expected to provide antibiotic exposure compatible with new EUCAST definitions of susceptibility categories and associated MIC breakpoints. However, further clinical evaluation is necessary.
Topics: Humans; Cefepime; Aztreonam; Anti-Bacterial Agents; Ceftazidime; Piperacillin; Microbial Sensitivity Tests; Monte Carlo Method
PubMed: 37796958
DOI: 10.1093/jac/dkad300 -
Nature Reviews. Genetics Jan 2016Differentiated sex chromosomes in mammals and other vertebrates evolved independently but in strikingly similar ways. Vertebrates with differentiated sex chromosomes... (Review)
Review
Differentiated sex chromosomes in mammals and other vertebrates evolved independently but in strikingly similar ways. Vertebrates with differentiated sex chromosomes share the problems of the unequal expression of the genes borne on sex chromosomes, both between the sexes and with respect to autosomes. Dosage compensation of genes on sex chromosomes is surprisingly variable - and can even be absent - in different vertebrate groups. Systems that compensate for different gene dosages include a wide range of global, regional and gene-by-gene processes that differ in their extent and their molecular mechanisms. However, many elements of these control systems are similar across distant phylogenetic divisions and show parallels to other gene silencing systems. These dosage systems cannot be identical by descent but were probably constructed from elements of ancient silencing mechanisms that are ubiquitous among vertebrates and shared throughout eukaryotes.
Topics: Animals; Dosage Compensation, Genetic; Evolution, Molecular; Gene Expression; Humans; Models, Genetic; Sex Chromosomes
PubMed: 26616198
DOI: 10.1038/nrg.2015.2 -
European Archives of... Mar 2023To investigate the dosages of swallowing exercises reported in intervention studies on post-stroke dysphagia through systematic review. (Review)
Review
PURPOSE
To investigate the dosages of swallowing exercises reported in intervention studies on post-stroke dysphagia through systematic review.
METHODS
Five electronic databases were searched from inception until February 2022 with reference tracing of included studies. Studies were included, where adults with post-stroke dysphagia received rehabilitative, behavioural swallowing exercises, pre/post outcomes were reported, and intervention dosage was described in detail, including frequency, intensity, time, and type of exercise. Two reviewers independently screened studies and rated quality using ASHA Levels of Evidence tool. Data was tabulated and narratively described.
RESULTS
54 studies were included with a total 1501 participants. Studies included 28 randomised controlled trials, 8 non-randomised controlled trials, 12 pre/post studies, 3 retrospective case controls and 3 case studies. Results showed inconsistent reporting of intervention dosage, with intensity the least consistently reported dosage component. While swallowing intervention was most commonly provided five times per week for four weeks, there was a wide breadth of type, frequency, intensity and duration of swallowing exercises reported. Dosage under-reporting and variation was particularly observed in "standard care" co-interventions or control groups. Study strengths included following PRISMA guidelines, providing a comprehensive review of swallowing exercise methodology and dosages, and including non-English studies. The limitation was lack of meta-analysis due to the heterogeneity of included studies.
CONCLUSIONS
Dosages of swallowing exercises are inconsistently reported and vary significantly in post-stroke dysphagia studies. Results indicate the need for consistent and comprehensive dosage reporting in dysphagia studies, and for further research into evidence-based principles to optimise swallowing exercise dosages.
SYSTEMATIC REVIEW REGISTRATION NUMBER
131294.
Topics: Adult; Humans; Deglutition Disorders; Deglutition; Stroke Rehabilitation; Retrospective Studies; Stroke
PubMed: 36471047
DOI: 10.1007/s00405-022-07735-7 -
Indian Journal of Pediatrics May 2019Determining the optimal dosages of isoniazid, rifampicin, pyrazinamide and ethambutol in children is necessary to obtain therapeutic serum concentrations of these drugs.... (Review)
Review
Determining the optimal dosages of isoniazid, rifampicin, pyrazinamide and ethambutol in children is necessary to obtain therapeutic serum concentrations of these drugs. Revised dosages have improved the exposure of 1st line anti-tubercular drugs to some extent; there is still scope for modification of the dosages to achieve exposures which can lead to favourable outcome of the disease. High dose of rifampicin is being investigated in clinical trials in adults with some benefit; studies are required in children. Inter-individual pharmacokinetic variability and the effect of age, nutritional status, Human immunodeficiency virus (HIV) infection, acetylator genotype may need to be accounted for in striving for the dosages best suited for an individual.
Topics: Age Factors; Antitubercular Agents; Child; Drug Overdose; Ethambutol; Food; Genotype; HIV Infections; Humans; Isoniazid; Malnutrition; Nutritional Status; Polymorphism, Genetic; Pyrazinamide; Rifampin; Treatment Outcome; Tuberculosis
PubMed: 30915644
DOI: 10.1007/s12098-019-02911-w