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International Journal of Radiation... Jul 1985Following the recommendations of the European Curietherapy Group, the three-dimensional dose distribution corresponding to various milligram-hour volumes has been...
Following the recommendations of the European Curietherapy Group, the three-dimensional dose distribution corresponding to various milligram-hour volumes has been analyzed according to its length, width, and height dimensions. Thus, it is possible to state the dimensions of a number of isodose surfaces for a dose prescription given in milligram-hours. Problems associated with the exact placement of the three-dimensional dose distribution in relation to the patient's anatomy are discussed.
Topics: Brachytherapy; Female; Humans; Radiotherapy Dosage; Radium; Time Factors; Uterine Cervical Neoplasms
PubMed: 4008296
DOI: 10.1016/0360-3016(85)90258-5 -
American Journal of Health-system... Nov 2011Vancomycin dosages in overweight and obese children were evaluated.
PURPOSE
Vancomycin dosages in overweight and obese children were evaluated.
METHODS
This retrospective study evaluated data for children who were age 2-17 years, received i.v. vancomycin, and were admitted to a children's hospital from September 1, 2007, through October 31, 2009. Patients were then stratified into two groups: normal-weight patients and overweight or obese patients. The primary objective was to compare the number of vancomycin regimens between groups with a trough concentration of 5-15 μg/mL. Secondary objectives included a comparison of dosage changes and toxicities. Multivariate, conditional logistic regression was performed to assess the relationship between attaining optimal vancomycin concentrations (5-15 μg/mL) and independent variables.
RESULTS
Data were collected for 232 courses of vancomycin, representing 187 patients. The mean ± S.D. initial dose for the normal-weight and overweight or obese groups differed significantly (461.3 ± 303.1 mg and 658.4 ± 389.6 mg, respectively; p < 0.01); the milligram-per-kilogram initial vancomycin dose did not. The multivariate analysis revealed that every-eight-hour regimens had increased odds of achieving therapeutic concentrations (p < 0.001), while obese children had decreased odds of achieving therapeutic concentrations (p = 0.037).
CONCLUSION
A study of prescribing behavior in one hospital revealed no significant difference in the size of vancomycin doses (in milligrams per kilogram) given to normal-weight children compared with overweight or obese children. Regimens using every-eight-hour dosing were significantly more likely than other regimens to result in a vancomycin trough concentration of 5-15 μg/mL, and regimens for obese children, compared with regimens for nonobese children, were less likely to produce trough concentrations in the same range of 5-15 μg/mL.
Topics: Adolescent; Anti-Bacterial Agents; Child; Child, Preschool; Dose-Response Relationship, Drug; Drug Administration Schedule; Female; Hospitals, Pediatric; Humans; Infusions, Intravenous; Logistic Models; Male; Multivariate Analysis; Obesity; Overweight; Retrospective Studies; Vancomycin
PubMed: 22011985
DOI: 10.2146/ajhp110107 -
The British Journal of Dermatology Aug 2020Previous studies have found a possible link between the risk of children developing atopic eczema, and hardness of the water used at home. The harder the water...
Previous studies have found a possible link between the risk of children developing atopic eczema, and hardness of the water used at home. The harder the water (containing more calcium), the more children seemed to develop eczema. Yet a study in children with eczema using water softeners to reduce water hardness had shown no difference in eczema severity. In this UK study, data was used from 1303 children who had participated in the Enquiring About Tolerance (EAT) study. The aim of that study was to investigate if food allergies can be prevented. The available data of these children was quite comprehensive and included if they developed eczema between 3 months and 36 months of age, and if they had a genetic mutation of their skin - specifically, a mutation of the gene that is responsible for producing the protein filaggrin in the skin. Filaggrin is necessary for a smooth, hydrated and healthy skin. What the researchers did was add to all these data the hardness of the water the children had used at home for bathing and washing, based on their postal code. They then divided these children into two groups: one half had used softer water (257 milligrams or less of calcium carbonate per litre), and the other had used harder water (258 or more milligrams). Overall the researchers found no significant difference between the two groups in parent-reported atopic eczema by 36 months of age. But when they took the filaggrin mutation into account, they found a big difference. Children who had a mutation of that filaggrin gene and who were exposed to harder water, had about a threefold increased risk of developing eczema than those without the mutation and who were exposed to softer water. The researchers conclude therefore that in children there seems to be a link between having a filaggrin mutation, being exposed to harder water and developing eczema.
Topics: Child; Dermatitis, Atopic; Eczema; Filaggrin Proteins; Hardness; Humans; Intermediate Filament Proteins; Mutation; Water
PubMed: 32740916
DOI: 10.1111/bjd.19184 -
Clinical Practice and Cases in... Nov 2018Lidocaine has been widely used as a local anesthetic as well as an antiarrhythmic. Its use in epidural anesthesia is increasing, which has introduced new risk and...
Lidocaine has been widely used as a local anesthetic as well as an antiarrhythmic. Its use in epidural anesthesia is increasing, which has introduced new risk and potential for harm not associated with older indications. We present a case of convulsion and atrial fibrillation seen after transforaminal cervical epidural injection with two milliliters of 2% lidocaine (40 milligrams) that resolved with no long-term sequelae. Patient had a negative serum lidocaine level. With cervical epidural injections being a common treatment for radicular pain, it is important for medical providers to be aware of the various complications associated with this procedure.
PubMed: 30443623
DOI: 10.5811/cpcem.2018.9.39539 -
Pain Medicine (Malden, Mass.) Jan 2016Previous studies examining opioid dose and overdose risk provide limited granularity by milligram strength and instead rely on thresholds. We quantify dose-dependent...
OBJECTIVE
Previous studies examining opioid dose and overdose risk provide limited granularity by milligram strength and instead rely on thresholds. We quantify dose-dependent overdose mortality over a large spectrum of clinically common doses. We also examine the contributions of benzodiazepines and extended release opioid formulations to mortality.
DESIGN
Prospective observational cohort with one year follow-up.
SETTING
One year in one state (NC) using a controlled substances prescription monitoring program, with name-linked mortality data.
SUBJECTS
Residential population of North Carolina (n = 9,560,234), with 2,182,374 opioid analgesic patients.
METHODS
Exposure was dispensed prescriptions of solid oral and transdermal opioid analgesics; person-years calculated using intent-to-treat principles. Outcome was overdose deaths involving opioid analgesics in a primary or additive role. Poisson models were created, implemented using generalized estimating equations.
RESULTS
Opioid analgesics were dispensed to 22.8% of residents. Among licensed clinicians, 89.6% prescribed opioid analgesics, and 40.0% prescribed ER formulations. There were 629 overdose deaths, half of which had an opioid analgesic prescription active on the day of death. Of 2,182,374 patients prescribed opioids, 478 overdose deaths were reported (0.022% per year). Mortality rates increased gradually across the range of average daily milligrams of morphine equivalents. 80.0% of opioid analgesic patients also received benzodiazepines. Rates of overdose death among those co-dispensed benzodiazepines and opioid analgesics were ten times higher (7.0 per 10,000 person-years, 95 percent CI: 6.3, 7.8) than opioid analgesics alone (0.7 per 10,000 person years, 95 percent CI: 0.6, 0.9).
CONCLUSIONS
Dose-dependent opioid overdose risk among patients increased gradually and did not show evidence of a distinct risk threshold. There is urgent need for guidance about combined classes of medicines to facilitate a better balance between pain relief and overdose risk.
Topics: Aged; Analgesics, Opioid; Benzodiazepines; Cohort Studies; Drug Overdose; Female; Humans; Male; Middle Aged; Morphine; Opioid-Related Disorders; Pain; Prescription Drugs; Prospective Studies
PubMed: 26333030
DOI: 10.1111/pme.12907 -
Science (New York, N.Y.) Jun 1983The compound 2-phenylethylamine is an "endogenous amphetamine" which may modulate central adrenergic functions. 2-Phenylethylamine is mainly metabolized by monoamine...
The compound 2-phenylethylamine is an "endogenous amphetamine" which may modulate central adrenergic functions. 2-Phenylethylamine is mainly metabolized by monoamine oxidase to form phenyl acetate (PAA). The 24-hour urinary excretion of PAA was measured in normal healthy volunteers and depressed patients. Patients were diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, edition 3. In 70 percent of healthy volunteers of both sexes, the excretion of PAA ranged between 70 and 175 milligrams per 24 hours (mean = 141.1 +/- 10.2). Inpatients with major depressive disorder (unipolar type) (N = 31) excreted less PAA (68.7 +/- 7.0 milligrams per 24 hours) and 55 percent of them excreted less than 70 milligrams per 24 hours; there were no significant differences in the PAA excretion between untreated patients (N = 13) and those treated with antidepressants that were not effective (N = 18). The PAA excretion was reduced to a lesser extent in 35 less severely depressed unipolar outpatients (drug-free for 1 week) (86.3 +/- 11.8 milligrams per 24 hours). These results suggest that low PAA urinary excretion may be a reliable state marker for the diagnosis of some forms of unipolar major depressive disorders.
Topics: Adolescent; Adult; Aged; Antidepressive Agents; Depressive Disorder; Female; Humans; Male; Middle Aged; Phenethylamines; Phenylacetates
PubMed: 6857245
DOI: 10.1126/science.6857245 -
Science (New York, N.Y.) Jul 1970Acetylsalicylic acid was added to cultures of human leukocytes at several time periods over a wide range of concentrations (0.1 to 300.0 micrograms per milliliter)....
Acetylsalicylic acid was added to cultures of human leukocytes at several time periods over a wide range of concentrations (0.1 to 300.0 micrograms per milliliter). Leukocytes were also cultured from human volunteers during the ingestion of two 300-milligram tablets four times daily (2400 milligrams per day) over a 1-month period. No significant increase in chromosome aberrations was detected in vitro or in vivo.
Topics: Aspirin; Chromosome Aberrations; Culture Techniques; Humans; Leukocytes; Mitosis
PubMed: 5427355
DOI: 10.1126/science.169.3941.198 -
Methods in Molecular Biology (Clifton,... 2018The cation-dependent mannose 6-phosphate receptor (CD-MPR) is a single-pass type I membrane protein. This protein functions to transport lysosomal enzymes displaying...
Cloning, Expression, and Purification of the Glycosylated Transmembrane Protein, Cation-Dependent Mannose 6-Phosphate Receptor, from Sf9 Cells Using the Baculovirus System.
The cation-dependent mannose 6-phosphate receptor (CD-MPR) is a single-pass type I membrane protein. This protein functions to transport lysosomal enzymes displaying phosphomannosyl residues from the Golgi complex and the cell surface to the lysosome. This glycosylated protein contains three disulfide bridges in its 159-residue extracytoplasmic domain. One of the problems with studying eukaryotic membrane proteins is isolating sufficient quantities. Structural studies typically require several hundred milligrams of highly purified protein. Here we present a method to isolate milligram quantities of CD-MPR/Asn81 suitable for structural studies.
Topics: Animals; Baculoviridae; Cell Membrane; Cloning, Molecular; Genetic Vectors; Glycosylation; Lysosomes; Protein Transport; Receptor, IGF Type 2; Recombinant Proteins; Sf9 Cells
PubMed: 29264801
DOI: 10.1007/978-1-4939-7553-2_7 -
Metabolism of juvenile hormone during adult development of Dermacentor variabilis (Acari: Ixodidae).Journal of Medical Entomology Jan 1990Juvenile hormone (JH)-I and -III were used as model substrates to study the in vitro metabolism of JH in the hemolymph and body homogenates of the American dog tick,...
Juvenile hormone (JH)-I and -III were used as model substrates to study the in vitro metabolism of JH in the hemolymph and body homogenates of the American dog tick, Dermacentor variabilis (Say). Ester hydrolysis was the principal pathway of JH metabolism in hemolymph and homogenates. JH also was converted into JH-diol primarily by body homogenates, indicating the presence of JH epoxide hydrolase activity. JH epoxide hydrolase activity, alpha-naphthyl acetate esterase activity, and protein concentration per milligram wet weight were significantly lower (t test, alpha = 0.05) in homogenates of partially fed, virgin and replete, mated females of D. variabilis compared with unfed, virgin females. The decline in these factors was probably because of the influx of water into the tissues caused by the blood meal. In addition, the epoxide hydrolase and alpha-naphthyl acetate esterase activity per milligram tissue protein decreased significantly during this time. Mating of fed females rather than feeding alone caused a significant decline in the tissue JH esterase activity per milligram wet weight but not per milligram protein. The JH esterase activity per milligram protein was significantly higher in partially fed, virgin and replete, mated females compared with unfed females, indicating that feeding may actually increase JH esterase activity on a protein basis. JH-III was metabolized 1.4 times faster than JH-I by the hemolymph of partially fed, virgin females. The inhibitors O,O-diisopropyl phosphorofluoridate and octylthio-1,1,1-trifluoropropan-2-one at 10(-4) M inhibited JH and alpha-naphthyl acetate esterase activity in hemolymph and body homogenate.
Topics: Animals; Chromatography, Thin Layer; Dermacentor; Female; Hemolymph; Juvenile Hormones; Male; Substrate Specificity; Ticks
PubMed: 2299654
DOI: 10.1093/jmedent/27.1.36 -
Clinical Drug Investigation Jul 2018Drug utilization research on benzodiazepines remains important for measuring trends in consumption within and across borders over time for the sake of monitoring...
Drug utilization research on benzodiazepines remains important for measuring trends in consumption within and across borders over time for the sake of monitoring prescribing patterns and identifying potential population safety concerns. The defined daily dose (DDD) system by the World Health Organization (WHO) remains the internationally accepted standard for measuring drug consumption; however, beyond consumption, DDD-based results are difficult to interpret when individual agents are compared with one another or are pooled into a total class-based estimate. The diazepam milligram equivalent (DME) system provides approximate conversions between benzodiazepines and Z-drugs (i.e. zopiclone, zolpidem, zaleplon) based on their pharmacologic potency. Despite this, conversion of total dispensed benzodiazepine quantities into DME values retains diazepam milligrams as the total unit of measurement, which is also impractical for population-level interpretation. In this paper, we propose the use of an integrated DME-DDD metric to obviate the limitations encountered when the component metrics are used in isolation. Through a case example, we demonstrate significant change in results between the DDD and DME-DDD method. Unlike the DDD method, the integrated DME-DDD metric offers estimation of population pharmacologic exposure, and enables superior interpretation of drug utilization results, especially for drug class summary reporting.
Topics: Azabicyclo Compounds; Benzodiazepines; Drug Prescriptions; Drug Utilization; Humans; Piperazines; Pyridines; Translational Research, Biomedical; Zolpidem
PubMed: 29619753
DOI: 10.1007/s40261-018-0648-y