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https://www.readbyqxmd.com/read/28812380/analysis-of-an-8-hour-acetylcysteine-infusion-protocol-for-repeated-supratherapeutic-ingestion-rsti-of-paracetamol
#1
Anselm Wong, Naren Gunja, Richard McNulty, Andis Graudins
OBJECTIVES: In Australia, the treatment guideline for patients with repeated supratherapeutic ingestion (RSTI) of paracetamol recommends an abbreviated acetylcysteine regimen if the paracetamol concentration is low (<10 mg/L) and alanine aminotransferase (ALT) is normal or static after 8 hours of infusion. There are currently no studies of this recommendation. METHOD: A retrospective review of paracetamol overdose presentations from October 2009 to August 2016 in two hospital toxicology networks was performed...
August 16, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28810844/effect-of-tolvaptan-on-renal-handling-of-water-and-sodium-gfr-and-central-hemodynamics-in-autosomal-dominant-polycystic-kidney-disease-during-inhibition-of-the-nitric-oxide-system-a-randomized-placebo-controlled-double-blind-crossover-study
#2
Safa Al Therwani, My Emma Sofie Malmberg, Jeppe Bakkestroem Rosenbaek, Jesper Noergaard Bech, Erling Bjerregaard Pedersen
BACKGROUND: Tolvaptan slows progression of autosomal dominant polycystic kidney disease (ADPKD) by antagonizing the vasopressin-cAMP axis. Nitric oxide (NO) stimulates natriuresis and diuresis, but its role is unknown during tolvaptan treatment in ADPKD. METHODS: Eighteen patients with ADPKD received tolvaptan 60 mg or placebo in a randomized, placebo-controlled, double blind, crossover study. L-NMMA (L-NG-monomethyl-arginine) was given as a bolus followed by continuous infusion during 60 min...
August 15, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28810636/necessity-of-heparin-for-maintaining-peripheral-venous-catheters-a-systematic-review-and-meta-analysis
#3
Tao You, Jianliang Jiang, Jianchang Chen, Weiting Xu, Li Xiang, Yang Jiao
Heparin has typically been used as a flushing or infusion solution for vascular lines in daily practice. However, several clinical trials have yielded controversial results about the benefits of heparin in maintaining peripheral venous catheters. The present meta-analysis was conducted to evaluate the efficacy of heparin on the patency profiles and complications in peripheral intravenous catheters. PubMed, Embase and Cochrane Central Register of Controlled Trials were searched up to February 2016 for randomized controlled trials comparing heparin with placebo in maintaining peripheral intravenous catheters...
August 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28809049/evolution-of-mnc-and-lymphocyte-collection-settings-employing-different-spectra-optia-%C3%A2-leukapheresis-systems
#4
M Punzel, A Kozlova, A Quade, A H Schmidt, R Smith
BACKGROUND AND OBJECTIVES: The Spectra Optia(®) continuous mononuclear cell (CMNC apheresis) system has emerged as the preferred device in peripheral blood stem cell collections over the original two-step Spectra Optia(®) mononuclear cell (MNC apheresis) system. Until now, no comparative data were available for non-stimulated MNC collections that are required for immunotherapy. MATERIALS AND METHODS: We compared collection parameters and product composition for Spectra Optia MNC- as well as CMNC-apheresis systems in non-stimulated MNC collections from 35 registry donors intended for donor lymphocyte infusions...
August 14, 2017: Vox Sanguinis
https://www.readbyqxmd.com/read/28808868/effect-of-multimodal-analgesia-on-opioid-use-after-open-ventral-hernia-repair
#5
Jeremy A Warren, Caroline Stoddard, Ahan L Hunter, Anthony J Horton, Carlyn Atwood, Joseph A Ewing, Steven Pusker, Vito A Cancellaro, Kevin B Walker, William S Cobb, Alfredo M Carbonell, Robert R Morgan
BACKGROUND: There is limited data on enhanced recovery after surgery (ERAS) protocols after ventral hernia repair (VHR). This study reports the impact of multimodal analgesia on opioid use after open VHR. METHODS: Retrospective review of open VHR treated during the initial 6 months after ERAS implementation. Protocol focused on opioid sparing using intraoperative ketamine and/or lidocaine infusion, selective epidural anesthesia, and postoperative ketamine infusion, ketorolac, and acetaminophen...
August 14, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28808577/transition-from-intravenous-to-enteral-ketamine-for-treatment-of-nonconvulsive-status-epilepticus
#6
Michael A Pizzi, Prasuna Kamireddi, William O Tatum, Jerry J Shih, Daniel A Jackson, William D Freeman
BACKGROUND: Nonconvulsive status epilepticus (NCSE) is a diagnosis that is often challenging and one that may progress to refractory NCSE. Ketamine is a noncompetitive N-methyl-d-aspartate antagonist that increasingly has been used to treat refractory status epilepticus. Current Neurocritical Care Society guidelines recommend intravenous (IV) ketamine infusion as an alternative treatment for refractory status epilepticus in adults. On the other hand, enteral ketamine use in NCSE has been reported in only 6 cases (1 adult and 5 pediatric) in the literature to date...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28807922/are-standard-doses-of-piperacillin-in-piperacillin-tazobactam-regimens-adequate-for-the-management-of-febrile-neutropenia-answers-from-population-pharmacokinetic-modelling-and-monte-carlo-simulations
#7
Fekade Bruck Sime, Uwe Hahn, Morgyn S Warner, Ing Soo Tiong, Michael S Roberts, Jeffrey Lipman, Sandra L Peake, Jason A Roberts
Changes in the pharmacokinetics of piperacillin in febrile neutropenic patients have been reported to result in sub-optimal exposures. This study aimed to develop a population pharmacokinetic model for piperacillin and perform dosing simulation to describe optimal dosing regimens for haematological malignancy patients with febrile neutropenia. Concentration-time data were obtained from previous prospective observational pharmacokinetic and interventional therapeutic drug monitoring studies. Non-parametric population pharmacokinetic analysis and Monte Carlo dosing simulations were performed with Pmetrics® package for R...
August 14, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28807913/reducing-antibacterial-development-risk-for-gsk1322322-by-exploring-potential-human-dose-regimens-in-nonclinical-efficacy-studies-using-immunocompetent-rats
#8
Jennifer L Hoover, Christine M Singley, Philippa Elefante, Peter DeMarsh, Magdalena Zalacain, Stephen Rittenhouse
Directly testing proposed clinical dosing regimens in nonclinical studies can reduce risk during the development of novel antibacterial agents. Optimal dosing regimens can be identified in animal models by testing recreated human pharmacokinetic profiles. An example of this approach is presented using continuous intravenous infusions of GSK1322322 in immunocompetent rats to evaluate recreated Phase 1 human exposures in pneumonia models with Streptococcus pneumoniae and Haemophilus influenzae and an abscess model with Staphylococcus aureus GSK1322322 was administered via continuous intravenous infusion to recreate 1000 or 1500 mg oral doses every 12h in humans...
August 14, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28805949/the-reversible-p2y12-antagonist-act-246475-causes-significantly-less-blood-loss-than-ticagrelor-at-equivalent-antithrombotic-efficacy-in-rat
#9
Markus Rey, Markus Kramberg, Patrick Hess, Keith Morrison, Roland Ernst, Franck Haag, Edgar Weber, Martine Clozel, Martine Baumann, Eva Caroff, Francis Hubler, Markus A Riederer, Beat Steiner
The P2Y12 receptor is a validated target for prevention of major adverse cardiovascular events in patients with acute coronary syndrome. The aim of this study was to compare two direct-acting, reversible P2Y12 antagonists, ACT-246475 and ticagrelor, in a rat thrombosis model by simultaneous quantification of their antithrombotic efficacy and surgery-induced blood loss. Blood flow velocity was assessed in the carotid artery after FeCl3 -induced thrombus formation using a Doppler flow probe. At the same time, blood loss after surgical wounding of the spleen was quantified...
October 2017: Pharmacology Research & Perspectives
https://www.readbyqxmd.com/read/28805662/clinical-and-immunological-responses-after-cd30-specific-chimeric-antigen-receptor-redirected-lymphocytes
#10
Carlos A Ramos, Brandon Ballard, Huimin Zhang, Olga Dakhova, Adrian P Gee, Zhuyong Mei, Mrinalini Bilgi, Meng-Fen Wu, Hao Liu, Bambi Grilley, Catherine M Bollard, Bill H Chang, Cliona M Rooney, Malcolm K Brenner, Helen E Heslop, Gianpietro Dotti, Barbara Savoldo
BACKGROUND: Targeting CD30 with monoclonal antibodies in Hodgkin lymphoma (HL) and anaplastic large cell lymphoma (ALCL) has had profound clinical success. However, adverse events, mainly mediated by the toxin component of the conjugated antibodies, cause treatment discontinuation in many patients. Targeting CD30 with T cells expressing a CD30-specific chimeric antigen receptor (CAR) may reduce the side effects and augment antitumor activity. METHODS: We conducted a phase I dose escalation study in which 9 patients with relapsed/refractory HL or ALCL were infused with autologous T cells that were gene-modified with a retroviral vector to express the CD30-specific CAR (CD30...
August 14, 2017: Journal of Clinical Investigation
https://www.readbyqxmd.com/read/28805611/propofol-in-combination-with-remifentanil-for-cesarean-section-placental-transfer-and-effect-on-mothers-and-newborns-at-different-induction-to-delivery-intervals
#11
Liguo Hu, Jianhui Pan, Shantang Zhang, Jinjing Yu, Keqiang He, Shuhua Shu, Ruiting Wang
OBJECTIVE: This study aims to describe the administration of propofol in combination with remifentanil for the induction of general anesthesia during cesarean section (CS). Our aim was to evaluate its impact on the drug concentrations of the maternal and neonatal blood at different induction of anesthesia to delivery (I-D) intervals as well as its effect on newborns. MATERIALS AND METHODS: In this double-blind randomized controlled study, patients undergoing elective CS were administered anesthesia at short (n = 20) or long (n = 20) I-D intervals...
August 2017: Taiwanese Journal of Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28805563/infusional-therapies-continuous-dopaminergic-stimulation-and-nonmotor-symptoms
#12
Ulrika Mundt-Petersen, Per Odin
Pump-based Parkinson (PD) therapies, including subcutaneous apomorphine infusion (CSA) and levodopa-carbidopa intestinal gel (LCIG), presently constitute the most effective pharmacological treatments available for advanced PD. These therapies are based on a more constant delivery of the dopaminergic drug resulting in a more continuous dopaminergic stimulation and a more stable treatment effect. This can be detected as reduction of time in off, reduction of dyskinesia frequency and severity, as well as increase of time in on without troublesome dyskinesias...
2017: International Review of Neurobiology
https://www.readbyqxmd.com/read/28803021/effect-of-dietary-supplementation-with-heat-treated-canola-meal-on-ruminal-nutrient-metabolism-in-lactating-dairy-cows
#13
S J Krizsan, H Gidlund, F Fatehi, P Huhtanen
An experiment was conducted to quantify the effects of incremental levels of heat-moisture-treated canola meal (TCM) fed to dairy cows on the relationship between ruminal nutrient digestion and milk production. Experimental diets were fed to 4 multiparous rumen-cannulated Nordic Red cows, averaging (mean ± standard deviation) 681 ± 54.8 kg of body weight, 111 ± 16 d in milk, and 29.1 ± 9.1 kg of milk/d at the start of the study, in a Latin square design with four 21-d periods. The 4 experimental dietary treatments consisted of a basal diet of grass silage and crimped barley, and 3 diets in which the crimped barley was replaced with TCM, giving 3 incremental levels of protein supplementation...
August 9, 2017: Journal of Dairy Science
https://www.readbyqxmd.com/read/28802598/effect-of-parecoxib-sodium-pretreatment-combined-with-dexmedetomidine-on-early-postoperative-cognitive-dysfunction-in-elderly-patients-after-shoulder-arthroscopy-a-randomized-double-blinded-controlled-trial
#14
Jian Lu, Gang Chen, Hongmei Zhou, Qinghe Zhou, Zhipeng Zhu, Cheng Wu
STUDY OBJECTIVE: To evaluate effect of parecoxib sodium pretreatment combined with dexmedetomidine on early postoperative cognitive dysfunction in elderly patients after shoulder arthroscopy. DESIGN: Randomized, double-blind study. SETTING: University-affiliated teaching hospital. PATIENTS: One hundred and fifty-two elderly patients scheduled for shoulder arthroscopy. INTERVENTIONS: At 15min before the induction of anesthesia, 152 patients received intravenously parecoxib sodium 40mg and dexmedetomidine at a dose of 0...
September 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28799879/the-pathophysiology-of-chronic-noncommunicating-hydrocephalus-lessons-from-continuous-intracranial-pressure-monitoring-and-ventricular-infusion-testing
#15
Per Kristian Eide
OBJECTIVE The pathophysiology of chronic noncommunicating hydrocephalus (ncHC) is poorly understood. This present study explored whether lessons about the pathophysiology of this clinical entity might be retrieved from results of overnight monitoring of pulsatile and static intracranial pressure (ICP) and ventricular infusion testing. METHODS The study cohort included adult patients (> 20 years of age) with chronic ncHC due to aqueductal stenosis in whom symptoms had lasted a minimum of 6 months. A reference cohort consisted of age- and sex-matched patients managed for communicating HC (cHC)...
August 11, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28799221/repose-repositioning-insulin-pump-therapy-in-type-1-diabetes
#16
N S Oliver
In 2008, the National Institute for Health and Care Excellence (NICE) technology appraisal of continuous subcutaneous insulin infusion (CSII, insulin pump therapy) for people with Type 1 diabetes was published [1]. Implementation of this enables children under the age of 12 years to access CSII, and consideration of CSII for adults and children over 12 years with challenging hypo- or hyperglycaemia. In Scotland, the Scottish Intercollegiate Guidelines Network (SIGN) guidance for management of diabetes states that CSII therapy should be considered for people unable to achieve their glycaemic targets, for those who experience recurring episodes of severe hypoglycaemia, and in infants and very young children with very low basal insulin requirements, for whom even small doses of basal insulin analogue may result in hypoglycaemia [2]...
August 11, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/28799206/the-incidence-and-characteristics-of-3-month-mortality-after-intraoperative-cardiac-arrest-in-adults
#17
M Hur, H-C Lee, K H Lee, J-T Kim, C-W Jung, H-P Park
BACKGROUND: There is little information about clinical outcomes after intraoperative cardiac arrest (IOCA). We determined the incidence and characteristics of 3-month mortality after IOCA. METHODS: The electronic medical records of 238,648 adult surgical patients from January 2005 to December 2014 were reviewed retrospectively. Characteristics of IOCA were documented using the Utstein reporting template. RESULTS: IOCA occurred in 50 patients (21/100,000 surgeries)...
August 11, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28797073/assessment-of-veterinary-drugs-in-plants-using-pharmacokinetic-approaches-the-absorption-distribution-and-elimination-of-tetracycline-and-sulfamethoxazole-in-ephemeral-vegetables
#18
Hui-Ru Chen, Tirawat Rairat, Shih-Hurng Loh, Yu-Chieh Wu, Thomas W Vickroy, Chi-Chung Chou
The present study was carried out to demonstrate novel use of pharmacokinetic approaches to characterize drug behaviors/movements in the vegetables with implications to food safety. The absorption, distribution, metabolism and most importantly, the elimination of tetracycline (TC) and sulfamethoxazole (SMX) in edible plants Brassica rapa chinensis and Ipomoea aquatica grown hydroponically were demonstrated and studied using non-compartmental pharmacokinetic analysis. The results revealed drug-dependent and vegetable-dependent pharmacokinetic differences and indicated that ephemeral vegetables could have high capacity accumulating antibiotics (up to 160 μg g-1 for TC and 38 μg g-1 for SMX) within hours...
2017: PloS One
https://www.readbyqxmd.com/read/28796889/dopamine-plasma-clearance-is-increased-in-piglets-compared-to-neonates-during-continuous-dopamine-infusion
#19
Martin B Rasmussen, Jan Bert Gramsbergen, Vibeke R Eriksen, Gorm Greisen
AIM: Piglets models have often been used to study the effects of dopamine infusion on hypotension in neonates. However, piglets need higher doses of dopamine than neonates to increase blood pressure. We investigated whether this difference was due to interspecific difference in dopamine pharmacokinetics. METHODS: Arterial blood samples were drawn from six neonates admitted to the neonatal intensive care unit of Copenhagen University Hospital and 20 newborn piglets during continuous dopamine infusion...
August 10, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28796827/impact-of-ghrelin-on-body-composition-and-muscle-function-in-a-long-term-rodent-model-of-critical-illness
#20
Neil E Hill, Kevin G Murphy, Saima Saeed, Rahul Phadke, Darren Chambers, Duncan R Wilson, Stephen J Brett, Mervyn Singer
BACKGROUND: Patients with multiple injuries or sepsis requiring intensive care treatment invariably develop a catabolic state with resultant loss of lean body mass, for which there are currently no effective treatments. Recovery can take months and mortality is high. We hypothesise that treatment with the orexigenic and anti-inflammatory gastric hormone, ghrelin may attenuate the loss of body mass following critical illness and improve recovery. METHODS: Male Wistar rats received an intraperitoneal injection of the fungal cell wall derivative zymosan to induce a prolonged peritonitis and consequent critical illness...
2017: PloS One
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