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Dario Cattaneo, Cristina Gervasoni, Valeria Cozzi, Simone Castoldi, Sara Baldelli, Emilio Clementi
Some studies have shown that adjustments to the linezolid dose guided by therapeutic drug monitoring (TDM) can reduce interindividual variability in drug exposure and improve linezolid tolerability. In this study, 6 years of linezolid TDM, a diagnostic service for our hospital and others in the Milan (Italy) area, is described. Samples were collected immediately before the morning dose intake (trough concentrations) in steady-state conditions. Linezolid concentrations were quantified by a validated high-performance liquid chromatography (HPLC) method...
October 12, 2016: International Journal of Antimicrobial Agents
Shery Jacob, Anroop B Nair
Given the distinctive characteristics of both epilepsy and antiepileptic drugs (AEDs), therapeutic drug monitoring (TDM) can make a significant contribution to the field of epilepsy. The measurement and interpretation of serum drug concentrations can be of benefit in the treatment of uncontrollable seizures and in cases of clinical toxicity; it can aid in the individualization of therapy and in adjusting for variable or nonlinear pharmacokinetics; and can be useful in special populations such as pregnancy. This review examines the potential for TDM of newer AEDs such as eslicarbazepine acetate, felbamate, gabapentin, lacosamide, lamotrigine, levetiracetam, perampanel, pregabalin, rufinamide, retigabine, stiripentol, tiagabine, topiramate, vigabatrin, and zonisamide...
October 20, 2016: Drugs in R&D
Prerna K Chawla, Zarir F Udwadia, Rajeev Soman, Ashok A Mahashur, Rohit A Amale, Alpa J Dherai, Rohan V Lokhande, Prasad R Naik, Tester F Ashavaid
Therapeutic Drug Monitoring (TDM) is a routinely practised clinical laboratory technique which aids the clinicians with a clear clinical judgement of the drug therapy and optimize the doses if necessary. Rifampicin is the most important and potent component of first line therapy of tuberculosis (TB). Several factors like age, weight, gender, doses and formulations, gastro-intestinal disorders, ethnicity etc alter the absorption and bioavailability of rifampicin thus altering the drug levels. Low plasma levels of rifampicin may play a plausible role in slow response to therapy, treatment failure or relapse or acquired drug resistance...
August 2016: Journal of the Association of Physicians of India
H Bakhtiar, H Mirzaei, M R Bagheri, N Fani, F Mashhadiabbas, M Baghaban Eslaminejad, D Sharifi, M H Nekoofar, Pmh Dummer
OBJECTIVES: The aim of this study is to compare the effect of treated dentine matrix (TDM) and tricalcium phosphate (TCP) scaffolds on odontogenic differentiation and mineralization of dental pulp stem cells (DPSCs) in furcation perforations created in the pulp chamber floor of premolar teeth in dogs. MATERIAL AND METHODS: DPSCs were isolated and cultured from the dental pulp of the maxillary left second and third premolars of dogs. The DPSCs were loaded on TCP (SC+TCP) and TDM (SC+TDM) scaffolds and inserted into intentionally perforated pulp chamber floors of premolars in dogs; six teeth were used for each group...
October 20, 2016: Clinical Oral Investigations
Paula Schaiquevich, Paula Taich, Natalia Riva, Francisco Leone, Nora Paternoster, Gabriel Mato, Paulo Cáceres Guido
Objective Determine the status of analytical laboratories that quantify immunosuppressants in transplant patients who are under therapeutic drug monitoring (TDM) for these drugs in Argentina in order to identify potential perfectible areas for action. Methods A survey of the clinical and analytical TDM centers in Argentina was conducted between September 2013 and November 2014 under the direction of the Garrahan Hospital Clinical Pharmacokinetics Unit and the National Unified Central Institute for Ablation and Implant Coordination...
March 2016: Revista Panamericana de Salud Pública, Pan American Journal of Public Health
Wanpen Vongpatanasin
OBJECTIVES: To assess the impact of therapeutic drug monitoring (TDM)-guided feedback on BP control in patients with resistant hypertension (RH), defined as blood pressure (BP) ≥140/90 mmHg despite ≥ 3 antihypertensive drugs. BACKGROUND: Nonadherence to antihypertensive medications is a major contributor to cardiovascular morbidity and mortality. Recent studies have implicated TDM as a reliable method of monitoring treatment adherence in patients with RH. However, the role of TDM-guided feedback on BP in RH has not been determined...
September 2016: Journal of Hypertension
Valentina Franco, Roberto Marchiselli, Cinzia Fattore, Elena Tartara, Giovambattista De Sarro, Emilio Russo, Emilio Perucca
BACKGROUND: Perampanel, a new specific non-competitive AMPA receptor antagonist, has been recently approved in the United States and the European Union for the adjunctive treatment of focal seizures and primary generalized tonic-clonic seizures associated with idiopathic generalized epilepsy. A positive relationship between plasma perampanel concentration and improvement in seizure control has been identified in regulatory trials, suggesting that therapeutic drug monitoring (TDM) could be useful in optimizing clinical response in patients with epilepsy treated with perampanel...
October 6, 2016: Therapeutic Drug Monitoring
M Herbrink, N de Vries, H Rosing, A D R Huitema, B Nuijen, J H M Schellens, J H Beijnen
BACKGROUND: A liquid chromatography/tandem mass spectrometry assay was developed to facilitate therapeutic drug monitoring (TDM) for 10 anticancer compounds (dasatinib, erlotinib, gefitinib, imatinib, lapatinib, nilotinib, pazopanib, sorafenib, sunitinib, and vemurafenib) and the active metabolite, N-desethyl-sunitinib. METHODS: The TDM assay is based on reversed-phase chromatography coupled with tandem mass spectrometry in the positive ion mode using multiple-reaction monitoring for analyte quantification...
October 5, 2016: Therapeutic Drug Monitoring
Linda Aurpibul, Sirinya Teerananchai, Wasana Prasitsuebsai, Tavitiya Sudjaritruk, Pope Kosalaraksa, Nia Kurniati, Khanh Huu Truong, Viet Chau Do, Lam Van Nguyen, Kulkanya Chokephaibulkit, Thida Singtoroj, Stephen J Kerr
BACKGROUND: Failure rates of second-line boosted protease inhibitor antiretroviral therapy regimens in children rise over time. Therapeutic drug monitoring (TDM) can contribute to assessments of adherence. The authors assessed the performance characteristics of the US DHHS-recommended lopinavir (LPV) concentration of 1.0 mg/L for predicting virologic failure (VF) and intermediate-to-high level LPV resistance in Asian children. MATERIALS AND METHODS: LPV concentration, HIV RNA level, and adherence data from study participants in Indonesia, Thailand, and Vietnam receiving second-line LPV-based ART and followed for ≥24 weeks were analyzed...
August 1, 2016: Therapeutic Drug Monitoring
Motoko Ikuma, Dai Watanabe, Hiroki Yagura, Misa Ashida, Masaaki Takahashi, Masaaki Shibata, Tadafumi Asaoka, Munehiro Yoshino, Tomoko Uehira, Wataru Sugiura, Takuma Shirasaka
An elderly woman with human immunodeficiency virus-1 infection developed short bowel syndrome as a result of extensive intestinal resection. Considering the possibility of poor absorption of antiretroviral drugs (ARVs), therapeutic drug monitoring (TDM) was performed. A single-dose test of 6 ARVs (darunavir, ritonavir, lopinavir, etravirine, maraviroc, and raltegravir) did not provide information on the appropriate ARV, and repeated TDM under continuous antiretroviral therapy resulted in viral suppression below 50 copies/mL, which was considered to be treatment success...
2016: Internal Medicine
Robert L Hunter, Shen-An Hwang, Chinnaswamy Jagannath, Jeffrey K Actor
Mycobacterium tuberculosis (MTB) has long been known to persist in grossly normal tissues even in people with active lesions and granulomas in other parts of the body. We recently reported that post-primary TB begins as an asymptomatic infection that slowly progresses, accumulating materials for a massive necrotizing reaction that results in cavitation. This paper explores the possible roles of trehalose 6,6' dimycolate (TDM) or cord factor in the ability of MTB to persist in such lesions without producing inflammation...
September 28, 2016: Tuberculosis
Ranjana Arora, Lisa Armitige, Audrey Wanger, Robert L Hunter, Shen-An Hwang
Trehalose 6,6'dimycolate (TDM) is a glycolipid found in nearly pure form on the surface of virulent Mycobacterium tuberculosis (MTB). This manuscript investigated the production of TDM, growth rate and colony morphology of multiple strains of MTB, each of which had been isolated from both pulmonary (sputum) and extrapulmonary sites of multiple patients. Since sputum contains MTB primarily from cavities and extrapulmonary biopsies are typically granulomas, this provided an opportunity to compare the behavior of single strains of MTB that had been isolated from cavities and granulomas...
September 28, 2016: Tuberculosis
Krm Ferrier, C E van Elk, P E Bunskoek, Mph van den Broek
Bottlenose dolphins (Tursiops truncatus) can suffer from fungal infections, which can be treated with voriconazole. In common practice, the voriconazole doses are extrapolated from human doses by adjusting for body weight only, because no dose regimen is available yet. Therefore, the aim of this study was to define a dose regimen for voriconazole in bottlenose dolphins. Dolphins treated with voriconazole between November 2005 and September 2015 at the Dolfinarium Harderwijk, the Netherlands, and TDM was performed were included...
October 4, 2016: Medical Mycology: Official Publication of the International Society for Human and Animal Mycology
Michael Paulzen, Ekkehard Haen, Benedikt Stegmann, Stefan Unterecker, Christoph Hiemke, Gerhard Gründer, Georgios Schoretsanitis
The purpose of this study was to disentangle an association between plasma concentrations of risperidone (RIS), its active metabolite 9-hydroxyrisperidone (9-OH-RIS) and the active moiety, AM (RIS + 9-OH-RIS), and clinical response in a naturalistic sample. Plasma concentrations of RIS, 9-OH-RIS and AM in patients out of a therapeutic drug monitoring (TDM) database were compared between responders (n = 64) and non-responders (n = 526) using the Clinical Global Impressions (CGI) Scale. Daily dosage of risperidone did not differ between responders and non-responders...
October 1, 2016: European Archives of Psychiatry and Clinical Neuroscience
Brigitte Barrois, Brigitte Perrouin-Verbe, Xavier De-Boissezon, Djamel Ben Smail, Dominique Casanova, Anthony Gelis, Denis Colin
Surgical indication is recommended for specific locations (pelvic stage 3 and 4 pressure ulcers) and if medical treatment is impossible: - global patient assessment is recommended before surgical indication with benefits and risks analysis; - analysis is conducted on several stages; - risk factors analysis and control level; - efficiency analysis about medical and preventive coverage; - pressure ulcer origin analysis; - compliance patient assessment (care contract); - systematic pre operative procedure is recommended: - multi-disciplinary et pluriprofessionnal consultation; - psychological assessment and follow up; - radiological assessment (systematical, no systematical IRM except if osteitis, no TDM, no scintigraphy); - biological assessment (inflammatory nutritional, micro biological); - no pre-operative antibiotherapy; - specify definition of surgical type - realize pre-operative micro biological taking is recommended:(according to bone aspect): - enforce systematic post operative procedures is recommended: - plan patient installation: every patient must have a preventive mattress and book curative mattress for multiple scrap; - plan total immediate post operative dumped according to patient compliance in PRM ward (during at least 3 weeks, often 4); - organize seated station progressive recharging in PRM ward (during at least 3 weeks); - extend patient supervision and allow seated station; - plan further supervision...
September 2016: Annals of Physical and Rehabilitation Medicine
Laura Martelli, Pablo Olivera, Xavier Roblin, Alain Attar, Laurent Peyrin-Biroulet
BACKGROUND: Therapeutic drug monitoring (TDM) of anti-TNF is increasingly used to manage inflammatory bowel diseases (IBD) and rheumatoid arthritis (RA). The cost-effectiveness of this strategy is debated. METHODS: All studies comparing the cost-effectiveness of a TDM-based strategy and an empirical dose management of anti-TNF in IBD or RA were screened. Studies were identified through the MEDLINE electronic database (up to July 2016), and annual international meeting abstracts were also manually reviewed...
September 24, 2016: Journal of Gastroenterology
David Metsu, Patrick Seraissol, Pierre Delobel, Christel Cinq-Frais, Lise Cuzin, Jacques Izopet, Etienne Chatelut, Peggy Gandia
To date, therapeutic drug monitoring (TDM) is carried out with anti-retrovirals and is usually based on total concentrations (Ct). However, for some patients, TDM does not reflect efficacy or the avoidance of toxicity as is the case for atazanavir (ATV), a HIV protease inhibitor. As the unbound concentration (Cu) is the pharmacological active form, the aim of the study was to evaluate the value of Cu and the unbound fraction (fu, fu = Cu / Ct) for the TDM of ATV. The variability of Cu and the corresponding fu of ATV were explored in 43 patients treated with ATV for an average of 13...
September 24, 2016: Fundamental & Clinical Pharmacology
Yijun Zhu, Amira Z Ksibe, Hendrik Schäfer, Claudia A Blindauer, Timothy D H Bugg, Yin Chen
Bacterial trimethylamine N-oxide (TMAO) demethylase, Tdm, carries out an unusual oxygen-independent demethylation reaction, resulting in the formation of dimethylamine and formaldehyde. In this study, site-directed mutagenesis, homology modelling and metal analyses by inorganic mass spectrometry have been applied to gain insight into metal stoichiometry and underlying catalytic mechanism of Tdm of Methylocella silvestris BL2. Herein, we demonstrate that active Tdm has 1 molar equivalent of Zn(2+) and 1 molar equivalent of non-haem Fe(2+) ...
September 19, 2016: FEBS Journal
Wanpen Vongpatanasin
OBJECTIVES: To assess the impact of therapeutic drug monitoring (TDM)-guided feedback on BP control in patients with resistant hypertension (RH), defined as blood pressure (BP) ≥140/90 mmHg despite ≥ 3 antihypertensive drugs. BACKGROUND: Nonadherence to antihypertensive medications is a major contributor to cardiovascular morbidity and mortality. Recent studies have implicated TDM as a reliable method of monitoring treatment adherence in patients with RH. However, the role of TDM-guided feedback on BP in RH has not been determined...
September 2016: Journal of Hypertension
Nuria Martinez, Natkunam Ketheesan, Kim West, Therese Vallerskog, Hardy Kornfeld
BACKGROUND:  Diabetes mellitus is associated with increased tuberculosis (TB) risk and disease severity. We previously reported that TB susceptibility in diabetic mice results from a delay in innate immune response to inhaled Mycobacterium tuberculosis, leading to delayed adaptive immune priming and consequently higher plateau lung bacterial burden and greater immune pathology. METHODS:  We tested the capacity of alveolar macrophages (AM) from diabetic mice to phagocytose M...
September 13, 2016: Journal of Infectious Diseases
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