Response to the Letter: Comment on “Effects of short-term hyperoxia on sytemic hemodynamics, oxygen transport, and microcirculation: An observational study in patients with septic shock and healthy volunteers”

2020 ◽  
Vol 56 ◽  
pp. 316-317
Author(s):  
Elisa Damiani ◽  
Erica Adrario ◽  
Andrea Carsetti ◽  
Roberta Domizi ◽  
Claudia Scorcella ◽  
...  
Keyword(s):  
Septic Shock ◽  
Observational Study ◽  
Healthy Volunteers ◽  
Oxygen Transport ◽  
Short Term ◽  
Letter Comment

Effects of short-term hyperoxia on sytemic hemodynamics, oxygen transport, and microcirculation: An observational study in patients with septic shock and healthy volunteers

2019 ◽  
Vol 53 ◽  
pp. 62-68 ◽  
Author(s):  
Emilio Daniel Valenzuela Espinoza ◽  
Mario Omar Pozo ◽  
Vanina Siham Kanoore Edul ◽  
Mariano Furche ◽  
María Fernanda Motta ◽  
...  
Keyword(s):  
Septic Shock ◽  
Observational Study ◽  
Healthy Volunteers ◽  
Oxygen Transport ◽  
Short Term

Neurobehavioral Effects of β-Escin

2019 ◽  
Vol 8 (1) ◽  
pp. 79-86
Author(s):  
Huda J. Waheed ◽  
Saad B. Nashtar ◽  
Ali I. Al-Gareeb ◽  
Hayder M. Al-Kuraishy
Keyword(s):  
Healthy Volunteers ◽  
Term Therapy ◽  
Horse Chestnut ◽  
Cortical Arousal ◽  
Short Term ◽  
Fusion Frequency ◽  
Insignificant Effect ◽  
Sensorimotor Reaction ◽  
Critical Fusion Frequency ◽  
Neurobehavioral Effects

Background: Aescin or β-escin is the main and active constituent of horse chestnut seed (Aesculus hippocastanum) used for the treatment of inflammatory edema, venous insufficiency and ischemic ulcerations. Aescin has many actions due to induction of endothelial nitric oxide and prostaglandin F2-α production moreover; aescin antagonizes the effect of histamine and 5HT at receptor levels. </P><P> Objective: The aim of the present study was to evaluate the neurobehavioral effects of aescin on normal healthy volunteers. </P><P> Method: A total number of 65 healthy participants with mean age of 21+1.1 years were recruited to study the effects of aescin on the neurobehavioral effects of normal healthy volunteers compared to placebo. The neurobehavioral effects were assessed by psychomotor performances and sensorimotor reaction, cortical arousal and central integrity processes and assessment of memory capacity. Results: Placebo produced insignificant amelioration of TRT and RRT p>0.05, with mild significant effect on MRT p=0.03. Aescin produced a significant effect in the amelioration of psychomotor performances and sensorimotor reaction p=0.0001. Regarding the differential effect of placebo and aescin on the cortical arousal and central integrity processes, placebo illustrated insignificant effect at p>0.05 whereas; aescin showed mild significant effect on Critical Fusion Frequency (CFFA) p<0.05 and highly significant effect on the other parameters p<0.01 except for critical-fusion frequency threshold when aescin illustrated insignificant effect at p>0.05. Aescin illustrated significant acceleration of ІІ-back WMA, ІІІ-back WMA and Second trial Short-Term Memory (STM) at p<0.01 compared to the placebo effect. Conclusion: Short-term therapy with aescin improves the neurobehavioral effects on healthy volunteers.

Effects of short-term saffron (Crocus sativus L.) intake on the in vivo activities of xenobiotic metabolizing enzymes in healthy volunteers

2019 ◽  
Vol 130 ◽  
pp. 32-43 ◽  
Author(s):  
Elias Begas ◽  
Maria Bounitsi ◽  
Thomas Kilindris ◽  
Evangelos Kouvaras ◽  
Konstantinos Makaritsis ◽  
...  
Keyword(s):  
Healthy Volunteers ◽  
Crocus Sativus ◽  
Short Term ◽  
Metabolizing Enzymes ◽  
Xenobiotic Metabolizing Enzymes ◽  
Crocus Sativus L

Predictive value of thyroxine for prognosis in pediatric septic shock: a prospective observational study

2020 ◽  
Vol 33 (5) ◽  
pp. 653-659
Author(s):  
Jia Song ◽  
Yun Cui ◽  
Chunxia Wang ◽  
Jiaying Dou ◽  
Huijie Miao ◽  
...  
Keyword(s):  
Septic Shock ◽  
Thyroid Hormone ◽  
Observational Study ◽  
Hospital Mortality ◽  
Predictive Value ◽  
Prospective Observational Study ◽  
Threshold Value ◽  
Nonthyroidal Illness ◽  
Hormone Levels ◽  
Thyroid Hormone Levels

AbstractBackgroundThyroid hormone plays an important role in the adaptation of metabolic function to critically ill. The relationship between thyroid hormone levels and the outcomes of septic shock is still unclear. The aim of this study was to assess the predictive value of thyroid hormone for prognosis in pediatric septic shock.MethodsWe performed a prospective observational study in a pediatric intensive care unit (PICU). Patients with septic shock were enrolled from August 2017 to July 2019. Clinical and laboratory indexes were collected, and thyroid hormone levels were measured on PICU admission.ResultsNinety-three patients who fulfilled the inclusion criteria were enrolled in this study. The incidence of nonthyroidal illness syndrome (NTIS) was 87.09% (81/93) in patients with septic shock. Multivariate logistic regression analysis showed that T4 level was independently associated with in-hospital mortality in patients with septic shock (OR: 0.965, 95% CI: 0.937–0.993, p = 0.017). The area under receiver operating characteristic (ROC) curve (AUC) for T4 was 0.762 (95% CI: 0.655–0.869). The cutoff threshold value of 58.71 nmol/L for T4 offered a sensitivity of 61.54% and a specificity of 85.07%, and patients with T4 < 58.71 nmol/L showed high mortality (60.0%). Moreover, T4 levels were negatively associated with the pediatric risk of mortality III scores (PRISM III), lactate (Lac) level in septic shock children.ConclusionsNonthyroidal illness syndrome is common in pediatric septic shock. T4 is an independent predictor for in-hospital mortality, and patients with T4 < 58.71 nmol/L on PICU admission could be with a risk of hospital mortality.

scholarly journals The relationship between maximal expiratory pressure values and critical outcomes in mechanically ventilated patients: a post hoc analysis of an observational study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yann Combret ◽  
Guillaume Prieur ◽  
Roger Hilfiker ◽  
Francis-Edouard Gravier ◽  
Pauline Smondack ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Observational Study ◽  
Univariate Analysis ◽  
Premature Death ◽  
Extubation Failure ◽  
Short Term ◽  
Expiratory Muscle ◽  
Maximal Expiratory Pressure ◽  
The Impact ◽  
The Relationship

Abstract Background Little interest has been paid to expiratory muscle strength, and the impact of expiratory muscle weakness on critical outcomes is not known. Very few studies assessed the relationship between maximal expiratory pressure (MEP) and critical outcomes. The aim of this study was to investigate the relationship between MEP and critical outcomes. Methods This work was a secondary analysis of a prospective, observational study of adult patients who required mechanical ventilation for ≥ 24 h in an 18-bed ICU. MEP was assessed before extubation after a successful, spontaneous breathing trial. The relationships between MEP and extubation failure, and short-term (30 days) mortality, were investigated. Univariate logistic regressions were computed to investigate the relationship between MEP values and critical outcomes. Two multivariate analyses, with and without maximal inspiratory pressure (MIP), both adjusted using principal component analysis, were undertaken. Unadjusted and adjusted ROC curves were computed to compare the respective ability of MEP, MIP and the combination of both measures to discriminate patients with and without extubation failure or premature death. Results One hundred and twenty-four patients were included. Median age was 66 years (IQR 18) and median mechanical ventilation duration was 7 days (IQR 6). Extubation failure rate was 15% (18/124 patients) and the rate for 30-day mortality was 11% (14/124 patient). Higher MEP values were significantly associated with a lower risk of extubation failure in the univariate analysis [OR 0.96 95% CI (0.93–0.98)], but not with short-term mortality. MEP was independently linked with extubation failure when MIP was not included in the multivariate model, but not when it was included, despite limited collinearity between these variables. This study was not able to differentiate the respective abilities of MEP, MIP, and their combination to discriminate patients with extubation failure or premature death (adjusted AUC for the combination of MEP and MIP: 0.825 and 0.650 for extubation failure and premature death, respectively). Conclusions MEP is related to extubation failure. But, the results did not support its use as a substitute for MIP, since the relationship between MEP and critical outcomes was no longer significant when MIP was included. The use of MIP and MEP measurements combined did not reach higher discriminative capacities for critical outcomes that MEP or MIP alone. Trial Registration This study was retrospectively registered at https://clinicaltrials.gov/ct2/show/NCT02363231?cond=NCT02363231&draw=2&rank=1 (NCT02363231) in 13 February 2015

Liberal vs. conservative vasopressor use to maintain mean arterial blood pressure during resuscitation of septic shock: an observational study

2007 ◽  
Vol 34 (1) ◽  
pp. 157-162 ◽  
Author(s):  
Sanjay Subramanian ◽  
Murat Yilmaz ◽  
Ahmer Rehman ◽  
Rolf D. Hubmayr ◽  
Bekele Afessa ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Septic Shock ◽  
Observational Study ◽  
Arterial Blood Pressure ◽  
Mean Arterial Blood Pressure ◽  
Arterial Blood ◽  
Vasopressor Use

scholarly journals Pharmacokinetic Interactions of Maraviroc with Darunavir-Ritonavir, Etravirine, and Etravirine-Darunavir-Ritonavir in Healthy Volunteers: Results of Two Drug Interaction Trials

2011 ◽  
Vol 55 (5) ◽  
pp. 2290-2296 ◽  
Author(s):  
Thomas N. Kakuda ◽  
Samantha Abel ◽  
John Davis ◽  
Julia Hamlin ◽  
Monika Schöller-Gyüre ◽  
...  
Keyword(s):  
Steady State ◽  
Healthy Volunteers ◽  
Potent Inhibitor ◽  
Cytochrome P450 3A ◽  
Short Term ◽  
Two Phase ◽  
Time Curve ◽  
Safety Issues ◽  
Concentration Time ◽  
Crossover Studies

ABSTRACTThe effects of darunavir-ritonavir at 600 and 100 mg twice daily (b.i.d.) alone, 200 mg of etravirine b.i.d. alone, or 600 and 100 mg of darunavir-ritonavir b.i.d. with 200 mg etravirine b.i.d. at steady state on the steady-state pharmacokinetics of maraviroc, and vice versa, in healthy volunteers were investigated in two phase I, randomized, two-period crossover studies. Safety and tolerability were also assessed. Coadministration of 150 mg maraviroc b.i.d. with darunavir-ritonavir increased the area under the plasma concentration-time curve from 0 to 12 h (AUC12) for maraviroc 4.05-fold relative to 150 mg of maraviroc b.i.d. alone. Coadministration of 300 mg maraviroc b.i.d. with etravirine decreased the maraviroc AUC12by 53% relative to 300 mg maraviroc b.i.d. alone. Coadministration of 150 mg maraviroc b.i.d. with etravirine-darunavir-ritonavir increased the maraviroc AUC123.10-fold relative to 150 mg maraviroc b.i.d. alone. Maraviroc did not significantly affect the pharmacokinetics of etravirine, darunavir, or ritonavir. Short-term coadministration of maraviroc with darunavir-ritonavir, etravirine, or both was generally well tolerated, with no safety issues reported in either trial. Maraviroc can be coadministered with darunavir-ritonavir, etravirine, or etravirine-darunavir-ritonavir. Maraviroc should be dosed at 600 mg b.i.d. with etravirine in the absence of a potent inhibitor of cytochrome P450 3A (CYP3A) (i.e., a boosted protease inhibitor) or at 150 mg b.i.d. when coadministered with darunavir-ritonavir with or without etravirine.

Lack of Analgesic Activity of Morphine-6-glucuronide after Short-term Intravenous Administration in Healthy Volunteers 

1997 ◽  
Vol 87 (6) ◽  
pp. 1348-1358 ◽  
Author(s):  
Jorn Lotsch ◽  
Gerd Kobal ◽  
Anne Stockmann ◽  
Kay Brune ◽  
Gerd Geisslinger ◽  
...  
Keyword(s):  
Healthy Volunteers ◽  
Analgesic Activity ◽  
Intravenous Administration ◽  
Opioid Analgesic ◽  
Plasma Concentrations ◽  
Experimental Pain ◽  
Controlled Study ◽  
Short Term ◽  
Analgesic Effects ◽  
Relative Contribution

Background The analgesic activity of morphine-6-glucuronide (M-6-G) is well recognized for its contribution to the effects of morphine and its possible use as an opioid analgesic with a wider therapeutic range than morphine. The present study attempted to quantify the relative contribution of M-6-G to analgesia observed after systemic administration of morphine. Methods In a placebo-controlled, sixfold crossover study in 20 healthy men, the effects of M-6-G were assessed at steady-state plasma concentrations of M-6-G identical to and two and three times higher than those measured after administration of morphine. Morphine and M-6-G were administered as an intravenous bolus followed by infusion over 4 h. Dosage A was M-6-G-bolus of 0.015 mg/kg plus infusion of 0.0072 mg x kg(-1) x h(-1). Dosage B was M-6-G-bolus of 0.029 mg/kg plus infusion of 0.014 mg x kg(-1) x h(-1). Dosage C was M-6-G-bolus of 0.044 mg/kg plus infusion of 0.022 mg x kg(-1) x h(-1). Dosage D was a morphine bolus of 0.14 mg/kg plus infusion of 0.05 mg x kg(-1) x h(-1) for 4 h. Dosage E was M-6-G combined with morphine (doses A + D). Dosage F was a placebo. The analgesic effects of M-6-G and morphine were measured before administration of the bolus and after 3.5 h using an experimental pain model based on pain-related cortical potentials and pain ratings after specific stimulation of the nasal nociceptor with short pulses of gaseous carbon dioxide. Results Morphine significantly reduced subjective and objective pain correlates compared with placebo. In contrast, M-6-G produced no statistically significant effects. The addition of M-6-G to morphine did not increase the effects of morphine. Morphine produced significantly more side effects than M-6-G. Conclusion After short-term intravenous administration at doses that produce plasma concentrations of M-6-G similar to those seen after administration of morphine, M-6-G had no analgesic effects in the present placebo-controlled study in healthy volunteers.

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