scholarly journals 196. Assessing the Clinical Impact of Intravenous Acyclovir Dosing in Obese Patients: Should We Be Using Ideal, Adjusted, or Total Body Weight?

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S102-S103
Author(s):  
Nicole Mulvey ◽  
Sumeet Jain ◽  
Keith Falsetta ◽  
Thien-Ly Doan
Keyword(s):  
Body Weight ◽  
Length Of Stay ◽  
Adverse Effects ◽  
Total Body Weight ◽  
Small Sample ◽  
Obese Patients ◽  
Duration Of Therapy ◽  
Significant Difference ◽  
Total Body ◽  
Island Jewish Medical

Abstract Background Obesity impacts the pharmacokinetics and pharmacodynamics of medications. Pharmacokinetic studies of intravenous (IV) acyclovir have demonstrated that dosing obese patients according to their ideal body weight (IBW) may provide a sub-therapeutic dose, while dosing based on total body weight (TBW) may increase adverse effects. This has led to the use of adjusted body weight (AdjBW) for dosing in this population; however, this has not been evaluated clinically. The purpose of this study is to assess the impact of different dosing strategies of IV acyclovir in obese patients. Methods This retrospective observational chart review evaluated adult patients admitted to Long Island Jewish Medical Center with a body mass index greater than or equal to 30 kg/m2 who received at least 48 hours of high-dose IV acyclovir therapy during the study period of January 2014 to August 2019. Patients were stratified to IBW, AdjBW, and TBW for analysis. The primary statistical tests utilized include descriptive statistics and logistic regression. The primary endpoint was the outcome of infection. The secondary endpoints included duration of therapy, length of stay, and adverse effects. Results 51 patients were included in the efficacy analysis and 84 patients were included in the safety analysis. Treatment failure occurred in 3 out of 51 patients (1 patient in IBW group, 2 patients in AdjBW group, p=0.445). There was no significant difference in median length of stay (p=0.977) or median duration of IV therapy (p=0.78). Nephrotoxicity occurred in 22.2%, 19.2%, and 22.7% of patients in the IBW, AdjBW, and TBW groups respectively (p=1). Conclusion When comparing different dosing modalities, there was no significant difference in the outcome of infection, duration of therapy, or length of stay. The results of this study were limited by small sample size. However, dosing patients according to AdjBW led to smaller doses of acyclovir, and therefore less drug exposure. Disclosures All Authors: No reported disclosures

Evaluation of a capped dosing telavancin regimen compared to standard dosing at a large community teaching hospital

2021 ◽  
Author(s):  
Fernando J. Diggs ◽  
Jonathan D. Edwards ◽  
Kimberly B. Garza ◽  
Ali A.M. Hassoun ◽  
Spencer H. Durham
Keyword(s):  
Body Weight ◽  
Adverse Effects ◽  
Teaching Hospital ◽  
Total Body Weight ◽  
Obese Patients ◽  
Dosing Regimen ◽  
Large Community ◽  
Total Body ◽  
Community Teaching ◽  
Equal Efficacy

Telavancin, a lipoglycopeptide antibiotic, is traditionally dosed as 10 mg/kg based on total body weight, but is associated with toxicities that limit its use. This study supports the use of a capped dosing regimen of 750 mg in obese patients, which is associated with equal efficacy and fewer adverse effects compared to traditional dosing.

scholarly journals Lean body weight versus total body weight to calculate the iodinated contrast media volume in abdominal CT: a randomised controlled trial

2020 ◽  
Vol 11 (1) ◽  
Author(s):  
Moreno Zanardo ◽  
Fabio Martino Doniselli ◽  
Anastassia Esseridou ◽  
Massimiliano Agrò ◽  
Nicol Antonina Rita Panarisi ◽  
...  
Keyword(s):  
Body Weight ◽  
Contrast Media ◽  
Controlled Trial ◽  
Total Body Weight ◽  
Lean Body Weight ◽  
Iodinated Contrast Media ◽  
Abdominal Ct ◽  
Iodinated Contrast ◽  
Significant Difference ◽  
Total Body

Abstract Objectives Iodinated contrast media (ICM) could be more appropriately dosed on patient lean body weight (LBW) than on total body weight (TBW). Methods After Ethics Committee approval, trial registration NCT03384979, patients aged ≥ 18 years scheduled for multiphasic abdominal CT were randomised for ICM dose to LBW group (0.63 gI/kg of LBW) or TBW group (0.44 gI/kg of TBW). Abdominal 64-row CT was performed using 120 kVp, 100–200 mAs, rotation time 0.5 s, pitch 1, Iopamidol (370 mgI/mL), and flow rate 3 mL/s. Levene, Mann–Whitney U, and χ2 tests were used. The primary endpoint was liver contrast enhancement (LCE). Results Of 335 enrolled patients, 17 were screening failures; 44 dropped out after randomisation; 274 patients were analysed (133 LBW group, 141 TBW group). The median age of LBW group (66 years) was slightly lower than that of TBW group (70 years). Although the median ICM-injected volume was comparable between groups, its variability was larger in the former (interquartile range 27 mL versus 21 mL, p = 0.01). The same was for unenhanced liver density (IQR 10 versus 7 HU) (p = 0.02). Median LCE was 40 (35–46) HU in the LBW group and 40 (35–44) HU in the TBW group, without significant difference for median (p = 0.41) and variability (p = 0.23). Suboptimal LCE (< 40 HU) was found in 64/133 (48%) patients in the LBW group and 69/141 (49%) in the TBW group, but no examination needed repeating. Conclusions The calculation of the ICM volume to be administered for abdominal CT based on the LBW does not imply a more consistent LCE.

P0264ASSESSMENT OF GFR IN MORBIDLY OBESE PATIENTS USING DIFFERENT EQUATIONS: WHICH IS THE BEST?

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Alaa Sabry ◽  
Amir Basiony ◽  
Mohamed Kamal
Keyword(s):  
Body Weight ◽  
Creatinine Clearance ◽  
Glomerular Filtration ◽  
Total Body Weight ◽  
Lean Body Weight ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Morbidly Obese Patient ◽  
Gault Formula ◽  
Total Body

Abstract Background and Aims Obesity is a potent risk factor for the development of kidney disease. The prevalence of abdominal obesity in Egyptians based upon the European cut-off points was 30.2% for men and 70.9% for women. To detect the best formula for estimation of glomerular filtration rates in morbidly obese individuals. Method: In this prospective study 82 morbidly obese patients were included, Age: 15 to 65 years, Morbidly obese patient (BMI &gt; 40 Kg/m2), Creatinine clearance calculated from a 24-h urine was done, Estimated glomerular filtration rate (eGFR): It was assessed to be correlated with creatinine clearance and detect the most suitable formula for morbidly obese patients. Cockcroft-Gault formula:  Cockcroft-Gault formula (for total body weight): ockcroft-Gault formula (for adjusted body weight): Cockcroft-Gault formula (for lean body weight), MDRD-eGFR (Modification of Diet in Renal Disease equation) (Shahbaz & Gupta, 2019), CKD-epidemiology (CKD-EPI): (Levey, et al, 2009) Results Demogrphic criteria of the studdied patients Conclusion: The equations that had the nearest values to creatinine clearance were CG-TBW-GFR and CGAjBW- GFR, both of them had a moderate reliability with more agreement for the CG-TBW-GFR equation . The CG-TBW-GFR formula was the most reliable one to measure GFR, followed by the CG-AjBW-GFR formula, while the CG-IBW, CG-LBW, MDRD-GFR and CKD-EPI-GFR formulae were not reliable at all .

scholarly journals Changes in Resting Energy Expenditure following Gastric Bypass Surgery: Impact on Total Body Weight.

2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Fathimath Naseer ◽  
Ruth Price ◽  
Adele McElroy ◽  
Carel Le Roux ◽  
Tamsyn Redpath ◽  
...  
Keyword(s):  
Weight Loss ◽  
Gastric Bypass ◽  
Body Weight ◽  
Energy Expenditure ◽  
Resting Energy Expenditure ◽  
Total Body Weight ◽  
Post Surgery ◽  
Significant Difference ◽  
Total Body ◽  
Ree Group

AbstractBariatric surgery, including Gastric Bypass (GBP) Surgery, is the most efficient modality to manage severe obesity. Resting Energy Expenditure (REE) is an area of interest in the context of weight loss (WL) as it has been postulated to be an independent predictor of WL success following GBP. As such, the aim of this study is to investigate the impact of REE on WL following GBP. 31 GBP patients (77.4% females BMI 45.5 ± 7.0kg/m2 ; 47.3 ± 11.6y) and 32 weight-stable controls (46.9% females; BMI 27.0 ± 4.6kg/m2 ; 41.1 ± 13.5y) were assessed at one-month pre-surgery and at 3 and 12-months post-surgery. Fat mass (FM) and fat-free mass (FFM) were measured using dual energy X-ray absorptiometry (Lunar iDXA, GE Healthcare). REE was measured under standardised conditions using indirect calorimetry (ECAL, Metabolic Health Solutions). Statistical analyses were performed with SPSS v24.0, Armonk, NY. Multiple regression analysis showed that FM (P = 0.001), FFM (P < 0.0001) and gender (P = 0.012) significantly predicted the interindividual variability in REE. Total body weight (TBW) was removed from the model due to collinearity. Adjusted-REE values were then generated using the above predictor variables. Low-REE and high-REE groups were created using within-group adjusted-REE split. At both follow-ups (3- and 12-months post-surgery), patients had a greater reduction in TBW, FM, FFM, measured-REE and adjusted-REE values compared with controls (P < 0.0001). There was also no significant difference between measured and adjusted-REE values at all time-points (P > 0.05). Patients with high REEs at baseline lost more TBW than those in the low-REE group at 3-months post-surgery (-24.9 ± 6.5 kg vs. -16.6 ± 7.0 kg; P = 0.005) and 12-months post-surgery (-41.3 ± 12.5 kg vs. -25.8 ± 10.4.0 kg; P = 0.003). There was no significant difference in mean TBW changes for controls in the low-and high-REE groups at both follow-ups. Patients with high REEs at 3-months post-surgery did not lose more TBW than those in the low-REE group at 12-months post-surgery (-30.1 ± 12.8 kg vs. -38.6 ± 14.4 kg; P = 0.155). Similarly, there was no difference in mean TBW reduction between controls in the low- and high-REE groups (P = 0.115). Thus while patients with a high adjusted-REE value at baseline (> 9746.6kJ/day) lost more weight at 3- and 12-months post-GBP, it is plausible that from the third to the 12th month post-surgery, other key drivers of weight loss, particularly the reduction in energy intake are more important in predicting WL. Further research with a larger sample size is required to increase the chances of detecting a true effect.

Estimation of Total Body Weight in Obese Patients

2009 ◽  
Vol 28 (3) ◽  
pp. 139-145 ◽  
Author(s):  
Cameron S. Crandall ◽  
Stephanie Gardner ◽  
Darren A. Braude
Keyword(s):  
Body Weight ◽  
Total Body Weight ◽  
Obese Patients ◽  
Total Body

scholarly journals Pharmacokinetic Study of Modafinil in Relation to Gender and Ethnicity in Healthy Young Chinese Volunteers

2010 ◽  
Vol 13 (3) ◽  
pp. 443 ◽  
Author(s):  
Tao Guo ◽  
Longshan Zhao ◽  
Dong-Ya Xia
Keyword(s):  
Body Weight ◽  
Oral Dose ◽  
High Performance ◽  
Area Under The Curve ◽  
Total Body Weight ◽  
Apparent Volume ◽  
Pharmacokinetic Parameters ◽  
Maximum Plasma ◽  
Significant Difference ◽  
Total Body

Purpose. The pharmacokinetics of modafinil were investigated in relation to gender and ethnicity in healthy young volunteers from Han, Mongolian, Korean, Uygur and Hui ( n = 10/group) following administration of a single 200 mg oral dose. Methods. Blood samples were collected over 48 h for the determination of plasma levels of modafinil and its acid metabolite by High performance liquid chromatography with an ultraviolet detector. Pharmacokinetic parameters were evaluated using noncompartmental methods. Results. Modafinil was well tolerated and safe at a single oral dose of 200 mg. All participants reported adverse events, none of which was serious or unexpected. The maximum plasma concentration (Cmax) and area under the curve for modafinil concentration versus time, which was extrapolated to infinity (AUC0-∞), were higher in women compared to men (p < 0.01). No gender-based difference was noted in the total body weight-normalized modafinil oral clearance. The total body weight-normalized modafinil apparent volume of distribution and the t1/2 was found to exhibit an ethnicity-based significant difference. Conclusion. The results of the current study suggest that there might be pharmacokinetic differences related to gender and ethnicity in the pharmacokinetics of modafinil.

Effect of Shearing Wool and the Hot Months of the Year on some Production Characteristics in Turkish Awassi Ewes

2020 ◽  
Vol 13 (1) ◽  
pp. 50-58
Author(s):  
Taha AL-Sharqi ◽  
Majid Abdullah
Keyword(s):  
Body Weight ◽  
Heat Stress ◽  
Birth Weight ◽  
Total Body Weight ◽  
Average Weight ◽  
Significant Difference ◽  
Group Control ◽  
Humidity Index ◽  
Total Body ◽  
Production Characteristics

This study aimed to investigate the effect of wool shearing and the environmental factors represented by some hot months of the year (July August and September) on some production characteristics in Turkish Awassi ewes. 18 ewes, aged 3-5 years, with an average weight of about 55±1.43 kg, were used. The ewes divided into three treatments. The first group control (T1) were not shorned the wool, the second group (T2) wool of ewes were sheared at a distance of 1 cm from skin, while third group (T3) wool of ewes were sheared at level of the skin. The value of the weekly Temperature-humidity index THI in this study (32.33, 31.08, 31.70, 32.53, 33.45, 33.83, 34.60, 33.91, 31.90, 31.10, 31.84, 32.74) weeks respectively, while the monthly THI was (31.63, 33.48, 31.82) months of the study in July August and September in a respectively. The results showed a significant difference (p<0.05) between the treatments in body weight that were recorded at the tenth week where the THI reached. While the Second group recorded (2.16 ± 0.802) kg compared to T1, T3 (0.916 ± 0.723) (0.583 ± 0.490) kg respectively. While the total body weight of ewes and birth weight showed non-significant differences between different treated groups. From another hand the result showed non-significant differences feed and significant differences in water consumption between different treated groups. From the current study concluded that the level of shearing wool in Turkish Awassi ewes in conjunction with high temperature has an effect in production characteristics by reducing the effect of heat stress on the ewes.

Evaluation of hydroponics fodder as a partial feed substitute in the ration of crossbred calves

2018 ◽  
Author(s):  
G. Rajkumar ◽  
M. T. Dipu ◽  
K. Lalu ◽  
K. Shyama ◽  
P. S. Banakar
Keyword(s):  
Body Weight ◽  
Weight Gain ◽  
Body Weight Gain ◽  
Average Daily Gain ◽  
Total Body Weight ◽  
Feed Conversion ◽  
Treatment Groups ◽  
Significant Difference ◽  
Green Fodder ◽  
Total Body

An experiment was conducted to evaluate the effect of maize green fodder produced by hydroponics system on the performance of eighteen weaned crossbred calves and Calves were divided into three groups T1, T2 and T3 of six each as uniformly. The calf starter in dietary treatments T1, T2 and T3 contained 24, 20 and 17 per cent of Crude Protein (CP), respectively and 70 per cent Total Digestible Nutrients (TDN). The T2 and T3 treatments were made iso-nitrogenous with T1 by supplementing hydroponics maize fodder. The results obtained in the present study showed significant difference among different treatment groups regarding Dry matter intake (DM), total body weight gain, Average daily gain (ADG) and Feed conversion ratio (FCR) with a higher (P less than 0.05) values observed for calves belonging to T3 than groups T1 and T2. Data on digestibility of nutrients does not reveal any difference (P>0.05) among treatment groups. Cost per kg gain was significantly (P less than 0.05) lower in T3 (Rs.102.14) than groups T2 (Rs. 111.64) and T1 (Rs. 119.82). On conclusion, feeding of hydroponics maize fodder as a partial feed substitute of calf starter on protein basis at seven per cent level improves the DM intake, total body weight gain, ADG and lowers the cost per kg body weight gain.

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