Effect of subchronic exposure to opioids on the effective dose of intravenous and inhalation anaesthetics

2017 ◽  
Vol 28 (4) ◽  
pp. 272-279 ◽  
Author(s):  
Mengchan Ou ◽  
Yu Li ◽  
Yi Kang ◽  
Xiaolin Zhao ◽  
Tao Zhu
2005 ◽  
Vol 44 (05) ◽  
pp. 119-130 ◽  
Author(s):  
P. Schnell-Inderst ◽  
D. Noßke ◽  
M. Weiss ◽  
A. Stamm-Meyer ◽  
G. Brix ◽  
...  

Summary:The aim of this study was to estimate both the frequency and effective dose of nuclear medicine procedures performed in Germany between 1996 and 2000 for different subgroups of patients. Methods: Electronically archived data from 14 hospitals and 10 private practices were restored and statistically analyzed. The effective dose per examination was calculated according to ICRP publication 80 using the tissue weighting factors given in ICRP publication 60. Based on the data collected, statistical parameters were computed to characterize the frequency and effective dose of the various nuclear medicine procedures. Results: In total, 604,771 nuclear medicine procedures performed in 433,709 patients were analyzed. On average, 1.4 examinations were carried out per patient and year. The median effective dose was 1.7 [5.-95. percentile; mean: 0.4–8.5; 2.9] mSv per examination and 2.3 [0.5–11.2; 3.5] mSv per patient. Interestingly, the mean effective dose per examination, but not the number of examinations per year increased with the age of the patients. Most frequent were examinations of the thyroid (36.7%), the skeleton (27.1%) and the cardiovascular system (11.1%), which were associated with a median effective dose of 0.5 [0.5–1.1; 0.7] mSv, 3.4 [2.9–5.1; 3.6] mSv and 7.3 [3.2–21.0; 9.5] mSv, respectively. Over the five-year period examined, the total annual number of PET procedures (222.3%) as well as of examinations of thyroid (24.5%), skeleton (17.9%), and the cardiovascular system (14.9%) increased markedly, whereas a decrease was observed for brain (-39.3%), lung (-20.2%) and renal (-15.0%) scans. Conclusion: The age- and gender-specific data presented in this study provide detailed public health information on both the current status and recent trends in the practice of diagnostic nuclear medicine examinations.


2002 ◽  
Vol 41 (02) ◽  
pp. 102-107 ◽  
Author(s):  
J. Kopp ◽  
H. Vogt ◽  
F. Wawroschek ◽  
S. Gröber ◽  
R. Dorn ◽  
...  

Summary Aim: To visualise the sentinel lymph nodes (SLNs) of the prostate we injected the radiotracer into the parenchyma of the prostate. The activity was deposited in liver, spleen, bone marrow, urinary bladder and regional lymphatic system. The aim of this work is to determine biokinetical data and to estimate radiation doses to the patient. Methods: The patients with prostate cancer received a sonographically controlled, transrectal administration of 99mTc-Nanocoll®, injected directly into both prostate lobes. In 10 randomly selected patients radionuclide distribution and its time course was determined via regions of interest (ROIs) over prostate, urinary bladder, liver, spleen and the lymph nodes. The uptake in the SLNs was estimated from gamma probe measurements at the surgically removed nodes. To compare tumour positive with tumour free lymph nodes according to SLN-uptake and SLNlocalisation we evaluated 108 lymph nodes out of 24 patients with tumour positive SLN. For calculating the effective dose according to ICRP 60 of the patients we used the MIRD-method and the Mirdose 3.1 software. Results: The average uptake of separate organs was: bladder content 24%, liver 25.5%, spleen 2%, sum of SLN 0.5%. An average of 9% of the applied activity remained in the prostate. The residual activity was mainly accumulated in bone marrow and blood. Occasionally a weak activity enrichment in intestinal tract and kidneys could be recognized. The effective dose to the patient was estimated to 7.6 μSv/MBq. The radioactivity uptake of the SLN varied in several orders of magnitude between 0.006% and 0.6%. The probability of SLN-metastasis was found to be independent from tracer uptake in the lymph node. The radioactivity uptake of the SLNs in distinct lymph node regions showed no significant differences. Conclusion: The radiotracer is transferred out of the prostate via blood flow, by direct transfer via the urethra into the bladder and by lymphatic transport. Injecting a total activity of 200 MBq leads to a mean effective dose of 1.5 mSv. It is not recommended to use the tracer uptake in lymph nodes as the only criterion to characterize SLNs.


1977 ◽  
Vol 37 (01) ◽  
pp. 154-161 ◽  
Author(s):  
B. A Janik ◽  
S. E Papaioannou

SummaryUrokinase, streptokinase, Brinase, trypsin, and SN 687, a bacterial exoprotease, have been evaluated in an ex vivo assay system. These enzymes were injected into rabbits and the fibrinolytic activity as well as other coagulation parameters were measured by in vitro techniques. Dose-response correlations have been made using the euglobulin lysis time as a measure of fibrinolytic activity and the 50% effective dose has been determined for each enzyme. Loading doses, equal to four times the 50% effective dose, were administered to monitor potential toxicity revealing that Brinase, trypsin, and SN 687 were very toxic at this concentration.Having established the 50% effective dose for each enzyme, further testing was conducted where relevant fibrinolytic and coagulation parameters were measured for up to two days following a 50% effective dose bolus injection of each enzyme. Our results have demonstrated that urokinase and streptokinase are plasminogen activators specifically activating the rabbit fibrinolytic system while Brinase, trypsin and SN 687 increase the general proteolytic activity in vivo.The advantages of this ex vivo assay system for evaluating relative fibrinolytic potencies and side effects for plasminogen activators and fibrinolytic proteases have been discussed.


1996 ◽  
Vol 75 (05) ◽  
pp. 731-733 ◽  
Author(s):  
V Cazaux ◽  
B Gauthier ◽  
A Elias ◽  
D Lefebvre ◽  
J Tredez ◽  
...  

SummaryDue to large inter-individual variations, the dose of vitamin K antagonist required to target the desired hypocoagulability is hardly predictible for a given patient, and the time needed to reach therapeutic equilibrium may be excessively long. This work reports on a simple method for predicting the daily maintenance dose of fluindione after the third intake. In a first step, 37 patients were delivered 20 mg of fluindione once a day, at 6 p.m. for 3 consecutive days. On the morning of the 4th day an INR was performed. During the following days the dose was adjusted to target an INR between 2 and 3. There was a good correlation (r = 0.83, p<0.001) between the INR performed on the morning of day 4 and the daily maintenance dose determined later by successive approximations. This allowed us to write a decisional algorithm to predict the effective maintenance dose of fluindione from the INR performed on day 4. The usefulness and the safety of this approach was tested in a second prospective study on 46 patients receiving fluindione according to the same initial scheme. The predicted dose was compared to the effective dose soon after having reached the equilibrium, then 30 and 90 days after. To within 5 mg (one quarter of a tablet), the predicted dose was the effective dose in 98%, 86% and 81% of the patients at the 3 times respectively. The mean time needed to reach the therapeutic equilibrium was reduced from 13 days in the first study to 6 days in the second study. No hemorrhagic complication occurred. Thus the strategy formerly developed to predict the daily maintenance dose of warfarin from the prothrombin time ratio or the thrombotest performed 3 days after starting the treatment may also be applied to fluindione and the INR measurement.


2015 ◽  
Vol 7 (1) ◽  
pp. 1324-1335
Author(s):  
Jabbar H. Jebur

Radon concentration, exhalation rate, annual effective dose, radium activity, thorium, uranium potassium and radium equivalent have been measured in the present investigation for soil in the area around the old fertilizer factory in southern of Basrah Governorate. The measurements based on CR39 track detector for passive method, RAD7 for active method and NaI(Tl) for gamma concentration measurements. Average values for radon concentration in soil were 112.04±10.76 Bq/m3 using passive technique and 104.56±6.05 Bq/m3 using RAD7. From the result of the passive technique, area and mass exhalation rates and the annual effective dose were calculated. Gamma ray spectroscopy for the soil samples were performed and found that the average concentrations of 226Ra, 232Th and 40K were 50.89 Bq/kg, 21.74 Bq/kg and 640.4 Bq/kg respectively. Gamma ray hazard indices were calculated and found they are within the world average.


Author(s):  
А.С. Казицкая ◽  
Т.К. Ядыкина ◽  
М.С. Бугаева ◽  
А.Г. Жукова ◽  
Н.Н. Михайлова ◽  
...  

В условиях непрерывного воздействия неблагоприятных факторов окружающей и производственной среды на человека особую актуальность приобретает изучение механизмов, поддерживающих гомеостаз организма. Длительное поступление фторидов в организм приводит к формированию хронической фтористой интоксикации, патогенез которой вызывает многочисленные споры и дискуссии. До сих пор недостаточно внимания уделяется изучению висцеральной патологии, обусловленной нарушениями иммунного статуса в условиях воздействия на организм соединений фтора. Практически отсутствуют исследования по изучению иммунной реактивности, определяющей морфофункциональный характер ответной реакции печени на ранних стадиях развития фтористой интоксикации. Цель работы - изучение действий патофизиологических механизмов иммунной реактивности печени при субхроническом действии на организм соединений фтора. Методика. Опыты проведены на 210 лабораторных крысах-самцах массой 180-220 г., разделенных на 2 группы: контрольную (n=80) и группу животных с субхроническим действием фторида натрия (n=130). Экспериментальные животные в течение 12 нед имели свободный доступ к водному раствору фторида натрия (концентрация 10 мг/л, что составляет суточную дозу фтора 1,2 мг/кг массы тела). Для изучения иммунологических и биохимических показателей забирали кровь из хвостовой вены через 1, 3, 6, 9, 12 нед от начала эксперимента. Для оценки состояния гуморального звена иммунитета определяли уровень сывороточных иммуноглобулинов (IgA, IgG, IgM) иммуноферментным анализом с помощью наборов реактивов ЗАО «Вектор-Бест» (Новосибирск). Уровень сывороточных цитокинов: TNF-α, IL-1β, 2, 4, 6, 10 определяли на анализаторе Multiskan EX методом иммуноферментного анализа с использованием наборов «Вектор Бест» (Новосибирск). Подсчет общего количества лейкоцитов произведен классическим способом в камере Горяева, анализ лейкоцитарной формулы - в окрашенных мазках периферической крови. Метаболические изменения оценивали по активности ферментов в ткани печени: щелочной фосфатазы (ЩФ), аланин- и аспартатаминотрансфераз (АЛТ, АСТ), лактатдегидрогеназы (ЛДГ), гаммаглутамилтранспептидазы (γ-ГТ). Активность ферментов определяли унифицированными методами с помощью наборов реактивов ЗАО «Вектор-Бест» (Новосибирск) на фотометре PM-750 (Германия). Гистологические исследования печени осуществляли после декапитации крыс, проводимой под эфирным наркозом. Результаты. Показано, что субхроническое воздействие фторида натрия сопровождается формированием внутриклеточных и внутрисосудистых повреждений печени. Активация медиаторов воспаления и развитие иммунологических нарушений в динамике эксперимента способствуют формированию системной воспалительной реакции, которая приводит к появлению стойких морфологических нарушений в печени и изменению активности ферментов основных метаболических путей. Заключение. Полученные результаты могут быть использованы при разработке и проведении профилактических мероприятий в условиях воздействия на организм высоких концентраций фтора с последовательным применением детоксикационной, иммуномодуляторной и органопротекторной коррекции. Studying mechanisms, which maintain the body homeostasis, is particularly important in the conditions of continuous impact of adverse environmental and manufacturing factors. Long-term exposure to fluorides leads to chronic fluoric intoxication, the pathogenesis of which is a subject of multiple controversy and discussions. Not enough attention is still paid to elucidating the visceral pathology associated with fluorine-induced immune disorders. There are virtually no studies of immune reactions that define the morphofunctional nature of the liver response to early stages of fluoric intoxication. Aim. To study pathophysiological mechanisms of hepatic immune reactivity in subchronic exposure of the body to fluorine compounds. Methods. Experiments were performed on 210 male rats weighing 180-220 g. The animals were divided into two groups: 1) control (n=80) and 2) subchronic exposure to sodium fluoride (n=130). The rats had free access to a 10 mg/l aqueous solution of sodium fluoride (daily dose, 1.2 mg/kg body weight) for 12 weeks. Blood was withdrawn from the caudal vein at 1, 3, 6, 9, and 12 weeks of the experiment for immunological and biochemical tests. Histological study of the liver was performed after decapitation of rats under ether anesthesia. Results. The subchronic exposure to sodium fluoride was associated with intracellular and intravascular damage of the liver. Activation of inflammatory mediators and development of immunological disorders during the experiment contributed to a systemic inflammatory reaction, which resulted in persistent morphological injuries of the liver and changes in enzyme activities in major metabolic pathways. Conclusion. The study results can be used for development and implementation of preventive measures against the effects of high fluorine concentrations, which would include a successive use of detoxification, immunomodulation and organ protection.


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