scholarly journals Determinants of Ceftazidime Clearance by Continuous Venovenous Hemofiltration and Continuous Venovenous Hemodialysis

2000 ◽  
Vol 44 (6) ◽  
pp. 1639-1644 ◽  
Author(s):  
Gary R. Matzke ◽  
Reginald F. Frye ◽  
Melanie S. Joy ◽  
Paul M. Palevsky

ABSTRACT Although several dosage adjustment regimens have been proposed, there is little quantitative information to guide the initiation of ceftazidime therapy in patients who are receiving continuous renal replacement therapy. To determine the clearance of ceftazidime by continuous venovenous hemofiltration (CVVH) and continuous venovenous hemodialysis (CVVHD), we performed controlled clearance studies with stable hemodialysis patients with three hemofilters: a 0.6-m2 acrylonitrile copolymer (AN69; Hospal) filter, a 2.1-m2 polymethylmethacrylate filter (PMMA; Toray) filter and a 0.65-m2 polysulfone (PS; Fresenius) filter. Subjects received 1,000 mg of ceftazidime intravenously prior to the start of a clearance study. The concentration of ceftazidime in multiple plasma and dialysate or ultrafiltrate samples was determined by high-performance liquid chromatography. The diffusional clearances (CIdiffusion) and sieving coefficients of ceftazidime were compared by a mixed-model repeated-measures analysis of variance with filter and blood, dialysate inflow, or ultrafiltration rate as the main effect and the patient as a random effect. The fraction of ceftazidime bound to plasma proteins was 17% ± 7% (range, 10 to 25%). The clearances of ceftazidime, urea, and creatinine by CVVHD were essentially constant at blood flow rates of 75 to 250 ml/min for all three filters. Significant linear relationships (P < 0.0001) were observed between CIdiffusion of ceftazidime and clearance of urea for all three filters: AN69 (slope = 0.83), PMMA (slope = 0.89), and PS (slope = 1.03). Ceftazidime clearance was membrane independent during CVVH and CVVHD. CVVH and CVVHD can significantly augment the clearance of ceftazidime. Dosing strategies for initiation of ceftazidime therapy in patients receiving CVVH and CVVHD are proposed.

2012 ◽  
Vol 2012 ◽  
pp. 1-12
Author(s):  
Rachel E. Maddux ◽  
Lars-Gunnar Lundh

The present study assessed the rate of depressive personality (DP), as measured by the self-report instrument depressive personality disorder inventory (DPDI), among 159 clients entering psychotherapy at an outpatient university clinic. The presenting clinical profile was evaluated for those with and without DP, including levels of depressed mood, other psychological symptoms, and global severity of psychopathology. Clients were followed naturalistically over the course of therapy, up to 40 weeks, and reassessed on these variables again after treatment. Results indicated that 44 percent of the sample qualified for DP prior to treatment, and these individuals had a comparatively more severe and complex presenting disposition than those without DP. Mixed-model repeated-measures analysis of variance was used to examine between-groups changes on mood and global severity over time, with those with DP demonstrating larger reductions on both outcome variables, although still showing more symptoms after treatment, than those without DP. Only eleven percent of the sample continued to endorse DP following treatment. These findings suggest that in routine clinical situations, psychotherapy may benefit individuals with DP.


2021 ◽  
Vol 186 (Supplement_1) ◽  
pp. 198-204
Author(s):  
Shawnna M Chee ◽  
Veronica E Bigornia ◽  
Daniel L Logsdon

ABSTRACT Introduction The CogScreen-Aeromedical Edition (CogScreen-AE) is a computerized neurocognitive assessment screening tool developed for the Federal Aviation Administration as a rapid, reliable means of measuring neurocognitive deficiency in civilian airline pilots. This has potential use and assessment of military aviators flying high performance aircraft under extreme conditions; however, no data exist on how the dynamic flight environment affects CogScreen-AE scores. The objectives of this study were to determine what changes in performance on CogScreen-AE scores are seen post-flight in Naval Aviators flying high performance aircraft and to determine the potential for use of CogScreen-AE as a screening tool to evaluate degree of impairment, recovery from neurological illness, and return to duty status of a military aviator. Materials and Methods Repeated measures, within-subjects experimental design with three CogScreen-AE administrations—introduction session, preflight session, and postflight session. An experimental study group was exposed to dynamic flight between preflight and postflight sessions, while a control group flew a desktop computer flight simulator between sessions. Data were analyzed by mixed model ANOVA using Statistical Package for the Social Sciences to compare CogScreen-AE pre- and postflight performance on 5 composite scores of variables that account for 45% of the variance in predicting flight performance. Results Preflight versus postflight scores demonstrated no significant differences in performance attributable to flight in high performance aircraft. Conclusions The CogScreen-AE performance is shown to be consistent preflight to post-flight. These data show that CogScreen-AE may be a reliable clinical instrument for assessing aviators’ cognitive function with regard to return to flight duty decision-making. We anticipate future work in determining how CogScreen-AE can be utilized in the operational environment and documenting recovery from neurologic illness.


2020 ◽  
pp. 030573562096979
Author(s):  
Eugenia Hernandez-Ruiz ◽  
Abbey L Dvorak

Mindfulness meditation has frequently used sound and music as an important component. However, research on effective music stimuli is scarce. After a series of studies evaluating the most effective, useful, and preferred auditory stimuli, we were interested in exploring whether these effective musical features were transferred to new music. In this study, we evaluate our original music stimuli with three new stimuli composed under similar principles. Non-musician and musician participants ( N = 114) in a multisite study evaluated their mindfulness state after listening to four music stimuli, and rated their usefulness and preference. Results from a repeated-measures analysis of variance (ANOVA) at each site indicated no significant difference in mindfulness effectiveness. Friedman’s ANOVAs for the usefulness of the music stimuli showed similar non-significant results in both sites. A mixed model among sites did not show significant differences among groups. Preference rankings were not significantly different for non-musicians, but musicians did show a statistically significant preference of the Original stimuli over Stimulus 2, probably due to sound quality. These results indicate the feasibility of transferring previously researched and effective musical features to new stimuli. Identifying the effective “active ingredients” of music interventions may be one way of supporting evidence-based practice in music therapy.


2019 ◽  
Vol 30 (6) ◽  
pp. NP1-NP2 ◽  
Author(s):  
Işıl Kutluturk Karagoz ◽  
Berhan Keskin ◽  
Flora Özkalaycı ◽  
Ali Karagöz

We have some criticism regarding some technical issues. Mixed models have begun to play a pivotal role in statistical analyses and offer many advantages over more conventional analyses regarding repeated variance analyses. First, they allow to avoid conducting multiple t-tests; second, they can accommodate for within-patient correlation; third, they allow to incorporate not only a random coefficient, but also a random slope, typically ‘linear’ time in longitudinal case series when there are enough data and patients’ trajectories vary a lot and improving model fit.


DICP ◽  
1989 ◽  
Vol 23 (7-8) ◽  
pp. 588-590 ◽  
Author(s):  
Linda S. Bullock ◽  
Joseph F. Fitzgerald ◽  
Helen I. Mazur

The stability of intravenous famotidine in dextrose 5% injection (D5W), NaCl 0.9% injection (NS), and sterile water for injection stored in polyvinyl chloride (PVC) syringes at 4°C for 14 days was studied. The concentration of famotidine samples was determined at time 0, 7 days, and 14 days by reverse-phase high-performance liquid chromatography. Samples were inspected for visual changes and tested for changes in pH. Results of the HPLC analysis indicated that the famotidine samples remained within 94-100 percent and 99-103 percent of the time 0 concentrations at 7 and 14 days, respectively. Repeated measures analysis of variance demonstrated a significant time effect on famotidine concentration as concentrations changed over time (p<0.01). This change was small in magnitude, however, and concentrations decreased at 7 days and increased at 14 days. Famotidine is stable at a concentration of 2 mg/mL in D5W, NS, and sterile water for injection stored in PVC syringes at 4°C for 14 days.


2021 ◽  
Vol 99 (Supplement_3) ◽  
pp. 180-181
Author(s):  
Ludovica Mammi ◽  
Damiano Cavallini ◽  
Alberto Palmonari ◽  
Alessandro Concolino ◽  
Francesca Ghiaccio ◽  
...  

Abstract Aim of the project was to evaluate behavioral and productive variations of dairy cows detected by automatic monitoring systems, during different seasons. Environmental data (Temperature (T, °C), Relative Humidity, (RH, %) and Temperature and Humidity Index (THI)), were recorded inside the pens by electronic probes during 4 periods over 2 years, for a total of 473 days. Fans and sprinklers were activated at THI &gt;60. Hundred lactating and dry cows were equipped with monitoring tag (Heatime-Pro, SCR Engineers Ltd.) that recorded continuously time (min/d) spent ruminating (RT), panting (PT) and feeding (FT). Daily PT and FT data were recorded as group average [lactating (LC) or dry], while RT and milk production were extracted as individual data. Four classes of environmental stress were identified based on maximum THI: comfort (C, THI &lt; 60, 101d), moderate stress (MS, 60&lt; THI &gt;69, 92d), stress (S, 70&lt; THI &gt;75, 102d), severe stress (SS, THI &gt;75, 178d). Behavioral and productive data were compared between classes. Data were analyzed by mixed model with repeated measures, with environmental class, group (dry or lactating), parity and interactions as fixed effect. Cow was included as random effect for RT and milk production. Means comparison was performed by Tukey post hoc test. All behavioral outcomes were influenced by heat stress (P &lt; .001, table 1). Panting increased linearly with maximum THI recorded, being highest during SS days in LC (49.6 min/d, P &lt; .001). FT and RT (min/d) were lowest (P &lt; .001) during S days (206.9, FT and 473.1, RT) and RT reached the lowest values in cows within 15 DIM (456.4). Milk production was affected in multiparous cows, with a linear reduction from C to SS days (P &lt; .001). Heat stress deeply affected cows behavior and performances, despite cooling systems. Automatic monitoring of these parameters can effectively help in detecting heat stress and consequently adopt strategies to improve animal welfare.


2019 ◽  
Vol 09 (02) ◽  
pp. e177-e184
Author(s):  
Annemaria De Tina ◽  
Jeremy Juang ◽  
Thomas F. McElrath ◽  
Jack D. Baty ◽  
Arvind Palanisamy

Objective To investigate differences in oxytocin (OXT) biodistribution between nonobese and obese parturients during labor. Study Design Patients with body mass index (BMI) of either ≥ 18 ≤ 24.9 kg/m2 (“nonobese”) or ≥ 30 kg/m2 (“obese”) undergoing elective induction of labor were included (N = 25 each). Blood samples were collected at baseline (T0), and 20 minutes after maximal OXT augmentation or adequate uterine contractions (T1) for OXT and oxytocinase assays. A mixed-model repeated-measures analysis of variance was used to test for group versus time interaction and analysis of covariance to detect a difference in OXT level at T1. Data presented as mean ± standard deviation or median (interquartile range), with p < 0.05 considered significant. Results The mean BMIs (kg/m2) were 22.1 ± 1.6 and 35.9 ± 5.1 in the nonobese and obese groups, respectively. No differences were observed in either the duration of OXT infusion, total dose of OXT, or plasma OXT (pg/mL) either at T0 or T1. However, plasma oxytocinase (ng/mL) was significantly lower at T0 (1.41 [0.67, 3.51] vs. 0.40 [0.29, 1.12]; p = 0.03) in the obese group. Conclusion We provide preliminary evidence that the disposition of OXT may not be different between obese and nonobese women during labor.


PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0250490
Author(s):  
Isabel Lange ◽  
Babak Alikhani ◽  
Frank Wacker ◽  
Hans-Juergen Raatschen

The objective of this study is to identify essential aspects influencing radiation dose in computed tomography [CT] of the chest, abdomen and pelvis by intraindividual comparison of imaging parameters and patient related factors. All patients receiving at least two consecutive CT examinations for tumor staging or follow-up within a period of 22 months were included in this retrospective study. Different CT dose estimates (computed tomography dose index [CTDIvol], dose length product [DLP], size-specific dose estimate [SSDE]) were correlated with patient’s body mass index [BMI], scan length and technical parameters (tube current, tube voltage, pitch, noise level, level of iterative reconstruction). Repeated-measures-analysis was initiated with focus on response variables (CTDIvol, DLP, SSDE) and possible factors (age, BMI, noise, scan length, peak kilovoltage [kVp], tube current, pitch, adaptive statistical iterative reconstruction [ASIR]). A univariate-linear-mixed-model with repeated-measures-analysis followed by Bonferroni adjustments was used to find associations between CT imaging parameters, BMI and dose estimates followed by a subsequent multivariate-mixed-model with repeated-measures-analysis with Bonferroni adjustments for significant parameters. A p-value <0.05 was considered statistically significant. We found all dose estimates in all imaging regions were substantially affected by tube current. The iterative reconstruction significantly influenced all dose estimates in the thoracoabdominopelvic scans as well as DLP and SSDE in chest-CT. Pitch factor affected all dose parameters in the thoracoabdominopelvic CT group. These results provide further evidence that tube current has a pivotal role and potential in radiation dose management. The use of iterative reconstruction algorithms can substantially decrease radiation dose especially in thoracoabdominopelvic and chest-CT-scans. Pitch factor should be kept at a level of ≥1.0 in order to reduce radiation dose.


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