Predicting Unbound Phenytoin Concentrations in the Critically Ill Neurosurgical Patient

1996 ◽  
Vol 30 (3) ◽  
pp. 219-223 ◽  
Author(s):  
Mark E Mlynarek ◽  
Edward L Peterson ◽  
Barbara J Zarowitz
Keyword(s):  
Serum Albumin ◽  
Critically Ill ◽  
Mean Value ◽  
Absolute Value ◽  
Trough Serum ◽  
Neurosurgical Patient ◽  
Neurosurgical Patients ◽  
Study Population ◽  
Neurosurgical Intensive Care Unit ◽  
The Mean

OBJECTIVE: To assess the correlation of measured unbound Phenytoin concentration (dphF) to estimated unbound concentration (dphEF) using the Sheiner-Tozer equation in critically ill patients in the neurosurgical intensive care unit. DESIGN: The dphF and total phenytoin (dphT) trough serum concentrations were measured during the first week of therapy in 17 consecutive patients with albumin concentrations less than 3.5 g/dL. Serum albumin concentrations were measured within 24 hours of serum phenytoin concentration measurement. SETTING: A university-affiliated urban teaching hospital. PARTICIPANTS: The study population consisted of 17 neurosurgical patients who were at least 18 years old. MAIN OUTCOME MEASURES: The predictability of the Sheiner-Tozer equation was tested by measuring dphF, dphT, and serum albumin concentrations. Measured phenytoin concentrations were compared with phenytoin concentrations calculated from the Sheiner-Tozer equation. To estimate correlation between variables linear regression was calculated. Mean absolute value of error and mean error were estimated to assess precision and bias between measures, respectively. RESULTS: The mean ± SD dphT was 13.05 ± 5.15 μg/mL. The measured dphF was 1.89 ± 0.80 compared with 2.00 ± 0.8 μg/mL for the dphEF (NS). Regression analysis for dphEF versus dphF revealed a significant correlation (r2 = 0.94, ρ = 0.001). The mean absolute value of error for the Sheiner-Tozer equation to predict dphEF was 0.167, which was 9% of the mean value of dphF (1.89). CONCLUSIONS: These results indicate that, in this population, the Sheiner-Tozer estimate of dphEF provides an unbiased, precise clinical estimate of dphF in patients for whom measured dphF is unavailable or impractical.

scholarly journals The Effect of Age, Gender, Refractive Status and Axial Length on the Measurements of Hertel Exophthalmometry

2015 ◽  
Vol 9 (1) ◽  
pp. 113-115 ◽  
Author(s):  
Omer Karti ◽  
Ozlem B Selver ◽  
Eyyup Karahan ◽  
Mehmet O Zengin ◽  
Murat Uyar
Keyword(s):  
Axial Length ◽  
Adult Population ◽  
Mean Value ◽  
Normative Values ◽  
Length Standard ◽  
Refractive Status ◽  
Study Population ◽  
The Mean ◽  
Effect Of Age ◽  
Healthy Females

Purpose : To evaluate the normal distribution of exophthalmometric values in Turkish adult population and the effect of age, gender, refractive status and axial length on globe position. Methods : One hundred and twenty-two males and 114 healthy females with age ranging from 18 to 87 years were included in the study. The study population was recruited from patients presenting to our institution for routine refractive examination. Hertel exophthalmometer was used to measure the degree of ocular protrusion. Effect of age, refractive error, interpupillary distance, and axial length on globe position was detected with linear regression analyses. Results : The mean Hertel exophthalmometric size was 15.7+2.6 mm (range; 11 to 21 mm). The mean value for males was 16.1±2.6 mm (range; 11 to 21 mm), and for females 15.5±2.6 mm (range; 11 to 20 mm). The mean distance between the lateral rims of the orbit was 102 + 5.1 mm (range; 88 to 111mm). The mean exophthalmometric values were not statistically different in males and females. Age and mean spherical equivalents were negatively correlated with exophthalmometric measurements. Axial length was positively correlated with exophthalmometric measurements. Conclusion : The exophthalmometric measurement of the eye is affected by the age, spherical equivalent and the axial length. Standard normative values of the Hertel exophthalmometric measurements should be reevaluated with larger samples.

Objective cyclodeviation measurement in normal subjects by means of Cyclocheck® application

2020 ◽  
pp. 112067212090531
Author(s):  
Justyna Simiera ◽  
Agata Joanna Ordon ◽  
Piotr Loba
Keyword(s):  
Normal Subjects ◽  
Mean Value ◽  
Angle Measurements ◽  
Corrected Visual Acuity ◽  
Normal Individuals ◽  
Muscle Balance ◽  
Study Population ◽  
The Mean ◽  
Fundus Photographs ◽  
The Right

Purpose: To evaluate the range of cyclodeviation in normal individuals by means of Cyclocheck® application recently designed by the authors and freely available at www.cyclocheck.com . Methods: Healthy subjects with normal muscle balance, best-corrected visual acuity of ⩾0.8, and stereopsis on Randot charts of ⩽100 s of arc were included in the study. Two separate digital fundus photographs were taken of each eye of every patient. The disk-foveal angle was calculated using the Cyclocheck® application. The average result of the disk-foveal angle measurements were considered for data analysis. Results: A total of 131 patients met inclusion criteria for the study population. The mean value of the disk-foveal angle in the whole study group (both right and left eye) was 6.39° ± 2.72° with 5.26° ± 2.56° (range from −0.4° to 12.55°) in the right eye and 7.52° ± 2.39° (range from 1.25° to 12.76°) in the left eye. The mean value of the disk-foveal angle of the left eye was greater by 2.26° than that of the right eye. Conclusion: Cyclocheck® software allows easy assessment of cyclodeviation. Normal individuals present with a positive value of the disk-foveal angle with a certain spread of the results. The analysis of obtained measurements revealed a significant asymmetry between both eyes with the left eye being more excyclodeviated in an otherwise orthotropic population, which remains a subject for further investigations.

Asymptotic Analysis of Wave Resistance of a Submerged Body Moving with an Oscillating Velocity

1993 ◽  
Vol 37 (02) ◽  
pp. 119-125
Author(s):  
N. G. Kuznetsov
Keyword(s):  
Perturbation Technique ◽  
Mean Value ◽  
Wave Resistance ◽  
The Body ◽  
Singular Perturbation Technique ◽  
Mean Values ◽  
Absolute Value ◽  
Submerged Body ◽  
Short Period ◽  
The Mean

An asymptotic study is made of potential and tree-surface elevation due to forward motion of a submerged body with an oscillating velocity. The latter is supposed to be a short period. As the nondimensional period ε 1, the singular perturbation technique is applied. Using two-term expansion for the potential, the principal terms of asymptotics for instant and mean values of wave resistance are obtained. The mean value (up to a term 0(e)) is the sum of two addends, the first of which is the wave resistance of the same body moving at the mean speed. The second addend is proportional to the dispersion of velocity with the coefficient depending on the form of the body. This coefficient vanishes if the body is symmetric with respect to the mid-section. Numerical examples for the two-dimensional problem show that there exist cylinders with the following property: the absolute value of wave resistance decreases when passing from motion at the mean speed to motion with oscillating velocity.

Abstract 19572: Elevated PETCO2 During Cardiac Resuscitation Without Return of Spontaneous Circulation

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Cameron Hypes ◽  
Dan Spaite ◽  
Tyler Vadeboncoeur ◽  
Ryan A Murphy ◽  
Chengcheng Hu ◽  
...  
Keyword(s):  
Cardiac Rhythm ◽  
Vital Signs ◽  
Mean Value ◽  
Spontaneous Circulation ◽  
Accelerometer Data ◽  
Improvement Program ◽  
Study Population ◽  
Cpr Quality ◽  
The Mean ◽  
End Tidal

Background: Quantitative End-Tidal CO2 (PETCO2) measurement during cardiac arrest is recommended for monitoring the CPR quality to detect ROSC. While low ETC02 can reflect suboptimal CPR quality and increases in ETC02 are often associated with ROSC the significance of high values of PETCO2 without ROSC remain unclear. Objectives: To describe the population of OHCA victims with high PETCO2 (>50 mm Hg) during ongoing resuscitation including demographics, rhythm characteristics, occurrence of ROSC, the later occurrence of field termination of resuscitation and the presumed etiology. Methods: An observational analysis of adult OHCAs with available PETCO2 data occurring between Oct 2010 and Nov 2014 at two sites involved in the Save Hearts in Arizona Registry and Education (SHARE) quality improvement program. CPR and PETCO2 data were recorded using ZOLL E and X Series EMS monitors. PETCO2 is reported as the mean value for each minute. The cardiac rhythm and the presence of ROSC were determined for each minute using EMS provider reports, vital signs, ECG, and accelerometer data. The first recorded minute of PETCO2 and minutes with ROSC were excluded. Results: Study population included 654 OHCAs with PETCO2 data, 96 cases (58% male, age median 65 (IQR 54-75)) with at least 1 min of high PETCO2 in the absence of ROSC were identified. Of these, 31 (32%) had ROSC at least once during their resuscitation. Cases were of presumed cardiac etiology in 81 (84%), while 12% and 4% had presumed respiratory and other etiologies, respectively. A total of 322 minutes of PETCO2 >50 mm Hg in the absence of ROSC were identified. The mean PETC02 value was 67 (IQR 54-75). Of these 296 minutes (92%) occurred during PEA. Despite high PETCO2, resuscitation was terminated in the field in 21 (22%) patients. Only one subject survived to hospital discharge. Conclusions: In this observational study, high PETCO2 was frequently found during resuscitation without ROSC and PEA was the most common cardiac rhythm. Further study is warranted to determine the significance and possible reasons for this finding.

scholarly journals Neurosurgery (General Neurosurgery)

2015 ◽  
Vol 42 (S1) ◽  
pp. S40-S40
Author(s):  
Z Merali ◽  
S Sharma ◽  
R MacDonald ◽  
E Massicotte
Keyword(s):  
Critically Ill ◽  
Geographic Region ◽  
Patient Needs ◽  
Ground Vehicles ◽  
Region Of Origin ◽  
Transport Time ◽  
Resource Limitations ◽  
Neurosurgical Patients ◽  
The Mean ◽  
In Transit

Background: Critically ill neurosurgical patients require expedient access to neurosurgical centers (NC) to improve outcome. In Ontario, many patients are initially evaluated at a non-neurosurgical center (NNC) and subsequently transferred to a NC by a provincial service using air or ground vehicles. We characterized transfers from NNC to NC for critically ill patients. Methods: A retrospective observational analysis was undertaken. The cohort included patients in Ontario with emergent and urgent neurologic pathologies who underwent transfer from a NNC to NC between January 1, 2011 and December 31, 2013. Timing, clinical, and geographic data were collected for each transfer. Results: We identified 1103 emergent/urgent transfers. The mean transfer time to a NC was 3.4hrs (SD – 3.0) and varied by the geographic region of origin. 17% of patients bypassed a closer NC during transfer to their destination NC. Transfers that bypassed a closer NC travelled further (162km vs. 477km, p<0.001), took longer (3.1hrs vs. 3.9hrs, p<0.001), and in some regions were associated with a higher risk of in-transit clinical decline (3.0% vs. 8.3%, p<0.05) when compared with transfers that ended at the closest NC. Conclusions: Transport time to a NC varied across Ontario. Transfers occasionally bypassed the nearest NC, which may reflect neurosurgical bed availability, resource limitations, or patient needs.

An observation of umbilical coiling index in a low risk population in Nigeria

2018 ◽  
Vol 46 (3) ◽  
pp. 341-345 ◽  
Author(s):  
Kikelomo T. Adesina ◽  
Olumuyiwa A. Ogunlaja ◽  
Adebunmi O. Olarinoye ◽  
Abiodun P. Aboyeji ◽  
Halimat J. Akande ◽  
...  
Keyword(s):  
Congenital Abnormalities ◽  
Mean Value ◽  
Adverse Perinatal Outcome ◽  
Umbilical Coiling Index ◽  
Study Population ◽  
Foetal Outcome ◽  
The Mean ◽  
Umbilical Cords ◽  
Cord Length ◽  
Gross Examination

Abstract Objectives: The umbilical coiling index (UCI) is one of cord parameters for foetal assessment with limited studies in our environment. With recent advances in its evaluation, its significance, pattern, abnormalities and correlates need to be defined in our parturients. Methods: The umbilical cords of 436 neonates were examined. Gross examination was done within 5 min of delivery. The UCI was defined as the number of complete coils per centimetre of cord. Normal UCI was defined as values between the 10th and 90th percentiles of the study population. Results: The mean umbilical cord length was 52.7±11.5 cm, mean number of coils was 10.8±5.1 and mean UCI was 0.21±0.099. The range was between 0.0 and 1.0. UCI values of 0.13 and 0.30 were 10th and 90th percentiles, respectively. Normal UCI was observed in 351 (80.5%) neonates, 44 (10.4%) and 41 (9.1%) had hypo- and hypercoiled cords, respectively. Congenital abnormalities occurred in the normocoiled and hypercoiled groups but was not demonstrated in the hypocoiled group. The mean value of UCI in neonates with congenital abnormalities was 0.29±0.12 (P=0.011). There was no significant statistical relationship between foetal outcome and degree of UCI. Conclusion: The UCI was not associated with adverse perinatal outcome in this study.

scholarly journals The Value of Admission Serum IL-8 Monitoring and the Correlation with IL-8 (-251A/T) Polymorphism in Critically Ill Patients

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Ayman Abd Al-Maksoud Yousef ◽  
Ghada Abdulmomen Suliman ◽  
Maaly Mohamed Mabrouk
Keyword(s):  
Genetic Polymorphism ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Mutant Allele ◽  
Mean Value ◽  
Sepsis Group ◽  
Positive Correlation ◽  
Complicated Process ◽  
Major Variation ◽  
The Mean

Background. The clinical management of sepsis is a highly complicated process. Disruption of the immune system explains in part the major variation in sepsis outcome. IL-8 is a proinflammatory cytokine, genetic polymorphism of this cytokine could explain the outcome of sepsis. The present study was conducted to determine the value of serum IL-8 monitoring and its (-251A/T) genetic polymorphism in critically ill patients. Patients and Methods. 180 critically ill patients were allocated into two groups, 90 septic patients (sepsis group) and 90 nonseptic patients (SIRS group). Admission serum IL-8 and its (-251A/T) mutant allele were detected. Results. The admission mean value of serum IL-8 was significantly elevated in sepsis group. In both groups, the mean value of serum IL-8 in nonsurvived patients and patients with IL-8 (-251A/T) mutant allele was significantly higher. A positive correlation of survival and IL-8 (-251A/T) mutant allele was detected in both groups. The serum IL-8 distinguished wild from IL-8 (-251A/T) mutant allele at a cut-off value of 600 pg/mL. Conclusion. The admission mean value of serum IL-8 was significantly elevated in septic, nonsurvived, and patients with IL-8 (-251A/T) mutant alleles. A positive correlation of survival and IL-8 (-251A/T) mutant allele patients was detected.

scholarly journals PROGRESSION OF AUTOANTIBODIES ANTI-GAD AND ANTI-IA2 IN TYPE 1A DIABETICS AGED OF 5 TO 21 YEARS IN CÔTE D’IVOIRE

2019 ◽  
Author(s):  
Aïssé Florence Judith Trébissou ◽  
Chiayé Claire Antoinette Yapo-Crezoit ◽  
Pascal Sibailly ◽  
Mamadou Sanogo ◽  
Amos Ankotché ◽  
...  
Keyword(s):  
Cote D'ivoire ◽  
Côte D’Ivoire ◽  
Cell Mass ◽  
Mean Value ◽  
Cote D’Ivoire ◽  
Gad Autoantibodies ◽  
A Value ◽  
Côte D'ivoire ◽  
Study Population ◽  
The Mean

AbstractBackgroundDiabetes autoantibodies are indispensable markers of diabetes classification.Objectiveto research autoantibodies anti-GAD and anti-IA2 in type 1A diabetics (T1D) aged 5 to 21 years, and to follow the progression of these autoantibodies in T1D patients, in Côte d’Ivoire.MethodsThe study population composed of 28 T1D patients, aged 5 to 21 years. T1D were followed up in two diabetes care centers in Abidjan district, Endocrinology departments of U.H.C of Yopougon and Treichville. Anti-GAD and anti-IA2 autoantibodies were researched by ELISA.Resultsanti-GAD and anti-IA2 were present in T1D and their siblings. After 2 years of diabetes, the titer of the anti-GAD autoantibodies increased to the mean value of 677.10 ± 353.20 IU / ml. Then, a fall of the anti-GAD autoantibodies until the cancellation was observed from the 8th to the 9th with values of 117 IU / ml to 10.14 IU / ml. Anti-IA2 autoantibodies fall at 9th year of diabetes with a value of 55.10 IU / ml.Conclusionanti-GAD and anti-IA2 autoantibodies persist after 9 years of diabetes, causing total destruction over time of the pancreatic β-cell mass in patients from Côte d’Ivoire, leading them to the death.

scholarly journals 2D-shear wave elastography: number of acquisitions can be reduced according to clinical setting

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Marco Dioguardi Burgio ◽  
Jules Grégory ◽  
Maxime Ronot ◽  
Riccardo Sartoris ◽  
Gilles Chatellier ◽  
...  
Keyword(s):  
Shear Wave ◽  
Liver Stiffness ◽  
Shear Wave Elastography ◽  
Mean Value ◽  
Factors Affecting ◽  
Absolute Value ◽  
Factors Associated ◽  
Supersonic Shear Imaging ◽  
The Mean ◽  
The Difference

Abstract Background The factors affecting intra-operator variability of two-dimensional shear wave elastography (2D-SWE) have not been clearly established. We evaluated 2D-SWE variability according to the number of measurements, clinical and laboratory features, and liver stiffness measurements (LSM). Methods At least three LSM were performed in 452 patients who underwent LSM by 2D-SWE (supersonic shear imaging) out of an initial database of 1650 patients. The mean value of the three LSM was our best measurement method. Bland–Altman plots were used to evaluate intra-operator variability when considering only one, or the first two measurements. Variability was assessed by taking the absolute value of the difference between the first LSM and the mean of the three LSM. Logistic regression was used to assess the factors associated with the highest tertile of variability. Results The limit of agreement was narrower with the mean of the first and second measurements than with each measurement taken separately (− 2.83 to 2.99 kPa vs. − 5.86 to 6.21 kPa and − 5.77 to 5.73 kPa for the first and second measurement, respectively). A BMI ≥ 25 kg/m2 and a first LSM by 2D-SWE ≥ 7.1 kPa increased the odds of higher variability by 3.4 and 3.9, respectively. Adding a second LSM didn’t change the variability in patients with BMI < 25 and a first LSM by 2D-SWE < 7.1 kPa. Conclusions Intra-operator variability of LSM by 2D-SWE increases with both a high BMI and high LSM value. In patients with BMI < 25 kg/m2 and a first LSM < 7.1 kPa we recommend performing only one LSM.

scholarly journals Ukuran Penyebaran Data pada Penjualan Smartphone Tahun 2019-2020

2021 ◽  
Author(s):  
Samuel Gibson Devonius ◽  
R.Arie Trihartanto ◽  
Theresia Meri Tarigan
Keyword(s):  
Data Distribution ◽  
Mean Value ◽  
Average Deviation ◽  
Absolute Value ◽  
Average Value ◽  
Central Value ◽  
Group Data ◽  
The Mean ◽  
Single Data ◽  
Data Group

The size of the spread is a measure that states how far the actual observed value deviates from or differs from the central value. The data distribution measure also serves to determine whether the value is truly representative or not, and the process of comparing the variability of the data. If a data group has an unequaldistribution of the average value, it is said that the mean value is not representative. The average deviation of the absolute value of the deviation of each observed value from the average divided by the number of observations. There are also 2 types of average deviation, namely Single Data and Group Data. The range is used for all differences between the maximum and minimum values, all of which are contained in the data. Deviation is the numbers divided by the number of numbers or the root of the average of the squared deviations.

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