scholarly journals Variation of the anal resting pressure induced by postexpiratory apnea effort in patients with constipation

2011 ◽  
Vol 48 (1) ◽  
pp. 30-35
Author(s):  
Thaís Helena Benetti ◽  
Maria Fernanda Santos ◽  
Melissa Eichenberger Alves Mergulhão ◽  
João José Fagundes ◽  
Maria de Lourdes Setsuko Ayrizono ◽  
...  
Keyword(s):  
Pelvic Floor ◽  
Valsalva Maneuver ◽  
Area Under The Curve ◽  
Pressure Variation ◽  
Common Symptom ◽  
Forced Expiration ◽  
Anal Pressure ◽  
Mean Values ◽  
Anal Orifice ◽  
The Mean

CONTEXT: Intestinal constipation - a common symptom among the general population - is more frequent in women. It may be secondary to an improper diet or organic or functional disturbances, such as dyskinesia of the pelvic floor. This is basically characterized by the absence of relaxation or paradoxical contraction of the pelvic floor and anal sphincter during evacuation. OBJECTIVE: To analyze, by manometric data, the anal pressure variation at rest, during evacuation effort by using the Valsalva maneuver and forced post-expiratory apnea in subjects with secondary constipation. METHODS: Twenty-one patients (19 females - 90.4%) with a mean age of 47.5 years old (23-72) were studied. The diagnosis was performed using anorectal manometry, with a catheter containing eight channels disposed at the axial axis, measuring the proximal (1) and distal (2) portions of the anal orifice. The elevation of the pressure values in relation to the resting with the evacuation effort was present in all patients. The Agachan score was used for clinical evaluation of constipation. The variables studied were: mean anal pressure of the anal orifice for 20 seconds at rest, the effort of evacuation using Valsalva maneuver and the effort of evacuation during apnea after forced expiration, as well as the area under the curve of the manometric tracing at moments Valsalva and apnea. RESULTS: The analysis of the mean values of the anal pressure variation at rest evidenced difference between proximal and distal channels (P = 0.007), independent of the moment and tendency to differ during moments Valsalva and apnea (P = 0.06). The mean of values of the area under the manometric tracing curve showed differences between moments Valsalva and apnea (P = 0.0008), either at the proximal portion or at the distal portion of the anal orifice. CONCLUSION: The effort of evacuation associated with postexpiratory apnea, when compared with the effort associated with the Valsalva maneuver, provides lower elevation of anal pressure at rest by the parameter area under the curve.

scholarly journals Zero order and area under curve spectrophotometric methods for determination of Levocetirizine in pharmaceutical formulation

2015 ◽  
Vol 1 (6) ◽  
pp. 270
Author(s):  
Audumbar Digambar Mali ◽  
Ritesh Bathe ◽  
Manojkumar Patil ◽  
Ashpak Tamboli
Keyword(s):  
Area Under The Curve ◽  
Zero Order ◽  
Pharmaceutical Dosage Forms ◽  
Mean Values ◽  
Spectrophotometric Methods ◽  
Ich Guidelines ◽  
Significant Difference ◽  
Curve Method ◽  
The Mean

Simple, fast and reliable spectrophotometric methods were developed for determination of Levocetirizine in bulk and pharmaceutical dosage forms. The solutions of standard and the sample were prepared in methanol. The quantitative determination of the drug was carried out using the zero order derivative values measured at 230 nm and the area under the curve method values measured at 227-234 nm (n=2). Calibration graphs constructed at their wavelengths of determination were linear in the concentration range of Levocetirizine using 5-25?g/ml (r=0.998 and r=0.999) for zero order and area under the curve spectrophotometric method. All the proposed methods have been extensively validated as per ICH guidelines. There was no significant difference between the performance of the proposed methods regarding the mean values and standard deviations. Developed spectrophotometric methods in this study are simple, accurate, precise and sensitive to assay of Levocetirizine in tablets.

Discordant GH and IGF-1 Results in Treated Acromegaly: Impact of GH Cutoffs and Mean Values Assessment

2020 ◽  
Author(s):  
Claudia Campana ◽  
Francesco Cocchiara ◽  
Giuliana Corica ◽  
Federica Nista ◽  
Marica Arvigo ◽  
...  
Keyword(s):  
Characteristic Curve ◽  
Area Under The Curve ◽  
Receiver Operator Characteristic Curve ◽  
Mean Values ◽  
Pituitary Diseases ◽  
Discordance Rate ◽  
Values Assessment ◽  
The Mean ◽  
The Impact

Abstract Context Discordant growth hormone (GH) and insulin-like growth factor-1 (IGF-1) values are frequent in acromegaly. Objective To evaluate the impact of different GH cutoffs on discordance rate. To investigate whether the mean of consecutive GH measurements impacts discordance rate when matched to the last available IGF-1 value. Design Retrospective study. Setting Referral center for pituitary diseases. Patients Ninety acromegaly patients with at least 3 consecutive evaluations for GH and IGF-1 using the same assay in the same laboratory (median follow-up 13 years). Interventions Multimodal treatment of acromegaly. Main Outcome Measures Single fasting GH (GHf) and IGF-1 (IGF-1f). Mean of 3 GH measurements (GHm), collected during consecutive routine patients’ evaluations. Results At last evaluation GHf values were 1.99 ± 2.79 µg/L and age-adjusted IGF-1f was 0.86 ± 0.44 × upper limit of normality (mean ± SD). The discordance rate using GHf was 52.2% (cutoff 1 µg/L) and 35.6% (cutoff 2.5 µg/L) (P = 0.025). “High GH” discordance was more common for GHf <1.0 µg/L, while “high IGF-1” was predominant for GHf <2.5 µg/L (P < 0.0001). Using GHm mitigated the impact of GH cutoffs on discordance (GHm <1.0 µg/L: 43.3%; GHm <2.5 µg/L: 38.9%; P = 0.265). At receiver-operator characteristic curve (ROC) analysis, both GHf and GHm were poor predictors of IGF-1f normalization (area under the curve [AUC] = 0.611 and AUC = 0.645, respectively). The prevalence of disease-related comorbidities did not significantly differ between controlled, discordant, and active disease patients. Discussion GH/IGF-1 discordance strongly depends on GH cutoffs. The use of GHm lessen the impact of GH cutoffs. Measurement of fasting GH levels (both GHf and GHm) is a poor predictor of IGF-1f normalization in our cohort.

scholarly journals Comparison of Autonomic Function using Valsalva Ratio, Heart Rate, and Blood Pressure in Meditators and Nonmeditators

2017 ◽  
Vol 1 (1) ◽  
pp. 6-9
Author(s):  
Roopam Bassi ◽  
Kiran   ◽  
Kawalinder Girgla
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Autonomic Function ◽  
Valsalva Maneuver ◽  
Well Being ◽  
Control Group ◽  
Relaxation Techniques ◽  
Mean Values ◽  
The Mean ◽  
The Difference

ABSTRACT Introduction In recent years, the various health benefits of meditation have been acknowledged by the scientific community as well as by the public. Apart from its physiological benefits, it can also improve the psychological and spiritual well-being. A case–control study was planned to investigate the effect of Rajyoga Meditation on cardiovascular autonomic activity in meditators and nonmeditators. Materials and methods The study was conducted on 100 subjects, randomized into two groups: meditators (n = 50; age 35.80 ± 7.69 years) and nonmeditators (n = 50; age 36.76 ± 6.38 years). The meditator group practiced meditation for 30 minutes in the morning as well as in the evening. The control group did not practice any type of meditation or relaxation techniques. The cardiovascular parameters – heart rate (HR), systolic (SBP) and diastolic blood pressure (DBP), and Valsalva maneuver tests – were performed in both the groups in the same environmental conditions. The data were compiled and analyzed using unpaired t test. Results The mean values of HR in meditators and the control group were 77.08 ± 5.39 and 80.68 ± 5.71 respectively, and the difference was statistically significant (p < 0.001). The mean values of SBP in meditators and nonmeditators were 124.60 ± 5.39 and 129.56 ± 4.30 mm Hg respectively, while those for DBP were 77.84 ± 4.65 and 80.80 ± 4.78 mm Hg respectively. The difference in both was statistically significant. In meditators, Valsalva ratio was 1.60 ± 0.20, while in nonmeditators, it was 1.33 ± 0.13, and the difference was highly significant. Conclusion Significant improvement is seen in physiological, cardiac, and parasympathetic parameters in Rajyoga meditators. A shift of the autonomic balance toward the parasympathetic side is seen. By purposefully energizing the parasympathetic system by meditation, we can combat the ill effects of stress and help heal many health conditions. How to cite this article Kiran, Thaman RG, Bassi R, Girgla K. Comparison of Autonomic Function using Valsalva Ratio, Heart Rate, and Blood Pressure in Meditators and Nonmeditators. Curr Trends Diagn Treat 2017;1(1):6-9.

scholarly journals DIAGNOSTIC CAPABILITIES OF DIGITAL FLUOROGRAPHY IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE

2015 ◽  
Vol 14 (1) ◽  
pp. 24-31
Author(s):  
N. A. Gorbunov ◽  
A. P. Dergilev ◽  
L. D. Sidorova ◽  
V. I. Kochura
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Optical Density ◽  
Stage I ◽  
Chronic Obstructive ◽  
Forced Expiration ◽  
Obstructive Pulmonary Disease ◽  
Mean Values ◽  
Digital Chest ◽  
The Mean

The purpose of the study – to examine the capabilities of the method of digital chest fluorography in diagnosis of chronic obstructive pulmonary disease (COPD) of different stages. By chest digital fluorography 247 patients with clinically diagnosed COPD stage I–III were examined. The average age of the patients was (55.3  1.7) years (16 to 88 years), forced expiration volume for the first second (FEV1) was (59.17  16.28) %. It was shown that for patients with COPD stage I most characteristic radiographic symptom was emphysema of the lung in the upper regions (26 (48%) of 54 patients); the mean values of the inspiratory lung optical density (ILOD) ranged from (703.48  2.15) to (807.47  5.61) optical density units (ODU), the expiratory lung optical density (ELOD) – from (786.05  6.15) to (830.23  4.71) ODU. For patients with COPD stage II the most common radiographic sign was the presence of amplification and deformation pulmonary pattern (95 (89%) of 107 patients); the mean values of ILOD ranged from (646.20  4.94) to (791.38  2.81) ODU, ELOD – from (677.34  9.91) to (813.91  3.29) ODU. Patients with COPD stage III were characterized by a combination of amplification and deformation pulmonary pattern (77 (90%) of 86 patients) with lung emphysema (51 (59%) of 86 patients); the mean values of the inspiratory lung optical density ranged from (765.93  16.4) to (863.37  15.83) ODU, expiratory lung optical density – from (826.80  11.64) to (881.37  4.29) ODU. Thus, we concluded that the method of digital chest fluorography, possessing low dose burden to the patient, can detect the characteristic radiological symptoms and determine the stage of the disease up to the values of the lung optical density in patients with COPD.

scholarly journals Evaluation of prediction score of contrast-induced nephropathy in inpatients undergone to digital or CT angiography

2020 ◽  
Vol 10 (3) ◽  
pp. 78-84
Author(s):  
Seleno Glauber de Jesus-Silva ◽  
Ana Elisa Chaves ◽  
Caio Augusto Alves Maciel ◽  
Edson Eziel Ferreira Scotini ◽  
Pablo Girardelli Mendonça Mesquita ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Roc Curve ◽  
Computed Tomography Angiography ◽  
Score Test ◽  
Area Under The Curve ◽  
Roc Curve Analysis ◽  
Contrast Induced Nephropathy ◽  
Mean Values ◽  
Iodinated Contrast ◽  
The Mean

Objectives: To assess the incidence of contrast-induced nephropathy (CIN) and determine the Mehran Score's (MS) ability to predict CIN in patients undergoing digital angiography or computed tomography angiography. Methods: 252 medical records of inpatients who underwent DA or CTA over 28 months in a quaternary hospital were reviewed. CIN was defined as serum creatinine> 0.5 mg / dL or > 25% increase in baseline creatinine, 48 h after administration of iodinated contrast. The ROC curve and the area under the curve (AUC) were used as a score test. Results: The majority (159; 63.1%) were male, and the average age was 60.4 years. Anemia, diabetes mellitus, and age > 75 years were the most prevalent factors. The incidence of CIN was 17.8% (n = 45). There was a decrease in the mean values ​​of creatinine pre and post among patients who did not suffer CIN (1.38 ± 1.22 vs 1.19 ± 0.89; t = 3.433; p = 0.0007), while among patients who suffering CIN, the mean increase was 1.03 mg / dL (1.43 ± 1.48 vs 2.46 ± 2.35 mg / dL; t = 5.44; p = 0.117). The ROC curve analysis identified a low correlation between MS and the occurrence of CIN (AUC = 0.506). Conclusion: The incidence of CIN in hospitalized patients undergoing angiography or computed tomography angiography was high. The EM did not allow the prediction of NIC.

the ‘Area Under the Curve’ or AUC. The AUC is taken as a measure of exposure of the drug to the subject. The peak or maximum concen-tration is referred to as Cmax and is an important safety measure. For regulatory approval of bioequivalence it is necessary to show from the trial results that the mean values of AUC and Cmax for T and R are not significantly different. The AUC is calculated by adding up the ar-eas of the regions identified by the vertical lines under the plot in Figure 7.1 using an arithmetic technique such as the trapezoidal rule (see, for example, Welling, 1986, 145–149, Rowland and Tozer, 1995, 469–471). Experience (e.g., FDA Guidance, 1992, 1997, 1999b, 2001) has dictated that AUC and Cmax need to be transformed to the natural logarithmic scale prior to analysis if the usual assumptions of normally distributed errors are to be made. Each of AUC and Cmax is analyzed separately and there is no adjustment to significance levels to allow for multiple testing (Hauck et al., 1995). We will refer to the derived variates as log(AUC) and log(Cmax), respectively. In bioequivalence trials there should be a wash-out period of at least five half-lives of the drugs between the active treatment periods. If this is the case, and there are no detectable pre-dose drug concentrations, there is no need to assume that carry-over effects are present and so it is not necessary to test for a differential carry-over effect (FDA Guidance, 2001). The model that is fitted to the data will be the one used in Section 5.3 of Chapter 5, which contains terms for subjects, periods and treatments. Following common practice we will also fit a sequence or group effect and consider subjects as a random effect nested within sequence. An example of fitting this model will be given in the next section. In the following sections we will consider three forms of bioequivalence: average (ABE), population (PBE) and individual (IBE). To simplify the following discussion we will refer only to log(AUC); the discussion for log(Cmax) is identical. To show that T and R are average bioequivalent it is only necessary to show that the mean log(AUC) for T is not significantly different from the mean log(AUC) for R. In other words we need to show that, ‘on average’, in the population of intended patients, the two drugs are bioequivalent. This measure does not take into account the variability of T and R. It is possible for one drug to be much more variable than the other, yet be similar in terms of mean log(AUC). It was for this reason that PBE was introduced. As we will see in Section 7.5, the measure of PBE that has been recommended by the regulators is a mixture of the mean and variance of the log(AUC) values (FDA Guidance, 1997, 1999a,b, 2000, 2001). Of course, two drugs could be similar in mean and variance over the

2003 ◽  
pp. 350-350
Keyword(s):  
Multiple Testing ◽  
Random Effect ◽  
Area Under The Curve ◽  
Mean Values ◽  
Fda Guidance ◽  
Significance Levels ◽  
Mean And Variance ◽  
The Mean ◽  
Carry Over ◽  
The One

scholarly journals Association of plasma DNA integrity and long fragment ALU247 in the diagnosis of epithelial ovarian cancer

2021 ◽  
pp. 35-45
Author(s):  
Feryal Farouk Sherif ◽  
Mohamed Ali El Desouky ◽  
Mona Gebril ◽  
Osama Mahmoud Azmy
Keyword(s):  
Ovarian Cancer ◽  
Epithelial Ovarian Cancer ◽  
Area Under The Curve ◽  
Dna Integrity ◽  
Plasma Dna ◽  
Clinical Value ◽  
Mean Values ◽  
Integrity Index ◽  
The Mean ◽  
Healthy Females

DNA Integrity index (DNA Int) and cell-free DNA (cf-DNA) represent promising biomarkers for epithelial ovarian cancer (EOC) detection. Tumor necrosis produces DNA fractions of different sizes, which contrasts apoptosis in normal tissue that releases smaller and more regular DNA fragments. Using ALU gene primers in quantitative PCR, the amplified cf-DNA is supposed to be either short fragments of 115 bp (ALU 115) or long fragments of 247 bp (ALU 247). ALU levels and DNA Int were determined in the plasma of 30 EOC patients, 30 benign cysts, and 15 healthy individuals. The mean values of DNA Int, ALU115, and ALU247 were elevated in malignant patients (0.51±0.09, 3.93 ng/ul ±1.93, 2.35 ng/ul ±1.1) respectively in comparison to healthy females (0.37±0.05; p < 0.001, 2.56 ng/ul ±0.9; p=0.027, 1.26±0.44; p< 0.01). A significant increase was shown in the mean values of DNA Int and ALU247 of EOC patients compared to those with benign cysts (0.4±0.06, p <0.001; 1.69±0.66, p =0.008) respectively. The area under the curve (AUC) for EOC versus healthy females achieved 0.913 (DNA Int), 0.696 (ALU115), and 0.809 (ALU247) with sensitivities and specificities were (86.7% and 93.3%) for DNA Int, (63.3% and 86.7%) for ALU115 and (76.7% and 86.7%) for ALU247 respectively. Furthermore, comparing patients with EOC versus those with benign cysts gave AUC of 0.834 (DNA Int), 0.564 (ALU115), and 0.681 (ALU247) with sensitivities and specificities were (80% and 80%) for DNA Int, (63.3% and 60%) for ALU115 and (60% and 80%) for ALU247 respectively. Higher DNA Int and plasma ALU247 could help in the assessment of EOC, and their measurements seem to have clinical value in diagnosis.

scholarly journals Pharmacokinetics of saquinavir, zidovudine, and zalcitabine in combination therapy.

1997 ◽  
Vol 41 (11) ◽  
pp. 2428-2432 ◽  
Author(s):  
G F Vanhove ◽  
H Kastrissios ◽  
J M Gries ◽  
D Verotta ◽  
K Park ◽  
...  
Keyword(s):  
Half Life ◽  
Area Under The Curve ◽  
Chronic Administration ◽  
Volume Of Distribution ◽  
Pharmacokinetic Parameters ◽  
Parameter Estimates ◽  
Pharmacokinetic Studies ◽  
Mean Values ◽  
Aids Clinical Trial Group ◽  
The Mean

We investigated the pharmacokinetics of zidovudine, zalcitabine, and saquinavir in AIDS Clinical Trial Group protocol 229. Patients received either saquinavir, zalcitabine, or a combination of both, together with zidovudine three times a day. Approximately 100 patients were enrolled in each treatment arm, and intensive pharmacokinetic studies were performed on about 25 patients per arm at weeks 1 and 12. We estimated the pharmacokinetic parameters of all three drugs by using parametric and nonparametric methods. The mean values of the pharmacokinetic parameters of zidovudine (clearance [CL]/bioavailability [F], 168 liters/h; volume of distribution [V]/F, 185 liters; half-life, 0.76 h) and zalcitabine (CL/F, 25 liters/h; V/F, 92.2 liters; half-life, 2.7 h) were similar to those reported previously. For saquinavir, the mean pharmacokinetic parameter estimates using parametric methods were as follows: maximum concentration of drug in serum [Cmax], 70.8 ng/ml; time to Cmax, 3.11 h; area under the curve, 809 ng x h/ml; CL/F, 989 liters/h; V/F, 1,503 liters; half-life, 1.38 h. For all three drugs, clearance decreased with age. Weight did not influence the clearance of zidovudine, but the clearance of zalcitabine and saquinavir increased with weight. There were no differences in pharmacokinetic parameters between study weeks and arms, suggesting that there is no change in kinetics with chronic administration and that there are no significant pharmacokinetic interactions among these three drugs.

scholarly journals Pharmacokinetic Profiles of Repaglinide in Elderly Subjects With Type 2 Diabetes

1999 ◽  
Vol 84 (4) ◽  
pp. 1475-1478 ◽  
Author(s):  
Vibeke Hatorp ◽  
Won-Chin Huang ◽  
Poul Strange
Keyword(s):  
Type 2 Diabetes ◽  
Multiple Dose ◽  
Area Under The Curve ◽  
Elderly Subjects ◽  
Maximal Concentration ◽  
Multiple Dosing ◽  
Mean Values ◽  
Pharmacokinetic Profiles ◽  
The Mean

Pharmacokinetic profiles of single- and multiple-dose regimens of repaglinide were evaluated in 12 elderly subjects with type 2 diabetes. On day 1, following a 1-hour fast, subjects received a single 2-mg dose of repaglinide. Starting on day 2 and continuing for 7 days, each subject received a 2-mg dose of repaglinide 15 minutes before each of the three main meals. On day 9, subjects received a single 2-mg dose of repaglinide. Pharmacokinetic profiles, including area under the curve (AUC), log(AUC), maximal concentration (Cmax), log(Cmax), time to maximal concentration (Tmax), and half-life (T1/2), were determined at completion of the single- and multiple-dose regimens (days 1 and 9, respectively). Trough repaglinide values were collected on days 2 through 7. The mean log(AUC) values after multiple dosing were significantly higher than the values obtained after a single dose. The mean values for log(Cmax), and Tmax were comparable after each dosing regimen. The T1/2 of repaglinide after multiple dosing was 1.7 hours. The trough values for repaglinide were low. No hypoglycemic events were reported. The pharmacokinetic profiles of repaglinide after single- and multiple-dose regimens were similar, and repaglinide was well tolerated by elderly subjects with type 2 diabetes.

scholarly journals Zero Order and Area Under Curve Spectrophotometric methods for determination of Oxcarbazepine in Pharmaceutical Formulation

2015 ◽  
Vol 1 (3) ◽  
pp. 156 ◽  
Author(s):  
Santosh Balaso Jadhav ◽  
Nilesh Patil ◽  
Ashpak Tamboli
Keyword(s):  
Area Under The Curve ◽  
Zero Order ◽  
Pharmaceutical Dosage Forms ◽  
Mean Values ◽  
Spectrophotometric Methods ◽  
Ich Guidelines ◽  
Significant Difference ◽  
Curve Method ◽  
The Mean

Simple, fast and reliable spectrophotometric methods were developed for determination of Oxcarbazepine in bulk and pharmaceutical dosage forms. The solutions of standard and the sample were prepared in Distilled Water. The quantitative determination of the drug was carried out using the zero order derivative values measured at 256 nm and the area under the curve method values measured at 252-258 nm (n=2). Calibration graphs constructed at their wavelengths of determination were linear in the concentration range of Oxcarbazepine using 5-25 ?g/.ml (r=0.998 and r=0.9986) for zero order and area under the curve spectrophotometric method. All the proposed methods have been extensively validated as per ICH guidelines. There was no significant difference between the performance of the proposed methods regarding the mean values and standard deviations. Developed spectrophotometric methods in this study are simple, accurate, precise and sensitive to assay of Oxcarbazepine in tablets.

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