scholarly journals KIDNEY INJURY MOLECULE-1 AS AN EARLY AMIKACIN-INDUCED NEPHROTOXICITY MARKER IN PATIENTS WITH SEPSIS HOSPITALIZED IN THE INTENSIVE CARE UNIT

Author(s):  
TRISNI UNTARI DEWI ◽  
INSTIATY . ◽  
RUDIANTO SEDONO ◽  
GESTINA ALISKA ◽  
MUHAMMAD KHIFZHON AZWAR ◽  
...  

Objective: This study sought to determine the correlation between trough plasma amikacin concentrations and urinary normalized kidney injurymolecule-1 (KIM-1) concentrations as an early biomarker of nephrotoxicity in patients with sepsis who are hospitalized in an intensive care unit.Methods: In this pilot study, 12 patients with sepsis were treated with amikacin 1000 mg/day between May 2015 and September 2015. The correlationbetween trough plasma amikacin concentrations measured after the third dose and the elevation of urinary normalized KIM-1 concentrations afterthe third amikacin dose relative to the first/second dose was evaluated.Results: In total, three patients had trough plasma amikacin concentrations exceeding the safe level (>10 μg/ml). Furthermore, eight patientsdisplayed higher normalized KIM-1 concentrations after third dose than after the first/second dose; however, there was no correlation betweentrough amikacin concentrations and the elevation of urinary normalized KIM-1 concentrations (r=0.3, p=0.3).Conclusion: The study results illustrated that short-term treatment with an amikacin dose of 1000 mg/day was generally safe in patients with sepsis.

2009 ◽  
Vol 32 (6) ◽  
pp. 322 ◽  
Author(s):  
B Rocic ◽  
N Bedernjak Bajuk ◽  
P Rocic ◽  
D S Weber ◽  
J Boras ◽  
...  

Purpose: To compare the antihyperglycemic effects of metformin and creatine in recently detected type II diabetics in a short-term clinical study. Methods: In a 14 day simmetrically randomized crossover study, recently detected type II diabetics received either creatine (2x3 g/day) or metformin (2x500 mg/day) for five days, followed by two days of washout, followed by cross-over to the opposite treatment for the next five days. Fasting and post-prandial (-15, 60, 90, 120, 180 and 240 min) blood glucose, insulin, c-peptide, creatine and lactate were measured every other day for the duration of treatment, and HbA1c only at the begining and at the end of the study. Results: Both creatine and metformin decreased glucose concentrations to similar levels at all time points vs. basal glucose values [-15, 60, 90, 120, 180, and 240 min]: 11.1±0.75 vs 9.1±0.55a vs 8.8±0.59b, 14.4±0.6 vs 12.9±0.47a vs 13.1±0.55a, 14.8±0.58 vs 13.0±0.46b vs 13.3±0.55a, 14.1±0.6 vs 11.9±0.42b vs 12.5±0.51a, 12.2±0.6 vs 9.6±0.36c vs 9.9±0.38c, and 10.1±0.47 vs 7.8±0.36c vs 8.4±0.4b; (aP < 0.05; bP < 0.01; cP < 0.001 vs. basal glucose values). Neither treatment altered insulin, c-peptide, or HbA1c. Lactate varied during the day, but never reached the upper level of the safety reference range. Conclusion: Short-term treatment with creatine and metformin elicits similar glucose lowering effects in recently detected type II diabetics. Further studies are necessary to determine the effect of creatine on long-term glucose and insulin regulation. Purpose: To compare the antihyperglycemic effects of metformin and creatine in recently detected type II diabetics in a short-term clinical study. Methods: In a 14 day simmetrically randomized crossover study, recently detected type II diabetics received either creatine (2x3 g/day) or metformin (2x500 mg/day) for five days, followed by two days of washout, followed by cross-over to the opposite treatment for the next five days. Fasting and post-prandial (-15, 60, 90, 120, 180 and 240 min) blood glucose, insulin, c-peptide, creatine and lactate were measured every other day for the duration of treatment, and HbA1c only at the begining and at the end of the study. Results: Both creatine and metformin decreased glucose concentrations to similar levels at all time points vs. basal glucose values [-15, 60, 90, 120, 180, and 240 min]: 11.1±0.75 vs 9.1±0.55a vs 8.8±0.59b, 14.4±0.6 vs 12.9±0.47a vs 13.1±0.55a, 14.8±0.58 vs 13.0±0.46b vs 13.3±0.55a, 14.1±0.6 vs 11.9±0.42b vs 12.5±0.51a, 12.2±0.6 vs 9.6±0.36c vs 9.9±0.38c, and 10.1±0.47 vs 7.8±0.36c vs 8.4±0.4b; (aP < 0.05; bP < 0.01; cP < 0.001 vs. basal glucose values). Neither treatment altered insulin, c-peptide, or HbA1c. Lactate varied during the day, but never reached the upper level of the safety reference range. Conclusion: Short-term treatment with creatine and metformin elicits similar glucose lowering effects in recently detected type II diabetics. Further studies are necessary to determine the effect of creatine on long-term glucose and insulin regulation.


1978 ◽  
Vol 86 (3) ◽  
pp. ORL-513-ORL-517 ◽  
Author(s):  
Nicholas L. Schenck

Recent evidence indicates that endotracheal intubation is supplanting tracheostomy for the short-term treatment of airway obstruction in epiglottitis and croup. Care should be provided by a triumvirate of physicians to include an otolaryngologist, a pediatrician, and an anesthesiologist. Intensive care facilities are also a prerequisite. Standard tracheostomy should be considered in cases requiring intubation longer than 72 hours.


1997 ◽  
Vol 6 (4) ◽  
pp. 9-16 ◽  
Author(s):  
Alison Behrman ◽  
Robert F. Orlikoff

Sophisticated, computer-based instrumentation has become increasingly available to the voice clinician. Yet substantial questions remain regarding its clinical necessity and usefulness. A theoretical model based on the scientific method is developed as a framework that can be used to guide the clinician in the selection and application of instrumental measures. Using the process of hypothesis testing, instrumentation is presented as an integral component of clinical practice. The uses of instrumental measures, and their relevance to long- and short-term treatment goals, are addressed. Clinical examples are presented to illustrate the incorporation of instrumentation and the scientific method into assessment and treatment.


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