945 resultados para Propofol, administration and dosage
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Cover title.
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"GAO/GGD-88-84."
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The aim of this review is to analyse critically the recent literature on the clinical pharmacokinetics and pharmacodynamics of tacrolimus in solid organ transplant recipients. Dosage and target concentration recommendations for tacrolimus vary from centre to centre, and large pharmacokinetic variability makes it difficult to predict what concentration will be achieved with a particular dose or dosage change. Therapeutic ranges have not been based on statistical approaches. The majority of pharmacokinetic studies have involved intense blood sampling in small homogeneous groups in the immediate post-transplant period. Most have used nonspecific immunoassays and provide little information on pharmacokinetic variability. Demographic investigations seeking correlations between pharmacokinetic parameters and patient factors have generally looked at one covariate at a time and have involved small patient numbers. Factors reported to influence the pharmacokinetics of tacrolimus include the patient group studied, hepatic dysfunction, hepatitis C status, time after transplantation, patient age, donor liver characteristics, recipient race, haematocrit and albumin concentrations, diurnal rhythm, food administration, corticosteroid dosage, diarrhoea and cytochrome P450 (CYP) isoenzyme and P-glycoprotein expression. Population analyses are adding to our understanding of the pharmacokinetics of tacrolimus, but such investigations are still in their infancy. A significant proportion of model variability remains unexplained. Population modelling and Bayesian forecasting may be improved if CYP isoenzymes and/or P-glycoprotein expression could be considered as covariates. Reports have been conflicting as to whether low tacrolimus trough concentrations are related to rejection. Several studies have demonstrated a correlation between high trough concentrations and toxicity, particularly nephrotoxicity. The best predictor of pharmacological effect may be drug concentrations in the transplanted organ itself. Researchers have started to question current reliance on trough measurement during therapeutic drug monitoring, with instances of toxicity and rejection occurring when trough concentrations are within 'acceptable' ranges. The correlation between blood concentration and drug exposure can be improved by use of non-trough timepoints. However, controversy exists as to whether this will provide any great benefit, given the added complexity in monitoring. Investigators are now attempting to quantify the pharmacological effects of tacrolimus on immune cells through assays that measure in vivo calcineurin inhibition and markers of immuno suppression such as cytokine concentration. To date, no studies have correlated pharmacodynamic marker assay results with immunosuppressive efficacy, as determined by allograft outcome, or investigated the relationship between calcineurin inhibition and drug adverse effects. Little is known about the magnitude of the pharmacodynamic variability of tacrolimus.
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Background and objective: There are no data about the influence of anaesthetics on cardiovascular variables during pressure support ventilation of the lungs through the laryngeal mask airway. We compared propofol, sevoflurane and isoflurane for maintenance of anaesthesia with the ProSeal (R) laryngeal mask airway during pressure support ventilation. Methods: Sixty healthy adults undergoing peripheral musculo-skeletal surgery were randomized for maintenance with sevoflurane end-tidal 29%, isoflurane end-tidal 1.1% or propofol 6 mg kg(-1) h(-1) in oxygen 33% and air. Pressure support ventilation comprised positive end-expiratory pressure set at 5 cmH(2)O, and pressure support set 5 cmH(2)O above positive end-expiratory pressure. Pressure support was initiated when inspiration produced a 2 cmH(2)O reduction in airway pressure. A blinded observer recorded cardiorespiratory variables (heart rate, mean blood pressure, oxygen saturation, air-way occlusion pressure, respiratory rate, expired tidal volume, expired minute volume and end-tidal CO2), adverse events and emergence times. Results: Respiratory rate and minute volume were 10-21% lower, and end-tidal CO2 6-11% higher with the propofol group compared with the sevoflurane or isoflurane groups, but otherwise cardiorespiratory variables were similar among groups. No adverse events occurred in any group. Emergence times were longer with the propofol group compared with the sevoflurane or isoflurane groups (10 vs. 7 vs. 7 min). Conclusion: Lung ventilation is less effective and emergence times are longer with propofol than sevoflurane or isoflurane for maintenance of anaesthesia during pressure support ventilation with the ProSeal (R) laryngeal mask airway. However, these differences are small and of doubtful clinical importance.
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Puts the case for reform of the law to allow for the administration of the estate of a missing person in the interim period between their disappearance and any later declaration of their presumed of death. Explains why reform is needed. Notes Parliamentary activities relating to the presumption of death and interim administration in the period 2008-12. Highlights Australian and Canadian legislation providing for such interim administration and the Irish Law Commission recommendations for a statutory scheme on administering a missing person's property.
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The improving performance of public administration and the reform of public financing system have been on agenda in Hungary for many years, in accordance with the international trends. However, governments have not expected and supported creating of a performance-oriented public administration in a comprehensive and explicit way. Nevertheless, there are bottom-up initiatives at organizational level, which target performance-oriented organizational function. The research focuses on organizations of central public administration where the successful application of performance management methods is most likely based on the international literature. These are the so called agency-type organizations, which are in Hungary called autonomous state-administration organizations independent of the Government (e.g. Hungarian Competition Authority), government bureaus (e.g. Hungarian Central Statistical Office), and central offices subordinated to the government (either the cabinet or a ministry) (e.g. Hungarian Meteorological Service). The studied agencies are legally independent organizations with managerial autonomy based on public law. The purpose of this study is to get an overview on organizational level performance management tools applied by Hungarian agencies, and to reveal the reasons and drivers of the application of these tools. The empirical research is based on a mixed methods approach which combines both quantitative methods and qualitative procedures. The first – quantitative – phase of the author’s research was content analysis of homepages of the studied organizations. As a results she got information about all agencies and their practice related to some performance management tools. The second – qualitative – phase was based on semi-structured face-to-face interviews with some senior managers of agencies. The author selected the interviewees based on the results of the first phase, the relatively strong performance orientation was an important selection criteria.
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Tourism and hospitality scholars and educational institutions in developing countries can benefit from systematic analysis of their counterparts in developed countries. Using the framework of sustainable competitive advantage, this paper explores the key organizational resources of the School of Hotel Administration at Cornell University that have assured its position as the leading hospitality program worldwide. The paper analyses key resources Cornell Hotel School uses to leverage and sustain its competitive advantage. Suggestions for positioning and enhancing future Chinese tourism and hospitality programs are provided. [Abstract in Chinese] 中国旅游发展起步较晚,在旅游教育的多数领域落后于西方发达国家。选择西方优秀旅游院系进行系统研究并总结其成功经验,对于提高我国旅游教育水平有着重要的意义。本文以持续竞争优势理论为框架,以全球旅游接待业教育的典范——康乃尔酒店管理学院为对象,详细分析了这所著名酒店学院的核心资源和确保其长期保持领袖地位的持续竞争优势,并提出可供中国旅游教育界参考借鉴的措施建议
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Numéro spécial: Translational Nanomedicine
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Hydroxyurea (HU), or hydroxycarbamide, is used for the treatment of some myeloproliferative and neoplastic diseases, and is currently the only drug approved by the FDA for use in sickle cell disease (SCD). Despite the relative success of HU therapy for SCD, a genetic disorder of the hemoglobin β chain that results in red-cell sickling, hemolysis, vascular inflammation and recurrent vasoocclusion, the exact mechanisms by which HU actuates remain unclear. We hypothesized that HU may modulate endothelial angiogenic processes, with important consequences for vascular inflammation. The effects of HU (50-200 μM; 17-24 h) on endothelial cell functions associated with key steps of angiogenesis were evaluated using human umbilical vein endothelial cell (HUVEC) cultures. Expression profiles of the HIF1A gene and the miRNAs 221 and 222, involved in endothelial function, were also determined in HUVECs following HU administration and the direct in vivo antiangiogenic effects of HU were assessed using a mouse Matrigel-plug neovascularization assay. Following incubation with HU, HUVECs exhibited high cell viability, but displayed a significant 75% inhibition in the rate of capillary-like-structure formation, and significant decreases in proliferative and invasive capacities. Furthermore, HU significantly decreased HIF1A expression, and induced the expression of miRNA 221, while downregulating miRNA 222. In vivo, HU reduced vascular endothelial growth factor (VEGF)-induced vascular development in Matrigel implants over 7 days. Findings indicate that HU is able to inhibit vessel assembly, a crucial angiogenic process, both in vitro and in vivo, and suggest that some of HU's therapeutic effects may occur through novel vascular mechanisms.
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Universidade Estadual de Campinas . Faculdade de Educação Física
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The objective was to determine the cardiopulmonary effects and eyeball centralization time obtained with 15 or 30µg kg-1 of atracurium in anesthetized dogs under spontaneous breathing. Eighteen healthy adult mixed-breed dogs were used, which received 0.1mg kg-1 acepromazine and 0.5mg kg-1 morphine IM, followed by 4mg kg-1 propofol IV and maintained on isoflurane anesthesia with spontaneous breathing. Animals received 1mL 0.9% NaCl IV (CG), 15µg kg-1 (G15) or 30µg kg-1 (G30) of atracurium IV. Eyeball centralization time was measured; heart rate (HR), systolic (SAP), mean (MAP) and diastolic (DAP) arterial pressures, respiratory rate (RR), tidal volume (Vt) and minute volume (Vm) were determined every 5min, and pH, arterial CO2 pressure (PaCO2 ), arterial O2 pressure (PaO2 ), hemoglobin oxygen saturation (SaO2 ), bicarbonate (HCO3-) and base excess (BE) every 15min until 60min. Both doses of atracurium produced a similar period of eyeball centralization. Vt in groups treated with atracurium was lower than in CG up to 15min. Vm in G15 differed from CG up to 10min and in G30 up to 25min. No differences were observed for cardiovascular parameters, RR, SaO2, PaO2, HCO3- and BE. pH decreased in CG between 30 and 60min and in G15 and G30 at 15min. G30 differed from CG between 15 and 30min. PaCO2 in GC differed from baseline between 30 and 60min and in G15 differed at 15min. Atracurium at the dose of 15µg kg-1 is adequate for short corneal procedures in inhalant-anesthetized dogs under spontaneous breathing.
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BACKGROUND: The objective of this study was to investigate the effect of chronic ingestion of free and protein-associated soy isoflavones on the antioxidant status in male Wistar rats. Free isoflavone (iso), protein-associated soy isoflavone (iso + prot) and soy protein (prot) extracts were administered for 30 days by gavage to the rats at a dosage of 1 mg aglycone isoflavones per 200 g body weight, adjusted daily, and the prot group was given the same concentration of soy protein received by the iso + prot group. Antioxidant capacity of plasma, thiobarbituric acid-reactive substance (TBARS) and glutathione (GSH) levels and catalase (CAT), glutathione peroxidase (GPx) and superoxide dismutase (SOD) activities in plasma, erythrocytes and tissues and gene expression levels in liver and kidney were evaluated. RESULTS: Chronic ingestion of free but not of protein-associated soy isoflavones nor of solely soy protein increased plasma antioxidant capacity and GPx activity in erythrocytes. Soy protein increased CAT activity and gene expression in liver. SOD activity in erythrocytes was increased by all treatments. CONCLUSION: The overall results confirm that dietary soy isoflavones have a positive effect on antioxidant status, enhancing antioxidant capacity of plasma and antioxidant enzymes in various tissues, but the effects are dependent on the form of administration and on a complex mechanism of antioxidant status balance on the organism. (C) 2010 Society of Chemical Industry
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Welcome to the 2002 Aboriginal and Torres Strait Islander Studies Unit Annual Report. This report is a brief summary of Unit activities during the 2002 calendar year. The Unit provides personal and academic support for Aboriginal and Torres Strait Islander students and specifically aims to increase the recruitment, retention, academic performance and graduation rates of Indigenous students. The Unit also administers schemes to help Indigenous students gain access to, and receive support in, tertiary studies such as the Alternative Entry scheme and the federally funded Aboriginal Tutorial Assistance Scheme (ATAS). The Unit is also the focus for teaching and research in Aboriginal and Torres Strait Islander Studies at the University of Queensland.
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Welcome to the 2003 Aboriginal and Torres Strait Islander Studies Unit Annual Report. This report is a brief summary of Unit activities during the 2003 calendar year. The Unit provides personal and academic support for Aboriginal and Torres Strait Islander students and specifically aims to increase the recruitment, retention, academic performance and graduation rates of Indigenous students. The Unit also administers schemes to help Indigenous students gain access to, and receive support in, tertiary studies such as the Alternative Entry scheme and the federally funded Aboriginal Tutorial Assistance Scheme (ATAS). The Unit is also the focus for teaching and research in Aboriginal and Torres Strait Islander Studies at the University of Queensland.
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Welcome to the 2005 Aboriginal and Torres Strait Islander Studies Unit Annual Report. This report is a brief summary of Unit activities during the 2005 calendar year. The Unit provides personal and academic support for Aboriginal and Torres Strait Islander students and specifically aims to increase the recruitment, retention, academic performance and graduation rates of Indigenous students. The Unit also administers schemes to help Indigenous students gain access to, and receive support in, tertiary studies such as the Alternative Entry scheme and the federally-funded Indigenous Tutorial Assistance Scheme (ITAS). The Unit is also the focus for teaching and research in Aboriginal and Torres Strait Islander Studies at the University of Queensland.