ISSN:1075-2765    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:1075-2765    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Seven methods using patient's age, weight, gender, and serum creatinine concentration were evaluated for mathematical and clinical predictive performance in estimating the creatinine clearance of Japanese patients. We compared the measured and estimated creatinine clearance in 179 hospitalized heart failure patients. The Gates equation was the most biased (mean prediction error, 17.9 mL/min), and the Yukawa equation was the most precise (mean absolute prediction error, 10.4 mL/min), followed by the Jelliffe, Bjornsson, Cockcroft and Gault, and Mawer equations. For all methods, precision was less when serum creatinine concentrations of <0.6 mg/dL were rounded than when serum creatinine concentrations of > 0.6 mg/dL were rounded. We conclude that in clinical practice where the renal function can vary widely, any of the published formulas can give satisfactory results. The Yukawa formula is concise and gives better results in Japanese patients.

ISSN:1075-2765    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

The standard methods of scoring sleep patterns do not ensure an accurate clinical impression of sleep quality. This is important especially in depressed insomniacs because persistent poor sleep increases the likelihood of recurrent depressive episodes. Changes in cyclic alternating patterns (CAP) in sleep have been shown to reflect corresponding changes in sleep quality. We evaluated the effects of nefazodone on CAP and standard sleep architecture in depressed insomniacs. The study was a single-center, single-blind, 6-week treatment of nefazodone hydrochloride followed by placebo withdrawal in 16 subjects meeting the DSM-IV criteria for depression who had a score of at least 18 on the 17-item Hamilton Depression Rating Scale, with insomnia-related items 4, 5, and 6 having a total score of 3 or greater. A mean daily dose of 339.1 ± 141.7 mg at endpoint of nefazodone significantly reduced Hamilton Depression Scores from 21.7 ± 3.0 on baseline to 5.8 ± 5.3 (P< .05) by the end of the study. Polysomnography showed an improvement in sleep latency and sleep efficiency (P< .05), but no alterations in rapid-eye-movement or slow-wave sleep. Subjective estimates of sleep quality improved throughout the study, but CAP rates did not show a significant improvement. The disparity between CAP rates and sleep quality in depressed insomniacs is discussed.

ISSN:1075-2765    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

The pharmacokinetics and pharmacodynamics of the a1-blocker bunazosin were studied in 9 patients with renal insufficiency and 11 healthy control subjects after a single oral administration of 3 mg. Plasma and urinary drug concentrations were determined using high-pressure liquid chroma-tography. The pharmacokinetic parameters of bunazosin elimination half-life and time to peak level were not statistically significantly affected by renal insufficiency. Peak level and area under the plasma concentration-time curve were significantly increased in patients with renal insufficiency compared with control subjects. In addition, plasma clearance and the apparent volume of distribution were significantly smaller in patients with renal insufficiency than in normal subjects. The urinary excretion of bunazosin was not affected by renal insufficiency. Although the normal subject group was not age matched with the patient group, it has been reported that the pharmacokinetics of bunazosin are not affected by age. These results suggest that hepatic metabolism is decreased in renal insufficiency. Concerning the pharmacodynamic effects, the changes in diastolic blood pressure and heart rate were weak but statistically significantly related to plasma bunazosin concentrations. There was no correlation between systolic blood pressure and plasma bunazosin levels. Hysteresis was observed between plasma drug levels and the pharmacodynamic effects.

ISSN:1075-2765    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

The purpose of this investigation was to determine the short-term stability of butorphanol tartrate in presence of diluents. A 10-mg/mL solution of butorphanol tartrate was diluted to 5 mg/mL using normal saline, 5% dextrose in water (D5W), or sterile water for injection. The diluted solutions were divided into two groups. The effect of temperature was tested by placing one group of sealed amber vials at room temperature and at 37° C. The effect of light was studied by placing a second group in amber and clear vials, then exposing them directly to light. At regular time intervals over a period of 5 weeks, the solutions were analyzed for butorphanol tartrate and degradation products using a high-performance liquid chromatography assay. The concentration of butorphanol tartrate remained practically unchanged, indicating that butorphanol tartrate is not affected by heat or light in the presence of any of the diluents over a period of 5 weeks.

ISSN:1075-2765    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Gastroparesis, defined as delayed gastric emptying because of abnormal gastric motility in the absence of mechanical outlet obstruction, is a common problem causing significant morbidity. Although many cases are caused by diabetes, more than 90 different conditions are known to interfere with normal gastric motor function (Scand J Gastroenterol 1995;30[Suppl]:7–16). Patients may present with nausea, vomiting, heartburn, early satiety, or postprandial pain. The current gold standard for quantifying gastric emptying is nuclear scintigraphy. The main goal of treatment is to improve patient comfort by accelerating the rate of gastric emptying, which may be achieved through dietary changes and the use of prokinetic agents. In rare instances, relief can only be obtained with surgical intervention. This report reviews the pathophysiology, clinical presentation, evaluation, and treatment of patients with gastroparesis, an understanding of which will lead to more effective patient care.

ISSN:1075-2765    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

A detailed consideration of how thromboxanes are implicated in glomerulonephritis is followed by a summary of how they have been used successfully in experimental and clinical situations. Most human studies have been short-term only.

ISSN:1075-2765    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:1075-2765    

出版商:OVID    

年代:1999

数据来源: OVID