Dose scaling for the morbidly obese

No abstrac

Anaesthetic induction with propofol: How much? How fast? How slow? What determines anesthetic induction dose? It’s the Front-End Kinetics, Doctor!

CITATION: Coetzee, J. F. 2019. Anaesthetic induction with propofol: How much? How fast? How slow? What determines anesthetic induction dose? It’s the Front-End Kinetics, Doctor!. Southern African Journal of Anaesthesia and Analgesia, 25(1):6-10.ENGLISH ABSTRACT: It has long been realised that linear dosing according to total body weight (TBW) results in overdosing obese patients and under-dosing small children. Injected drug doses calculated on a mg.kg-1 body weight basis work well only for patients of normal habitus. As long ago as 1969, in a study of induction doses of thiopentone,  ulfsohn and Joshi2 concluded that thiopentone was better administered according to lean body mass (LBM) than to TBW. They reasoned that endomorphic somatotypes required less thiopentone than mesomorphs and ectomorphs of the same TBW, because they had less LBM. They pointed out that there is a strong association between LBM, cardiac output and basal metabolic rate, and suggested that the LBM contained the “pharmacologically active mass”. Obese patients can perhaps be loosely regarded as ordinary individuals entrapped in a cocoon of fat into which hardly any injected drug is distributed. However the LBM of obese persons also increases as they accumulate fat, mainly due to increased muscle mass, as well as  enlargement of other organs and blood volume. The dilemma is that LBM does not increase at the same rate as the increase in fat. Thus, although we know that they need more drug than normal-weight patients, how much more is often uncertain.http://www.sajaa.co.za/index.php/sajaa/article/view/2169Publisher's versio

Utilization of Liquid Chromatography/Mass Spectrometry to Detect Drug Residues in Milk: Applications for Research and Commercial Dairying

Prevention of drug residues in milk is a daily endeavor on dairy farms. There is increasing scrutiny from the public and government when it comes to drug residues in milk. Drug residues can result from simple human errors, disease processes not allowing for normal clearance of a drug, or malicious activity. The testing methodologies used to detect drug residues have become more sensitive with many tests available that can detect drug levels below ten parts per billion (ppb)

Targeting FGFR signaling to disrupt cellular cross-talk in pancreatic cancer

PhD Thesi

Topical Flunixin Meglumine Effects on Pain Associated Biomarkers after Dehorning

Twenty-four calves were dehorned and treated with either topical flunixin meglumine formulated for systemic absorption or a placebo. Biomarkers associated with pain were evaluated for up to 72 hour after the dehorning procedure. Plasma cortisol concentrations, 90 minutes post-dehorning, and mechanical nociception threshold at the control site were the only tested biomarkers where a significant difference was demonstrated. No other differences of biomarkers between the two dehorned groups were observed for any time points. Although this product is easy to dose and dispense, its effects on pain biomarkers appears to be negligible

A study to examine the relationship between uterine pathology and depletion of oxytetracycline in plasma and milk after intrauterine infusion

Citation: Gorden, P. J., Ydstie, J., Kleinhenz, M. D., Wulf, L. W., Gehring, R., Wang, C., & Coetzee, J. F. (2016). A study to examine the relationship between uterine pathology and depletion of oxytetracycline in plasma and milk after intrauterine infusion. Journal of Animal Science, 94, 30-30. doi:10.2527/msasas2016-065Metritis is a frequent problem in postpartum dairy cows. Intrauterine therapy with oxytetracycline (OTC) is often used to improve therapeutic outcomes, although efficacy data supporting this therapy are ambiguous. Several manuscripts describe the depletion of OTC from milk following intrauterine therapy. However, none of these studies have correlated uterine severity scores with milk OTC concentrations using highly sensitive detection systems. Our objective was to do this to test the hypothesis that cows with more severe uterine severity would have higher OTC residues in milk following intrauterine therapy. Thirty-two cows received a single treatment of 4 g of OTC via intrauterine infusion. Blood and milk samples were collected before intrauterine therapy and throughout the trial period of 96 h after infusion. Uterine severity scores were assigned at initiation of therapy and every 24 h throughout the remainder of the trial. Plasma and milk samples were analyzed for OTC concentrations using liquid chromatography coupled with mass spectrometry. Following treatment, OTC rapidly diffused from the uterus to plasma and from plasma to milk. Maximum concentration in plasma and milk occurred within 24 h following intrauterine infusion and 18 of the cows still had detectable levels of OTC in milk 4 d after intrauterine infusion. Greater uterine severity score at the initiation of treatment showed a significant positively correlation with higher milk OTC concentration at the second milking following treatment (R2 = 0.46, P = 0.01) but there was no correlation between initial uterine severity score and OTC concentration at the conclusion of the study (R2 = ?0.06, P = 0.75). In the United States, intrauterine administration of OTC is considered to be an extra-label therapy. The use of uterine severity score can be used to predict OTC concentration in the first day following therapy but should not be used as a predictor of OTC concentrations 96 h after treatment. Dairy producers should consult with their veterinarian to develop strategies that will prevent the presence of violative residues of OTC in bulk tank milk following intrauterine therapy