1,691 research outputs found
Poplitealaneurysma
Zusammenfassung: Das Poplitealaneurisma (PA) ist eine typische Erkrankung von Männern über 65 Jahren, bei denen häufig Aneurysmen der Aorta, der iliacalen, femoralen und kontralateralen Poplitealarterie vorkommen. Als Ursache des Poplitealaneurysmas (PA) werden prioritär die Degradation durch Matrixmetalloproteinasen, eine entzündliche Reaktion mit Bildung von reaktiven Sauerstoffradikalen sowie der oxidative Stress in der Arterienwand postuliert. Zwei Drittel der Patienten kommen wegen Symptomen zum Chirurgen, die übrigen wegen eines Zufallsbefundes oder weil bereits die Gegenseite operiert wurde. Die akute und chronische Ischämie mit ihrer hohen Morbidität stehen im Vordergrund. Asymptomatische PA sollten ab einem Durchmesser von 2cm therapeutisch angegangen werden, besonders wenn sie partiell thrombosiert sind. Zur Diagnostik reicht eine Duplexuntersuchung. Die digitale Subtraktionsangiographie ist die wichtigste Untersuchung für die Operationsplanung. Lokalisierte Befunde, die auf die Kniekehle begrenzt sind, können von dorsal, langstreckige PA müssen durch einen Zugang von medial mit einem Interponat überbrückt werden. Dabei ist eine autologe Vene dem Kunststoffinterponat vorzuziehen. Im Fall eines Veneninterponates oder -bypasses kann mit einer Offenheitsrate von 85% nach 5Jahren gerechnet werden. Endografts sollen nur ausnahmsweise oder im Rahmen von Studien eingesetzt werde
Fatigue in long-duration travel diaries
This paper introduces a new long-duration travel diary survey undertaken in a small town and rural environment, which complements the existing urban Mobidrive survey of 1999. Policy-making is dominated by the 1-day view of the world provided by the usual diaries. Long-duration surveys can balance this by highlighting the strong intrapersonal variance in choices, modes used and other aspects of travel behaviour. They also allow us to gain an understanding of the activity space of the travellers. The new 2003 Thurgau data followed the protocol of the earlier study, but developed the set of questions further. These new questions concerned the social context of respondents as well as trip-related items, such as planning horizon of the activity, previous frequency of visits or the groups involved in the trip or activity. The descriptive and model-based analysis of the data showed that respondent fatigue is not an issue in either survey. Where significant deviations from a steady number of reported trips were found, they showed positive tendencies, i.e. learning. The skill accrued in the intensive round of contacts between respondent and interviewer is significant. Papers on travel diaries tend not to report interviewer effects, although their impacts are clearly discernable. The analysis shows that the four interviewers employed in this survey had a substantial effect on the number of reported trip
High-Throughput Qualitative and Quantitative Drug Checking by MALDI HRMS.
Illicit drugs are a global health problem, since both their acute and chronic consumption have negative impacts on the drug user's health. Drug checking facilities are receiving growing interest as they allow drug users to chemically analyze their product prior to consumption to assess the presence of adulterants or other non-expected substances. Such harm reduction programs allow the reduction of the risks associated with drug consumption without encouraging it. In particular, the emergence of new psychoactive substances (NPS) emphasizes the risk for the population increasing the diversity and the lability of illicit drugs on the market. Analytical developments are required to catch up with this rapid evolution and reduce the potential harm caused by such consumption. In this study, we developed a matrix-assisted laser desorption/ionization (MALDI) high-resolution mass spectrometry (HRMS) strategy for the high-throughput qualitative and quantitative analysis of drug checking samples. The use of online-based m/z cloud library for untargeted compound search improved the ability to identify unknown compounds. Sixty-seven drug checking samples were analyzed using this analytical strategy, allowing the detection of 10 designer drugs and several classical drugs of abuse (mainly cocaine and MDMA) as well as adulterants and contaminants. The results were then compared with routine analyses of the same samples using conventional approaches showing similar performance while removing the use of chromatographic separation thus resulting in a significant reduction of the time required for sample preparation and analysis. This study enlightens the potential of MALDI-HRMS as a high-throughput approach allowing to speed-up up to six times the identification and quantification of substances enabling to catch the fast changes on the drug of abuse market. This strategy could be an interesting alternative analytical approach, allowing better prevention and harm reduction for drug users
Dosing regimen of gentamicin in neonates: evaluation of current guidelines based on a large population pharmacokinetic analysis
Objectives: Gentamicin is among the most commonly prescribed antibiotics in newborns, but large interindividual variability in exposure levels exists. Based on a population pharmacokinetic analysis of a cohort of unselected neonates, we aimed to validate current dosing recommendations from a recent reference guideline (Neofax®).
Methods: From 3039 concentrations collected in 994 preterm (median gestational age 32.3 weeks, range 24.2-36.5) and 455 term newborns, treated at the University Hospital of Lausanne between 2006 and 2011, a population pharmacokinetic analysis was performed with NONMEM®. Model-based simulations were used to assess the ability of dosing regimens to bring concentrations into targets: trough ≤ 1mg/L and peak ~ 8mg/L.
Results: A two-compartment model best characterized gentamicin pharmacokinetics. Model parameters are presented in the table. Body weight, gestational age and postnatal age positively influence clearance, which decreases under dopamine administration. Body weight and gestational age influence the distribution volume. Model based simulations confirm that preterm infants need doses superior to 4 mg/kg, and extended dosage intervals, up to 48 hours for very preterm newborns, whereas most term newborns would achieve adequate exposure under 4 mg/kg q. 24 h. More than 90% of neonates would achieve trough concentrations below 2 mg/L and peaks above 6 mg/L following most recent guidelines.
Conclusions: Simulated gentamicin exposure demonstrates good accordance with recent dosing recommendations for target concentration achievement
The steps to therapeutic drug monitoring: A structured approach illustrated with imatinib
Pharmacometric methods have hugely benefited from progress in analytical and computer sciences during the past decades, and play nowadays a central role in the clinical development of new medicinal drugs. It is time that these methods translate into patient care through therapeutic drug monitoring (TDM), due to become a mainstay of precision medicine no less than genomic approaches to control variability in drug response and improve the efficacy and safety of treatments. In this review, we make the case for structuring TDM development along five generic questions: 1) Is the concerned drug a candidate to TDM? 2) What is the normal range for the drug's concentration? 3) What is the therapeutic target for the drug's concentration? 4) How to adjust the dosage of the drug to drive concentrations close to target? 5) Does evidence support the usefulness of TDM for this drug? We exemplify this approach through an overview of our development of the TDM of imatinib, the very first targeted anticancer agent. We express our position that a similar story shall apply to other drugs in this class, as well as to a wide range of treatments critical for the control of various life-threatening conditions. Despite hurdles that still jeopardize progress in TDM, there is no doubt that upcoming technological advances will shape and foster many innovative therapeutic monitoring methods
Analysis of fast turbulent reconnection with self-consistent determination of turbulence timescale
We present results of Reynolds-averaged turbulence model simulation on the
problem of magnetic reconnection. In the model, in addition to the mean
density, momentum, magnetic field, and energy equations, the evolution
equations of the turbulent cross-helicity , turbulent energy and its
dissipation rate are simultaneously solved to calculate the rate
of magnetic reconnection for a Harris-type current sheet. In contrast to
previous works based on algebraic modeling, the turbulence timescale is
self-determined by the nonlinear evolutions of and , their
ratio being a timescale. We compare the reconnection rate produced by our
mean-field model to the resistive non-turbulent MHD rate. To test whether
different regimes of reconnection are produced, we vary the initial strength of
turbulent energy and study the effect on the amount of magnetic flux
reconnected in time.Comment: 10 pages, 7 figure
Evaluation of range of motion restriction within the hip joint
In Total Hip Arthroplasty, determining the impingement free range of motion requirement is a complex task. This is because in the native hip, motion is restricted by both impingement as well as soft tissue restraint. The aim of this study is to determine a range of motion benchmark which can identify motions which are at risk from impingement and those which are constrained due to soft tissue. Two experimental methodologies were used to determine motions which were limited by impingement and those motions which were limited by both impingement and soft tissue restraint. By comparing these two experimental results, motions which were limited by impingement were able to be separated from those motions which were limited by soft tissue restraint. The results show motions in extension as well as flexion combined with adduction are limited by soft tissue restraint. Motions in flexion, flexion combined with abduction and adduction are at risk from osseous impingement. Consequently, these motions represent where the maximum likely damage will occur in femoroacetabular impingement or at most risk of prosthetic impingement in Total Hip Arthroplasty
Exciton diffusion length and charge extraction yield in organic bilayer solar cells
A method for resolving the diffusion length of excitons and the extraction yield of charge carriers is presented based on the performance of organic bilayer solar cells and careful modeling. The technique uses a simultaneous variation of the absorber thickness and the excitation wavelength. Rigorously differing solar cell structures as well as independent photoluminescence quenching measurements give consistent results
- …