The population pharmacokinetics of theophylline in neonates and young infants

The population pharmacokinetics of theophylline were evaluated using 391 theophylline serum concentration measurements from 108 neonates and young infants (postnatal age 0–26 weeks), who received theophylline for the treatment of neonatal apnea. A one-compartment pharmacokinetic model with first-order elimination was used, with intravenous aminophylline and oral theophylline administration modeled as zero-order infusions. The effect of a variety of developmental and demographic factors on clearance (CL) and volume (V) were investigated. Hypothesis testing to evaluate potentially significant factors produced a final model in which clearance was based on weight (kg) raised to an exponential power and postnatal age (weeks), with CL (ml/hr)=17.5 (weight) 1.28 + 1.17 (postnatal age). Clearance was reduced by 12% for patients receiving parenteral nutrition. Volume of distribution in this population was adequately described using only weight, with V (L)=0.858 L/kg. Bioavailability of orally administered drug was not significantly less than unity. Interindividual variability in clearance was modest, with a coefficient of variation for clearance of 16%. An estimate of interindividual variability in volume could not be obtained. As a measure of residual variability in theophylline serum concentrations, the coefficients of variation for theophylline serum concentrations of 5.0, 10.0, and 13.0 mg/L were found to be approximately, 25, 12, and 9%, respectively. The identification of influential patient factors and the quantification of their influence on theophylline disposition allow for a priori estimates of theophylline pharmacokinetic parameters in these patients.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/45039/1/10928_2005_Article_BF01059087.pd

Sclerosing mesenteritis affecting the small and the large intestine in a male patient with non-Hodgkin lymphoma: a case presentation and review of the literature

<p>Abstract</p> <p>Introduction</p> <p>Sclerosing mesenteritis is a rare disease resembling a mesenteric tumour. We present here a case of sclerosing mesenteritis that affected both the large and the small intestine of the patient. Therapeutic and diagnostic issues are discussed.</p> <p>Case presentation</p> <p>A 62-year-old man with a history of non-Hodgkin lymphoma presented with fatigue, a palpable tender abdominal mass and clinical signs of progressing intestinal obstruction. The preoperative evaluation failed to prove recurrence of the lymphoma or any other definite diagnosis. A laparotomy was performed through a midline incision. The mesentery resembled a tumour-like thickened and fibrotic mass. Abundant, rigid intestinal loop adhesions were observed. Diffuse fibrotic infiltration of the ileum and of the sigmoid colon, which obviously affected the intestinal vascular supply, were identified. A right colectomy and partial sigmoidectomy were performed. Pathological evaluation revealed extensive myofibroblastic reaction of the mesentery with accompanying loci of fat necrosis and areas of inflammation. A diffuse fibrotic infiltration that focally showed a ground-glass appearance was observed. The post-operative course was complicated by respiratory insufficiency and infections and the patient died 2 months after the operation.</p> <p>Conclusion</p> <p>Sclerosing mesenteritis that affects both the small and the large intestine is extremely rare. The disease is characterized by myofibroblastic reaction, fat necrosis and diffuse fibrosis of the mesentery. Pathological confirmation may be required for definite diagnosis. If the disease is characterized by severe and diffuse fibrosis, then the application of surgical therapy may be problematic.</p

Detrital chromite concentrations, nearshore Port au Port Bay, Newfoundland

A nearshore sediment sampling program was undertaken in Port au Port Bay, western Newfoundland. The -objectives of the program were to map the distribution of detrital chromite in the seabed sediments and to evaluate the paleoenvironmental evolution of chromite-bearing sedimentary facies. Bottom sediments were found to be enriched in detrital chromite in an area adjacent to and parallel to the east shore of the bay, south of the mouth of the Fox Island River. During glaciation, chromite from the Lewis Hills ophiolite complex was incorporated in glacial materials. Post-glacial reworking of chromite-bearing sediments by fluvial and marine processes is observed in a number of sedimentary facies: fluvial sediments of the Fox Island River, a large outwash plain and marine-limit delta occurring near the mouth of Fox Island River, an erosional lag blanketing the outwash delta, and emergent and submergent beach terraces bordering a small coastal embayment south of Fox Island River, The relatively low wave energy of the Port au Port Bay area appears, however, to have precluded extensive placer development in all sedimentary facies. R&#xC9;SUM&#xC9; Un programme d'&#xE9;hantillonage des s&#xE9;diments c&#xF4;tiers fut entrepris dans la baie de Port-au-Port, dans l'ouest de Terre-Neuve. Les buts de ce programme &#xE9;taient de cartographier la distribution de la chromite d&#xE9;tritique dans les s&#xE9;diments de fonds marin et d'&#xE9;valuer l’&#xE9;volution pal&#xE9;o-environnementale des faci&#xE8;s s&#xE9;dimentaires porteurs de chromite. Les s&#xE9;diments de fond se sont r&#xE9;v&#xE8;les &#xEA;tre enrichis en chromite d&#xE9;triiique dans une zone adjacente et parall&#xE8;le &#xE0; la c&#xF4;te est de la baie, au sud de l’embouchure de la rivi&#xE8;re de file Fox. Pendant la glaciation, la chromite du complexe ophiolitique de Lewis Hills fut incorpor&#xE9;e dans les mat&#xE9;riaux glaciaires. Le remaniement post-glaciaire des s&#xE9;diments porteurs de chromite par des processus fluviaux et marins est observ&#xE9; dans un certain nombre de faci&#xE8;s s&#xE9;dimentaires: les s&#xE9;diments fluviaux de la rivi&#xE8;re de Tile Fox, unsandur &#xE9;tenductun delta de contact glaciaire situe pr&#xE8;s de l'embouchure de la rivi&#xE8;re de Tile Fox, un gravier r&#xE9;siduel qui recouvre le sandur et des terrasses marines &#xE9;mergentes et submerges bordant une anse situ&#xE9;e au sud de la rivi&#xE8;re de l'ile Fox. L'&#xE9;nergie relativement basse des vagues de la r&#xE9;gion de Port-au-Port semble toutefois avoir emp&#xEA;ch&#xE9; la formation de placers &#xE9;tendus dans tous les faci&#xE8;s s&#xE9;diment aires. [Traduit par le journal

CD4 Count at Entry into Care and at Antiretroviral Therapy Prescription among Adults with Human Immunodeficiency Virus in the United States, 2005-2018.

From 2005 to 2018, among 32013 adults with human immunodeficiency virus entering care, median time to antiretroviral therapy (ART) prescription declined from 69 to 6 days, CD4 count at entry into care increased from 300 to 362 cells/μL, and CD4 count at ART prescription increased from 160 to 364 cells/μL