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Gotowa bibliografia na temat „Dose titration”

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Data publikacji: 4 czerwca 2021
Data aktualizacji: 20 lutego 2023

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Artykuły w czasopismach na temat "Dose titration"

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Nalamachu, MD, Srinivas R., Neha Parikh, Larry Dillaha, MD i Richard Rauck, MD. "Lack of correlation between the effective dose of fentanyl sublingual spray for breakthrough cancer pain and the around-the-clock opioid dose". Journal of Opioid Management 10, nr 4 (1.07.2014): 247. http://dx.doi.org/10.5055/jom.2014.0212.

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Objective: To examine the relationship between the dose of fentanyl sublingual spray needed to control breakthrough cancer pain (BTCP) and the dose of around-the-clock (ATC) opioid used to control background pain.Design: Analysis was based on the open-label, dose-titration phase (up to 26 days) of a randomized, double-blind, placebo-controlled trial.Patients: Opioid-tolerant cancer patients (aged ≥18 years) with chronic pain of ≤moderate severity in the 24 hours before screening while receiving stable doses of scheduled ATC opioid therapy for ≥1 week and 1 to 4 episodes of BTCP per day.Interventions: Fentanyl sublingual spray was initiated at 100 μg. Dose titration proceeded until a dose was reached that provided adequate pain relief for two consecutive BTCP episodes without intolerable adverse effects (AEs).Results: Overall, 98/130 (75.4 percent) patients completed the dose-titration phase and achieved pain relief, and 73.5 percent of those who completed the titration period attained an effective dose of ≥600 μg (median effective dose, 800 μg). No clinically relevant correlation was found between effective doses of fentanyl sublingual spray for the treatment of BTCP and the ATC opioid doses used to control persistent pain (Spearman rank correlation [rs ] = 0.351, n = 98). Sixty percent of patients reported ≥1 AE during the dose-titration phase. The most common AEs considered related to study treatment were nausea (6.2 percent), somnolence (4.6 percent), dizziness (3.8 percent), and vomiting (3.8 percent).Conclusions: These findings highlight the importance of titrating the dose of fentanyl sublingual spray to optimize dosing for individual patients.
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Bond, T. Christopher, Jaime Rubin, Steven X. Wang i Alex Yang. "More Frequent Hemoglobin Measurements and More Frequent Epoetin Alfa Titrations Are Both Associated with Increased Epoetin Alfa Dose but Not More Time in Target Hemoglobin Range",. Blood 118, nr 21 (18.11.2011): 4194. http://dx.doi.org/10.1182/blood.v118.21.4194.4194.

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Abstract Abstract 4194 For the past 20 years, management of hemoglobin (Hb) level via erythropoiesis-stimulating agents (ESAs), such as epoetin alfa (EPO) has been the norm in the care of end-stage renal disease (ESRD) patients. Recently, questions about patient safety and new economic bundling rules have brought renewed focus on appropriate Hb targets and how they relate to the use of EPO. Important issues related to Hb control are the frequency of Hb measurements, Hb value, the frequency of changes in EPO dose (titrations), and total EPO dose. Current practice aims to achieve greater control of Hb by more frequent measurement and finer EPO dose titrations. No studies have definitively shown that levels of titration and measurement frequency lead to better clinical outcomes or more efficient use of EPO. One large retrospective analysis found increasing Hb measurements and EPO dose titration frequency decreased patient variability around the facility-level Hb mean (Khan et al, 2011). However, a second study found that frequent titrations have been shown to be the most important driver of Hb cycling—potentially dangerous large fluctuations in Hb levels (Fishbane and Berns, 2005). The issue remains controversial. We conducted a retrospective database analysis in order to quantify the frequency of Hb dose titrations and measurements, and to evaluate their relationship to ESA dose and the ability to keep patients within a Hb range of 10–12 g/dL. Data from prevalent (≥ 120 days), adult (>18 years old) hemodialysis patients dialyzing at DaVita dialysis clinics ≥ 3 times per week between January 1, 2009 and December 31, 2010 were included. For every session, patients' stable dosing periods were defined as any series of at least 3 doses during which the dose did not change more than 10% from first dose in the series. Dose holds were defined as ≥ 3 consecutive sessions with 0 EPO dose. An EPO dose of 0 lasting <3 consecutive sessions was ignored when identifying stable periods and holds. Doses not categorized as part of a stable period or a dose hold were considered transition periods. A dose titration was defined as a difference of > 10% between any of the following: the mean dose of 2 consecutive stable periods; the mean dose of stable period and next/previous dose in transition period; and 2 consecutive doses within a transition period. Transitions involving a dose hold were counted as 1 titration if the patient then returned to a dose within 10% of the mean of the prior period; or 2 titrations otherwise. Similar rules were developed for the minority of patients who received EPO once or twice per week. Correlations among measures (titrations/patient-month and Hb measurements/patient-month with mean monthly EPO dose and time with Hb in range) were assessed using Pearson product-moment correlation and linear regression (adjusted for racial composition, percentage of dialysis vascular access types, percentage with comorbidities, and mean age, vintage, and BMI) at the physician and the facility levels. Time in range was defined as total patient time in range/total patient-time. Facility level analyses were weighted by facility load (minimum of 300 patient-months) and are reported here. Information from 81,464 patients at 1,336 facilities was assessed. The mean number of titrations was 13.6 ± 2.83 (mean ± SD) per patient per year and the mean number of Hb measurements was 36.3 ± 8.24 per patient per year. The mean percent of patient-time in range among these facilities was 57.1% ± 5.8%. At the facility level, after adjustment for case mix factors (mean age, vintage, and BMI at facility, access types, and racial composition) the annual number of dose titrations per patient and Hb measurements per patient were not associated with the percent of patient-months within a 10–12 g/dL Hb range (p=0.12 and p=0.47; respectively). An analysis of ESA utilization showed that an increase of 1 titration per patient at the facility level was associated with an extra 18,000 U (p<0.001) per patient. In this retrospective study of >80,000 US dialysis patients over 2 years, neither increased Hb measurements nor increased EPO titrations were associated with improving patient-time in Hb range. However, increased EPO titrations were associated with significantly increased EPO utilization. Although these associations do not demonstrate causality (or the direction of potential causality), they do underscore the need to assess titration practices. Disclosures: Bond: DaVita Clinical Research: Employment; Affymax Inc: Research presented in this study was paid for by Affymax. Rubin:DaVita Clinical Research: Employment; Affymax: The research presented in this abstract was paid for by Affymax. Wang:DaVita Clinical Research: Employment; Affymax: The research presented in this abstract was paid for by Affymax. Yang:Affymax: Employment.
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MASSEY, J. A., i P. ABRAMS. "Dose Titration in Clinical Trials". British Journal of Urology 58, nr 2-4 (kwiecień 1986): 125–28. http://dx.doi.org/10.1111/j.1464-410x.1986.tb09010.x.

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Papangkorn, Kongnara, Kiran Vangara, Benjamin J. Bruno, Kilyoung Kim, Nachiappan Chidambaram, Anthony DelConte, Mahesh Patel i in. "Efficacy and Safety of TLANDO, A Novel Oral Easy to Prescribe and Use TRT Option". Journal of the Endocrine Society 5, Supplement_1 (1.05.2021): A486. http://dx.doi.org/10.1210/jendso/bvab048.994.

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Abstract Most widely used testosterone replacement therapy (TRT) products can be inconvenient and cumbersome topical and invasive injectable requiring dose adjustments to attain efficacy. In a pivotal study, a recently approved oral TRT only 26% of patients did not require any dose adjustment. Typically, patients start on a sub-therapeutic dose with gradual dose increases to attain efficacy resulting in additional visit(s) to clinic and pharmacy. Physician research data (N=402) suggested it typically takes 3-6 months of titrations to reach an efficacious dose for majority of patients, a significant barrier in effecting a switch without a period of “efficacy gap”. The requirement of additional visit(s) presents significant challenges for new and current patients desiring to start and to switch to a convenient TRT option, especially in the current COVID-19 pandemic. Recent reports suggest increase of disease severity/mortality in men with low testosterone is possibly due to underlying co-morbidities commonly associated with male hypogonadism. There remains a need for an effective, safe, and easy to use and prescribe product that does not require dose titration. TLANDO is a “triglyceride-free” oral single strength TRT with single dose designed to lymphatically deliver effective and safe levels of testosterone regardless of meal fat content. Moreover, dose titration is prone to some inherent titration decision errors and requires understanding of often complex titration rules. The objective is to assess whether TLANDO, an oral TRT without requiring dose titration, safely restores effective testosterone (T) levels in hypogonadal men. An open-label, single-arm, multicenter study (NCT03242590) was performed with TLANDO in hypogonadal males (N=95). Subjects received orally 225 mg twice a day testosterone undecanoate (TU) for 24 days without dose adjustment. Efficacy was evaluated by % of subjects who achieved daily T Cavg within the eugonadal range. Using 450mg daily dose without dose adjustment, 80% of subjects (95% CI of 72% to 88%) achieved a T Cavg in the normal range and safely restored with mean T Cavg of 476±184 ng/dL post steady state. T restoration was comparable to other non-oral TRT products. TLANDO was well tolerated with no deaths, no drug-related severe AEs, and no hepatic AEs. In conclusion, effective T restoration using TLANDO, an easy to use and prescribe oral TRT option, was confirmed. Minimal AEs were reported with no hepatic AEs. Upon approval, TLANDO will be the first convenient TRT option without requiring dose adjustments; therefore, enabling selection of an efficacious dose from the start of therapy. TLANDO is well suited for new or existing TRT patients desiring a convenient oral option.
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Lin, Rongbo, Jinfeng Zhu, Shuitu Feng, Sunzhi Lin, Jianqian Fu, Yongzhi Yao, Lixia Hong i in. "Patient controlled analgesia (PCA) versus non-PCA intravenous hydromorphone titration for severe cancer pain: A randomized, controlled, multicenter, phase III trial, HMORCT09-1." Journal of Clinical Oncology 37, nr 15_suppl (20.05.2019): TPS11635. http://dx.doi.org/10.1200/jco.2019.37.15_suppl.tps11635.

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TPS11635 Background: The opioid dose for an individual with cancer pain to provide adequate relief of pain with an acceptable degree of side effects is variable. Opioid titration is a process to obtain the tailored dose. Conventional titration is administered by a clinician or nurse. PCA is that patients control cancer pain by self-administration of intravenous opioids using programmable pump. The aim of our study is to evaluate the efficacy of PCA titration versus conventional titration intravenously for severe cancer pain (10-point numerical rating scale, NRS ≥ 7). Injectable Hydromorphone was selected as pharmaceutical analgesics, which works as well as morphine and oxycodone and had similar side effects. Methods: This is currently enrolling patients (n=230) with severe cancer pain during previous 24 hours. Patients are randomized 1:1 and stratified by opioid intolerance or opioid tolerance into PCA or non-PCA titration. PCA titration using programmable pump: bolus hydromorphone at 0.5mg (for opioid intolerance) or hydromorphone dose equivalent to 10% to 20% of the total opioid taken in the previous 24 hours with a lockout time 15 minutes (for opioid tolerance) was administered by the patients educated. No basal infusion was set in the pump. Non-PCA titration administered by a nurse or clinician: Initial hydromorphone doses were same with PCA titration. Reassess pain at 15 minutes. Increased dose of hydromorphone by 50%-100% if pain unchanged or increased, or repeat same dose if pain decreased to NRS 4-6, or continue at current effective dose as needed over initial 24 hours. The primary endpoint is the time needed to successful titration was defined the time from the first dose of hydromorphone after randomization to achieve satisfied pain control. The satisfied pain control was defined NRS pain score ≤ 3 at rest in at least 2 consecutive assessment (15 minutes interval). The time needed to successful titration was extended to achieve satisfied pain control again if NRS pain score ≥ 7 after satisfied pain control within 24 hours. The failure of successful titration was defined that satisfied pain control does not achieve within 24 hours. Secondary endpoints include the percentage of patients titrated successfully, the mean NRS pain score of 24 hours, the total dose of hydromorphone titrated, and adverse events. Clinical trial information: NCT03375515.
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Norris, David C. "Dose Titration Algorithm Tuning (DTAT) should supersede the Maximum Tolerated Dose (MTD) concept in oncology dose-finding trials". F1000Research 6 (7.02.2017): 112. http://dx.doi.org/10.12688/f1000research.10624.1.

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Background. Absent adaptive, individualized dose-finding in early-phase oncology trials, subsequent ‘confirmatory’ Phase III trials risk suboptimal dosing, with resulting loss of statistical power and reduced probability of technical success for the investigational drug. While progress has been made toward explicitly adaptive dose-finding and quantitative modeling of dose-response relationships, most such work continues to be organized around a concept of ‘the’ maximum tolerated dose (MTD). The purpose of this paper is to demonstrate concretely how the aim of early-phase trials might be conceived of, not as ‘dose-finding’, but as dosing algorithm-finding. Methods. A Phase I dosing study is simulated, for a notional cytotoxic chemotherapy drug, with neutropenia constituting the critical dose-limiting toxicity. The drug’s population pharmacokinetics and myelosuppression dynamics are simulated using published parameter estimates for docetaxel. The amenability of this model to linearization is explored empirically. The properties of a simple dose titration algorithm targeting neutrophil nadir of 500 cells/mm3 using a Newton-Raphson heuristic are explored through simulation in 25 simulated study subjects. Results. Individual-level myelosuppression dynamics in the simulation model approximately linearize under simple transformations of neutrophil concentration and drug dose. The simulated dose titration exhibits largely satisfactory convergence, with great variance in individualized optimal dosing. Some titration courses exhibit overshooting. Conclusions. The large inter-individual variability in simulated optimal dosing underscores the need to replace ‘the’ MTD with an individualized concept of MTDi . To illustrate this principle, the simplest possible dose titration algorithm capable of realizing such a concept is demonstrated. Qualitative phenomena observed in this demonstration support discussion of the notion of tuning such algorithms. The individual-level linearization of myelosuppression dynamics demonstrated for the simulation model used here suggest that a titration algorithm specified in the more general terms of the linear Kalman filter will be worth exploring.
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Yeh, Yu-Chen, Joseph C. Cappelleri, Xiaocong L. Marston i Ahmed Shelbaya. "Effects of dose titration on adherence and treatment duration of pregabalin among patients with neuropathic pain: A MarketScan database study". PLOS ONE 16, nr 1 (20.01.2021): e0242467. http://dx.doi.org/10.1371/journal.pone.0242467.

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Objective To examine pregabalin dose titration and its impact on treatment adherence and duration in patients with neuropathic pain (NeP). Methods MarketScan database (2009–2014) was used to extract a cohort of incident adult pregabalin users with NeP who had at least 12 months of follow-up data. Any dose augmentation within 45 days following the first pregabalin claim was defined as dose titration. Adherence (measured by medication possession ratio/MPR) and persistence (measured as the duration of continuous treatment) were compared between the cohorts with and without dose titration. Logistic regressions and Cox proportional hazards models were used to identify the factors associated with adherence (MPR ≥ 0.8) and predictors of time to discontinuation. Results Among the 5,186 patients in the analysis, only 18% of patients had dose titration. Patients who had dose titration were approximately 2.6 times as likely to be adherent (MPR ≥ 0.8) (odds ratio = 2.59, P < 0.001) than those who did not have dose titration. Kaplan-Meier analysis shows that the time to discontinuation or switch was significantly longer among patients who had dose titration (4.99 vs. 4.04 months, P = 0.009). Conclusions Dose titration was associated with improved treatment adherence and persistence among NeP patients receiving pregabalin. The findings will provide valuable evidence to increase physician awareness of dose recommendations in the prescribing information and to educate patients on the importance of titration and adherence.
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Santosh Kumar, Rada, i R. Venkata Sandhya. "Titration Design: An Important Key in Drug Dose Determination". Journal of Drug Delivery and Therapeutics 9, nr 4-s (29.08.2019): 826–28. http://dx.doi.org/10.22270/jddt.v9i4-s.3374.

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Drug titration is the process of adjusting the dose of a medicine for the maximum benefits without adverse effects. To determine the optimum dose range the clinical trials are carried out and it is divided into two types of study design. The parallel type study design and titration type study design. The titration studies provide the information about the cumulative effects of the drug. Titration designs are mainly used in dose determining especially in insulin, anticonvulsants, anti-depressants, and sedatives. In the analysis of titration design, the phase I, II, III clinical trials are carried out to determine the dose-response relationship, safety and efficacy of the drug.
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Anis, Mursalin M., i Natasha Pollak. "Treatment of Palatal Myoclonus with Botulinum Toxin Injection". Case Reports in Otolaryngology 2013 (2013): 1–3. http://dx.doi.org/10.1155/2013/231505.

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Palatal myoclonus is a rare cause of pulsatile tinnitus in patients presenting to the otolaryngology office. Rhythmic involuntary contractions of the palatal muscles produce the pulsatile tinnitus in these patients. Treatment of this benign but distressing condition with anxiolytics, anticonvulsants, and surgery has been largely unsuccessful. A few investigators have obtained promising results with botulinum toxin injection into the palatal muscles. We present a patient with palatal myoclonus who failed conservative treatment with anxiolytics. Unilateral injection of botulinum toxin into her tensor veli palatini muscle under electromyographic guidance resolved pulsatile tinnitus in her ipsilateral ear and unmasked pulsatile tinnitus in the contralateral ear. A novel method of following transient postinjection symptoms using a diary is presented in this study. Botulinum toxin dose must be titrated to achieve optimal results in each individual patient, analogous to titrations done for spasmodic dysphonia. Knowledge of the temporal onset of postinjection side effects and symptomatic relief may aid physicians in dose titration and surveillance. We present suggestions on titrating the botulinum toxin dose to optimal levels. A review of the literature on the use of botulinum toxin for palatal myoclonus and some common complications are discussed.
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Tomita, Yoshihiko, Hirotsugu Uemura, Mototsugu Oya, Nobuo Shinohara, Tomonori Habuchi, Yosuke Fujii, Yoichi Kamei, Yoshiko Umeyama, A. H. Bair i Brian I. Rini. "Patients with metastatic renal cell carcinoma who have benefit from axitinib dose titration: Analysis from a randomized, double-blind, axitinib dose titration phase II study." Journal of Clinical Oncology 35, nr 6_suppl (20.02.2017): 438. http://dx.doi.org/10.1200/jco.2017.35.6_suppl.438.

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438 Background: Axitinib is a potent, selective inhibitor of VEGF receptors. In a randomized, double-blind, phase II study in patients with metastatic renal cell carcinoma, median overall survival (OS) was 42.7 months who underwent axitinib titration versus (vs.) 30.4 months in placebo titration (hazard ratio [HR]: 0.785; 95% confidence interval: 0.485, 1.272). OS Kaplan-Meier curves for two arms appeared to cross over at approximately 24 months and thus we investigated baseline characteristics associated with OS benefit from axitinib titration. Methods: Patients received axitinib 5 mg twice daily (BID) for 28 days. Patients who met the dose titration criteria were randomized 1:1 to axitinib titration or placebo titration. Patients who did not meet the dose titration criteria continued axitinib 5 mg BID. Baseline characteristics were compared between patients with OS ≥ 24 and < 24 months who were randomized to axitinib titration and subsequently, multivariate analysis for baseline characteristics was conducted to investigate effect of interaction with axitinib titration. Results: Fifty-six patients underwent axitinib titration with 53 evaluable for this analysis. Thirty-three patients had an OS ≥ 24 months and had significantly fewer metastatic sites (≤2, ≥3: 52/48% vs. 10/90%), compared to the 20 patients with OS < 24 months. In addition, a lower percentage of patients with OS ≥ 24 months had lymph node metastasis (45 vs. 75%), liver metastasis (15 vs. 45%), duration from diagnosis to treatment <1 year (36 vs. 85%), and baseline hemoglobin (Hb) < LLN (lower limit of normal) (33 vs. 75%), compared to the patients with OS < 24 months. In multivariate analysis in total of 112 patients who were randomized to axitinib or placebo titration, duration from diagnosis and baseline Hb were significantly associated with favorable OS with axitinib titration (p<0.1). Conclusions: Duration from diagnosis and baseline Hb are associated with favorable OS with axitinib titration. Clinical trial information: NCT00835978.
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Rozprawy doktorskie na temat "Dose titration"

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Islam, Khan Md Shaiful. "Dose titration, tolerance and compatibility of some feed additives in broiler". [S.l. : s.n.], 2005. http://www.bsz-bw.de/cgi-bin/xvms.cgi?SWB12046170.

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CHen, Canghai. "Optimised dose titration for Duodopatreatment based on simulation experiments– implementation in a decision supportsystem". Thesis, Högskolan Dalarna, Datateknik, 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:du-3978.

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The aim of this work was to design a set of rules for levodopa infusion dose adjustment in Parkinson’s disease based on a simulation experiments. Using this simulator, optimal infusions dose in different conditions were calculated. There are seven conditions (-3 to +3)appearing in a rating scale for Parkinson’s disease patients. By finding mean of the differences between conditions and optimal dose, two sets of rules were designed. The set of rules was optimized by several testing. Usefulness for optimizing the titration procedure of new infusion patients based on rule-based reasoning was investigated. Results show that both of the number of the steps and the errors for finding optimal dose was shorten by new rules. At last, the dose predicted with new rules well on each single occasion of majority of patients in simulation experiments.
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Sothirajah, Shobana. "Clinical Algorithms for Maintaining Asthma Control". Thesis, The University of Sydney, 2008. http://hdl.handle.net/2123/3546.

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Rationale: Asthma management aims to achieve optimal control on the minimal effective dose of medication. We assessed the effectiveness of two algorithms to guide ICS dose in well-controlled patients on ICS+LABA in a double-blind study, comparing dose adjustment guided by exhaled nitric oxide (eNO) to clinical care algorithm(CCA) based on symptoms and lung function. Methods: We randomised non-smoking adult asthmatics on minimum FP dose 100μgs daily +LABA to ICS adjustment using eNO or CCA, assessed over 5 visits during 8 months treatment. Primary endpoints were asthma-free days and asthma related quality of life (QOL). Analysis was by mixed model regression and generalised estimating equations with log link. Results: 69 subjects were randomised (eNO:34, CCA:35) and 58 completed the study. At baseline mean FEV1 was 94% pred., mean eNO (200ml/sec) 7.1 ppb, median ACQ6 score 0.33. Median ICS dose was 500 μg (IQR 100-500) at baseline and 100 μg on both eNO (IQR 100-200) and CCA arms (IQR 100–100) at end of study. There were no significant differences between eNO and CCA groups in asthma-free days (RR=0.92, 95% CI 0.8–1.01), AQL (RRAQL
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Sothirajah, Shobana. "Clinical Algorithms for Maintaining Asthma Control". University of Sydney, 2008. http://hdl.handle.net/2123/3546.

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Master of Science in Medicine
Rationale: Asthma management aims to achieve optimal control on the minimal effective dose of medication. We assessed the effectiveness of two algorithms to guide ICS dose in well-controlled patients on ICS+LABA in a double-blind study, comparing dose adjustment guided by exhaled nitric oxide (eNO) to clinical care algorithm(CCA) based on symptoms and lung function. Methods: We randomised non-smoking adult asthmatics on minimum FP dose 100μgs daily +LABA to ICS adjustment using eNO or CCA, assessed over 5 visits during 8 months treatment. Primary endpoints were asthma-free days and asthma related quality of life (QOL). Analysis was by mixed model regression and generalised estimating equations with log link. Results: 69 subjects were randomised (eNO:34, CCA:35) and 58 completed the study. At baseline mean FEV1 was 94% pred., mean eNO (200ml/sec) 7.1 ppb, median ACQ6 score 0.33. Median ICS dose was 500 μg (IQR 100-500) at baseline and 100 μg on both eNO (IQR 100-200) and CCA arms (IQR 100–100) at end of study. There were no significant differences between eNO and CCA groups in asthma-free days (RR=0.92, 95% CI 0.8–1.01), AQL (RRAQL
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Bedding, Alun W. "The Bayesian analysis of dose titration to effect in phase 2 clinical trials in order to design phase 3". Thesis, University of Reading, 2008. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.500538.

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Jiang, Xiaowen. "A fuzzy logic controller for intestinal levodopa infusion in Parkinson’s disease". Thesis, Högskolan Dalarna, Datateknik, 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:du-4727.

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The aim of this work is to evaluate the fuzzy system for different types of patients for levodopa infusion in Parkinson Disease based on simulation experiments using the pharmacokinetic-pharmacodynamic model. Fuzzy system is to control patient’s condition by adjusting the value of flow rate, and it must be effective on three types of patients, there are three different types of patients, including sensitive, typical and tolerant patient; the sensitive patients are very sensitive to drug dosage, but the tolerant patients are resistant to drug dose, so it is important for controller to deal with dose increment and decrement to adapt different types of patients, such as sensitive and tolerant patients. Using the fuzzy system, three different types of patients can get useful control for simulating medication treatment, and controller will get good effect for patients, when the initial flow rate of infusion is in the small range of the approximate optimal value for the current patient’ type.
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Poulet, Emmanuel. "Quantité d'énergie délivrée au cours du traitement ECT : titration ou méthode "âge-dose"? Données de la littérature et éléments du débat. Données originales issues de trois études prospectives". Bordeaux 2, 1999. http://www.theses.fr/1999BOR23062.

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Santos, Monique Barreto. "Estudo da forma??o dos complexos coacervados obtidos a partir de prote?nas globulares". Universidade Federal Rural do Rio de Janeiro, 2016. https://tede.ufrrj.br/jspui/handle/jspui/1297.

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Proteins are biopolymers of high nutritional and functional significance has been widely used as food ingredients. The interaction between two different proteins oppositely charged, and can give rise to complex coacervate currently used as an ingredient in food technology or as a microencapsulating agent. The formation of complex coacervates between Lysozyme and Ovalbumin and between Bovine serum albumin (BSA) and Lysozyme has been investigated as a function of pH, mass ratio of total and concentration of NaCl. For both interactions studied, complexing latched in a wide pH range which corresponds to the interval between the pI of proteins. Among Ovalbumin and Lysozyme interaction was more intense in the ratio r = 1 at pH 7.5 and BSA and Lysozyme most complex formation has occurred on the ratio r = 0.5 and pH 9.0. Changes in the ionic strength by adding NaCl negatively affected the interaction between Lysozyme and BSA already at a concentration of 0.01 mol / L and 0.03 mol / L abolished the interaction between Lysozyme and Ovalbumin. Through Potential - zeta can be seen that the formation of insoluble complexes was highest near the pI for all studied reasons, indicating that the interaction is given by neutralization of opposite charges. The Infrared spectra suggested that electrostatic interactions led interactions however, hydrogen bonds also had a hand in the coacervation process for the proteins under study. The micrographs showed that the insoluble complexes showed spherical structure and particle size showed the formation of structures with an average size around 2 ?m, much larger than the observable size for the isolated proteins. The isothermal titration calorimetry showed that the interaction between Lysozyme and Ovalbumin was exothermic and was performed in two steps, the first and second entropy directed enthalpy driven. The differential scanning calorimetry suggested the presence of a single point of denaturation, that the interaction between Lysozyme and BSA led to a new biopolymer with denaturation temperature 67 ? C differs from isolated proteins. These studies suggested that complex coacervates formed between Ovalbumin / Lysozyme and BSA / Lysozyme could be used as the encapsulating bioactive agent or as food ingredients in order to add nutritional value.
Prote?nas s?o biopol?meros de grande import?ncia nutricional e funcional tendo sido amplamente utilizadas como ingredientes alimentares. A intera??o entre duas prote?nas diferentes e opostamente carregadas pode dar origem aos complexo coacervado, atualmente utilizados como ingrediente na tecnologia de alimentos ou como agente de microencapsula??o. A forma??o de complexos coacervados entre Ovalbumina e Lisozima e entre Albumina s?rica bovina (BSA) e Lisozima foi investigada em fun??o do pH, raz?o de massa total e concentra??o de NaCl. Para as duas intera??es estudadas, a complexa??o acorreu em uma ampla faixa de pH, que corresponde ao intervalo entre os pI das prote?nas. Entre Ovalbumina e Lisozima a intera??o foi mais intensa na raz?o r=1 em pH 7,5 e para BSA e Lisozima a maior forma??o de complexos ocorreu na raz?o r=0,5 e pH 9,0. Altera??es na for?a i?nica por adi??o de NaCl influenciaram negativamente a intera??o entre Albumina BSA e Lisozima j? na concentra??o de 0,01 mol/L e a 0,03 mol/L suprimiu a intera??o entre Ovalbumina e Lisozima. Por meio do Potencial - zeta pode-se verificar que a forma??o de complexos insol?veis foi m?xima pr?ximo ao pI para todas as raz?es estudadas, indicando que a intera??o se deu por neutraliza??o de cargas opostas. Os espectros no infravermelho sugeriram que intera??es eletrost?ticas conduziram as intera??es no entanto, liga??es de hidrog?nio tamb?m tiveram participa??o no processo de coacerva??o para as prote?nas em estudo. As micrografias revelaram que os complexos insol?veis apresentavam estrutura esf?rica e o tamanho de part?cula demonstrou a forma??o de estruturas com tamanho m?dio em torno de 2 ?m, as quais s?o bem maiores do que o tamanho obervado para as prote?nas isoladas. A calorimetria de titula??o isot?rmica demonstrou que a intera??o entre Ovalbumina e Lisozima foi exot?rmica, a qual ocorreu em duas etapas, a primeira entropicamente dirigida e a segunda entalpicamente dirigida. A calorimetria diferencial de varredura sugeriu, pela presen?a de um ?nico ponto de desnatura??o, que a intera??o entre BSA e Lisozima deu origem a um novo biopol?mero com temperatura de desnatura??o a 67?C, diferente das prote?nas isoladas. Estes estudos sugeriram que complexos coacervados formados entre Ovalbumina / Lisozima e BSA / Lisozima poderiam ser utilizados como agente encapsulante de bioativos ou como ingredientes alimentares com o objetivo de agregar valor nutricional.
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Shen, Yu-chiu, i 沈玉秋. "Dynamic dose control of wastewater chlorination/dechlorination using pH and ORP titration". Thesis, 2006. http://ndltd.ncl.edu.tw/handle/03536921633798395144.

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碩士
國立聯合大學
環境與安全衛生工程學系碩士班
94
An automatic pH-ORP (oxidation-reduction potential) titration device was developed in this study to be applied to dynamically control the doses of wastewater chlorination and dechlorination. The peaks or valleys on the pH and ORP profiles in the titration/back-titration could indicate the influent concentrations of chlorine-consumed materials (mainly ammonia nitrogen for chlorination) and residual chlorines (for dechlorination). The required dose for chlorination can be determined and optimized by multiplying the identified ammonia concentration to the optimal chlorine to nitrogen weight ratio (Cl/N). The required dechlorination dose was also found to be correlating to the residual chlorine concentration with linear relationship. These experimental results make an innovative and dynamic feed-forward dose control for wastewater chlorination and dechlorination. Two control factors, CFC and CFD, were proposed to regulate the chlorination and dechlorination doses to meet the requirements of total coliform counts and residual chlorination concentrations for different proposes of wastewater reclamation. The pH-ORP titration/back-titration can precisely predict the required doses for wastewater chlorination and dechlorination. In addition, a Back Propagation Neural Network (BPN) was also used to build the control model, which was successfully used to predict the required doses, effluent total coliform count, and effluent chlorine residuals. A series of continuous wastewater chlorination and dechlorination experiments were conducted in a continuous laboratory-scale reactor to evaluate the proposed control strategy. The results of the continuous control experiments have shown that both of the chlorination and dechlorination were effectively controlled, appropriate disinfection efficiencies and remaining chlorine residuals in effluent were controlled simultaneously for different treated targets. Additionally, the potential benefit on chemical saving was also achieved.
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Islam, Khan Md Shaiful [Verfasser]. "Dose titration, tolerance and compatibility of some feed additives in broiler / presented by Khan Md. Shaiful Islam". 2005. http://d-nb.info/976069830/34.

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Książki na temat "Dose titration"

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Wiffen, Philip, Marc Mitchell, Melanie Snelling i Nicola Stoner. Patient-specific issues. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198735823.003.0011.

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This chapter covers patient-specific issues related to children, older people, injecting drug users, and surgical patients. For children, drug pharmacokinetics and pharmacodynamics and dose calculations are reviewed. The specific concerns around adherence and also medicines licensing in children are covered. For older people, the topics include pharmacokinetics, pharmacokinetics, and medication review. Guidance is given on managing injecting drug users, especially in an in-patient setting, including a suggested regimen for titration of methadone to avoid opioid withdrawal. For surgical patients, the topics covered include management of regular medicines during the nil-by-mouth period, drug interactions with perioperative drugs, and a brief description of the impact of selected drugs in the perioperative period.
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Fullerton, James N., i Mervyn Singer. Oxygen in critical illness. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0032.

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Oxygen therapy is primarily administered to alleviate arterial hypoxaemia and tissue hypoxia, and to facilitate aerobic cellular respiration. Hypoxaemia (PaO2 < 8 kPa [60 mmHg], SaO2 <92%) is associated with end-organ damage and adverse clinical outcomes, serving as a proxy measure for reduced intracellular PO2. Increasing the fraction of inspired oxygen should form part of an overall strategy to maximize tissue oxygen delivery. Permissive hypoxaemia represents a valid treatment strategy in a selected patient cohort. Oxygen is a drug and oxygen therapy is not benign, and oxygen administration at high, sustained doses (FiO2 >0.5, >12 hours) may cause oxygen toxicity. Observational studies in both mechanically-ventilated patients and survivors of non-traumatic cardiac arrest indicate an independent association between increasing hyperoxaemia and mortality. Oxygen therapy may additionally precipitate hypercapnic ventilatory failure in those at risk and oxygen should be administered to achieve a prescribed target SaO2 or PaO2 range, via adjustment of dose and delivery device. If no monitoring is available, hypoxaemia should be avoided by giving high-flow oxygen to achieve a FiO2 of near 1.0 with subsequent titration once oxygenation status is established.
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Gupta, Rajesh. Randomized controlled trial evidence for gabapentin in post-herpetic neuralgia. Redaktorzy Paul Farquhar-Smith, Pierre Beaulieu i Sian Jagger. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198834359.003.0069.

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The landmark paper discussed in this chapter is ‘Gabapentin for the treatment of postherpetic neuralgia: A randomized controlled trial’, published by Rowbotham et al. in 1998. In the study, a 4-week initial period of titration of gabapentin (up to a maximum of 3,600 mg) or matching placebo was given, followed by a further 4-week period at the maximum tolerated dose. The primary efficacy measure was change in average daily pain score from start to finish of the treatment, and secondary measures observed were the average daily sleep score, a short-form McGill Pain Questionnaire, the subject’s global impression of change, the investigator-rated clinical global impression of change, the Short Form 36, a quality-of-life questionnaire, and a Profile of Mood States questionnaire. Subjects receiving gabapentin had significant reduction in daily pain scores as well as improvement in secondary measures of pain, although with an increased incidence of side effects.
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Cavanna, Andrea E. Topiramate. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198791577.003.0013.

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Topiramate is a second-generation antiepileptic drug characterized by a good range of antiepileptic indications, with an acceptable interaction profile in polytherapy. Topiramate has an acceptable behavioural tolerability profile, although it has been associated with a number of negative behavioural effects in patients with epilepsy (in particular depression, irritability, and psychotic symptoms). Identified risk factors for the development of behavioural adverse effects include high starting doses and rapid titration schedules, as well as personal or family history of psychiatric disorders. Topiramate has a restricted range of psychiatric uses , although its clinically significant effect in promoting weight loss in patients with behavioural problems can increase its potential usefulness in psychiatric populations.
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Servin, Frédérique S., i Valérie Billard. Anaesthesia for the obese patient. Redaktor Philip M. Hopkins. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199642045.003.0087.

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Obesity is becoming an epidemic health problem, and the number of surgical patients with a body mass index of more than 50 kg m−2 requiring anaesthesia is increasing. Obesity is associated with physiopathological changes such as metabolic syndrome, cardiovascular disorders, or sleep apnoea syndrome, most of which improve with weight loss. Regarding pharmacokinetics, volumes of distribution are increased for both lipophilic and hydrophilic drugs. Consequently, doses should be adjusted to total body weight (propofol for maintenance, succinylcholine, vancomycin), or lean body mass (remifentanil, non-depolarizing neuromuscular blocking agent). For all drugs, titration based on monitoring of effects is recommended. To minimize recovery delays, drugs with a rapid offset of action such as remifentanil and desflurane are preferable. Poor tolerance to apnoea with early hypoxaemia and atelectasis warrant rapid sequence induction and protective ventilation. Careful positioning will prevent pressure injuries and minimize rhabdomyolysis which are frequent. Because of an increased risk of pulmonary embolism, multimodal prevention is mandatory. Regional anaesthesia, albeit technically difficult, is beneficial in obese patients to treat postoperative pain and improve rehabilitation. Maximizing the safety of anaesthesia for morbidly obese patients requires a good knowledge of the physiopathology of obesity and great attention to detail in planning and executing anaesthetic management. Even in elective surgery, many cases can be technical challenges and only a step-by-step approach to the avoidance of potential adverse events will result in the optimal outcome.
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Części książek na temat "Dose titration"

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Nahler, Gerhard. "dose titration study". W Dictionary of Pharmaceutical Medicine, 55. Vienna: Springer Vienna, 2009. http://dx.doi.org/10.1007/978-3-211-89836-9_413.

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Marroni, A., G. Oriani i C. Longoni. "HBO Dose Titration". W Handbook on Hyperbaric Medicine, 81–93. Milano: Springer Milan, 1996. http://dx.doi.org/10.1007/978-88-470-2198-3_4.

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Dancey, Janet, Boris Freidlin i Larry Rubinstein. "Accelerated Titration Designs". W Statistical Methods for Dose-Finding Experiments, 91–113. Chichester, UK: John Wiley & Sons, Ltd, 2006. http://dx.doi.org/10.1002/0470861258.ch4.

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Riaño, David, i Aida Kamišalić. "Modelling and Assessment of One-Drug Dose Titration". W Artificial Intelligence in Medicine, 459–68. Cham: Springer International Publishing, 2021. http://dx.doi.org/10.1007/978-3-030-77211-6_55.

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Howell, S. J., A. Rahim i S. M. Shalet. "Dose Titration and Monitoring GH Treatment in the Adult". W Growth Hormone, 281–90. Boston, MA: Springer US, 1999. http://dx.doi.org/10.1007/978-1-4615-5163-8_18.

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"Dose Titration". W Encyclopedia of Pain, 1058. Berlin, Heidelberg: Springer Berlin Heidelberg, 2013. http://dx.doi.org/10.1007/978-3-642-28753-4_200636.

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"Opioid Dose Titration". W Encyclopedia of Pain, 2419. Berlin, Heidelberg: Springer Berlin Heidelberg, 2013. http://dx.doi.org/10.1007/978-3-642-28753-4_201531.

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Brody, Tom. "Dose Modification and Dose Titration". W FDA's Drug Review Process and the Package Label, 101–51. Elsevier, 2018. http://dx.doi.org/10.1016/b978-0-12-814647-7.00004-x.

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Asadi-Pooya, Ali A., i Michael R. Sperling. "Antiseizure Medications Dosage Forms and Administration Guidelines". W Antiseizure Medications, 17–86. Wyd. 3. Oxford University Press, 2022. http://dx.doi.org/10.1093/med/9780197541210.003.0002.

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Abstract In this chapter, the dosage forms, starting dose, titration schedule, maintenance dose, dose limits, and discontinuation schedule of various antiseizure medications (ASMs) are discussed. In addition, administration guidelines, contraindications, precautions, and information for patients are discussed briefly. A number of key points in the successful administration of ASMs are also discussed; among these, choosing the correct ASM for seizure type or syndrome; using the lowest possible dose to achieve seizure freedom; monitoring for adverse effects; weighing the relative risks and benefits of monotherapy versus polytherapy; and determining when surgical or non-medical therapies may be appropriate.
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Ku, Jennifer. "Pain Management in Calciphylaxis". W Pain, 319–26. Oxford University Press, 2022. http://dx.doi.org/10.1093/med/9780197542873.003.0038.

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Pain management in calciphylaxis is challenging due to the complex etiology of pain. Effective pain control requires multimodal treatment to limit further ischemic damage by inhibiting vascular calcification, minimizing thrombosis, and promoting wound healing. Efficacy of available pharmacological and nonpharmacological interventions is still unclear, with individual responses varying between patients. Other modalities for calciphylaxis pain include aggressive titration of opioids and the addition of neuropathic pain agents. As patients with calciphylaxis often have impaired renal function, all pharmacotherapeutic selection should take into consideration the need for renal dose adjustments and risk of renal toxicity. Last, discussions on goals of care are important given the rapid progression and high symptom burden of calciphylaxis. Important topics to discuss include dialysis, kidney transplantation, and end-of-life care.
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Streszczenia konferencji na temat "Dose titration"

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Kaewthai, Ratchanee, Sotarat Thammaboosadee i Supaporn Kiattisin. "Diabetes dose titration identification model". W 2015 8th Biomedical Engineering International Conference (BMEiCON). IEEE, 2015. http://dx.doi.org/10.1109/bmeicon.2015.7399557.

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Jabbal, Sunny, i Brian Lipworth. "Late Breaking Abstract - Blood eosinophils in inhaled steroid dose titration". W ERS International Congress 2017 abstracts. European Respiratory Society, 2017. http://dx.doi.org/10.1183/1393003.congress-2017.oa4830.

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Anderson, R. C., S. A. Buckley, D. J. Nisbet, J. R. DeLoach i L. H. Stanker. "Modelling S. choleraesuis infection by oral route of inoculation; titration of dose strength". W Seventh International Symposium on the Epidemiology and Control of Foodborne Pathogens in Pork. Iowa State University, Digital Press, 1997. http://dx.doi.org/10.31274/safepork-180809-182.

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Ghofrani, HA, MM Hoeper, G. Hoeffken, M. Halank, G. Weimann i F. Grimminger. "Riociguat Dose Titration in Patients with Chronic Thromboembolic Pulmonary Hypertension (CTEPH) or Pulmonary Arterial Hypertension (PAH)." W American Thoracic Society 2009 International Conference, May 15-20, 2009 • San Diego, California. American Thoracic Society, 2009. http://dx.doi.org/10.1164/ajrccm-conference.2009.179.1_meetingabstracts.a3337.

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Grünig, Ekkehard, Benjamin Egenlauf, Tobias J. Lange, Ulrich Krüger, Rob Grover, Michelle Pernow, Andrew Traube, Thomas Viethen i Stephan Rosenkranz. "Safety and tolerability of rapid dose-titration of subcutaneous (SC) treprostinil in pulmonary arterial hypertension (PAH)". W Annual Congress 2015. European Respiratory Society, 2015. http://dx.doi.org/10.1183/13993003.congress-2015.pa2114.

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Fu, A.-C., DC Taylor i DS Reasner. "THU0608 Association between allopurinol dose-titration and serum uric acid levels in gout patients: us electronic health record data". W Annual European Congress of Rheumatology, 14–17 June, 2017. BMJ Publishing Group Ltd and European League Against Rheumatism, 2017. http://dx.doi.org/10.1136/annrheumdis-2017-eular.6314.

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Barcellos, Cristiano, Monica Palmanhani i Rodrigo de Carvalho. "Switch from Basal Insulin to Ideglira: Why Hyperglycemia Does Not Occur at The Beginning of Ideglira Titration Despite The Great Amount Reduction of Dose from Basal Insulin? Case Report". W XXI I Congresso Brasileiro de Nutrologia. Thieme Revinter Publicações Ltda, 2018. http://dx.doi.org/10.1055/s-0038-1675040.

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Schmidt, B., M. R. Buchanan, F. Ofosu, L. A. Brooker, M. Andrew i McMaster Univ. "ANTITHROMBOTIC PROPERTIES OF HEPARIN IN A NEONATAL MODEL OF THROMBIN INDUCED VENOUS STASIS THROMBOSIS". W XIth International Congress on Thrombosis and Haemostasis. Schattauer GmbH, 1987. http://dx.doi.org/10.1055/s-0038-1643608.

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Anecdotal clinical experience suggests that more heparin is required in newborn infants that in adult patients to effectively treat thrombotic disease. We compared the ability of heparin to inhibit thrombus formation induced by a pathological bolus of thrombin and stasis in newborn piglets and 3 week old pigs. The coagulation system of the newborn piglet closely resembles that of the human neonate Including low antithrombin III (AT-III) activity (0.5U/ml). By 3 weeks, adult porcine values for coagulation factors and inhibitors are reached, while blood volume/kg body weight still approximates that of the newborn piglet. Piglets and pigs were pretreated with saline, 10 or 25U/kg heparin (n ≥16/group/dose. Following an injection of 100U/kg thrombin, systemic 125I-fibrinogen consumption and local 125I-fibrinogen incorporation into jugular venous stasis thrombi were measured. Peak heparin levels were identical In both age groups (Anti-factor Xa assay and protamine sulphate titration). Heparin was less effective in preventing thrombus formation in piglets than in pigs (Table). Heparin was also less effective in preventing systemic neonatal 125I-fibrinogen consumption (p<0.0001 at both heparin doses).Raising AT-III levels to adult values significantly improved the antithrombotic properties of heparin in neonatal piglets. Thrombus formation was completely abolished in 19 or 22 piglets who received a combination of human or porcine AT-III concentrate and 25U/kg heparin. Raising the heparin dose to 50U/kg had the same effect. We conclude that the efficacy of heparin in neutralizing thrombin is decreased in newborn piglets. Treatment with AT-III concentrate overcomes this relative heparin resistance, and may help reduce high heparin doses otherwise required in neonatal thrombotic disease.
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Fernandez, Jose Alejandro, Daniela Martinez, Franklin Salazar-Rodríguez i Johnny Bullon. "Determination of the Concentration of Commercial Cationic Surfactants in Aqueous Solutions by the Colloidal Titration Method". W 2022 AOCS Annual Meeting & Expo. American Oil Chemists' Society (AOCS), 2022. http://dx.doi.org/10.21748/kwwz9816.

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Cationic Surfactant's quantification in aqueous solution is relevant in fundamental and applied research, as well as for quality control in processes in the chemical industry. Colloidal titration is a commonly used method for surface charge determination in colloidal systems such as polyelectrolytes, macromolecules and solid particles, but it can also be applied for the detection of ionic surfactants in aqueous solution. It is a simple technique, easy to implement in a laboratory and its principle is based on the stoichiometric neutralization between two species of opposite charge, potassium polyvinylsulfonate (standard PVSK) and a cationic polyelectrolyte or cationic surfactant. When the stoichiometric ratio is exceeded, the excess polyelectrolyte reacts with a cationic indicator (crystal violet) forming an electrically neutral pair that modifies the solutions' absorbance value which is determined by spectrophotometry at 587 nm. To assess the feasibility of this technique, the colloidal titration method was normalized by titration between two standard polyelectrolytes (PDADMAC and PVSK), also with analytical grade cationic surfactants (DDBAB, CTAB and HDBAC) and finally with some commercial ones (Praepagen WK, Dodigen 1828, Empygen BAC 50). High molecular weight surfactants showed stoichiometric proportionality between their concentration and the amount of tritant added for concentration between 10-100 mN. This proportionality was not observed for low molecular weight surfactants. Finally, it was also observed that for commercial surfactants the presence of 0.01 M sodium chloride does not affect the titration results.
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Albiol Chiva, Jaume, Juan Peris Vicente, María José Ruiz Ángel, Mar Esteve Amorós, Samuel Carda Broch, Pau Esteve Amorós, Estel la Esteve Amorós, Diego Kassuha i Josep Esteve Romero. "Implementation of Computer Assisted Experimental Work in Analytical Chemistry Laboratory Teaching". W Fifth International Conference on Higher Education Advances. Valencia: Universitat Politècnica València, 2019. http://dx.doi.org/10.4995/head19.2019.9161.

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Computer-Assisted Experimental Work (CAEW) consists in the incorporation of computer-connected apparatus in the laboratory. This is a new insight into teaching of Classical Analytical Chemistry, wherein the experiments are usually manually conducted. However, it does not represent a complete break with traditional methodology, as the design and goal of the experiment are essentially the same. In this work, we present the implementation of CAEW to a practical included in the Laboratory part of “Analytical Chemistry IV”, taught at the fourth academic year of the Degree in Chemistry: “Potentiometric titration of a mixture of iodure and chlorure with silver”. Three couples of students used an Ag-ion selective electrode connected to a computer, while the other three couples employed a digital one. The results were comparable, though the computer-assisted method provided significant improvements, like; the students get familiar with new technologies at an accessible level, the titration can be visually followed on the screen via the titration curve, the calculations are automatically performed, allowing the detection of experimental and registration of mistakes, it avoids errors caused by the transcription and processing of the data, and the students achieve their practical disposing of the final results, and all their work corrected by the teacher.
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