Thesis (M.S.)--University of Michigan, 1974.

Thesis (M.S.)--University of Michigan, 1974.

Thesis (M.S.)--University of Michigan, 1974.

Profschrift-Veeartsenijk. hoogeschool, Utrecht. / "Stellingen": leaf laid in. "Literatuur": p. [143]-145.

Thesis (Ph. D.)--Rïjksuniversiteit te Groningen, 1983. / Summary and vita in Dutch. Includes bibliographical references.

Class of 2015 Abstract / Objectives: Evaluate prescriber knowledge on naloxone use for opioid overdose reversals in intravenous drug users. Interview prescribers on their perceptions about intravenous drug users, syringe access programs, and other related topics. Subjects: Prescribers and medical professionals in the State of Arizona. Methods: Medical facilities were contacted by email, fax, or telephone requesting for prescribers to complete the survey and return by email or fax, or call to schedule a face-to-face appointment. The respondents of the survey were kept anonymous and were permitted to answer the survey in free text. Surveys were sent to the 68 selected medical facilities at least twice during the study period. Results: All of the six respondents were male, of the respondents had at least 11 years experience, with two having >30 years. A majority practiced in rehab centers or worked with drug abuse patients, however the number of patients treated per week by respondent varies from 10-320. Also of note five of the six respondents had a family member or relative with an addiction to opioids. The respondents seem to be in support of a naloxone distribution program however it is difficult to draw any conclusions since the number of responses was low. Conclusions: It appears that prescribers have a favorable perception of naloxone use and support harm reduction strategies, however response rate was too low to make any definitive conclusions.

La perfusion intraveineuse, continue ou intermittente, est un acte courant dans les services de soins bien que non dénué de risque. Différents dispositifs médicaux peuvent être employés pour permettre l’administration parfois simultanée de plusieurs substances actives. Ces dispositifs peuvent, de par leurs caractéristiques propres, générer des fluctuations plus ou moins importantes du débit massique de principe actif, c’est-à-dire la quantité de médicament administrée au patient par unité de temps. Le premier axe de travail concernant ces dispositifs médicaux est l’étude des prescriptions des normes, en particulier les définitions, les méthodes d’essai et les seuils de conformité attendus. Les principaux éléments de physiologie et de mécanique des fluides sont abordés afin d’appréhender la problématique. Cette étude est complétée par l’analyse des données de la littérature concernant l’impact des dispositifs médicaux sur le débit massique des principes actifs délivrés par voie intraveineuse. Une revue systématique de la littérature a été effectuée. Elle porte sur les travaux in vitro ou in vivo se rapportant au sujet et concernant tout élément susceptible de modifier le débit ou la concentration du médicament perfusé. Le premier travail expérimental réalisé in vitro concerne la perfusion simultanée de trois médicaments au moyen d’un dispositif unique de perfusion présentant plusieurs points d’accès. Les trois médicaments étaient perfusés par pousse-seringues et une solution d’hydratation par gravité. Le but de cette étude était d’évaluer l'impact des caractéristiques (volume résiduel et valve anti-retour) de deux dispositifs de perfusion, un premier présentant un très faible volume résiduel (0,046 ml) et une valve anti-retour et le second présentant un volume résiduel élevé (6,16 ml) et sans valve anti-retour) sur le débit massique de trois principes actifs. La quantification simultanée de trois principes actifs en solution (dinitrate d’isosorbide, midazolam et noradrénaline) a nécessité la mise au point d’une méthode multivariée sur spectre UV (régression partial least square (PLS)). Cette technique a permis de doser en continu (1 dosage par seconde) les trois principes actifs à la sortie de la ligne de perfusion. La méthode a été validée dans les échelles de concentrations respectives de 5-60, 10-80 et 2,5-20 µg.mL-1 pour le dinitrate d’isosorbide, le midazolam et la noradrénaline, dans des mélanges binaires et 6,67 à 30, 0,83 à 7,5 et 1,67 à 23,33 µg.ml−1 pour ces mêmes produits, dans des mélanges ternaires. La mise au point du modèle a permis de retenir la zone du spectre située entre 220 et 300 nm associée à un index Q2cum optimal. L’étude de recouvrement, employant le modèle pour prédire les compositions de 8 mélanges ternaires, retrouvait des valeurs de concentrations situées dans un intervalle de 99,5 à 101 % des valeurs théoriques. Les principaux paramètres dans cette étude étaient 1) l'évolution du débit massique des trois médicaments, 2) la valeur du plateau du débit massique à l'équilibre, et 3) l’efficience de perfusion (flow change efficiency (FCE)). Le FCE est obtenu en divisant l’aire sous la courbe du débit massique expérimental en fonction du temps par l’aire sous la courbe du débit massique attendu en fonction du temps. Ce paramètre est calculé pour chaque intervalle de 5 minutes après le début de la perfusion. Les systèmes de perfusion avec un volume résiduel réduit offrent de façon significative un meilleur FCE (53,0  15,4% avec un volume résiduel très faible après 5 minutes de perfusion comparativement à 5,6  8,2% avec un système de perfusion avec un volume résiduel élevé), quel que soient les conditions de changements de débit. Une relation non-linéaire a été établie entre le volume résiduel, le temps depuis le début de la perfusion et le FCE. [...] / Intravenous infusion, whether used continuously or intermittently, is a common feature in healthcare, although not without risk. Various medical devices can be used to administer the infusion, sometimes simultaneously, of several active substances . These devices, because of their characteristics, may generate more or less significant variations in drug mass flow rate, which is the amount of drug delivered per unit of time to the patient. The first part of this work on these medical devices focuses on studying standard requirements and norms, especially definitions, as well as trial methods and expected conformity thresholds. The main elements of physiology and fluid mechanics are also addressed to offer a better grasp of the problems involved. This study is complemented by analyses of published data on the impact of medical devices on drug mass flow rate when delivered intravenously. A systematic review of publications was made, covering in vitro or in vivo studies related to the topic, targeting more particularly any infusion device likely to alter the flow or concentration of the infused drug. The first experimental in vitro work involves the simultaneous infusion of three drugs using a single infusion device with several access points. The three drugs were infused by syringe pump and a hydration solution by gravity. The purpose of this study was to assess the impact of certain features (residual volume and check valve) of two infusion devices (the former with very low residual volume and a check valve and the latter with a high residual volume and no check valve) on the mass flow of three active ingredients. Simultaneous quantification of three active ingredients in solution (isosorbide dinitrate, midazolam and norepinephrine) made it necessary to develop a multivariate method on UV spectrum (partial least square regression (PLS)). This technique meant that the three drugs could be dosed continuously (1 dose per second) at the catheter egress. The method was validated for concentration scales of 5-60, 10-80 and from 2.5 to 20 µg/ml for isosorbide dinitrate, midazolam and noradrenaline in binary mixtures and 6.67 to 30, 0.83 to 7.5 and 1.67 to 23.33 µg/ml for the same products, in ternary mixtures. The perfecting of the model made it possible to maintain the spectral region between 220 and 300 nm with an optimal Q2cum index. The recovery study, performed on prediction sets containing eight different ternary mixtures of isosorbide dinitrate, midazolam and noradrenalin, yielded recovery values ranging from 99.5 to 101% of the theoretic values. The main parameters assessed in this study were 1) the evolution of mass flow rate for the three drugs, 2) the value of the plateau mass flow rate, and 3) flow change efficiency (FCE).. FCE is obtained by dividing the area under the curve of the experimental mass flow in relation to time by the area under the curve of the expected mass flow in relation to time. This parameter was calculated at each 5-minute interval after the start of infusion. Infusion systems with reduced residual volume provided significantly better FCE (53.0  15.4% with very low residual volume after 5 minutes’ infusion compared to 5.6  8.2% with high residual volume), regardless of any changes in flow conditions. A nonlinear relationship was established between residual volume, time since the onset of infusion and FCE. [...]

This project was divided into two studies. The first investigated the pharmacokinetics of imipramine hydrochloride (IMI) in bulls. IMI was administered intravenously to three bulls (600-705.5 kg) at a dose of 2mg/kg body weight (BW). Intravenous plasma concentrations of IMI over time were determined by fluorescence polarization immunoassay (FPIA). IMI plasma concentration versus time profile was best described by a two compartmental open model with first-order rate constants. IMI distributed rapidly, (t½<font face="symbol">a</font>) at 7.2 ± 4.2 min, exhibited a very large apparent steady state volume of distribution (Vdss) of 4.2 ± 0.9 <font face="symbol">l</font>/kg BW, had a very short terminal elimination half-life (t½<font face="symbol">b</font>) of 140 ± 15 min and showed a rapid total body clearance (C<font face="symbol">l</font>) of 22.7 ± 7 m<font face="symbol">l</font>/min/kg. Both IMI and the pharmacologically active metabolite, desipramine was negligible in serum at 24 hours. All three bulls treated with IMI showed pronounced central nervous system signs immediately post injection. Signs of generalised weakness and ataxia were evident. All CNS signs dissipated 15-20 minutes post injection and should therefore not influence the treatment interval. An interval of at least 23 hours between repeat treatments of IMI, representing a period of at least 10 half-lives, is recommended. The dose of 2 mg/kg BW used in this study was similar to that routinely used in stallions without fatal side effects. One of the three bulls exhibited spontaneous emission and ejaculation with this dose. The second study investigated the effects of IMI on ampullar strips of bulls in organ baths. Vasa deferentia were collected from 16 freshly slaughtered post-puberal bulls of various breeds. Longitudinal ampullar strips were prepared and placed into 20 ml modified Krebs bicarbonate solution, aerated with a mixture of 02 (95 %) and CO2 (5 %) in water-jacketed organ baths. The effect on the smooth muscle tissue of noradrenaline (NA) alone, NA in combination with IMI and IMI alone was evaluated. NA alone consistently produced dose-dependant smooth muscle tissue contractions. IMI doses equivalent to <1 mg/kg BW (body weight equivalent; bwe) had NA potentiating effects. Doses of <0.1 mg/kg bwe were consistently potentiating while doses of >0.1 mg to <1 mg/kg bwe partially blocked NA stimulating effects. Amplitude of rhythmic contractions increased while contraction frequency decreased at this level. This study supports the adrenergic potentiating effects of IMI at doses of 0.05-0.2 mg/kg bwe with higher doses having paradoxical effects. Doses of IMI < 2 mg/kg bwe completely blocked NA effects. Tissue response to NA, after IMI blockade, started to recover 146-186 minutes after application of IMI at <2 mg/kg bwe. In the absence of NA, IMI had no effect on smooth muscle activity. The time to an IMI effect on NA initiated smooth muscle activity was 8 minutes. On the basis of the results of this in vitro study, we propose that IMI can be used to enhance semen collection by means of electro-stimulation in domestic bulls and immobilised wildlife species such as buffalo, provided that the correct dose is used. / Dissertation (MMedVet (Gyn))--University of Pretoria, 2005. / Production Animal Studies / unrestricted

Glucans are microbial cell wall carbohydrates that are shed into the circulation of patients with infections. Glucans are immunomodulatory and have structures that are influenced by bacterial or fungal species and growth conditions. We developed a method to covalently label carbohydrates with a fluorophore on the reducing terminus, and used the method to study the pharmacokinetics following intravenous administration of three highly purified and characterized glucans (glucan phosphate, laminarin and scleroglucan) that varied according to molecular size, branching frequency and solution conformation. Elimination half-life was longer (3.8±0.8 vs. 2.6±0.2 and 3.1±0.6 h) and volume of distribution lower (350±88 ml/kg vs. 540±146 and 612±154 ml/kg) for glucan phosphate than for laminarin and scleroglucan. Clearance was lower for glucan phosphate (42±6 ml/kg h) than for laminarin (103±17 ml/kg h) and scleroglucan (117±19 ml/kg h). Since plasma levels at steady state are inversely related to clearance, these differences suggest that pharmacokinetics could favor higher blood levels of glucans with certain physicochemical properties.

Indiana University-Purdue University Indianapolis (IUPUI) / Background: SMOF lipid™ infusion containing soybean oil, medium-chain triglycerides, olive oil, and fish oil has been approved and recommended for use in adults receiving parenteral nutrition (PN). Research shows that SMOF lipid infusion is safe for use in post-operative and critically ill patients. Improved patient outcomes are linked to SMOF lipid use over traditional soybean oil lipid emulsions. Objective: The purpose of this study was to determine the effect of SMOF lipid infusion on incidence of infection, ICU length of stay, hospital length of stay, and mortality in adult trauma patients as compared to parenteral nutrition utilizing 100% soybean oil emulsion or a lipid-free, dextrose and amino acid administration. Methods and Analysis: A retrospective chart review was conducted for adult trauma patients admitted to Eskenazi Health’s surgical intensive care unit (SICU) that received PN from May 2017 to May 2020. Data were collected from the electronic health record and trauma registry. Results: Twenty-nine patients were included who met study criteria: 17 patients in the traditional lipid cohort and 12 in the SMOF lipid cohort. The length of PN therapy was comparable between the traditional and SMOF ILE groups, 13.9 days (± 11.5) and 13.3 days (± 14.3) respectively. All 12 patients in the SMOF lipid cohort received intravenous lipid emulsion (ILE) compared to 42% (n=7) of traditional lipid group patients (p=0.001). SMOF treatment group were provided 100% of estimated energy needs via PN compared to an average of 94% (± 9.7) of estimated energy needs in the traditional lipid treatment group (p=0.036). Incidence of infection during initial hospitalization was significantly lower in the SMOF treatment group (n=3, 25%) compared to the traditional lipid treatment group (n=13, 76%). Mortality was decreased in the SMOF treatment group (0%) when contrasted to the Intralipid treatment group (23.5%), p=0.04. Conclusion: Patients receiving SMOF lipid emulsion within PN therapy had better clinical outcomes compared to those receiving Intralipid soybean-lipid emulsion or a dextrose and amino acid administration.