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Pratt, Rod, and Jeff Hopkins-Weise. "Redcoats in the 1840s Moreton Bay and New Zealand frontier wars." Queensland Review 26, no. 01 (June 2019): 32–52. http://dx.doi.org/10.1017/qre.2019.6.
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AbstractThis article examines the significant place of the 99th (Lanarkshire) Regiment of Foot as part of the shared history of Australia and New Zealand through the 1840s and 1850s, including its role in frontier conflict with Aboriginal peoples in Queensland and Māori peoples in New Zealand. This preliminary comparison explores the role and experiences of detachments of the British Army’s 99th Regiment on three different colonial frontiers during the 1840s transitional period: the end of convict transportation and the opening of free settlement in Moreton Bay in 1842–48; the short-lived North Australia colony (later Gladstone) in 1847; and New Zealand’s North Island in 1845–47.
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Herkalo, Keith. "The 104th (New Brunswick) Regiment of Foot in the War of 1812 by John R. Grodzinski." Ontario History 107, no. 1 (2015): 147. http://dx.doi.org/10.7202/1050689ar.
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Kelly, Rhonda Alice. "The incidence and prevention of foot problems among male Phase One British Army recruits at an Army Training Regiment." Journal of the Royal Army Medical Corps 161, Suppl 1 (November 30, 2015): i56—i59. http://dx.doi.org/10.1136/jramc-2015-000578.
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Tucker, Patrick M. "The mysterious ruins: Rescuing the Spafford farmstead from the forgotten war of 1812." North American Archaeologist 39, no. 2 (April 2018): 87–130. http://dx.doi.org/10.1177/0197693118772593.
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The Amos Spafford farmstead (33Wo50) of Port Miami in northwest Ohio disappeared from the historical record after the War of 1812. Port Miami, a Franco-American village, was the first U.S. federal customs facility established in Ohio in 1805. It was destroyed in 1812 by a British and Native American detachment led by Captain Peter Latouche Chambers (British 41st Regiment of Foot), the Shawnee leader Tecumseh, and the Wyandot leader Roundhead. Port Miami’s destruction became lost over the years to the historical memory and consciousness of Ohio. Salvage excavations of the Spafford farmstead (1810–1823) in 1977 and its history provide an archaeological window within which to view Port Miami’s obliteration and its recovery to the community heritage of the state.
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Bene, Krisztián. "Changes in the Composition, Equipment and Tactics of the 1st Foreign Cavalry Regiment of the French Foreign Legion during the Indochina War." Nemzet és Biztonság 16, no. 2 (February 15, 2024): 114–25. http://dx.doi.org/10.32576/nb.2023.2.8.
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For nearly a hundred years after its creation, the French Foreign Legion consisted exclusively of infantry units, supplemented only temporarily by “mounted” infantry units, depending on the needs of the theatre of operations. These units did not exceed the size of a company, and their members used their mounts (horses, mules, camels) only to move around, and continued to fight their battles on foot. Based on this positive experience, the 1st Foreign Cavalry Regiment was created in 1922, and was then successfully deployed in Syria and Morocco between the two World Wars, and with varying effectiveness in France, Tunisia and Germany during the Second World War. The First Indochina War broke out in 1946 and the 1st Foreign Cavalry Regiment joined the conflict in Southeast Asia in 1947, only to leave in 1955 as one of the last French units. During the war, the ranks of the troop, composed mainly of foreign nationals, were reinforced within a short time by a significant number of local soldiers to alleviate the permanent shortage. In addition, depending on local geography, the unit was equipped with armoured and amphibious vehicles, and sometimes ships, which were used to develop new tactics and operate effectively in these new and very different circumstances. In view of its successes, the unit was greatly improved, originally consisting of 7 squadrons, and by the end of the conflict it had grown to 18 squadrons.
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Hundert, Zbigniew. "The Enlistment Letters (listy przypowiednie) for Marcin Zamoyski with the Years 1656, 1679 and 1683 on Cavalry Banners and Foot Regiment in the Polish Crown Army." Res Historica 43 (January 9, 2018): 313. http://dx.doi.org/10.17951/rh.2017.0.313.
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Hundert, Zbigniew. "The Enlistment Letters (listy przypowiednie) for Marcin Zamoyski with the Years 1656, 1679 and 1683 on Cavalry Banners and Foot Regiment in the Polish Crown Army." Res Historica 43 (January 9, 2018): 313–36. http://dx.doi.org/10.17951/rh.2017.43.313-336.
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Singh, Inderjeet, Lalhmunlien Robert Varte, and Shweta Rawat. "Estimation of Stature from Different Anthropometric Measurements of Gorkha Soldiers." Defence Life Science Journal 4, no. 1 (December 31, 2018): 33–37. http://dx.doi.org/10.14429/dlsj.4.11763.
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Stature is one of the most important elements in the identification of a person. Many different anthropometric dimensions can be used in the estimation of stature. Establishing the identity of an individual from body fragments has become an important necessity in recent times due to natural and man-made disasters. This study was performed on 226 Gurung soldiers of Gorkha regiment of Indian Army. The studied soldier’s age range was 18 years - 48 years. Six anthropometric measurements (Stature, Hand length, Arm length, Standing knee height, Foot length and Leg length) were measured and stature is estimated with the help of these measurements.There was no significant difference between actual and estimated stature. All anthropometric measurements were highly correlated with stature at significance level p< 0.001 but leg length had better correlation (r=0.816) compared to other variables. Staturecan be estimated with the help of standing knee height (r=0.686, p<0.001) and arm length (r=0.653, p<0.001). It can be concluded that leg length was a very good predictor of stature estimation for the studied population.
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Deng, Pengbo, Huaping Yang, Cen Chen, Chengping Hu, Liming Cao, Qihua Gu, Jian An, et al. "The efficacy and safety profile of anlotinib with etoposide plus cisplatin/carboplatin in treatment-naive extensive-stage small cell lung cancer(SCLC) patients: Results from a phase II single-arm trial." Journal of Clinical Oncology 38, no. 15_suppl (May 20, 2020): 9066. http://dx.doi.org/10.1200/jco.2020.38.15_suppl.9066.
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9066 Background: Combination of etoposide and cisplatin/carboplatin is the most commonly used initial chemoptherapy regiment in extensive-stage small cell lung cancer. A meta-analysis released that, there is no significant difference was observed in Objective response rate(ORR), progression-free survival (PFS), or overall survival(OS) in patients(pts) receiving cisplatin-base versus carboplatin-based regimens. We performed a single-arm phase II trial to determine if maintain of single-agent anlotinib, an oral VEGFR, FGFR, PDGFR and c-Kit tyrosine kinase inhibitor, after 4-6 cycles of anlotinib + etoposide + cisplatin/carboplatin would improve PFS and ORR. Methods: SCLC pts (18~70 yrs, extensive-stage SCLC, no prior systematic chemo/ICI therapy) received anlotinib( 12mg QD from day 1 to 14 of a 21-day cycle) +etoposide( 100mg/m2, d1~3 of 21-day cycle)+ cisplatin( 75-80mg/m2,Q3W)/ carboplatin( AUC = 5~6,Q3W) for 4~6 cycles, and anlotinib maintenance. The dual-primary endpoint were PFS and ORR. Results: Between Oct.2018 to Dec.2019, 27 pts enrolled and included in the efficacy and safety analysis: age: median 62 (range:44-71); male 93%; cisplatin/ carboplatin/ both 11%/78%/11%; 37%(10/27) of pts required chemotherapy dose modification only, and the other 30% (8/27) of pts required anlotinib+ chemotherapy dose modification.The median PFS was 9.61 months ( 95%Cl:7.80-11.42). ORR was 77.78% (21/27), disease control rate (DCR) was 96.30% (26/27).Toxicities≥grade 3 included: neutropenia 22%, leukopenia 11%, hand-foot syndrome 15%, nausea 4%, mucositis 4%, edema 4%, anorexia 4%, xerostomia 4% and fatigue 4%; there were no grade 5 toxicities. Conclusions: Combined treatment with anlotinib plus etoposide and cisplatin/carboplatin for treatment-naive extensive-stage SCLC was well tolerated with promising PFS and ORR to date but showed no new risk for AEs. Based on these encouraging results, phase III trial of anlotinib plus etoposide and cisplatin/carboplatin for treatment-naive SCLC has been warranted.
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Phiri, Bizeck Jube. "The African Participation and Experiences in the First and Second World Wars in Northern Rhodesia: A Historical Perspective 1914–1948." Journal of Asian and African Studies 57, no. 1 (November 17, 2021): 47–59. http://dx.doi.org/10.1177/00219096211054909.
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Unlike existing studies that examined each of the two World Wars and Africans separately, this study explores African participation and experiences in the First and Second World Wars in Northern Rhodesia (colonial Zambia) together during the period, 1914–1948. A lot has been written on the history of the World Wars in colonial Africa. However, there is not much literature that focuses on African participation and experiences during the two world wars. This study is focused on the core theme, that is, the role played by Africans in both World Wars. This is the main theme that informs the study. The core theme is sub-divided into the following three sub-themes: the making of the Northern Rhodesia Police under the British South African Company, BSACo, a Chartered Company that prohibited by law from housing a standing; recruitment of personnel for the Northern Rhodesia Regiment; the role played by traditional authorities in the recruitment of ‘Askari’ – the Foot Soldiers and the ‘Tenga-Tenga’ War Carriers and the role of government propaganda while bringing to the fore African agency during both Wars. Also discussed in the study is the demobilisation process in which African servicemen – the Foot Soldiers and the ‘Tenga-Tenga’ War Carriers – felt cheated by an Empire-wide system of racial discrimination and hierarchy. Although an expanded government propaganda machinery contributed to the growth of an African political voice in Northern Rhodesia during the period, 1914–1948, that political voice neither included nor translated to much debate or discussion about the concerns of African ex-servicemen and their personal affairs. The study equally examines how their state of affairs affected the relationship between the ex-servicemen and their traditional leaders who were active in the recruitment process that brought them into the Wars in the first place. The study concludes with the re-examination of the older arguments that African servicemen did not play an active role in nationalist politics after the World Wars, and submits otherwise, that is, that they actually did.
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Lomas, M., J. Salvador, M. Ruiz, and J. L. Bayo. "Safety of long-term administration of capecitabine in metastatic breast cancer patients." Journal of Clinical Oncology 24, no. 18_suppl (June 20, 2006): 10755. http://dx.doi.org/10.1200/jco.2006.24.18_suppl.10755.
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10755 Background: To evaluate the effectiveness and tolerability of long -term treatment with capecitabine in metastatic breast cancer patients. Capecitabine (C) has been administered offering clinical benefit to women with metastatic breast cancer (MBC) (ORR: 42%). The aim of this trial was to evaluate the efficacy and tolerance of capecitbine in long-term treatment, administered as first, second and third line treatment in MBC. Methods: Patients ≥ 18 years old with MBC, ECOG performance status (PS) ≤2, HER-2 neu negative, non-chemotherapy naive were included in this prospective, multicentre, non-randomized. To date, twenty-two ambulatory patients were evaluable for toxicity and response. Median age 59.2 years (37–81). All of patients had previously received adjuvant treatment. Hormonal therapy were allowed as clinically required. They received three weekly cycles of oral capecitabine 1000–1250 mg/m2 twice daily, days 1–14, followed one week rest until progression or relapse. Results: The overall response rate (ORR) is including PR, CR, and EE 78%. The median treatment duration was 14 months, median range (3–32). Median progression-free and overall survival have not yet been reached. The most common grade ½ (NCIC CTC) treatment related adverse events were /23, hand foot syndrome 4/23, diarrea 1/23. Conclusions: These preliminary data confirm that the treatment with capecitabine (C) is an effective and well tolerated regiment in metastatic breast cancer patients. No significant financial relationships to disclose.
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Rose, Edward. "British pioneers of the geology of Gibraltar, Part 1: the artilleryman Thomas James (ca 1720-1782); infantryman Ninian Imrie of Denmuir (ca 1752-1820); and ex-militiaman James Smith of Jordanhill (1782-1867)." Earth Sciences History 32, no. 2 (January 1, 2013): 252–78. http://dx.doi.org/10.17704/eshi.32.2.y46w1v7758755766.
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The rocky peninsula of Gibraltar juts south from Spain at the western entrance to the Mediterranean Sea. Long famous as a landmark, it was ceded to Great Britain by the Treaty of Utrecht in 1713, and progressively developed as a naval and military base. Thomas James, a Royal Artillery officer stationed on Gibraltar from 1749 to 1755, was the first member of the British garrison to publish geological observations on the Rock, within a book of 1771 completed in New York. His military career culminated after active service against revolutionary Americans, finally in the rank of major-general, but with no further known contributions to geology. The Scotsman Ninian Imrie of Denmuir, an officer of the First Regiment of Foot (The Royal Scots), served on Gibraltar within the period 1784 to 1793, and was the first to publish an account specifically on its geology, in the Transactions of the Royal Society of Edinburgh in 1798. A career soldier, he achieved the rank of lieutenant-colonel before retiring to Scotland, and to amateur geological studies influenced by active membership of Edinburgh's Wernerian Natural History Society. James Smith of Jordanhill, near Glasgow, served in Great Britain in the Renfrewshire Militia during the Napoleonic Wars but, benefiting from a family fortune, later spent much time as a yachtsman and scholar of wide interests and influence. His studies on Gibraltar, published by the Geological Society of London in 1846, were the first to attempt a tectonic interpretation of the Rock's geological history, and to record local evidence for Quaternary sea level change.
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Aliakbar, Adil Hassan, Malath Azeez Alsaadi, and Abbas Abd Zaid Barrak. "Evaluation of the Surgical and Pharmacological Treatment of Diabetic Foot Infection: A Retrospective Study." Open Access Macedonian Journal of Medical Sciences 7, no. 9 (May 14, 2019): 1499–504. http://dx.doi.org/10.3889/oamjms.2019.298.
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BACKGROUND: Diabetic foot infection is a major cause of patient disabilities and lowers limb amputations, with high treatment costs and hospitalisation requirements.
AIM: Aim of this study was to evaluate surgical wound care plus antibiotic effects in the treatment of mild and moderate diabetic foot infections.
METHODS: This retrospective study involved 60 patients with diabetic foot infections with or without osteomyelitis. The patients were categorised as group 1 mild and group 2 moderate. Both groups were treated using local wound debridement and the systemic administration of antibiotics. Group 1 (16) patients were treated with two regimens of oral antibiotics in two regimens, A (amoxicillin/clavulanate + metronidazole) and B (clindamycin + metronidazole), for 10-14 days. Group 2 (42) patients were treated with oral plus intravenous antibiotics in two regimens, A (ampicillin + cloxacillin + metronidazole) and B (lincomycin + metronidazole), for 6 weeks. The patients followed-up with local wound care specialists for 3 months to evaluate the treatment outcomes (cure, improvement, or failure).
RESULTS: Group 1 had an 80% cure rate under regimen A and a 100% cure rate under regimen B. Group 2 regimen A patients had a 61.5% cure rate and 11.53% improved, while regimen B patients had a 68.75% cure rate and 12.5% improved. Failure in both regimens was 23.8% in 20 patients with osteomyelitis, while 35% were cured and 20% improved during the study period.
CONCLUSION: Local surgical wound care for 3 months with antibiotic regimens for 6 weeks resulted in good response and cure rates, with lower costs and fewer instances of hospitalisation. Intravenous lincomycin and oral metronidazole achieved higher cure responses for moderate diabetic foot infections.
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Welch, C. C., M. K. Grace, C. J. Billington, and A. S. Levine. "Preference and diet type affect macronutrient selection after morphine, NPY, norepinephrine, and deprivation." American Journal of Physiology-Regulatory, Integrative and Comparative Physiology 266, no. 2 (February 1, 1994): R426—R433. http://dx.doi.org/10.1152/ajpregu.1994.266.2.r426.
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The orexigenic agents morphine, neuropeptide Y (NPY), and norepinephrine (NE) and deprivation have been reported to induce selection of specific macronutrients: fat, carbohydrate (CHO), CHO, and fat, respectively. We utilized analysis of covariance to compensate for the influence of baseline preference on feeding induced by six experimental procedures: morphine, NPY, NE, 24 and 48 h food deprivation, and chronic dietary restriction. Rats received one of two dietary regimens: three macronutrient diets containing CHO, protein, or fat (regimen I) and two nutritionally complete diets that were high CHO or high fat (regimen II). Baseline preference significantly influenced dietary selection after all six experimental procedures studied in regimen I and after NPY, NE, 48 h food deprivation, and chronic dietary restriction in regimen II (covariate P < 0.05). In both dietary regimens, morphine (5 mg/kg) increased consumption of fat, NPY (5 micrograms icv) increased selection of CHO, and consumption of all diets was induced equally after NE injections (20 micrograms icv). After 24 or 48 h food deprivation, animals consumed more fat in regimen I and more CHO diet in regimen II. Restricting food intake by 20% increased fat and protein consumption in regimen I but had no effect in regimen II. Diet selection is affected by prior preference, feeding stimulus, and type of diet choice presented.
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Ezzet, F., M. van Vugt, F. Nosten, S. Looareesuwan, and N. J. White. "Pharmacokinetics and Pharmacodynamics of Lumefantrine (Benflumetol) in Acute Falciparum Malaria." Antimicrobial Agents and Chemotherapy 44, no. 3 (March 1, 2000): 697–704. http://dx.doi.org/10.1128/aac.44.3.697-704.2000.
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ABSTRACT The objective of this study was to conduct a prospective population pharmacokinetic and pharmacodynamic evaluation of lumefantrine during blinded comparisons of artemether-lumefantrine treatment regimens in uncomplicated multidrug-resistant falciparum malaria. Three combination regimens containing an average adult lumefantrine dose of 1,920 mg over 3 days (four doses) (regimen A) or 2,780 mg over 3 or 5 days (six doses) (regimen B or C, respectively) were given to 266 Thai patients. Detailed observations were obtained for 51 hospitalized adults, and sparse data were collected for 215 patients of all ages in a community setting. The population absorption half-life of lumefantrine was 4.5 h. The model-based median (5th and 95th percentiles) peak plasma lumefantrine concentrations were 6.2 (0.25 and 14.8) μg/ml after regimen A, 9.0 (1.1 and 19.8) μg/ml after regimen B, and 8 (1.4 and 17.4) μg/ml after regimen C. During acute malaria, there was marked variability in the fraction of drug absorbed by patients (coefficient of variation, 150%). The fraction increased considerably and variability fell with clinical recovery, largely because food intake was resumed; taking a normal meal close to drug administration increased oral bioavailability by 108% (90% confidence interval, 64 to 164) (P, 0.0001). The higher-dose regimens (B and C) gave 60 and 100% higher areas under the concentration-time curves (AUC), respectively, and thus longer durations for which plasma lumefantrine concentrations exceeded the putative in vivo MIC of 280 μg/ml (median for regimen B, 252 h; that for regimen C, 298 h; that for regimen A, 204 h [P, 0.0001]) and higher cure rates. Lumefantrine oral bioavailability is very dependent on food and is consequently poor in acute malaria but improves markedly with recovery. The high cure rates with the two six-dose regimens resulted from increased AUC and increased time at which lumefantrine concentrations were above the in vivo MIC.
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Pelly, Fiona E., and Sarah J. Burkhart. "Dietary Regimens of Athletes Competing at the Delhi 2010 Commonwealth Games." International Journal of Sport Nutrition and Exercise Metabolism 24, no. 1 (February 2014): 28–36. http://dx.doi.org/10.1123/ijsnem.2013-0023.
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The aim of this study was to investigate the dietary regimens reported by athletes competing at a major international competition and report whether these were based on nutrient composition, religious beliefs, cultural eating style, food intolerance or avoidance of certain ingredients. A questionnaire was randomly distributed to 351 athletes in the main dining hall of the athletes’ village over the three main meal periods during the Delhi 2010 Commonwealth Games (23rd Sept—14th Oct, 2010). The majority (n = 218, 62%) of athletes reported following one or more dietary regimens, with 50% (n = 174) following a diet based on the nutrient composition of the food. Significantly more athletes from weight category and aesthetic sports (28%, p = .005) and from power/sprint sports (41%, p = .004) followed low fat and high protein regimens respectively. Other specialized dietary regimens were followed by 33% of participants, with avoidance of red meat (13%), vegetarian (7%), Halal (6%), and low lactose regimens (5%) reported most frequently. Significantly more athletes from non-Western regions followed a vegetarian diet (p < .001), while more vegetarians reported avoiding additives (p = .013) and wheat (p ≤ .001). A Western style of eating was the most commonly reported cultural regimen (72% of total with 23% from non-Western regions). Those following a Western diet were significantly more likely to report following a regimen based on nutrient composition (p = .02). As a high proportion of athletes from differing countries and sports follow specialized dietary regimens, caterers and organizers should ensure that adequate nutrition support and food items are available at similar events.
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CHARUEST, JEAN-PIERRE, SYLVAIN PAGE, and JACQUES J. DUFOUR. "EFFET DU RÉGIME LUMINEUX IMPOSÉ DURANT LA GESTATION ET LA LACTATION SUR LES PERFORMANCES REPRODUCTIVES DES TRUIES À LEURS QUATRE PREMIERES PORTÉES." Canadian Journal of Animal Science 68, no. 4 (December 1, 1988): 1015–25. http://dx.doi.org/10.4141/cjas88-116.
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During a 3-yr period, 902 Landrace-Yorkshire gilts were randomly assigned to a 4 h light: 20 h dark (4) or a 16 h light: 8 h dark (16) photoperiod as they entered the reproductive herd at an average age of 225 ± 15 d. The two light regimens were maintained throughout gestation (G) until 1 wk prior to farrowing. For the lactation period (L) the gilts were either maintained on the same light regimen as during gestation or switched to the opposite one before being returned at weaning to the light regimen imposed during gestation. Four light regimens were then formed, namely G4-L4, G4-L16, G16-L4 and G16-L16, and the practical consequences of such light regimens evaluated in a commercial herd. Conception rate at first service, age at first farrowing and litter size in gilts were not influenced by light regimens. At first weaning, more sows in the L16 groups failed to be bred by 32 d postweaning (P < 0.08) while at second and third weanings only a few sows on either light regimen failed to be bred. The proportion of sows bred between days 4–7 postweaning was higher for the G4-L4 and G16-L16 light regimens in first, second and third sows (P < 0.03, 0.02 and 0.06 respectively). Litter size at second farrowing was greater in sows of the G16-L4 regimen than in any other one (P < 0.03) but was similar in all groups at third and fourth farrowings. These data indicate that alternation of light regimens between gestation and lactation increases the weaning-estrus interval while a G16-L4 sequence improves conception rate and litter size of second parity sows. Key words: Swine, photoperiod, productivity, physiological stage, parity
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Kelly, William D., J. Benjamin Jackson, and Julia Bian. "The Cost of Multimodal vs Opioid Postoperative Pain Regimens for the Foot & Ankle Surgical Patient." Foot & Ankle Orthopaedics 8, no. 1 (January 2023): 2473011423S0001. http://dx.doi.org/10.1177/2473011423s00010.
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Category: Other; Other Introduction/ Purpose: Orthopedic surgeons are one of the highest prescribing specialties of opioids in medicine. To address the ongoing opioid crisis in the United States, many surgeons have adopted multimodal regimens for post-operative pain control to decrease the need for opioids. Recent studies have demonstrated the effectiveness of opioid-sparing multimodal pain management therapies when compared to opioid inclusive therapies. However, to date there are no published studies analyzing the cost of multimodal vs opioid postoperative pain regimens for the elective foot & ankle surgical post-surgical patient. Methods: A secondary analysis of data collected from two studies that evaluated pain control after elective forefoot surgery was analyzed. The index study examined the number of opioid pills consumed post-operatively. A follow-up then examined the clinical utility of the non-opioid pain regimen for pain control post-operatively. Medications in the non-opioid multimodal regimen included cyclobenzaprine, ketorolac, meloxicam, pregabalin, and acetaminophen. Using information collected during these two studies, deidentified patient profiles were constructed using the patient’s insurance carrier and preferred pharmacy to determine the cost of each patient’s post-operative regimen (narcotics vs multimodal). All patients, 40 patients from the multimodal pain pathway study and 59 from the opioid pain control study, were included in this analysis and their prescription costs were totaled and analyzed. Results: A box plot was constructed to visualize data and identify outliers to be removed for data analysis. Prescriptions in the opioid group had an average cost of $8.92 (SD=$5.74) while the multimodal group had an average cost of $25.60 (SD=$10.49), p Conclusion: Patients whose post-operative pain was managed by an opioid-free multimodal regimen had statistically significant higher prescription costs than with opioid monotherapy regardless of health insurance type. However, the difference may not be clinically significant as on average it was $17. As more studies demonstrate the effectiveness of opioid-free post-operative pain management, it may be reassuring to surgeons that despite a greater number of medications with the multimodal protocol the average cost difference was only about $17. This information may allow surgeons to prescribe this regimen to all patients regardless of socioeconomic status and continue to decrease post-operative opioid prescriptions.
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Ralston, Brian M. "Oral Drug Regimen for Athlete's Foot." Physician and Sportsmedicine 25, no. 9 (September 1997): 96k—96af. http://dx.doi.org/10.1080/00913847.1997.11439138.
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Wilson, Evan. "Protecting the Empire's Frontier: Officers of the 18th (Royal Irish) Regiment of Foot during its North American Service, 1767-1776. By Steven M. Baule. Athens, OH: Ohio University Press. 2014. x + 332 p. Illus. and maps. $69.95 (hb). ISBN 978-0-8214-2054-." Journal for Eighteenth-Century Studies 40, no. 1 (January 31, 2017): 147–48. http://dx.doi.org/10.1111/1754-0208.12335.
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Moyle, Graeme, Christopher Higgs, Alastair Teague, Sundhiya Mandalia, Mark Nelson, Margaret Johnson, Martin Fisher, and Brian Gazzard. "An Open-Label, Randomized Comparative Pilot Study of a Single-Class Quadruple Therapy Regimen versus a 2–Class Triple Therapy Regimen for Individuals Initiating Antiretroviral Therapy." Antiviral Therapy 11, no. 1 (January 2006): 73–78. http://dx.doi.org/10.1177/135965350601100106.
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Objective To examine the antiviral potency and tolerability profile of a single-class four drug (quadruple) nucleoside reverse transcriptase inhibitor (NRTI) regimen compared with a 2-class standard-of-care regimen. Methodology A three-centre, randomized, open-label comparative pilot study of zidovudine/lamivudine/efavirenz (triple) versus abacavir/lamivudine/zidovudine/tenofovir (quadruple) therapy in HIV-1-infected, treatment-naive individuals. Both regimens were taken without regard to food and consisted of a twice-daily regimen and 3 pills/day. The study power was based on time-weighted average changes in HIV-1 RNA load. Results A total of 114 individuals (56 triple, 57 quadruple) received at least one dose of medication. Patients were well matched at baseline for viral load (mean 5.26 log10 versus 5.13 log10, respectively) and CD4 cell count (median 193 versus 153 cells/mm3, respectively). The two regimens performed similarly with regards to all endpoints. At week 48, by intention-to-treat, missing=failure analysis, 68% of triple- and 67% of quadruple-drug treated patients had an HIV-1 RNA <50 copies/ml ( P>0.05). On-treatment analysis showed 40/40 (100%) of triple- and 39/40 (97.5%) of quadruple-drug treated patients ( P=0.996) had responded to <50 copies/ml. No unexpected adverse events were reported. Changes in total cholesterol and triglycerides were modest but significantly favoured the quadruple therapy regimen at multiple time points. Conclusion This pilot study suggests a quadruple NRTI-based regimen provides similar antiviral potency, tolerability and administrative characteristics to a 2-class triple therapy regimen. These findings should be confirmed in a more fully powered study. Potent quadruple NRTI-based regimens may have advantages for some individuals with regards to salvageability, tolerability and drug interactions.
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Jitaree, Kamonchanok, Korbtham Sathirakul, Jantana Houngsaitong, Orarik Asuphon, Weerayuth Saelim, Visanu Thamlikitkul, and Preecha Montakantikul. "Pharmacokinetic/Pharmacodynamic (PK/PD) Simulation for Dosage Optimization of Colistin Against Carbapenem-Resistant Klebsiella pneumoniae and Carbapenem-Resistant Escherichia coli." Antibiotics 8, no. 3 (August 22, 2019): 125. http://dx.doi.org/10.3390/antibiotics8030125.
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The purpose was to explore the optimal dosage regimen of colistin using Monte Carlo simulations, for the treatment of carbapenem-resistant Klebsiella pneumoniae and carbapenem-resistant Escherichia coli based on PK/PD targets in critically ill patients. A total of 116 carbapenem-resistant K. pneumoniae and E. coli were obtained from various clinical specimens at Siriraj Hospital in Bangkok, Thailand. Minimum inhibitory concentrations (MICs) of colistin were determined by broth microdilution method. Monte Carlo simulation was used to calculate the cumulative fraction of response (CFR) for European Medicine Agency (EMA), US-Food and Drug Administration (FDA), Nation et al., Siriraj Hospital and our study regimens. The targeted CFR was 90%. For colistin-susceptible K. pneumoniae, all of the dosage regimens achieved ≥90% CFR in patients with creatinine clearance <80 mL/min except the FDA-approved regimens for patients with creatinine clearance 51–79 and 11–29 mL/min, respectively. While, patients with creatinine clearance ≥80 mL/min, CFR ≥90% was observed in Siriraj Hospital and our study regimen. For colistin-susceptible E. coli, all of the dosage regimens achieved ≥90% CFR regardless of renal function. In contrast, the currently approved regimens achieved CFR target in only 10-50% for colistin-resistant isolates subgroup. These results suggest that currently approved regimens still recommended for colistin-susceptible CRE. For colistin-resistant CRE, alternative approaches such as high dose or combination therapy should be considered.
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Rainier, Margaret. "Fort Donald and the Abalondolozi regiment." New Contree 9 (July 11, 2024): 6. http://dx.doi.org/10.4102/nc.v9i0.813.
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Newly available sources of information have made it possible to establish the exact date and circumstances of the building of Fort Donald on the Pondoland-East Griqualand border, by Donald Strachan and members of the Abalondolozi regiment. Particulars about the formation, composition and services of this multi-racial volunteer corps, formally gazetted as a British unit in 1880, during the Basuto war, have also been traced. Strachan, a pioneer in Nomansland before the arrival there of Adam Kok and his Griquas in 1863, served as a magistrate both under the Griqua government, and the Cape administration from 1874. Part of his duties entailed the defence of his district in times of unrest. When colonial and imperial troops were engaged elsewhere, the Abalondolozi constituted the chief element in the defence of East Griqualand. Yet their service, (like those of Strachan himself) were but scantily rewarded. This neglect has resulted in lasting resentment among these outstanding Black troops and their people.
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Hagemeijer, Noortje, Gabrielle Donahue, Gijs Helmerhorst, Daniel Guss, Gino Kerkhoffs, Christopher DiGiovanni, and Anne Johnson. "Opioid Prescribing Patterns of the American Orthopaedic Foot & Ankle Society." Foot & Ankle Orthopaedics 3, no. 3 (July 1, 2018): 2473011418S0023. http://dx.doi.org/10.1177/2473011418s00236.
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Category: Other Introduction/Purpose: Amid the current opioid epidemic in the United States, surgeons are forced to more carefully manage postoperative pain prescriptions. Despite the enthusiastic engagement of physicians, politicians and the general public, however, clear guidelines for opioid prescribing postoperatively still do not exist, including after foot and ankle surgery. Given the ablity to improve patient outcomes by decreasing treatment variability in other realms of medicine, this study sought to quantify the postoperative opioid prescribing regimens of American foot and ankle surgeons as an initial step towards understanding prescription patterns and establishing a baseline regimen from which future guidelines may stem. Methods: A total of 1235 active and candidate members of the American Orthopaedic Foot & Ankle Society (AOFAS) from the United States and Canada were invited to fill out a postoperative pain management survey using a Research Electronic Data Capture (REDCap) web-based application. Surgeons were asked to report on their pain prescription regimens, including type and number of pills, after nine common foot and ankle procedures rated as minor, moderate, or major in severity. The presence of a regional block anesthesia was also recorded. Opioid prescriptions were then converted to the equivalent of 5 mg oxycodone pills for standardization and inter-prescriber comparison. Results: Two hundred twenty-four (18%) surgeons completed the survey. Because of highly skewed data results are reported as medians and the range. Postoperative opioid prescriptions, given in oxycodone 5 mg pill equivalents, were as follows: 39 (8-133) pills for minor procedure, 45 (10-180) pills for a moderate soft tissue procedure, 53 (16-186) pills for a moderate bony procedure, and 60 (20-200) pills for a major bony procedure. Conclusion: Wide variation between surgeons was noted in postoperative pain management. Median prescription opioid doses vary from 39 to 60 oxycodone pills depending on procedure type. It is likely that the amount of opioids prescribed is excessive for adequate pain management, especially for smaller procedures. We propose a post-operative pain regimen that limits the number of pills prescribed based on studies from other surgical specialties. Future studies are necessary to assess the efficacy of current postoperative pain management practices and to guide improved pain management that limits the use of opioids where possible.
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Walker, W. L., K. M. Schmit, E. C. Welch, L. A. Vonnahme, A. Talwar, M. Nguyen, D. Stojanovic, A. J. Langer, and N. M. Cocoros. "Using the Food and Drug Administration´s Sentinel System for surveillance of TB infection." International Journal of Tuberculosis and Lung Disease 26, no. 12 (December 1, 2022): 1170–76. http://dx.doi.org/10.5588/ijtld.22.0259.
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BACKGROUND: We examined patterns in care for individuals treated for latent TB infection (LTBI) in the US Food and Drug Administration´s Sentinel System.METHODS: Using administrative claims data, we identified patients who filled standard LTBI treatment prescriptions during 2008–2019. In these cohorts, we assessed LTBI testing, clinical management, and treatment duration.RESULTS: Among 113,338 patients who filled LTBI prescriptions, 80% (90,377) received isoniazid (INH) only, 19% (21,235) rifampin (RIF) only, and 2% (1,726) INH + rifapentine (RPT). By regimen, the proportion of patients with documented prior testing for TBI was 79%, 54%, and 91%, respectively. Median therapy duration was 84 days (IQR 35–84) for the 3-month once-weekly INH + RPT regimen, 60 days (IQR 30–100) for the 6- to 9-month INH regimen, and 30 days (IQR 2–60) for the 4-month RIF regimen.CONCLUSIONS: Among the cohorts, INH-only was the most commonly prescribed LTBI treatment. Most persons who filled a prescription for LTBI treatment did not have evidence of completing recommended treatment duration. These data further support preferential use of shorter-course regimens such as INH + RPT.
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EDMONDS, SARAH L., ROBERT R. McCORMACK, SIFANG STEVE ZHOU, DAVID R. MACINGA, and CHRISTOPHER M. FRICKER. "Hand Hygiene Regimens for the Reduction of Risk in Food Service Environments." Journal of Food Protection 75, no. 7 (July 1, 2012): 1303–9. http://dx.doi.org/10.4315/0362-028x.jfp-11-449.
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Pathogenic strains of Escherichia coli and human norovirus are the main etiologic agents of foodborne illness resulting from inadequate hand hygiene practices by food service workers. This study was conducted to evaluate the antibacterial and antiviral efficacy of various hand hygiene product regimens under different soil conditions representative of those in food service settings and assess the impact of product formulation on this efficacy. On hands contaminated with chicken broth containing E. coli, representing a moderate soil load, a regimen combining an antimicrobial hand washing product with a 70% ethanol advanced formula (EtOH AF) gel achieved a 5.22-log reduction, whereas a nonantimicrobial hand washing product alone achieved a 3.10-log reduction. When hands were heavily soiled from handling ground beef containing E. coli, a wash-sanitize regimen with a 0.5% chloroxylenol antimicrobial hand washing product and the 70% EtOH AF gel achieved a 4.60-log reduction, whereas a wash-sanitize regimen with a 62% EtOH foam achieved a 4.11-log reduction. Sanitizing with the 70% EtOH AF gel alone was more effective than hand washing with a nonantimicrobial product for reducing murine norovirus (MNV), a surrogate for human norovirus, with 2.60- and 1.79-log reductions, respectively. When combined with hand washing, the 70% EtOH AF gel produced a 3.19-log reduction against MNV. A regimen using the SaniTwice protocol with the 70% EtOH AF gel produced a 4.04-log reduction against MNV. These data suggest that although the process of hand washing helped to remove pathogens from the hands, use of a wash-sanitize regimen was even more effective for reducing organisms. Use of a high-efficacy sanitizer as part of a wash-sanitize regimen further increased the efficacy of the regimen. The use of a well-formulated alcohol-based hand rub as part of a wash-sanitize regimen should be considered as a means to reduce risk of infection transmission in food service facilities.
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Li, Xunde, Edward R. Atwill, Lissa A. Dunbar, and Kenneth W. Tate. "Effect of Daily Temperature Fluctuation during the Cool Season on the Infectivity of Cryptosporidium parvum." Applied and Environmental Microbiology 76, no. 4 (December 18, 2009): 989–93. http://dx.doi.org/10.1128/aem.02103-09.
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ABSTRACT The present work calculated the rate of inactivation of Cryptosporidium parvum oocysts attributable to daily oscillations of low ambient temperatures. The relationship between air temperature and the internal temperature of bovine feces on commercial operations was measured, and three representative 24-h thermal regimens in the ∼15°C, ∼25°C, and ∼35°C ranges were chosen and emulated using a thermocycler. C. parvum oocysts suspended in deionized water were exposed to the temperature cycles, and their infectivity in mice was tested. Oral inoculation of 103 treated oocysts per neonatal BALB/c mouse (∼14 times the 50% infective dose) resulted in time- and temperature-dependent reductions in the proportion of infected mice. Oocysts were completely noninfectious after 14 24-h cycles with the 30°C regimen and after 70 24-h cycles with the 20°C regimen. In contrast, oocysts remained infectious after 90 24-h cycles with the 10°C regimens. The estimated numbers of days needed for a 1-log10 reduction in C. parvum oocyst infectivity were 4.9, 28.7, and 71.5 days for the 30, 20, and 10°C thermal regimens, respectively. The loss of infectivity of oocysts induced by these thermal regimens was due in part to partial or complete in vitro excystation.
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Godinho-Mota, Jordana Carolina Marques, Larissa Vaz-Gonçalves, Isis Danyelle Dias Custódio, Jaqueline Schroeder de Souza, João Felipe Mota, Maria Cristina Gonzalez, Priscylla Rodrigues Vilella, et al. "Impact of Chemotherapy Regimens on Body Composition of Breast Cancer Women: A Multicenter Study across Four Brazilian Regions." Nutrients 15, no. 7 (March 30, 2023): 1689. http://dx.doi.org/10.3390/nu15071689.
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This study aimed to investigate the effect of chemotherapy (CT) and its different types of regimens on the anthropometry and body composition of women with breast cancer. Three-hundred-and-four women with breast cancer were enrolled in this multicenter study. The participants were evaluated before the infusion of the first cycle of CT (pre-CT), and until two weeks after CT completion (post-CT), regarding body weight, body mass index (BMI); waist circumference (WC); waist-to-height ratio (WHtR); conicity index (C-index); fat mass index (FMI); and fat-free mass index (FFMI). CT regimens were classified as anthracycline-based (AC—doxorubicin or epirubicin); anthracyclines and taxane (ACT); cyclophosphamide, methotrexate, and 5-fluorouracil (CMF); or isolated taxanes (paclitaxel or docetaxel). Women significantly increased BMI and FMI post-CT (p < 0.001 and p = 0.007, respectively). The ACT regimen increased FMI (p < 0.001), while FFMI increased after AC (p = 0.007). It is concluded that the CT negatively impacted body composition and the type of regime had a strong influence. The ACT regimen promoted an increase in FMI compared to other regimens, and the AC increased FFMI. These findings reinforce the importance of nutritional monitoring of breast cancer patients throughout the entire CT treatment.
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Grenby, T. H., and A. Phillips. "Dental and metabolic effects of lactitol in the diet of laboratory rats." British Journal of Nutrition 61, no. 1 (January 1989): 17–24. http://dx.doi.org/10.1079/bjn19890088.
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1. Because so little is known about the properties of lactitol as a possible alternative bulk sweetener to sucrose, it was tested in two large-scale experiments in laboratory rats. Matched groups of caries-active Osborne-Mendel rats were fed on uniform diets containing lactitol and compared with a sucrose control in both experiments, plus a xylitol control in the first experiment.2. In the early stages of the experiments weight gains and food utilization were better on the sucrose than on the lactitol regimens. Body-fat storage was higher on the sucrose than on the polyol regimens.3. At the end of 8 weeks the mandibular molars were examined for dental plaque accumulation and dental caries. The dental caries scores when 160 g sucrose/kg in the diet was replaced by lactitol were lower by a highly significant margin, bringing them down to the same low level as those on a 160 g xylitol/kg regimen.4. Testing lactitol in a manufactured food product, shortbread biscuits, in comparison with ordinary sucrose biscuits, showed differences in plaque scores (significant) and caries levels (highly significant), with 60% fewer lesions on the lactitol regimen.5. The results confirm the low cariogenic potential of lactitol, but show metabolic differences compared with sucrose.
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Guruprasad, Bhat. "Retrospective study of oxaliplatin, leucovarin and 5 fluoruracil regimen in patients with advanced gastric cancer with poor performance status: A study at a tertiary center of South India." South Asian Journal of Cancer 07, no. 04 (October 2018): 223–25. http://dx.doi.org/10.4103/sajc.sajc_1_18.
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Abstract Background: Gastric carcinoma is the leading cause of cancer in south India. Gastric cancer is frequently diagnosed in locally advanced or metastatic setting in Indian scenario and has a poor survival. There is no standard chemotherapy regimen which can be used in advanced gastric cancer (AGC) patients. Objective: The aim of this study was to assess the clinical activity and toxicity of oxaliplatin with infusional 5-fluorouracil and leucovorin administered every 3 weeks in patients with locally advanced and inoperable gastric cancer. Patients and Methods: In this retrospective study, the case records of 25 patients who have received OLF regimen were analyzed. Results: The median number of cycles for patients was 6 (range: 4–12 cycles). Overall response rate was 36%, with all patients having stable disease. Median survival of patients was 6 months (7 months in locally advanced). Compared to other regimens, there was less toxicity (less hematologic toxicity, less nausea and vomiting, no hair loss, no renal toxicity, no hand foot syndrome, and lesser admissions). Conclusions: OLF regimen is an acceptable regimen in poor performance status AGC patients with adequate response and an acceptable toxicity profile.
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Bhatti, Laveeza, and Jay Gladstein. "Once-Daily Nevirapine XR." Journal of the International Association of Physicians in AIDS Care 11, no. 6 (August 27, 2012): 369–73. http://dx.doi.org/10.1177/1545109712456427.
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Nevirapine (NVP) was the first nonnucleoside reverse transcriptase inhibitor (NNRTI) approved by the US Food and Drug Administration (FDA) in 1996, for the treatment of HIV infection. Current treatment guidelines include NVP as a component of a recommended alternative NNRTI regimen, which may be the preferred regimen for patients with established cardiovascular risk factors since NVP has minimal untoward effects on serum lipids. Two randomized and controlled clinical trials established the noninferior virologic efficacy of twice-daily NVP versus ritonavir-boosted atazanavir (ATV/r), a protease inhibitor with limited effects on serum lipids, each drug on a background regimen of once-daily (QD) tenofovir (TDF)/emtricitabine (FTC). An extended-release (XR) formulation of NVP was developed since QD dosing and reduced pill burdens have been shown to improve regimen adherence. This formulation (Viramune XR 400 mg) was recently FDA approved based on the results of 2 randomized, controlled clinical trials. The XR formulation will provide additional treatment options for patients who may benefit from NVP-based regimens.
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Abu-El-Noor, Nasser Ibrahim, Yousef Ibrahim Aljeesh, Bettina Bottcher, and Mysoon Khalil Abu-El-Noor. "Assessing Barriers to and Level of Adherence to Hypertension Therapy among Palestinians Living in the Gaza Strip: A Chance for Policy Innovation." International Journal of Hypertension 2020 (September 24, 2020): 1–12. http://dx.doi.org/10.1155/2020/7650915.
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Introduction. Hypertension is a major health concern, especially in low-income countries. Nonadherence and poor or no persistence in adhering to hypertension treatment regimens result in uncontrolled high blood pressure, increasing rates of mortality and morbidity, and preventable healthcare costs. The aim of this study was to assess the level of adherence and barriers to treatment regimens among hypertensive patients living in the Gaza Strip, Palestine. Methods. A convenience sample of 648 participants completed the Hill-Bone Compliance to High Blood Pressure Therapy Scale. The great majority of participants (n = 521, 80.4%) was highly adherent to their treatment regimen, 123 participants (18.98%) were classified as moderately nonadherent, and 4 (0.62%) participants were classified as highly nonadherent to their hypertension treatment regimen. Participants of this study showed the highest adherence rate to the domain of medication adherence (mean of 1.42 out of 4) followed by appointment keeping (mean 1.8), while they were least adherent to diet (mean of 2.18). The greatest three barriers to adherence to the recommended treatment regimen reported by participants were inability to exercise, inability to resist fast and fried food, and inability to keep themselves away from salty foods. Conclusion. Overall adherence to medication in Gaza was surprisingly good in patients with a diagnosis of hypertension for at least one year. However, adherence to lifestyle advice or dietary regimes remains poor. A combination of interventions using low-cost mobile technology, combined with face-to-face interventions by healthcare professionals, can be applied to improve adherence to hypertension treatment regimens in order to reduce the consequences of uncontrolled blood pressure.
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Dorighello, Gabriel G., Juliana C. Rovani, Christopher J. F. Luhman, Bruno A. Paim, Helena F. Raposo, Anibal E. Vercesi, and Helena C. F. Oliveira. "Food restriction by intermittent fasting induces diabetes and obesity and aggravates spontaneous atherosclerosis development in hypercholesterolaemic mice." British Journal of Nutrition 111, no. 6 (November 1, 2013): 979–86. http://dx.doi.org/10.1017/s0007114513003383.
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Different regimens of food restriction have been associated with protection against obesity, diabetes and CVD. In the present study, we hypothesised that food restriction would bring benefits to atherosclerosis- and diabetes-prone hypercholesterolaemic LDL-receptor knockout mice. For this purpose, 2-month-old mice were submitted to an intermittent fasting (IF) regimen (fasting every other day) over a 3-month period, which resulted in an overall 20 % reduction in food intake. Contrary to our expectation, epididymal and carcass fat depots and adipocyte size were significantly enlarged by 15, 72 and 68 %, respectively, in the IF mice compared with the ad libitum-fed mice. Accordingly, plasma levels of leptin were 50 % higher in the IF mice than in the ad libitum-fed mice. In addition, the IF mice showed increased plasma levels of total cholesterol (37 %), VLDL-cholesterol (195 %) and LDL-cholesterol (50 %). As expected, in wild-type mice, the IF regimen decreased plasma cholesterol levels and epididymal fat mass. Glucose homeostasis was also disturbed by the IF regimen in LDL-receptor knockout mice. Elevated levels of glycaemia (40 %), insulinaemia (50 %), glucose intolerance and insulin resistance were observed in the IF mice. Systemic inflammatory markers, TNF-α and C-reactive protein, were significantly increased and spontaneous atherosclerosis development were markedly increased (3-fold) in the IF mice. In conclusion, the IF regimen induced obesity and diabetes and worsened the development of spontaneous atherosclerosis in LDL-receptor knockout mice. Although being efficient in a wild-type background, this type of food restriction is not beneficial in the context of genetic hypercholesterolaemia.
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Chinarov, Roman, Galina Singina, Nikolay Taradajnik, and Sergey Pozyabin. "PSXVI-16 The quality of cows’ oocyte derived at different timing regimens of transvaginal follicular puncture." Journal of Animal Science 99, Supplement_3 (October 8, 2021): 330–31. http://dx.doi.org/10.1093/jas/skab235.608.
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Abstract Recovery of oocytes from live animals through ultrasound-guided transvaginal follicular aspiration (Ovum Pick-Up, OPU) is an essential element of modern livestock development. The aim of our work was to study the effect of two different timing regimens on the quality of oocytes, recovered from cycled Simmental heifers (n = 4). Follicle aspirations were performed once a week (1/w) or twice a week (2/w). The same donor animals were used for each timing regimens. 228 and 224 follicles were aspirated at 2/w and 1/w regimen, respectively, and 280 cumulus-oocyte complexes (COCs) were recovered (140 COCs at each of timing regimen), which corresponds to the recovery rate of 61.4±5.9% and 62.1±6.3%. On average, 4.4 oocytes were received from each donor per session. We observed a significant increase by 1.2 times (P < 0.05) of the proportion of OPU-oocytes of good quality, which were characterized by normal morphology, when performing the procedure in the 2/w compared to 1/w regimen (65.7±4.0% vs. 53.6±3.0% of the total number of recovered oocytes, respectively). The proportion of oocytes at the MII stage of meiosis after 24 hours of maturation was similar in both groups: 73.3±5.6% (2/w regimen) and 74.7±2.4% (1/w regimen). Proportion of oocytes with signs of apoptotic changes was also not significantly differed between the groups: 8.0±3.1 and 9.8±3.3%, respectively. We did not observe the effect of the frequency of OPU sessions on the embryo cleavage rate (on average 63.5%) and the blastocysts development rate (on average 16.7%). Our data will be used to optimize the timing regimen of oocyte retrieval from living Simmental donor heifers. The studies were performed under financial support of the RFBR (project No. 20-316-90003) and the Russian Ministry of Science and Higher Education.
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Koreyba, K. A. "Antiplatelet agents in complex medication therapy in diabetic foot disease." Russian Medical Inquiry 4, no. 7 (2020): 457–62. http://dx.doi.org/10.32364/2587-6821-2020-4-7-457-462.
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The urgency of the problem concerning treatment of diabetic foot disease is due to the following reasons: pathogenesis ambiguity of this pathology, tendency to trophic defects relapse and increase in volume during the conservative treatment, resistance to conservative treatment, deterioration of the life quality of patients, treatment complexity and duration, and significant economic costs for treatment and rehabilitation. The patterns of complex medication therapy effects include insufficient evidence for most drugs, the lack of generally accepted regimens and the low efficacy of existing ones. Given the own experience and using a mathematical model, it was proved that the benefits of using Cilostazol as part of combined medication therapy regimen for patients with diabetic foot syndrome and stage IIA, IIB chronic limb ischemia according to the classification of Fontaine-Leriche-Pokrovsky. The need to adhere to National Clinical Guidelines was justified.KEYWORDS: diabetic foot syndrome, national clinical guidelines, disaggregants, pulse oximetry, chronic limb ischemia, oxygen saturation,outcomes assessment.FOR CITATION: Koreyba K.A. Antiplatelet agents in complex medication therapy in diabetic foot disease. Russian Medical Inquiry. 2020;4(7):457–462. DOI: 10.32364/2587-6821-2020-4-7-457-462.
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Qiu, M., F. Bi, J. Liu, Q. Li, and C. Yi. "Gemcitabine and capecitabine as third-line treatment in patients with metastatic colorectal cancer after failure of irinotecan and oxaliplatin." Journal of Clinical Oncology 29, no. 4_suppl (February 1, 2011): 620. http://dx.doi.org/10.1200/jco.2011.29.4_suppl.620.
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620 Background: There is no standard chemotherapeutic regimen for patients with advanced colorectal cancer (CRC) progressing after combination regimens including irinotecan and oxaliplatin and having good performance status. 5-FU and gemcitabine are synergistic in preclinical studies of colon cancer cells. And gemcitabine also increases intracellular release of 5-FU from capecitabine. The aim of this study is to evaluate the efficacy and tolerance of the gemcitabine/capecitabine combination as third-line treatment for patients with advanced colorectal cancer. Methods: Between May 2007 and September 2009, the data on 12 patients with metastatic colorectal cancer after failure of irinotecan- and oxaliplatin-containing regimens reviewed retrospectively. The median patient age was 54.0 years (range 37-77). The ECOG performance status was 0, 1 or 2. All patients has 2 or more previous chemotherapy. Patients received GemCap regimen (oral capecitabine 1,000 mg/m2 twice daily on days 1 to 14 plus Gem 1,000 mg/m2 on days 1 and 8 every 3 weeks). Eleven patients were evaluable for the response and all patients were evaluable for toxicity. Results: No partial response was achieved and disease stabilization in 4 (36.4.3%) cases. Median progression-free survival and median overall survival were 9.1 weeks (range 3.0-18.0) and 22.3 weeks (range 10.5- 53.0). Four patients with disease stabilization had longer median progression-free survival than those with disease progression (13 weeks vs. 6.2 weeks). No toxic deaths occurred. Grade 3 toxicities were thrombocytopenia (in 2 patients), neutropenia (in 2 patients) and mucositis (in 1 patient), hand-foot syndrome (in 1 patient) and GI toxicity (in 2 patients). Conclusions: The combination of gemcitabine and capecitabine was found to be a safe palliative regimen for heavily pretreated patients with metastatic CRC. Despite no patients had radiologic response, patients with disease stabilization achieved better progression-free survival. This regimen seems to be potentially effective regimen in the treatment of CRC. No significant financial relationships to disclose.
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Kang, Irene, Darcy V. Spicer, Janice M. Lu, Susan G. Groshen, Denice Tsao-Wei, and Agustin A. Garcia. "Phase II trial of metronomic capecitabine and cyclophosphamide with lapatinib and trastuzumab in patients with HER2-positive metastatic breast cancer." Journal of Clinical Oncology 37, no. 15_suppl (May 20, 2019): e12508-e12508. http://dx.doi.org/10.1200/jco.2019.37.15_suppl.e12508.
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e12508 Background: Metronomic chemotherapy is an emerging paradigm of cancer therapy in which low doses of chemotherapy are delivered at frequent intervals. Activity in patients with metastatic breast cancer (MBC) has been demonstrated in several phase II clinical trials. Methods: We proposed a regimen with metronomic chemotherapy and dual HER2 inhibition in HER2 positive patients with MBC. We hypothesized that this regimen will be highly active in MBC and have a favorable toxicity profile. Patients were treated on a 21-day cycle with capecitabine 1500mg PO daily, cyclophosphamide 50mg daily, lapatinib 1000mg PO daily and trastuzumab 6mg/kg IV once per 21-day cycle. This regimen was continued until disease progression or unacceptable toxicity. Primary endpoint was progression free survival (PFS). Secondary endpoints were overall response rate (ORR), clinical benefit rate (CBR), overall survival (OS), and safety and tolerability of this regimen. Eligibility criteria were patients 18 years of age and older who had histologically confirmed HER2-positive metastatic breast cancer with prior trastuzumab use in the adjuvant or metastatic setting with no more than two prior regimens for MBC. Results: Ten patients were accrued from Jan 2014-Oct 2016. Median age was 52 (range 38 - 79) years. Median number of chemotherapy regimens for metastatic disease was 0.5 (range 0-2). Median PFS was 13.7 (95% CI: 2.6, 16.6) months. Median OS was 29.6 (95% CI: 11.8, 60.5+) months. ORR was 30%, and CBR was 70%. Grade 3 or 4 toxicities were identified in 6 patients. The most common toxicities of any grade were fatigue (100%), diarrhea (80%), anemia, neutropenia, ALT increase, nausea and hand-foot syndrome 50% each. One patient achieved CR for over 3 years and continues on treatment at time of this report. 8 patients progressed and 1 patient withdrew from study without response evaluation. The trial was closed due to lack of accrual. Conclusions: The proposed regimen of metronomic capecitabine and cyclophosphamide with lapatinib and trastuzumab appears to be active in patients with HER2 positive MBC but with significant toxicity. Clinical trial information: NCT01873833.
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McGregor, E. M., C. P. Campbell, S. P. Miller, P. P. Purslow, and I. B. Mandell. "Effect of nutritional regimen including limit feeding and breed on growth performance, carcass characteristics and meat quality in beef cattle." Canadian Journal of Animal Science 92, no. 3 (September 2012): 327–41. http://dx.doi.org/10.4141/cjas2011-126.
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McGregor, E M., Campbell, C. P., Miller, S. P., Purslow, P. P. and Mandell, I. B. 2012. Effect of nutritional regimen including limit feeding and breed on growth performance, carcass characteristics and meat quality in beef cattle. Can. J. Anim. Sci. 92: 327–341. The effects of nutritional management regimen and breed on growth performance, carcass attributes, and meat quality were evaluated in 68 British (BRIT) and Continental (CONT) crossbred steers, managed on one of three nutritional regimens: (1) ad libitum access to a 77% corn diet (ALGRAIN), (2) limit feeding initially of the 77% corn diet, followed by ad libitum access to the 77% corn diet (LFGRAIN), and (3) limit feeding initially of a 90% haylage diet, followed by ad libitum access to the 77% corn diet (LFHAYL). Nutritional regimen by breed interactions (P<0.02) were present for average daily gain, dry matter intake (DMI), gain to feed, and shear force. LFHAYL regimen decreased gains to a greater extent for BRIT steers than CONT steers managed on ALGRAIN or LFGRAIN. Feed intakes were similar across nutritional regimens for CONT steers, while DMI was depressed in BRIT on LFHAYL as compared with steers started on ALGRAIN or LFGRAIN. Gain to feed was greater in BRIT cattle on LFGRAIN vs. ALGRAIN, while gain to feed was similar in CONT started on grain (ALGRAIN, LFGRAIN). Shear force was lower for beef from LFHAYL BRIT vs. beef from BRIT on ALGRAIN or LFGRAIN, while the converse was true for CONT. Limit feeding of a high-energy diet may be appropriate for cattle of British background to reduce feed input costs, while ensuring tenderness.
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Evans, D. G., A. J. Kempster, and D. E. Steane. "Differential rates of genetic change and genotype × environment interactions in six pig breeding company populations and a purebred Large White population." Animal Science 47, no. 3 (December 1988): 457–66. http://dx.doi.org/10.1017/s0003356100003603.
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ABSTRACTDifferential rates of genetic change in litter productivity, growth and carcass traits were estimated for the pig populations of six British breeding companies from their relative performance between 1972 and 1981 in the Meat and Livestock Commission's Commercial Pig Evaluation. Pigs were grown on one of two feeding regimens and slaughtered at one of three live weights (61, 93 and 118 kg).Important differentials were found for a number of traits. Annual rates of change in litter size at birth differed by 0·34 pigs between the two extreme populations. The range between populations for live-weight daily gain (ad libitum feeding) was 20 g, for lean weight daily gain (restricted feeding) it was 6 g, and for lean weight food conversion (feeding regimens pooled) it was 28 g food per g gain. The average annual rate of change of the six company populations was compared with the rate achieved by the purebred Large White breed over the period 1972 to 1977. For mean piglet birth weight the rate was 30 g higher for the company populations, whilst for carcass weight daily gain it was 24 g higher.There was little evidence for population × feeding regimen interactions except that companies ranked differently in average daily food intake, live-weight daily gain and carcass weight daily gain on the two feeding regimens. On limited evidence, population × slaughter weight interactions were also unimportant.
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Pauley, Kathryn A., Tracy L. Sandritter, Jennifer A. Lowry, and D. Adam Algren. "Evaluation of an Alternative Intravenous N-Acetylcysteine Regimen in Pediatric Patients." Journal of Pediatric Pharmacology and Therapeutics 20, no. 3 (May 1, 2015): 178–85. http://dx.doi.org/10.5863/1551-6776-20.3.178.
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OBJECTIVE: Conventionally, intravenous N-acetylcysteine (IV-NAC) administration is a 3-bag regimen administered over the course of 21 hours, which increases the risk of reconstitution and administration errors. To minimize errors, an alternative IV-NAC regimen consists of a loading dose (150 mg/kg) followed by a maintenance infusion (15 mg/kg/hr) until termination criteria are met. The aim was to determine the clinical outcomes of an alternative IV-NAC regimen in pediatric patients. METHODS: A retrospective review of pharmacy dispensing records and diagnostic codes at a pediatric hospital identified patients who received alternative IV-NAC dosing from March 1, 2008, to September 10, 2012, for acetaminophen overdoses. Exclusion criteria included chronic liver disease, initiation of oral or other IV-NAC regimens, and initiation of standard IV-NAC infusion prior to facility transfer. Clinical and laboratory data were abstracted from the electronic medical record. Descriptive statistics were utilized. Clinical outcomes and adverse drug reaction incidences were compared between the alternative and Food and Drug Administration (FDA)–approved IV-NAC regimens. RESULTS: Fifty-nine patients (mean age 13.4 ± 4.3 years; range: 2 months-18 years) with acetaminophen overdoses were identified. Upon IV-NAC discontinuation, 45 patients had normal alanine transaminase (ALT) concentrations, while 14 patients' ALT concentrations remained elevated (median 140 units/L) but were trending downward. Two patients (3.4%) developed hepatotoxicity (aspartate transaminase/ALT > 1000 units/L). No patients developed hepatic failure, were listed for a liver transplant, were intubated, underwent hemodialysis, or died. Two patients (3.4%) developed anaphylactoid reactions. No known medication or administration errors occurred. Clinical outcome incidences of the studied endpoints with the alternative IV-NAC regimen are at the lower end of published incidence ranges compared to the FDA IV-NAC regimen for acetaminophen overdoses. CONCLUSIONS: This alternative IV-NAC regimen appears to be effective and well tolerated among pediatric patients when compared to the FDA-approved regimen. It may also result in fewer reconstitution and administration errors, leading to improved patient safety.
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Kim, Hyun Kyung, and Olga Vasylyeva. "Time-to-Report of the Bone Culture and Microbiologic Adequacy of Empiric Antibiotics in Patient’s with Diabetic Foot Osteomyelitis." Open Forum Infectious Diseases 4, suppl_1 (2017): S94—S95. http://dx.doi.org/10.1093/ofid/ofx163.067.
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Abstract Background Bone cultures in diabetic foot infection is the most accurate method to identify causative pathogen, while there is only 30% concordance between superficial wound swab and bone biopsy cultures. Diabetic foot infection is commonly polymicrobial, therefore report on the bone biopsy culture may come with several updates before it is finalized. Our study is aimed to describe how often additional pathogens were identified after patients’ discharge on antibiotics therapy for diabetic foot osteomyelitis, and evaluate microbiological appropriateness of antibiotic regimen upon discharge based on the final result of the bone culture. Methods Medical records of the patients 18 years old or older, who had inpatient bone biopsy, deep tissue debridement or amputation for diabetic foot infection, were reviewed from January 2014 through Dec 2015 in Rochester Regional Health System. Antibiotic regimens for the patients discharged before final culture result were evaluated for microbiological appropriateness by two reviewers trained in infectious diseases. Results In total, 198 procedures were screened, 158 procedures met inclusion criteria, out of which 74 patients with 80 procedures (51%) were discharged before the final culture result was available. Average time from procedure to the final culture report was 6 days, and from discharge to the final culture was 3.7 days. In most of the cases (70%, 56 out of 80) the patients were discharged on empiric regimen discordant with final culture result. Predominant organisms were Gram-positive bacteria 74%, with Gram negatives 24%, and yeast 2%. Most infections were polymicrobial (81%), mixed with anaerobic bacteria in 37%. The most frequent isolates were Staphylococcus aureus (15%), Corynebacterium (14%), anaerobic Gram-positive cocci (12%), and Staphylococcus epidermidis (8%). All negative Gram stains (31%, 25 out of 80) had positive growth on culture. Conclusion Half of the patients with diabetic foot osteomyelitis, who underwent bone biopsy, were discharged before final culture results were available. Most of them were discharged on empiric regimen discordant with final culture. This data suggests that careful outpatient follow-up on the final culture would likely result in modification of antibiotics therapy to target newly reported pathogen. Disclosures All authors: No reported disclosures.
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Dixon, R., A. L. Pozniak, H. M. Watt, P. Rolan, and J. Posner. "Single-dose and steady-state pharmacokinetics of a novel microfluidized suspension of atovaquone in human immunodeficiency virus-seropositive patients." Antimicrobial Agents and Chemotherapy 40, no. 3 (March 1996): 556–60. http://dx.doi.org/10.1128/aac.40.3.556.
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The single- and multiple-dose pharmacokinetics of and tolerability to a new microfluidized suspension of atovaquone were studied in human immunodeficiency virus-seropositive patients with CD4 counts of < or = 200 cells per mm3 in order to define a dosing regimen for the treatment of Pneumocystis carinii pneumonia. This was an open study with groups of six patients each. In the first part of the study, six subjects received escalating single doses of 500, 1,000, and 1,500 mg after an overnight fast at weekly intervals. In the second part of the study, groups of six subjects were dosed for 14 days according to three regimens: 1,000 mg twice daily fasting, twice daily with a high-fat meal, or once daily with a high-fat meal. Plasma atovaquone levels were assayed by high-performance liquid chromatography. Pharmacokinetic parameters were determined by noncompartmental methods, and statistical comparison of parameters for single doses was performed by analysis of variance. Plasma drug concentrations increased with single doses from 500 to 1,000 mg but were no higher with a dose of 1,500 mg. Thus, 1,000 mg was selected for multiple administration. A regimen of 1,000 mg twice daily with food resulted in a 93% increase in the average trough steady-state concentration compared with 1,000 mg once daily with food. Food increased the bioavailability of atovaquone 1.4-fold over that in the fasting state. All patients who received 1,000 mg twice daily with food achieved target steady-state concentrations in plasma of 15 to 25 micrograms/ml. Multiple-dose regimens were generally well tolerated, but the higher levels in plasma achieved by 1,000 mg twice daily with food were associated with an increased incidence of rash. In conclusion, target plasma atovaquone concentrations for the treatment of P. carinii pneumonia can be achieved in most patients with 1,000 mg twice daily in a fasting state and in all patients with 1,000 mg twice daily administered with food, but at higher concentrations in plasma, there may be an increased risk of rash.
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Xia, Ling, Yu Gao, Jun Gong, Jing Dai, Jin Peng, Lilin He, Weidong Chen, et al. "Apatinib in combination with docetaxel and S1 chemotherapy in the first-line treatment of metastatic gastric cancer." Journal of Clinical Oncology 39, no. 15_suppl (May 20, 2021): 4055. http://dx.doi.org/10.1200/jco.2021.39.15_suppl.4055.
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4055 Background: First-line chemotherapy in metastatic gastric cancer, either doublet or triplet-regiment, the average OS is less than one year. Anti-VEGF target therapy is proven to be effective both in second and third line settings. As for apatinib, which is the tyrosine kinase inhibitor showed highly affinity for VEGFR2, is permitted by SFDA to be used in the third line treatment of gastric cancer since September 2014. The post-market stage IV clinic trial Ahead-G201 further confirmed it can improve the OS in chemotherapy-refractory gastric cancer. What’s more, apatinib could reverse paclitaxel resistance and improve the R0 resection rate in conversion of unresected gastric cancer in neoadjuvant settings. However, the safety and efficacy of apatinib in combination with docetaxel plus S1 in the first line treatment of metastatic gastric cancer is unknown and worthy of investigation. Methods: With expectation to improve PFS from 5.3m (the START Study) to 7m, this investigator-initiated, single arm, multi-center, registered phase II prospective study was designed to enroll 48 eligible patients diagnosed with metastatic gastric cancer. Each participant was expected to finish six cycles of chemotherapy plus apatinib (docetaxel 75mg/m2, d1, Q3W; S1 according to BSA: <1.25 40mg po bid; 1.25̃1.5 50mg po bid; >1.5 60mg po bid; d1-14, Q3W; apatinib 500mg po qd). The toxicity was determined according to CTCAE 4.0. Efficacy assessed every two cycles (6 weeks) during the study and every 2 months during the follow-up period. The primary endpoint was PFS. The secondary endpoint was OS, ORR, and DCR. The tumor response was determined according to RECIST 1.1 criteria. Results: Baseline characteristics (FAS population): From July 2017 to December 2020, 45 patients from 5 centers across Hubei province were enrolled. Among them, 44 are eligible for analysis. There are 15 females and 30 males, median age 55 years old, median metastasis sites is 2, yet 63.6% of them have involved at least 2 organs. Safety: 90.91% patients reported adverse events (AEs). The incidence of grade 3-4 AEs was 47.73%. Main 3-4 AEs were oral ulceration (13.64%), leucopenia (13.64%), neutropenia (13.64%), hand-foot syndrome (6.82%), hypertension (6.82%), and thrombocytopenia (6.82%). Efficacy: By Jan 31th, 2021, 44 patients were evaluable for response and survival, 26 of them achieved partial response (PR), 9 achieved stable disease (SD), and 8 experienced progression disease (PD). The ORR is 60.47%, the DCR is 81.4%. Median PFS is 7.46m, median OS is 12.42m. So we closed the study in advance. Conclusions: Adding apatinib to standard DS chemotherapy as the first line treatment would be well tolerant in patients with metastatic gastric cancer, the spectrum of toxicity were not exceeding expectation. This modality also exhibits prolonged PFS, which might provide an alternative therapeutic strategy for metastatic gastric cancer. Clinical trial information: NCT03154983.
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Wiesner, Agnieszka, Mariusz Szuta, Agnieszka Galanty, and Paweł Paśko. "Optimal Dosing Regimen of Osteoporosis Drugs in Relation to Food Intake as the Key for the Enhancement of the Treatment Effectiveness—A Concise Literature Review." Foods 10, no. 4 (March 29, 2021): 720. http://dx.doi.org/10.3390/foods10040720.
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Bisphosphonates and selective estrogen receptor modulators (SERMs) represent the two most important groups of medications taken orally and employed in osteoporosis treatment. Effectiveness of the therapy may be affected by poor patient adherence, in particular, due to the inconvenient dosing regimen of oral bisphosphonates. With this review we aimed to assess the effects that food, beverages, and dietary supplements consumed during treatment, along with the dosing regimens, may have on pharmacokinetics and pharmacodynamics of oral drugs employed in treating osteoporosis; we also aimed to shape the recommendations valuable for professional patients’ counseling and education, to provide appropriate dosing regimens in order to improve adherence to the therapy. Food, beverages such as coffee, juices, and mineral water, as well as dietary supplements containing multivalent cations, e.g., calcium, magnesium, aluminium, iron, showed to have a deleterious effect on the bioavailability of all the investigated oral bisphosphonates, specifically alendronate, risedronate, ibandronate, minodronate, and etidronate. For risedronate, a delayed-release (DR) tablet was designed to solve the malabsorption problem in the presence of food, hence DR risedronate can be ingested following breakfast. For other oral bisphosphonates, the proper interval between drug and food, beverages, and dietary supplements intake should be maintained to minimize the risk of interactions. The effect of food on pharmacokinetic parameters of selective estrogen receptor modulators (SERMs) was found to be clinically irrelevant.
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Prodanova, Krasimira. "Optimizing Multiple Drug Administration from Depot by Applying Pharmacokinetic Concepts." International Journal Bioautomation 24, no. 4 (December 2020): 337–48. http://dx.doi.org/10.7546/ijba.2020.24.4.000593.
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For the multiple drug administration from therapeutic reasons it is important to maintain the concentration in the blood plasma in an appropriate range. In the present paper an optimization approach is developed to determine drug dosage regimen to achieve the desired plasma concentrations after application from depot, i.e. oral, muscular, subcutant. The developed methodology allows the optimization of both the dose and the dosage interval. Performance of the developed methodology is evaluated by computing bias and precision of the estimated trough and peak drug concentrations that are reached after dosage regimen determinations. This article focuses on an optimal impulsive control of compartment model to individualise dosage regimens of Amikacin in the context of extended dosage intervals. Amikacin is an aminoglycoside antibiotic used to treat various bacterial infections.
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McKAY, R. I., R. J. PARKER, and W. GUENTER. "GENOTYPE BY DIET INTERACTION IN MICE SELECTED ON THREE DIETARY REGIMENS." Canadian Journal of Animal Science 66, no. 2 (June 1, 1986): 399–404. http://dx.doi.org/10.4141/cjas86-041.
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The effect on 10-wk body weight of seven generations of selection in three nutritional regimens (corn, rye and wheat) for two growth related traits, adjusted body weight (ABW) or adjusted feed efficiency (AFE) was evaluated. Selected mice were 3.2 g heavier (P < 0.01) than mice from the diet control (DC) lines. No effects of selection regimen or differences between the two selected lines for 10-wk weight were significant (P > 0.05). During generation 8 a crossover study was undertaken. Mice from each line (ABW, AFE or DC) from each selection regimen were fed the corn, rye and wheat diets. Response was estimated as a deviation from the DC line fed the same diet. No significant (P > 0.05) regimen by diet interactions were detected in either the ABW or the AFE lines. However, mice in the ABW line tended (P = 0.18) to have higher final weights on test (approximately 1 g) when fed the selection diet compared to the two alternative diets. Key words: Mice, genotype by diet interaction, body weight, feed efficiency
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Moore, Brioni R., Sam Salman, John Benjamin, Madhu Page-Sharp, Leanne J. Robinson, Elizabeth Waita, Kevin T. Batty, et al. "Pharmacokinetic Properties of Single-Dose Primaquine in Papua New Guinean Children: Feasibility of Abbreviated High-Dose Regimens for Radical Cure of Vivax Malaria." Antimicrobial Agents and Chemotherapy 58, no. 1 (November 4, 2013): 432–39. http://dx.doi.org/10.1128/aac.01437-13.
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ABSTRACTSince conventional 14-day primaquine (PMQ) radical cure of vivax malaria is associated with poor compliance, and as total dose, not therapy duration, determines efficacy, a preliminary pharmacokinetic study of two doses (0.5 and 1.0 mg/kg of body weight) was conducted in 28 healthy glucose-6-phosphate dehydrogenase-normal Papua New Guinean children, aged 5 to 12 years, to facilitate development of abbreviated high-dose regimens. Dosing was with food and was directly observed, and venous blood samples were drawn during a 168-h postdose period. Detailed safety monitoring was performed for hepatorenal function and hemoglobin and methemoglobin concentrations. Plasma concentrations of PMQ and its metabolite carboxyprimaquine (CPMQ) were determined by liquid chromatography-mass spectrometry and analyzed using population pharmacokinetic methods. The derived models were used in simulations. Both single-dose regimens were well tolerated with no changes in safety parameters. The mean PMQ central volume of distribution and clearance relative to bioavailability (200 liters/70 kg and 24.6 liters/h/70 kg) were within published ranges for adults. The median predicted maximal concentrations (Cmax) for both PMQ and CPMQ after the last dose of a 1.0 mg/kg 7-day PMQ regimen were approximately double those at the end of 14 days of 0.5 mg/kg daily, while a regimen of 1.0 mg/kg twice daily resulted in a 2.38 and 3.33 times higherCmaxfor PMQ and CPMQ, respectively. All predicted medianCmaxconcentrations were within ranges for adult high-dose studies that also showed acceptable safety and tolerability. The present pharmacokinetic data, the first for PMQ in children, show that further studies of abbreviated high-dose regimens are feasible in this age group.
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Waterman, G. N., O. Yellin, R. A. Swift, J. Hilger, and J. R. Berenson. "A retrospective review of pegylated liposomal doxorubicin (PLD), bortezomib, and dexamethasone (DVD) for relapsed or refractory (R/R) multiple myeloma (MM)." Journal of Clinical Oncology 27, no. 15_suppl (May 20, 2009): e19523-e19523. http://dx.doi.org/10.1200/jco.2009.27.15_suppl.e19523.
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e19523 Background: Preclinical data show that PLD and bortezomib demonstrate synergistic anti-MM effects. Clinical trials have demonstrated the efficacy of this combination for MM patients (pts) as well as its superiority to bortezomib alone. In vivo studies have shown that more frequent administration of low-dose PLD produces enhanced anti-MM effects with better tolerability compared to weekly standard doses of PLD. Thus, a low dose PLD dosing schedule was evaluated in combination with bortezomib and dexamethasone for pts with R/R MM. Methods: This retrospective analysis sought to evaluate the DVD regimen for pts with R/R MM. Twenty pts who had received and failed at least one prior treatment for MM were studied. Treatment consisted of intravenous administration of 40 mg dexamethasone, 1.0 mg/m2 bortezomib and 5.0 mg/m2 PLD on days 1, 4, 8 and 11 of a 28-day cycle. Pts ranged in age from 43–81 years (median 65), and had received between 1–14 prior therapies (median 5). Baseline disease stage was: 6 (I), 7 (II), and 7 (III). Elevated serum creatinine levels at baseline were found in 30% of patients. Results: The objective response rate (ORR) was 50%, which included 1 complete response (5%), 1 very good partial response (5%), 4 partial responses (20%), and 4 minimal responses (20%). Sixteen pts had previously received bortezomib-containing regimens and 6 (38%) responded. Among the entire cohort, the duration of response was 2+-19+ months (mo) (median 7 mo). Six pts had stable disease (30%) lasting between 5–9 mo (median 9 mo). Progression-free survival was 1+-19+ mo (median 8 mo). The regimen was well tolerated with a single mild case of transient hand and foot syndrome and 10 pts developed grade 1 or 2 peripheral neuropathy. One pt discontinued the regimen due to an adverse event (AE; 5%). The median overall survival was 17 mo (range 1+-33+ mo). Conclusions: Patients treated with the DVD regimen in this study who had failed many prior regimens (median 5) with progressive disease demonstrated a high response rate (50%). In addition, there were few significant or drug-related AEs. Because of these encouraging results, we are now evaluating this regimen in a phase 2 clinical trial in the frontline setting. [Table: see text]
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Thomson, ABR, P. Sinclair, A. Matisko, E. Rosen, T. Andersson, and B. Olofsson. "Influence of Food on the Bioavailability of an Enteric-Coated Tablet Formulation of Omeprazole 20 mg Under Repeated Dose Conditions." Canadian Journal of Gastroenterology 11, no. 8 (1997): 663–67. http://dx.doi.org/10.1155/1997/830856.
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The objective of this study was to investigate the influence of food on the bioavailability of omeprazole (20 mg) given as an enteric-coated tablet under repeated dose conditions. This open randomized crossover study consisted of three seven-day treatment periods, each separated by a drug-free period. During each treatment period an enteric-coated tablet of omeprazole was taken once daily either under fasting conditions, or immediately before or after a standardized breakfast. On the last day of each treatment period, blood samples for the determination of plasma omeprazole concentrations were collected at baseline and at predetermined intervals over the 24 h period following drug administration. Fifty-seven male and female subjects, aged 18 to 52 years, completed the study according to the protocol. No statistically significant differences were found when comparing either the before breakfast or after breakfast treatment regimens with the fasting regimen for the estimated mean area under the plasma concentration-time curve (AUC). The maximum plasma concentration was not found to differ significantly among any of the treatment regimens. However, the lower limit of the CI for the comparison of fasting/before breakfast was not contained within the limits of bioequivalence. The time to reach maximum plasma concentration was significantly different when fasting and after breakfast regimens were compared. Thus, under repeated dose conditions, food has no influence on the bioavailability (expressed as AUC) of omeprazole given as the enteric-coated tablet formulation.
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Gordon, Frederick J., Michael G. Porter, C. Sinclair Mayne, Edmund F. Unsworth, and David J. Kilpatrick. "Effect of forage digestibility and type of concentrate on nutrient utilization by lactating dairy cattle." Journal of Dairy Research 62, no. 1 (February 1995): 15–27. http://dx.doi.org/10.1017/s002202990003363x.
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SummarySix lactating dairy cows were used in a three period, part balanced changeover design experiment to investigate the effects of forage digestibility and concentrate composition on the efficiency of nutrient utilization in lactating dairy cows. Six treatments comprising three forage regimens and two concentrate types (starch υ. fibre) were examined in a 3 × 2 factorial design. The three forage regimens were high digestibility grass silage offered ad lib. (HA) or restricted to 6·5 kg dry matter/d (HR) and a low digestibility grass silage offered ad lib. (LA). Within each forage regimen animals were offered 10 kg·d of supplements containing either high-starch or high-fibre concentrations. Experimental periods lasted 28 d with a 10 d recording period, during which animal performance, ration digestibility and nitrogen and energy utilization were measured. Respiratory exchange measurements were made over a 72 h period using indirect open-circuit calorimetry. Throughout the experiment, there were no significant forage × concentrate interactions in any of the intake, production or nutrient utilization results. Milk yield was significantly influenced by forage regimen (24·1, 21·7 and 21·9 kg/d for HA, HR and LA respectively) and concentrate type (21·6 and 23·5 kg/d for high-starch and high-fibre respectively). Concentrate type also significantly influenced milk protein concentration (32·8 and 30·9 g/kg for high-starch and high-fibre respectively). Forage regimen significantly influenced the efficiency of utilization of metabolizable energy (ME) for milk production (κ1) with values of 0·62, 0·64 and 0·59 for HA, HR and LA respectively. Concentrate type had no significant effect on ME intake, heat production or κ1, although animals receiving the high-fibre concentrates synthesized proportionately 0·11 more milk energy per unit of available energy (ME intake – heat production) than those receiving the high-starch concentrates. Interpolation of the values obtained with the two high digestibility forage regimens indicated that at similar ME intakes there was a trend towards a higher κ1 with the diet based on high digestibility silage, and this was in line with the higher metabolizability of the overall diet with this silage.