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1

Potential life-threatening variations of drug concentrations in intravenous infusion systems: potassium chloride, insulin, and heparin  

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The investigation of concentrations of active agents in common carrier media for intravenous infusion revealed that potassium chloride tends to form a pool when it is added without mixing to carrier media in glass or polyvinyl chloride (PVC) containers which are already suspended in their functional position with ports pointing downwards. Heparin behaves in a similar fashion when added without mixing to carrier media in PVC containers. Such uneven distribution may expose a patient to potentially dangerous, possibly lethal, concentrations of a drug even when a relatively small amount of it is used. Insulin floats to the top of a Haemaccel container if its contents are not adequately mixed after addition of insulin. The resultant irregularity of insulin dosage may make the management of diabetic ketoacidosis more difficult. It is recommended that the instructions for the adequate mixing of contents should appear on all containers of carrier media for intravenous infusions.

Bergman, N.; Vellar, I.D.

1982-09-18

2

Survival of intravenous chemotherapy infusion sites.  

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Factors associated with the failure of intravenous infusions due to phlebitis and extravasation were studied with 218 infusions delivering cytotoxic drugs. The survival rate of these infusions was not significantly different from that of 56 non-cytotoxic infusions in oncology patients. Although survival analysis indicated that cisplatin was associated with longer survival, this was probably an artifact caused by this drug usually being preceded by 24 h prehydration. Multivariate analysis indi...

Hecker, J. F.

1990-01-01

3

Transition From Intravenous to Subcutaneous Insulin  

Science.gov (United States)

OBJECTIVE The study objectives were 1) to assess the effectiveness and safety of a standardized protocol for the transition to subcutaneous insulin and oral feeding in diabetic or hyperglycemic patients with acute coronary syndrome (ACS) who were receiving intravenous insulin and glucose at the time of the transfer from the intensive cardiac care unit to a general ward and 2) to identify predictors of transition outcome. RESEARCH DESIGN AND METHODS This was a prospective observational study. The protocol specifies that patients receive a 100% of their daily subcutaneous insulin requirement from the first day of oral feeding, calculated from the intravenous insulin rate during the final 12 h divided into two: 50% basal and 50% prandial. RESULTS In 142 patients (93 male, 49 female, age range 47–88 years, 135 with known diabetes) the first day after transition, 44.8% of blood glucose (BG) measurements were within the strict range of 100–140 mg/dL before meals and 100–180 mg/dL after meals, and 70.8% were within the broader ranges of 80–160 mg/dL and 80–200 mg/dL, respectively. Pre- or postprandial hypoglycemia (BG <70 mg/dL) occurred in 11 patients (7.7%) on the first day and in 38 patients (26.8%) on the first 3 days after transition. Old age, high doses of intravenous insulin, and wide BG variations in the 24 h before insulin infusion was stopped were predictive of poor BG control after transition. CONCLUSIONS This study shows the effectiveness and safety of a standardized protocol for the transition from intravenous to subcutaneous insulin in patients with ACS when regular oral feeding was resumed.

Avanzini, Fausto; Marelli, Giuseppe; Donzelli, Walter; Busi, Giovanna; Carbone, Stefania; Bellato, Laura; Colombo, Elena Lucia; Foschi, Roberto; Riva, Emma; Roncaglioni, Maria Carla; De Martini, Mario

2011-01-01

4

Intravenous infusion of sterile water for the treatment of hypernatraemia.  

Science.gov (United States)

Little research has been carried out into the infusion of intravenous sterile water for the treatment of hypernatraemia, and it remains a contentious issue. We conducted a review of the literature and extract results following an extensive search of Medline 1946, Embase 1974, ProQuest, evidence-based practice resources, national and international guideline sites and the publications of various professional bodies. The review is presented on the infusion of sterile water (hypotonic fluid) to lower serum sodium level in those circumstances when enteral supplementation of water is not possible, such as in postoperative patients or when other isotonic fluids (such as 5% dextrose in water infusion) are less than ideal-for example, hyperglycaemic patients on an insulin infusion. Absence of guidelines has limited the use of sterile water, even as an off-label drug when it can be administered relatively safely via a central line. PMID:24580394

Ramaswamykanive, H; Greaves, J

2014-03-01

5

Insulin Infusion Set: The Achilles Heel of Continuous Subcutaneous Insulin Infusion  

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Continuous subcutaneous insulin infusion from an insulin pump depends on reliable transfer of the pumped insulin to the subcutaneous insulin depot by means of an insulin infusion set (IIS). Despite their widespread use, the published knowledge about IISs and related issues regarding the impact of placement and wear time on insulin absorption/insulin action is relatively small. We also have to acknowledge that our knowledge is limited with regard to how often patients encounter issues with IIS...

Heinemann, Lutz; Krinelke, Lars

2012-01-01

6

INTRAVENOUS FENTANYL INFUSION AS AN ANALAGESIC AGENTS FOR LABOR PAIN  

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Introduction. There are few studies about intravenous fentanyl infusion for reduce labor pain. This study evaluate the usefulness of intravenous fentanyl infusion for labor analgesia. Methods. Seventy seven healthy pregnant women were randomized to recive 1.5-2.5µg/kg/hr intravenous fentanyl infusion (interventional group) or placebo (control group). Maternal labor pain intensity, systolic, diastolic and mean arterial blood pressure, pulse and respiratory rate, frequency of nausea and v...

Soltani Nezhad, H.; SH ARAM; Monajjemi, Z.; Jaafar-zadeh, L.

2001-01-01

7

Reassessment of external insulin infusion pumps.  

Science.gov (United States)

Continuous subcutaneous insulin infusion (CSII) therapy using external infusion pumps provides an alternative to multiple daily injections (MDI) for insulin-dependent diabetics who require intensive insulin therapy. CSII allows for the delivery of regular insulin continuously at preset basal rates and at bolus doses, which can be varied in response to insulin needs of the patient. Intensive insulin therapy by CSII or MDI was administered to diabetics to improve control of their blood glucose levels and to assess its effects on the development of complications such as retinopathy and nephropathy. CSII appeared to be as effective as MDI in attaining near-normoglycemia and improving metabolic control in patients with insulin-dependent diabetes mellitus who required intensive insulin therapy. It was not clear, however, whether the improved control of the blood glucose levels resulted in the prevention or progression of the diabetic complications. The risks of having adverse effects, such as diabetic ketoacidosis or hypoglycemia, were higher with CSII as compared with MDI; both methods having higher risks of these complications in comparison to conventional insulin therapy. CSII may be beneficial for patients requiring intensive insulin therapy who may need greater lifestyle flexibility with regard to meal timing, work, and recreational scheduling. PMID:2129578

Hotta, S S; Adams, D

1990-01-01

8

INTRAVENOUS FENTANYL INFUSION AS AN ANALAGESIC AGENTS FOR LABOR PAIN  

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Full Text Available Introduction. There are few studies about intravenous fentanyl infusion for reduce labor pain. This study evaluate the usefulness of intravenous fentanyl infusion for labor analgesia. Methods. Seventy seven healthy pregnant women were randomized to recive 1.5-2.5µg/kg/hr intravenous fentanyl infusion (interventional group or placebo (control group. Maternal labor pain intensity, systolic, diastolic and mean arterial blood pressure, pulse and respiratory rate, frequency of nausea and vomiting were monitored. Fetal heart rate (FHR and neonatal APGAR score also monitored. Results. Maternal intensity of labor pain, frequency of nausea and FHR changes were significantly lower in interventional group. There was no significant difference between groups about maternal frequency of vomiting, systolic, diastolic and mean arterial pressure, pulse rate and neonatal 1 and 5 min APGAR score. Discussion. Intravenous fentanyl infusion (1.5-2 µg/kg/hr during active phase of labor can diminish labor pain without any side effects of neonate and mother.

H SOLTANI NEZHAD

2001-06-01

9

How to Keep an Infusion Log: Intravenous Immune Globulin (IVIG)  

Science.gov (United States)

... left at the end is a highly purified immunoglobulin preparation that has only trace (intravenous (IV) infusion. In the usual case, the immunoglobulin replacement lasts approximately one month in the patient ...

10

Subcutaneous insulin infusion: change in basal infusion rate has no immediate effect on insulin absorption rate  

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Eight insulin-dependent diabetic patients were simultaneously given subcutaneous infusions (1.12 IU/h each) of /sup 125/I-labeled Actrapid insulin in each side of the abdominal wall. After 24 h of infusion, the size of the infused insulin depots was measured by external counting for 5 h. The basal infusion rate was then doubled in one side and halved in the other for the next 4 h. Finally, 1.12 IU/h of insulin was given in both sides of the abdominal wall for an additional 3 h. The changes in the size of the depots were measured, and the absorption rates for each hour were calculated. During the first 5 h of infusion, the depot size was almost constant (approximately 5 IU) with an absorption rate that equaled the infusion rate. Doubling the infusion rate led to a significant increase in depot size, but the absorption rate remained unchanged for the first 3 h, and only thereafter was a significant increase seen. When the infusion rate was reduced to the initial 1.12 IU/h, the absorption rate remained elevated during the next 3 h. Correspondingly, when the infusion rate was decreased, the depot size also decreased, but the absorption rate remained unchanged for the first 3 h. The results show that a change in the basal insulin infusion rate does not lead to any immediate change in the insulin absorption rate. This should be considered when planning an insulin-infusion program that includes alteration(s) in the basal-rate setting.

Hildebrandt, P.; Birch, K.; Jensen, B.M.; Kuehl, C.

1986-11-01

11

Subcutaneous insulin infusion: change in basal infusion rate has no immediate effect on insulin absorption rate  

International Nuclear Information System (INIS)

Eight insulin-dependent diabetic patients were simultaneously given subcutaneous infusions (1.12 IU/h each) of "1"2"5I-labeled Actrapid insulin in each side of the abdominal wall. After 24 h of infusion, the size of the infused insulin depots was measured by external counting for 5 h. The basal infusion rate was then doubled in one side and halved in the other for the next 4 h. Finally, 1.12 IU/h of insulin was given in both sides of the abdominal wall for an additional 3 h. The changes in the size of the depots were measured, and the absorption rates for each hour were calculated. During the first 5 h of infusion, the depot size was almost constant (approximately 5 IU) with an absorption rate that equaled the infusion rate. Doubling the infusion rate led to a significant increase in depot size, but the absorption rate remained unchanged for the first 3 h, and only thereafter was a significant increase seen. When the infusion rate was reduced to the initial 1.12 IU/h, the absorption rate remained elevated during the next 3 h. Correspondingly, when the infusion rate was decreased, the depot size also decreased, but the absorption rate remained unchanged for the first 3 h. The results show that a change in the basal insulin infusion rate does not lead to any immediate change in the insulin absorption rate. This should be considered when planning an insulin-infusion program that includes alteration(s) in the basal-rate setting

1986-01-01

12

Implantable, remotely-programmable insulin infusion system  

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An implantable, remotely-programmable insulin infusion system is described which has a mass of 280 grams and an implanted lifetime exceeding two years. The system uses a rotary solenoid-driven peristaltic pump controlled by low power CMOS timing circuitry which provides bimodal insulin delivery. Fifteen low rates from 0.39 to 5.9 units/hour and 15 high doses from 0.84 to 12.5 units are available using U100 insulin. The system has been tested in the laboratory, evaluated in diabetic dogs, and implanted in one diabetic human.

Carlson, G.A.; Bair, R.E.; Gaona, J.I. Jr.; Love, J.T.; Urenda, R.S.

1981-10-01

13

Insulin delivery route for the artificial pancreas: subcutaneous, intraperitoneal, or intravenous? Pros and cons.  

Science.gov (United States)

Insulin delivery is a crucial component of a closed-loop system aiming at the development of an artificial pancreas. The intravenous route, which has been used in the bedside artificial pancreas model for 30 years, has clear advantages in terms of pharmacokinetics and pharmacodynamics, but cannot be used in any ambulatory system so far. Subcutaneous (SC) insulin infusion benefits from the broad expansion of insulin pump therapy that promoted the availability of constantly improving technology and fast-acting insulin analog use. However, persistent delays of insulin absorption and action, variability and shortterm stability of insulin infusion from SC-inserted catheters generate effectiveness and safety issues in view of an ambulatory, automated, glucose-controlled, artificial beta cell. Intraperitoneal insulin delivery, although still marginally used in diabetes care, may offer an interesting alternative because of its more-physiological plasma insulin profiles and sustained stability and reliability of insulin delivery. PMID:19885254

Renard, Eric

2008-07-01

14

Allergy reactions to insulin: effects of continuous subcutaneous insulin infusion and insulin analogues.  

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The purification of animal insulin preparations and the use of human recombinant insulin have markedly reduced the incidence but not completely suppressed the occurrence of insulin allergy manifestations. Advances in technologies concerning the mode of delivery of insulin, i.e. continuous subcutaneous insulin infusion (CSII), and the use of insulin analogues, resulting from the alteration in the amino acid sequence of the native insulin molecule, may influence the immunogenicity and antigenic...

Radermecker, Re?gis; Scheen, Andre?

2007-01-01

15

Thrombolytic treatment for acute ischemic cerebral stroke: intraarterial urokinase infusion vs. intravenous heparin and urokinase infusion  

International Nuclear Information System (INIS)

To evaluate the efficacy and limitation of intra-arterial urokinase (IAUK) infusion for treatment of acute cerebral stroke. Twenty-seven acute cerebral stroke patients treated with IAUK infusion within six hours of stroke onset were reviewed. All patients showed normal initial brain findings on CT. In 21 patients, urokinase(5-15 x 105IU) was administered through a microcatheter placed into or proximal to occluded segment. Mechanical disruption of thrombus by guidewire was performed in 17 patients. Angiographic and clinical responses and complications after IAUK infusion, were evaluated and the results were compared with those of intravenous heparin(N=19) and urokinase infusion(N=19). Complete or partial angiographic recanalization of occluded segment was found in 18 patients (67%), and neurologic improvement was followed in 14 patients(52%). The degree of improvement on the stroke scale score after IAUK infusion was statistically more significant(p<0.05) than that shown after intravenous heparin and urokinase infusion. Complications after IAUK infusion were large(15%) and small amount intracerebral hemorrhage(15%), contrast leakage into brain parenchyma(11%), and gastrointestinal bleeding(4%). Between the IAVK and the intravenous urokinase infusion group, differences in extent and types of complications were statistically insignificant, but were significantly higher in those two groups than in the intravenous heparin infusion group. IAUK infusion may be effective for the treatment of acute cerebral stroke

1996-07-01

16

Thrombolytic treatment for acute ischemic cerebral stroke: intraarterial urokinase infusion vs. intravenous heparin and urokinase infusion  

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To evaluate the efficacy and limitation of intra-arterial urokinase (IAUK) infusion for treatment of acute cerebral stroke. Twenty-seven acute cerebral stroke patients treated with IAUK infusion within six hours of stroke onset were reviewed. All patients showed normal initial brain findings on CT. In 21 patients, urokinase(5-15 x 10{sup 5}IU) was administered through a microcatheter placed into or proximal to occluded segment. Mechanical disruption of thrombus by guidewire was performed in 17 patients. Angiographic and clinical responses and complications after IAUK infusion, were evaluated and the results were compared with those of intravenous heparin(N=19) and urokinase infusion(N=19). Complete or partial angiographic recanalization of occluded segment was found in 18 patients (67%), and neurologic improvement was followed in 14 patients(52%). The degree of improvement on the stroke scale score after IAUK infusion was statistically more significant(p<0.05) than that shown after intravenous heparin and urokinase infusion. Complications after IAUK infusion were large(15%) and small amount intracerebral hemorrhage(15%), contrast leakage into brain parenchyma(11%), and gastrointestinal bleeding(4%). Between the IAVK and the intravenous urokinase infusion group, differences in extent and types of complications were statistically insignificant, but were significantly higher in those two groups than in the intravenous heparin infusion group. IAUK infusion may be effective for the treatment of acute cerebral stroke.

Ko, Gi Young; Suh, Dae Chul; Lee, Jae Hong; Kim, Jun Hyoung; Choi, Choong Gon; Lee, Ho Kyu; Lee, Myoung Chong [Ulsan Univ. College of Medicine, Seoul (Korea, Republic of)

1996-07-01

17

Pharmacokinetics of Ertapenem following Intravenous and Subcutaneous Infusions in Patients?  

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Steady-state pharmacokinetics of ertapenem were compared in patients after 1-g intravenous and subcutaneous (s.c.) infusions. Bioavailability was 99% ± 18% after s.c. administration, but peaks were reduced by about (43 ± 29 versus 115 ± 28 ?g/ml) and times to peak were delayed. Simulations based on unbound concentrations show that time over the MIC should always be longer than 30% to 40% of the dosing interval, suggesting that s.c. infusion could be an alternative in patients with reduced...

Frasca, Denis; Marchand, Sandrine; Petitpas, Franck; Dahyot-fizelier, Claire; Couet, William; Mimoz, Olivier

2010-01-01

18

The Effects of Magnetic Resonance Imaging on Intravenous Infusion Devices  

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We evaluated the effects of magnetic resonance imaging on the accuracy of three types of intravenous infusion pump devices, IVAC 530, IMED 927 and IMED 960/965. The devices were exposed to a 2,800-gauss static magnetic field at a pulsed radio frequency of 11.9 MHz operating at a maximum power of 1,200 W. Each device was tested at low, medium and fast flow rates in a controlled environment and during magnetic resonance imaging. Intravenous therapy could be carried out normally during magnetic ...

Engler, Mary B.; Engler, Marguerite M.

1985-01-01

19

THE ROLE OF INTRAVENOUS AMINO ACID INFUSION IN OLIGOHYDRAMNIOS  

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Oligohydramnios means the fetus is in a compromised condition. Ante partum amniotic fluid index (A.F.I.) assessment is one of the reliable, good predictor and standard technique for assessment of fetal well-being in antenatal period. In the present study 25 cases of Oligohydramnios in the third trimester were given intravenous amino acid in 1000cc of 10% fructodex drip on 1st day and the amino acid infusion drip in 500 ml of 10% fructodex daily till 6 days. After that biweekly till patient de...

2012-01-01

20

Inhibition of Insulin Secretion by Infused Epinephrine in Phesus Monkeys.  

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The effect of infused l-epinephrine bitartrate on plasma insulin levels has been studied in the fasted, normal, waking rhesus monkey, with chronically implanted venous catheters. It was demonstrated that sharp rises in peripheral plasma glucose levels dur...

A. O. Kris R. E. Miller F. E. Wherry J. W. Mason

1965-01-01

 
 
 
 
21

Cardiovascular effects of intravenous ghrelin infusion in healthy young men  

DEFF Research Database (Denmark)

Ghrelin infusion improves cardiac function in patients suffering from cardiac failure, and bolus administration of ghrelin increases cardiac output in healthy subjects. The cardiovascular effects of more continuous intravenous ghrelin exposure remain to be studied. We therefore studied the cardiovascular effects of a constant infusion of human ghrelin at a rate of 5 pmol/kg per minute for 180 min. Fifteen healthy, young (aged 23.2 +/- 0.5 yr), normal-weight (23.0 +/- 0.4 kg/m(2)) men volunteered in a randomized double-blind, placebo-controlled crossover study. With the subjects remaining fasting, peak myocardial systolic velocity S', tissue tracking TT, left ventricular ejection fraction EF, and endothelium-dependent flow-mediated vasodilatation were measured. Ghrelin infusion increased S' 9% (P = 0.002) and TT 10% (P <0.001), whereas EF, resting blood flow velocity, and endothelium-dependent flow-mediated vasodilatation did not change (P = 0.13). This was associated with a peak in serum growth hormone after 60 min of infusion (37.77 +/- 5.27 ng/ml, P <0.001), a doubling of free fatty acid levels (P = 0.001), and a 1.6-fold increase in cortisol levels (P <0.05), whereas glucose and catecholamine levels were constant. In conclusion, supraphysiological levels of ghrelin stimulate left ventricular function in terms of S' and TT in healthy young normal-weight men without changing resting blood flow velocity and endothelium-dependent flow-mediated vasodilatation. The effects did not translate into detectable increments in EF.

Vestergaard, Esben Thyssen; Andersen, Niels Holmark

2007-01-01

22

THE ROLE OF INTRAVENOUS AMINO ACID INFUSION IN OLIGOHYDRAMNIOS  

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Full Text Available Oligohydramnios means the fetus is in a compromised condition. Ante partum amniotic fluid index (A.F.I. assessment is one of the reliable, good predictor and standard technique for assessment of fetal well-being in antenatal period. In the present study 25 cases of Oligohydramnios in the third trimester were given intravenous amino acid in 1000cc of 10% fructodex drip on 1st day and the amino acid infusion drip in 500 ml of 10% fructodex daily till 6 days. After that biweekly till patient deliver or till term. There were 4 cases of severe Oligohydramnios and 21 cases of moderate Oligohydramnios at the time of their first visit. After amino acid infusion therapy, on repeat ultrasonography, 9 (36% cases patients with moderate Oligohydramnios had improved amniotic fluid index (AFI to normal whereas two patients with severe Oligohydramnios had improved A.F.I. to moderate Oligohydramnios and remaining 12 and two patients of moderate and severe Oligohydramnios group patients did not show any changes in A.F.I. Maximum cases delivered vaginally.

Ritu Gupta et al

2012-10-01

23

Comparison of continuous subcutaneous and intravenous hydromorphone infusions for management of cancer pain.  

Science.gov (United States)

To compare the safety and efficacy of subcutaneous and intravenous infusion of opioid analgesics, a randomised, double-blind, crossover trial was carried out in inpatients. 15 patients with severe cancer pain received two 48 h infusions of hydromorphone--one subcutaneously and one intravenously in randomly allocated order. The study was made double-blind by the use of two infusion pumps throughout; during the active subcutaneous infusion the intravenous pump delivered saline and vice versa. Serial measurements of pain intensity, pain relief, mood, and sedation by means of visual analogue scales showed no clinically or statistically significant difference between the two infusion routes. Side-effects were slight, and the mean number of morphine injections for breakthrough pain did not differ significantly between the routes (4.8 [SD 4.5] for intravenous vs 5.3 [5.6] for subcutaneous). Plasma hydromorphone concentrations measured at 24 h and 48 h of infusion showed stable steady-state pharmacokinetics; the mean bioavailability from subcutaneous infusion was 78% of that with intravenous infusion. Because of the simplicity, technical advantages, and cost-effectiveness of continuous subcutaneous opioid infusion into the chest wall or trunk, intravenous opioid infusion for the management of severe cancer pain should be abandoned. PMID:1704089

Moulin, D E; Kreeft, J H; Murray-Parsons, N; Bouquillon, A I

1991-02-23

24

Glucose uptake and pulsatile insulin infusion: euglycaemic clamp and (3-/sup 3/H)glucose studies in healthy subjects  

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To test the hypothesis that insulin has a greater effect on glucose metabolism when given as pulsatile rather than as continuous infusion, a 354-min euglycaemic clamp study was carried out in 8 healthy subjects. At random order soluble insulin was given intravenously either at a constant rate of 0.45mU/kg center dot min or in identical amounts in pulses of 1/sup 1///sub 2/ to 2/sup 1///sub 4/ min followed by intervals of 10/sup 1///sub 2/ to 9/sup 3///sub 4/ min. Average serum insulin levels were similar during the two infusion protocols, but pulsatile administration induced oscillations ranging between 15 and 62 ..mu..U/ml. Glucose uptake expressed as metabolic clearance rate (MCR) for glucose was significantly increased during pulsatile insulin delivery as compared with continuous administration (270-294 min: 8.7+-0.7 vs 6.8+-0.9 ml/kg center dot min, P < 0.01, and 330-354 min: 8.9 +- 0.5 vs 7.4 +- 0.9 ml/kg center dotmin, P<0.05). The superior efficacy of pulsatile insulin delivery on glucose uptake was not consistently found until after 210 min of insulin administration. In both infusion protocols, endogenous glucose production as estimated by the (3-/sup 3/H)glucose infusion technique was suppressed to insignificant values. Finally, the effect of insulin on endogenous insulin secretion and lipolysis as assessed by changes in serum C-peptide and serum FFA was uninfluenced by the infusion mode. In conclusion, insulin infusion resulting in physiological serum insulin levels enhances glucose uptake in peripheral tissues in healthy subjects to a higher degree when given in a pulsed pattern mimicking that of the normal endocrine pancreas than when given as a continuous infusion.

Schmitz, O.; Arnfred, J.; Hother Nielsen, O.; Beck-Nielsen, H.; Oerskov, H.

1986-01-01

25

Glucose uptake and pulsatile insulin infusion: euglycaemic clamp and [3-"3H]glucose studies in healthy subjects  

International Nuclear Information System (INIS)

To test the hypothesis that insulin has a greater effect on glucose metabolism when given as pulsatile than as continuous infusion, a 354-min euglycaemic clamp study was carried out in 8 healthy subjects. At random order soluble insulin was given intravenously either at a constant rate of 0.45mU/kg · min or in identical amounts in pulses of 1"1/_2 to 2"1/_4 min followed by intervals of 10"1/_2 to 9"3/_4 min. Average serum insulin levels were similar during the two infusion protocols, but pulsatile administration induced oscillations ranging between 15 and 62 ?U/ml. Glucose uptake expressed as metabolic clearance rate (MCR) for glucose was significantly increased during pulsatile insulin delivery as compared with continuous administration (270-294 min: 8.7±0.7 vs 6.8±0.9 ml/kg · min, P < 0.01, and 330-354 min: 8.9 ± 0.5 vs 7.4 ± 0.9 ml/kg ·min, P<0.05). The superior efficacy of pulsatile insulin delivery on glucose uptake was not consistently found until after 210 min of insulin administration. In both infusion protocols, endogenous glucose production as estimated by the [3-"3H]glucose infusion technique was suppressed to insignificant values. Finally, the effect of insulin on endogenous insulin secretion and lipolysis as assessed by changes in serum C-peptide and serum FFA was uninfluenced by the infusion mode. In conclusion, insulin infusion resulting in physiological serum insulin levels enhances glucose uptake in peripheral tissues in healthy subjects to a higher degree when given in a pulsed pattern mimicking that of the normal endocrine pancreas than when given as a continuous infusion. (author)

1986-01-01

26

Lack of antibacterial activity after intravenous hydrogen peroxide infusion in experimental Escherichia coli sepsis.  

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The intravenous administration of hydrogen peroxide has been reported to benefit patients with pneumonia and to reduce Plasmodium parasitemia in experimentally infected mice. We assessed the antibacterial activity of intravenously infused hydrogen peroxide against hydrogen peroxide-susceptible Escherichia coli (MBC of hydrogen peroxide, 0.23 mM) in experimentally infected rabbits. No decrease in the level of bacteremia was detected at the maximum intravenous infusion rate of hydrogen peroxide...

Shenep, J. L.; Stokes, D. C.; Hughes, W. T.

1985-01-01

27

Haemolytic anaemia as a complication to intravenous immunoglobulin infusion  

DEFF Research Database (Denmark)

Intravenous immunoglobulin (IVIg) is an established treatment for various neuromuscular disorders. Recently, we have observed a few cases of haemolytic anaemia following IVIg treatment. The objective of this study was to determine the extent of anaemia and haemolysis as a complication to IVIg. In a prospective study we included 28 post-polio patients treated with 2g per kilo of Privigen® and 22 CIDP patients treated with 1.7±0.4 (mean±SD) g per kilo of Kiovig®. The post-polio patients were all IVIg treatment naitive whereas the CIDP patients were in maintenance therapy. Venous blood samples were performed before and two weeks after infusion of IVIg. Following treatment blood haemoglobin declined from 8.6±0.8 to 8.1±1.3mmol/l, p<0.001. Furthermore, decreasing haptoglobin and increasing reticulocyte count, blood bilirubin, and lactate dehydrogenase were observed, all p<0.05. The decrease of haemoglobin was 0.79±1.2 in the treatment naive versus 0.25±0.3mmol/l in the long-term treated patients, p=0.05. Alterations of reticulocyte count, haptoglobin and lactate dehydrogenase were more pronounced in the treatment naive group, all p<0.05. In 7 patients we observed a substantial decline of haemoglobin of more than 1.5mmol/l (1.8-2.9). Six of those 7 patients had undetectable levels of haptoglobin after IVIg and the mean reticulocyte count, blood bilirubin and lactate dehydrogenase increased 420%, 130% and 108%. All were in the de-novo treated group. Our observations indicate that treatment naive patients are susceptible to develop haemolysis. Haemolytic anaemia is a severe side effect that seems to be more frequent after immunoglobulin infusions than previously recognized.

Markvardsen, Lars Høj; Harbo, Thomas

28

The effects of short term intravenous infusion of a soybean based lipid emulsion on some blood constituents in sheep: A preliminary study  

Directory of Open Access Journals (Sweden)

Full Text Available To evaluate the effect of intravenous infusion of a soybean based lipid emulsion (Lipovenoes 10% on some blood constituents in sheep, a replicated 2 × 2 Latin square design experiment was conducted in four clinically healthy ewes. Lipid emulsion (LE group or normal saline (NS group was infused intravenously at a rate of 0.025 mL kg-1 per min for 6 hr and the concentrations of blood triglyceride, glucose, insulin, calcium, magnesium, phosphorous, sodium and potassium were measured before (baseline and then at timepoints 2, 4, 6, 12 and 24 hr after infusion. Compared to the baseline values and/or NS infusion, LE infusion resulted in a significant increase in the concentrations of triglyceride (p 0.05. In conclusion, intravenous infusion of Lipovenoes temporarily influenced some blood constituents. Increased triglyceride concentrations were associated with an increase in HOMA-IR values indicating a state of insulin resistance. No remarkable adverse effect was observed following LE infusion and lipid based emulsions can be safely used in ruminants not suffering from extensive lipid mobilization.

Hamid Akbari

2014-04-01

29

Insulin secretion after short- and long-term low-grade free fatty acid infusion in men with increased risk of developing type 2 diabetes.  

DEFF Research Database (Denmark)

We studied the effect of a low-grade short- and long-term 20% Intralipid infusion (0.4 mL(-1) x kg(-1) x h(-1)) on insulin secretion and insulin action in 15 elderly obese men; 7 glucose intolerant first-degree relatives of type 2 diabetic patients (impaired glucose tolerance [IGT] relatives) and 8 healthy controls of similar age and body mass index (BMI). Intravenous glucose tolerance test (IVGTT) and a graded glucose infusion (dose-response test [DORE]) were performed to determine first phase insulin response and to explore the dose response relationship between glucose concentration and insulin secretion rates (ISR). ISR were calculated by deconvolution of plasma C-peptide concentrations. Insulin action was determined by performing a 120-minute hyperinsulinemic euglycemic clamp. All tests were performed 3 times, preceded by 0, 2, or 24 hours Intralipid infusion. Disposition indices (DI) were calculated for the IVGTT. Insulin action was reduced 25% after 2 and 24 hours Intralipid infusion in both groups. InIGT relatives, the beta-cell responsiveness to glucose (measured during DORE) decreased after 2 and 24 hours Intralipid infusion (P=.02), whereas first phase insulin response (measured during IVGTT) decreased after 24 hours Intralipid infusion. Insulin secretion measured during DORE and IVGTT was not affected by Intralipid infusion in controls. DI decreased after 2 and 24 hours Intralipid infusion in the total study population. In conclusion, insulin resistance induced by low-grade short- and long-term Intralipid infusion is not balanced by an adequate compensatory increase in insulin secretion in IGT relatives or in matched controls. IGT relatives appear to be more sensitive to the deleterious effects of low-grade fat infusion on insulin secretion than normal glucose tolerant control subjects.

Storgaard, Heidi; Jensen, Christine B

2003-01-01

30

Acute Cardiovascular Effects of Guanazole (NSC Number 1895) Following Continuous Intravenous Infusion to Anesthetized Beaglehounds.  

Science.gov (United States)

Guanazole, in doses of 1750, 2500 and 5000 mg/kg was given by intravenous infusion over 60 minutes to normal, anesthetized beaglehounds instrumented for monitoring various cardiovascular parameters. Records were taken during two control periods 15 minutes...

R. L. Hamlin F. S. Pipers K. Nguyen P. Mihalko R. M. Folk

1977-01-01

31

Effect of Insulin Infusion on Liver Protein Synthesis during Hemodialysis  

DEFF Research Database (Denmark)

Background Hemodialysis (HD) is a catabolic procedure that may contribute to the high frequency of protein-energy wasting among patients receiving maintenance HD. The present study investigated the additional effect of glucose and glucose-insulin infusion on liver protein synthesis during HD compared with a meal alone. Methods In a randomized cross-over study with three arms, 11 non-diabetic HD patients were assigned to receive a conventional HD session with either: � no treatment (NT) � IV infusion of glucose (G) � IV infusion of glucose-insulin (GI) During infusions blood glucose levels were maintained at 8.0-10.0 mmol/L by additional glucose infusion. Glucose and glucose-insulin infusions were commenced 2 h prior to HD and continued throughout the HD session. Fasting blood samples were collected at baseline before infusion and followed by the only meal allowed during the study. Results Blood glucose and insulin: The change in blood glucose differed significantly from baseline (-120 min) to end of HD (240 min) between the NT group and the G group (p=0.002); there was no significant difference in the change between the NT group and the GI group (p=0.06), or between the G group and the GI group (p=0.15). Fibrinogen and albumin: There was an overall increase in serum albumin (38.8±2.1 to 40.4±2.5 g/L, p<0.0001) and in serum fibrinogen (11.7±1.7 to 12.8±1.8 µmol/L, p<0.0001) from HD start (0 min) to 2 h post HD (360 min), but no significant difference in the change in either albumin (p=0.12) or fibrinogen (p=0.12) between the groups. IGFBP-1: During the first 4 h after baseline (-120 min) we observed an overall decrease in serum IGF-binding protein 1 (IGFBP-1) (from 267±147 to 140±84 µg/L, p<0.0001), but no difference in the change between groups (p=0.41). However, from 4 h after baseline to the end of the study there was a significant difference in the change in serum IGFBP-1 between the groups (p=0.003) with a significant increase in serum IGFBP-1 in the NT group (p<0.0001), but not in the G group or GI group (p=0.50 and p=0.07, respectively). Conclusions Compared with a meal neither glucose nor glucose-insulin infusion appear to have any extra effects on liver protein synthesis during HD.

Reinhard, Mark; Frystyk, Jan

32

Lung microdialysis study of levofloxacin in rats following intravenous infusion at steady state.  

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Lung microdialysis has been used with rats to investigate antibiotic distribution after single-dose administration. However, conducting such experiments after intravenous infusion at steady state would constitute a more convenient alternative, which was evaluated here, using levofloxacin (LVX) as a test compound. Microdialysis probes were inserted in blood and muscle, used as a comparator, between 9:00 a.m. and 11:00 a.m. Intravenous LVX infusion was started 6 h later and maintained until the...

Marchand, Sandrine; Frasca, Denis; Dahyot Fizelier, Claire; Breheret, Celine; Mimoz, Olivier; Couet, William

2008-01-01

33

Outcome Evaluation of Intravenous Infusion of Urokinase for Acute Ischemic Stroke  

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The aim of this study was to evaluate the clinical effect of a continuous infusion of urokinase in cerebral stoke patients who were late admitted over 6 hours after onset. From January to December in 2008, acute cerebral stroke patients (n=143) treated with intravenous urokinase infusion (Group I, n=93) or not (Group II, n=50) after 6 hours and within 72 hours of stroke onset were reviewed. Continuous intravenous infusion of urokinase was done for 5 days. The clinical outcome for each patient...

Lee, Rae Seop; Ok, Young Chul; Lim, Jun Seob; Lim, Byung Chan; Cho, Kyu Yong; Lee, Min Cheol

2012-01-01

34

Cardiovascular stability with rapid intravenous infusion of ondansetron.  

Science.gov (United States)

The acute cardiovascular effects of rapid iv administration of the antiemetic ondansetron, a selective serotonin (5-HT3) receptor antagonist were determined in a randomized, blinded, placebo-controlled study. Measurements of heart rate, blood pressure, oxygen saturation and respiratory rate were made preoperatively over a five-minute period which followed a two-minute infusion of the medication. Intraoperative and postoperative data were not collected. None of the variables recorded changed significantly during the infusion or in the observation period which followed. Within the limitations of this study, we detected no cardiovascular change in the five minutes between the end of the drug infusion and the induction of anaesthesia. PMID:8513525

Heyman, J S; Young, M L; Bagshaw, R J; Levy, W J; Geer, R T; Aukburg, S J; Joslyn, A F; Conahan, T J

1993-05-01

35

The contamination of intravenous fluids by writing on the infusion bag: Fact or fiction?  

Directory of Open Access Journals (Sweden)

Full Text Available Introduction -Laboratory experiments were conducted to ascertain whether Sharpie® brand black permanent marker ink will permeate through intravenous infusion bags. The practice of writing directly on infusion bags is a frequent yet controversial practice. There are no known written standards that exist which pertain to this practice. Methods – Five types of intravenous bags containing different solutions marked with black ink from a fine point felt tipped Sharpie® marker. Sample extraction occurred after infusion bags had been warmed to 40 C or remained ambient.  Spectrophotometric scans and measurements were conducted at 300 to 600 NM on each solution contained in the experimental bags. Writing with Sharpie® pens on filter paper and surgical tape was also conducted. Results – A total of 17 experiments were conducted with intravenous bags of five different types of manufacture.  There appeared to be no visible or ultraviolet spectrophotometric evidence of leaching of the ink from Sharpie® pens. Four different lot numbers of Sharpie® pens were used. Surgical tape that was written on using Sharpie® markers readily exhibited visible evidence of permeability. Discussion - The experiments conducted would appear to indicate that the infusion containers tested maintained an intact barrier to the application of Sharpie® brand permanent marker ink. Writing on surgical tape does not stop the permeability of Sharpie® pens. This study could serve as a suitable pilot study for others to conduct a much more comprehensive study using a greater number of intravenous containers, solutions and ink markers.   Keywords: Fluid therapy, infusion, ink, intravenous, writing.

James Daniel Langston

2013-11-01

36

Analysis of the Environmental Impact of Insulin Infusion Sets Based on Loss of Resources with Waste  

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Insulin pump therapy [continuous subcutaneous insulin infusion (CSII)] requires regular change of infusion sets every 2-3 days in order to minimize the risk of skin irritations or other adverse events. This has been discussed to be a potential burden to the environment. The purpose of this analysis was to perform an environmental assessment of insulin pump infusion sets based on loss of resources occurring during incineration of the discarded products and by means of a lifecycle concept used ...

Pfu?tzner, Andreas; Musholt, Petra B.; Malmgren-hansen, Bjoern; Nilsson, Nils H.; Forst, Thomas

2011-01-01

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Protocol-directed insulin infusion sliding scales improve perioperative hyperglycaemia in critical care  

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Abstract Perioperative hyperglycaemia is associated with poor outcomes in patients undergoing cardiac surgery. Frequent postoperative hyperglycaemia in cardiac surgery patients has led to the initiation of an insulin infusion sliding scale for quality improvement. A systematic review was conducted to determine whether a protocol-directed insulin infusion sliding scale is as safe and effective as a conventional practitioner-directed insulin infusion sliding scale, within targe...

Hui Man; Kumar Arun; Adams Gary G

2012-01-01

38

Progress in gammaglobulin therapy for immunodeficiency: from subcutaneous to intravenous infusions and back again.  

Science.gov (United States)

The year 1952 marked the first use of subcutaneous immunoglobulin therapy to treat primary immunodeficiency disease. Subsequently, intramuscular and then intravenous administration became the norm in the United States and most of Europe. Intravenous immunoglobulin therapy, however, can be burdensome and often causes systemic side effects. To overcome obstacles presented by the intravenous route of administration, subcutaneous preparations were developed. To further enhance patient satisfaction, adherence, and quality of life, enzyme-enhanced subcutaneous immunoglobulin administration using hyaluronidase, an enzyme spreading agent, was studied. The dose and flow rate of traditional subcutaneous immunoglobulin infusion is limited by the inhibition of bulk fluid flow by the extracellular matrix. Recombinant human hyaluronidase, administered with or immediately prior to infusate, increases the absorption and dispersion of infused fluids and drugs. Results from a phase III clinical trial indicate that subcutaneous immunoglobulin infusion, facilitated by recombinant human hyaluronidase, is well tolerated, and delivers infusion volumes at treatment intervals and rates equivalent to intravenous administration. This review surveys the state of the art of immunoglobulin replacement therapy. PMID:22828788

Wasserman, Richard L

2012-12-01

39

The pharmacokinetics of ifosfamide given as short and long intravenous infusions in cancer patients.  

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1. We investigated the pharmacokinetics of ifosfamide 5 g m-2 given by two regimens. Six patients (one female), median age 55 (range 40-71) years, all with lung cancer received 5 g m-2 ifosfamide (median ifosfamide dose 8.95 g) as an intravenous infusion over 0.5 h with mesna. Four other cancer patients (all male) of median age 52.5 (range 23-72) years were studied on seven treatment occasions with 5 g m-2 ifosfamide (median ifosfamide dose 8.88 g) as a 24 h intravenous infusion with mesna. P...

Lewis, L. D.; Fitzgerald, D. L.; Mohan, P.; Thatcher, N.; Harper, P. G.; Rogers, H. J.

1991-01-01

40

Gene Expression in Lung and Liver After Intravenous Infusion of Polyethylenimine Complexes of Sleeping Beauty Transposons  

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Two methods of systemic gene delivery have been extensively explored, using the mouse as a model system: hydrodynamic delivery, wherein a DNA solution equivalent in volume to 10% of the mouse weight is injected intravenously in less than 10?sec, and condensation of DNA with polyethylenimine (PEI) for standard intravenous infusion. Our goal in this study was to evaluate quantitatively the kinetics of gene expression, using these two methods for delivery of Sleeping Beauty transposons. Transp...

Podetz-pedersen, Kelly M.; Bell, Jason B.; Steele, Terry W. J.; Wilber, Andrew; Shier, W. Thomas; Belur, Lalitha R.; Mcivor, R. Scott; Hackett, Perry B.

2010-01-01

 
 
 
 
41

Pethidine clearance during continuous intravenous infusions in postoperative patients.  

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1 Pethidine pharmacokinetics in ten female patients during continuous i.v. infusion for 32 h post-surgery have been determined. 2 The blood clearance of pethidine (mean +/- 2.d.) measured directly was 599 +/- 135 ml/min and is in marked contrast to some reported values. 3 Other model-dependent pharmacokinetic parameters were consistent with previously reported values. 4 Pethidine and indocyanine green clearance were correlated but the correlation was mediated through body weight. 5 Pethidine ...

Austin, K. L.; Stapleton, J. V.; Mather, L. E.

1981-01-01

42

Treatment of lung cancer with bronchial artery infusion of cisplatin and intravenous sodium thiosulfate rescue  

International Nuclear Information System (INIS)

Forty-nine patients with primary lung cancer were treated with bronchial artery infusion of cisplatin and intravenous injection of an antidote, sodium thiosulfate. More than 50% reduction of tumor size (PR) was observed in 8 of 9 small cell carcinomas (SCLC) and in 16 of 40 non-small cell carcinomas (NSCLC). In NSCLC patients PR was obtained in 71% (12/17) after repeated infusions (? 200 mg cisplatin) and in 17% (4/23) after a single infusion (? 150 mg cisplatin). There was a significant linear relationship between cisplatin dose and tumor reduction in this group. No severe adverse effects were encountered. (orig.)

1988-01-01

43

Intracranial hemodynamics during intravenous infusion of glyceryl trinitrate  

DEFF Research Database (Denmark)

The mechanisms of glyceryl trinitrate (GTN)-induced headache are not fully elucidated. In this study we administered GTN 0.5 microg/kg/min i.v. for 20 min in six healthy volunteers. Before, during and 60 min after the infusion, we investigated regional cerebral blood flow (rCBF), cerebral blood volume (CBV), both estimated with SPECT, and blood flow velocity (BFV) in the middle cerebral artery (MCA), measured with transcranial Doppler. Headache was scored on a numerical verbal rating (0-10) scale. rCBF was unchanged, CBV was slightly increased (13%) during GTN infusion, whereas BFV decreased both during (20%) and 60 min (15%) after GTN. Headache was short-lived and maximal during infusion. This discrepancy of time-effect curves for the effect of GTN on headache and dilatation of MCA indicates that MCA is most likely not the primary source of pain in GTN-induced headache. The time-effect curves for the effect of GTN on headache and on dilation of MCA differed markedly. This indicates that MCA is most likely not the primary source of pain in GTN-induced headache Udgivelsesdato: 2008/6

Iversen, H.K.; Holm, S.

2008-01-01

44

Boron biodistribution in Beagles after intravenous infusion of 4-dihydroxyborylphenylalanine-fructose complex  

Energy Technology Data Exchange (ETDEWEB)

Boron biodistribution after intravenous infusion of 4-dihydroxyborylphenylalanine-fructose (BPA-F) complex was investigated in six dogs. Blood samples were evaluated during and following doses of 205 and 250 mg/kgbw BPA in a 30 min infusion, and 500 mg/kgbw in a 1 h infusion. Samples from whole blood, urine, brain and other organs were analysed for boron content after varying times following the onset of infusion. The whole blood boron concentrations declined from 27 to 8.4 ppm over the period of 39-165 min after the onset of infusion and the levels increased from 1.9 to 12 ppm in the grey matter of the brain over the same period. The boron concentrations in whole blood decreased steadily, whereas the boron values in brain tissue rose steadily with time. It was concluded that whole blood boron concentrations do not seem to reflect accurately the boron concentration in brain tissue at respective time points.

Kulvik, M.E. E-mail: martti.kulvik@welho.com; Vaehaetalo, J.K.; Benczik, J.; Snellman, M.; Laakso, J.; Hermans, R.; Jaerviluoma, E.; Rasilainen, M.; Faerkkilae, M.; Kallio, M.E

2004-11-01

45

Reassessment of insulin dosing guidelines in continuous subcutaneous insulin infusion treated type 1 diabetes.  

Science.gov (United States)

It is a daunting task to initiate or evaluate continuous subcutaneous insulin infusion, pump, dosing in a patient with type 1 diabetes. Choosing a low dose may lead to hyperglycemia or, too high, hypoglycemia. Mathematical dosing guidelines were used with the first human insulin injection in 1922. Since that time, they have been enlarged and modified. The current widely published guidelines were developed from retrospective evaluations of pump-downloads in patients without specified diet conditions or timed glucose testing. When diet is controlled and glucose testing is timed to evaluate post-meal excursions and during sleep, recent prospective studies found that these current dosing recommendations for basal insulin were too high and for bolus insulin too low. Further, simple mathematical interrelationships were published that kept the right proportions between the bolus dosing factors and the basal dose. PMID:24792068

King, Allen Bennett

2014-06-01

46

Effect of prolonged intravenous glucose and essential amino acid infusion on nitrogen balance, muscle protein degradation and ubiquitin-conjugating enzyme gene expression in calves  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Intravenous infusions of glucose and amino acids increase both nitrogen balance and muscle accretion. We hypothesised that co-infusion of glucose (to stimulate insulin and essential amino acids (EAA would act additively to improve nitrogen balance by decreasing muscle protein degradation in association with alterations in muscle expression of components of the ubiquitin-proteasome proteolytic pathway. Methods We examined the effect of a 5 day intravenous infusions of saline, glucose, EAA and glucose + EAA, on urinary nitrogen excretion and muscle protein degradation. We carried out the study in 6 restrained calves since ruminants offer the advantage that muscle protein degradation can be assessed by excretion of 3 methyl-histidine and multiple muscle biopsies can be taken from the same animal. On the final day of infusion blood samples were taken for hormone and metabolite measurement and muscle biopsies for expression of ubiquitin, the 14-kDa E2 ubiquitin conjugating enzyme, and proteasome sub-units C2 and C8. Results On day 5 of glucose infusion, plasma glucose, insulin and IGF-1 concentrations were increased while urea nitrogen excretion and myofibrillar protein degradation was decreased. Co-infusion of glucose + EAA prevented the loss of urinary nitrogen observed with EAA infusions alone and enhanced the increase in plasma IGF-1 concentration but there was no synergistic effect of glucose + EAA on the decrease in myofibrillar protein degradation. Muscle mRNA expression of the ubiquitin conjugating enzyme, 14-kDa E2 and proteasome sub-unit C2 were significantly decreased, after glucose but not amino acid infusions, and there was no further response to the combined infusions of glucose + EAA. Conclusion Prolonged glucose infusion decreases myofibrillar protein degradation, prevents the excretion of infused EAA, and acts additively with EAA to increase plasma IGF-1 and improve net nitrogen balance. There was no evidence of synergistic effects between glucose + EAA infusion on muscle protein degradation or expression of components of the ubiquitin-proteasome proteolytic pathway.

Scaife Jes R

2008-02-01

47

Multiorgan crystal deposition following intravenous oxalate infusion in rat  

International Nuclear Information System (INIS)

Deposition of calcium oxalate is responsible for the pathologic manifestations of oxalosis and may contribute to multiorgan dysfunction in uremia and to the progression of renal damage after renal failure is established. We have developed a rat model of oxalosis using a single intravenous injection of sodium oxalate, 0.3 mmol./kg. body weight, in rats. Polarized light microscopy and section freeze-dry autoradiography were used to identify "1"4C-oxalate within the renal parenchyma and in extrarenal organs. "1"4C-oxalate crystals under three mu in length were identified within one min. of injection in proximal tubule lumens. Section freeze-dry autoradiography showed occasional minute crystals within glomeruli, heart, lung and liver at one hr. In contrast to concentrative cellular uptake demonstrated in rat renal cortical slices in vitro, intracellular accumulation of "1"4C-oxalate could not be detected in vivo. Within the first 24 hr., renal oxalate retention reached a maximum of 25 +/- 4 per cent of the injected dose/gm. kidney compared to a maximum of only 7 +/- 3 per cent/gm. kidney after intraperitoneal administration. Although less than one per cent dose/gm. kidney remained after one week, crystal fragments were scattered throughout the cortex and medulla, often surrounded by foci of interstitial nephritis. The retention of crystals in kidney and other body organs following i.v. oxalate provides a model of oxalosis which stimulates pathophysiologic events in a variety of clinical situations characterized by transiently or persistently elevated serum oxalate

1986-01-01

48

Pharmacokinetics of FK506 in Liver Transplant Recipients After Continuous Intravenous Infusion  

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The first-dose pharmacokinetics of FK506 was studied in nine orthotopic liver transplant patients receiving continuous intravenous infusion of 0.15 mg/kg/day. Multiple blood samples were obtained during the infusion and plasma FK506 concentrations were measured hy enzyme-linked immunosorbent assay. The plasma clearance ranged from 0.47 to 5.8 L/minute, and the half-life ranged from 4.5 hours to 33.1 hours. These results indicate the pharmacokinetics of FK506 to be highly variable between pati...

Jain, Ashok B.; Abu-elmagd, Kareem; Abdallah, Hisham; Warty, Vijay; Fung, John; Todo, Satoru; Starzl, Thomas E.; Venkataramanan, Raman

1993-01-01

49

Does intravenous saline infusion compromise the stability of [123I] meta-iodobenzylguanidine?  

Science.gov (United States)

To avoid adverse effects during the administration of [I] meta-iodobenzylguanidine (MIBG), infusion of the drug that has been previously diluted is proposed. Stability of [I] MIBG in sodium chloride solutions is studied, looking for incompatibilities in the formulation. Stability was tested on the basis of the percentage of free [I] iodide on solid-phase extraction. No increase in percentages of free [I] iodide was found in diluted and undiluted samples over time (P>0.05). Intravenous saline infusion of [I] MIBG could be a useful tool for controlling the administration rate, minimizing the side effects and lowering the exposure of the staff to ionizing radiation. PMID:24637441

Martínez, Teresa; Chivato, Tomás; Roldán, Marta; Miñana, Elena

2014-06-01

50

Dose proportional pharmacokinetics of alprostadil (prostaglandin E1) in healthy volunteers following intravenous infusion.  

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Prostaglandin E1 (PGE1) (30, 60, 120 micrograms) was administered by intravenous infusion over a 120 min period in an open, three way randomized, cross-over study to 12 healthy male volunteers. For the evaluation of PGE1, PGE0 and 15-keto-PGE0, blood samples were drawn prior to, during and after the infusion. Analytical measurements were performed by gas chromatography/negative ion chemical ionization triple stage quadruple mass spectrometry, a highly specific and sensitive GC/MS/MS-method. D...

Cawello, W.; Leonhardt, A.; Schweer, H.; Seyberth, H. W.; Bonn, R.; Lomeli, A. L.

1995-01-01

51

Insulin secretion and cellular glucose metabolism after prolonged low-grade intralipid infusion in young men.  

DEFF Research Database (Denmark)

We examined the simultaneous effects of a 24-h low-grade Intralipid infusion on peripheral glucose disposal, intracellular glucose partitioning and insulin secretion rates in twenty young men, by 2-step hyperinsulinemic euglycemic clamp [low insulin clamp (LI), 10 mU/m(2) x min; high insulin clamp (HI), 40 mU/m(2) x min], 3-(3)H-glucose, indirect calorimetry, and iv glucose tolerance test. Free fatty acid concentrations were similar during basal steady state but 3.7- to 13-fold higher during clamps. P-glucagon increased and the insulin/glucagon ratio decreased at both LI and HI during Intralipid infusion. At LI, glucose oxidation decreased by 10%, whereas glucose disposal, glycolytic flux, glucose storage, and glucose production were not significantly altered. At HI, glucose disposal, and glucose oxidation decreased by 12% and 24%, respectively, during Intralipid infusion. Glycolytic flux, glucose storage, and glucose production were unchanged. Insulin secretion rates increased in response to Intralipid infusion, but disposition indices (DI = insulin action.insulin secretion) were unchanged. In conclusion, a 24-h low-grade Intralipid infusion caused insulin resistance in the oxidative (but not in the nonoxidative) glucose metabolism in young healthy men. Moreover, insulin hypersecretion perfectly countered the free-fatty acid-induced insulin resistance. Future studies are needed to determine the role of a prolonged moderate lipid load in subjects at increased risk of developing diabetes.

Jensen, Christine B; Storgaard, Heidi

2003-01-01

52

Insulin secretion and cellular glucose metabolism after prolonged low-grade intralipid infusion in young men  

DEFF Research Database (Denmark)

We examined the simultaneous effects of a 24-h low-grade Intralipid infusion on peripheral glucose disposal, intracellular glucose partitioning and insulin secretion rates in twenty young men, by 2-step hyperinsulinemic euglycemic clamp [low insulin clamp (LI), 10 mU/m(2) x min; high insulin clamp (HI), 40 mU/m(2) x min], 3-(3)H-glucose, indirect calorimetry, and iv glucose tolerance test. Free fatty acid concentrations were similar during basal steady state but 3.7- to 13-fold higher during clamps. P-glucagon increased and the insulin/glucagon ratio decreased at both LI and HI during Intralipid infusion. At LI, glucose oxidation decreased by 10%, whereas glucose disposal, glycolytic flux, glucose storage, and glucose production were not significantly altered. At HI, glucose disposal, and glucose oxidation decreased by 12% and 24%, respectively, during Intralipid infusion. Glycolytic flux, glucose storage, and glucose production were unchanged. Insulin secretion rates increased in response to Intralipid infusion, but disposition indices (DI = insulin action.insulin secretion) were unchanged. In conclusion, a 24-h low-grade Intralipid infusion caused insulin resistance in the oxidative (but not in the nonoxidative) glucose metabolism in young healthy men. Moreover, insulin hypersecretion perfectly countered the free-fatty acid-induced insulin resistance. Future studies are needed to determine the role of a prolonged moderate lipid load in subjects at increased risk of developing diabetes.

Jensen, Christine B; Storgaard, Heidi

2003-01-01

53

Increased dietary sodium alters Fos expression in the lamina terminalis during intravenous angiotensin II infusion  

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These studies examined the effects of increased dietary sodium on expression of Fos, the protein product of c-fos, in forebrain structures in the rat following intravenous infusion with angiotensin II (AngII). Animals were provided with either tap water (Tap) or isotonic saline solution (Iso) as their sole drinking fluid for 3–5 weeks prior to testing. Rats were then implanted with catheters in a femoral artery and vein. The following day the conscious, unrestrained animals received iv infu...

Bealer, Steven L.; Metcalf, Cameron; Heyborne, Ryan

2007-01-01

54

Treatment of lung cancer with bronchial artery infusion of cisplatin and intravenous sodium thiosulfate rescue  

Energy Technology Data Exchange (ETDEWEB)

Forty-nine patients with primary lung cancer were treated with bronchial artery infusion of cisplatin and intravenous injection of an antidote, sodium thiosulfate. More than 50% reduction of tumor size (PR) was observed in 8 of 9 small cell carcinomas (SCLC) and in 16 of 40 non-small cell carcinomas (NSCLC). In NSCLC patients PR was obtained in 71% (12/17) after repeated infusions (greater than or equal to 200 mg cisplatin) and in 17% (4/23) after a single infusion (less than or equal to 150 mg cisplatin). There was a significant linear relationship between cisplatin dose and tumor reduction in this group. No severe adverse effects were encountered.

Uchiyama, N.; Kobayashi, H.; Nakajo, M.; Shinohara, S.

1988-01-01

55

Computer simulations of propofol infusions for total intravenous anaesthesia in dogs : review article  

Directory of Open Access Journals (Sweden)

Full Text Available The volatile anaesthetic agents halothane, isoflurane and enflurane are all chlorofluorocarbons and according to international treaties, their emission into the atmosphere will be prohibited from the year 2030. The agents desflurane and sevoflurane are fluorinated hydrocarbons and act as greenhouse gases. The future of veterinary anaesthesia could be dependent on the development of total intravenous anaesthesia. Drugs utilised in total intravenous anaesthesia (TIVA should have a short duration of action and no tendency to accumulate in the body. Propofol has been the dominant agent used. Computer technology has enabled targeted plasma concentration controlled infusions to replace manual infusion regimens. This study simulated the pharmacokinetics of various infusion regimens similar to those used in clinical practice using previously published pharmocokinetic data. Bolus doses of 0, 4, 6 and 8 mg/kg were simulated in combination with infusion rates of 0, 0.2, 0.3 and 0.4 mg/kg/min for either 240 or 1440 min. The computer was also programmed to maintain a steady state plasma concentration based on the previous simulated data. Generated data were then compared with published data. Changes in the context-sensitive half-life for propofol were also evaluated. Results showed that the generated data were similar to published data. A decrease in plasma concentration to levels associated with a light plane of anaesthesia was evident even when the highest bolus dose and infusion rate were used. There was a slow rise in plasma concentration when only an infusion was used. A lightening of anaesthetic plane may be evident early in the course of TIVA and careful monitoring of anaesthetic depth is required. As the duration of the infusion increased, plasma concentration steadily rose but achieved 95 % of the steady state by 204 min. The most dramatic changes in plasma concentration occurred in the first hour of an infusion. Similarly, the infusion rates decreased most in the first 70 min. Most changes in anaesthetic depth are likely to occur early in the course of TIVA and careful observation of anaesthetic depth is required.

K.E. Joubert

2012-05-01

56

Evidence for reduced thermic effect of insulin and glucose infusions in Pima Indians.  

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Several authors have reported a reduced thermic effect of food in obese subjects. The hyperinsulinemic-euglycemic clamp technique has been used to measure one component of the thermic effect of food, insulin and insulin-mediated glucose disposal. We used this technique to measure the thermic responses to insulin and glucose infusions in 120 glucose-tolerant Pima Indians, a population with a high prevalence of obesity. During high-dose insulin infusions (400 mU/m2 per min) the measured increas...

Bogardus, C.; Lillioja, S.; Mott, D.; Zawadzki, J.; Young, A.; Abbott, W.

1985-01-01

57

Utilities associated with subcutaneous injections and intravenous infusions for treatment of patients with bone metastases  

Directory of Open Access Journals (Sweden)

Full Text Available Louis S Matza,1 Ze Cong,2 Karen Chung,2 Alison Stopeck,3 Katia Tonkin,4 Janet Brown,5 Ada Braun,2 Kate Van Brunt,6 Kelly McDaniel1 1Outcomes Research, United BioSource Corporation, Bethesda, MD, USA; 2Amgen, Inc, Thousand Oaks, CA, USA; 3Department of Medicine, University of Arizona, Tucson, AZ, USA; 4Department of Oncology, University of Alberta, Edmonton, Alberta, Canada; 5Leeds Institute of Molecular Medicine, St James University Hospital, Leeds, UK; 6formerly with Outcomes Research, United BioSource Corporation, Bethesda, MD, USA Introduction: Although cost-utility models are often used to estimate the value of treatments for metastatic cancer, limited information is available on the utility of common treatment modalities. Bisphosphonate treatment for bone metastases is frequently administered via intravenous infusion, while a newer treatment is administered as a subcutaneous injection. This study estimated the impact of these treatment modalities on health state preference. Methods: Participants from the UK general population completed time trade-off interviews to assess the utility of health state vignettes. Respondents first rated a health state representing cancer with bone metastases. Subsequent health states added descriptions of treatment modalities (ie, injection or infusion to this basic health state. The two treatment modalities were presented with and without chemotherapy, and infusion characteristics were varied by duration (30 minutes or 2 hours and renal monitoring. Results: A total of 121 participants completed the interviews (52.1% female, 76.9% white. Cancer with bone metastases had a mean utility of 0.40 on a standard utility scale (1 = full health; 0 = dead. The injection, 30-minute infusion, and 2-hour infusion had mean disutilities of ?0.004, ?0.02, and ?0.04, respectively. The mean disutility of the 30-minute infusion was greater with renal monitoring than without. Chemotherapy was associated with substantial disutility (?0.17. When added to health states with chemotherapy, the mean disutilities of injection, 30-minute infusion, and 2-hour infusion were ?0.02, ?0.03, and ?0.04, respectively. The disutility associated with injection was significantly lower than the disutility of the 30-minute and 2-hour infusions (P < 0.05, regardless of chemotherapy status. Conclusion: Respondents perceived an inconvenience with each type of treatment modality, but injections were preferred over infusions. The resulting utilities may be used in cost-utility models examining the value of treatments for the prevention of skeletal-related events in patients with bone metastases. Keywords: skeletal-related event, infusion, injection

Matza LS

2013-08-01

58

Psychopathology and Continuous Subcutaneous Insulin Infusion in Type 1 Diabetes  

Science.gov (United States)

Aim. Continuous subcutaneous insulin infusion (CSII) is used as an option in patients with diabetes failing to multiple daily injections (MDI). Psychological factors may play a relevant role in the failure to attain therapeutic goals in patients on MDI. This could lead to an overrepresentation of psychopathology in patients treated with CSII. Methods. A consecutive series of 100 patients with type 1 diabetes was studied, collecting main clinical parameters and assessing psychopathology with the self-reported questionnaire Symptom Checklist 90-revised. Patients on CSII were then compared with those on MDI. Results. Of the 100 enrolled patients, 44 and 56 were on CSII and MDI, respectively. Among men, those on CSII were younger than those on MDI; conversely, no difference in age was observed in women. Women on CSII showed higher scores on most Symptom Checklist 90 subscales than those on MDI, whereas no differences were observed in men. Conclusion. Women with type 1 diabetes treated with CSII display higher levels of psychopathology than those on MDI. This is probably the consequence of the fact that patients selected for CSII are those failing to MDI. Higher levels of psychopathology could represent a limit for the attainment and maintenance of therapeutic goals with CSII.

Lamanna, Caterina; Dicembrini, Ilaria; Faravelli, Carlo; Calasso, Caterina; Mannucci, Edoardo

2013-01-01

59

[Nuclear medicine studies of tissue concentration and hemodynamic effects of retrograde intravenous pressure infusions].  

Science.gov (United States)

In 12 patients with trophic foot-lesions (diabetic feet) retrograde intravenous pressure infusions (150 ml) containing radioactive tracers (99m Tc, 99m Tc labelled human serum albumin) were carried out. With the veins emptied time-activity curves over the legs reflect tissue concentrations after release of the occlusion. Tissue-concentration is about 3 times higher than after intraarterial and 7 times higher than after intravenous injection of the same dose. The high count-rates which can be measured in the wound-secretion demonstrate the "rinsing effect" of the injected fluid. Hemodynamic investigations have been performed in a double blind study. 8 patients received buflomedil and 9 got placebo 3 times per week by retrograde intravenous pressure infusions. After 3 weeks there was an increase of the peak-flow on the lower leg (venous occlusion plethysmography), an increase of transcutaneous oxygen pressure and a fall of peak flow-time and of plasma-viscosity, both for buflomedil and for placebo (without statistical significance). Preliminary investigations after an arterial occlusion for 1 hour showed an increase of flow-values measured by venous occlusion plethysmography which reached a maximum after 4 to 5 days. PMID:8397459

Partsch, H; Jochmann, W; Mostbeck, A; Hirschl, M

1993-01-01

60

Nuclearmedical investigations on tissue concentration and hemodynamic effects of retrograde intravenous pressure infusion  

International Nuclear Information System (INIS)

In 12 patients with trophic foot-lesions (diabetic feet) retrograde intravenous pressure infusions (150 ml) containing radioactive tracers (99m Tc, 99m Tc labelled human serum albumin) were carried out. With the veins emptied time-activity curves over the legs reflect tissue concentrations after release of the occlusion. Tissue-concentration is about 3 times higher than after intraarterial and 7 times higher than after intravenous injection of the same dose. The high count-rates which can be measured in the wound-secretion demonstrate the 'rinsing effect' of the injected fluid. Hemodynamic investigations have been performed in a double blind study. 8 patients received buflomedil and 9 got placebo 3 times per week by retrograde intravenous pressure infusions. After 3 weeks there was an increase of the peak-flow on the lower leg (venous occlusion plethysmography), an increase of transcutaneous oxygen pressure and a fall of peak flow-time and of plasma-viscosity, both for buflomedil and for placebo (without statistical significance): Preliminary investigations after an arterial occlusion for 1 hour showed an increase of flow-values measured by venous occlusion plethysmography which reached a maximum after 4 to 5 days

1993-01-01

 
 
 
 
61

Effect of corticosteroids on phlebitis induced by intravenous infusion of antineoplastic agents in rabbits  

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Full Text Available Purpose: Phlebitis caused by intravenous infusion of antineoplastic agents is one of the critical problems when anticancer therapy is prolonged. We have already reported that both rapid infusion and dilution of the injection solution were effective methods for reducing phlebitis caused by vinorelbine (VNR in rabbits. The aim of this study was to explore other practical methods for preventing phlebitis caused by VNR and doxorubicin (DXR in a rabbit model. VNR is often used with cisplatin, and dexamethasone (DEX has been co-administered for prevention of cisplatin-induced nausea. DXR is used with prednisolone (PSL in the CHOP regimen for the treatment of non-Hodgkin's lymphoma. Therefore, the present study investigated the prevention of phlebitis due to VNR with DEX and that due to DXR with PSL. Methods: VNR and DXR were diluted with normal saline to prepare test solutions at concentrations of 0.6 mg/mL and 1.4 mg/mL, respectively. Each test solution was infused into the auricular veins of rabbits. Two days after VNR infusion and three days after DXR infusion, the veins were evaluated histopathologically. The effect of DEX on VNR-induced phlebitis was evaluated by infusion of DEX before or after VNR. The effect of PSL on DXR-induced phlebitis was similarly evaluated by co-infusion of PSL. Results: The histopathological features of phlebitis caused by the antineoplastic agents differed between VNR and DXR: VNR did not cause the loss of venous endothelial cells, but caused inflammatory cell infiltration, edema, and epidermal degeneration. In contrast, DXR caused the loss of venous endothelial cells and chrondrocyte necrosis. Pre-treatment and post-treatment with DEX significantly decreased VNR-induced phlebitis compared with the control group and pre-treatment was particularly effective. Co-infusion of PSL also significantly decreased phlebitis caused by DXR, but its effect was less marked. Conclusion: The present findings suggested that pre-treatment with DEX may be a useful method for preventing phlebitis due to VNR, and that co-infusion of PSL has the potential to prevent phlebitis caused by DXR.

Emiko Kohno, Saori Murase, Kenji Matsuyama, Noboru Okamura

2009-01-01

62

Unprecedented high insulin secretion in a healthy human subject after intravenous glucagon-like peptide-1 : a case report  

DEFF Research Database (Denmark)

BACKGROUND: The gut-derived incretin hormones, glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1, are released in response to ingestion of nutrients. Both hormones are highly insulinotropic in strictly glucose-dependent fashions and glucagon-like peptide-1 is often referred to as one of the most insulinotropic substances known. CASE PRESENTATION: Plasma insulin and C-peptide concentrations were measured in a healthy Caucasian male (age: 53 years; body mass index: 28.6 kg/m2; fasting plasma glucose: 5.7 mM; 2 h plasma glucose value following 75 g-oral glucose tolerance test: 3.5 mM; glycated haemoglobin A1c: 5.5%) during glucagon (1 mg) and meal (2,370 kJ) tests, and during two 2 h 15 mM-hyperglycaemic clamps with continuous intravenous infusion of glucagon-like peptide-1 (1 pmol/kg/min) and glucose-dependent insulinotropic polypeptide (4 pmol/kg/min), respectively. Normal insulin and C-peptide responses were observed during meal test (peak concentrations: 300 and 3,278 pM) and glucagontest (peak concentrations: 250 and 2,483 pM). During the hyperglycaemic clamp with continuous intravenous infusion of GLP-1 the subject exhibited plasma insulin and C-peptide concentrations of 13,770 and 22,380 pM, respectively. CONCLUSIONS: To our knowledge insulin and C-peptide concentrations of these magnitudes have never been reported. Thus, the present data support the view that glucagon-like peptide-1 is one of the most insulinotropic substances known.

Knop, Filip K; Lund, Asger

2014-01-01

63

Central and renal haemodynamic effects of intravenous infusion of non-ionic and ionic contrast media  

International Nuclear Information System (INIS)

The central and renal haemodynamic effects after intravenous infusion (1 ml/s) of a non-ionic (iohexol) and an ionic (metrizoate) contrast medium were investigated in 16 pigs. The injected contrast media induced marked haemodynamic changes compared with normal saline. However, there were no significant differences between the ionic and the non-ionic media. It was concluded that the effects were only partially caused by an increase in the blood volume due to the injected volume. In addition, the effects related to the viscosity, the osmolality and other not specified pharmacodynamic properties of the media are proposed to be of importance. (orig.)

1985-01-01

64

Protocol-directed insulin infusion sliding scales improve perioperative hyperglycaemia in critical care  

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Full Text Available Abstract Perioperative hyperglycaemia is associated with poor outcomes in patients undergoing cardiac surgery. Frequent postoperative hyperglycaemia in cardiac surgery patients has led to the initiation of an insulin infusion sliding scale for quality improvement. A systematic review was conducted to determine whether a protocol-directed insulin infusion sliding scale is as safe and effective as a conventional practitioner-directed insulin infusion sliding scale, within target blood glucose ranges. A literature survey was conducted to identify reports on the effectiveness and safety of an insulin infusion protocol, using seven electronic databases from 2000 to 2012: MEDLINE, CINAHL, EMBASE, the Cochrane Library, the Joanna Briggs Institute Library and SIGLE. Data were extracted using pre-determined systematic review and meta-analysis criteria. Seven research studies met the inclusion criteria. There was an improvement in overall glycaemic control in five of these studies. The implementation of protocols led to the achievement of blood glucose concentration targets more rapidly and the maintenance of a specified target blood glucose range for a longer time, without any increased frequency of hyperglycaemia. Of the seven studies, four used controls and three had no controls. In terms of the meta-analysis carried out, four studies revealed a failure of patients reaching target blood glucose levels (P P It can be concluded that the protocol-directed insulin infusion sliding scale is safe and improves blood glucose control when compared with the conventional practitioner-directed insulin infusion sliding scale. This study supports the adoption of a protocol-directed insulin infusion sliding scale as a standard of care for post-cardiac surgery patients.

Hui Man

2012-10-01

65

Increase in the resistance of stenotic coronary segment by intravenous infusion of isoproterenol.  

Directory of Open Access Journals (Sweden)

Full Text Available The effects of intravenous infusion of isoproterenol on stenosis resistance were studied in the anesthetized open-chest dog. The circumflex coronary artery (LCx was isolated near its origin and an electromagnetic flow transducer was placed around the vessel for measuring coronary flow. A polyethylene catheter was inserted into the small branch of LCx for monitoring distal coronary pressure. LCx was constricted with a thick cotton string to a degree of obstruction that eliminated reactive hyperemia following a 20-second coronary occlusion. The coronary resistance across the stenotic segment (RL was calculated as the pressure gradient across the stenosis divided by coronary flow. Isoproterenol was infused intravenously in a dose to keep the heart rate at a level 25-30% above the control with and without coronary constriction. For maintaining the ascending aortic pressure at the pre-isoproterenol level, the descending thoracic aorta was constricted with a tape. In the absence of coronary constriction, the vascular resistance of large coronary arteries was not affected by isoproterenol with a significant increase in coronary flow. In the presence of coronary stenosis, isoproterenol markedly increased RI regardless of additional aortic constriction. The magnitude of the increase in RL during aortic constriction varied directly with the percent increase in the pressure gradient across the coronary stenosis. Pacing-tachycardia essentially did not affect RL. These results suggest that isoproterenol increased the vascular resistance of the stenotic segment with fixed caliber.

Saito,Daiji

1983-02-01

66

Intravenous infusion of L-isomers of phenylalanine and tryptophan stimulate gastric acid secretion at physiologic plasma concentrations in normal subjects and after parietal cell vagotomy.  

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To determine whether intravenous infusion of individual amino acids stimulated gastric acid secretion in man, graded doses of phenylalanine, tryptophan, glycine, alanine, histidine, and NaCl control were infused on separate days in nine healthy subjects. Intravenous infusion of phenylalanine and tryptophan significantly stimulated gastric acid secretion to 50 and 52%, respectively, of the acid secretory response to intragastric peptone. Intravenous alanine and histidine were without effect, w...

Mcarthur, K. E.; Isenberg, J. I.; Hogan, D. L.; Dreier, S. J.

1983-01-01

67

Differential sensitivity of glycogenolysis and gluconeogenesis to insulin infusions in dogs.  

Science.gov (United States)

The suppressive effect of insulin on hepatic glucose production is generally recognized. Though it is well established that this effect is at least partially due to inhibition of glycogenolysis, controversy still exists about insulin's effect on gluconeogenesis. The present study was undertaken to determine whether insulin could affect gluconeogenesis from alanine in the intact dog and to compare the effect of insulin on glycogenolysis and gluconeogenesis. In anesthetized dogs fasted overnight, blood samples were drawn simultaneously from a femoral artery and hepatic vein. Alanine-U-14C, 10 mu Ci./kg., was infused over 110 minutes. A constant insulin infusion at either 1 or 5 mU./kg./min. was begun at 50 minutes, and blood glucose concentration was maintained by a variable glucose infusion. When insulin was infused at 1 mU./kg./min., resulting in plasma immunoreactive insulin (IRI) levels of 73 +/- 10 muU./ml., the net splanchnic glucose production (NSGP) was suppressed from 2.7 +/- 2 mg./kg./min. to virtually zero. In constrast, this small increment in insulin concentration had no demonstrable effect on the net splanchnic uptake of alanine or on the conversion of plasma alanine to glucose (7.9 +/- 0.3 mu mol/min.). Insulin infused at 5 mU./kg./min. resulted in IRI levels of 240 +/- 25 muU./ml. This higher insulin concentration was associated with a marked suppression of both the NSGP (100 per cent) and the conversion of plasma alanine to glucose (90 per cent) but did not affect the extraction of alanine by the splanchnic bed. Doses of both 1 and 5 mU./kg./min. were associated with a 35 per cent fall in immunoreactive glucagon levels. These data demonstrate that (1) glycogenolysis is more sensitive than gluconeogenesis to the inhibitory effect of small increments in insulin concentrations, (2) gluconeogenesis could be suppressed by insulin but only at higher insulin concentrations, (3) this suppression of gluconeogenesis from alanine by insulin was due to an intrahepatic effect rather than an effect on the splanchnic extraction of alanine, and finally, (4) that insulin can suppress glucagon in the absence of hyperglycemia. PMID:1269837

Chiasson, J L; Liljenquist, J E; Finger, F E; Lacy, W W

1976-04-01

68

Differential effects of cranial radiation on growth hormone response to arginine and insulin infusion  

International Nuclear Information System (INIS)

The growth hormone responses to arginine infusion and to insulin-induced hypoglycemia were studied in 13 patients with neoplastic disease after treatment with radiation and chemotherapy. Patients who received intensive cranial radiation (greater than 2,400 rads) had no response to either arginine or insulin; those who received moderate cranial radiation (greater than or equal to 2,400 rads) had GH response to arginine but not to insulin; patients receiving no cranial radiation responded to both arginine and insulin. These data support the hypothesis that GH secretion in response to arginine infusion has a different mechanism in contrast to the response to insulin-induced hypoglycemia and that the latter is more vulnerable to cranial radiation

1978-01-01

69

Systematic review: continuous intraperitoneal insulin infusion with implantable insulin pumps for diabetes mellitus.  

Science.gov (United States)

Continuous intraperitoneal insulin infusion (CIPII) with implantable insulin pumps (IIPs) is a treatment option for diabetes, which is not widely utilized nor freely accessible in clinical practice. The aim of this study was to summarize available evidence on use of IIPs for CIPII for diabetes treatment, since its introduction to clinical use on the following outcomes: HbA1c, hypoglycaemic events, and complications of treatment. Secondary outcomes: complications of diabetes and treatment satisfaction. Following the procedure for a systematic review this paper may contribute to a balanced evaluation of the need and effectiveness of IIPs. A pre-specified, registered protocol (CRD42012002150) was followed. Studies investigating all diabetes populations and types of IIPs were considered eligible. The sensitive search strategy was developed in collaboration with a clinical librarian and contents experts. PUBMED, MEDLINE, CENTRAL EMBASE, trial registries, and other databases were searched. References were screened independently by two authors, and decisions on study selection were recorded. Of the 1,703 references screened, 362 were assessed as potentially eligible. Ninety-four were identified as studies using IIPs. Fifteen papers, together reporting on four-randomized trials, and eight cohorts were included. Narrative analysis is provided, and data tables are available. CIPII by way of IIPs is effective in lowering HbA1c levels and reducing hypoglycaemic events. Superiority of IIP treatment is likely related to patient characteristics, one subgroup being patients unable to acquire satisfactory glycaemic control with subcutaneous insulin treatment. Higher treatment satisfaction was also reported for this subgroup. For these patients, risk of morbidity may be considered acceptable. Patients' perspectives, influence on quality of life, and possible other outcomes should also be considered important factors in weighing individual benefits and risks. A more uniform method of reporting would help strengthen the evidence base. PMID:24595518

Spaan, Nienke; Teplova, Alina; Stam, Gerrit; Spaan, Jos; Lucas, Cees

2014-06-01

70

Portable detectors for /sup 125/I-insulin absorption measurement during subcutaneous infusion with portable pumps  

Energy Technology Data Exchange (ETDEWEB)

Programmed subcutaneous insulin infusion is a promising method for normalisation of the blood glucose concentration in insulin-dependent diabetics. The absorption rate from the depot is usually measured intermittently by radioactively-labelled insulin and stationary scintillation detectors. Small portable detectors are an alternative, however, and continuous absorption measurements could be made during normal life conditions. Contrary to conventional single injection therapy, the insulin depot initially expands during infusion treatment, changing the geometry during measurements. In the present study the methodological aspects and geometrical dependences were investigated. Simulated studies were made with various plane disc /sup 125/I sources in Perspex phantoms as well as /sup 125/I-insulin absorption studies in short-term subcutaneous infusion experiments with anesthetised rabbits. Results from portable, end-window Geiger-Mueller (GM) detectors fixed above the depots and close to the surfaces of phantom or skin were compared with results obtained by a conventional stationary NaI(Tl) detector 15 cm from the phantom or skin surface. With a /sup 125/I-insulin infusion site at 5 mm depth in the subcutaneous tissue of rabbits, an overall linear proportionality was found between the results obtained with a NaI(Tl) detector and a GM detector raised 15 mm above the skin surface inside the detector housing.

Bojsen, J.; Kolendorf, K. (Finseninstitutet, Copenhagen (Denmark)); Deckert, T. (Steno Memorial Hospital, Copenhagen (Denmark))

1984-04-01

71

Portable detectors for 125I-insulin absorption measurement during subcutaneous infusion with portable pumps  

International Nuclear Information System (INIS)

Programmed subcutaneous insulin infusion is a promising method for normalisation of the blood glucose concentration in insulin-dependent diabetics. The absorption rate from the depot is usually measured intermittently by radioactively-labelled insulin and stationary scintillation detectors. Small portable detectors are an alternative, however, and continuous absorption measurements could be made during normal life conditions. Contrary to conventional single injection therapy, the insulin depot initially expands during infusion treatment, changing the geometry during measurements. In the present study the methodological aspects and geometrical dependences were investigated. Simulated studies were made with various plane disc 125I sources in Perspex phantoms as well as 125I-insulin absorption studies in short-term subcutaneous infusion experiments with anaesthetised rabbits. Results from portable, end-window Geiger-Mueller (GM) detectors fixed above the depots and close to the surfaces of phantom or skin were compared with results obtained by a conventional stationary NaI(Tl) detector 15 cm from the phantom or skin surface. With a 125I-insulin infusion site at 5 mm depth in the subcutaneous tissue of rabbits, an overall linear proportionality was found between the results obtained with a NaI(Tl) detector and a GM detector raised 15 mm above the skin surface inside the detector housing. (author)

1984-01-01

72

Evaluation for intravenous, arterial and local infusion of a hypoxic cell radiosensitizer RK28 on rabbit VX2 tumor system  

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We evaluated the radiosensitizing effect of intraarterial, intravenous and local infusion of a hypoxic cell radiosensitizer RK28 on rabbit VX2 tumor system. Six rabbits were treated in each infusion group. VX2 tumor was implanted in the left hind leg. Tumor grown up to 3 cm in diameter was treated with 15 Gy of X-ray irradiation just after infusion of radiosensitizer RK28 (80 mg/kg.b.w.). Intratumoral and serum mean concentration of RK28 and its metabolites were measured. Tumor regression curve and survival time were analyzed. The following results were obtained. Mean concentration of RK28 was about 2.5 times greater in local infusion and 1.5 times in intraarterial infusion than in intravenous infusion. Significant regression of tumor was obtained in intraarterial infusion (p<0.01). There was no significant difference in survival time. These data suggest that the usefulness of intraarterial infusion of RK28 for local control using intraoperative radiation therapy and brachytherapy. (author).

Kuramitsu, Tatsuya (Yamaguchi Univ., Ube (Japan). School of Medicine)

1993-12-01

73

Effects of the rate of insulin infusion during isoglycemic, hyperinsulinemic clamp procedures on measures of insulin action in healthy, mature thoroughbred mares.  

Science.gov (United States)

The objective of this study was to determine whether the rate of insulin infusion during isoglycemic hyperinsulinemic clamp procedures affected measures of insulin action, including glucose disposal and plasma non-esterified fatty acid, endothelin-1, and nitric oxide concentrations, in mature, healthy horses. Eight thoroughbred mares were studied during a 2-h hyperinsulinemic clamp procedure, conducted at each of 4 rates of insulin infusion: 0 (CON), 1.2 (LOWINS), 3 (MEDINS), and 6 (HIGHINS) mU · kg(-1) · min(-1). The infusion rate of a dextrose solution was adjusted throughout the clamp procedures to maintain blood glucose levels within 10% of baseline glucose concentrations. Plasma insulin concentrations were measured throughout the clamp procedures, and used with the rate of glucose infusion to calculate the plasma insulin concentration-to-rate of glucose infusion ratio, a measure of insulin action on glucose disposal. The rate of glucose infusion increased with rate of insulin infusion (P 0.05). The data indicate that it is important to standardize insulin infusion rate if data are to be compared between hyperinsulinemic clamp studies. PMID:24315754

Urschel, K L; Escobar, J; McCutcheon, L J; Geor, R J

2014-04-01

74

Effects of sitagliptin and metformin treatment on incretin hormone and insulin secretory responses to oral and "isoglycemic" intravenous glucose  

DEFF Research Database (Denmark)

Dipeptidyl peptidase-4 (DPP-4) inhibitors prevent degradation of incretin hormones (glucagon-like peptide 1 [GLP-1] and glucose-dependent insulinotropic polypeptide [GIP]), whereas metformin may increase GLP-1 levels. We examined, in a four-period crossover trial, the influence of metformin (2,000 mg/day), sitagliptin (100 mg/day), or their combination, on GLP-1 responses and on the incretin effect in 20 patients with type 2 diabetes, comparing an oral glucose challenge (75 g, day 5) and an "isoglycemic" intravenous glucose infusion (day 6). Fasting total GLP-1 was significantly increased by metformin and not changed by sitagliptin. After oral glucose, metformin increased and sitagliptin significantly decreased (by 53%) total GLP-1. Fasting and postload intact GLP-1 increased with sitagliptin but not with metformin. After oral glucose, only sitagliptin, but not metformin, significantly augmented insulin secretion, in monotherapy and as an add-on to metformin. The incretin effect was not changed numerically with any of the treatments. In conclusion, sitagliptin increased intact GLP-1 and GIP through DPP-4 inhibition but reduced total GLP-1 and GIP (feedback inhibition) without affecting the numerical contribution of the incretin effect. Insulin secretion with sitagliptin treatment was similarly stimulated with oral and "isoglycemic" intravenous glucose. This points to an important contribution of small changes in incretin concentrations within the basal range or to additional insulinotropic agents besides GLP mediating the antidiabetic effects of DPP-4 inhibition.

Deacon, Carolyn F; Holst, Jens Juul

2014-01-01

75

A comparison of the effects of intravenous propranolol and nadolol on the renal response to hypertonic saline infusion.  

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Intravenous loading with 500 ml of 2.7% saline increased the clearance of PAH and inulin and urine sodium excretion in 14 healthy subjects. Intravenous propranolol (0.075 and 0.15 mg/kg) did not alter PAH or inulin clearance at rest but abolished the increase expected during saline infusion. There was no consistent effect on urinary sodium excretion. Intravenous nadolol (0.05 and 0.75 mg/kg) reduced resting PAH and inulin clearances by up to 25%. Both clearances fell significantly during sali...

1985-01-01

76

Glucose-Insulin-Potassium infusion for ischemic stroke: a placebo controlled randomized clinical trial  

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"nBackground: Hyperglycemia after acute stroke is a common finding that has been associated with an increased risk of death. For the last several years, it was believed that post-stroke hyperglycemia may worsen brain infarction in animal models. According to previous studies, the anti-inflammatory effect of insulin has a protective role on ischemic tissues. Glucose-insulin-potassium (GIK) infusions can be safely administered to acute stroke patients with mild to moderate hyperglycemia pr...

Kahnouji H, Ghorbani A.

2008-01-01

77

Response of colo-rectal hepatic metastases to concomitant radiotherapy and intravenous infusion 5 fluorouracil  

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Twenty-three patients with colo-rectal hepatic metastases were retrospectively reviewed after completing treatment with split course liver irradiation and continually infused concomitant intravenous 5-fluorouracil. Although no patient attained a complete response, an objective partial response was documented in 15 (Responders). The Responders had a median survival of 45 weeks whereas Non-responders had a median survival of 17 weeks. Patients with metastatic disease solely in the liver or those with a Karnofsky performance score (k.p.s) of over sixty, had a median survival of 49 weeks. Patients with multiple organ metastatic involvement had a median survival of 25 weeks and those with a Karnofsky with less than 60 had a median survival of 27 weeks. (p values of 0.006 and 0.03, respectively.) The overall survival of the group completing treatment was 30 weeks, and 19 patients (83%) achieved subjective palliation. The patients tolerated therapy well. There was minimal hematological toxicity; 3 patients developed a leucocyte count of less than 2000 and 1 developed a platelet count of 30,000. The palliation and prolongation of survival attained with minimal complications suggest that adjuvant liver irradiation with concomitant infusion 5-fluorouracil radiosensitization may be an option to offer patients identified to be at high risk of developing subclinical liver disease.

Rotman, M.; Kuruvilla, A.M.; Choi, K.; Bhutiani, I.; Aziz, H.; Rosenthal, J.; Braverman, A.; Marti, J.; Brandys, M.

1986-12-01

78

Response of colo-rectal hepatic metastases to concomitant radiotherapy and intravenous infusion 5 fluorouracil  

International Nuclear Information System (INIS)

Twenty-three patients with colo-rectal hepatic metastases were retrospectively reviewed after completing treatment with split course liver irradiation and continually infused concomitant intravenous 5-fluorouracil. Although no patient attained a complete response, an objective partial response was documented in 15 (Responders). The Responders had a median survival of 45 weeks whereas Non-responders had a median survival of 17 weeks. Patients with metastatic disease solely in the liver or those with a Karnofsky performance score (k.p.s) of over sixty, had a median survival of 49 weeks. Patients with multiple organ metastatic involvement had a median survival of 25 weeks and those with a Karnofsky with less than 60 had a median survival of 27 weeks. (p values of 0.006 and 0.03, respectively.) The overall survival of the group completing treatment was 30 weeks, and 19 patients (83%) achieved subjective palliation. The patients tolerated therapy well. There was minimal hematological toxicity; 3 patients developed a leucocyte count of less than 2000 and 1 developed a platelet count of 30,000. The palliation and prolongation of survival attained with minimal complications suggest that adjuvant liver irradiation with concomitant infusion 5-fluorouracil radiosensitization may be an option to offer patients identified to be at high risk of developing subclinical liver disease

1986-01-01

79

A case of necrolytic migratory erythema managed for 24 months with intravenous amino acid and lipid infusions.  

Science.gov (United States)

A 9-year-old castrated male Shetland sheepdog was diagnosed with necrolytic migratory erythema and hepatocutaneous syndrome. Necrolytic migratory erythema was treated with intermittent intravenous amino acids as needed to control cutaneous lesions. The addition of lipid infusions extended the treatment interval. The patient had a favorable response for 24 months. PMID:24155493

Bach, Jonathan F; Glasser, Seth A

2013-09-01

80

Explorative study of pharmacokinetics and pharmacodynamics after change in Basal insulin infusion rate  

DEFF Research Database (Denmark)

The use of insulin pumps is rapidly increasing and new, technologically more advanced pumps are continuously being developed. It is of interest to assess the clinical relevance of the many technical features of these pumps, e.g., the effect on pharmacokinetics and pharmacodynamics with change in infusion rate.

Ihlo, Charlotte A; Lauritzen, Torsten

2011-01-01

 
 
 
 
81

The Experiences of School Nurses Caring for Students Receiving Continuous Subcutaneous Insulin Infusion Therapy  

Science.gov (United States)

Diabetes mellitus is the most common metabolic disorder in childhood. Today, children with diabetes are receiving new technologically advanced treatment options, such as continuous subcutaneous insulin infusion (CSII) therapy. School nurses are the primary health caregivers of children with diabetes during school hours. Therefore, it is important…

Darby, Wendy

2006-01-01

82

Glucose-Insulin-Potassium infusion for ischemic stroke: a placebo controlled randomized clinical trial  

Directory of Open Access Journals (Sweden)

Full Text Available "nBackground: Hyperglycemia after acute stroke is a common finding that has been associated with an increased risk of death. For the last several years, it was believed that post-stroke hyperglycemia may worsen brain infarction in animal models. According to previous studies, the anti-inflammatory effect of insulin has a protective role on ischemic tissues. Glucose-insulin-potassium (GIK infusions can be safely administered to acute stroke patients with mild to moderate hyperglycemia producing a physiological but attenuated glucose response to acute stroke, the effectiveness of which remains to be elucidated. In this study, we compared the effects of GIK infusion vs. placebo in ischemic stroke patients."n"nMethods: In this double blind randomized controlled trial, the intervention group consisted of 48 patients who received GIK infusion for 24 hours and the control group included 50 patients who received normal saline infusion for 24 hours. All patients had been admitted to Shariati Hospital during the first 24 hours after the onset of ischemic stroke. At one and three months after the treatment, patients were examined for morbidity and mortality using the Bethel and Modified- Rankin-Scale (MRS questionnaires."n"nResults: GIK infusions significantly reduced plasma glucose concentrations. Statistically significant differences between the two groups were observed for disability and mortality. However, in spite of the protective effects of insulin and adverse effect of hyperglycemia in ischemic tissues, we observed no significant therapeutic effect from the GIK solution on patient outcome."n"nConclusions: Although hyperglycemia following acute stroke has been associated with subsequent mortality and impaired neurological recovery, the maintenance of euglycemia in the acute phase has not been shown to improve prognosis. According to this study, GIK infusion has no significant clinical benefit on the outcome of stroke patients. Thus, we cannot recommend routine use of GIK infusion in post-stroke hyperglycemia as an adjuvant treatment for ischemic stroke."n"n

Kahnouji H, Ghorbani A, Yousefi N, Alaleh A

2008-07-01

83

Intravenous Suitability Studies of Commonly Used Oxacillin Sodium Solutions in the ACCUFUSER® Infusion Device  

Directory of Open Access Journals (Sweden)

Full Text Available Our study compares two commonly used solutions of oxacillin sodium, 5.0 mg/mL in either 0.9% sodium chloride (NS or 5% dextrose water (D5W, for their continued suitability for IV usage, and stability of active compound over time, when stored at two different controlled temperatures for six weeks. Both solutions were stored in an intravenous infusion device commercially available as Accufuser® and kept at a continuously maintained temperature of either 4 ± 2?C (CT or 25 ± 2?C (RT. Suitability for IV administration was assessed by measuring changes in macrographical transparency and pH over time, and drug stability was assessed by measuring changes in oxacillin concentration over time using high-performance liquid chromatography (HPLC. After 6 weeks, concentrations of oxacillin were unchanged in the CT solutions, while both RT solutions showed significant decreases in the concentration of oxacillin after only two weeks. Final concentration compared to starting concentrations after 6 weeks at RT, were 36.57% in NS, while virtually no oxacillin was detectable in D5W. Also pH measurements showed a slight decrement at 2 weeks with RT, and at 6 weeks, there was a significant change in pH in both NS and D5W at RT. There was no significant change in color, transparency or appearance after 6 weeks in any of the oxacillin solutions stored in the Accufuser® infusion device. In summary, two commonly used IV solutions for oxacillin administration(5 mg/mL in NS or D5W stored ready to use in the Accufuser® showed significant changes over time when maintained at RT, that would make the solutions inappropriate for therapeutic use. Both solutions when maintained in CT were not significantly altered and continued to be appropriate in pH and drug concentration for IV therapy. This suggests that ready-to-use solutions of oxacillin sodium in the Accufuser® infusion device can be kept at CT for up to 6 weeks safely but should not be stored at RT due to loss of potency and changes in pH.

Min-Jeong Kim

2011-07-01

84

The safety and tolerability of different intravenous administrations of levetiracetam, bolus versus infusion, in intensive care unit patients.  

Science.gov (United States)

This study reviews our experience with the safety and tolerability of levetiracetam (LVM) with different methods of intravenous administration in intensive care unit (ICU) patients. We used retrospective chart review to identify 33 ICU patients who received intravenous LVM for treatment of seizures. Collected data included age, gender, diagnosis on admission, dosing regimen, documented seizure activity, adverse reactions, concomitant use of other antiepileptic drugs, and condition on discharge. A total of 33 ICU patients were given intravenous (IV) LVM as add-on treatment to standard regimen for treatment of breakthrough seizures or status epilepticus or given as preventive medication postoperatively. Among these 33 patients, 16 received intravenous LVM as bolus, and 17 received intravenous LVM as continuous infusion. Safety and tolerability of intravenous LVM were evaluated on the basis of the occurrence of adverse or side effects reported in daily progress notes of the physicians and nurses. There were no significant adverse or side effects reported in daily progress notes. The addition of intravenous LVM to the standard regimen for controlling seizures in ICU patients seems feasible and tolerable. PMID:24357676

Burakgazi, Evren; Bashir, Sairah; Doss, Vindoth; Pellock, Jack

2014-04-01

85

Risk and benefits of continuous subcutaneous insulin infusion (CSII) treatment in school children and adolescents.  

Science.gov (United States)

Continuous subcutaneous insulin infusion (CSII) therapy with technically advanced modern insulin pumps is a treatment option enabling patients and multidisciplinary diabetes teams to achieve all current goals for the treatment of children and adolescents with type 1 diabetes mellitus (T1DM): near-normoglycemia, low rate of hypoglycemia, preventing or delaying long-term complications and increasing quality of life. Clinical studies demonstrate that CSII therapy reduces glycosylated hemoglobin A1c (HbA1c) with a concomitant decrease in the rate of hypoglycemic events, without excessive weight gain and with an increase of patients' treatment satisfaction in all pediatric age groups. With the development of continuous glucose sensing coupled with an insulin pump, patients can hope for an ever-increasing technological support for the management of insulin therapy in the foreseeable future. PMID:16774614

Battelino, Tadej

2006-08-01

86

Continuous subcutaneous insulin infusion in children and adolescents with type 1 diabetes: Do the benefits outweigh the risks?  

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Intensive management of diabetes is the gold standard in the treatment of children with type 1 diabetes. Novel insulin delivery techniques have been developed to improve the ability to administer multiple daily doses of insulin. Continuous subcutaneous insulin infusion (CSII) is a method of insulin delivery that is increasing in popularity. The present article reviews the risks and benefits of CSII in children. At this time, there is limited quality published evidence to make a definitive cla...

Toth, Gillian H.

2005-01-01

87

Therapeutic effect of intravenous infusion of perfluorocarbon emulsion on LPS-induced acute lung injury in rats.  

Science.gov (United States)

Acute lung injury (ALI) and its more severe form, acute respiratory distress syndrome (ARDS) are the leading causes of death in critical care. Despite extensive efforts in research and clinical medicine, mortality remains high in these diseases. Perfluorocarbon (PFC), a chemical compound known as liquid ventilation medium, is capable of dissolving large amounts of physiologically important gases (mainly oxygen and carbon dioxide). In this study we aimed to investigate the effect of intravenous infusion of PFC emulsion on lipopolysaccharide (LPS) induced ALI in rats and elucidate its mechanism of action. Forty two Wistar rats were randomly divided into three groups: 6 rats were treated with saline solution by intratracheal instillation (control group), 18 rats were treated with LPS by intratracheal instillation (LPS group) and the other 18 rats received PFC through femoral vein prior to LPS instillation (LPS+PFC group). The rats in the control group were sacrificed 6 hours later after saline instillation. At 2, 4 and 6 hours of exposure to LPS, 6 rats in the LPS group and 6 rats in LPS+PFC group were sacrificed at each time point. By analyzing pulmonary pathology, partial pressure of oxygen in the blood (PaO2) and lung wet-dry weight ratio (W/D) of each rat, we found that intravenous infusion of PFC significantly alleviated acute lung injury induced by LPS. Moreover, we showed that the expression of pulmonary myeloperoxidase (MPO), intercellular adhesion molecule-1 (ICAM-1) of endothelial cells and CD11b of polymorphonuclear neutrophils (PMN) induced by LPS were significantly decreased by PFC treatment in vivo. Our results indicate that intravenous infusion of PFC inhibits the infiltration of PMNs into lung tissue, which has been shown as the core pathogenesis of ALI/ARDS. Thus, our study provides a theoretical foundation for using intravenous infusion of PFC to prevent and treat ALI/ARDS in clinical practice. PMID:24489970

Hou, Shike; Ding, Hui; Lv, Qi; Yin, Xiaofeng; Song, Jianqi; Landén, Ning Xu; Fan, Haojun

2014-01-01

88

Thallium-201 scintigraphy after intravenous infusion of adenosine compared with exercise thallium testing in the diagnosis of coronary artery disease  

Energy Technology Data Exchange (ETDEWEB)

Adenosine is an endogenously produced compound that has significant effects as a coronary and systemic vasodilator. Previous studies suggest that intravenous infusion of adenosine, coupled with thallium-201 scintigraphy, may have specific value as a noninvasive means of evaluating coronary artery disease. The purpose of this study was to compare the diagnostic value of adenosine thallium testing with that of standard exercise thallium testing. One hundred subjects were studied with exercise thallium imaging and thallium imaging after adenosine infusion, including 47 with angiographically proved coronary artery disease and 53 control subjects. The overall sensitivity of the thallium procedures was 81% for the exercise study and 83% for the adenosine study (p = NS); the specificity was 74% for the exercise study and 75% for the adenosine study (p = NS). The diagnostic accuracy of the exercise study was 77% and that of the adenosine study was 79%. Ninety-four percent of subjects had an adverse effect due to the adenosine infusion; however, most of these effects were mild and well tolerated. All adverse effects abated within 30 to 45 s of the termination of the study, consistent with the very brief half-life of the agent. Thus, thallium-201 scintigraphy after intravenous infusion of adenosine has a diagnostic value similar to that of exercise thallium testing for evaluation of coronary artery disease. Adenosine thallium testing may be particularly useful in evaluating patients unable to perform treadmill exercise testing.

Coyne, E.P.; Belvedere, D.A.; Vande Streek, P.R.; Weiland, F.L.; Evans, R.B.; Spaccavento, L.J. (Department of Medicine, Wilford Hall United States Air Force Medical Center, Lackland Air Force Base, Texas (USA))

1991-05-01

89

Thallium-201 scintigraphy after intravenous infusion of adenosine compared with exercise thallium testing in the diagnosis of coronary artery disease  

International Nuclear Information System (INIS)

Adenosine is an endogenously produced compound that has significant effects as a coronary and systemic vasodilator. Previous studies suggest that intravenous infusion of adenosine, coupled with thallium-201 scintigraphy, may have specific value as a noninvasive means of evaluating coronary artery disease. The purpose of this study was to compare the diagnostic value of adenosine thallium testing with that of standard exercise thallium testing. One hundred subjects were studied with exercise thallium imaging and thallium imaging after adenosine infusion, including 47 with angiographically proved coronary artery disease and 53 control subjects. The overall sensitivity of the thallium procedures was 81% for the exercise study and 83% for the adenosine study (p = NS); the specificity was 74% for the exercise study and 75% for the adenosine study (p = NS). The diagnostic accuracy of the exercise study was 77% and that of the adenosine study was 79%. Ninety-four percent of subjects had an adverse effect due to the adenosine infusion; however, most of these effects were mild and well tolerated. All adverse effects abated within 30 to 45 s of the termination of the study, consistent with the very brief half-life of the agent. Thus, thallium-201 scintigraphy after intravenous infusion of adenosine has a diagnostic value similar to that of exercise thallium testing for evaluation of coronary artery disease. Adenosine thallium testing may be particularly useful in evaluating patients unable to perform treadmill exercise testing

1991-01-01

90

Guidelines for Application of Continuous Subcutaneous Insulin Infusion (Insulin Pump) Therapy in the Perioperative Period  

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Case reports indicate that diabetes patients receiving outpatient insulin pump therapy have been allowed to continue treatment during surgical procedures. Although allowed during surgery, there is actually little information in the medical literature on how to manage patients receiving insulin pump therapy during a planned surgical procedure. A multidisciplinary work group reviewed current information regarding the use of insulin pumps in the perioperative period. Although the work group iden...

Boyle, Mary E.; Seifert, Karen M.; Beer, Karen A.; Apsey, Heidi A.; Nassar, Adrienne A.; Littman, Stephanie D.; Magallanez, Janice M.; Schlinkert, Richard T.; Stearns, Joshua D.; Hovan, Michael J.; Cook, Curtiss B.

2012-01-01

91

Peripheral nerve function in patients with painful diabetic neuropathy treated with continuous subcutaneous insulin infusion.  

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In order to study the effects of improved metabolic control on painful diabetic polyneuropathy, 15 patients were treated with continuous subcutaneous insulin infusion over a 12 month period. Polyneuropathy was assessed by pain score, neurological examinations, nerve conduction studies and determination of sensory thresholds and cardiovascular reflexes. Improved metabolic control was confirmed by significantly improved levels of glycosylated haemoglobin (11.7 +/- 0.3% at entry to the study, to...

1987-01-01

92

Design of a safer approach to intravenous drug infusions: failure mode effects analysis  

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Objectives: A set of standard processes was developed for delivering continuous drug infusions in order to improve (1) patient safety; (2) efficiency in staff workflow; (3) hemodynamic stability during infusion changes, and (4) efficient use of resources. Failure modes effects analysis (FMEA) was used to examine the impact of process changes on the reliability of delivering drug infusions.

Apkon, M.; Leonard, J.; Probst, L.; Delizio, L.; Vitale, R.

2004-01-01

93

Tumor vascularity under hypertension induced by intravenous infusion of angiotensin II  

International Nuclear Information System (INIS)

We studied whether or not the blood flow of tumors was increased by AT-II-induced hypertension in patients. Angiograms of 51 patients before and after intravenous infusion of AT-II were compared carefully from 5 points of view which suggested increased tumor blood flow. These were, 1) Contraction of small arteries feeding normal tissue, 2) Enhanced visualization of tumor vessels, 3) Enhanced visualization of tumor stain, 4) Increase of venous return from tumor-bearing region, and 5) Enhanced visualization of metastatic lymph nodes. The results were as follows. Contractions of small arteries feeding normal tissue [Finding 1)] were observed in 34 cases (66.6 %) and enhanced visualization of tumor vessels, tumor stain and so on [Finding 2)-5] were observed in 18 cases (35.3 %). Concequently, an increase of tumor blood flow was suggested in 40 cases (78.4 %). Blood flow of human tumors and normal tissue during the full course of induced hypertension with AT-II were measures by means of radionuclide angiography (99mTc-RBC) and laser Doppler velocimetry. Activities of the tumor-bearing region and the mid-portion of the thigh (selected as normal tissue) were measured continuously by collimated scintillation detectors. In 26 measurements out of 31 (83.8 %), the activity in the thigh decreased promptly and returned to the baseline synchronously with the rise and fall of blood pressure. In contrast, in 11 measurements (34.4 %) the activity of the tumor-bearing region increased and returned to the baseline accompanying the change of blood pressure. Preliminary observations using laser Doppler velocimetry revealed an increase of blood flow in 5 tumors. In conclusion, the blood flow of human tumors was increased by AT-II, in agreement with the findings in animal tumors. (J.P.N.)

1986-01-01

94

Incretin hormone and insulin responses to oral versus intravenous lipid administration in humans  

DEFF Research Database (Denmark)

Context: The incretin effect is responsible for the higher insulin response to oral glucose than to iv glucose at matching glucose levels. It is notknownwhetherthis effect is restricted to glucose only. Objective: The aim of the study was to examine whether insulin and incretin hormone responses are higher after oral vs. iv challenge of a lipid emulsion with matching triglyceride levels in humans. Design, Settings, and Participants: A lipid emulsion (Intralipid) was administered orally (3 ml/kg) or iv (variable infusion rates to match triglyceride levels after oral ingestion) in healthy lean males (n 12) at a University Clinical Research Unit. Samples were collected during 300 min. Main Outcome Measures:Wemeasured the suprabasal area under the curve for insulin, glucagonlike peptide-1 (GLP-1), glucose-dependent insulinotropic polypeptide (GIP), and the insulin secretory rate based on C-peptide levels by deconvolution. Results: Triglyceride levels increased similarly after oral and iv lipid; also, glucose and free fatty acid levels were similar in the two tests. Oral lipid elicited a clear insulin and C-peptide response, whereas no insulin or C-peptide responses were observed during iv lipid. Total and intact GIP and GLP-1 levels both increased after oral lipid administration but were not significantly altered after iv lipid. Conclusions: At matching triglyceride levels and with no difference in glucose and free fatty acid levels, oral lipid ingestion but not iv lipid infusion elicits a clear insulin response in association with increased GIP and GLP-1 concentrations. This may suggest that the incretin hormones also contribute to the islet response to noncarbohydrate nutrients.

Lindgren, Ola; Carr, Richard D

2011-01-01

95

Strict glycemic control in diabetic dogs with closed-loop intraperitoneal insulin infusion algorithm designed for an artificial endocrine pancreas.  

Science.gov (United States)

The ultimate goal of the development of an artificial endocrine pancreas is to achieve long-term strict glycemic regulation. To establish the physiological insulin delivery route of the artificial endocrine pancreas, intraperitoneal insulin infusion may be important. For this purpose, we tried to develop a closed-loop intraperitoneal insulin infusion algorithm by analyzing the pharmacokinetics of intraperitoneal regular insulin absorption using a mathematical model. The parameters for this algorithm were calculated to simulate the plasma insulin profile after intraperitoneal insulin injection as closely as possible. To evaluate the appropriateness of this algorithm, we tried glycemic control after an oral glucose load of 2 g/kg or a meal load of 80 kcal/kg in diabetic dogs by applying the algorithm. With the use of the subcutaneous insulin lispro infusion algorithm, which we have previously reported, alloxan-induced diabetic dogs exhibited postprandial hyperglycemia and delayed hyperinsulinemia, followed by hypoglycemia after an oral glucose load of 2 g/kg. However, by using the intraperitoneal insulin infusion algorithm, excellent glycemic control (postprandial blood glucose levels of 9.1 +/- 0.8 mmol/l at 70 min and 3.8 +/- 0.3 mmol/l at 240 min, respectively) could be achieved without any associated delayed hyperinsulinemia or hypoglycemia. Glycemic excursion after a meal load of 80 kcal/kg was also controlled from 3.9 to 10.1 mmol/l. Our results confirm that the intraperitoneal insulin infusion algorithm in vivo is feasible and that this algorithm can be superior to the subcutaneous insulin lispro infusion algorithm in the regulation of blood glucose. PMID:14598126

Matsuo, Yasuto; Shimoda, Seiya; Sakakida, Michiharu; Nishida, Kenro; Sekigami, Taiji; Ichimori, Shinji; Ichinose, Kenshi; Shichiri, Motoaki; Araki, Eiichi

2003-01-01

96

Effect of glucose and insulin infusion on the myocardial extraction of a radioiodinated methyl-substituted fatty acid  

International Nuclear Information System (INIS)

We investigated the one-way. An extraction of 14-iodophenyl-tetradecanoic acid (BMTDA) in the canine heart under fasting conditions and during infusion of glucose plus insulin in eight an esthetized greyhound dogs. Myocardial extraction measurements were made with dual tracer approach, using Tc-99m albumin as reference tracer. Prior to, and during, infusion of 10% glucose and 25 units of regular insulin, heart rate, blood pressure, plasma glucose, insulin and free fatty acid levels were measured. Myocardial blood flow was determined using Sn-113 and Ru-103 radioactive microspheres. The mean extraction fraction of BMTDA was 0.38+-SEM 0.06 at baseline and increased to 0.44+-0.06 during hyperglycemia plus insulin (P<0.025). Plasma glucose and insulin were higher during the infusion (P<0.01) while plasma free fatty acids significantly declined (P<0.01). There were no changes in hemodynamics or myocardial blood flow during the infusion. We conclude that glucose and insulin infusion result in increased first-pass extraction fraction of radioiodinated BMTDA unaccompanied by changes in coronary flow or hemodynamics, implying an insulin-mediated augmented transport of BMTDA. (orig.)

1986-01-01

97

Effect of glucose and insulin infusion on the myocardial extraction of a radioiodinated methyl-substituted fatty acid  

Energy Technology Data Exchange (ETDEWEB)

We investigated the one-way. An extraction of 14-iodophenyl-tetradecanoic acid (BMTDA) in the canine heart under fasting conditions and during infusion of glucose plus insulin in eight an esthetized greyhound dogs. Myocardial extraction measurements were made with dual tracer approach, using Tc-99m albumin as reference tracer. Prior to, and during, infusion of 10% glucose and 25 units of regular insulin, heart rate, blood pressure, plasma glucose, insulin and free fatty acid levels were measured. Myocardial blood flow was determined using Sn-113 and Ru-103 radioactive microspheres. The mean extraction fraction of BMTDA was 0.38+-SEM 0.06 at baseline and increased to 0.44+-0.06 during hyperglycemia plus insulin. Plasma glucose and insulin were higher during the infusion while plasma free fatty acids significantly declined. There were no changes in hemodynamics or myocardial blood flow during the infusion. We conclude that glucose and insulin infusion result in increased first-pass extraction fraction of radioiodinated BMTDA unaccompanied by changes in coronary flow or hemodynamics, implying an insulin-mediated augmented transport of BMTDA.

Bianco, J.A.; Elmaleh, D.R.; Leppo, J.A.; King, M.A.; Moring, A.; Livni, E.; Espinoza, E.; Alpert, J.S.; Strauss, H.W.

1986-07-01

98

Validity of the reduced-sample insulin modified frequently-sampled intravenous glucose tolerance test using the nonlinear regression approach.  

Science.gov (United States)

The disposition index, the product of the insulin sensitivity index (S(I)) and the acute insulin response to glucose, is linked in African Americans to chromosome 11q. This link was determined with S(I) calculated with the nonlinear regression approach to the minimal model and data from the reduced-sample insulin-modified frequently-sampled intravenous glucose tolerance test (Reduced-Sample-IM-FSIGT). However, the application of the nonlinear regression approach to calculate S(I) using data from the Reduced-Sample-IM-FSIGT has been challenged as being not only inaccurate but also having a high failure rate in insulin-resistant subjects. Our goal was to determine the accuracy and failure rate of the Reduced-Sample-IM-FSIGT using the nonlinear regression approach to the minimal model. With S(I) from the Full-Sample-IM-FSIGT considered the standard and using the nonlinear regression approach to the minimal model, we compared the agreement between S(I) from the Full- and Reduced-Sample-IM-FSIGT protocols. One hundred African Americans (body mass index, 31.3 +/- 7.6 kg/m(2) [mean +/- SD]; range, 19.0-56.9 kg/m(2)) had FSIGTs. Glucose (0.3 g/kg) was given at baseline. Insulin was infused from 20 to 25 minutes (total insulin dose, 0.02 U/kg). For the Full-Sample-IM-FSIGT, S(I) was calculated based on the glucose and insulin samples taken at -1, 1, 2, 3, 4, 5, 6, 7, 8,10, 12, 14, 16, 19, 22, 23, 24, 25, 27, 30, 40, 50, 60, 70, 80, 90, 100, 120, 150, and 180 minutes. For the Reduced-Sample-FSIGT, S(I) was calculated based on the time points that appear in bold. Agreement was determined by Spearman correlation, concordance, and the Bland-Altman method. In addition, for both protocols, the population was divided into tertiles of S(I). Insulin resistance was defined by the lowest tertile of S(I) from the Full-Sample-IM-FSIGT. The distribution of subjects across tertiles was compared by rank order and kappa statistic. We found that the rate of failure of resolution of S(I) by the Reduced-Sample-IM-FSIGT was 3% (3/100). For the remaining 97 subjects, S(I) for the Full- and Reduced-Sample-IM-FSIGTs were as follows: 3.76 +/- 2.41 L mU(-1) min(-1) (range, 0.58-14.50) and 4.29 +/- 2.89 L mU(-1) min(-1) (range, 0.52-14.42); relative error, 21% +/- 18%; Spearman r = 0.97; and concordance, 0.94 (both P < .001). After log transformation, the Bland-Altman limits of agreement were -0.29 and 0.53. The exact agreement for distribution of the population in the insulin-resistant tertile vs the insulin-sensitive tertiles was 92%, kappa of 0.82 +/- 0.06. Using the nonlinear regression approach and data from the Reduced-Sample-IM-FSIGT in subjects with a wide range of insulin sensitivity, failure to resolve S(I) occurred in only 3% of subjects. The agreement and maintenance of rank order of S(I) between protocols support the use of the nonlinear regression approach to the minimal model and the Reduced-Sample-IM-FSIGT in clinical studies. PMID:19154955

Sumner, Anne E; Luercio, Marcella F; Frempong, Barbara A; Ricks, Madia; Sen, Sabyasachi; Kushner, Harvey; Tulloch-Reid, Marshall K

2009-02-01

99

Validity of the Reduced-Sample-Insulin-Modified-Frequently Sampled Intravenous Glucose Tolerance Test Using the Nonlinear Regression Approach  

Science.gov (United States)

The Disposition Index, the product of the insulin sensitivity index (SI) and the acute insulin response to glucose, is linked in African-Americans to chromosome 11q. This link was determined with SI calculated with the nonlinear regression approach to the minimal model and data from the Reduced-Sampled-Insulin-Modified-Frequently-Sampled-Intravenous-Glucose-Tolerance-Test (Reduced-Sample-IM-FSIGT). However, the application of the nonlinear regression approach to calculate SI using data from the Reduced-Sample-IM-FSIGT has been challenged as being not only inaccurate but also having a high failure rate in insulin-resistant subjects. Our goal was to determine the accuracy and failure rate of the Reduced-Sample-IM-FSIGT using the nonlinear regression approach to the minimal model. With SI from the Full-Sample-IM-FISGT considered the standard and using the nonlinear regression approach to the minimal model, we compared the agreement between SI from the Full and Reduced-Sample-IM-FSIGT protocols. One hundred African-Americans, (BMI 31.3±7.6 kg/m2 (mean±SD), range 19.0-56.9 kg/m2) had FSIGTs. Glucose (0.3g/kg) was given at baseline. Insulin was infused from 20 to 25 minutes (total insulin dose 0.02U/kg). For the Full-Sample-IM-FSIGT, SI was calculated based on the glucose and insulin samples taken at -1, 1, 2, 3, 4, 5, 6, 7, 8,10, 12, 14, 16, 19, 22, 23, 24, 25, 27, 30, 40, 50, 60, 70, 80, 90, 100, 120, 150, 180. For the Reduced-Sample-FSIGT, SI was calculated based on the timepoints which appear in bold. Agreement was determined by Spearman correlation, concordance and the Bland-Altman method. In addition, for both protocols, the population was divided into tertiles of SI. Insulin resistance was defined by the lowest tertile of SI from the Full-Sample-IM-FSIGT. The distribution of subjects across tertiles was compared by rank order and kappa statistic. We found that the rate of failure of resolution of SI by the Reduced-Sample-IM-FSIGT was 3%(3/100). For the remaining 97 subjects, SI for the Full and Reduced-Sample-IM-FSIGT were: 3.76±2.41 L.mU-1.min-1, range 0.58-14.50 and 4.29±2.89 L.mU-1.min-1, range 0.52-14.42, relative error 21±18%, Spearman r=0.97, concordance 0.94, (both P<0.001). After log transformation the Bland Altman limits of agreement were: -0.29 and 0.53. The exact agreement for distribution of the population in the insulin-resistant tertile versus the insulin-sensitive tertiles was 92%, kappa 0.82±0.06. Using the nonlinear regression approach and data from the Reduced-Sample-IM-FSIGT in subjects with a wide range of insulin sensitivity, failure to resolve SI occurred in only 3% of subjects. The agreement and maintenance of rank order of SI between protocols supports the use of the nonlinear regression approach to the minimal model and the Reduced-Sample-IM-FSIGT in clinical studies.

Sumner, Anne E.; Luercio, Marcella F.; Frempong, Barbara A.; Ricks, Madia; Sen, Sabyasachi; Kushner, Harvey; Tulloch-Reid, Marshall K.

2009-01-01

100

Economic Evaluation of Continuous Subcutaneous Insulin Infusion for Children with Diabetes—Part II  

Directory of Open Access Journals (Sweden)

Full Text Available The aim of this study is to assess long-term metabolic outcomes in children with diabetes mellitus and to compare the efficacy, feasibility and metabolic control expenses for treatment with continuous subcutaneous insulin infusion (CSII, compared to human insulin treatment. The study sample included 34 children aged 3 to 18 years with type 1 diabetes, 17 with continuous subcutaneous insulin infusion (CSII therapy and 17 with standard treatment with human insulin. The study observed for the following variables: duration of the disease, diabetic control, HbA1c deviation scores; height and weight deviation and price of the treatment. Methods applied include meta-analyses in the published medical literature, pharmacoeconomic analysis and statistical analysis. From the 34 children with diabetes type 1 observed retrospectively during the period 1999-2012, 17 were on CSII (mean age 10 years, mean duration of the disease—7 years, average usage of CSII—3 years. The test stripes cost 533 Euro/year (1100 stripes per year and their average cost according to the duration of the disease is 3779.45 Euro since diagnosis. The blood glucose monitoring system costs 20 Euro and for the duration of the disease—4.96 Euro per patient per year. The average improvement of HbA(1c after the CSII introduction is 1.85, while after the application of human insulin—0.28. The treatment with CSII leads to significant improvement in glycemic control compared to the treatment with human insulin. The reduced HbA(1c shows good diabetes management, from one point of view, and good quality of life—from another.

Elina Petkova

2013-10-01

 
 
 
 
101

Intravenous ATP infusions can be safely administered in the home setting: a study in pre-terminal cancer patients.  

Science.gov (United States)

The aim of the study was to investigate the safety of adenosine 5'-triphosphate (ATP) administration at home in pre-terminal cancer patients. Included were patients with cancer for whom medical treatment options were restricted to supportive care, who had a life expectancy of less than 6 months, a World Health Organization performance status 1 or 2, and suffered from at least one of the following complaints: fatigue, anorexia or weight loss >5% over the previous 6 months. Side effects were registered systematically on a standard form according to the National Cancer Institute (NCI) Common Toxicity Criteria. Fifty-one patients received a total of 266 intravenous ATP infusions. Of these, 11 infusions (4%) were given at the lowest dose of 20 microg kg(-1) min(-1), 85 infusions (32%) at 25-40 microg kg(-1) min(-1), and 170 (64%) at the highest dose of 45-50 microg kg(-1) min(-1) ATP. The majority of ATP infusions (63%) were without side effects. Dyspnea was the most common side effect (14% of infusions), followed by chest discomfort (12%) and the urge to take a deep breath (11%). No symptoms of cardiac ischemia occurred in any of the infusions. All side effects were transient and resolved within minutes after lowering the ATP infusion rate. Side effects were most frequent in the presence of cardiac disorders. We conclude that ATP at a maximum dose of 50 microg kg(-1) min(-1) can be safely administered in the home setting in patients with pre-terminal cancer. PMID:17786387

Beijer, Sandra; Gielisse, Eric A R; Hupperets, Pierre S; van den Borne, Ben E E M; van den Beuken-van Everdingen, Marieke; Nijziel, Marten R; van Henten, Arjen M J; Dagnelie, Pieter C

2007-12-01

102

Closed-loop subcutaneous insulin infusion algorithm with a short-acting insulin analog for long-term clinical application of a wearable artificial endocrine pancreas.  

Science.gov (United States)

Considering the management and safety of the insulin delivery route when a wearable artificial endocrine pancreas is applied to ambulatory diabetic patients on a long-term basis, we developed a s.c. insulin infusion algorithm by analyzing the dynamics of a s.c. injected short-acting insulin analog (Insulin Lispro) by a three-compartment model. Principally the insulin infusion algorithm was developed as a transfer function with the first-order delay in both proportional and derivative actions to blood glucose concentrations. The parameters for this algorithm were calculated to simulate a physiological plasma insulin profile as closely as possible. By applying this algorithm with regular insulin, diabetic patients showed a 2 h postprandial hyperglycemia and a delayed hyperinsulinemia, followed by hypoglycemic episodes 4-5 h after oral glucose load, just as observed in the computer simulation study. However, using Insulin Lispro, a near-physiological glycemic control (postprandial blood glucose of 153.1 +/- 8.3 mg/100 ml at 60 min and 90.3 +/- 7.1 mg/100 ml at 180 min, respectively) could be achieved without showing any delayed hyperinsulinemia or hypoglycemia. Daily glycemic excursions were also controlled near-physiologically and although the daily insulin requirement (731.7 +/- 160.5 mU/kg/day) was slightly higher, it was not significantly different from that with i.v. insulin infusion (622.3 +/- 142.6 mU/kg/day). These results indicate that the application of s.c. insulin infusion algorithm with Insulin Lispro is feasible for long-term glycemic control with a wearable artificial endocrine pancreas in ambulatory diabetic patients. PMID:9444512

Shimoda, S; Nishida, K; Sakakida, M; Konno, Y; Ichinose, K; Uehara, M; Nowak, T; Shichiri, M

1997-01-01

103

A pilot study of nalbuphine versus tramadol administered through continuous intravenous infusion for postoperative pain control in children.  

Science.gov (United States)

Nalbuphine and tramadol are potent analgesic drugs. Our aim was to preliminarily assess and compare the efficacy and safety of nalbuphine and tramadol for postoperative analgesia in children. In a double-blind design, 24 ASA 1-3 children aged 1 to 10 years undergoing a scheduled surgical procedure were randomly allocated to receive either an intravenous bolus dose of nalbuphine 100 microg/kg immediately before the end of surgery followed by an infusion of 0.2 microg/kg/min for 72 hrs., or an intravenous bolus dose of tramadol 1000 microg/kg followed by an infusion of 2.0 microg/kg/min for 72 hrs. Postoperative pain control and drug-related adverse events were recorded. Three children who received nalbuphine required an extra bolus dose within the 12 hrs. of post-surgery versus one child in the tramadol group. A similar number of patients in both groups required an increment in the infusion rate within the 72 post-surgery hours. Sedation was observed in 2 children in the nalbuphine group and in 1 child in the tramadol group. Four children presented vomiting with tramadol and two with nalbuphine. Cardiovascular parameters remained within the normal ranges in both groups. In conclusion, the bolus/infusion regimen of tramadol evaluated in this study appears to have better postoperative analgesic efficacy than the bolus/infusion regimen of nalbuphine. These preliminary results require further confirmation by studies with a sample size enough to clearly identify differences in their efficacy as well as in the rate of adverse events secondary to the administration of each of them. PMID:19848049

Moyao-García, Diana; Hernández-Palacios, Juan C; Ramírez-Mora, Juan C; Nava-Ocampo, Alejandro A

2009-08-01

104

Overnight versus 24 hours of continuous subcutaneous insulin infusion as supplement to oral antidiabetic drugs in type 2 diabetes  

DEFF Research Database (Denmark)

Basal continuous subcutaneous insulin infusion (CSII) therapy at a fixed rate may effectively improve glycemic control in patients with type 2 diabetes when oral antidiabetic treatment fails. Regimens of simple constant subcutaneous delivery of insulin may provide theoretical advantages in type 2 diabetes.

Parkner, Tina; Laursen, Torben

2007-01-01

105

A Case of Malignant Melanoma with In-Transit Metastasis That Responded to Intravenous Infusion of Interferon-?  

Science.gov (United States)

A 77-year-old man with a history of surgical resection of malignant melanoma involving the fifth toe of his left foot 14 years ago presented at the Kariya Toyota General Hospital with a 3-month history of skin ulcer at the same site and red nodules on the lower left leg. Malignant melanoma was suspected, and the patient was referred to our department. On examination, a skin ulcer measuring 25 × 20 mm was observed at the amputation site on the left foot. In addition, multiple red nodules were observed on the lower left leg. Skin biopsies of the ulcer and nodules revealed recurrent malignant melanoma with in-transit metastasis. Two weeks later, he developed acute myocardial infarction and was hospitalized at the Kariya Toyota General Hospital. One month later, the myocardial infarction ameliorated, and he was transferred to our department. As the myocardial infarction had decreased the patient's tolerance to surgery, interferon-? was administered by intravenous infusion. The skin ulcer and red nodules on the lower left leg disappeared 26 weeks after infusion had been initiated. The patient's progress has been satisfactory, with no evidence of recurrence or metastasis at 1 year and 9 months after the initiation of intravenous infusion.

Arima, Masaru; Iwata, Youhei; Morita, Yusuke; Kobayashi, Tsukane; Sasaki, Ryousuke; Suzuki, Kayoko; Matsunaga, Kayoko

2014-01-01

106

A Case of Malignant Melanoma with In-Transit Metastasis That Responded to Intravenous Infusion of Interferon-?.  

Science.gov (United States)

A 77-year-old man with a history of surgical resection of malignant melanoma involving the fifth toe of his left foot 14 years ago presented at the Kariya Toyota General Hospital with a 3-month history of skin ulcer at the same site and red nodules on the lower left leg. Malignant melanoma was suspected, and the patient was referred to our department. On examination, a skin ulcer measuring 25 × 20 mm was observed at the amputation site on the left foot. In addition, multiple red nodules were observed on the lower left leg. Skin biopsies of the ulcer and nodules revealed recurrent malignant melanoma with in-transit metastasis. Two weeks later, he developed acute myocardial infarction and was hospitalized at the Kariya Toyota General Hospital. One month later, the myocardial infarction ameliorated, and he was transferred to our department. As the myocardial infarction had decreased the patient's tolerance to surgery, interferon-? was administered by intravenous infusion. The skin ulcer and red nodules on the lower left leg disappeared 26 weeks after infusion had been initiated. The patient's progress has been satisfactory, with no evidence of recurrence or metastasis at 1 year and 9 months after the initiation of intravenous infusion. PMID:24707255

Arima, Masaru; Iwata, Youhei; Morita, Yusuke; Kobayashi, Tsukane; Sasaki, Ryousuke; Suzuki, Kayoko; Matsunaga, Kayoko

2014-01-01

107

Toxicity of Guanazole (NSC 1895) Administered by 48-Hour Intravenous Infusions in Dogs.  

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Two dogs were administered 5.0 gm/kg Guanazole, Triazole 3,5-diamino-S (NSC 1895) by 48-hour i.v. infusion followed by an observation period of 183 days and a second infusion of 7.5 gm/kg. Clinical signs were minimal but liver damage was indicated by tran...

P. E. Palm E. P. Arnold P. C. Rachwall C. J. Kensler

1972-01-01

108

Vasoactive intestinal peptide and secretin: effects of combined and separate intravenous infusions on bile secretion in man  

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The effects of intravenously administered vasoactive intestinal peptide (VIP) and secretin on bile secretion were studied in 12 patients with complete biliary fistulas. The two peptides were administered both simultaneously and separately. During VIP infusion, bile volume increased by 60%, and during the combined VIP and secretin infursion bile volume increased by another 70%. VIP increased bile bicarbonate concentration by some 30%. Although secretin did not increase the concentration, bicarbonate output increased threefold during secretin infusion but only twofold during VIP infusion. The outputs of bile acids were not significantly affected by the two peptides, whereas the concentration decreased by 40% and 70% after VIP and secretin, respectively. The canalicular bile flow, measured by ({sup 14}C)erythritol, was unaffected by VIP infusion, whereas secretin alone and the combination of the two peptides increased the canalicular clearance by 80%. The choleretic effect of VIP thus seems to occur only at the ductular level. Secretin exerts its effect at the ductular level and possibly also at the canalicular level. It is concluded that the two peptides have additive effects on the ductular bile flow.. 32 refs., 5 figs., 5 tabs.

Nyberg, B.; Sonnenfeld, T.; Einarsson, K. (Karolinska Inst., Stockholm (Sweden))

1991-01-01

109

Vasoactive intestinal peptide and secretin: effects of combined and separate intravenous infusions on bile secretion in man  

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The effects of intravenously administered vasoactive intestinal peptide (VIP) and secretin on bile secretion were studied in 12 patients with complete biliary fistulas. The two peptides were administered both simultaneously and separately. During VIP infusion, bile volume increased by 60%, and during the combined VIP and secretin infursion bile volume increased by another 70%. VIP increased bile bicarbonate concentration by some 30%. Although secretin did not increase the concentration, bicarbonate output increased threefold during secretin infusion but only twofold during VIP infusion. The outputs of bile acids were not significantly affected by the two peptides, whereas the concentration decreased by 40% and 70% after VIP and secretin, respectively. The canalicular bile flow, measured by [14C]erythritol, was unaffected by VIP infusion, whereas secretin alone and the combination of the two peptides increased the canalicular clearance by 80%. The choleretic effect of VIP thus seems to occur only at the ductular level. Secretin exerts its effect at the ductular level and possibly also at the canalicular level. It is concluded that the two peptides have additive effects on the ductular bile flow.. 32 refs., 5 figs., 5 tabs

1991-01-01

110

Validity of the Reduced-Sample-Insulin-Modified-Frequently Sampled Intravenous Glucose Tolerance Test Using the Nonlinear Regression Approach  

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The Disposition Index, the product of the insulin sensitivity index (SI) and the acute insulin response to glucose, is linked in African-Americans to chromosome 11q. This link was determined with SI calculated with the nonlinear regression approach to the minimal model and data from the Reduced-Sampled-Insulin-Modified-Frequently-Sampled-Intravenous-Glucose-Tolerance-Test (Reduced-Sample-IM-FSIGT). However, the application of the nonlinear regression approach to calculate SI using data from t...

2009-01-01

111

IN VITRO EFFECTS OF INTRAVENOUS PROPOFOL INFUSION ON CYTOKINE GENE EXPRESSION IN RATS  

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Full Text Available Objective: The aim of this study was to evaluate the effects of propofol infusion on cytokine gene expression levels of bone marrow and mesentheric lymph nodes in rats after surgical trauma.Methods: Twenty male Sprague-Dawley rats weighing between 300-320 g were divided into two groups (n=10. Midline laparatomy incision was performed to both groups. Group I received 5 ml/kg/hr iv serum physiologic infusion. Group II received 5 mg/kg/hr iv propofol infusion. After infusions, mesentheric lymph node and bone marrow samples were obtained for the measurement of IL-1, IL-6 and TNF? gene expression levels by real time polymerase chain reaction (RT-PCR method. Results: IL-1 (p<0.002 and TNF? (p<0.018 levels of the mesentheric lymph node were significantly lower in group II compared with group I. TNF? gene expression level in the bone marrow was also significantly lower in group II compared with group I (p<0.0015.Conclusion: Propofol infusion during surgery caused significantly more proinflammatory cytokine gene expression supression in mesentheric lymph nodes compared to bone marrow in rats. We concluded that propofol infusion may have a limited and especially local immune supressive effect.

Emel Özveren

2008-01-01

112

Influence of insulin antibodies on pharmacokinetics and bioavailability of recombinant human and highly purified beef insulins in insulin dependent diabetics.  

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Sixteen insulin dependent diabetics of long standing, with undetectable fasting plasma C peptide concentrations, and eight non-diabetic controls were each infused intravenously with biosynthetic human and highly purified beef insulin (1 mU/kg/min) while euglycaemia was maintained by a Biostator. No difference was observed between the two insulins in respect of insulin pharmacokinetics or biological action. The diabetics showed appreciable insulin resistance, manifested by a 40% reduction in t...

1985-01-01

113

An insulin infusion advisory system for type 1 diabetes patients based on non-linear model predictive control methods.  

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In this paper, an Insulin Infusion Advisory System (IIAS) for Type 1 diabetes patients, which use insulin pumps for the Continuous Subcutaneous Insulin Infusion (CSII) is presented. The purpose of the system is to estimate the appropriate insulin infusion rates. The system is based on a Non-Linear Model Predictive Controller (NMPC) which uses a hybrid model. The model comprises a Compartmental Model (CM), which simulates the absorption of the glucose to the blood due to meal intakes, and a Neural Network (NN), which simulates the glucose-insulin kinetics. The NN is a Recurrent NN (RNN) trained with the Real Time Recurrent Learning (RTRL) algorithm. The output of the model consists of short term glucose predictions and provides input to the NMPC, in order for the latter to estimate the optimum insulin infusion rates. For the development and the evaluation of the IIAS, data generated from a Mathematical Model (MM) of a Type 1 diabetes patient have been used. The proposed control strategy is evaluated at multiple meal disturbances, various noise levels and additional time delays. The results indicate that the implemented IIAS is capable of handling multiple meals, which correspond to realistic meal profiles, large noise levels and time delays. PMID:18003374

Zarkogianni, Konstantia; Mougiakakou, Stavroula G; Prountzou, Aikaterini; Vazeou, Andriani; Bartsocas, Christos S; Nikita, Konstantina S

2007-01-01

114

Acute Cardiovascular Effects of Isoxazole (NSC-163501) Following Continuous Intravenous Infusion to Anesthetized Beaglehounds.  

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Acute cardiovascular effects of Isoxazole (NSC-163501) given, intravenously, in doses of 50, 100, or 200 mg/kg, were monitored in healthy anesthetized beaglehounds. Records of cardiovascular function were monitored during two control periods, and at 5, 20...

R. L. Hamlin F. S. Pipers P. Mihalko R. M. Folk T. Gram

1978-01-01

115

Changes in atrial natriuretic peptide concentrations during intravenous saline infusion in hypoxic cor pulmonale.  

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BACKGROUND: The pathogenesis of oedema in hypoxic cor pulmonale is poorly understood. One possibility is a failure of atrial natriuretic peptide release, leading to salt and water retention. This hypothesis was tested by observing the response to an intravenous saline challenge in patients with and without cor pulmonale. METHODS: Plasma atrial natriuretic peptide concentrations were measured before and for three hours after an intravenous saline load (0.1 ml 2.7% saline/kg/min for 60 minutes)...

1991-01-01

116

Consumption of Ocimum sanctum L. and Citrus paradisi infusions modulates lipid metabolism and insulin resistance in obese rats.  

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A high saturated fat and fructose diet leads to metabolic disorders through dysregulation of genes involved in lipid metabolism. Consumption of plant infusions reduces these obesity alterations, but the precise mechanism remains unclear. In this study, we investigated the effect and the possible mechanism of Ocimum sanctum L. (OS) and Citrus paradisi (CP) infusions in diet-induced obese rats. CP and OS infusions suppressed hepatic tissue fat accumulation, and significantly down-regulated the mRNA levels of two hepatic lipogenesis genes: sterol regulatory element binding protein 1c (SREBP1c) and fatty acid synthase (FAS) compared with the obese control. Treatment with these infusions up-regulated the hepatic expression of mRNA related to mitochondrial fatty acid uptake: peroxisome proliferator activated receptor alpha (PPAR?) and the expression of carnitine palmitoyl-transferase 1a (CPT1a). Both infusions improved insulin resistance, with OS showing the major effect. Consumption of these infusions reduces the damage caused by free radicals, protecting hepatic lipids and proteins. Additionally, plant infusions increase activity of hepatic enzymes: glutathione S-transferase (GST), glutathione peroxidase (GPX), and catalase (CAT). Our results suggest that the effects of CP and OS infusions on lipid metabolism are related to the down-regulation of genes involved in lipogenesis, particularly for OS, and to the increase in lipid ?-oxidation, especially for CP infusion. In conclusion, the consumption of these plant infusions is a feasible adjuvant therapy for metabolic changes induced by obesity. PMID:24584283

Gamboa-Gómez, Claudia; Salgado, Luis M; González-Gallardo, Adriana; Ramos-Gómez, Minerva; Loarca-Piña, Guadalupe; Reynoso-Camacho, Rosalía

2014-04-23

117

Short-lasting systemic and regional benefits of early crystalloid infusion after intravenous inoculation of dogs with live Escherichia coli  

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Full Text Available We investigated the systemic and regional hemodynamic effects of early crystalloid infusion in an experimental model of septic shock induced by intravenous inoculation with live Escherichia coli. Anesthetized dogs received an intravenous infusion of 1.2 x 10(10 cfu/kg live E. coli in 30 min. After 30 min of observation, they were randomized to controls (no fluids; N = 7, or fluid resuscitation with lactated Ringer's solution, 16 ml/kg (N = 7 or 32 ml/kg (N = 7 over 30 min and followed for 120 min. Cardiac index, portal blood flow, mean arterial pressure, systemic and regional oxygen-derived variables, blood lactate, and gastric PCO2 were assessed. Rapid and progressive cardiovascular deterioration with reduction in cardiac output, mean arterial pressure and portal blood flow (~50, ~25 and ~70%, respectively was induced by the live bacteria challenge. Systemic and regional territories showed significant increases in oxygen extraction and in lactate levels. Significant increases in venous-arterial (~9.6 mmHg, portal-arterial (~12.1 mmHg and gastric mucosal-arterial (~18.4 mmHg PCO2 gradients were also observed. Early fluid replacement, especially with 32 ml/kg volumes of crystalloids, promoted only partial and transient benefits such as increases of ~76% in cardiac index, of ~50% in portal vein blood flow and decreases in venous-arterial, portal-arterial, gastric mucosal-arterial PCO2 gradients (7.2 ± 1.0, 7.2 ± 1.3 and 9.7 ± 2.5 mmHg, respectively. The fluid infusion promoted only modest and transient benefits, unable to restore the systemic and regional perfusional and metabolic changes in this hypodynamic septic shock model.

A.G. Garrido

2005-06-01

118

Intravenous infusions of glucose stimulate key lipogenic enzymes in adipose tissue of dairy cows in a dose-dependent manner.  

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The present study was investigated whether increasing amounts of glucose supply have a stimulatory effect on the mRNA abundance and activity of key lipogenic enzymes in adipose tissue of midlactation dairy cows. Twelve Holstein-Friesian dairy cows in midlactation were cannulated in the jugular vein and infused with either a 40% glucose solution (n=6) or saline (n=6). For glucose infusion cows, the infusion dose increased by 1.25%/d relative to the initial net energy for lactation (NEL) requirement until a maximum dose equating to a surplus of 30% NEL was reached on d 24. This maximum dose was maintained until d 28 and stopped thereafter (between d 29-32). Cows in the saline infusion group received an equivalent volume of 0.9% saline solution. Samples of subcutaneous adipose tissue were taken on d 0, 8, 16, 24, and 32 when surplus glucose reached 0, 10, 20, and 30% of the NEL requirement, respectively. The mRNA abundance of fatty acid synthase, cytoplasmic acetyl-coenzyme A synthetase, cytoplasmic glycerol 3-phosphate dehydrogenase-1, and glucose 6-phosphate dehydrogenase showed linear treatment × dose interactions with increasing mRNA abundance with increasing glucose dose. The increased mRNA abundance was paralleled by a linear treatment × dose interaction for fatty acid synthase and acetyl-coenzyme A synthetase enzymatic activities. The mRNA abundance of ATP-citrate lyase showed a tendency for linear treatment × dose interaction with increasing mRNA abundance with increasing glucose dose. The mRNA abundance of all tested enzymes, as well as the activities of fatty acid synthase and acetyl-coenzyme A synthetase, correlated with plasma glucose and serum insulin levels. In a multiple regression model, the predictive value of insulin was dominant over that of glucose. In conclusion, gradual increases in glucose supply upregulate key lipogenic enzymes in adipose tissue of midlactating dairy cows with linear dose dependency. Insulin appears to be critically involved in this regulation. PMID:23660139

Carra, Mirja; Al-Trad, Bahaa; Penner, Gregory B; Wittek, Thomas; Gäbel, Gotthold; Für, Manfred; Aschenbach, Jörg R

2013-07-01

119

Evaluation of the Effect of Intravenous Lidocaein Infusion on Postoperative Analgesia after Cesarean Section under Spinal Anesthesia  

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Full Text Available Introduction & Objective: Many surgical patients still experience moderate to severe pain after surgery despite efforts to administer new drugs and techniques. Postoperative analgesia clearly enhances patient’s satisfaction and facilitates earlier mobilization and rehabilitation. lidocaein has been introduced as part of post operative pain management and clinical studies revealed analgesic actions in patients with chronic neuropathic pain. Our goal in this study was to determine the effect of intravenous lidocaein on post operative pain of women under-going cesarean section under spinal anesthesia. Materials & Methods: In this double blinded clinical trial study, 72 patients candidate for Ce-sarean section under spinal anesthesia were randomly selected and divided in two groups. In the case group, infusion of1.5 mg/kg lidocaein and in the control group infusion of the same volume normal saline started 15 minutes before the beginning of operation. After spinal anes-thesia with definite technique in both groups, infusion of 1.5 mg/kg/h lidocaein in case group and the same volume normal saline in the control group was administered and continued till 0.5 hour after finishing the operation. Data including systolic and diastolic blood pressure, heart rate, analgesic score according VAS and using of analgesic drugs were recorded during 24 hours after the operation. Results: Pain intensity according to VAS score in the time 2,6,12 hours post operation were significantly lower in the case group ( P2= 0.05, P6 = 0.01, P12= 0.05 .Analgesic consumption in form of suppository & IV,24 hours after surgery, was significantly lower in the case group.(P=0.001. Conclusion: Lidocaein infusion can decrease pain intensity & analgesic consumption after ce-sarean section under spinal anesthesia. (Sci J Hamadan Univ Med Sci 2013; 20 (1:9-14

M. H. Bakhshaei

2013-04-01

120

Maintenance time of sedative effects after an intravenous infusion of diazepam: A guide for endoscopy using diazepam  

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Full Text Available AIM: To examine whether the sedative effects assessed by psychomotor tests would depend on the cytochrome P450 (CYP 2C19 genotypes after an infusion regimen of diazepam commonly used for gastrointestinal endoscopy in Japan.METHODS: Fifteen healthy Japanese volunteers consisting of three different CYP2C19 genotype groups underwent a critical flicker fusion test, an eye movement analysis and a postural sway test as a test for physical sedative effects, and a visual analog scale (VAS symptom assessment method as a test for mental sedative effects during the 336 h period after the intravenous infusion of diazepam (5 mg.RESULTS: The physical sedative effects assessed by the critical flicker test continued for 1 h (t values of 5 min, 30 min and 60 min later: 4.35, 5.00 and 3.19, respectively and those by the moving radial area of a postural sway test continued for 3 h (t values of 5 h, 30 h, 60 min and 3 h later: -4.05, -3.42, -2.17 and -2.58, respectively, which changed significantly compared with the baseline level before infusion (P < 0.05. On the other hand, the mental sedative effects by the VAS method improved within 1 h. The CYP2C19 genotype-dependent differences in the postinfusion sedative effects were not observed in any of the four psychomotor function tests.CONCLUSION: With the psychomotor tests, the objective sedative effects of diazepam continued for 1 h to 3 h irrespective of CYP2C19 genotype status and the subjective sedative symptoms improved within 1 h. Up to 3 h of clinical care appears to be required after the infusion of diazepam, although patients feel subjectively improved.

Mitsushige Sugimoto, Takahisa Furuta, Akiko Nakamura, Naohito Shirai, Mutsuhiro Ikuma, Shingen Misaka, Shinya Uchida, Hiroshi Watanabe, Kyoichi Ohashi, Takashi Ishizaki, Akira Hishida

2008-09-01

 
 
 
 
121

[Haemolytic anaemia as a complication to intravenous infusion of human immunoglobulin].  

Science.gov (United States)

A 85-year-old female treated for chronic inflammatory demyelinating polyradiculoneuropathy had three episodes of anaemia one week following treatment with large doses (2g/kg body weight) of immunoglobulin (Ig). At the final episode, she presented with haemolytic anaemia with fatigue, jaundice and loss of appetite. During the next two months anaemia was recognized in two additional cases. Subsequently, a series of twelve conseuntively studied IVIg treated patients showed a significant decrease of haemoglobin of 0.80 mmol/l 8-15 days after infusion. Haemolytic anaemia is a severe side effect that seems to be more frequent than previously recognized. It may possibly be prevented by the use of lyophilized Ig-preparations with low isohaemagglutinin titers or by slower Ig infusion rates. PMID:21849136

Juel, Jacob; Markvardsen, Lars Høj; Jakobsen, Johannes

2011-08-15

122

Accidental intravenous infusion of a large dose of magnesium sulphate during labor: A case report.  

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During labor and child delivery, a wide range of drugs are administered. Most of these medications are high-alert medications, which can cause significant harm to the patient due to its inadvertent use. Errors could be caused due to unfamiliarity with safe dosage ranges, confusion between similar looking drugs, mislabeling of drugs, equipment misuse, or malfunction and communication errors. We report a case of inadvertent infusion of a large dose of magnesium sulphate in a pregnant woman. PMID:24106365

Kumar, Kamal; Al Arebi, Arif; Singh, Indu

2013-07-01

123

Regression of atherosclerosis by the intravenous infusion of specific biochemical nutrient substrates in animals and humans.  

Science.gov (United States)

Preliminary studies in 400 New Zealand albino rabbits produced a reliable animal model of nutrient-induced atherosclerosis that simulated that observed in humans. Atherosclerosis was then induced in an additional 1600 rabbits in sets of 40 animals each, maintaining plasma cholesterol concentrations between 1000 and 2000 mg/dL for 6-20 weeks. In each set, 10 control rabbits were killed to document baseline atherosclerosis, and the other 30 rabbits were assigned randomly to one of three groups of 10 rabbits. Groups of 10 rabbits were either continued on the atherogenic diet (group I), given standard laboratory rabbit pellets (group II), or infused continuously with specially formulated anticholesterol solutions via central venous catheters (group III) for 6 weeks. At autopsy, atherosclerotic lesions consistently involved 85-95% of the aorta in group I. In group II, atherosclerosis was comparable with the baseline control group with no regression. In group III, regression of atherosclerosis by 90-95% was consistently documented. Correlations between plasma amino acids and plasma cholesterol concentrations were established in four humans with severe atherosclerosis to maximize the cholesterol reduction capacity of the amino acid formulation. Infusion of the modified total parenteral nutrition solution induced prompt reduction in plasma cholesterol levels by 40-60% regardless of the initial level and was accompanied by evidence of regression of atherosclerosis after a 90-day infusion therapy period. PMID:3115205

Dudrick, S J

1987-09-01

124

Intravenous infusion of magnesium chloride improves epicenter blood flow during the acute stage of contusive spinal cord injury in rats.  

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Vasospasm, hemorrhage, and loss of microvessels at the site of contusive or compressive spinal cord injury lead to infarction and initiate secondary degeneration. Here, we used intravenous injection of endothelial-binding lectin followed by histology to show that the number of perfused microvessels at the injury site is decreased by 80-90% as early as 20?min following a moderate T9 contusion in adult female rats. Hemorrhage within the spinal cord also was maximal at 20?min, consistent with its vasoconstrictive actions in the central nervous system (CNS). Microvascular blood flow recovered to up to 50% of normal volume in the injury penumbra by 6?h, but not at the epicenter. A comparison with an endothelial cell marker suggested that many microvessels fail to be reperfused up to 48?h post-injury. The ischemia was probably caused by vasospasm of vessels penetrating the parenchyma, because repeated Doppler measurements over the spinal cord showed a doubling of total blood flow over the first 12?h. Moreover, intravenous infusion of magnesium chloride, used clinically to treat CNS vasospasm, greatly improved the number of perfused microvessels at 24 and 48?h. The magnesium treatment seemed safe as it did not increase hemorrhage, despite the improved parenchymal blood flow. However, the treatment did not reduce acute microvessel, motor neuron or oligodendrocyte loss, and when infused for 7 days did not affect functional recovery or spared epicenter white matter over a 4 week period. These data suggest that microvascular blood flow can be restored with a clinically relevant treatment following spinal cord injury. PMID:23302047

Muradov, Johongir M; Hagg, Theo

2013-05-15

125

Effect of intravenous drip infusion of cyclophosphamide with high-dose Astragalus injection in treating lupus nephritis  

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Full Text Available Objective: To observe the effect of high-dose Astragalus injection and cyclophosphamide (CTX on infection, urine protein and immune function of the patients with lupus nephritis.Methods: Forty-three patients diagnosed as systemic lupus erythematosus (SLE complicated by kidney damage and qi-deficiency syndrome were randomly divided into trial group (n=23 and control group (n=20. Patients in both groups were treated for 3 months. Intravenous drip infusion of 0.8 g CTX was administered to all patients once a month, while intravenous drip infusion of 20 ml Astragalus injection was only administered to patients in the trial group every day for 12 days in each month.Results: The decrease of active clinical symptom score after the treatment in the trial group was greater than that in the control group (P<0.05. The infection rates of the trial group and the control group were 4.35% and 25% respectively. The decrease of 24-hour urine protein and CD8, and the increase of red blood cell count and serum albumin in the trial group were greater than those in the control group, and there were significant differences between the two groups (P<0.05. White blood cell count in the trial group was decreased less than that in the control group after the treatment (P<0.05.Conclusion: High-dose Astragalus injection used together with CTX is more effective than CTX alone in decreasing infection rate and urine protein and improving immune function for patients with lupus nephritis.

Li SU

2007-05-01

126

(-)-Epigallocatechin-3-gallate (EGCG) modulates neurological function when intravenously infused in acute and, chronically injured spinal cord of adult rats.  

Science.gov (United States)

Spinal cord injury (SCI) causes severe and long lasting motor and sensory deficits, chronic pain, and autonomic dysreflexia. (-)-epigallocatechin-3-gallate (EGCG) has shown to produce neuroprotective effect in a broad range of neurodegenerative disease animal models. This study designed to test the efficacy of intravenous infusion of EGCG for 36 h, in acutely injured rats' spinal cord: within first 4 h post-injury and, in chronically SC injured rats: after one year of injury. Functional outcomes measured using standard BBB scale, The Louisville Swim Scale (LSS) and, pain behavior assessment tests. 72 Female adult rats subjected to moderate thoracic SCI using MASCIS Impactor, blindly randomized as the following: (I) Acute SCI + EGCG (II) Acute SCI + saline. (III) Chronic SCI + EGCG. (IV) Chronic SCI + saline and, sham SCI animals. EGCG i.v. treatment of acute and, chronic SCI animals resulted in significantly better recovery of motor and sensory functions, BBB and LSS (P < 0.005) and (P < 0.05) respectively. Tactile allodynia, mechanical nociception (P < 0.05) significantly improved. Paw withdrawal and, tail flick latencies increase significantly (P < 0.05). Moreover, in the EGCG treated acute SCI animals the percentage of lesion size area significantly reduced (P < 0.0001) and, the number of neurons in the spinal cord increased (P < 0.001). Percent areas of GAP-43 and GFAP immunohistochemistry showed significant (P < 0.05) increase. We conclude that the therapeutic window of opportunity for EGCG to depict neurological recovery in SCI animals, is viable up to one year post SCI when intravenously infused for 36 h. PMID:24071567

Renno, Waleed M; Al-Khaledi, Ghanim; Mousa, Alyaa; Karam, Shaima M; Abul, Habib; Asfar, Sami

2014-02-01

127

Plasma nitrate plus nitrite changes during continuous intravenous infusion interleukin 2.  

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Nitric oxide (NO), a biologically active mediator generated in many cell types by the enzyme NO synthase, may play an important role in cardiovascular toxicity that is frequently observed in cancer patients during intravenous (i.v.) interleukin 2 (IL-2) therapy. The induction of NO synthase and the production of NO seem to be involved in the pathogenesis of the vascular leakage syndrome, as well as in the regulation of myocardial contractility. In the present study, we evaluated the pattern o...

1996-01-01

128

Differential effects of ketoconazole on exposure to temsirolimus following intravenous infusion of temsirolimus  

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Intravenous (i.v.) temsirolimus, a novel inhibitor of mammalian target of rapamycin, is approved for the treatment of advanced renal cell carcinoma and is being studied in patients with mantle cell lymphoma. Because temsirolimus and its primary metabolite, sirolimus, are metabolised by the cytochrome P450 3A4 pathway (CYP3A4), the potential exists for pharmacokinetic (PK) drug interactions with the numerous agents that modulate CYP3A4 isozyme activity. We investigated the effects of ketoconaz...

Boni, J. P.; Leister, C.; Burns, J.; Hug, B.

2008-01-01

129

Interdisciplinary development of an intravenous infusion protocol for Orthoclone OKT3.  

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The development and implementation of an infusion protocol for Orthoclone OKT3 (Ortho Biotech, Inc., Raritan, NJ) is described in this article. OKT3 is a potent immunosuppressant drug used to lower the incidence of graft rejection in transplant patients. Nurses and physicians use the protocol described in this article to administer OKT3 to heart and lung transplant patients at our institution. Pharmacokinetics, along with the nursing care, associated with OKT3 administration are described in the protocol section. The benefits of protocol use are reported in the conclusion. PMID:8788828

Byrd, J G; Raulinaitis, A; Burke, P B; Welsh, D

1996-01-01

130

Therapeutic response to intravenous infusions of glucocerebrosidase in a patient with Gaucher disease  

International Nuclear Information System (INIS)

Enzyme replacement has been under consideration as a therapeutic strategy for patients with Gaucher disease for more than two decades. Previous studies indicated that single injections of purified glucocerebrosidase reduced the amount of storage material in the liver. It was important to determine whether administration of exogenous enzyme on a regular basis would be of clinical benefit. The authors weekly i.v. infusions of a macrophage-targeted preparation of human placental glucocerebrosidase in a child with type 1 Gaucher disease increased hemoglobin over a 20-week period. The platelet count also increased. Phagocytic activity in the spleen decreased during the period of enzyme administration, and there was radiographic evidence of skeletal improvement. These observations document objective clinical responses to enzyme supplementation in a patient with a sphingolipid storage disorder

1990-01-01

131

First Clinical Experience with a High-Capacity Implantable Infusion Pump for Continuous Intravenous Chemotherapy  

International Nuclear Information System (INIS)

Purpose: To evaluate the efficiency of a new high-capacity pump for systemic venous chemotherapy and to verify the quality of implantation by interventional radiology staff. Methods: A total of 47 infusion pumps with a 60-ml reservoir and variable flow rates (2, 6, 8, or 12 ml/24 hr) were implanted by radiologists in 46 patients with solid tumor metastases requiring treatment with a single, continuously infused cytostatic agent. The reservoir was refilled transcutaneously, usually once weekly. The flow accuracy of the pump was assessed from actual drug delivery recorded on 34 patients over a minimum observation period of 180 days. Results: No early complications occurred in any of the 47 implants in 46 patients. A total of 12 (25.53%) complications occurred between 3 and 24 months after implantation. Seven (14.90%) of these were due to the external design of the pump, while five (10.63%) were related to the central venous catheter. In the 34 patients available for pump evaluation (follow-up of at least 180 days), the system was used for a total of 14,191 days (range 180-911 days, mean 417.38 days), giving an overall complication rate of 0.84 per 1000 days of operation. The mean flow rate accuracy was 90.26%. Conclusion: The new implantable pump showed good flow rate accuracy and reliable operation. The pump-related complications were related to its external design and have now been corrected by appropriate modifications. From a radiologic and surgical viewpoint, the venous implantation procedure is identical to that of conventional vascular access devices and can be performed by radiologists familiar with these techniques. The current limitations lie in the high cost of the pump and, for certain drugs, the short time between refills

1999-01-01

132

Regional myocardial lidocaine concentration following continuous intravenous infusion early and later after myocardial infarction  

International Nuclear Information System (INIS)

The regional concentration of lidocaine using a double constant infusion technique (250 micrograms/kg/min x 15 minutes followed by 35 micrograms/kg/mg/min x 120 minutes) was studied immediately (2 hours) in seven dogs and 24 hours (six dogs) after myocardial infarction. Tissue levels were determined by gas chromatography and related to regional myocardial blood flow as determined by the radioactive microsphere technique in multiple samples. At 2 hours after infarction a significantly higher lidocaine concentration (4.1 +/- 0.42 micrograms/g) was found in zones with greatly reduced blood flow (regional myocardial blood flow less than 0.2 ml/min per g) when compared with that (2.6 +/- 0.19 micrograms/g) in zones with normal blood flow (regional myocardial blood flow greater than 0.8 ml/min per g) (p less than 0.01). In contrast, in the 24 hour model the opposite situation was observed. Although the concentration of lidocaine in the infarct zone was substantial, a significant decline in lidocaine tissue concentration was found in the zones of lowest blood flow (regional myocardial blood flow less than 0.2 ml/min per g) when compared with that in normal zones (1.76 +/- 0.21 versus 3.38 +/- 0.21 micrograms/g, p less than 0.001). In addition, no significant differences in lidocaine concentrations were found between endocardium and epicardium in any of the groups other than those related to regional myocardial blood flow. Thus, with the double constant infusion technique, lidocaine reached normal and ischemic myocardium in concentrations equivalent to therapeutic plasma concentrations, even in lower infarct blood flow zones, with no significant differences between endocardium and epicardium. Of perhaps greater significance, the age of the ischemic insult is an important determinant of lidocaine tissue distribution in infarcted myocardium

1982-01-01

133

Evaluation of platelet deposition at local thrombophlebitis, caused by intravenous infusion of anticancer drug (Bisantrene), with In-111-platelets in rabbits  

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Several anticancer drugs produce localized thrombophlebitis (LTP) when infused intravenously and LTP is the dose-limiting factor. LTP was studied in New Zealand albino rabbits by I.V. infusion of Bisantrene (BS: approx. = 40 mg/rabbit, six rabbits via ear veins, five via jugular veins, two control, 0.9% saline). Radioactivity in three sections of each harvested vein was determined with a gamma counter, and the ratio of radioactivity per mg of infused vein and control vein was determined and the results are presented in this paper. Scanning electron micrograph of BS-infused vein lumen revealed plaques of amorphous material (BS) and adherent platelet thrombus. Platelet deposition at BS-induced LTP in jugular and ear veins reached a maximum at four to eight hours. Thus, LTP could be imaged and quantified with In-111-labeled platelets.

Dewanjee, M.K.; Powis, G.; Chowdhury, S.

1985-05-01

134

Evaluation of platelet deposition at local thrombophlebitis, caused by intravenous infusion of anticancer drug (Bisantrene), with In-111-platelets in rabbits  

International Nuclear Information System (INIS)

Several anticancer drugs produce localized thrombophlebitis (LTP) when infused intravenously and LTP is the dose-limiting factor. LTP was studied in New Zealand albino rabbits by I.V. infusion of Bisantrene (BS: ? 40 mg/rabbit, six rabbits via ear veins, five via jugular veins, two control, 0.9% saline). Radioactivity in three sections of each harvested vein was determined with a gamma counter, and the ratio of radioactivity per mg of infused vein and control vein was determined and the results are presented in this paper. Scanning electron micrograph of BS-infused vein lumen revealed plaques of amorphous material (BS) and adherent platelet thrombus. Platelet deposition at BS-induced LTP in jugular and ear veins reached a maximum at four to eight hours. Thus, LTP could be imaged and quantified with In-111-labeled platelets

1985-05-01

135

Assessment of right ventricular function by intravenous infusion of krypton-81m  

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Kr-81m equilibrium ventriculography was used to assess right ventricular (RV) function at rest (R) and during submaximal bicycle exercise (E) in patients (pts) with different cardiopulmonary disorders. Kr-81 was continuously eluted in 5% dextrose from a portable Rb-81 generator and infused through a peripheral vein. Due to the short half-life (13s) and the free diffusibility of Kr-81 through the alveolar membrane, activity in the left side of the heart is negligible. This allows imaging in a RAO position which provides the best separation between the right atrium and the RV. Determination of RV ejection fraction (RVEF) involved the definition of an endiastolic and an endsystolic region of interest by a semiautomatic computer algorithm. The standard deviation of RVEF determinations by two independent observers was 0.047. Kr-81 RVEF was related to X-ray angiographic (XR) RVEF and hemodynamic measurements. The correlation coefficient between Kr-81 and XR RVEF was 0.82(n=25). When all pts were divided into two groups according to their mean pulmonary artery pressure, significant differences in the RVEF during E between these groups were found with both Kr-81 and XR ventriculography. The correspondence between KR-81 and XR data underlines the potential of Kr-81 as a reliable noninvasive tool in assessing RV function

1984-06-05

136

Assessment of right ventricular function by intravenous infusion of krypton-81m  

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Kr-81m equilibrium ventriculography was used to assess right ventricular (RV) function at rest (R) and during submaximal bicycle exercise (E) in patients (pts) with different cardiopulmonary disorders. Kr-81 was continuously eluted in 5% dextrose from a portable Rb-81 generator and infused through a peripheral vein. Due to the short half-life (13s) and the free diffusibility of Kr-81 through the alveolar membrane, activity in the left side of the heart is negligible. This allows imaging in a RAO position which provides the best separation between the right atrium and the RV. Determination of RV ejection fraction (RVEF) involved the definition of an endiastolic and an endsystolic region of interest by a semiautomatic computer algorithm. The standard deviation of RVEF determinations by two independent observers was 0.047. Kr-81 RVEF was related to X-ray angiographic (XR) RVEF and hemodynamic measurements. The correlation coefficient between Kr-81 and XR RVEF was 0.82(n=25). When all pts were divided into two groups according to their mean pulmonary artery pressure, significant differences in the RVEF during E between these groups were found with both Kr-81 and XR ventriculography. The correspondence between KR-81 and XR data underlines the potential of Kr-81 as a reliable noninvasive tool in assessing RV function.

Spielmann, R.P.; Nienaber, C.; Wasmus, G.; Stritzke, P.; Montz, R.; Mathey, D.G.

1984-01-01

137

Intravenous Infusion of Mesenchymal Stem/Stromal Cells Decreased CCR7(+) Antigen Presenting Cells in Mice with Corneal Allotransplantation.  

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Abstract Purpose: To investigate the effects of intravenous (IV) infusion of human mesenchymal stem/stromal cells (hMSCs) on activation and migration of CCR7(+) antigen presenting cells (APCs) in allogeneic corneal transplantation. Materials and Methods: We first analyzed the cellular and molecular profiles of draining lymph nodes (DLNs) in early and late phases after syngeneic or allogeneic corneal transplantation in mice, and then investigated the effects of hMSCs on APCs expressing CCR7, a key molecule implicated in APC migration to DLNs. Results: After early transplantation, the numbers of MHC class II(+)CD11b(+)CD11c(-), MHC class II(+)CD11b(-)CD11c(+), and MHC II(+)CD11b(+)CD11c(+) cells as well as the levels of APC-derived cytokines (IL-12a and IL-12b) driving the Th1 response were increased in both syngeneic and allogeneic transplants indicating activation of APCs. In late phase, the numbers of CD3(+)CD4(+)CD8(-) and CD3(+)CD4(-)CD8(+) cells and the levels of T cell-derived cytokines were increased in allogeneic transplants, but not in syngeneic transplants indicating immune rejection. The peri-transplant infusion of IV hMSCs significantly reduced the numbers of CCR7(+)CD11b(+) or CCR7(+)CD11c(+) cells in DLNs and the cornea in the early phase. Also, the expression of CCR7 and its ligands, CCL19, CCL21, and CXC3R as well as IL-12 were markedly decreased by hMSCs in the cornea and DLNs. Conclusions: IV hMSCs reduced the activation and migration of CCR7(+) APCs in the cornea and DLNs in allogeneic corneal transplantation. PMID:24502523

Lee, Hyun Ju; Ko, Jung Hwa; Ko, Ah Young; Kim, Mee Kum; Wee, Won Ryang; Oh, Joo Youn

2014-08-01

138

Usefulness of Intravenous Anesthesia Using a Target-controlled Infusion System with Local Anesthesia in Submuscular Breast Augmentation Surgery  

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Full Text Available Background Patients have anxiety and fear of complications due to general anesthesia.Through new instruments and local anesthetic drugs, a variety of anesthetic methods havebeen introduced. These methods keep hospital costs down and save time for patients. Inparticular, the target-controlled infusion (TCI system maintains a relatively accurate level ofplasma concentration, so the depth of anesthesia can be adjusted more easily. We conductedthis study to examine whether intravenous anesthesia using the TCI system with propofol andremifentanil would be an effective method of anesthesia in breast augmentation.Methods This study recruited 100 patients who underwent breast augmentation surgeryfrom February to August 2011. Intravenous anesthesia was performed with 10 mg/mLpropofol and 50 ?g/mL remifentanil simultaneously administered using two separate modulesof a continuous computer-assisted TCI system. The average target concentration was set at2 ?g/mL and 2 ng/mL for propofol and remifentanil, respectively, and titrated against clinicaleffect and vital signs. Oxygen saturation, electrocardiography, and respiratory status werecontinuously measured during surgery. Blood pressure was measured at 5-minute intervals.Information collected includes total duration of surgery, dose of drugs administered duringsurgery, memory about surgery, and side effects.Results Intraoperatively, there was transient hypotension in two cases and hypoxia in threecases. However, there were no serious complications due to anesthesia such as respiratorydifficulty, deep vein thrombosis, or malignant hypertension, for which an endotrachealintubation or reversal agent would have been needed. All the patients were discharged on theday of surgery and able to ambulate normally.Conclusions Our results indicate that anesthetic methods, where the TCI of propofol andremifentanil is used, might replace general anesthesia with endotracheal intubation in breastaugmentation surgery.

Kyu-Jin Chung

2012-09-01

139

?-ketoisocaproate (KIC), leucine (LEU), and CO_2 metabolism in fed and insulin-infused sheep  

International Nuclear Information System (INIS)

[1-"1"4C] LEU and ["1"4C] bicarbonate were infused successively into fed sheep. Saline (C) or insulin plus glucose (I) also were infused into a mesenteric vein. Blood samples were taken from portal, hepatic, caudal vena cava and arterial vessels for determination of net and unidirectional metabolism. Arterial insulin concentrations were 26.4 +/- 2.3 in C and 58.5 +/- 6.4 ?U/ml in I but glucagon and glucose concentrations were unchanged. KIC and LEU concentrations decreased in I (9.1 +/- 0.6 to 6.6 +/- 0.3; 89.4 +/- 3.0 to 75.2 +/- 2.6 ?mol/l) whereas CO_2 concentrations increased (26.2 +/- 0.6 to 27.2 +/- 0.5 mmol/L). KIC, LEU and CO_2 turnovers all decreased in I (13.5 +/- 1.5 to 10.2 +/- 1.0; 132 +/- 11 to 121 +/- 9; 89,900 +/- 780 to 85800 +/- 810 ?mol/min). Whole-body KIC oxidation decreased from 4.1 +/- 0.3 to 3.3 +/- 0.3 but LEU oxidation (8.2 +/- 0.8 ?mol/min) was unchanged. Portal absorption of KIC increased (1.2 +/- 0.3 to 3.1 +/- 0.6) and hepatic utilization was unchanged (2.5 +/- 0.8 ?mol/min). Thus, a splanchnic utilization in C switched to a net production in I. KIC release by the hindquarters decreased from 4.5 +/- 0.9 to 3.0 +/- 0.9 ?mol/min). Net portal production of LEU (7.6 +- 3.3), hepatic utilization (4.1 +/- 1.8) and hindquarters utilization (3.4 +/- 1.0 ?mol/min) were all unchanged in I. Indeed, unidirectional utilization and production of LEU by the hindquarters (5.4 +/- 0.5 to 5.5 +/- 0.7; 4.1 + 0.2 to 4.1 +/- 0.3 ?mol/min) were remarkably consistent

1986-03-01

140

Stimulation of adrenal chromaffin cell proliferation by hypercalcemia induced by intravenous infusion of calcium gluconate in rats.  

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Increased incidence of adrenal pheochromocytoma is frequently encountered in rat carcinogenicity studies. In some of the studies, the finding is judged to be due to a rat-specific mechanism of carcinogenesis caused by a disturbance of calcium homeostasis. However, direct evidence that the proliferation of chromaffin cells in the adrenal medulla is induced solely by hypercalcemia is not available. In this study, calcium gluconate was intravenously infused for 7 days to rat chromaffin cells by a tail cuff method, and cumulative labeling with bromodeoxyuridine (BrdU) was carried out to evaluate the proliferative activity. The serum calcium concentration was dose-dependently increased, and a high calcium concentration was stably sustained from day 2 to 7. In the adrenal medulla, BrdU-positive chromaffin cells increased in the calcium gluconate-treated animals, and the BrdU-labeling index increased in a dose-dependent manner. In addition, an increased BrdU-labeling index of chromaffin cells was shown to correlate with the serum calcium concentration. Our results demonstrate that hypercalcemia directly enhances the proliferative activity of chromaffin cells and that the proliferative activity is correlated with the serum calcium concentration. PMID:23345932

Isobe, Kaori; Ito, Tsuneo; Komatsu, Shun-Ichiro; Asanuma, Kentaro; Fujii, Etsuko; Kato, Chie; Adachi, Kenji; Kato, Atsuhiko; Sugimoto, Tetsuro; Suzuki, Masami

2012-12-01

 
 
 
 
141

Practical closed-loop insulin delivery. A system for the maintenance of overnight euglycemia and the calculation of basal insulin requirements in insulin-dependent diabetics.  

Science.gov (United States)

We evaluated a practical closed-loop system of insulin delivery consisting of hourly blood glucose determinations using glucose oxidase reagent strips and an intravenous infusion of insulin controlled by a commonly available controller. In 25 insulin-dependent diabetic subjects, this system was successful in achieving and maintaining near euglycemia (blood glucose, 101 +/- 2 mg/dL, mean +/- SE) in the fasting state between 0200 and 0800 hours. This system may be useful in the management of insulin-dependent diabetic patients in various hospital settings. Also, in 10 subjects treated subsequently using a continuous subcutaneous insulin infusion, the mean hourly insulin infusion rate using the described system correlated well (r = 0.92) with the optimal overnight basal rate needed during continous subcutaneous insulin infusion therapy. PMID:7103278

White, N H; Skor, D; Santiago, J V

1982-08-01

142

Insulin-like growth factor-I improves glucose and lipid metabolism in type 2 diabetes mellitus.  

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Hyperglycemia, hyperinsulinemia, and insulin resistance cause vascular disease in type 2 diabetes mellitus. Dietary treatment alone often fails and oral drugs or insulin enhance hyperinsulinemia. In previous studies, an intravenous bolus of recombinant human insulin-like growth factor-I (rhIGF-I) caused normoglycemia in insulin-resistant diabetics whereas rhIGF-I infusions lowered insulin and lipid levels in healthy humans, suggesting that rhIGF-I is effective in insulin-resistant states. Thu...

Zenobi, P. D.; Jaeggi-groisman, S. E.; Riesen, W. F.; Røder, M. E.; Froesch, E. R.

1992-01-01

143

Safety and feasibility of thallium-201 myocardial SPECT with intravenous infusion of disodium adenosine triphosphate (ATP) in the diagnosis of coronary artery disease  

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ATP (adenosine triphosphate) is a potent coronary vasodilator with a rapid onset of action and a very short half-life. Myocardial perfusion scintigraphy with intravenous ATP has not yet bee sufficiently proven in the diagnosis, follow-up, and risk stratification of coronary artery disease. The purpose of this study was to evaluate the safety, feasibility and diagnostic accuracy of pharmacologic stress thallium-102 myocardial SPECT using an intravenous ATP infusion in patients with suspected coronary artery disease. Thallium-201 myocardial SPECT in 319 patients with suspected coronary artery disease were performed after the infusion of ATP (0.08 mg/min for 6 min). The adverse effects were carefully monitored. Coronary angiography was also performed within 3 weeks. Although 76.5% of he patients had some adverse effects, they were transient, mild, and well tolerated. In all patients, the ATP infusion protocol was completed and only 2 patients required aminophylline. The adverse effects were dyspnea in 63%, headache in 31%, flushing in 21%, chest pain in 14% and abdominal discomfort in 5% of the patients. The sensitivity and specificity were 80% and 90% respectively. Thallium-201 myocardial SPECT after 6 min-infusion of ATP at a rate of 0.08 mg/kg/min is safe and has a diagnostic value in detecting coronary artery disease

1998-08-01

144

Safety and feasibility of thallium-201 myocardial SPECT with intravenous infusion of disodium adenosine triphosphate (ATP) in the diagnosis of coronary artery disease  

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ATP (adenosine triphosphate) is a potent coronary vasodilator with a rapid onset of action and a very short half-life. Myocardial perfusion scintigraphy with intravenous ATP has not yet bee sufficiently proven in the diagnosis, follow-up, and risk stratification of coronary artery disease. The purpose of this study was to evaluate the safety, feasibility and diagnostic accuracy of pharmacologic stress thallium-102 myocardial SPECT using an intravenous ATP infusion in patients with suspected coronary artery disease. Thallium-201 myocardial SPECT in 319 patients with suspected coronary artery disease were performed after the infusion of ATP (0.08 mg/min for 6 min). The adverse effects were carefully monitored. Coronary angiography was also performed within 3 weeks. Although 76.5% of he patients had some adverse effects, they were transient, mild, and well tolerated. In all patients, the ATP infusion protocol was completed and only 2 patients required aminophylline. The adverse effects were dyspnea in 63%, headache in 31%, flushing in 21%, chest pain in 14% and abdominal discomfort in 5% of the patients. The sensitivity and specificity were 80% and 90% respectively. Thallium-201 myocardial SPECT after 6 min-infusion of ATP at a rate of 0.08 mg/kg/min is safe and has a diagnostic value in detecting coronary artery disease.

Pai, Moon Sun; Park, Chan H.; Yoon, Seok Nam; Kim, Won; Kim, Han Soo [College of Medicine, Ajou Univ., Suwon (Korea, Republic of)

1998-08-01

145

Treatment Efficacy of Subcutaneous Insulin Infusion Therapy In Type 1 Diabetic Patients - Orijinal Article  

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Full Text Available Objective: Current goals of treatment of diabetes are to achieve near-normal glycemia, minimize the risk of severe hypoglycemia, limit excessive weight gain, and to improve quality of life. Insulin pump or continuous subcutaneous insulin infusion (CSII therapy provides a treatment option to aid in achieving all of these goals. CSII is a viable alternative to multiple daily injections (MDI therapy for patients with diabetes who are capable and motivated. In this study, we aimed to compare the diabetic control and treatment satisfaction in our patients using CSII and MDI. Materials and Methods: Fifty patients with type 1 diabetes, who had been followed between 2005-2008, were enrolled in the study. Changes in biomedical outcomes (glycated haemoglobin; HbA1c, hypoglycaemia, and weigth gain pre-CSII, during the last year and at the end of the study were analyzed retrospectively. For treatment satisfaction and compliance, we used a questionnaire containing 12 questions. The patients were divided into two groups according to MDI or CSII therapy use for least one year: Group 1 using CSII (n:27 and Group 2 using MDI (n:23. Results: There was no significant difference between the last HbA1c levels in both groups. In CSII group, decrease in HbA1c was 0.79% for average follow-up of 1.66 years ( 9.19%±2.23; 8.40%±1.17. When the two groups were compared in terms of hypoglycemia rates and weight gain over the last year, no statistically significant difference was found, but in CSII group, hypoglycemia rates were lower. Finally, CSII group demonstrated a higher treatment satisfaction rate and higher compliance, while a negative correlation was detected between frequency of home blood glucose monitoring and HbA1c levels in all patients. Conclusion: CSII therapy is effective in improving glycemic control with higher treatment satisfaction when compared with MDI therapy in selected type 1 diabetic patients. Turk Jem 2010; 14: 80-4

Soner

2010-12-01

146

Effects and Safety of Allogenic Mesenchymal Stem Cells Intravenous Infusion in Active Ankylosing Spondylitis Patients Who Failed NSAIDs: A 20 Week Clinical Trial.  

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Objective: To evaluate the feasibility, safety, and efficacy of intravenous infusion of allogenic mesenchymal stem cells (MSCs) in ankylosing spondylitis (AS) patients who are refractory to or could not tolerate the side effects of nonsteroidal anti-inflammatory drugs (NSAIDs). Method: AS patients enrolled in this study received 4 intravenous infusions (IVI) of MSCs on days 0,7,14, and 21. The percentage of ASAS20 responders (the primary endpoint) at the 4th week and the mean ASAS20 response duration (the secondary endpoint) were used to assess treatment response to MSC infusion and duration of the therapeutic effects. Ankylosing Spondylitis Disease Activity Score Containing C-reactive Protein (ASDAS-CRP) and other pre-established evaluation indices were also adopted to evaluate the clinical effects. Magnetic resonance imaging (MRI) was performed to detect changes of bone marrow edema in the spine. The safety of this treatment was also evaluated. Results: Thirty-one patients were included, and the percentage of ASAS20 responders reached 77.4% at the 4th week and the mean ASAS20 response duration was 7.1 weeks. The mean ASDAS-CRP score decreased from 3.6±0.6 to 2.4±0.5 at the 4th week, and then increased to 3.2±0.8 at the 20th week. The average total inflammation extent (TIE) detected by MRI decreased from 533,482.5 at baseline to 480,692.3 at the 4th week (p>0.05) and 400,547.2 at the 20th week (p<0.05). No adverse effects were noted. Conclusion: Intravenous infusion of MSCs is a feasible, safe, and promising treatment for patients with AS. PMID:23711393

Wang, Peng; Li, Yuxi; Huang, Lin; Yang, Jiewen; Yang, Rui; Deng, Wen; Liang, Biling; Dai, Lie; Meng, Qingqi; Gao, Liangbin; Chen, Xiaodong; Shen, Jun; Tang, Yong; Zhang, Xin; Hou, Jingyi; Ye, Jichao; Chen, Keng; Cai, Zhaopeng; Wu, Yanfeng; Shen, Huiyong

2013-05-22

147

Thallium-201 myocardial scintigraphy after intravenous infusion of adenosine triphosphate disodium; A preliminary study in the diagnosis of coronary artery disease  

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The feasibility and safety of thallium-201 myocardial scintigraphy after the intravenous infusion of adenosine triphosphate disodium (ATP)(Adetphos, Kowa) were studied in eight patients with angina pectoris and/or old myocardial infarction. Coronary arteriography (CAG) was performed by the conventional method in all patients. ATP was infused for 5 min and thallium was injected at 3 min after the start of ATP infusion. ATP was given at 0.12 mg/min/kg in two patients (group A), 0.16 mg/min/kg in three patients (group B), 0.20 mg/min/kg in one patient (group C), and 0.28 mg/min/kg in two patients (group D). SPECT images were obtained at 10 min and 180 min after thallium injection. No significant hemodynamic changes were observed in groups A and B. Severe hypotension was observed in group C and one member of group D. Chest pain was experienced by one patient in group A, two in group B, one in group C, and both of the two in group D. ST depression on the electrocardiogram (ECG) was documented in one patient each of groups B and C. In one patient of group D, the study was discontinued because of complete atrioventricular block persistent for 5 beats. The correlation between thallium imaging and CAG was unclear in group A, reasonable in groups B and C, and obscure in group D because of side effects. None of the patients who developed side effects of ATP were administered sublingual nitroglycerin or intravenous aminophylline. Their symptoms or ECG changes improved spontaneously within 2 min and disappeared within 5 min after termination of infusion. In conclusion, the optimal ATP regimen for this purpose was considered to be a 5 min infusion at 0.16 mg/kg/min and this method was found to be feasible and safe. (author).

Kinoshita, Shinichiro; Yamashita, Saburo; Suzuki, Tetsuo; Muramatsu, Toshihiro; Ide, Masao; Dohi, Yutaka; Nishimura, Katsuyuki; Miyamae, Tatsuya (Saitama Medical School, Moroyama (Japan))

1991-12-01

148

Evaluation of myocardial viability following acute myocardial infarction using 201Tl SPECT after thallium-glucose-insulin infusion. Comparison with 18F-FDG positron emission tomography  

International Nuclear Information System (INIS)

The aim of this study was to evaluate myocardial viability in patients after acute myocardial infarction (AMI). We compared 201Tl SPECT after 201Tl with GIK (10% glucose 250 ml, insulin 5 U and KCI 10 mEq) infusion (GIK-201Tl) with resting 201Tl and 99mTc-pyrophosphate (PYP) dual SPECT, positron emission computed tomography (PET) using 18F-fluorodeoxyglucose (18F-FDG) in 21 patients with their first AMI, who all underwent successful reperfusion. GIK-201Tl SPECT, 201Tl and 99mTc-PYP dual SPECT were done within 10 days after admission and 18F-FDG-PET was performed at 3 weeks. GIK-201Tl SPECT was obtained after 30 min of GIK-201Tl infusion. 18F-FDG (370 MBq) was injected intravenously after oral glucose (1 g/kg) loading, and then PET was obtained. PET and SPECT images were divided into 20 segments. Regional tracer uptake was scored using a 4-point scoring system (3=normal to 0=defect), and summed to a regional uptake score (RUS). Regional area means the infarcted area in which 99mTc-PYP accumulated. The number of decreased uptake segments (ES) was then determined. The infarcted area was defined as the area of 99mTc-PYP uptake. The ESs for the GIK-201Tl and 18F-FDG-PET images were significantly lower than the number of 99mTc-PYP uptake segments. The RUS for GIK-201Tl was higher than that for resting-201Tl imaging and similar to those for 18F-FDG-PET. In the detection of myocardial viability following AMI, GIK-201Tl imaging is useful with findings similar to those of 18F-FDG-PET. (author)

2004-09-01

149

Actions of intravenous injections of AVP and oxytocin on plasma ACTH, GH, insulin and glucagon concentrations in goats.  

Science.gov (United States)

This study was conducted to investigate the arginine-vasopressin (AVP)- and oxytocin-induced changes in plasma adrenocorticotropic hormone (ACTH), growth hormone (GH), insulin and glucagon levels and their metabolite concentrations in goats. In this study, five goats were intravenously injected with either AVP (0.3?nmol/kg body weight (BW)) or oxytocin (0.7?IU/kg BW). AVP injection significantly increased ACTH and GH secretions compared to controls, although insulin and glucagon concentrations were not altered. The incremental areas (ICAs) of the ACTH and GH concentrations were higher in the AVP group than in the saline group. Oxytocin injections increased insulin and glucagon secretions, while ACTH level was not altered. GH levels became elevated 30?min after the oxytocin injection. The ICAs of insulin and glucagon after oxytocin was injected were higher than those of the control. Results indicate that AVP is a potent stimulant of ACTH and GH secretions, while oxytocin uses different pathways to regulate insulin and glucagon secretions in goats. PMID:24206398

Roh, Sang-Gun; Koiwa, Kohta; Sato, Katsuyoshi; Ohtani, Yoshihisa; Takahashi, Tatsuyuki; Katoh, Kazuo

2014-03-01

150

Insulin responses to selective arterial calcium infusion under hyperinsulinemic euglycemic glucose clamps: case studies in adult nesidioblastosis and childhood insulinoma.  

Science.gov (United States)

Selective arterial calcium stimulation and hepatic venous sampling (ASVS) for insulin secretion is used as a diagnostic procedure in patients with insulinomas or adult nesidioblastosis. In some of those patients, severe hypoglycemia requiring urgent glucose administration occurs during the procedure. Such glucose administration, however, may affect the results and damage the validity of the test. We report two cases of hyperinsulinemic hypoglycemia, in which ASVS tests were successfully performed under hyperinsulinemic euglycemic glucose clamps. A 40-year-old male with nesidioblastosis developed continual severe hypoglycemia several years after a Billroth II-Braun gastrectomy, and continuous glucose infusion could not be stopped even during ASVS tests. A 9-year-old girl with an insulinoma that showed atypical hypovascularity on imaging examinations had ASVS tests under a glucose clamp for safety. Hyperinsulinemic (approximately 100 microU/ml) euglycemic (approximately 90 mg/dl) clamps were achieved by an artificial endocrine pancreas. The insulin analogue lispro was utilized for clamps and endogenous insulin was measured with an assay that does not cross-react with the analogue. Diagnostically significant responses (more than twofold) of insulin secretion were observed under hyperinsulinemic clamps in both cases. The use of the hyperinsulinemic glucose clamp technique during the ASVS test should be considered for maintaining the safety of some hypoglycemic patients. PMID:17053293

Nakagawa, Atsushi; Ueno, Keiichi; Ito, Masatsune; Okamoto, Shinya; Uehara, Keigo; Ito, Hiroki; Mishina, Suguru; Kinoshita, Eriko; Nojima, Takayuki; Takahashi, Hiroaki; Ikawa, Hiromichi; Takashima, Shigeki; Nishizawa, Makoto; Nakano, Shigeru; Kigoshi, Toshikazu; Nakabayashi, Hajime; Uchida, Kenzo

2007-02-01

151

Acute ST elevation myocardial infarction after intravenous immunoglobulin infusion in a young patient: a rare but probable adverse effect of immunoglobulin  

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Full Text Available Intravenous immunoglobulin (IVIG is used in the treatment of a variety of disorders, including autoimmune conditions. IVIG has been considered a safe medication, with minor and transient adverse effects. With the wider use of IVIG, the reported rate of adverse effects has been increased, some of them are potentially fatal cardiovascular reactions due to induction of hypercoagulable state. We report a 40-year-old female treated with IVIG for Guillain-Barre syndrome, who developed chest pain 1 hr following IVIG infusion. The symptoms were associated with ST elevation in anterior leads on electrocardiogram. This anterior wall myocardial infarction (MI is compatible with IVIG-induced hypercoagulability and considered as a probable adverse effect of this medication. To the best of our knowledge, this is probably the first case report where a young patient developed acute MI without any cardiac risk factors after IVIG infusion. [Int J Basic Clin Pharmacol 2014; 3(3.000: 569-571

Manish Ruhela

2014-06-01

152

Comparative study of toxic reactions and pharmacological dynamics of DDP administrated by trans-arterial injection and intravenous infusion in patients with NSCLC  

International Nuclear Information System (INIS)

Objective: Through a comparative analysis serum concentration of DDP administrated by intra-arterial injection and intravenous infusion in patients with non-small cell lung cancer (NSCLC), the whole body toxic reactions and the pharmacological mechanism of chemotherapy agents administrated by bronchial artery infusion (BAI) was studied. Methods: In total 60 patients with advanced NSCLC confirmed by pathology were randomly enrolled into two groups in this study. The 30 patients in group A were treated by BAI chemotherapy with DDP at the dose of 80 mg/m2 within 30 min, while MMC at the dose of 10 mg/m2 and VDS at the dose of 3 mg/m2 were given intravenously. Patients in group B was given intravenous chemotherapy of the same components as that given in group A. Blood samples was collected at 5 min, 15 min, 30 min, 1h, 2h, 4h, 8h, 24h and 48h from the beginning of DDP infusion. High performance liquid chromatography (HPLC) was used to measure DDP concentration in blood samples and a time-concentrate curve was drawn. During chemotherapy, the side-effects were investigated. Results: (1) Both group A and B reached a peak concentration at 30 min. Peak concentration value of group B is higher than that of group A. There was a statistical difference of peak concentration between group A and B (P<0.001). (2) AUC value of group B is higher than that of group A, with a statistical difference (P<0.05). (3) The incidence of gastrointestinal complication and kidney function damage has a statistical difference between group A and B (P=0.002 and 0.028 respectively). Conclusion: The side-effects is slighter in BAI chemotherapy than in IV chemotherapy in the treatment of NSCLC

2003-03-01

153

2-chlorodeoxyadenosine (2-CdA) in 2-hour versus 24-hour intravenous infusion in the treatment of patients with hairy cell leukemia.  

Science.gov (United States)

Forty one patients with hairy cell leukemia (HCL) were treated with 2-chloro-deoxyadenosine (2-CdA) administered in various schedules. Complete remission (CR) was achieved in 31 (76%) patients and partial remission (PR) in 9 (22%). The mean duration of remission (CR + PR) was 25.2 months (range 9-45 months). One patient did not respond to therapy. Twelve out of 16 patients (75%) achieved CR after 5-day intravenous infusions of 2-CdA and 19 out of 25 patients (76%) after 7-day courses. In 19 out of 23 patients (82.6%) CR was achieved after intermittent 2-hour infusions and in 12 out of 18 (66.7%) after continuous 24-hour infusion. The differences were not statistically significant. Side effects of 2-CdA were similar in both groups except for infections, which were less frequently observed in the group treated for 5 days. The results of our study suggest that 2-CdA can be effectively administered to patients with HCL using 5-day courses and a 2-hour daily infusion. PMID:8724536

Robak, T; B?asi?ska-Morawiec, M; Krykowski, E; Hansz, J; Komarnicki, M; Kazimierczak, M; Konopka, L; Maj, S; Hellmann, A; Zaucha, J M; Urasi?ski, L; Zdziarska, B; Kotlarek-Haus, S; Usnarska-Zubkiewicz, L; Kuratowska, Z; Dwilewicz-Trojaczek, J; Ho?owiecki, J; Krawczyk-Kulis, M; Grieb, P

1996-06-01

154

Intravenous labetalol in severe hypertension  

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1 Labetalol was administered by intravenous infusion or by the combination of intravenous bolus injection plus infusion to 15 patients with severe essential hypertension and to one with phaeochromocytoma.

Dal Palu, C.; Pessina, A. C.; Semplicini, A.; Hlede, M.; Morandin, F.; Palatini, P.; Sperti, G.; Rossi, G. P.

1982-01-01

155

Multiple-Dose Pharmacokinetics and Safety of the New Antifungal Triazole BAL4815 after Intravenous Infusion and Oral Administration of Its Prodrug, BAL8557, in Healthy Volunteers  

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BAL8557 is the water-soluble prodrug of BAL4815, a new broad-spectrum antifungal. Healthy male subjects were randomly assigned to four treatment cohorts to receive multiple oral doses or multiple 1-h constant-rate intravenous infusions of BAL8557. Loading doses of BAL8557 were equivalent to 100 mg (followed by once-daily maintenance doses of 50 mg) or 200 mg (followed by once-daily maintenance doses of 100 mg) of BAL4815. In each cohort, six subjects received active drug and two subjects rece...

Schmitt-hoffmann, Anne; Roos, Brigitte; Maares, Ju?rgen; Heep, Markus; Spickerman, Jochen; Weidekamm, Erhard; Brown, Tom; Roehrle, Michael

2006-01-01

156

Prevention of methionine and ammonia-induced coma by intravenous infusion of a branched chain amino acid solution to rats with liver injury.  

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Full Text Available The prevention of hepatic encephalopathy by the intravenous infusion of a branched chain amino acid (BCAA-enriched solution was investigated in methionine and ammonium acetate-treated rats whose liver was already injured with carbon tetrachloride. A BCAA-enriched solution protected the rats from entering a coma. The brain BCAA contents became higher, and the brain methionine and tyrosine levels and the ratio of glutamine to glutamic acid in the brain diminished after administering the BCAA-enriched solution.

Shiota,Tetsuya

1984-10-01

157

Pharmacokinetics of R 82913 in AIDS patients: a phase I dose-finding study of oral administration compared with intravenous infusion.  

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The pharmacokinetics of oral administration of R 82913, or tetrahydroimidazol [4,5,1-jk]-benzodiazepin-2(1H)-one or -thione (TIBO), was compared with those of intravenous administration in five AIDS patients. TIBO was administered as a single daily 1-h infusion of 100 mg for 29 days and orally as a single daily dose for 14 days with three consecutive regimens of 100, 200, and 100 mg with probenecid (1 g) daily. Each cycle was followed by a wash-out period. Oral bioavailability of TIBO appears...

Wit, S.; Hermans, P.; Sommereijns, B.; O Doherty, E.; Westenborghs, R.; Velde, V.; Cauwenbergh, G. F.; Clumeck, N.

1992-01-01

158

Effect of ramipril on insulin sensitivity in obese patients. Time-course study of glucose infusion rate during euglycaemic hyperinsulinaemic clamp.  

Science.gov (United States)

To assess the effects of angiotensin converting enzyme (ACE) inhibitor on insulin action in obesity, five normotensive non-diabetic obese women were examined on two occasions as part of a double-blind, randomized, cross-over study involving ten days of treatment with either 1.25 mg ramipril or placebo. The study consisted of a euglycaemic hyperinsulinaemic clamp (two periods of insulin infusion at rates of 0.4 and 1 mU/kg/min, 2 h for each step) combined with indirect calorimetry. The most notable results involved a significantly faster time-course of glucose infusion rates during the first 30 min of each insulin infusion period [analysed by calculating slopes (S1 and S2)] after ramipril than placebo administration. The mean glucose infusion rates reached during the last 30 min of each insulin infusion period (G1 and G2), as well as the increases in carbohydrate oxidation rates during the clamp (C1-C0 and C2-C0) and the decreases in plasma nonesterified fatty acids (A0-A1 and A0-A2), were not significantly different after ramipril and placebo. According to robust principal component analysis of S1, S2, G1, G2, C1, C2, A1 and A2 (orthogonally to C0 and A0), insulin sensitivity was improved with ramipril as compared to placebo (p = 0.013). This study strongly suggests that a low dose of an ACE inhibitor increases the activation phase of insulin action in normotensive nondiabetic obese patients and may accelerate insulin action. PMID:8697308

Valensi, P; Derobert, E; Genthon, R; Riou, J P

1996-06-01

159

Intravenous salbutamol bolus compared with an aminophylline infusion in children with severe asthma: a randomised controlled trial  

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Background: The relative efficacies of aminophylline and salbutamol in severe acute childhood asthma are currently unclear. A single bolus of salbutamol was compared with a continuous aminophylline infusion in children with severe asthma in a randomised double blind study.

2003-01-01

160

Maintenance time of sedative effects after an intravenous infusion of diazepam: A guide for endoscopy using diazepam  

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AIM: To examine whether the sedative effects assessed by psychomotor tests would depend on the cytochrome P450 (CYP) 2C19 genotypes after an infusion regimen of diazepam commonly used for gastrointestinal endoscopy in Japan.

Sugimoto, Mitsushige; Furuta, Takahisa; Nakamura, Akiko; Shirai, Naohito; Ikuma, Mutsuhiro; Misaka, Shingen; Uchida, Shinya; Watanabe, Hiroshi; Ohashi, Kyoichi; Ishizaki, Takashi; Hishida, Akira

2008-01-01

 
 
 
 
161

Successful management of allergy to the insulin excipient metacresol in a child with type 1 diabetes: a case report  

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Full Text Available Abstract Introduction Insulin allergy to human insulin preparations during the treatment of diabetes is suggested to occur at rates ranging from Case presentation We present the case of a 12-year-old Caucasian girl with localized allergy to the insulin excipient metacresol, and the subsequent desensitization therapy using continuous subcutaneous insulin infusion with simultaneous intravenous insulin infusion. Conclusions This is the first documented case of allergy to the metacresol component of insulin in the pediatric type 1 diabetes literature. We describe an approach to diagnosis and management of metacresol allergy in type 1 diabetes.

Wheeler Benjamin J

2012-08-01

162

Effects of intravenous infusion of esmolol and propranolol on biventricular performance at rest and during exercise as assessed by quantitative radionuclide angiography.  

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This double-blind, randomized, crossover study examined the effects of intravenous infusion of esmolol (a new ultra-short-acting beta-receptor blocking agent) and propranolol on cardiovascular performance at rest and during peak upright exercise in 15 patients. Biventricular function was assessed by means of first-pass radionuclide ventriculography with a computerized multicrystal camera. At rest, significant treatment differences between esmolol and propranolol vs baseline were found for the heart rate, systolic blood pressure, double product, left ventricular ejection fraction (EF), systolic blood pressure to end-systolic volume ratio, cardiac index and right ventricular EF. During exercise, significant treatment differences were also found for the heart rate, systolic blood pressure, double product, right ventricular EF and cardiac index. The mean baseline measurements were higher than the mean treatment measurements, but no significant differences were found between mean esmolol and mean propranolol measurements at rest and during exercise except for the exercise systolic blood pressure, which was lower during esmolol infusion. The magnitude of drug effect was greater at the time of exercise than at rest. The blood level of esmolol decreased markedly by 30 minutes after infusion. Esmolol was well tolerated, with no important local, systemic or laboratory abnormalities. Thus, the effects of esmolol on cardiovascular performance at rest and exercise are similar to those of propranolol. PMID:3993558

Iskandrian, A S; Hakki, A H; Laddu, A; Steck, J; Saunders, R; Kane-Marsch, S; Morganroth, J

1985-05-01

163

Continuous intravenous infusion of prostaglandin E1 improves myocardial perfusion reserve in patients with ischemic heart disease assessed by positron emission tomography. A pilot study  

International Nuclear Information System (INIS)

Recent investigation has demonstrated that prostaglandin E1 (PGE1) therapy increased capillary density in explanted hearts. Dynamic 13N-ammonia positron emission tomography (PET) is reliable for non-invasive measurement of myocardial blood flow and myocardial perfusion reserve (MPR). The aim of this study was to investigate the effects of PGE1 therapy during 4 weeks on reduction of myocardial perfusion abnormalities and increase of MPR in the patients with ischemic heart disease. In this double-blind, placebo-controlled trial, we randomly assigned 11 patients who had symptomatic heart failure and documented myocardial ischemia to 4 weeks intravenous infusion of PGE1 (2.5 ng/kg/min; 8 patients, age 60±13 years) or saline (3 patients, age 57±13 years). Dynamic 13N-ammonia PET scans at rest and during adenosine stress were obtained at baseline and 12 weeks after treatment completion. Quantitative size/severity of perfusion defects and MPR change from baseline to follow-up PET were determined using a 17-segment model. Compared with the control group, baseline MPR in the PGE1 group was significantly lower (1.96±0.78 vs. 2.71±0.73; P1 infusion (1.96±0.78 to 2.16±0.77; P1 infusion sustained MPR improvement in patients with ischemic heart disease. This may be an attractive therapeutic approach for no-option patients with severe ischemic cardiomyopathy. (author)

2011-08-01

164

Labetalol infusion for refractory hypertension causing severe hypotension and bradycardia: an issue of patient safety  

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Incremental doses of intravenous labetalol are safe and effective and, at times, such therapy may need to be augmented by a continuous infusion of labetalol to control severe hypertension. Continuous infusions of labetalol may exceed the recommended maximum daily dose of 300 mg on occasion. We report a case in which hypertension occurring after an abdominal aortic aneurysm repair, initially responsive to intermittent intravenous beta-blockade, became resistant to this therapy leading to the choice of an intravenous labetalol infusion as the therapeutic option. The labetalol infusion resulted in a profound cardiovascular compromise in this postoperative critically ill patient. While infusions of labetalol have successfully been used, prolonged administration in the intensive care unit requires vigilance and the establishment of a therapeutic rationale/policy for interventions, such as the ready availability of glucagon, ?-agonists, phosphodiesterase inhibitors, insulin, and vasopressin when severe cardiovascular depression occurs.

Fahed, Samir; Grum, Daniel F; Papadimos, Thomas J

2008-01-01

165

Labetalol infusion for refractory hypertension causing severe hypotension and bradycardia: an issue of patient safety  

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Full Text Available Abstract Incremental doses of intravenous labetalol are safe and effective and, at times, such therapy may need to be augmented by a continuous infusion of labetalol to control severe hypertension. Continuous infusions of labetalol may exceed the recommended maximum daily dose of 300 mg on occasion. We report a case in which hypertension occurring after an abdominal aortic aneurysm repair, initially responsive to intermittent intravenous beta-blockade, became resistant to this therapy leading to the choice of an intravenous labetalol infusion as the therapeutic option. The labetalol infusion resulted in a profound cardiovascular compromise in this postoperative critically ill patient. While infusions of labetalol have successfully been used, prolonged administration in the intensive care unit requires vigilance and the establishment of a therapeutic rationale/policy for interventions, such as the ready availability of glucagon, ?-agonists, phosphodiesterase inhibitors, insulin, and vasopressin when severe cardiovascular depression occurs.

Papadimos Thomas J

2008-05-01

166

Advantages of the single delay model for the assessment of insulin sensitivity from the intravenous glucose tolerance test  

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Full Text Available Abstract Background The Minimal Model, (MM, used to assess insulin sensitivity (IS from Intra-Venous Glucose-Tolerance Test (IVGTT data, suffers from frequent lack of identifiability (parameter estimates with Coefficients of Variation (CV less than 52%. The recently proposed Single Delay Model (SDM is evaluated as a practical alternative. Methods The SDM was applied to 74 IVGTTs from lean (19, overweight (22, obese (22 and morbidly obese (11 subjects. Estimates from the SDM (KxgI were compared with the corresponding MM (SI, 1/HOMA-IR index and Euglycemic-Hyperinsulinemic Clamp (M-EHC over 7 subjects estimates. Results KxgI was identifiable in 73 out of 74 subjects (CV = 69% in the 74th subject and ranged from 1.25 × 10-5 to 4.36 × 10-4min-1pM-1; SI CV was >52% in 36 subjects (up to 2.36 × 109% and presented 18 extreme values (? 1.5 × 10-12 or ? 3.99. KxgI correlated well with 1/HOMA-IR (r = 0.56, P xgI-SI and 1/HOMA-IR-SI were high (r = 0.864 and 0.52 respectively and significant (P I sub-sample (56 subjects. Correlations KxgI vs. M-EHC and SI vs. M-EHC were positive (r = 0.92, P = 0.004 and r = 0.83, P = 0.02 respectively. KxgI decreased for higher BMI's (P I significantly so only over the non-extreme-SI sub-sample. The Acute Insulin Response Index was also computed and the expected inverse (hyperbolic relationship with the KxgI observed. Conclusions Precise estimation of insulin sensitivity over a wide range of BMI, stability of all other model parameters, closer adherence to accepted physiology make the SDM a useful alternative tool for the evaluation of insulin sensitivity from the IVGTT.

De Gaetano Andrea

2010-03-01

167

Ghrelin Infusion in Humans Induces Acute Insulin Resistance and Lipolysis Independent of Growth Hormone Signaling  

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OBJECTIVE—Ghrelin is a gut-derived peptide and an endogenous ligand for the growth hormone (GH) secretagogue receptor. Exogenous ghrelin stimulates the release of GH (potently) and adrenocorticotropic hormone (ACTH) (moderately). Ghrelin is also orexigenic, but its impact on substrate metabolism is controversial. We aimed to study direct effects of ghrelin on substrate metabolism and insulin sensitivity in human subjects.

Vestergaard, Esben Thyssen; Gormsen, Lars Christian; Jessen, Niels; Lund, Sten; Hansen, Troels Krarup; Moller, Niels; Jorgensen, Jens Otto Lunde

2008-01-01

168

Effects of insulin-like growth factor-I on glucose tolerance, insulin levels, and insulin secretion.  

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Insulin-like growth factor-I (IGF-I) and insulin interact with related receptors to lower plasma glucose and to exert mitogenic effects. Recombinant human IGF-I (rhIGF-I) was recently shown to decrease serum levels of insulin and C-peptide in fasted normal subjects without affecting plasma glucose levels. In this study we have investigated in six healthy volunteers the responses of glucose, insulin, and C-peptide levels to intravenous rhIGF-I infusions (7 and 14 micrograms/kg.h) during standa...

Zenobi, P. D.; Graf, S.; Ursprung, H.; Froesch, E. R.

1992-01-01

169

Intermittent 2-hour intravenous infusions of 2-chlorodeoxyadenosine in the treatment of 110 patients with refractory or previously untreated B-cell chronic lymphocytic leukemia.  

Science.gov (United States)

The purpose of our study was to determine the effectiveness of 2-CdA in 2-hour intravenous infusions in the treatment of B-CLL. One hundred and ten patients with B-CLL received 1 to 10 courses of 2-CdA (median 2.5) at a dosage of 0.12 mg/kg daily for 5 consecutive days. Eighteen of them were untreated and 92 relapsed or became refractory to previous therapeutic modalities. Complete remission (CR) was achieved in 8 (7.3%) and partial remission (PR) in 35 patients (31.8%) giving an overall response rate of 39.1%. In 3 patients, cross-resistance to fludarabine was noticed. Toxic effects of 2-CdA were more frequently observed in previously treated patients. Hemorrhagic complications due to drug-induced thrombocytopenia were noticed in 25 (22.7%) and severe infections including sepsis in 14 (12.7%) patients. PMID:8882965

Robak, T; B?asinka-Morawiec, M; Krykowski, E; Kasznicki, M; P?uzanska, A; Potemski, P; Hellmann, A; Zaucha, J M; Lewandowski, K; Dmoszynska, A; Hansz, J; Komarnicki, M; Konopka, L; Durzynski, T; Ceglarek, B; Sikorska, A; Kotlarek-Haus, S; Mazur, G; Urasinski, I; Zdziarska, B; Maj, S; Kopec, I; Skotnicki, A B; Dwilewicz-Trojaczek, J; Grieb, P

1996-08-01

170

Relative roles of insulin clearance and insulin sensitivity in the prebreakfast increase in insulin requirements in insulin-dependent diabetic patients.  

Science.gov (United States)

During continuous subcutaneous or intravenous insulin infusion therapy, many patients with insulin-dependent diabetes (IDD) require more insulin in the prebreakfast period (0600-0800 h) than earlier in the morning (0100-0300 h). This study was designed to assess whether variations in insulin clearance or insulin sensitivity might contribute to overnight variations in insulin requirements. Euglycemic insulin clamp studies were performed in random sequence from 2400 to 0300 h and from 0500 to 0800 h on successive nights in 10 subjects with IDD. Insulin was infused at a rate of 40 mU/min/m2 and plasma glucose concentration was maintained at 100 mg/dl by a variable rate glucose infusion from a Biostator GCIIS (Miles Laboratories, Elkhart, Indiana). Insulin clearance was (mean +/- SEM) 277 +/- 41 ml/min/m2 between 0700 and 0800 h compared with 256 +/- 41 ml/min/m2 between 0200 and 0300 h (P less than 0.05), while glucose infusion rates were the same [3.86 +/- 0.52 mg/kg/min from 0730 to 0800 h versus 3.99 +/- 0.51 mg/kg/min from 0230 to 0300 h (P = NS)]. All eight patients with a previously documented prebreakfast increase in insulin requirements had higher insulin clearance at this time. These results indicate that differences in insulin clearance between the prebreakfast period and the early morning may account partially for the higher prebreakfast insulin requirements in some subjects with IDD, and the variations in insulin requirements during the night are not due to variations in insulin sensitivity. PMID:6360768

Skor, D A; White, N H; Thomas, L; Santiago, J V

1984-01-01

171

Influence of Cytochrome P450 2C19 on the pharmacokinetics of lansoprazole administered by single and successive intravenous infusion in healthy Chinese volunteers  

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Full Text Available This study aimed to explore the effect of CYP2C19 polymorphisms on the pharmacokinetics of lansoprazole administered by single and successive intravenous (iv infusions in healthy Chinese volunteers. A total of 30 subjects, including 20 extensive metabolizers (EMs and 10 poor metabolizers (PMs were recruited and randomly assigned to three groups receiving doses of 15, 30 and 60 mg. All subjects received a single dose of lansoprazole during a 60-min period, and only the 30 mg dose group continued to receive the same dose iv for the next seven days (twice daily. Plasma concentrations of lansoprazole were monitored by high performance liquid chromatography (HPLC at the following times: 15, 30, 45, 60, 75, 105, 165, 225, 300, 390, 480, 600 and 720 min after lansoprazole administration. After a single intravenous infusion in the three groups, AUC, Cmax and t½ were significantly higher in PMs than in EMs, while total clearance (Cltotal in PMs was significantly lower than that in EMs. Mean AUC and Cmax ratios in EMs and PMs were 2.1:1 and 1.4:1, respectively. After repeated doses of 30 mg, the AUC, Cmax, and t½ increased significantly, while the Cltotal decreased significantly in EMs. Mean AUC and Cmax ratios in EMs and PMs amounted to 2.2:1.4 and 1.5:1.2, respectively. Lansoprazole displays a linear increase in AUC and Cmax over a dose range of 15-60 mg, and these were dependent on individual CYP2C19 status.

Xiyong Zhang

2012-01-01

172

Kinetics of ofloxacin and its metabolites in cerebrospinal fluid after a single intravenous infusion of 400 milligrams of ofloxacin.  

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Ofloxacin has been reported to diffuse readily into the cerebrospinal fluid (CSF) in subjects with both inflamed and uninflamed meninges. However, with moderately susceptible bacteria, ofloxacin concentrations in CSF may be subtherapeutic after administration of an intravenous (i.v.) dose of 200 mg. For this reason, the kinetics of a higher dose of ofloxacin in CSF was studied with humans. Six patients with occlusive hydrocephalus caused by cerebrovascular diseases who had undergone external ...

Nau, R.; Kinzig, M.; Dreyhaupt, T.; Kolenda, H.; So?rgel, F.; Prange, H. W.

1994-01-01

173

Normal neurologic and developmental outcome after an accidental intravenous infusion of expressed breast milk in a neonate.  

LENUS (Irish Health Repository)

Here we describe a premature male infant who was accidentally given 10 mL of expressed breast milk intravenously over a 3.5-hour period. Having survived this event with supportive care, this boy was attending regular school with no obvious neurologic or learning difficulties at 6 years of age. In 1998, after a query on an e-mail discussion group for health care providers in neonatology (NICU-net), we were informed of 8 similar events that proved fatal in 3 infants. A root-cause analysis revealed that accidental intravenous administration of breast milk or formula can be avoided by the use of color-coded enteral-administration sets with Luer connections that are not compatible with intravenous cannulas. The addition of methylene blue to feeds, or bolus enteral feeds (instead of continuous gastric feedings), may also help prevent such errors. These cases show the value of gathering information about rare but important events through a neonatal network. In addition, they confirm that prevention of medical error should focus on faulty systems rather than faulty people.

Ryan, C Anthony

2012-02-03

174

Fourteen successful consecutive cases of ABO-incompatible living donor liver transplantation: new simplified intravenous immunoglobulin protocol without local infusion therapy.  

Science.gov (United States)

Since various innovative strategies including local infusion therapy and rituximab have been introduced, the survivals and outcomes of recipients in ABO-incompatible (ABO-I) living donor liver transplantation (LDLT) have remarkably improved. Thus, ABO-I LDLT can be a feasible therapeutic option for the patient with end-stage liver disease if an ABO-compatible donor is not available. Although most ABO-I protocols are based on rituximab, plasma exchange, and local infusion therapy, treatment strategies have been changing according to a center's preference or their results. Nonetheless, the consensus of the ABO-I LDLT protocol remains undetermined. Herein, we present our experience with new simple ABO-I LDLT protocol and the excellent results for 14 patients from January 2011 to May 2013. All patients were administrated a single dose of rituximab over 7 days before transplantation followed by plasma exchange to lower anti-ABO antibody titer ?32. The basic immunosuppression protocol consisted of tacrolimus and steroids with mycophenolate mofetil starting 3 days before transplantation. Splenectomy was not performed routinely and local infusion therapy was not applied at the postoperative period. Instead, the patients received intravenous immunoglobulin (IVIG) after LDLT on days 1, 3, and 5. Neither antibody-mediated rejection nor biliary stricture were encountered in the patients, with a mean follow-up of 16.27 ± 9.4 months. This new simplified ABO-I LDLT protocol seems to prevent antibody-mediated rejection and could be considered as the safe and effective modality to overcome the ABO blood-type barrier in LDLT. PMID:24767341

Kim, J D; Choi, D L; Han, Y S

2014-04-01

175

Metabolic and hematologic changes occurring after rapid intravenous infusion of gammaglobulin in patients with antibody deficiency syndromes  

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OBJECTIVE: We wished to investigate whether increased IgG infusion rates are associated with metabolic and hematologic changes in pediatric patients with antibody deficiency syndromes. METHODS: We studied 7 patients (2-16 years old) with primary antibody deficiencies who had been on regular IgG replacement treatment, 350-600 mg/kg/dose every 3 weeks with a 3% IVIG preparation, for periods ranging from 6 months to 4 years. Initially, the IgG concentration of IVIG preparations was increased to ...

1998-01-01

176

Treatment of acute pancreatitis with protease inhibitors administered through intravenous infusion: an updated systematic review and meta-analysis  

Science.gov (United States)

Background The intravenous use of protease inhibitors in patients with acute pancreatitis is still controversial. The purpose of this study was to evaluate the effectiveness of protease inhibitors intravenously administered to prevent pancreatitis-associated complications. Methods We updated our previous meta-analysis with articles of randomized controlled trials published from January 1965 to March 2013 on the effectiveness of protease inhibitors for acute pancreatitis. A systematic search of PubMed, EMBASE, the Cochrane Library, and Japana Centra Revuo Medicina was conducted. In addition, Internet-based registries (ClinicalTrials.gov, controlled-trials.com, UMIN, JMACCT, and JAPIC) were used to search for on-going clinical trials. Furthermore, references of review articles and previously published meta-analyses were handsearched. The main outcome of interest was the overall mortality rate from acute pancreatitis. Results Seventeen trials were selected for analysis. Overall, protease inhibitors did not achieve a significant risk reduction in mortality (pooled risk difference [RD], -0.02; 95% Confidence Interval [CI], -0.05 to 0.01; number needed to treat [NNT], 74.8) with low heterogeneity. A subgroup analysis in moderate to severe pancreatitis (defined by control mortality rate [CMR] >0.10) did not show a significant effect of protease inhibitors to prevent death (pooled RD, -0.03; 95% CI, -0.07 to 0.01; NNT, 1603.9) with low heterogeneity. An additional subgroup analysis of two trials with CMR >0.20 (i.e., low quality) revealed a significant risk reduction. Conclusion The present meta-analysis re-confirmed that there is no solid evidence that supports the intravenous use of protease inhibitors to prevent death due to acute pancreatitis.

2014-01-01

177

The Effect of Intravenous Magnesium Sulfate Infusion on Sensory Spinal Block and Postoperative Pain Score in Abdominal Hysterectomy  

Science.gov (United States)

Aim. The aim of this study was to investigate the effect of i.v. infusion of magnesium sulphate during spinal anesthesia on duration of spinal block and postoperative pain. Methods. Forty ASA physical status I and status II, aged between 18 and 65, female patients undergoing abdominal hysterectomy under spinal anesthesia were enrolled in this study. Patients in the magnesium group (Group M, n = 20) received magnesium sulphate 65?mg?kg?1 infusion in 250?mL 5% dextrose at 3.5?mL/min rate, and control group (Group C, n = 20) received at the same volume of saline during operation in a double-blind randomized manner. Duration of sensory and motor block, systolic, diastolic, and mean arterial blood pressures, heart rates, pain scores (VAS values), and side effects were recorded for each patient. Blood and CSF samples were taken for analysis of magnesium concentrations. Results. Regression of sensorial block was longer in Group M when compared with that in Group C (175 ± 39 versus 136 ± 32?min) (P hysterectomy.

Kahraman, Fatih; Eroglu, Ahmet

2014-01-01

178

[Deviation of activated partial thromboplastin time from optimal level after 12 hours of intravenous infusion of unfractionated heparin -- an independent predictor of recurrence and unfavorable 30-day prognosis in patients with myocardial infarction].  

Science.gov (United States)

Aim of the study was to assess significance of deviations of activated partial thromboplastin time (APTT) from optimal level (50-75 sec) after 48 hours of intravenous infusion of unfractionated heparin (UFH) in streptokinase treated patients with myocardial infarction (MI) for prognosis of nonfatal reinfarction and cumulative criterion comprising cardiac death, nonfatal MI and early postinfarction angina. Infusion of streptokinase (1,500,000 U in 30-60 min) was carried out after loading dose of aspirin (250 mg) and intravenous bolus (5,000 U) of UFH in 75 patients (age 34-76 years) admitted within 6 hours after onset of acute ST-elevation MI. UFH infusion was started prior to termination of administration of streptokinase and continued for 48 hours. During first 12 hours infusion rate was 1,000 or 800 U/hour in patients with body mass > or = 80 and hypocoagulation by 12th hour of UFH infusion was associated with worse prognosis. APTT levels in 6, 24, and 36 hours of UFH infusion had no prognostic significance in relation to events assessed in the study. PMID:16234765

Shalaev, S V; Shava, V P; Petrik, E S; Pushnikova, M A; Zhuravleva, T D

2005-01-01

179

Efeitos da infusão contínua de propofol ou etomidato sobre variáveis intracranianas em cães Effects of propofol or etomidate intravenous infusion on intracranial variables in dogs  

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Full Text Available Avaliaram-se os efeitos da infusão contínua de propofol ou de etomidato sobre as variáveis intracranianas em cães nomocapneicos. Foram utilizados 20 cães adultos distribuídos aleatoriamente em dois grupos: grupo propofol (GP e grupo etomidato (GE. Para o GP, os animais foram induzidos à anestesia com propofol (10mg/kg e, ato contínuo, iniciaram-se a infusão do fármaco (0,6mg/kg/min e a ventilação controlada. No GE, o etomidato foi usado para indução (5mg/kg e manutenção empregando-se a dose de 0,5mg/kg/min nos 10 minutos iniciais e, em seguida, de 0,2mg/kg/min. Após 30 minutos da implantação do cateter de fibra óptica do monitor de pressão intracraniana (PIC na superfície do córtex cerebral direito, realizaram-se as primeiras mensurações (M1 da PIC, da pressão de perfusão cerebral (PPC, da temperatura intracraniana (TIC, de temperatura corpórea (TC, da pressão arterial média (PAM e da frequência cardíaca (FC. As demais mensurações ocorreram em intervalos de 20 minutos (M2, M3 e M4. O propofol e o etomidato não ocasionaram alterações significativas nas variáveis estudadas com exceção da TC e TIC. Concluiu-se que a infusão contínua desses fármacos em cães mantém a perfusão cerebral e a autorregulação cerebral. Cães anestesiados com etomidato apresentam efeitos adversos intensos e redução gradativa da temperatura corpórea e intracraniana.The effects of total intravenous infusion of propofol or etomidate on intracranial variables in normocapneic dogs were evaluated. Twenty adult mongrel dogs were randomly allotted to: propofol group (GP or etomidate group (GE. In GP animals, the propofol was used for induction (10mg/kg, followed by immediate continuous infusion of the drug (0.6mg/kg/min and controlled ventilation. In GE dogs, the etomidate was used for induction (5mg/kg, followed by a continuous rate infusion (CRI at 0.5mg/kg/min during the first ten minutes and, right after, it was changed to 0.2mg/kg/min. The initial measurement (M1 was recorded 30 minutes after the implant of the fiber optic catheter and, after that, every 20 minutes (M2, M3, and M4. The studied parameters were intracranial pressure (ICP, cerebral perfusion pressure (CPP, intracranial temperature (ICT, body temperature (BT, mean arterial pressure (MAP, and heart rate (HR. The propofol and etomidate did not change the studied variables, except the ICT and BT. It was concluded that the continuous infusion of these drugs maintains the cerebral perfusion and autoregulation. Dogs anesthetized with etomidate have adverse effects and body and intracranial temperature decrease.

D.P. Paula

2010-04-01

180

HEPATIC ARTERIAL INFUSION AND INTRAVENOUS CHEMOTHERAPY IN UNRESECTABLE LIVER METASTASES FROM COLORECTAL CANCER VERSUS SYSTEMIC CHEMOTHERAPY ALONE  

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Full Text Available Methods: In collaboration with Angiography Lab - “Floreasca” Emergency Hospital ,14 patients with hepatic metastases of colorectal origin, unresecable, were administered hepatic intraarterial chemotherapy and 22 patients were administered only systemic chemotherapy with Oxaliplatinum 150 mg, 5 Fluorouracil 2500 mg, Follinate calcium 150 mg. Results: It was thus demonstrated that the therapy using HAI with 5 Fluorouracil, Pharmarubicin, Iomeron, in association with a systemic regimen based on Oxaliplatin and 5 Fluorouracil (an average of 4 cures was efficient in 64% of cases . Moreover, tumor response to therapy allowed consequent curative resection or RFA in 18% of cases. OS was of 20 months and PFS of 11months. In conclusion, administering chemotherapy by hepatic arterial infusion is both efficient and well tolerated in unresecable metastases of colo-rectal cancers. Associating systemic chemotherapy improves on the response rates. The femoral catheter implant is feasible and easies the administration of palliative and neo-adjuvant treatments

Sânziana Ionescu

2011-08-01

 
 
 
 
181

Hyperglucagonemia during insulin deficiency accelerates protein catabolism  

International Nuclear Information System (INIS)

Hyperglucagonemia coexists with insulin deficiency or insulin resistance in many conditions where urinary nitrogen excretion is increased, but the precise role of glucagon in these conditions is controversial. The purpose of this study was to evaluate the effect of hyperglucagonemia on protein metabolism in insulin-deficient subjects. The authors used the stable isotope of an essential amino acid (L-[1-13C]leucine) as a tracer of in vivo protein metabolism. A combined deficiency of insulin and glucagon was induced by intravenous infusion of somatostatin. Hyperglucagonemia and hypoinsulinemia were induced by infusions of somatostatin and glucagon. When somatostatin alone was infused leucine flux increased, indicating a 6-17% increase in proteolysis. When somatostatin and glucagon were infused, leucine flux increased, indicating a 12-32% increase in proteolysis. The increase in leucine flux during the infusion of somatostatin and glucagon was higher than the increase during infusion of somatostatin alone. Somatostatin alone did not change leucine oxidation, whereas the somatostatin plus glucagon increased leucine oxidation 100%. They conclude that hyperglucagonemia accelerated proteolysis and leucine oxidation in insulin-deficient humans

1987-01-01

182

Expression of islet iNOS and inhibition of glucose stimulated insulin release after long-term lipid infusion in the rat is counteracted by PACAP27.  

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Chronic exposure of pancreatic islets to elevated plasma lipids ( lipotoxicity) can lead to beta-cell dysfunction, with overtime becoming irreversible. We examined, by confocal microscopy and biochemistry, whether the expression of islet inducible nitric oxide synthase ( iNOS) and the concomitant inhibition of glucose-stimulated insulin release seen after lipid infusion in rats was modulated by the islet neuropeptide pituitary adenylate cyclase-activating polypeptide ( PACAP) 27. Lipid infusi...

Qader, Saleem; Jimenez, Javier; Ekelund, Mats; Lundquist, Ingmar; Salehi, Albert

2007-01-01

183

Eventos adversos en 1395 infusiones con diferentes preparados de gammaglobulina intravenosa / Adverse events in 1395 infusions with different intravenous gammaglobulin products  

Scientific Electronic Library Online (English)

Full Text Available SciELO Argentina | Language: Spanish Abstract in spanish Los procesos de aislamiento y esterilización de la gammaglobulina endovenosa (IVIG) afectan las características del producto terminado y, por lo tanto, su tolerabilidad. Distintos productos tienen diferentes incidencias de reacciones adversas. Este trabajo cuantifica los eventos adversos (EA) inmedi [...] atos provocados por distintas preparaciones de IVIG. Analizamos 1395 infusiones en 28 pacientes, con una mediana de 32.5 por sujeto (rango 2-214), utilizando seis preparados distintos de IVIG, con una dosis total promedio de 40.3 ± 8.3 g. Analizamos retrospectivamente 1 031 infusiones y 364 prospectivamente. Los pacientes utilizaron una media de 2.68 ± 1.8 IVIG diferentes, con una mediana de 2 (rango 1-6) por persona. El número de marcas comerciales utilizadas se relacionó con el número de infusiones recibidas, r = 0.73. En 24 (2.3%) de 1031 infusiones analizadas en forma retrospectiva se registraron EA que afectaron a 11 de los 23 casos incluidos, con una media de 2.18 ± 1.08 EA por afectado. De 24 pacientes y de 364 infusiones prospectivas, en 14 pacientes y en 32 (7.2%) procedimientos se observaron EA. Veinticuatro (42.9%) de 56 EA fueron leves, 31 (55.5%) moderados y uno (1.8%) fue grave. La velocidad de infusión fue de 9.04 ± 4.6 g/h para las que presentaron EA vs. 10.6 ± 4.6 g/h para las que no (p = 0.31). La incidencia, la gravedad y la proporción de pacientes afectados con EA para cada marca comercial de IVIG fueron muy diferentes entre sí. Esta información debe ser tomada en cuenta en el momento de selección de la IVIG a utilizar. Abstract in english The processes of isolation and sterilization of intravenous gamma globulin (IVIG) affect the end product characteristics and, therefore, its tolerability. Different products have different incidences of adverse reactions. The aim of this study was to quantify the immediate adverse events (AE) caused [...] by the different IVIG preparations. We analyzed 1 395 infusions in 28 patients, with a median of 32.5 per subject (range 2-214), using six different IVIG preparations, with an average dose 40.3 ±8.3 g. One thousand and thirty-one infusions were analyzed retrospectively and 364 prospectively. Patients used a mean of 2.68 ±1.8 different IVIGs, with a median of 2 (range 1-6) per person. The number of trademarks used was related to the number of infusions received, r = 0.73. AE presented in 24 (2.3%) of 1 031 infusions retrospectively analyzed, affecting 11 of 23 patients enrolled, with a mean of 2.18 ± 1.08 AE per subject. Of 24 patients and 364 infusions prospectively analyzed, AE were observed in 14 patients and in 32 (7.2%) procedures. Twenty-four (42.9%) of 56 AE were mild, 31 (55.5%) moderate and one (1.8%) severe. The infusion rate was 9.04±4.6 g/h for those presenting AE vs. 10.6±4.6 g/h for those who did not (p = 0.31, NS). The incidence, severity and proportion of patients with AE for each brand of IVIG were very different from each other. This information should be taken into account when selecting the IVIG to be used.

Malbrán, Alejandro; Larrauri, Blas; Juri, María Cecilia; Fernández Romero, Diego S..

184

Desarrollo tecnológico de sulfato de cinc 5 mg/mL infusión intravenosa Technological development of zinc sulphate 5 mg/mL intravenous infusion  

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Full Text Available Se desarrolló una formulación de sulfato de cinc 5 mg/mL para infusión intravenosa que cumplió con las especificaciones de calidad de la USP 26, así como con el estudio de la estabilidad física, química, microbiológica y biológica de la solución, almacenada en envases de vidrio neutro de 5 mL de calidad hidrolítica I. El producto se expuso al calor por 90 días, y al calor y acción de la luz durante un período de 180 días, así como a vida de estante en condiciones normales de temperatura ambiente. Se comprobó la efectividad de los preservativos antimicrobianos presentes en la formulación. De los estudios realizados se determinó que la solución es estable por un período de más de 18 meses, almacenada a temperatura ambiente.A formulation of zinc sulphate 5 mg/mL for intravenous infusion was developed. It met the quality specifications of the USP 26, and it underwent the study of physical, chemical, microbiological and biological stability of the solution stored in neutral glass flasks of 5 ml of hydrolitic quality I. The product was exposed to heat for 90 days and to heat and the action of light for a period of 180 days, as well as to a shelf life under normal conditions of room temperature. It was proved the effectivity of the antimicrobial preservatives present in the formulation. According to the conducted studies, it was determined that the solution is stable for more than 18 months stored at room temperature.

Armando Gato del Monte

2005-08-01

185

Enhancing the [(13) C]bicarbonate signal in cardiac hyperpolarized [1-(13) C]pyruvate MRS studies by infusion of glucose, insulin and potassium  

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A change in myocardial metabolism is a known effect of several diseases. MRS with hyperpolarized (13) C-labelled pyruvate is a technique capable of detecting changes in myocardial pyruvate metabolism, and has proven to be useful for the evaluation of myocardial ischaemia in vivo. However, during fasting, the myocardial glucose oxidation is low and the fatty acid oxidation (β-oxidation) is high, which complicates the interpretation of pyruvate metabolism with the technique. The aim of this study was to investigate whether the infusion of glucose, insulin and potassium (GIK) could increase the myocardial glucose oxidation in the citric acid cycle, reflected as an increase in the [(13) C]bicarbonate signal in cardiac hyperpolarized [1-(13) C]pyruvate MRS measurements in fasted rats. Two groups of rats were infused with two different doses of GIK and investigated by MRS after injection of hyperpolarized [1-(13) C]pyruvate. No [(13) C]bicarbonate signal could be detected in the fasted state. However, a significantincrease in the [(13) C]bicarbonate signal was observed by the infusion of a high dose of GIK. This study demonstrates that a high [(13) C]bicarbonate signal can be achieved by GIK infusion in fasted rats. The increased [(13) C]bicarbonate signal indicates an increased flux of pyruvate through the pyruvate dehydrogenase enzyme complex and an increase in myocardial glucose oxidation through the citric acid cycle. Copyright © 2013 John Wiley & Sons, Ltd.

Lauritzen, Mette Hauge; Laustsen, Christoffer

2013-01-01

186

Enhancing the [13C]bicarbonate signal in cardiac hyperpolarized [1â?13C]pyruvate MRS studies by infusion of glucose, insulin and potassium  

DEFF Research Database (Denmark)

A change in myocardial metabolism is a known effect of several diseases. MRS with hyperpolarized 13C�labelled pyruvate is a technique capable of detecting changes in myocardial pyruvate metabolism, and has proven to be useful for the evaluation of myocardial ischaemia in vivo. However, during fasting, the myocardial glucose oxidation is low and the fatty acid oxidation (β�oxidation) is high, which complicates the interpretation of pyruvate metabolism with the technique. The aim of this study was to investigate whether the infusion of glucose, insulin and potassium (GIK) could increase the myocardial glucose oxidation in the citric acid cycle, reflected as an increase in the [13C]bicarbonate signal in cardiac hyperpolarized [1�13C]pyruvate MRS measurements in fasted rats. Two groups of rats were infused with two different doses of GIK and investigated by MRS after injection of hyperpolarized [1�13C]pyruvate. No [13C]bicarbonate signal could be detected in the fasted state. However, a significant increase in the [13C]bicarbonate signal was observed by the infusion of a high dose of GIK. This study demonstrates that a high [13C]bicarbonate signal can be achieved by GIK infusion in fasted rats. The increased [13C]bicarbonate signal indicates an increased flux of pyruvate through the pyruvate dehydrogenase enzyme complex and an increase in myocardial glucose oxidation through the citric acid cycle. Copyright © 2013 John Wiley & Sons, Ltd.

Lauritzen, Mette Hauge; Laustsen, Christoffer

2013-01-01

187

Desarrollo tecnológico de sulfato de cinc 5 mg/mL infusión intravenosa / Technological development of zinc sulphate 5 mg/mL intravenous infusion  

Scientific Electronic Library Online (English)

Full Text Available SciELO Cuba | Language: Spanish Abstract in spanish Se desarrolló una formulación de sulfato de cinc 5 mg/mL para infusión intravenosa que cumplió con las especificaciones de calidad de la USP 26, así como con el estudio de la estabilidad física, química, microbiológica y biológica de la solución, almacenada en envases de vidrio neutro de 5 mL de cal [...] idad hidrolítica I. El producto se expuso al calor por 90 días, y al calor y acción de la luz durante un período de 180 días, así como a vida de estante en condiciones normales de temperatura ambiente. Se comprobó la efectividad de los preservativos antimicrobianos presentes en la formulación. De los estudios realizados se determinó que la solución es estable por un período de más de 18 meses, almacenada a temperatura ambiente. Abstract in english A formulation of zinc sulphate 5 mg/mL for intravenous infusion was developed. It met the quality specifications of the USP 26, and it underwent the study of physical, chemical, microbiological and biological stability of the solution stored in neutral glass flasks of 5 ml of hydrolitic quality I. T [...] he product was exposed to heat for 90 days and to heat and the action of light for a period of 180 days, as well as to a shelf life under normal conditions of room temperature. It was proved the effectivity of the antimicrobial preservatives present in the formulation. According to the conducted studies, it was determined that the solution is stable for more than 18 months stored at room temperature.

Armando, Gato del Monte; Ania, González Villazón; Zenia, Pardo Ruiz.

188

Acute metabolic effects of exenatide in patients with type 1 diabetes with and without residual insulin to oral and intravenous glucose challenges.  

Science.gov (United States)

OBJECTIVE Glucagon-like peptide 1 (GLP-1) is an incretin hormone that is released from the gastrointestinal tract. Treatment with GLP-1 analogs has proven to be of clinical use for patients with type 2 diabetes. Patients with type 1 diabetes, particularly those with residual ?-cell function, may also respond to treatment, but the acute metabolic effects of GLP-1 analogs on these patients in reaction to both oral and intravenous glucose challenges are not well understood. RESEARCH DESIGN AND METHODS Seventeen patients with type 1 diabetes, half of whom had residual insulin production, underwent two mixed-meal tolerance tests (MMTTs) and two intravenous glucose tolerance tests (IVGTTs), with and without pretreatment with exenatide. No exogenous bolus insulin was administered for the studies. Glucose excursions, insulin secretion rates (ISRs), and levels of glucagon, endogenous GLP-1, and gastric inhibitory polypeptide were measured after the meal or glucose loads. RESULTS During the MMTT, glucose levels were suppressed with exenatide in patients with or without residual insulin production (P = 0.0003). Exenatide treatment did not change the absolute ISR, but the ISR to glucose levels were increased (P = 0.0078). Gastric emptying was delayed (P = 0.0017), and glucagon was suppressed (P = 0.0015). None of these hormonal or glucose changes were detected during the IVGTT with exenatide administration. CONCLUSIONS Exenatide showed a significant antidiabetogenic effect prior to an oral meal in patients with type 1 diabetes involving glucagon suppression and gastric emptying, while preserving increased insulin secretion. GLP-1 analogs may be useful as an adjunctive treatment in type 1 diabetes. PMID:23939544

Ghazi, Tara; Rink, Linda; Sherr, Jennifer L; Herold, Kevan C

2014-01-01

189

Massive Levemir (Long-Acting) Insulin Overdose: Case Report  

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A 52-year-old insulin-dependant diabetic man presented to the Emergency Department 2 hours after a deliberate massive overdose of 2100 units of long-acting Levemir insulin and a large quantity of whisky. On initial assessment, his GCS was 3/15 and his capillary blood sugar was 2.6?mmol/L. The patient was given a 50?ml bolus of 50% dextrose, followed by intravenous infusions of both 5% and 10% dextrose. Despite the continuous infusions, he experienced 4 symptomatic hypoglycaemic episodes i...

Mamatha Oduru; Mahmood Ahmad

2012-01-01

190

Diferença entre volume de fluidos cristaloides intravenosos prescritos e infundidos em pacientes no pós-operatório precoce Difference between intravenous crystalloid fluids prescribed and infused in patients during early postoperative period  

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Full Text Available OBJETIVO: O objetivo deste trabalho foi auditar a real quantidade de fluídos cristalóides infundidos por via intravenosa em pacientes submetidos a operações abdominais de grande porte num hospital universitário. MÉTODOS: Computou-se a carga hídrica total (CHT de fluidos cristalóides intravenosos infundida diariamente do 1º ao 4º dia de PO em 31 pacientes submetidos à operações de grande porte. Comparou-se a CHT com a carga hídrica prescrita (CHP pelo médico. A CHT foi definida como a somatória da CHP acrescida de diluentes e medicações intravenosas. O protocolo do serviço recomendava a hidratação venosa no peri-operatório entre 30 e 50 mL/Kg/dia em pacientes com prescrição de jejum oral. A comparação entre CHT e CHP foi realizada em todos os dias de pós-operatório pelo teste t pareado. Estabeleceu-se em 5% o nível de significância estatística. RESULTADOS: A CHT infundida do 1º ao 4ºdia de pós-operatório foi de 12,8 (6,4-17,5 L. Desse total, 9,5 litros (74,3% corresponderam a CHP e 3,3 L (25,7% a diluentes e medicações venosas. Em todos os dias de pós-operatório a CHT foi significativamente maior que a CHP (pOBJECTIVE: The aim of this study was to audit the real amount of crystalloid intravenous fluids infused in patients underwent major abdominal operations in a University hospital. METHODS: The whole intravenous crystalloid fluid load (CHT infused from the 1st to the 4th postoperative day in 31 patients underwent major abdominal operations was registered. This amount was compared to the volume daily prescribed (CHP by the physician. CHT was defined as the sum of CHP plus diluents and intravenous drugs received by the patients. Hydration protocol of the service was 30-50 mL/Kd/day for patient with nil per os prescription. Comparisons between CHT and CHP was done in each postoperative day using paired T test. A 5% level was established as significant. RESULTS: CHT summed from 1st to 4th PO days was (mean and range 12.8 (6.4-17.5 L corresponding to 9.5 L (74.3% of CHP and 3.3 L (25.7% of diluents and intravenous drugs. In each postoperative day, CHT was significantly greater than CHP (p<0.001. Until the 3rd PO day patients received a CHT greater than 50 mL/Kg/day. CONCLUSION:. Medical prescription does not contain the real amount of crystalloid intravenous fluids infused. Diluents and intravenous drug may reach 25% of the intravenous fluids load.

José Eduardo de Aguilar-Nascimento

2010-02-01

191

Prospective, randomized study of ropivacaine wound infusion versus intrathecal morphine with intravenous fentanyl for analgesia in living donors for liver transplantation.  

Science.gov (United States)

Postoperative analgesia and care for living liver donors have become particular interests for clinicians as the use of living donor liver transplantation has increased. Local anesthetic-based analgesia has been known to provide effective pain control. In this prospective, randomized study, we compared the postoperative analgesic efficacy of local anesthetic-based analgesia (PainBuster) with the efficacy of opioid-based analgesia [intrathecal morphine (ITM) with intravenous (IV) fentanyl] in liver donors. Forty adult donors were randomly allocated to 1 of 2 groups: an ITM/IV fentanyl group (n = 21) and a PainBuster group (n = 19). Donors in the PainBuster group received 0.5% ropivacaine via a multi-orifice catheter (ON-Q PainBuster) placed at the wound. Donors in the ITM/IV fentanyl group received ITM sulfate (400 ?g) preoperatively and a continuous IV fentanyl infusion postoperatively. A visual analogue scale (VAS) at rest and with coughing and rescue IV fentanyl and meperidine consumption were assessed for 72 hours after the operation. Side effects, including sedation, dizziness, nausea, vomiting, pruritus, respiratory depression, wound seroma or hematoma, and the first time to flatus, were recorded. The VAS score at rest during the first 12 postoperative hours was significantly lower for the ITM/IV fentanyl group. At other times, the VAS scores were comparable between the groups. In the PainBuster group, rescue IV fentanyl and meperidine use was significantly reduced 24 to 48 hours and 48 to 72 hours after surgery in comparison with the first 24 postoperative hours. The time to first flatus was significantly reduced in the PainBuster group. There were no differences in side effects. In conclusion, analgesia was more satisfactory with ITM/IV fentanyl versus PainBuster during the first 12 hours after surgery, but they became comparable thereafter, with a shortened bowel recovery time in the PainBuster group. The concurrent use of ITM with PainBuster may be considered in a future investigation. PMID:23788468

Lee, Sang Hyun; Gwak, Mi Sook; Choi, Soo Joo; Park, Hui Gyeong; Kim, Gaab Soo; Kim, Myung Hee; Ahn, Hyun Joo; Kim, Jieae; Kwon, Choon Hyuck; Kim, Tae Seok

2013-09-01

192

Safety and efficacy of sitagliptin in combination with transient continuous subcutaneous insulin infusion (CSII) therapy in patients with newly diagnosed type 2 diabetes.  

Science.gov (United States)

Sitagliptin was used as monotherapy or in combination with metformin, thiazolidinedione or sulfonylurea. It is not clear whether effects are enhanced or unique when in combination with transient continuous subcutaneous insulin infusion (CSII) therapy. The aim of this study was to assess the safety and efficacy of sitagliptin in combination with transient CSII therapy in patients with newly diagnosed type 2 diabetes. Eighty patients with newly diagnosed type 2 diabetes from July 2011 to May 2013 were recruited into the study. These patients were randomly divided into a CSII monotherapy group (group A, n = 40) or a sitagliptin in combination with CSII therapy group (group B, n = 40) and received insulin intensive therapy. Treatments were maintained for 2 weeks. 75g oral glucose tolerance test (OGTT) was performed before and after treatments, and the levels of glucose, insulin and C-peptide were examined. The results indicated that, compared with CSII therapy group, the level of plasma glucose significantly decreased, the levels of insulin and C-peptide strikingly increased and homeostasis model assessment for beta-cell function (HOMA-?) and Insulinogenic index (Ins index) were improved in the group of sitagliptin in combination with CSII therapy. Above all, the incidence of hypoglycemia was lower, insulin doses were less and the rate of recovery to normal glucose tolerance (NGT) or impaired glucose tolerance (IGT) determined by 75gOGTT was higher in the latter. So, Sitagliptin in combination with CSII therapy can be a new safe and effective therapy in patients with newly diagnosed type 2diabetes. PMID:24621778

Yuan, Guoyue; Jia, Jue; Zhang, Caili; Yu, Shuqin; Dong, Sijing; Ye, Jingjing; Zhu, Tianyi; Tang, Bingqian; Qian, Weiyun; Wang, Dong; Yang, Ling; Zhou, Libin; Mao, Chaoming

2014-05-31

193

The conversion of phenylalanine to tyrosine in man. Direct measurement by continuous intravenous tracer infusions of L-[ring-_2H5]phenylalanine and L-[1-_1_3C] tyrosine in the postabsorptive state  

International Nuclear Information System (INIS)

Steady state phenylalanine and tyrosine turnover and the rate of conversion of phenylalanine of tyrosine in vivo were determined in 6 healthy postabsorptive adult volunteers. Continuous infusions of tracer amounts of L-[ring-_2H5]phenylalanine were determined intravenously for 13-14 hr. After 9-10 hr, a priming dose followed by a continuous infusion of L-[1-_1_3C]tyrosine was added and maintained, along with the [_2H5]phenylalanine infusion, for 4 hr. Venous plasma samples were obtained before the initiation of each infusion and every 30 min during the course of the combined [_2H5]phenylalanine and [_1_3C]tyrosine infusion for determination of isotopic enrichments of [_2H5]phenylalanine, [_1_3C]tyrosine, and [_2H4]tyrosine by gas chromatograph-mass spectrometric analysis of the N-trifluoroacetyl-, methyl ester derivatives of the amino acids. Calculated from the observed enrichments, free phenylalanine and tyrosine turnover rates were 36.1 +/- 5.1 mumole . kg-1 . h-1 and 39.8 +/- 3.5 mumole . kg-1 . h-1, respectively. Phenylalanine was converted to tyrosine at the rate of 5.83 +/- 0.59 mumole . kg-1 . h-1, accounting for approximately 16% of either the phenylalanine or the tyrosine flux. The results indicate that the normal basal steady state phenylalanine hydroxylase activity in vivo in man is lower than that obtained from phenylalanine loading studies. This supports the existence of some type of substance activation of the enzyme as reflected in the previously reported exponential relationship between phenylalanine concentration and phenylalanine hydroxylase activity in vitro. The use of continuous simultaneous infusions of tracer amounts of stable isotope-labeled phenylalanine and tyrosine provides a direct means for studying physiological regulation of phenylalanine hydroxylase activity in vivo

1982-01-01

194

High heritability and genetic correlation of intravenous glucose- and tolbutamide-induced insulin secretion among non-diabetic family members of type 2 diabetic patients  

DEFF Research Database (Denmark)

AIMS/HYPOTHESIS: The aim of this study was to estimate the heritability of quantitative measures of glucose regulation obtained from a tolbutamide-modified frequently sampled IVGTT (t-FSIGT) and to correlate the heritability of the glucose-stimulated beta cell response to the tolbutamide-induced beta cell response. In addition, single nucleotide polymorphisms (SNPs) having an exclusive effect on either glucose- or tolbutamide-stimulated insulin release were identified. METHODS: Two hundred and eighty-four non-diabetic family members of patients with type 2 diabetes underwent a t-FSIGT with intravenous injection of glucose at tâ??=â??0 min and tolbutamide at tâ??=â??20 min. Measurements of plasma glucose, serum insulin and serum C-peptide were taken at 33 time points from fasting to 180 min. Insulin secretion rate, acute insulin response (AIR), disposition index (DI) after glucose and disposition index after tolbutamide (DIT), insulin sensitivity (SI), glucose effectiveness (SG) and beta cell responsiveness to glucose were calculated. A polygenic variance component model was used to estimate heritability, genetic correlations and associations. RESULTS: We found high heritabilities for acute insulin secretion subsequent to glucose stimulation (AIRglucose h (2)â??±â??SE: 0.88â??±â??0.14), but these were slightly lower after tolbutamide (AIRtolbutamide h (2)â??±â??SE: 0.69â??±â??0.14). We also estimated the heritabilities for SI (h (2)â??±â??SE: 0.26â??±â??0.12), SG (h (2)â??±â??SE: 0.47â??±â??0.13), DI (h (2)â??±â??SE: 0.56â??±â??0.14), DIT (h (2)â??±â??SE: 0.49â??±â??0.14) and beta cell responsiveness to glucose (h (2)â??±â??SE: 0.66â??±â??0.12). Additionally, strong genetic correlations were found between measures of beta cell response after glucose and tolbutamide stimulation, with correlation coefficients ranging from 0.77 to 0.88. Furthermore, we identified five SNPs with an exclusive effect on either glucose-stimulated (rs5215, rs1111875, rs11920090) or tolbutamide-stimulated (rs10946398, rs864745) insulin secretion. CONCLUSIONS/INTERPRETATION: Our data demonstrate thatboth glucose- and tolbutamide-induced insulin secretions are highly heritable traits, which are largely under the control of the same genes.

Hornbak, Malene; Allin, Kristine H

2014-01-01

195

Formation of biologically active 13,14-dihydro-prostaglandin E1 during intravenous infusion of prostaglandin E1 in newborns with ductus arteriosus-dependent congenital heart disease.  

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Plasma concentrations of prostaglandin (PG) E1 (12-150, median 25 pg ml-1) and 13,14-dihydro-PGE1 (3-62, median 45.5 pg ml-1) were measured by gas chromatography-mass spectrometry in eight newborns with ductus arteriosus-dependent congenital heart disease during continuous intravenous infusion of PGE1. Formation of 13,14-dihydro-PGE1 was demonstrated for the first time in neonates. Since 13,14-dihydro-PGE1 has similar biological activities as the parent compound PGE1, pharmacological effects ...

Leonhardt, A.; Schweer, H.; Wolf, D.; Seyberth, H. W.

1992-01-01

196

Acute metabolic effects and half-lives of intravenously administered insulinlike growth factors I and II in normal and hypophysectomized rats.  

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Insulinlike growth factors (IGF) act qualitatively like insulin on insulin target tissues in vitro. In the circulation in vivo they are bound to specific carrier proteins. In this form or when continuously infused into hypophysectomized (hypox) rats they do not exert acute insulinlike effects on glucose homeostasis. This study definitively shows that intravenous bolus injections of pure IGF I or II act acutely on glucose homeostasis: they lower the blood sugar, enhance the disappearance of U-...

Zapf, J.; Hauri, C.; Waldvogel, M.; Froesch, E. R.

1986-01-01

197

Effect of a 48-hour intravenous delta 4-androstenedione infusion on the pregnant rhesus monkey in the last third of gestation: changes in maternal plasma estradiol concentrations and myometrial contractility.  

Science.gov (United States)

Increased myometrial activity in the pregnant rhesus monkey occurs in situations in which plasma estrogen concentrations are elevated. Examples of such situations are after laparotomy, with or without hysterotomy, and before delivery. The increased activity occurs primarily in the hours of darkness. To investigate the possibility of a causal relationship between the rise in estrogens and myometrial activity, we infused androstenedione intravenously for 48 hours to the rhesus monkey in the last third of gestation. Myometrial activity was quantified either as an increase in the number of individual contraction events or as a change in the power spectrum at high frequencies characteristic of contractions. Androstenedione infusion was followed by increased myometrial activity. Maternal plasma 17 beta-estradiol concentration was significantly elevated at 10 AM on the second day of androstenedione infusion. We conclude that, in the rhesus monkey late in gestation, estradiol may play a role in the regulation of the contraction activity observed during the hours of darkness in several different situations. PMID:2764065

Figueroa, J P; Honnebier, M B; Binienda, Z; Wimsatt, J; Nathanielsz, P W

1989-08-01

198

Infusão de insulina em terapia intensiva: ensaio controlado randomizado / Infusion de insulina en cuidados intensivos: ensayo controlado aleatorizado / Insulin infusion in intensive care: randomized controlled trial  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese Ensaio clínico controlado e aleatorizado que comparou o uso de protocolo de insulina intensivo e convencional na evolução clínica de pacientes em sepse grave e choque séptico, nas primeiras 72 h. Foi conduzido em um hospital universitário na cidade de São Paulo. O [...] s pacientes (n=46) foram alocados em dois grupos: glicêmico intensivo (glicemia entre 80-110mg/dl) e convencional (180-220mg/dl). Utilizaram-se testes t-Student e Qui-Quadrado na análise dos dados. Observou-se diferença estatisticamente significativa (p<0,001) na média glicêmica, mas não houve diferença para as variáveis pressão arterial média mínima (p=0,06) e máxima (p=0,11), creatinina sérica (p=0,33) e na mortalidade (p=0,11). Apesar de não haver diferença entre os grupos quanto à mortalidade, a instabilidade hemodinâmica no grupo convencional foi mais duradoura e somente nele ocorreram óbitos. Abstract in spanish Ensayo clínico aleatorio controlado y randomizado que comparó el uso de protocolo de insulina intensivo y convencional en la evolución clínica de pacientes en sepsis grave y shock séptico, en las primeras 72 horas. Fue realizado en un hospital universitario de la ciudad de [...] São Paulo. Los pacientes (n=46) fueron distribuidos en dos grupos: glucémico intensivo (glucemia entre 80-110mg/dl) y convencional (180-220mg/dl). Se utilizaron tests t-Student y Chi-cuadrado para análisis de los datos. Se observó diferencia estadísticamente significativa (p<0,001) en la media glucémica, pero no hubo diferencia para las variables presión arterial mínima (p=0,06) y máxima (p=0,11), creatinina sérica (p=0,33) y en la mortalidad (p=0,11). A pesar de no existir diferencia entre los grupos en cuanto a mortalidad, la inestabilidad hemodinámica en el grupo convencional fue más duradera y sólo en él existieron decesos. Abstract in english This randomized controlled trial compared the use of an intensive and conventional insulin protocol on clinical outcomes in patients with severe sepsis and septic shock, in the first 72 hours. It was conducted at a university hospital in the city of São Paulo. Patients (n=46) were allocated in [...] to two groups: intensive glycemic (blood glucose between 80-110mg/dl) and conventional (180-220mg/dl). The Student's t-test and chi-square test were used for data analysis. A statistically significant (p<0.001) difference was observed in mean glycemia, but there was no difference in the variables of mean minimum arterial pressure (p=0.06) or maximum (p=0.11), serum creatinine (p=0,33) or in mortality (p=0.11). Although there was no difference between the groups regarding mortality, hemodynamic instability in the conventional group was longer and the only deaths occurred in it.

Miranda, Milena Penteado Ferraro; Crespo, Jeiel Carlos Lamonica; Secoli, Silvia Regina.

2013-06-01

199

Plasma levels of atrial natriuretic peptide and brain natriuretic peptide following intravenous saline infusion in oedematous chronic obstructive pulmonary disease and non-oedematous chronic obstructive pulmonary disease.  

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Some patients with chronic obstructive pulmonary disease (COPD) develop oedematous COPD (oCOPD) with peripheral oedema and have a poor prognosis. The cause of the fluid retention is poorly understood but could be due to defective release of a natriuretic factor. We investigated this hypothesis by measuring levels of brain natriuretic peptide (BNP) and atrial natriuretic peptide (ANP) before and after a 0.1 ml/kg/min 2.7% saline infusion in 6 patients with hypoxemic COPD but no history of oedema and 7 COPD patients with oCOPD. Vasopressin, aldosterone, plasma and urinary urea and electrolytes and osmolality were measured. Arterial blood gases and spirometry were also recorded. The two groups were similar in terms of age, weight, PaO2, PaCO2 and FVC. FEV1 was significantly lower in the oCOPD group. The oCOPD group excreted less urine (202 +/- 23 vs. 364 +/- 48 ml; p h after the saline load compared to the pre-infusion values (30 +/- 7 vs. 11 +/- 2; p h after the infusion had ended (45 +/- 6 vs. 27 +/- 2; p h after the saline load, BNP and ANP levels were significantly greater in the oCOPD group (BNP 32 +/- 2 vs. 24 +/- 1; p h after the infusion ended (45 +/- 6 vs. 26 +/- 2; p < 0.05). Although aldosterone levels were greater in the oCOPD group before the saline infusion, the hormone level was suppressed appropriately by the infusion. In conclusion, the cause of oedema in oCOPD and the inability to excrete a saline load is not due to a failure of release of BNP or ANP. PMID:8933657

Sheedy, W; Stewart, A G; Morice, A H

1996-01-01

200

Infusion of glucose and lipids at physiological rates causes acute endoplasmic reticulum stress in rat liver.  

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Endoplasmic reticulum (ER) stress has recently been implicated as a cause for obesity-related insulin resistance; however, what causes ER stress in obesity has remained uncertain. Here, we have tested the hypothesis that macronutrients can cause acute (ER) stress in rat liver. Examined were the effects of intravenously infused glucose and/or lipids on proximal ER stress sensor activation (PERK, eIF2-?, ATF4, Xbox protein 1 (XBP1s)), unfolded protein response (UPR) proteins (GRP78, calnexin, calreticulin, protein disulphide isomerase (PDI), stress kinases (JNK, p38 MAPK) and insulin signaling (insulin/receptor substrate (IRS) 1/2 associated phosphoinositol-3-kinase (PI3K)) in rat liver. Glucose and/or lipid infusions, ranging from 23.8 to 69.5 kJ/4 h (equivalent to between ~17% and ~50% of normal daily energy intake), activated the proximal ER stress sensor PERK and ATF6 increased the protein abundance of calnexin, calreticulin and PDI and increased two GRP78 isoforms. Glucose and glucose plus lipid infusions induced comparable degrees of ER stress, but only infusions containing lipid activated stress kinases (JNK and p38 MAPK) and inhibited insulin signaling (PI3K). In summary, physiologic amounts of both glucose and lipids acutely increased ER stress in livers 12-h fasted rats and dependent on the presence of fat, caused insulin resistance. We conclude that this type of acute ER stress is likely to occur during normal daily nutrient intake. PMID:21475143

Boden, Guenther; Song, Weiwei; Duan, Xunbao; Cheung, Peter; Kresge, Karen; Barrero, Carlos; Merali, Salim

2011-07-01

 
 
 
 
201

The use of a volumetric infusion pump for the intra-arterial infusion of drugs.  

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Volumetric infusion pumps are widely used for intravenous infusions. We have extended their use to the intra-arterial infusion of drugs. An in vitro evaluation of the performance of such devices, under experimental conditions comparable to an intra-arterial infusion, was carried out. The results obtained confirmed the accuracy of volumetric infusion pumps for intra-arterial infusions. The system was found to be safe, reliable and simple in clinical practice.

Cooper, A. M.; Lilliman, M.

1985-01-01

202

Insulin  

Science.gov (United States)

The manipulation of organic materials--cells, tissues, and even living organisms--offers many exciting possibilities for the future from organic computers to improved aquaculture. Commercial researchers are using the microgravity environment to produce large near perfect protein crystals Research on insulin has yielded crystals that far surpass the quality of insulin crystals grown on the ground. Using these crystals industry partners are working to develop new and improved treatments for diabetes. Other researchers are exploring the possibility of producing antibiotics using plant cell cultures which could lead to both orbital production and the improvement of ground-based antibiotic production.

2004-01-01

203

Diferença entre volume de fluidos cristaloides intravenosos prescritos e infundidos em pacientes no pós-operatório precoce / Difference between intravenous crystalloid fluids prescribed and infused in patients during early postoperative period  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese OBJETIVO: O objetivo deste trabalho foi auditar a real quantidade de fluídos cristalóides infundidos por via intravenosa em pacientes submetidos a operações abdominais de grande porte num hospital universitário. MÉTODOS: Computou-se a carga hídrica total (CHT) de fluidos cristalóides intravenosos in [...] fundida diariamente do 1º ao 4º dia de PO em 31 pacientes submetidos à operações de grande porte. Comparou-se a CHT com a carga hídrica prescrita (CHP) pelo médico. A CHT foi definida como a somatória da CHP acrescida de diluentes e medicações intravenosas. O protocolo do serviço recomendava a hidratação venosa no peri-operatório entre 30 e 50 mL/Kg/dia em pacientes com prescrição de jejum oral. A comparação entre CHT e CHP foi realizada em todos os dias de pós-operatório pelo teste t pareado. Estabeleceu-se em 5% o nível de significância estatística. RESULTADOS: A CHT infundida do 1º ao 4ºdia de pós-operatório foi de 12,8 (6,4-17,5) L. Desse total, 9,5 litros (74,3%) corresponderam a CHP e 3,3 L (25,7%) a diluentes e medicações venosas. Em todos os dias de pós-operatório a CHT foi significativamente maior que a CHP (p Abstract in english OBJECTIVE: The aim of this study was to audit the real amount of crystalloid intravenous fluids infused in patients underwent major abdominal operations in a University hospital. METHODS: The whole intravenous crystalloid fluid load (CHT) infused from the 1st to the 4th postoperative day in 31 patie [...] nts underwent major abdominal operations was registered. This amount was compared to the volume daily prescribed (CHP) by the physician. CHT was defined as the sum of CHP plus diluents and intravenous drugs received by the patients. Hydration protocol of the service was 30-50 mL/Kd/day for patient with nil per os prescription. Comparisons between CHT and CHP was done in each postoperative day using paired T test. A 5% level was established as significant. RESULTS: CHT summed from 1st to 4th PO days was (mean and range) 12.8 (6.4-17.5) L corresponding to 9.5 L (74.3%) of CHP and 3.3 L (25.7%) of diluents and intravenous drugs. In each postoperative day, CHT was significantly greater than CHP (p

Aguilar-Nascimento, José Eduardo de; Diniz, Breno Nadaf; Neves, José de Souza.

204

Renal response to graded intravenous hypertonic NaCl infusion in healthy and hypertensive subjects:dose-related impairment in distal NaCl reabsorption  

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The effects of graded acute intravenous hypertonic NaCl loads on the baseline relationship between osmolal clearance and free water reabsorption established during high NaCl dietary intake and on the fractional excretion of various ions were investigated in 15 healthy subjects and in 12 “normal renin” essential hypertensive patients. No significant influence on the baseline relationship could be demonstrated after a moderate NaCl load in the healthy subjects, while free water reabsorption...

Rado?, J. P.; Juhos, E.; Dorhout Mees, E. J.

1980-01-01

205

Application of the euglycaemic clamp technique to bioassay of insulin analogues.  

Science.gov (United States)

The euglycaemic clamp method may offer a precise and clinically valid approach to assess the in vivo potency of new insulin analogues or derivatives relative to a human insulin standard. The proposed protocol was designed to overcome problems due to differences in pharmacokinetics between the test and standard preparations. An analogue of human insulin, GlyA21+ArgB27+ThrB30-NH2, which is absorbed very slowly after subcutaneous injection, and human insulin were compared in intravenous clamp experiments in pigs. Both insulins were infused for 4 h to achieve steady state glucose metabolism. The infusion rate ranged from 2.5-8 pmol min-1 kg-1. Parallel dose response curves were obtained with the mean glucose infusion rate from 180-240 min as the response and the logarithm of the insulin infusion rate as the dose. Standard bioassay analysis showed that the molar potency of the analogue relative to human insulin was 95.2% with a 95% confidence interval of 82.3-111.2%. To assess the clinical validity of the method a similar euglycaemic clamp study was carried out in human volunteers. The insulin infusion rates were 3 and 6 pmol min-1 kg-1, and the mean glucose infusion rate over the final 180-240 min period of the clamp was used as response. The statistical analysis showed, as in the pig clamp bioassay, no significant deviations from steady state or from the assumption of parallelism. The resulting molar potency of the analogue relative to human insulin was 85.5% with a 95% confidence interval of 49.5-128.4%. This was in agreement with the result of the pig clamp bioassay.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1389109

V?lund, A; Ribel, U; Dam, P L; Markussen, J; Langkjaer, L; Dolben, J; Owens, D R

1992-06-01

206

[Infusion solutions].  

Science.gov (United States)

Infusion solutions or preparations for intravenous administration have been developed since 1830 after the work of Thomas Latta. This particular pharmaceutical form, which brings large accounts of liquid (100 to 3000 ml) and nourishes, equilibrates, hydrates, clears, serves as a vehicule for many drugs and allows organ storage, has had a considerable development owing to its successes in a number of severe diseases and because it has supported the emergence of critical care and intensive care medicine. This form has an unappreciated story. It was first used in hospitals but it is now manufactured by the pharmaceutical industry after a long series of technical improvements and galenic innovations bringing solutions to the problems successively encountered (microbial contamination, embolism, blood alteration, "saline fever", degradation and adsorption of drugs, allergic shock...) and answers to the new requirements resulting from progresses in physiology and biology (hydroeletrolytic support, plasma expansion, energy supply, acidobasic homeostasis, malnutrition...). This story is depicted with respect to the indications, the formulation, the infusion devices from the origin to nowadays. PMID:14606483

Dauphin, Alain; Cazalaa, Jean-Bernard; Pradeau, Dominique; Chaouky, Hamitha; Saince-Viard, Dominique

2003-01-01

207

Isoxsuprine infusion in the rat: alterations in maternal, fetal and neonatal glucose homeostasis.  

Science.gov (United States)

To determine the mechanism of alteration in glucose homeostasis associated with maternal isoxsuprine administration, isoxsuprine or 0.04 M saline was administered intravenously for 3 hours to term pregnant and age-matched virgin rats. Isoxsuprine infusion significantly increased plasma glucose and insulin concentrations and decreased hepatic glycogen stores in both. Compared to rat pups of saline infused mothers, pups of isoxsuprine infused mothers had significantly elevated plasma glucose concentrations for the first 4 hours of life and plasma insulin concentrations for the first two. Plasma glucose concentrations for the offspring of isoxsuprine treated mothers then decreased significantly and remained so until 16 hours of age. Hepatic glycogen concentrations were significantly less in rat pups of isoxsuprine treated mothers at birth and for the first 4 hours of life. In a limited number of studies, isoxsuprine was present at birth in substantial quantities (80-85% of maternal levels) in the plasma of rat pups of isoxsuprine infused mothers. These data suggest that maternal isoxsuprine therapy mobilizes hepatic glycogen and results in maternal hyperlgycemia. Maternal isoxsuprine infusion may directly deplete fetal hepatic glycogen and result in transient fetal and neonatal hyperglycemia. the in utero depletion of glycogen and possibly, the early stimulation of insulin production may be responsible for the later significant decreases in plasma glucose in the offspring of isoxsuprine treated mothers. PMID:7035644

Ogata, E S

1981-01-01

208

Estudos hemodinâmicos e da função endotelial em porcas saudáveis após injeção em bolus endovenoso de azul de metileno Hemodynamic and vascular endothelium function studies in healthy pigs after intravenous bolus infusion of methylene blue  

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Full Text Available OBJETIVO: Benefícios clínicos obtidos pelo azul de metileno (AM no tratamento da vasoplegia induzida pela ação do óxido nítrico (NO têm sido relatados na sepse, na síndrome da resposta inflamatória sistêmica (SIRS em cirurgia cardíaca e no choque anafilático, mas a sua segurança é muitas vezes questionada, principalmente relacionada aos seus efeitos hemodinâmicos e à possibilidade de causar disfunção endotelial. O objetivo deste estudo foi examinar os efeitos hemodinâmicos e a função endotelial da infusão endovenosa in vivo do AM em porcos. MÉTODOS: O protocolo de estudo incluiu dois grupos experimentais de porcas fêmeas: Grupo I (Controle - os animais (n = 6 não receberam AM; Grupo II (AM - os animais receberam 3 mg/kg de AM em forma de bolus endovenoso. Após quinze minutos de registro dos parâmetros hemodinâmicos os animais foram sacrificados por exsangüinação, e os estudos in vitro foram conduzidos usando segmentos de artérias coronária, hepática, mesentérica superior, renal, para determinar o efeito do AM na função endotelial relacionada com a liberação de NO. Mediu-se também o NO plasmático nos dois grupos experimentais. RESULTADOS: Os resultados obtidos no presente estudo foram: 1 a infusão endovenosa de AM (3,0 mg/kg não causou nenhuma alteração hemodinâmica significativa; 2 os valores absolutos e porcentuais e nitrito/nitrato plasmático (NOx não apresentaram diferenças nos dois grupos experimentais; 3 o estudo in vitro dos segmentos arteriais (coronária, hepática, renal e mesentérica superior não apresentou disfunção endotelial nos dois grupos. Os resultados sugerem que a injeção endovenosa de AM é segura. Esse dado concorda com dados clínicos no qual o AM foi utilizado para tratar a síndrome vasoplégica após circulação extracorpórea, síndrome da resposta infamatória sistêmica (SIRS e anafilaxia. Os resultados não foram inesperados porque os animais não apresentavam vasoplegia, não se esperando que a inibição da guanilatociclase tenha algum efeito. CONCLUSÃO: A infusão em bolus endovenoso in vivo na dose investigada (3 mg/kg não causou alterações hemodinâmicas e comprometimento da liberação in vitro de NO.OBJECTIVE: Clinical benefit of methylene blue (MB treating NO-induced vasoplegia has been reported in sepsis, systemic inflammatory response syndrome (SIRS in cardiac surgery and anaphylactic shock, but its safety is sometimes questioned, mainly regarding its hemodynamic effects and the possibility of causing endothelium dysfunction. To examine the nitric oxide plasma levels and cardiovascular effects of the infusion of MB in vivo and its effects on endothelium-dependent and endothelium-independent in vitro vascular relaxation. METHODS: The study protocol included two experimental groups of female pigs: Group I (Control - the animals (n=6 did not receive MB; Group II (MB - the animals received 3 mg/kg of MB intravenous bolus infusion. After fifteen minutes of hemodynamic parameter recording the animals were sacrificed by exsanguination, and in vitro studies were conducted using segments of coronary, hepatic, superior mesenteric and renal arteries, to determine the effect of MB on the arterial endothelium function with regard to NO release. Nitric oxide plasma levels (NOx were measured in each of the experimental groups. RESULTS: The results obtained in the present investigation were: 1 intravenous infusion of MB (3.0 mg/kg caused no hemodynamic changes; 2 absolute and percent plasma NOx values did not differ between the experimental groups; and 3 in vitro study of vascular relaxation showed no significant difference between groups. These results show that MB intravenous infusion seems to be safe. This finding agrees with data from clinical experiments where MB was used to treat vasoplegic syndrome after cardiopulmonary bypass, systemic inflammatory response syndrome (SIRS and anaphylaxis. These results were not unexpected because, as in healthy subjects, hemodynamics is only fine tuned and not fully under NO cont

Antonio Carlos Menardi

2006-10-01

209

IT infusion  

Science.gov (United States)

Infusing IT technology is a perennial challenge. The Technology Infusion and Maturity Assessment approach of Cornford & Hicks is shown applied to an example of IT infusion: moedl-based V&V of spacecraft software.

Feather, M. S.

2002-01-01

210

Anesthesia with propofol induces insulin resistance systemically in skeletal and cardiac muscles and liver of rats  

Energy Technology Data Exchange (ETDEWEB)

Highlights: ? Propofol, as a model anesthetic drug, induced whole body insulin resistance. ? Propofol anesthesia decreased glucose infusion rate to maintain euglycemia. ? Propofol decreased insulin-mediated glucose uptake in skeletal and cardiac muscles. ? Propofol increased hepatic glucose output confirming hepatic insulin resistance. -- Abstract: Hyperglycemia together with hepatic and muscle insulin resistance are common features in critically ill patients, and these changes are associated with enhanced inflammatory response, increased susceptibility to infection, muscle wasting, and worsened prognosis. Tight blood glucose control by intensive insulin treatment may reduce the morbidity and mortality in intensive care units. Although some anesthetics have been shown to cause insulin resistance, it remains unknown how and in which tissues insulin resistance is induced by anesthetics. Moreover, the effects of propofol, a clinically relevant intravenous anesthetic, also used in the intensive care unit for sedation, on insulin sensitivity have not yet been investigated. Euglycemic hyperinsulinemic clamp study was performed in rats anesthetized with propofol and conscious unrestrained rats. To evaluate glucose uptake in tissues and hepatic glucose output [{sup 3}H]glucose and 2-deoxy[{sup 14}C]glucose were infused during the clamp study. Anesthesia with propofol induced a marked whole-body insulin resistance compared with conscious rats, as reflected by significantly decreased glucose infusion rate to maintain euglycemia. Insulin-stimulated tissue glucose uptake was decreased in skeletal muscle and heart, and hepatic glucose output was increased in propofol anesthetized rats. Anesthesia with propofol induces systemic insulin resistance along with decreases in insulin-stimulated glucose uptake in skeletal and heart muscle and attenuation of the insulin-mediated suppression of hepatic glucose output in rats.

Yasuda, Yoshikazu; Fukushima, Yuji; Kaneki, Masao [Department of Anaesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Shriners Hospitals for Children, Harvard Medical School, Boston, MA 02114 (United States); Martyn, J.A. Jeevendra, E-mail: jmartyn@partners.org [Department of Anaesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Shriners Hospitals for Children, Harvard Medical School, Boston, MA 02114 (United States)

2013-02-01

211

Anesthesia with propofol induces insulin resistance systemically in skeletal and cardiac muscles and liver of rats  

International Nuclear Information System (INIS)

Highlights: ? Propofol, as a model anesthetic drug, induced whole body insulin resistance. ? Propofol anesthesia decreased glucose infusion rate to maintain euglycemia. ? Propofol decreased insulin-mediated glucose uptake in skeletal and cardiac muscles. ? Propofol increased hepatic glucose output confirming hepatic insulin resistance. -- Abstract: Hyperglycemia together with hepatic and muscle insulin resistance are common features in critically ill patients, and these changes are associated with enhanced inflammatory response, increased susceptibility to infection, muscle wasting, and worsened prognosis. Tight blood glucose control by intensive insulin treatment may reduce the morbidity and mortality in intensive care units. Although some anesthetics have been shown to cause insulin resistance, it remains unknown how and in which tissues insulin resistance is induced by anesthetics. Moreover, the effects of propofol, a clinically relevant intravenous anesthetic, also used in the intensive care unit for sedation, on insulin sensitivity have not yet been investigated. Euglycemic hyperinsulinemic clamp study was performed in rats anesthetized with propofol and conscious unrestrained rats. To evaluate glucose uptake in tissues and hepatic glucose output [3H]glucose and 2-deoxy[14C]glucose were infused during the clamp study. Anesthesia with propofol induced a marked whole-body insulin resistance compared with conscious rats, as reflected by significantly decreased glucose infusion rate to maintain euglycemia. Insulin-stimulated tissue glucose uptake was decreased in skeletal muscle and heart, and hepatic glucose output was increased in propofol anesthetized rats. Anesthesia with propofol induces systemic insulin resistance along with decreases in insulin-stimulated glucose uptake in skeletal and heart muscle and attenuation of the insulin-mediated suppression of hepatic glucose output in rats

2013-02-01

212

Effect of short-term intralipid infusion on the immune response during low-dose endotoxemia in humans  

DEFF Research Database (Denmark)

Novel anti-inflammatory effects of insulin have recently been described, and insulin therapy to maintain euglycemia suppresses the plasma levels of free fatty acids (FFA) and increases the survival of critically ill patients. We aimed to explore the effect of short-term high levels of plasma FFA on the inflammatory response to a low dose of endotoxin. Fourteen healthy male volunteers underwent the following two trials in a randomized crossover design: 1) continuous infusion of 20% Intralipid [0.7 ml.kg(-1).h(-1) (1.54 g/kg)] for 11 h, and 2) infusion of isotonic saline for 11 h (control). In each trial, heparin was given to activate lipoprotein lipase, and an intravenous bolus of endotoxin (0.1 ng/kg) was given after 6 h of Intralipid/saline infusion. Blood samples and muscle and fat biopsies were obtained before the Intralipid/saline infusion and before as well as after infusion of an endotoxin bolus. Plasma levels of FFA, triglycerides, and glycerol were markedly increased during the Intralipid infusion. Endotoxin exposure induced an increase in plasma levels of TNF-alpha, IL-6, and neutrophils and further stimulated gene expression of TNF-alpha and IL-6 in both skeletal muscle and adipose tissue. The systemic inflammatory response to endotoxin was significantly pronounced during Intralipid infusion. Short-term hyperlipidemia enhances the inflammatory response to endotoxin, and skeletal muscle and adipose tissue are capable of producing essential inflammatory mediators after endotoxin stimulation Udgivelsesdato: 2008/2

Krogh-Madsen, R.; Plomgaard, P.

2008-01-01

213

Placebo- and amitriptyline-controlled evaluation of central nervous system effects of the NK1 receptor antagonist aprepitant and intravenous alcohol infusion at pseudo-steady state.  

Science.gov (United States)

Recent interest in NK1 receptor antagonists has focused on a potential role in the treatment of drug addiction and substance abuse. In the present study, the potential for interactions between the NK1 receptor antagonist aprepitant and alcohol, given as an infusion at a target level of 0.65 g/L, was evaluated. Amitriptyline was included as positive control to provide an impression of the profile of central nervous system (CNS) effects. In a double-blind, randomized, placebo- and amitriptyline-controlled study, the pharmacokinetics and CNS effects of aprepitant and alcohol were investigated in 16 healthy volunteers. Cognitive and psychomotor function tests included the visual verbal learning test (VVLT), Bond and Lader visual analogue scales (VAS), digit symbol substitution test (DSST), visual pattern recognition, binary choice reaction time, critical flicker fusion (CFF), body sway, finger tapping, and adaptive tracking. Alcohol impaired finger tapping and body sway. Amitriptyline impaired DSST performance, VAS alertness, CFF, body sway, finger tapping, and adaptive tracking. No impairments were found after administration of aprepitant. Co-administration of aprepitant with alcohol was generally well tolerated and did not cause significant additive CNS effects, compared with alcohol alone. Therefore, our study found no indications for clinically relevant interactions between aprepitant and alcohol. PMID:23775877

te Beek, Erik T; Tatosian, Daniel; Majumdar, Anup; Selverian, Diana; Klaassen, Erica S; Petty, Kevin J; Gargano, Cynthia; van Dyck, Kristien; McCrea, Jacqueline; Murphy, Gail; van Gerven, Joop M A

2013-08-01

214

Calcineurin inhibitors acutely improve insulin sensitivity without affecting insulin secretion in healthy human volunteers  

DEFF Research Database (Denmark)

WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT: New Onset Diabetes After Transplantation is related to treatment with immunosuppressive medica-tions. Clinical studies have shown that risk of new onset diabetes is greater with tacrolimus compared with cyclosporine. The diabetogenicity of cyclosporine and tacrolimus has been attributed to both beta cell dysfunction and impaired insulin sensitivity. WHAT THIS STUDY ADDS: This is the first trial to investigate beta cell function and insulin sensitivity using gold standard methodology in healthy human volunteers treated with clinically relevant doses of cyclosporine and tacrolimus. We document that both drugs acutely increase insulin sensitivity, while first phase and pulsatile insulin secretion remain unaffected. This study demonstrates that cyclosporine and tacrolimus have similar acute effects on glucose metabolism in healthy humans. ABSTRACT: BACKGROUND AND PURPOSE. Introducing the calcineurin inhibitors (CNIs) cyclosporine (CsA) and tacrolimus (Tac) has improved the outcome of organ transplants, but complications such as New Onset Diabetes mellitus After Transplantation (NODAT) cause impairment of survival rates. The relative contribution of each CNI to the pathogenesis and development of NODAT remains unclear. We sought to compare the impact of CsA and Tac on glucose metabolism in human subjects. EXPERIMENTAL APPROACH. Ten healthy men underwent 5-hour infusions of CsA, Tac and saline in a randomized, double-blind, cross-over study. During infusion glucose metabolism was investigated using following methods: A hyperinsulinemic-euglycemic clamp, an intravenous glucose tolerance test (IVGTT), glucose-stimulated insulin concentration time-series and indirect calorimetry. RESULTS. Clamp derived insulin sensitivity was increased by 25 % during CsA (P <0.0001) and 13 % during Tac administration (P= 0.047), whereas first phase and pulsatile insulin secretion were unaffected. Coinciding with the CNI induced improved insulin sensitivity, glucose oxidation rates increased, whileinsulin clearance rates decreased, only non-significantly. Tac singularly lowered hsCRP levels, otherwise no changes were observed in circulating glucagon, FFA or adiponectin levels. Mean blood levels of CNIs were 486.9 ± 23.5 μg/l for CsA and 12.8 ± 0.5 μg/l for Tac. CONCLUSIONS. In conclusion acute effects of intravenous CsA and to a lesser degree Tac infusions in healthy volunteers include increased insulin sensitivity, without any effect on first phase or pulsatile insulin secretion.

�zbay, Aygen; Møller, Niels

2012-01-01

215

Use of real time continuous glucose monitoring and intravenous insulin in type 1 diabetic mothers to prevent respiratory distress and hypoglycaemia in infants  

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Full Text Available Abstract Background Pregnancy in Type 1 diabetic patients is a precarious condition, both for mother and fetus with increased the risk of prematurity and, immediately after delivery with risk of respiratory distress syndrome and hypoglycaemia in newborns. A strict control and monitoring of diabetes throughout pregnancy is important in reducing the impact of the disease on the fetus and newborn. In recent years many new technologies have been introduced to ameliorate diabetes monitoring, where the last is the Real-time Continuous Glucose Monitoring System (RT-CGMS. Methods In the last three years, 72 h continuous glucose monitoring system (RT-CGMS (Medtronic, CA was performed in 18 pregnant women with Type 1 diabetes in two moments of pregnancy: during treatment with betamethasone to prevent respiratory distress and during delivery. In both cases insulin was administered intravenous and the dose was changed on the basis of glycaemia. Results The results present the use of this new technique during two topics moments of pregnancy of type 1 diabetes patients when is very important intensively to monitor diabetes and to obtain the well being of the fetus. No infant experimented hypoglycaemia or respiratory distress syndrome at the moment and in the first hours after the birth. Conclusion We wish to stress the importance reducing glycaemia during administration of betamethasone and during labor. It is conceivable that the scarce attention paid to monitoring glucose levels in diabetic mothers during labor in gynaecological world may be due to the difficulty in glucose monitoring with the devices until now available. Hopefully, our anecdotal account may prompt improvements with RT-CGMS, and may lead to a better approach to the problem, thereby changing the prognosis of infants born to diabetic mothers.

Passaro Patrizia

2008-07-01

216

Glucagon responses to increasing oral loads of glucose and corresponding isoglycaemic intravenous glucose infusions in patients with type 2 diabetes and healthy individuals  

DEFF Research Database (Denmark)

AIMS/HYPOTHESIS: Type 2 diabetes is associated with hypersecretion of glucagon during an OGTT, whereas i.v. glucose suppresses glucagon levels. This suggests that type 2 diabetic hyperglucagonaemia may result from glucose stimulation of the gastrointestinal tract. We evaluated glucagon responses to increasing amounts of glucose given orally and corresponding isoglycaemic i.v. glucose infusions (IIGIs) in patients with type 2 diabetes and in healthy controls. METHODS: Plasma glucagon responses were measured during three 4 h OGTTs with increasing loads of glucose (25 g, 75 g and 125 g) and three corresponding IIGIs in eight patients with type 2 diabetes (age [meanâ??±â??SEM] 57â??±â??4 years; BMI 29.5â??±â??1.0 kg/m(2); HbA1c 7.0â??±â??0.3% [53â??±â??2 mmol/mol]) and eight healthy individuals (age 57â??±â??4 years; BMI 28.9â??±â??0.7 kg/m(2); HbA1c 5.4â??±â??0.1% [36â??±â??1 mmol/mol]). RESULTS: In healthy controls no difference in glucagon suppression during the first 45 min of the 25 g OGTT and the corresponding IIGI (-153â??±â??35 vs -133â??±â??24 minâ??Ã?â??pmol/l; pâ??=â??NS) was observed, whereas patients with type 2 diabetes only exhibited significant glucagon suppression following IIGI (29â??±â??27 vs -144â??±â??20 minâ??Ã?â??pmol/l; pâ??=â??0.005). At higher oral glucose loads this difference increased and also became evident in healthy controls. CONCLUSIONS/INTERPRETATION: In patients with type 2 diabetes increasing amounts of oral glucose elicit hypersecretion of glucagon, whereas corresponding IIGIs result in significant glucagon suppression; a phenomenon that is also observed in healthy individuals when larger glucose loads are ingested orally. This suggests that the hyperglucagonaemic response to oral glucose in type 2 diabetes may represent a pathological version of a gut-derived physiological phenomenon. Trial registration: ClinicalTrials.gov NCT00529048.

Knop, Filip K; Lund, Asger

2014-01-01

217

Determination of hydromorphone in human plasma by a sensitive RP-HPLC-ESI-MS method and its application to a clinical pharmacokinetic study in postoperative patients after low dose intravenous administration with infusion pump.  

Science.gov (United States)

A sensitive reverse phase high performance liquid chromatography-electrospray ionization-mass spectrometry (RP-HPLC-ESI-MS) method has been developed and validated for the determination of hydromorphone in human plasma using naloxone as the internal standard (IS). After alkalization with saturated sodium bicarbonate, the plasma samples were extracted with ethyl acetate. Chromatographic separation was performed on a C18 column with the column temperature of 50 °C and a mobile phase of 5mM ammonium acetate buffer containing 1% formic acid-methanol (88:12, v/v). Hydromorphone and the IS were detected by selected ion monitoring using the protonated molecules at m/z 286.2 for hydromorphone and m/z 328.2 for the IS. Calibration curve was linear over the range of 0.01-50 ng/mL. The lower limit of quantification was 0.01 ng/mL. The method was successfully applied to the pharmacokinetic study in postoperative patients after intravenous infusion of 1.5mg hydromorphone hydrochloride. The obtained main pharmacokinetic parameters of hydromorphone in postoperative patients were as follows: the maximum hydromorphone plasma concentration (C(max)) was (24.15 ± 12.51)ng/mL, the time to the C(max) was (10.0 ± 0.0)min, and the elimination half-life was (2.7 ± 0.8)h. PMID:22169470

Sun, Luning; Pan, Yinbin; Ding, Li; Luo, Xuemei; Yan, Zhengyu; Liu, Cunming; Qian, Yanning; Chu, Yan

2012-03-01

218

Intravenous solution therapy simplified  

Directory of Open Access Journals (Sweden)

Full Text Available The Health Matters Advisory Committee, a statutory body constituted under the Health Act 63 of 1977, appointed a National Intravenous Infusion Rationalisation Committee, consisting of experts from the medical and pharmaceutical professions to investigate and make re commendations regarding the availability and use of intravenous solutions in South Africa with the view to promoting patient safety, simplifying therapy for the clinicians, and providing economy for both the producer and the consumer. When the recommendations are implemented the range of formulations will be reduced from 103 to 41 and containers from over 70 to 21. Considerable modification will result in improvements and ultimate standardisation of administration sets and packs.

G.W. Schepers

1982-09-01

219

Preventive effects of octreotide (SMS 201-995) on diabetic ketogenesis during insulin withdrawal.  

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1. Exogenous somatostatin inhibits glucagon secretion and prevents ketoacidosis in diabetic patients, but has the therapeutic disadvantage of requiring continuous intravenous infusion to exhibit these effects. 2. Consequently, we examined the effect of subcutaneous administration of the long-acting somatostatin analogue octreotide (SMS 201-995) on early ketogenesis in diabetic ketoacidosis. On two separate occasions insulin was withdrawn over a period of 9 h from seven type I diabetic patient...

Diem, P.; Robertson, R. P.

1991-01-01

220

Abnormal sympathetic overactivity evoked by insulin in the skeletal muscle of patients with essential hypertension.  

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The reason why hyperinsulinemia is associated with essential hypertension is not known. To test the hypothesis of a pathophysiologic link mediated by the sympathetic nervous system, we measured the changes in forearm norepinephrine release, by using the forearm perfusion technique in conjunction with the infusion of tritiated NE, in patients with essential hypertension and in normal subjects receiving insulin intravenously (1 mU/kg per min) while maintaining euglycemia. Hyperinsulinemia (50-6...

1992-01-01

 
 
 
 
221

Acute administration of unacylated ghrelin has no effect on Basal or stimulated insulin secretion in healthy humans.  

Science.gov (United States)

Unacylated ghrelin (UAG) is the predominant ghrelin isoform in the circulation. Despite its inability to activate the classical ghrelin receptor, preclinical studies suggest that UAG may promote ?-cell function. We hypothesized that UAG would oppose the effects of acylated ghrelin (AG) on insulin secretion and glucose tolerance. AG (1 µg/kg/h), UAG (4 µg/kg/h), combined AG+UAG, or saline were infused to 17 healthy subjects (9 men and 8 women) on four occasions in randomized order. Ghrelin was infused for 30 min to achieve steady-state levels and continued through a 3-h intravenous glucose tolerance test. The acute insulin response to glucose (AIRg), insulin sensitivity index (SI), disposition index (DI), and intravenous glucose tolerance (kg) were compared for each subject during the four infusions. AG infusion raised fasting glucose levels but had no effect on fasting plasma insulin. Compared with the saline control, AG and AG+UAG both decreased AIRg, but UAG alone had no effect. SI did not differ among the treatments. AG, but not UAG, reduced DI and kg and increased plasma growth hormone. UAG did not alter growth hormone, cortisol, glucagon, or free fatty acid levels. UAG selectively decreased glucose and fructose consumption compared with the other treatments. In contrast to previous reports, acute administration of UAG does not have independent effects on glucose tolerance or ?-cell function and neither augments nor antagonizes the effects of AG. PMID:24550190

Tong, Jenny; Davis, Harold W; Summer, Suzanne; Benoit, Stephen C; Haque, Ahrar; Bidlingmaier, Martin; Tschöp, Matthias H; D'Alessio, David

2014-07-01

222

Intravenous labetalol in severe hypertension  

Science.gov (United States)

1 Labetalol was administered by intravenous infusion or by the combination of intravenous bolus injection plus infusion to 15 patients with severe essential hypertension and to one with phaeochromocytoma. 2 With the infusion alone the reduction of arterial pressure was slow to develop and limited in degree, but with the combination of the bolus injection plus the infusion the reduction in pressure was more prompt, more pronounced and longer lasting. Apart from an uncomplicated syncopal attack in one patient, no serious side — effects were encountered. 3 Subsequent treatment with oral labetalol usually required the addition of a diuretic to control the blood pressure probably due to sodium and fluid retention during treatment with labetalol alone.

Dal Palu, C.; Pessina, A. C.; Semplicini, A.; Hlede, M.; Morandin, F.; Palatini, P.; Sperti, G.; Rossi, G. P.

1982-01-01

223

Direct effects of TNF-α on local fuel metabolism and cytokine levels in the placebo controlled bilaterally infused human leg; increased insulin sensitivity, increased net protein breakdown and increased IL-6 release  

DEFF Research Database (Denmark)

TNF-α has widespread metabolic actions. Systemic TNF-α administration, however, generates a complex hormonal and metabolic response. Our study was designed to test whether regional, placebo controlled TNF-α infusion directly affects insulin resistance and protein breakdown. We studied eight healthy volunteers once with bilateral femoral vein and artery catheters during a 3 h basal period and a 3 h hyperinsulinemic euglycemic clamp. One artery was perfused with saline and one with TNF-α. During the clamp TNF-α perfusion increased glucose arterio-venous differences (0.91±0.17 mmol/l vs. 0.74±0.15 mmol/l, p=0.012) and leg glucose uptake rates. Net phenylalanine release was increased by TNF-α perfusion with concomitant increases in appearance and disappearance rates. Free fatty acid kinetics were not affected by TNF-α, whereas IL-6 release increased. Insulin and protein signaling in muscle biopsies was not affected by TNF-α. TNF-α directly increased net muscle protein loss, which may contribute to cachexia and general protein loss during severe illness. The finding of increased insulin sensitivity, which could relate to IL-6, is of major clinical interest and may concurrently act to provide adequate tissue fuel supply and contribute to the occurrence of systemic hypoglycemia. This distinct metabolic feature places TNF-α among the rare insulin mimetics of human origin.

Bach, Ermina; Nielsen, Roni R

2013-01-01

224

Beta Agonist Lung Injury TrIal-2 (BALTI-2 trial protocol: A randomised, double-blind, placebo-controlled of intravenous infusion of salbutamol in the acute respiratory distress syndrome  

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Full Text Available Abstract Background The Acute Respiratory Distress Syndrome (ARDS is a common cause of respiratory failure in critically ill patients. Experimental studies suggest that treatment with beta agonists may be helpful in ARDS. The Beta Agonist Lung Injury TrIal (BALTI-2 is a multicentre, pragmatic, randomised, double-blind, placebo-controlled clinical trial which aims to determine if sustained treatment with intravenous (IV salbutamol will improve survival in ARDS. Methods/Design Patients fulfilling the American-European Consensus Conference Definition of ARDS will be randomised in a 1:1 ratio to receive an IV infusion either of salbutamol (15 ?g kg ideal body weight-1 hr-1 or placebo (0.9% sodium chloride solution, for a maximum of seven days. Allocation to randomised groups will use minimisation to ensure balance with respect to hospital of recruitment, age group (85 years and PaO2/FiO2 ratio (?6.7, 6.8- 13.2, ?13.3 kPa. Data will be recorded by participating ICUs until hospital discharge, and all surviving patients will be followed up by post at six and twelve months post randomisation. The primary outcome is mortality at 28 days after randomisation; secondary outcomes are mortality in ICU, mortality in hospital, number of ventilator-free days, number of organ failure-free days, mortality at twelve months post-randomisation, quality of life at six and twelve months, length of stay in ICU, length of stay in hospital, adverse effects (tachycardia, arrhythmia or other side effects sufficient to stop treatment drug. 1,334 patients will be recruited from about fifty ICUs in the UK. An economic evaluation will be conducted alongside the trial. Trial Registration Current Controlled Trials ISRCTN38366450.

McCabe Chris

2011-05-01

225

Infusion thrombophlebitis: the histological and clinical features.  

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Thrombophlebitis was induced in 8 greyhounds by intravenous infusion of naftidrofuryl (Praxilene), dextrose saline being used as a control. The histological features were the same in the treated and the control veins: circulating polymorphonuclear leucocytes became attached to and later infiltrated the vein endothelium. In more severe cases the deeper layers of the vein wall were affected. The clinical features in 97 patients receiving intravenous infusions of physiological saline, dextrose s...

Woodhouse, C. R.

1980-01-01

226

Infusion extractor  

Science.gov (United States)

This invention relates to an apparatus and method of removing desirable constituents from an infusible material by infusion extraction. A piston operating in a first chamber draws a solvent into the first chamber where it may be heated, and then moves the heated solvent into a second chamber containing the infusible material, where infusion extraction takes place. The piston then moves the solvent containing the extract through a filter into the first chamber, leaving the extraction residue in the second chamber. The method is applicable to operation in low or micro-gravity environments.

Chang-Diaz, Franklin R. (inventor)

1986-01-01

227

Intensive insulin therapy in critical care settings.  

Science.gov (United States)

Hyperglycemia in hospitalized patients has been shown to increase both morbidity and mortality, regardless of the presence of preexisting diabetes. In order to achieve recommended glycemic goals, many patients require the use of intravenous insulin therapy in the critical care setting. Following the publication of a landmark trial evaluating the benefits of intensive insulin therapy in critically ill patients, a worldwide increased effort to achieve strict glycemic control has ensued. Maintaining blood glucose levels between 80 and 110 mg/dL has been shown to improve outcomes such as mortality and infectious complications in critically ill patients, while also decreasing length of hospital stay and healthcare expenditures. However, achieving strict glycemic control has proven to be a challenge for many institutions, partly due to the prevalence of hypoglycemia. As demonstrated by studies which have been terminated prematurely due to increased risk for hypoglycemic episodes, the benefits versus risks of intensive insulin therapy must be weighed carefully. Patients receiving continuous infusions of insulin require close monitoring, which may increase workload for intensive care unit staff. In an effort to balance the risks and benefits of intensive insulin therapy, many hospitals are incorporating standardized protocols and using an interdisciplinary approach toward patient care. PMID:19149505

Eastman, Darla Klug; Bottenberg, Michelle M; Hegge, Karly A; Ourth, Heather; Kabadi, Udaya

2009-01-01

228

Symptomatic cerebral oedema during treatment of diabetic ketoacidosis: effect of adjuvant octreotide infusion  

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Full Text Available Abstract Introduction A potentially lethal complication of diabetic ketoacidosis (DKA in children is brain oedema, whether caused by DKA itself or by the therapeutic infusion of insulin and fluids. Case presentation A 10-year old previously healthy boy with DKA became unconscious and apnoeic due to cerebral oedema (confirmed by abnormal EEG and CT-scan during treatment with intravenous fluids (36 ml/h and insulin (0.1 units/kg/h. He was intubated and artificially ventilated, without impact on EEG and CT-scan. Subsequently, adjuvant infusion of octreotide was applied (3.5 ?g/kg/h, suppressing growth hormone (GH and IGF-1 production and necessitating the insulin dose to be reduced to 0.05 - 0.025 units/kg/h. The brain oedema improved and the boy made a full recovery. Conclusion Co-therapy with octreotide was associated with a favourable outcome in the present patient with DKA and cerebral oedema. Whether this could be ascribed to the effects of octreotide on the insulin requirement or on the GH/IGF-axis remains to be elucidated.

Seewi Ora

2010-08-01

229

Comparative study of amino acid, ammonia and pancreatic hormone levels in the blood of cirrhotic patients following intragastric and intravenous administration of a branched-chain amino acid-enriched solution.  

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Full Text Available The blood levels of amino acids, ammonia and pancreatic hormones following the intragastric and intravenous administration of a branched-chain amino acid (BCAA-enriched solution were comparatively investigated in control subjects and patients with liver cirrhosis. There was no essential difference in the time course of serum amino acid and blood ammonia levels between the intragastric and intravenous infusions. Elevation of serum insulin concentrations in cirrhotic patients was significant only immediately after the administration through the enteral route. However, plasma glucagon levels increased similarly when the BCAA-enriched solution was administered through either route. The results indicate that both enteral and intravenous infusions will have similar therapeutic effects on the impaired protein metabolism in cirrhotic patients with protein-calorie malnutrition.

Watanabe,Akiharu

1983-10-01

230

Angiotensin-(1-7) Recruits Muscle Microvasculature and Enhances Insulin's Metabolic Action via Mas Receptor.  

Science.gov (United States)

Angiotensin-(1-7) [Ang-(1-7)], an endogenous ligand for the G protein-coupled receptor Mas, exerts both vasodilatory and insulin-sensitizing effects. In skeletal muscle, relaxation of precapillary arterioles recruits microvasculature and increases the endothelial surface area available for nutrient and hormone exchanges. To assess whether Ang-(1-7) recruits microvasculature and enhances insulin action in muscle, overnight-fasted adult rats received an intravenous infusion of Ang-(1-7) (0, 10, or 100 ng/kg per minute) for 150 minutes with or without a simultaneous infusion of the Mas inhibitor A-779 and a superimposition of a euglycemic insulin clamp (3 mU/kg per minute) from 30 to 150 minutes. Hind limb muscle microvascular blood volume, microvascular flow velocity, and microvascular blood flow were determined. Myographic changes in tension were measured on preconstricted distal saphenous artery. Ang-(1-7) dose-dependently relaxed the saphenous artery (PAng-(1-7) rapidly increased muscle microvascular blood volume and microvascular blood flow (PAng-(1-7) infusion further increased muscle microvascular blood volume and microvascular blood flow (?2.5 fold; PAng-(1-7). We conclude that Ang-(1-7) by activating Mas recruits muscle microvasculature and enhances the metabolic action of insulin. These effects may contribute to the cardiovascular protective responses associated with Mas activation and explain the insulin-sensitizing action of Ang-(1-7). PMID:24711523

Fu, Zhuo; Zhao, Lina; Aylor, Kevin W; Carey, Robert M; Barrett, Eugene J; Liu, Zhenqi

2014-06-01

231

Insulin Pump Therapy: What Is the Evidence for Using Different Types of Boluses for Coverage of Prandial Insulin Requirements?  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Bolus infusion of insulin along with a meal is a standard procedure with continuous subcutaneous insulin infusion. Modern insulin pumps allow applying this bolus in four different ways: infusion of the total dose at once or splitting the dose into two boluses, infusion of a part of the bolus in the usual manner plus infusion of the other part over a prolonged period of time (with a higher infusion rate than the basal rate), or infusion of the total dose in the form of an elevated basal rate. ...

Heinemann, Lutz

2009-01-01

232

An audit of hospital based outpatient infusions and a pilot program of community-based monoclonal antibody infusions.  

LENUS (Irish Health Repository)

INTRODUCTION: Infliximab, a chimeric monoclonal antibody to tumour necrosis factor alpha, is administered as an intravenous infusion requiring a costly hospital day case or inpatient admission. METHODS: An audit of all current therapies given by intravenous infusions in an outpatient setting in St Vincent\\'s University Hospital (SVUH) was undertaken. Furthermore, in conjunction with TCP homecare, we established in a general practise health clinic, the first Irish community infusion centre for the administration of infliximab in August 2006. RESULTS: All outpatient departments indicated that they would favour a centralized hospital infusion unit. There were no adverse events and the mean global satisfaction improved in the community infliximab infusion pilot programme of seven patients. CONCLUSION: This study suggests efficiencies in providing centralized infusion facilities, while the community based infusion of infliximab is feasible and safe in this small cohort and identifies the community infusion unit as a viable and cost efficient alternative for administration of infliximab.

Doran, J-P

2012-02-01

233

Diagnosis of coronary artery disease by thallium-201 myocardial scintigraphy with intravenous infusion of SUNY4001 (adenosine) in effort angina pectoris. The clinical trial report at multi-center. Phase II  

International Nuclear Information System (INIS)

Forty-four patients with effort angina pectoris were evaluated with SUNY4001 (adenosine) thallium-201 (201Tl) myocardial scintigraphy to detect coronary artery disease. These patients had single-vessel disease (?American Heart Association (AHA) 90% stenosis) in either right coronary artery (RCA) or left anterior descending (LAD). Adenosine was infused at the rate of 120 or 140 ?g/kg/min for six minutes. One hundred eleven MBq of 201Tl was injected after three minutes of the start of the infusion. The early and delayed images were obtained by SPECT imaging. The sensitivity was 94.7% at 120 ?g/kg/min and 84.2% at 140 ?g/kg/min. Adenosine 201Tl myocardial scintigraphy showed high accuracy for detecting significant coronary artery disease. Adverse reactions occurred in 77.3% of the patients. Regarding the rates of the adverse reactions, there was no significant difference between 120 and 140 ?g/kg/min. Major adverse reactions were Chest pain/discomfort (52.3%) and Flushing/Feeling of warmth (27.3%). No serious complication was observed at any infusion rate. Most of adverse reactions disappeared shortly. Only two patients required treatment for moderate chest pain, which, however, disappeared in several minutes. One of the treatments was merely the termination of adenosine infusion, and the other was sublingual spray of nitroglycerin. Adenosine infusion caused slight decrease in blood pressure and increase in heart rate. The hemodynamic changes resolved within several minutes after the adenosine infusion. Decrease in systolic blood pressure of more than 20 mmHg from the base level occurred in 26.1% and 52.4% at 120 and 140 ?g/kg/min infusion rate respectively. Therefore, the adenosine infusion at 120 ?g/kg/min should be considered safe and useful for the diagnosis of coronary artery disease by pharmacologic stress imaging. (author)

2004-05-01

234

[Diagnosis of coronary artery disease by thallium-201 myocardial scintigraphy with intravenous infusion of SUNY4001 (adenosine) in effort angina pectoris--the clinical trial report at multi-center: phase II].  

Science.gov (United States)

Forty-four patients with effort angina pectoris were evaluated with SUNY4001 (adenosine) thallium-201 (201Tl) myocardial scintigraphy to detect coronary artery disease. These patients had single-vessel disease (> or = AHA 90% stenosis) in either RCA or LAD. Adenosine was infused at the rate of 120 or 140 microg/kg/min for six minutes. 111 MBq of 201Tl was injected after three minutes of the start of the infusion. The early and delayed images were obtained by SPECT imaging. The sensitivity was 94.7% at 120 microg/kg/min and 84.2% at 140 microg/kg/min. Adenosine 201Tl myocardial scintigraphy showed high accuracy for detecting significant coronary artery disease. Adverse reactions occurred in 77.3% of the patients. Regarding the rates of the adverse reactions, there was no significant difference between 120 and 140 microg/kg/min. Major adverse reactions were Chest pain/discomfort (52.3%) and Flushing/Feeling of warmth (27.3%). No serious complication was observed at any infusion rate. Most of adverse reactions disappeared sortly. Only two patients required treatment for moderate chest pain, which, however, disappeared in several minutes. One of the treatments was merely the termination of adenosine infusion, and the other was sublingual spray of nitroglycerin. Adenosine infusion caused slight decrease in blood pressure and increase in heart rate. The hemodynamic changes resolved within several minutes after the adenosine infusion. Decrease in systolic blood pressure of more than 20 mmHg from the base level occurred in 26.1% and 52.4% at 120 and 140 microg/kg/min infusion rate respectively. Therefore, the adenosine infusion at 120 microg/kg/min should be considered safe and useful for the diagnosis of coronary artery disease by pharmacologic stress imaging. PMID:15354725

Sakata, Yasushi; Nishimura, Tsunehiko; Yamazaki, Junichi; Nishimura, Shigeyuki; Kaivyas, Teishi; Kodama, Kazuhisa; Kato, Kazuzo

2004-05-01

235

Fish oil omega-3 fatty acids partially prevent lipid-induced insulin resistance in human skeletal muscle without limiting acylcarnitine accumulation.  

Science.gov (United States)

Acylcarnitine accumulation in skeletal muscle and plasma has been observed in numerous models of mitochondrial lipid overload and insulin resistance. Fish oil n3PUFA (omega-3 polyunsaturated fatty acids) are thought to protect against lipid-induced insulin resistance. The present study tested the hypothesis that the addition of n3PUFA to an intravenous lipid emulsion would limit muscle acylcarnitine accumulation and reduce the inhibitory effect of lipid overload on insulin action. On three occasions, six healthy young men underwent a 6-h euglycaemic-hyperinsulinaemic clamp accompanied by intravenous infusion of saline (Control), 10% Intralipid® [n6PUFA (omega-6 polyunsaturated fatty acids)] or 10% Intralipid®+10% Omegaven® (2:1; n3PUFA). The decline in insulin-stimulated whole-body glucose infusion rate, muscle PDCa (pyruvate dehydrogenase complex activation) and glycogen storage associated with n6PUFA compared with Control was prevented with n3PUFA. Muscle acetyl-CoA accumulation was greater following n6PUFA compared with Control and n3PUFA, suggesting that mitochondrial lipid overload was responsible for the lower insulin action observed. Despite these favourable metabolic effects of n3PUFA, accumulation of total muscle acylcarnitine was not attenuated when compared with n6PUFA. These findings demonstrate that n3PUFA exert beneficial effects on insulin-stimulated skeletal muscle glucose storage and oxidation independently of total acylcarnitine accumulation, which does not always reflect mitochondrial lipid overload. PMID:24611892

Stephens, Francis B; Mendis, Buddhike; Shannon, Chris E; Cooper, Scott; Ortori, Catharine A; Barrett, David A; Mansell, Peter; Tsintzas, Kostas

2014-09-01

236

Estimation of prehepatic insulin secretion: comparison between standardized C-peptide and insulin kinetic models  

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Our aim was to compare traditional C-peptide-based method and insulin-based method with standardized kinetic parameters in the estimation of prehepatic insulin secretion rate (ISR). One-hundred thirty-four subjects with varying degrees of glucose tolerance received an insulin-modified intravenous glucose tolerance test and a standard oral glucose tolerance test with measurement of plasma insulin and C-peptide. From the intravenous glucose tolerance test, we determined insulin kinetics paramet...

Tura, Andrea; Pacini, Giovanni; Kautzky-willer, Alexandra; Gastaldelli, Amalia; De-fronzo, Ralph; Ferrannini, Ele; Mari, Andrea

2011-01-01

237

Warmed intravenous infusion for controlling intraoperative hypothermia / Infusão venosa aquecida no controle da hipotermia no período intraoperatório / Infusión venosa calentada en el control de la hipotermia durante el período intraoperatorio  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in portuguese OBJETIVO: verificar a eficácia da intervenção de infusão venosa aquecida, na prevenção da hipotermia em pacientes no período intraoperatório. MÉTODO: estudo experimental, comparativo, de campo, prospectivo e quantitativo [...] , realizado em um hospital público federal. A amostra foi constituída por 60 adultos, que tiveram, como um dos critérios de inclusão, a temperatura axilar entre 36 e 37,1ºC e acesso cirúrgico abdominal, divididos em grupos controle e experimental, compostos utilizando-se a técnica de amostragem probabilística sistemática. RESULTADOS: nos 2 grupos, 22 pacientes (73,4%) saíram da sala de operação com hipotermia, ou seja, temperatura inferior a 36ºC (p=1,0000). A temperatura da sala de operação na entrada do paciente e a temperatura do paciente na entrada da sala de operação foram estatisticamente significativas para influenciar a ocorrência de hipotermia. CONCLUSÃO: o planejamento e implementação das intervenções de enfermagem, realizadas pelo enfermeiro, são essenciais para prevenção da hipotermia e manutenção da normotermia perioperatória. Abstract in spanish OBJETIVO: verificar la eficacia de la intervención de infusión venosa calentada en la prevención de la hipotermia en pacientes en el período intraoperatorio. MÉTODO: estudio experimental, comparativo, de campo, prospectivo y cuantitativo, e [...] n un hospital público federal. La muestra abarcó a 60 adultos, que tuvieron como uno de los criterios de inclusión la temperatura axilar entre 36ºC y 37,1ºC y acceso quirúrgico abdominal, divididos en grupos control y experimental, compuestos utilizándose la técnica de muestreo probabilístico sistemático. RESULTADOS: en los 2 grupos, 22 pacientes (73,4%) salieron del quirófano con hipotermia, o sea, temperatura inferior a 36ºC (p=1,0000). La temperatura del quirófano cuando de la entrada del paciente y la temperatura del paciente cuando de la entrada en el quirófano fueron estadísticamente significativas para influir en la ocurrencia de hipotermia. CONCLUSÍON: la planificación e implementación de las intervenciones de enfermería practicadas por el enfermero son esenciales para prevenir la hipotermia y mantener la normotermia perioperatoria. Abstract in english OBJECTIVE: to verify the effectiveness of warmed intravenous infusion for hypothermia prevention in patients during the intraoperative period. METHOD: experimental, comparative, field, prospective and quantitative study undertaken at a federal public hospital. The [...] sample was composed of 60 adults, included based on the criteria of axillary temperature between 36ºC and 37.1ºC and surgical abdominal access, divided into control and experimental groups, using the systematic probability sampling technique. RESULTS: 22 patients (73.4%) from both groups left the operating room with hypothermia, that is, with temperatures below 36ºC (p=1.0000). The operating room temperature when patients arrived and patients' temperature when they arrived at the operating room were statistically significant to affect the occurrence of hypothermia. CONCLUSION: the planning and implementation of nursing interventions carried out by baccalaureate nurses are essential for preventing hypothermia and maintaining perioperative normothermia.

Mattia, Ana Lúcia De; Barbosa, Maria Helena; Freitas Filho, João Paulo Aché de; Rocha, Adelaide De Mattia; Pereira, Nathália Haib Costa.

2013-06-01

238

Examination of the role of the pituitary-adrenocortical axis, counterregulatory hormones, and insulin clearance in variable nocturnal insulin requirements in insulin-dependent diabetes.  

Science.gov (United States)

In insulin-dependent diabetics, insulin requirements increase significantly after 0600 h, resulting in prebreakfast hyperglycemia with either conventional insulin therapy or constant insulin infusions with insulin infusion devices. In order to clarify the role of the pituitary-adrenocortical axis and further examine the mechanisms of the phenomenon of nocturnal variability in insulin requirements, we studied five IDDs using a closed-loop insulin infusion device (Biostator, GCIIS). The subjects were given saline (SAL) or dexamethasone (DEX) i.v. from 1800 to 0900 h on successive nights. From 2400-0300 to 0600-0900 h, mean insulin infusion rates required to maintain blood glucose values between 109 and 120 mg/dl increased by 0.21 +/- 0.05 mU/kg/min during the SAL infusion, and 0.16 +/- 0.04 mU/kg/min during the DEX infusion, when plasma cortisols were suppressed to less than or equal to 2 micrograms/dl. Mean free insulin concentrations did not increase and remained constant throughout both study nights in spite of the significantly higher 0600-0900-h insulin infusion rates. Growth hormone, glucagon, epinephrine, and norepinephrine concentrations showed normal nocturnal and early morning patterns during both study nights. We conclude that the nocturnal variability in insulin requirements persists despite suppression of the pituitary-adrenocortical axis, and that increased free insulin clearance or degradation may contribute to the "dawn phenomenon" of rising prebreakfast glucose despite constant insulin infusion. PMID:6341122

Skor, D A; White, N H; Thomas, L; Shah, S D; Cryer, P E; Santiago, J V

1983-05-01

239

Inhaled insulin: overview of a novel route of insulin administration  

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Diabetes is a chronic disease characterized by inadequate insulin secretion with resulting hyperglycemia. Diabetes complications include both microvascular and macrovascular disease, both of which are affected by optimal diabetes control. Many individuals with diabetes rely on subcutaneous insulin administration by injection or continuous infusion to control glucose levels. Novel routes of insulin administration are an area of interest in the diabetes field, given that insulin injection thera...

Mastrandrea, Lucy D.

2010-01-01

240

Non-insulin-dependent diabetes mellitus: diagnostic and therapeutic challenges in the severely burned patient--a case report.  

Science.gov (United States)

The purpose of this paper is to describe the management of a previously undiagnosed non-insulin-dependent diabetic patient with a severe burn injury. The hyperglycaemia and glucose intolerance following burn injury was complicated by the hyperglycaemia of diabetes mellitus. Intravenous insulin infusion monitored by hourly glucose levels was required to manage this hyperglycaemia. During day 11 postburn injury, this patient required 2104 units of insulin to control his hyperglycaemia. Aggressive detection and management of infections complemented by early debridement and coverage of the burn wound were other important considerations in the management of this patient. The diagnosis of non-insulin-dependent diabetes mellitus (NIDDM) was made after the patient recovered from his burn injury. His rehabilitation programme has included primary prevention strategies for NIDDM that focus on health-improving behaviours such as improved diet, exercise, and weight control. PMID:8054148

Park, S M; Zachmann, G C; Holliday, W L; Fryburg, D A; Edlich, R F; Himel, H N

1994-06-01

 
 
 
 
241

Importance of transcapillary insulin transport on insulin action in vivo  

International Nuclear Information System (INIS)

The relationship between transcapillary insulin transport and insulin action was examined in normal conscious dogs. Plasma and thoracic duct lymph insulin, and insulin action were simultaneously measured during euglycemic clamps and intravenous glucose tolerance tests. During the clamps, while 14C-inulin reached an equilibrium, steady-state (ss) plasma insulin was higher than lymph and the ratio of 3:2 was maintained during basal, activation and deactivation phases: 18 ± 2 vs. 12 ± 1, 51 ± 2 vs. 32 ± 1, and 18 ± 3 vs. 13 ± 1 ?U/ml. In addition, it took longer for lymph insulin to reach ss than plasma insulin during activation and deactivation: 11 ± 2 vs. 31 ± 5 and 8 ± 2 vs. 32 ± 6 min. During IVGTT, plasma insulin peaked within 5 ± 2 min; lymph insulin rose slowly to a lower peak. The significant gradient and delay between plasma and lymph insulin concentrations suggest a restricted transcapillary insulin transport

1989-01-01

242

Managing diabetes with inhaled insulin  

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The incidence of diabetes is increasing world-wide. Many individuals with diabetes require insulin to control their blood sugar and prevent both microvascular and macrovascular complications associated with this chronic disease. Current regimens involve delivery of subcutaneous insulin by injection or continuous insulin infusion. One area of research to advance diabetes care is aimed at developing alternate routes of insulin administration that will make daily management less invasive for ...

Mastrandrea, Lucy D.

2012-01-01

243

A discrete Single Delay Model for the Intra-Venous Glucose Tolerance Test  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Due to the increasing importance of identifying insulin resistance, a need exists to have a reliable mathematical model representing the glucose/insulin control system. Such a model should be simple enough to allow precise estimation of insulin sensitivity on a single patient, yet exhibit stable dynamics and reproduce accepted physiological behavior. Results A new, discrete Single Delay Model (SDM of the glucose/insulin system is proposed, applicable to Intra-Venous Glucose Tolerance Tests (IVGTTs as well as to multiple injection and infusion schemes, which is fitted to both glucose and insulin observations simultaneously. The SDM is stable around baseline equilibrium values and has positive bounded solutions at all times. Applying a similar definition as for the Minimal Model (MM SI index, insulin sensitivity is directly represented by the free parameter KxgI of the SDM. In order to assess the reliability of Insulin Sensitivity determinations, both SDM and MM have been fitted to 40 IVGTTs from healthy volunteers. Precision of all parameter estimates is better with the SDM: 40 out of 40 subjects showed identifiable (CV xgI from the SDM, 20 out of 40 having identifiable SI from the MM. KxgI correlates well with the inverse of the HOMA-IR index, while SI correlates only when excluding five subjects with extreme SI values. With the exception of these five subjects, the SDM and MM derived indices correlate very well (r = 0.93. Conclusion The SDM is theoretically sound and practically robust, and can routinely be considered for the determination of insulin sensitivity from the IVGTT. Free software for estimating the SDM parameters is available.

Panunzi Simona

2007-09-01

244

Insulin transport across capillaries is rate limiting for insulin action in dogs.  

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This study examined the relationship between transcapillary insulin transport and insulin action in vivo. During euglycemic clamps (n = 7) in normal conscious dogs we simultaneously measured plasma and thoracic duct lymph insulin and glucose utilization (Rd). Clamps consisted of an activation phase with constant insulin infusion (0.6 mU/kg per min) and a deactivation phase. [14C]Inulin was infused as a passively transported control substance. While [14C]inulin reached an equilibrium between p...

Yang, Y. J.; Hope, I. D.; Ader, M.; Bergman, R. N.

1989-01-01

245

Intravenous leiomyomatosis.  

Science.gov (United States)

Leiomyomas are benign tumors arising from smooth muscle of the uterus. Intravenous leiomyomatosis is characterized by intraluminal growth of benign smooth muscle into either venous or lymphatic vessels outside the limits of myoma. It commonly extends into the pelvic veins and manifests as worm-like protrusions of tumor emanating from veins at the parametrial margins of hysterectomy specimen. The tumor can cause life-threatening symptoms if it involves inferior vena cava or right atrium. We report a case of intravenous leiomyomatosis of the uterus managed at our institution. PMID:24027407

Mariyappa, Narayanaswamy; Manikyam, Uday Kumar; Krishnamurthy, Dinesh; Preeti, K; Agarwal, Yamini; Prakar, U

2012-07-01

246

Insulin release, insulin sensitivity, and glucose intolerance.  

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Groups of subjects with different degrees of glucose intolerance were examined in order to determine, first, the capacity of the beta cells to release insulin upon glucose stimulation and, second, sensitivity to insulin. The groups were selected on the basis of fasting blood glucose value and tolerances to oral and intravenous glucose administration. The body weights, ages, and sexes of the subjects were well matched with those of control subjects with normal tolerances to oral and intravenou...

Efendic?, S.; Wajngot, A.; Cerasi, E.; Luft, R.

1980-01-01

247

Effect of IL-6 on the insulin sensitivity in patients with type 2 diabetes  

DEFF Research Database (Denmark)

Elevated interleukin-6 (IL-6) levels are associated with type 2 diabetes, but its role in glucose metabolism is controversial. We investigated the effect of IL-6 on insulin-stimulated glucose metabolism in type 2 diabetes patients and hypothesized that an acute, moderate IL-6 elevation would increase the insulin-mediated glucose uptake. Men with type 2 diabetes not treated with insulin [n = 9, age 54.9 ± 9.7 (mean ± SD) yr, body mass index 34.8 ± 6.1 kg/m(2), HbA1c 7.0 ± 1.0%] received continuous intravenous infusion with either recombinant human IL-6 (rhIL-6) or placebo. After 1 h with placebo or rhIL-6, a 3-h hyperinsulinemic-isoglycemic clamp was initiated. Whole body glucose metabolism was measured using stable isotope-labeled tracers. Signal transducer and activator of transcription 3 (STAT3) phosphorylation and suppressor of cytokine signaling 3 (SOCS3) expression were measured in muscle biopsies. Whole body energy expenditure was measured using indirect calorimetry. In response to the infusion of rhIL-6, circulating levels of IL-6 (P < 0.001), neutrophils (P < 0.001), and cortisol (P < 0.001) increased while lymphocytes decreased (P < 0.01). However, IL-6 infusion did not change glucose infusion rate, rate of appearance, or rate of disappearance during the clamp. While IL-6 enhanced phosphorylation of STAT3 in skeletal muscle (P = 0.041), the expression of SOCS3 remained unchanged. Whole body oxygen uptake (P < 0.01) and expired carbon dioxide (P < 0.01) increased during rhIL-6 infusion. In summary, although IL-6 induced local and systemic responses, the insulin-stimulated glucose uptake was not affected. While different contributing factors may be involved, our results are in contrast to our hypothesis and previous findings in young, healthy men.

Krogh-Madsen, R; Holst, Jens Juul

2014-01-01

248

Effect of IL-6 on the insulin sensitivity in patients with type 2 diabetes.  

Science.gov (United States)

Elevated interleukin-6 (IL-6) levels are associated with type 2 diabetes, but its role in glucose metabolism is controversial. We investigated the effect of IL-6 on insulin-stimulated glucose metabolism in type 2 diabetes patients and hypothesized that an acute, moderate IL-6 elevation would increase the insulin-mediated glucose uptake. Men with type 2 diabetes not treated with insulin [n = 9, age 54.9 ± 9.7 (mean ± SD) yr, body mass index 34.8 ± 6.1 kg/m(2), HbA1c 7.0 ± 1.0%] received continuous intravenous infusion with either recombinant human IL-6 (rhIL-6) or placebo. After 1 h with placebo or rhIL-6, a 3-h hyperinsulinemic-isoglycemic clamp was initiated. Whole body glucose metabolism was measured using stable isotope-labeled tracers. Signal transducer and activator of transcription 3 (STAT3) phosphorylation and suppressor of cytokine signaling 3 (SOCS3) expression were measured in muscle biopsies. Whole body energy expenditure was measured using indirect calorimetry. In response to the infusion of rhIL-6, circulating levels of IL-6 (P < 0.001), neutrophils (P < 0.001), and cortisol (P < 0.001) increased while lymphocytes decreased (P < 0.01). However, IL-6 infusion did not change glucose infusion rate, rate of appearance, or rate of disappearance during the clamp. While IL-6 enhanced phosphorylation of STAT3 in skeletal muscle (P = 0.041), the expression of SOCS3 remained unchanged. Whole body oxygen uptake (P < 0.01) and expired carbon dioxide (P < 0.01) increased during rhIL-6 infusion. In summary, although IL-6 induced local and systemic responses, the insulin-stimulated glucose uptake was not affected. While different contributing factors may be involved, our results are in contrast to our hypothesis and previous findings in young, healthy men. PMID:24473436

Harder-Lauridsen, N M; Krogh-Madsen, R; Holst, J J; Plomgaard, P; Leick, L; Pedersen, B K; Fischer, C P

2014-04-01

249

Free insulin profiles during intensive treatment with biosynthetic human insulin.  

Science.gov (United States)

24 h profiles of free insulin and glucose were determined in insulin-dependent diabetic patients on intensive insulin regimens with biosynthetic human insulin, either as continuous subcutaneous insulin infusion (CSII) with mealtime bolus doses (n = 6), or intensified conventional insulin therapy (ICIT) with preprandial injections of regular insulin and intermediate-acting insulin at bedtime (n = 6). The free insulin profiles were similar to the normal profiles but there were some important differences: CSII gave hyperinsulinaemia at daytime compared to normal people (p less than 0.05) and also to ICIT (p less than 0.005); ICIT but not CSII gave hyperinsulinaemia at midnight (p less than 0.05) whereas fasting free insulin was too-low to keep blood glucose normal; the insulin peaks after the bolus doses were retarded with a maximum after 30-90 min and a return to the basal level after 5-7 h (ICIT) or 8-9 h (CSII). The height of the insulin peaks were of similar magnitude at all meals and did not differ significantly between ICIT, CSII, and normal people. Time-to-peak was dependent on the injection level. We conclude, that intensive regimens with biosynthetic hum insulin do not give normoinsulinaemia but insulin profiles that resemble physiology. Biosynthetic human NPH insulin may be rather short-acting for overnight glucose control. The interval that should be recommended between preprandial insulin dose and meal may vary depending on the preinjection insulin level. PMID:3044863

Olsson, P O; Arnqvist, H J; Von Schenck, H V

1988-01-01

250

Hyperammonemic Encephalopathy Resulting From Intravenous Valproate for Status Epilepticus.  

Science.gov (United States)

The FDA approved vaiproate sodium injection (iv VPA) for seizure management in patients unable to receive oral VPA. Subsequent studies confirming the safety of rapid infusion of iv VPA led to investigations of its use for status epilepticus. Intravenous v...

K. C. Richards A. Verma M. E. Newmark R. A. Hrachovy

2004-01-01

251

Reações infusionais imediatas a agentes imunobiológicos endovenosos no tratamento de doenças autoimunes: experiência de 2.126 procedimentos em um centro de infusão não oncológico / Immediate infusional reactions to intravenous immunobiological agents for the treatment of autoimmune diseases: experience of 2126 procedures in a non-oncologic infusion centre  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese Introdução: Com o crescimento do uso de drogas imunobiológicas (IBD) ampliamos o conhecimento sobre sua eficácia e segurança. Objetivo: Analisar as reações infusionais imediatas (RII) às IBD endovenosas - infliximabe (IFX), rituximabe (RTX), abatacepte (A [...] BT) e tocilizumabe (TCZ) - no tratamento de doenças autoimunes. Método: Avaliamos 2.126 infusões feitas no CID (Centro de Infusão) em 268 pacientes. A droga usada, a indicação clínica, o tempo de infusão e o uso de pré-medicação foram determinados pelo médico prescritor. Foram consideradas RII todas as intercorrências apresentadas durante a infusão e/ou período observacional de 30 minutos. A conduta adotada nas RII seguiu os protocolos do CID. Resultados: Em relação ao tipo de IBD, as infusões foram distribuídas em: IFX (1.584; 74,5%), TCZ (226; 10,63%), RTX (185; 8,7%) e ABT (131; 6,16%). As RII foram descritas em 87 procedimentos (4,09%): 77 no grupo IFX e 10 no grupo RTX. Não foram descritas RII nos grupos de ABT e TCZ. A maioria foi considerada leve (n = 5; 41,17%) ou moderada (n = 50; 58,81%) e não houve reações graves. Das infusões interrompidas, 79 (92,9%) foram reiniciadas e concluídas com êxito. Apenas seis (0,28%) não foram concluídas por causa das RII. Conclusão: Apesar da diferença entre o número de procedimentos por droga, trata-se de uma análise de "vida real", na qual a incidência de RII foi semelhante à descrita na literatura. A baixa incidência de RII corrobora os dados de segurança tanto de forma quantitativa como qualitativa e ressalta a importância do acompanhamento médico especializado durante a infusão. Abstract in english Introduction: With the increasing use of immunobiological drugs (IBD), the knowledge about their effectiveness and safety has increased. Objective: To analyze the immediate infusional reactions (IIR) to intravenous IBD: infliximab (IFX), rituximab (RTX), abatacept (ABT) and tocilizumab (TCZ) on [...] the treatment of autoimmune diseases. Method: 2126 infusions performed in the Infusion Centre - CID in 268 patients were analyzed. The used drug, its clinical indication, infusion time, and use of premedication were determined by the prescribing physician. All intercurrences presented during infusion and/or during a thirty minutes observation period were considered as IIR. The approach adopted in IIR followed the protocols of the Infusion Centre - CID. Results: Regarding the type of IBD, the infused drugs given were: IFX (1584, 74.5%), TCZ (226, 10.63%), RTX (185, 8.7%) and ABT (131, 6,16%). IIR were described in 87 procedures (9.4%): 77 - IFX group and 10 - RTX group. IIR were not described in ABT and TCZ groups. Most were considered as mild (n = 5; 41.17%) or moderate (n = 50, 58.81%) reactions; there were no serious reactions. Regarding to discontinue infusions, 79 (92.9%) were resumed and completed successfully. Only six (0.28% of infusions) were not completed because of IIR. Conclusion: Despite the differences between the number of procedures per drug, ours is a "real life" analysis, where the incidence of IIR was similar to that described in the literature. The low incidence of IIR corroborates the safety data, both quantitatively and qualitatively, and underscores the importance of specialized medical support during infusion.

Moss, Ingrid Bandeira; Moss, Monique Bandeira; Reis, Debora Silva dos; Coelho, Reno Martins.

252

Krypton 81m infusion studies. Chapter 18  

International Nuclear Information System (INIS)

A technique is described to give a continuous, constant-rate, intravascular infusion of "8"1Krsup(m). Modifications of earlier generators included production of sodium-free "8"1Rb, the use of a solution of commercial sterile isotonic non-ionic 5% dextrose-in-water as an eluant, the incorporation of a constant-rate infusion pump, and the miniaturization of the generator column and catheter system. Results are presented of studies of "8"1Krsup(m) distribution in dogs, using both intravenous and intra-arterial infusion. (author)

1978-01-01

253

Pharmacokinetics of morphine infusion in premature neonates.  

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Morphine pharmacokinetics were studied in 17 premature neonates (26-34 weeks' gestation) after intravenous infusion during the first 24 hours of life. Infants received either standard dose morphine that comprised of a 100 micrograms/kg/hour loading infusion for 2 hours followed by a maintenance infusion of 12.5 micrograms/kg/hour, or a high dose of 200 micrograms/kg/hour for 2 hours followed by 50 micrograms/kg/hour. Mean plasma concentrations of morphine (SD) after 2 and 24 hours were 99 (12...

Hartley, R.; Green, M.; Quinn, M.; Levene, M. I.

1993-01-01

254

The effect of glucagon on infusion cholangiography  

International Nuclear Information System (INIS)

An assessment has been made of the effects of glucagon on biliary tract opacification during intravenous cholangiography. Two series of infusion cholangiograms were obtained at two investigating centres designated A and B. In series A, 41 patients had ioglycamide infusions at a rate of 0.2833 g min-1 over 1 h. In series B, 31 patients had ioglycamide infusions at a rate of 0.3886 g min-1 over 30 min. Radiographs were taken in both series immediately at the end of the infusion, 10 min later and 30 min after the infusion. Two mg of intravenous glucagon was injected into alternate cases in both series A and B immediately after the first radiograph was taken at the completion of the ioglycamide infusion. Two observers in each series then assessed the radiographic opacification of the biliary system without prior knowledge of which patients had received the glucagon. Delineation of the biliary system was considered better in both series in those patients who received glucagon when compared with the controls. Gallbladder opacification was definitely increased in series A in those receiving glucagon, and a similar tendency was shown in series B. The amount of contrast in the upper intestine was increased in series A in the glucagon group, but not in series B. It is concluded that glucagon improves visualisation of the biliary tract, especially the gallbladder at infusion cholangiography. (author)

1979-01-01

255

Beta Agonist Lung Injury TrIal-2 (BALTI-2) trial protocol: A randomised, double-blind, placebo-controlled of intravenous infusion of salbutamol in the acute respiratory distress syndrome  

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Abstract Background The Acute Respiratory Distress Syndrome (ARDS) is a common cause of respiratory failure in critically ill patients. Experimental studies suggest that treatment with beta agonists may be helpful in ARDS. The Beta Agonist Lung Injury TrIal (BALTI-2) is a multicentre, pragmatic, randomised, double-blind, placebo-controlled clinical trial which aims to determine if sustained treatment with intravenous (IV) salbutamol will improve survival in ARDS. Metho...

Perkins Gavin D; Gates Simon; Lamb Sarah E; McCabe Chris; Young Duncan; Gao Fang

2011-01-01

256

Effect of intravenous infusion of a soybean oil emulsion on plasma concentration of 15-Keto-13, 14-dihydro-prostaglandin F2? and ovarian function in cycling Holstein heifers  

International Nuclear Information System (INIS)

Feeding of rumen-inert linoleic acid (dietary PGF2? precursor) may alter ovarian activity by augmenting PGF synthesis and stimulating energy balance. Six cycling Holstein heifers (mean body weight of 310 kg) received (IV) either 1 L of a 20% soybean oil emulsion (50% linoleic, 26% oleic, 10% palmitic, 9% linolenic and 3.5% stearic; 2 Mcal; n=3) or 1 L of physiological saline (n=3) over 4 h on days 9, 10, 11, 12 and 13 of the oestrous cycle. Each heifer was challenged with 3 mg oestradiol (IV; day 15) and 100 units oxytocin (IV; day 16). Plasma progesterone (p4; days 7-oestrus), oestradiol (days 9-13) and PGFM (days 9-13, day 15 (-2 to 10 h after oestradiol) and day 16 (-1 to 2 h after oxytocin)) were determined. Pre-infusion concentrations of PGFM (pg/mL) were similar for treated (32.1±3.9) and saline (31.5±2.6) animals. After each infusion of Intralipid, plasma PGFM increased (P4 profiles (days 7-oestrus) were dissimilar (P3 mm as determined by ultrasound) per ovary (6.0 vs. 2.0; P<0.01), and accumulative follicular size per ovary (31.8 vs. 10.8 mm; P<0.01). Fatty acids (i.e. linoleic acid) can alter PGF secretion, luteal function and follicular dynamics during the oestrous cycle. (author). 28 refs, 6 figs, 1 tab

1990-01-01

257

Avaliação da efetividade e segurança do protocolo de infusão de insulina de Yale para o controle glicêmico intensivo Assessment of effectiveness and safety of Yale insulin infusion protocol in a brazilian medical and surgical Intensive Care Unit  

Directory of Open Access Journals (Sweden)

Full Text Available JUSTIFICATIVA E OBJETIVOS: O controle glicêmico intensivo ocupa lugar de destaque no manuseio dos pacientes críticos. O objetivo desde estudo foi avaliar a efetividade e a segurança do protocolo de insulinoterapia por via venosa de Yale nos pacientes críticos internados em unidade de terapia intensiva geral em hospital comunitário. MÉTODO: Foi realizado um estudo retrospectivo e comparativo entre 2 coortes de pacientes críticos, antes e após a implantação do controle glicêmico intensivo. Os desfechos de interesse do estudo foram glicemia média durante o tratamento, tempo para atingir a faixa alvo de 80 a 140 mg/dL, percentual de glicemia dentro desta faixa e incidência de hipoglicemia. RESULTADOS: Foram estudados 112 pacientes, divididos em dois grupos. Sessenta pacientes constituíram o grupo controle (GC e 52 o grupo protocolo (GP. A glicemia média no GP foi de 131,2 ± 14,7 mg/dL versus 181,7 ± 36,1 mg/dL no GC. Os pacientes no GP alcançaram a faixa alvo mais rápido [mediana 7h (4 - 10h versus mediana 96h (46 - 278h] no GC. O percentual de glicemia dentro da faixa-alvo foi de 65% no GP e de 32% no GC. Não houve diferença estatística significativa na incidência de hipoglicemia grave; 4 pacientes no GP versus 2 pacientes no GC. CONCLUSÕES: O protocolo de insulinoterapia por via venosa contínua de Yale, mostrou-se efetivo e seguro para o manuseio do controle glicêmico em unidade de terapia intensiva que atende pacientes clínicos e cirúrgicos.BACKGROUND AND OBJECTIVES: Actually tight glycemic control is a major concern in critical care. The objective of this study was to evaluate effectiveness and safety of Yale insulin infusion protocol in a Brazilian medical and surgical intensive care unit. METHODS: Retrospective, before-after cohort study. Selected end-points were mean blood glucose levels, time-to-reach target range of 80 - 140 mg/dL, and percent of blood glucose in target range and hypoglycemia incidence. RESULTS: Were studied 112 patients: 60 in control group (CG and 52 in protocol group (PG. Bedside blood glucose was measured 5392 times for a mean value of 131.2 ± 14.7 mg/dL in the PG versus 2485 times for a mean value of 181.7 ± 36.1 mg/dL in the CG. Blood glucose values were in the target range 65% and 32% of the times, respectively for PG and CG groups (p < 0.001. The median time to reach glucose target range was 7 h (range 4 -10 h for PG and 96 hr (range 46 - 278 h for CG (p < 0.001. Incidence of severe hypoglycemia did not reach difference statistically significant: 4 patients in PG versus 2 patients in CG. CONCLUSIONS: Yale insulin infusion protocol was effective and safe to improve blood glucose control in a Brazilian medical and surgical intensive care unit.

José Roberto Carvalho Diener

2006-09-01

258

Human insulin: study of safety and efficacy in man.  

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The safety and efficacy of a new highly purified neutral soluble human insulin produced by conversion of porcine insulin was compared with a highly purified neutral soluble porcine insulin in six normal men. The insulins were administered by subcutaneous injection at a dose of 0.075 U/kg body weight. Somatostatin was infused during the experiment to suppress endogenous insulin secretin. No difference was found in the plasma glucose, insulin, or metabolite responses. Thus the potency, onset, a...

1981-01-01

259

Insulin clearance contributes to the variability of nocturnal insulin requirement in insulin-dependent diabetes mellitus.  

Science.gov (United States)

We have previously described, in insulin-dependent diabetic subjects (IDDM), a small, but significant, increase in the insulin clearance rate (ICR) during 0600-0800 h as compared with 0100-0300 h. To determine whether this increase was also seen at more physiologic levels of insulin replacement, we calculated ICR during euglycemic clamp studies in 13 patients with IDDM with a constant infusion of insulin at 20 mU/min/m2 and during insulin replacement from the Biostator GCIIS without exogenous glucose. During the euglycemic clamp study with constant insulin infusion at 20 mU/min/m2, the ICR was 16% higher at 0600-0800 h than at 0100-0300 h (264 +/- 50 ml/min/m2 versus 228 +/- 51 ml/min/m2; P less than 0.005). During insulin replacement by the Biostator, the mean insulin infusion rate increased by 92 +/- 27% (7.5 +/- 1.1 to 13.5 +/- 1.2 mU/min/m2; P less than 0.001) and ICR increased by 123 +/- 30% (130 +/- 24 to 268 +/- 51 ml/min/m2; P less than 0.01) during the prebreakfast period when compared with 0100-0300 h. There was a highly significant correlation (r = 0.97) between the increment in insulin infusion rate and the increment in ICR. Measurement of insulin concentration in saline solutions, delivered by the Biostator at a same rate and under similar conditions to those in this study, showed that insulin delivery was stable for the 8-h period of this study.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:3905459

Dux, S; White, N H; Skor, D A; Santiago, J V

1985-12-01

260

Efeitos cardiorrespiratórios e analgésicos da cetamina por via epidural, por infusão intravenosa contínua ou pela associação de ambas, em cães submetidos à osteossíntese de fêmur / Cardiorespiratory and analgesic effects of ketamine via epidural route, intravenous continuous infusion or association of both, in dogs submitted to femoral osteosynthesis  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese A cetamina tem demonstrado efeito analgésico em doses subanestésicas, além da manutenção da estabilidade dos parâmetros fisiológicos. O estudo objetivou avaliar os efeitos cardiorrespiratórios e a analgesia pós-operatória da cetamina administrada por via epidural, por infusão intravenosa contínua ou [...] pela associação de ambas, em cães submetidos à osteossíntese de fêmur. Foram utilizadas 25 cadelas, hígidas, distribuídas aleatoriamente em quatro grupos: CEP (2mg kg-1 de cetamina associada à lidocaína 2% via epidural), CIV (lidocaína 2% via epidural e 1mg kg-1 de cetamina IV seguido de infusão contínua IV com 100µg kg min-1 da mesma), CIVEP (2mg kg-1 de cetamina associada à lidocaína 2% via epidural e 1mg kg-1 de cetamina IV, seguido de infusão contínua IV com 100µg kg min-1) e CON (anestesia epidural com lidocaína 2%). Avaliaram-se FC, f, PAS, PAM, PAD, T°C, tempo de bloqueio motor e analgesia pós-operatória por meio de escala analógica visual. Houve elevação da FC no CIV e diminuição desse parâmetro no CEP. As pressões arteriais mantiveram-se dentro dos valores fisiológicos e não foram observadas diferenças na f e T°C. O tempo de duração do bloqueio anestésico foi potencializado nos grupos que receberam cetamina epidural, diferindo significativamente em relação ao controle. O tempo para a analgesia resgate não diferiu entre os grupos. Conclui-se que a administração de cetamina pela via epidural, por infusão contínua intravenosa ou pela associação de ambas promoveu estabilidade cardiorrespiratória no período transcirúrgico, porém não foi capaz de prolongar a duração da analgesia pós-operatória em cães submetidos à osteossíntese de fêmur. Abstract in english Ketamine has demonstrated analgesic effects in subanesthetic doses, besides the maintenance of stability of physiological parameters. The study aimed to evaluate the cardiorespiratory effects and the post operative analgesia of ketamine via epidural route, intravenous continuous infusion or associat [...] ion of both, in dogs submitted to femoral osteosynthesis. Twenty-five healthy bitches were randomly assigned to four groups: CEP (2mg kg-1 of ketamine associated with lidocaine 2% via epidural route), CIV (lidocaine 2% via epidural route and 1mg kg-1 of ketamine IV, followed by IV continuous infusion of 100µg kg min-1 of ketamine), CIVEP (epidural anesthesia identical to CEP and ketamine infusion as in CIV) and CON (epidural anesthesia with lidocaine 2%). HR, RR, SAP, MAP, DAP and T°C, sensitive blockade time and post operative analgesia measured with visual analog scale were evaluated. There was an increase in HR in CIV and decrease of this parameter in CEP. Arterial pressures kept within physiological values and differences in RR and T°C were not observed. The anesthetic blockade time was augmented in the groups which received epidural ketamine, differing significantly in relation to the control. The time for rescue analgesia did not differ between the groups. It can be concluded the administration of ketamine via epidural route, intravenous continuous infusion or the association of both promoted cardiorespiratory stability during the operative period; however, it was not able to extend the duration of post operative analgesia in dogs submitted to femoral osteosynthesis.

Carregaro, Adriano Bonfim; Freitas, Gabrielle Coelho; Marques, Jenifer de Santana; Trein, Thomas Alexander; Pohl, Virgínia Heinze; Salbego, Fabiano Zanini; Raiser, Alceu Gaspar.

 
 
 
 
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Efeitos cardiorrespiratórios e analgésicos da cetamina por via epidural, por infusão intravenosa contínua ou pela associação de ambas, em cães submetidos à osteossíntese de fêmur Cardiorespiratory and analgesic effects of ketamine via epidural route, intravenous continuous infusion or association of both, in dogs submitted to femoral osteosynthesis  

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Full Text Available A cetamina tem demonstrado efeito analgésico em doses subanestésicas, além da manutenção da estabilidade dos parâmetros fisiológicos. O estudo objetivou avaliar os efeitos cardiorrespiratórios e a analgesia pós-operatória da cetamina administrada por via epidural, por infusão intravenosa contínua ou pela associação de ambas, em cães submetidos à osteossíntese de fêmur. Foram utilizadas 25 cadelas, hígidas, distribuídas aleatoriamente em quatro grupos: CEP (2mg kg-1 de cetamina associada à lidocaína 2% via epidural, CIV (lidocaína 2% via epidural e 1mg kg-1 de cetamina IV seguido de infusão contínua IV com 100µg kg min-1 da mesma, CIVEP (2mg kg-1 de cetamina associada à lidocaína 2% via epidural e 1mg kg-1 de cetamina IV, seguido de infusão contínua IV com 100µg kg min-1 e CON (anestesia epidural com lidocaína 2%. Avaliaram-se FC, f, PAS, PAM, PAD, T°C, tempo de bloqueio motor e analgesia pós-operatória por meio de escala analógica visual. Houve elevação da FC no CIV e diminuição desse parâmetro no CEP. As pressões arteriais mantiveram-se dentro dos valores fisiológicos e não foram observadas diferenças na f e T°C. O tempo de duração do bloqueio anestésico foi potencializado nos grupos que receberam cetamina epidural, diferindo significativamente em relação ao controle. O tempo para a analgesia resgate não diferiu entre os grupos. Conclui-se que a administração de cetamina pela via epidural, por infusão contínua intravenosa ou pela associação de ambas promoveu estabilidade cardiorrespiratória no período transcirúrgico, porém não foi capaz de prolongar a duração da analgesia pós-operatória em cães submetidos à osteossíntese de fêmur.Ketamine has demonstrated analgesic effects in subanesthetic doses, besides the maintenance of stability of physiological parameters. The study aimed to evaluate the cardiorespiratory effects and the post operative analgesia of ketamine via epidural route, intravenous continuous infusion or association of both, in dogs submitted to femoral osteosynthesis. Twenty-five healthy bitches were randomly assigned to four groups: CEP (2mg kg-1 of ketamine associated with lidocaine 2% via epidural route, CIV (lidocaine 2% via epidural route and 1mg kg-1 of ketamine IV, followed by IV continuous infusion of 100µg kg min-1 of ketamine, CIVEP (epidural anesthesia identical to CEP and ketamine infusion as in CIV and CON (epidural anesthesia with lidocaine 2%. HR, RR, SAP, MAP, DAP and T°C, sensitive blockade time and post operative analgesia measured with visual analog scale were evaluated. There was an increase in HR in CIV and decrease of this parameter in CEP. Arterial pressures kept within physiological values and differences in RR and T°C were not observed. The anesthetic blockade time was augmented in the groups which received epidural ketamine, differing significantly in relation to the control. The time for rescue analgesia did not differ between the groups. It can be concluded the administration of ketamine via epidural route, intravenous continuous infusion or the association of both promoted cardiorespiratory stability during the operative period; however, it was not able to extend the duration of post operative analgesia in dogs submitted to femoral osteosynthesis.

Adriano Bonfim Carregaro

2010-07-01

262

Accuracy of drug infusion pumps under computer control.  

Science.gov (United States)

Prototype systems implementing algorithms for automated drug infusions are typically constructed by coupling a microcomputer to a drug infusion pump through a serial communications interface. Infusion rates demanded of the infusion pump in many computed-controlled drug delivery applications are made to change at intervals much shorter than those encountered under routine clinical use. Because the ability of infusion pumps to maintain accurate flow rates during high frequency rate changes has not been documented, the purpose of this study was to validate the volumetric accuracy of three commercially available infusion pumps operating in a demanding computer-controlled application. In independent 2-h evaluations, the infusion rate demanded of each pump changed as often as every 5, 10, or 15 s using an algorithm for computer-controlled pharmacokinetic model-driven intravenous infusion. Accuracy of the infusion devices was determined gravimetrically. At all measurement times, each of the infusion pumps was accurate to within approximately +/- 5% of the expected volumetric output under each of the infusion rate intervals tested. Flow rate accuracy of +/- 5% is equal to the nominal expected accuracy of these infusion pumps in conventional clinical use. PMID:1473827

Connor, S B; Quill, T J; Jacobs, J R

1992-09-01

263

Review of pharmacokinetic models for target controlled infusions in anesthesia  

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Full Text Available Intravenous injection of anesthetic drugs dates back to the 17th Century when opium and chloral hydrate have been injected intravenously. It was not until the 1930s intravenous anesthesia became popular with the invention of barbiturates.Early intravenous anesthetic agents such as barbiturates were ideal for induction of anesthesia, but not suitable for maintenance of anesthesia. Most of these drugs accumulated significantly with increasing durations of infusion and also resulted in cardiorespiratory depression. The invention of propofol and shorter acting opioid analgesics such as remifentanil and alfentanil have revolutionized intravenous anesthesia. The rapid onset and offset of these drugs lends itself to being suitable agents for maintenance of anesthesia over prolonged periods of time. Detailed understanding of the pharmacokinetics of propofol and remifentanil, combined with technological advances in intravenous pumps capable of accurate delivery of drugs have resulted in great development of the field of total intravenous anesthesia and target controlled infusions. I would like to discuss, in this article, the pharmacokinetics and pharmacokinetic models behind these intravenous infusion pumps. [Int J Basic Clin Pharmacol 2014; 3(3.000: 417-423

Subash Kennedy Sivasubramaniam

2014-06-01

264

Avaliação da efetividade e segurança do protocolo de infusão de insulina de Yale para o controle glicêmico intensivo / Assessment of effectiveness and safety of Yale insulin infusion protocol in a brazilian medical and surgical Intensive Care Unit  

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Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese JUSTIFICATIVA E OBJETIVOS: O controle glicêmico intensivo ocupa lugar de destaque no manuseio dos pacientes críticos. O objetivo desde estudo foi avaliar a efetividade e a segurança do protocolo de insulinoterapia por via venosa de Yale nos pacientes críticos internados em unidade de terapia intensi [...] va geral em hospital comunitário. MÉTODO: Foi realizado um estudo retrospectivo e comparativo entre 2 coortes de pacientes críticos, antes e após a implantação do controle glicêmico intensivo. Os desfechos de interesse do estudo foram glicemia média durante o tratamento, tempo para atingir a faixa alvo de 80 a 140 mg/dL, percentual de glicemia dentro desta faixa e incidência de hipoglicemia. RESULTADOS: Foram estudados 112 pacientes, divididos em dois grupos. Sessenta pacientes constituíram o grupo controle (GC) e 52 o grupo protocolo (GP). A glicemia média no GP foi de 131,2 ± 14,7 mg/dL versus 181,7 ± 36,1 mg/dL no GC. Os pacientes no GP alcançaram a faixa alvo mais rápido [mediana 7h (4 - 10h) versus mediana 96h (46 - 278h)] no GC. O percentual de glicemia dentro da faixa-alvo foi de 65% no GP e de 32% no GC. Não houve diferença estatística significativa na incidência de hipoglicemia grave; 4 pacientes no GP versus 2 pacientes no GC. CONCLUSÕES: O protocolo de insulinoterapia por via venosa contínua de Yale, mostrou-se efetivo e seguro para o manuseio do controle glicêmico em unidade de terapia intensiva que atende pacientes clínicos e cirúrgicos. Abstract in english BACKGROUND AND OBJECTIVES: Actually tight glycemic control is a major concern in critical care. The objective of this study was to evaluate effectiveness and safety of Yale insulin infusion protocol in a Brazilian medical and surgical intensive care unit. METHODS: Retrospective, before-after cohort [...] study. Selected end-points were mean blood glucose levels, time-to-reach target range of 80 - 140 mg/dL, and percent of blood glucose in target range and hypoglycemia incidence. RESULTS: Were studied 112 patients: 60 in control group (CG) and 52 in protocol group (PG). Bedside blood glucose was measured 5392 times for a mean value of 131.2 ± 14.7 mg/dL in the PG versus 2485 times for a mean value of 181.7 ± 36.1 mg/dL in the CG. Blood glucose values were in the target range 65% and 32% of the times, respectively for PG and CG groups (p

José Roberto Carvalho, Diener; Carlos Eduardo Elias dos, Prazeres; Cilmar Mello da, Rosa; Urubatan Collaço, Alberton.

265

Intravenous drug delivery in neonates: lessons learnt.  

Science.gov (United States)

Intravenous drug administration presents a series of challenges that relate to the pathophysiology of the neonate and intravenous infusion systems in neonates. These challenges arise from slow intravenous flow rates, small drug volume, dead space volume and limitations on the flush volume in neonates. While there is a reasonable understanding of newborn pharmacokinetics, an appreciation of the substantial delay and variability in the rate of drug delivery from the intravenous line is often lacking. This can lead to difficulties in accurately determining the pharmacokinetic and pharmacodynamic relationship of drugs in the smallest patients. The physical variables that affect the passage of drugs through neonatal lines need to be further explored in order to improve our understanding of their impact on the delivery of drugs by this route in neonates. Through careful investigation, the underlying causes of delayed drug delivery may be identified and administration protocols can then be modified to ensure predictable, appropriate drug input kinetics. PMID:24482352

Sherwin, Catherine M T; Medlicott, Natalie J; Reith, David M; Broadbent, Roland S

2014-06-01

266

Adenosine infusion increases plasma levels of VEGF in humans  

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Full Text Available Abstract Background Many in vitro studies have shown that adenosine (Ado can induce vascular endothelial growth factor (VEGF mRNA and protein expression and stimulate endothelial proliferation. In the present study, we seek to determine whether Ado can increase circulating levels of VEGF protein in the intact human. Methods Five outpatients 49.3 ± 6.7 years of age and weighing 88.2 ± 8.5 kg were selected. They were given a 6 min intravenous infusion of Ado (0.14 mg kg-1 min-1 in conjunction with sestamibi myocardial perfusion scans. Mean blood pressure (MBP, calculated from systolic and diastolic values and heart rate (HR were determined before Ado infusion and every 2 min for the next 10 min. Plasma VEGF concentrations (ELISA were determined immediately before Ado infusion and 1 h, 2 h, and 8 h after the infusion. Results Plasma VEGF concentration averaged 20.3 ± 2.0 pg ml-1 prior to Ado infusion, and increased to 62.7 ± 18.1 pg ml-1 at 1 h post- infusion (p -1. MBP averaged 116 ± 7 mmHg and heart rate averaged 70 ± 7 prior to Ado infusion. MBP decreased by a maximum of ~22% and HR increased by a maximum of ~17% during the infusion. Conclusion We conclude from these preliminary findings that intravenous infusion of adenosine can increase plasma levels of VEGF in humans.

Pryor Janelle S

2005-06-01

267

Managing diabetes with inhaled insulin  

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Full Text Available The incidence of diabetes is increasing world-wide. Many individuals with diabetes require insulin to control their blood sugar and prevent both microvascular and macrovascular complications associated with this chronic disease. Current regimens involve delivery of subcutaneous insulin by injection or continuous insulin infusion. One area of research to advance diabetes care is aimed at developing alternate routes of insulin administration that will make daily management less invasive for patients. This review will focus on inhaled insulin, a novel formulation which takes advantage of drug delivery through the pulmonary system. The pharmacology, efficacy, and safety of inhaled insulin will be discussed. In addition, the status of inhaled insulin as a potential therapy for individuals with diabetes will be reviewed.

Lucy D Mastrandrea

2012-01-01

268

Intensive Insulin Therapy in Surgical Patients with Type 2 Diabetes Mellitus  

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Full Text Available The aim of the investigation was to assess the efficiency of intensive insulin therapy in surgical patients with type 2 diabetes mellitus (DM 2 in intensive care unit in relation to the effect on postoperative clinical progression and 90-day survival of patients. Materials and Methods. The study included 89 patients hospitalized in intensive care unit for various surgical pathologies, with DM 2 in past medical history. On admission the patients were divided into 4 groups in a random manner. First 72 h target glycemia range for groups 1 and 2 was glucose level of 6.5–8.5 mmol/L, and for groups 3 and 4 — 8.6–11.0 mmol/L. Continuous insulin infusion was chosen for the treatment of groups 1 and 3 for the same period, the patients of groups 2 and 4 were given divided insulin injections. The severity of all patients was studied first 24 h and 72 h after inpatient treatment according to APACHE II, SAPS II.Conclusion. In ICU patients suffering from type 2 DM with various surgical pathology, target glycemic levels of 6.5–8.5 and 8.6–11.0 within the frame of one insulin therapy method are not associated with the differences in relation to the severity and outcome of the main pathology. Glycemic control in target range of 6.5–11.0 mmol/L by intravenous insulin infusion has the advantage over divided insulin subcutaneous injections regarding the severity and outcome of the main pathology.

?.S. Komissarova

2013-03-01

269

Adverse Reaction Following Intravenous Immunoglobulin in Primary Immunodeficiency Patients  

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Full Text Available AbstractBackground and Purpose: Intravenous immunoglobulin is used for primary immunodeficiency disorders. There have been some reports that intravenous immunoglobulin causes side effects. The aim of this study was to investigate intravenous immunoglobulin side effects in immunodeficiency patients.Materials and Methods: The study utilized the data of 29 primary immunodeficiency patients that were referred to allergy and immunology department in Medical Children Center in Tehran. 29 patients having completed record data files in the hospital, were the subjects of this study.Results: Of 29 immune deficiency patients (aged 15 months to 55 years, they were 19 Males (65/51% and 10(34/48% Females. Prevalence of disorders include common variable immunodeficiency 16(55/17%, Bruton disease 8(27/58%, hyper IgM 4 (13/79% and severe combind immunodeficiency 1 (3/44%. Based on the recorded data, the duration of infusion has been 5 months to 15 years. 15 patients had reported side effects (51/72%. 34 infusions from the total of 1,626 infusions accompanied with side effects (2/09%. Most side effects were occurred during 30 minutes onset of infusion and most were caused by rapid infusion. Most side effects were mild reactions (fever, chills and ….Conclusion: Intravenous immunoglobulin is a rather safe drug with mild side effects. With an appropriate technique and proper infusion, these side effects can be reduced.

J. Ghaffari, M.D.+

2007-01-01

270

Soluble, fatty acid acylated insulins bind to albumin and show protracted action in pigs.  

Science.gov (United States)

We have synthesized insulins acylated by fatty acids in the epsilon-amino group of LysB29. Soluble preparations can be made in the usual concentration of 600 nmol/ml (100 IU/ml) at neutral pH. The time for 50% disappearance after subcutaneous injection of the corresponding TyrA14(125I)-labelled insulins in pigs correlated with the affinity for binding to albumin (r = 0.97), suggesting that the mechanism of prolonged disappearance is binding to albumin in subcutis. Most protracted was LysB29-tetradecanoyl des-(B30) insulin. The time for 50% disappearance was 14.3 +/- 2.2 h, significantly longer than that of Neutral Protamine Hagedorn (NPH) insulin, 10.5 +/- 4.3 h (p < 0.001), and with less inter-pig variation (p < 0.001). Intravenous bolus injections of LysB29-tetradecanoyl des-(B30) human insulin showed a protracted blood glucose lowering effect compared to that of human insulin. The relative affinity of LysB29-tetradecanoyl des-(B30) insulin to the insulin receptor is 46%. In a 24-h glucose clamp study in pigs the total glucose consumptions for LysB29-tetradecanoyl des-(B30) insulin and NPH were not significantly different (p = 0.88), whereas the times when 50% of the total glucose had been infused were significantly different, 7.9 +/- 1.0 h and 6.2 +/- 1.3 h, respectively (p < 0.04). The glucose disposal curve caused by LysB29-tetradecanoyl des-(B30) insulin was more steady than that caused by NPH, without the pronounced peak at 3 h. Unlike the crystalline insulins, the soluble LysB29-tetradecanoyl des-(B30) insulin does not elicit invasion of macrophages at the site of injection. Thus, LysB29-tetradecanoyl des-(B30) insulin might be suitable for providing basal insulin in the treatment of diabetes mellitus. PMID:8721773

Markussen, J; Havelund, S; Kurtzhals, P; Andersen, A S; Halstrøm, J; Hasselager, E; Larsen, U D; Ribel, U; Schäffer, L; Vad, K; Jonassen, I

1996-03-01

271

Effect of glucose-insulin-potassium on thallium-201 myocardial redistribution  

Energy Technology Data Exchange (ETDEWEB)

Intravenous infusion of glucose-insulin-potassium (GIK) has been shown to alter the net rate of clearance of /sup 201/Tl from transiently ischemic and normally perfused canine myocardium. This study was performed to determine if GIK would also decrease the extent of thallium redistribution after transient myocardial ischemia. Six anesthetized, open-chest dogs underwent two studies, one with GIK and another with saline infusion. The left anterior descending coronary artery was occluded, /sup 201/Tl injected, and the occlusion released 5-min later. An i.v. infusion of either GIK (4 dogs) or saline (2 dogs) was then begun and continued for the 120-min duration of serial myocardial imaging using a standard scintillation camera. The experiment was then repeated with an infusion of saline (4 dogs) or GIK (2 dogs). The dose of /sup 201/Tl for the second study was at least 5 times more than was used for the first study. The serial 2-min images were then displayed on computer and regions of interest were drawn over the areas of transient ischemia (TI) and normal perfusion (NP). The ratio of average counts per picture element for the area of TI compared to NP was calculated. One hundred and twenty minutes after /sup 201/Tl administration, the change in the TI/NP ratio (% fill-in) was significantly less for the GIK infusion compared to saline infusion (control) 15.4 +/- 4.0% vs 26.2 +/- 6.0% (mean +/- SE) (P less than 0.01), respectively. Therefore, GIK infusion appeared to decrease the extent of thallium redistribution compared to saline control.

Wilson, R.A.; Okada, R.D.; Barlai-Kovach, M.; Strauss, H.W.

1985-01-01

272

Influence of growth hormone on overnight insulin requirements in insulin-dependent diabetes.  

Science.gov (United States)

After a 0100-0300 h nadir, the insulin requirements to maintain blood glucose at 90-110 mg/dl increase substantially in the prebreakfast (0600-0800 h) period in some insulin-dependent diabetic patients (IDDMs). Early insulin-like and delayed insulin-antagonistic effects of physiologic early morning increases in growth hormone (hGH) secretion may account for this variability of overnight insulin requirements. To assess the role of hGH, we studied five IDDMs using a closed-loop insulin infusion device (Biostator, GCIIS). Either saline (C) or somatostatin plus glucagon (SRIF + G) was infused during separate overnight (2400-0800 h) study periods. An infusion of hGH from 2400 to 0130 h was added to SRIF + G infusion during an additional study period (SRIF + G + hGH). In comparison to 0100-0300 h, mean insulin infusion rates required to maintain blood glucose values between 105 and 120 mg/dl during the prebreakfast period increased by 66 +/- 25% during C, and 42 +/- 12% during SRIF + G when serum growth hormone was suppressed to less than or equal to 0.75 ng/ml. During SRIF + G + hGH, the mean prebreakfast insulin infusion rate increased by 42 +/- 11% with a mean peak hGH level of 14.7 +/- 5.4 ng/ml at 0130 h. Mean plasma free insulin levels remained constant during the night despite the significantly higher insulin infusion rates between 0600 and 0800 h. During SRIF + G, insulin requirements remained constant overnight before 0600 h, whereas during both C and SRIF + G + hGH conditions, a nadir was noted between 0100 and 0300 h.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:2857143

Skor, D A; White, N H; Thomas, L; Santiago, J V

1985-02-01

273

Glucose-dependent insulinotropic polypeptide : a bifunctional glucose-dependent regulator of glucagon and insulin secretion in humans  

DEFF Research Database (Denmark)

OBJECTIVE To evaluate the glucose dependency of glucose-dependent insulinotropic polypeptide (GIP) effects on insulin and glucagon release in 10 healthy male subjects ([means ± SEM] aged 23 ± 1 years, BMI 23 ± 1 kg/m2, and HbA1c 5.5 ± 0.1%). RESEARCH DESIGN AND METHODS Saline or physiological doses of GIP were administered intravenously (randomized and double blinded) during 90 min of insulin-induced hypoglycemia, euglycemia, or hyperglycemia. RESULTS During hypoglycemia, GIP infusion caused greater glucagon responses during the first 30 min compared with saline (76 ± 17 vs. 28 ± 16 pmol/L per 30 min, P < 0.008), with similar peak levels of glucagon reached after 60 min. During euglycemia, GIP infusion elicited larger glucagon responses (62 ± 18 vs. -11 ± 8 pmol/L per 90 min, P < 0.005). During hyperglycemia, comparable suppression of plasma glucagon (-461 ± 81 vs. -371 ± 50 pmol/L per 90 min, P = 0.26) was observed with GIP and saline infusions. In addition, during hyperglycemia, GIP more than doubled the insulin secretion rate (P < 0.0001). CONCLUSIONS In healthy subjects, GIP has no effect on glucagon responses during hyperglycemia while strongly potentiating insulin secretion. In contrast, GIP increases glucagon levels during fasting and hypoglycemic conditions, where it has little or no effect on insulin secretion. Thus, GIP seems to be a physiological bifunctional blood glucose stabilizer with diverging glucose-dependent effects on the two main pancreatic glucoregulatory hormones.

Christensen, Mikkel; Vedtofte, Louise

2011-01-01

274

[The infusion therapy of the acute bleeding].  

Science.gov (United States)

Intravenous colloid and crystalloid solutions are the mainstay of the acute bleeding therapy. Infusion therapy normalizes the blood circulation volume and improves its flow characteristics. The conducted study revealed that the method normovolemic hemodilution lead to an early unknown type of oxygen insufficiency called the dilutional anemic hypoxia. Authors set up and proved the hypothesis, that decompensated dilutional anemic hypoxia lead to cardiac insufficiency, leading finally to the so called dilutional circulatory hypoxia. PMID:18833153

Bagdasarova, E A; Iarochkin, V S; Chernookov, A I; Bagdasarov, V V; Ramishvili, V Sh

2008-01-01

275

Intravenous labetalol in the treatment of severe hypertension  

Science.gov (United States)

1 We have compared, in patients with severe hypertension, the administration of intravenous labetalol by single rapid injection, by repeated bolus injections, and by incremental infusion. 2 Incremental infusion was the most consistently (albeit not invariably) effective method, and that least prone to cause side-effects. 3 An occasional very marked decrease in blood pressure was seen with all these techniques but least often with incremental infusion. Thus close and continuous supervision is mandatory. 4 All three methods produced slight but significant decreases in heart rate, and in plasma angiotensin II and aldosterone. 5 Intravenous labetalol was also effective in controlling hypertensive crises of phaeochromocytoma and those following the withdrawal of clonidine. 6 In a total of 70 severely hypertensive patients given intravenous labetalol, none showed adverse neurological or cardiological sequelae.

Cumming, A. M. M.; Brown, J. J.; Lever, A. F.; Robertson, J. I. S.

1982-01-01

276

Evaluating the Safety and Efficiency of a CPOE System for Continuous Medication Infusions in a Pediatric ICU  

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Critically ill children often require continuous intravenous infusions of life-supporting medications. The complexity of ordering such infusions makes this an error prone process, and such errors can result in serious adverse events. A CPOE system was developed and evaluated to assess its impact on the safety and efficiency of prescribing continuous medication infusions.

Vaidya, Vinay; Sowan, Azizeh K.; Mills, Mary Etta; Soeken, Karen; Gaffoor, Mohamed; Hilmas, Elora

2006-01-01

277

Short communication: intramammary infusion of IGF-I increases bromodeoxyuridine labeling in mammary epithelial cells of prepubertal heifers.  

Science.gov (United States)

When dairy heifers are fed to gain more than 900 g of body weight/d, they have less mammary parenchymal DNA at puberty but more insulin-like growth factor-I (IGF-I) in serum. This negative relationship between serum IGF-I concentration and mammary epithelial cell proliferation is in disagreement with the extensively reported role of IGF-I as a stimulator of mammary epithelial cell proliferation. Despite the large body of evidence suggesting that an increase in IGF-I concentration should lead to an increase in mammary epithelial cell proliferation of prepubertal heifers, it had not been previously tested. Our objective was to determine if intramammary infusions of IGF-I would stimulate mammogenesis in prepubertal heifers in vivo. After 7 d of treatment, bromodeoxyuridine was infused intravenously and heifers were slaughtered 3 h later. Samples from 3 regions of the mammary parenchyma were collected, fixed, sliced, and incubated with bromodeoxyuridine monoclonal antibody to identify cells in the S-phase of the cell cycle. Intramammary infusion of IGF-I increased the percentage of epithelial cells in the S-phase by 52% (6.4 vs. 4.2%, +/- 0.3%). Proliferation was similar in all 3 parenchymal regions, and the response to IGF-I was similar in each region. We conclude that local IGF-I increases proliferation of mammary parenchymal epithelial cells in prepubertal heifers. PMID:16027190

Silva, L F P; Liesman, J S; Etchebarne, B E; Nielsen, M S Weber; Vandehaar, M J

2005-08-01

278

Haemorrheological effects of prostaglandin E1 infusion in Raynaud's syndrome.  

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Eighteen patients with severe Raynaud's syndrome had impaired deformability of erythrocytes, as measured by filtration through 5 micron diameter pores, compared with 19 healthy controls. The patients were given prostaglandin E1 (PGE1) or placebo by intravenous infusion for 72 h to assess the haemorrheological action of PGE1. Contrary to a previous report, PGE1 did not improve erythrocyte filterability. Infusion of PGE1 did, however, evoke an acute phase response with hyperproteinaemia and a l...

Lucas, G. S.; Simms, M. H.; Caldwell, N. M.; Alexander, S. J.; Stuart, J.

1984-01-01

279

Labetalol infusion for refractory hypertension causing severe hypotension and bradycardia: an issue of patient safety  

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Abstract Incremental doses of intravenous labetalol are safe and effective and, at times, such therapy may need to be augmented by a continuous infusion of labetalol to control severe hypertension. Continuous infusions of labetalol may exceed the recommended maximum daily dose of 300 mg on occasion. We report a case in which hypertension occurring after an abdominal aortic aneurysm repair, initially responsive to intermittent intravenous beta-blockade, became resistant to this thera...

Fahed Samir; Grum Daniel F; Papadimos Thomas J

2008-01-01

280

Epinephrine-induced Insulin Resistance in Man  

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Endogenous release of epinephrine after stress as well as exogenous epinephrine infusion are known to result in impaired glucose tolerance. Previous studies of man and animals have demonstrated that this effect of epinephrine results from inhibition of insulin secretion and augmentation of hepatic glucose production. However, the effect of epinephrine on tissue sensitivity to insulin, and the relative contributions of peripheral vs. hepatic resistance to impaired insulin action, have not been...

Deibert, David C.; Defronzo, Ralph A.

1980-01-01

 
 
 
 
281

Effects of insulin on ovine fetal leucine kinetics and protein metabolism.  

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Fetuses of eight pregnant ewes (114-117 d of gestation) were used to study whether fetal insulin concentration affects fetal protein accretion and, if so, whether such changes are caused by effects on protein synthesis or protein breakdown. Fetal leucine kinetics were measured by infusion of [1-14C]leucine during each of three protocols: (I) low vs. normal insulin concentration; (II) low vs. high insulin concentration; and (III) low vs. high insulin concentration during amino acid infusion to...

Milley, J. R.

1994-01-01

282

Heparina e insulina en el tratamiento de la pancreatitis aguda por hipertrigliceridemia: Experiencia en 5 casos Heparin and/or insulin treatment of acute pancreatitis caused by hypertriglyceridemia  

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Full Text Available Background: Hypertriglyceridemia over 1,000 mg/dl can provoke acute pancreatitis and its persistence can worsen the clinical outcome. On the contrary, a rapid decrease in triglyceride level is beneficial. Plasmapheresis has been performed in some patients to remove chylomicrons from the circulation, while heparin and/or insulin have been administered in some other cases to rapidly reduce blood triglycerides. Heparin and insulin stimulate lipoprotein-lipase activity and accelerate chylomicron degradation. Aim: To report five patients with acute pancreatitis treated with heparin and insulin. Patients and methods: Five patients (4 females and 1 male seen in the last two years, who suffered acute pancreatitis induced by hypertriglyceridemia are reported. Initial blood triglyceride levels were above 1,000 mg/dl (range 1,590-8,690 mg/dl. Besides the usual treatment of acute pancreatitis, heparin and/or insulin were administered intravenously in continuous infusion. Heparin dose was guided by usual parameters of blood coagulation, and insulin dose, by serial determinations of blood glucose. Pancreatic necrosis was demonstrated in 4 patients. Results: Serum triglyceride levels decreased to <500 mg/dl within 3 days in all cases. No complication of treatment was observed and all patients survived. Early and late complications of pancreatitis occurred in one patient. Conclusion: Administration of heparin and/or insulin is an efficient alternative to reduce triglyceride levels in patients with acute pancreatitis and hypertriglyceridemia (Rev Méd Chile 2001; 129: 1373-8

Zoltán Berger F

2001-12-01

283

Insulin dose response studies in severely insulin resistant type 2 diabetes - evidence for effectiveness of very high insulin doses  

DEFF Research Database (Denmark)

Aim: To combat diabetic complications strict glycaemic control is desirable in type 2 diabetes, but some patients are severely insulin resistant and it is not known whether high doses of insulin are effective. This study was designed to determine the acute dose response effects of insulin in patients with type 2 diabetes and severe insulin resistance. Materials and Methods: We included 8 insulin resistant (mean insulin dose: 186 IU/d. BMI: 35) subjects with type 2 diabetes in a single-blinded, randomised crossover study. Each subject was studied on two occasions. On each occasion subjects underwent two 3-h hyperinsulinaemic euglycaemic clamps. The subjects were randomised to two low-dose insulin infusions (0.5 and 1.5 mU/kg/min in random order) on one occasion and to two high-dose insulin infusions (3.0 and 5.0 mU/kg/min in random order) on another occasion. Results: On all occasions steady state glucose infusion rates (GIR) were accomplished and we observed a clear dose response relation with GIR values of 0.4 ±0.2 (SE), 2.6 ±0.6, 3.7 ±0.8, and 4.9 ±0.9 mg/kg/min during the 0.5, 1.5, 3.0, and 5.0 mU/kg/min insulin infusions, respectively(P 800 IU/d, suggesting effectiveness of very high insulin doses in severely insulin resistant subjects.

Opstrup, Ulla Kampmann; Hoeyem, P

2011-01-01

284

Long-term Efficacy of Insulin Pump Therapy in Children with Type 1 Diabetes Mellitus  

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Objective: Insulin pumps have been well established for insulin delivery. However, questions about long-term efficacy of insulin pump therapy still remain. We evaluated the long-term efficacy of continuous insulin infusion pump therapy (CSII) in pediatric patients with type 1 diabetes mellitus (T1DM).

Batajoo, Ruby Joshi; Messina, Catherine R.; Wilson, Thomas A.

2012-01-01

285

The education of patients in prandial insulin dosing related to the structure of bolus calculators  

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The metabolic effect of insulin pump therapy depends on precise adjustments of insulin to food intake ratio. Calculation of prandial insulin dose is a complex process employing many variant factors such as pre-prandial glucose and carbohydrate (CHO) levels, glucose index, insulin to CHO ratio (ICR) and active insulin. Bolus calculators are very effective in controlling blood glucose level in patients treated with continuous subcutaneous insulin infusion (CSII). Most of modern bolus calculator...

Marlena B?azik; Ewa Pa?kowska

2010-01-01

286

Relief of pain by infusion of morphine after operation: does tolerance develop?  

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To see whether continuous intravenous infusion of opiates provides more effective postoperative relief of pain than conventional intramuscular injection these regimens were compared in a prospective double blind trial. Thirty patients undergoing elective cholecystectomy were allocated randomly to receive an infusion of morphine or an infusion of placebo (control group) for 24 hours. Both groups were allowed supplementary morphine boluses as requested. During the first 48 hours after operation...

Marshall, H.; Porteous, C.; Mcmillan, I.; Macpherson, S. G.; Nimmo, W. S.

1985-01-01

287

Intravenous iron therapy: how far have we come?  

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Full Text Available Oral iron supplementation is usually the first choice for the treatment of iron deficiency anemia (IDA because of its effectiveness and low cost. But unfortunately in many iron deficient conditions, oral iron is a less than the ideal treatment mainly because of adverse events related to the gastrointestinal tract as well as the long course required to treat anemia and replenish body iron stores. The first iron product for intravenous use was high-molecular-weight iron dextran. However, dextran-containing intravenous iron preparations are associated with an elevated risk of anaphylactic reactions, which made physicians reluctant to prescribe intravenous iron in the treatment of iron deficiency anemia for many years. In 1999 and 2001, two new intravenous iron preparations (ferric gluconate and iron sucrose were introduced into the market as safer alternatives to iron dextran. Over the last five years, three new intravenous iron dextran-free preparations have been developed and have better safety profiles than the more traditional intravenous compounds, as none require test doses and all these products are promising in respect to a more rapid replacement of body iron stores (15-60 minutes/infusion as they can be given at higher doses (from 500 mg to more than 1000 mg/infusion. The purpose of this review is to discuss some pertinent issues in relation to the history, pharmacology, administration, efficacy, safety profile and toxicity of intravenous iron for the treatment of iron deficiency anemia.

Rodolfo Delfini Cançado

2011-12-01

288

Insulin resistance and thyroid disorders.  

Science.gov (United States)

Insulin resistance is defined as a glucose homeostasis disorder involving a decreased sensitivity of muscles, adipose tissue, liver and other body tissues to insulin, despite its normal or increased concentration in blood. Insulin resistance may be asymptomatic or occur presenting a variety of disorders, such as: glucose tolerance impairment, type 2 diabetes, as well as hypercholesterolaemia, hypertriglyceridaemia, obesity, and arterial hypertension. Insulin acts via specific receptors present on the surface of most cells of the body. The greatest number of these receptors is found on adipocytes, hepatocytes and striated muscle cells. There are three mechanisms of insulin resistance: pre-receptor, receptor and post-receptor. Multiple methods of assessing insulin resistance are based on the concurrent measurements of glucose and insulin levels in blood serum. The glucose and insulin measurements are conducted in baseline conditions or after intravenous administration of a specific quantity of glucose or insulin. The methods of assessing insulin resistance are divided into direct and indirect. The current 'gold standard' in the assessment of insulin sensitivity is the determination of tissue glucose utilisation using the metabolic clamp technique. The presence of disorders of carbohydrate metabolism has been demonstrated in thyroid disease involving either overt hyperthyroidism or overt hypothyroidism. The severity of the disease is proportional to the severity of these disorders. The possible influence of subclinical forms of both hyperthyroidism and hypothyroidism on carbohydrate disorders is still under discussion. Thyroid hormones have a significant effect on glucose metabolism and the development of insulin resistance. In hyperthyroidism, impaired glucose tolerance may be the result of mainly hepatic insulin resistance, whereas in hypothyroidism the available data suggests that the insulin resistance of peripheral tissues prevails. PMID:24549605

Gierach, Marcin; Gierach, Joanna; Junik, Roman

2014-01-01

289

Intramammary infusion of leptin decreases proliferation of mammary epithelial cells in prepubertal heifers.  

Science.gov (United States)

High energy intake and excessive body fatness impair mammogenesis in prepubertal ruminants. High energy intake and excessive fatness also increase serum leptin. Our objective was to determine if an infusion of leptin decreases proliferation of mammary epithelial cells of prepubertal heifers in vivo. Ovine leptin at 100 microg/ quarter per d with or without 10 microg of insulin-like growth factor (IGF)-I was infused via the teat canal into mammary glands of prepubertal dairy heifers; contralateral quarters were used as controls. After 7 d of treatment, bromodeoxyuridine was infused intravenously and heifers were slaughtered approximately 2 h later. Tissue from 3 regions of the mammary parenchyma was collected and immunostained for bromodeoxyuridine (BrdU), proliferating cell nuclear antigen (Ki-67), and caspase-3. Leptin decreased the number of mammary epithelial cells in the S-phase of the cell cycle by 48% in IGF-I-treated quarters and by 19% in saline-treated quarters. Leptin did not alter the number of mammary epithelial cells within the cell cycle, as indicated by Ki-67 labeling. Caspase-3 immunostaining within the mammary parenchyma was very low in these heifers, but leptin significantly increased labeling in saline-treated quarters. Leptin enhanced SOCS-3 expression in IGF-I-treated quarters but did not alter SOCS-1 or SOCS-5 expression. We conclude that a high concentration of leptin in the bovine mammary gland reduces proliferation of mammary epithelial cells. The reduced proliferation is accompanied by an increase in SOCS-3 expression, suggesting a possible mechanism for leptin inhibition of IGF-I action. Whether leptin might be a physiological regulator of mammogenesis remains to be determined. PMID:18650280

Silva, L F P; Etchebarne, B E; Nielsen, M S Weber; Liesman, J S; Kiupel, M; VandeHaar, M J

2008-08-01

290

Intraosseous Infusion Device.  

Science.gov (United States)

A device for infusion or aspiration that includes a base and at least one needle positioned within the base, where the base includes one or more locators for positioning the infusion device in relation to one or more predetermined anatomical features. A d...

D. Nedder J. F. Stokes M. J. Turieo R. P. Maloney R. W. Etheredge

2005-01-01

291

Long-term use of intramuscular insulin therapy in a type I diabetic patient with subcutaneous insulin resistance.  

Science.gov (United States)

We studied a 26-year-old Type 1 diabetic patient who experienced recurrent episodes of ketoacidosis and who was unresponsive to subcutaneous insulin, but normally responsive to intravenous insulin as demonstrated by insulin challenge test. Attempts at intravenous and intraperitoneal insulin administration were complicated by recurrent septicaemia. We therefore investigated the hypoglycaemic effect of intramuscular insulin administration in this patient. After intramuscular injection of NPH and Ultralente human insulin (0.1 U kg-1), the lowest plasma glucose levels occurred 1 and 7 h later, respectively; the hypoglycaemic effect lasted approximately 2 and 12 h, respectively. We based insulin therapy on intramuscular NPH as a fast-acting insulin and Ultralente as an intermediate-acting insulin using four injections a day. During the next 24 months, the patient was hospitalized for 4 weeks versus 56 weeks in the 20 months preceding intramuscular insulin administration, and was able to resume full-time work. HbAlC decreased from 11.7% to 8.7% (normal range: 4.2-5.9%). Thus, long-term intramuscular insulin therapy is a feasible alternative to intravenous or intraperitoneal insulin in patients with well-demonstrated resistance to subcutaneous insulin. PMID:8458196

Brossard, J H; Havrankova, J; Rioux, D; Bertrand, S; D'Amour, P

1993-03-01

292

Enhancement of insulin action after oral glucose ingestion.  

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Previous investigations in normal humans and rats have shown an increase in insulin sensitivity and binding affinity of adipocytes isolated 1-3 h after glucose ingestion. To determine whether a rapid enhancement of the action of insulin follows glucose ingestion in vivo, the present studies have utilized 120-min 20 mU/m2 X min euglycemic insulin infusions before and after 7.5-, 15-, 25-, and 100-g oral glucose loads. Euglycemic insulin infusions after the carbohydrate challenge were begun aft...

1986-01-01

293

Assessment of single-dose benzodiazepines on insulin secretion, insulin sensitivity and glucose effectiveness in healthy volunteers: a double-blind, placebo-controlled, randomized cross-over trial [ISRCTN08745124  

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Full Text Available Abstract Background The present study aimed at investigating in healthy volunteers the effects of diazepam and clonazepam on beta-cell function, insulin sensitivity and glucose effectiveness based on the frequently sampled intravenous (0.5 gkg-1 glucose tolerance test with minimal-model analysis. Methods The study was designed as a double-blind, placebo-controlled, cross-over clinical trial. Diazepam (10 mg and clonazepam (1 mg were infused during 30 min to 15 male subjects with a mean age of 22 years (range: 20–29, after informed consent was given. Benzodiazepines were assayed by capillary gas chromatography with electron capture, insulin by radioimmunoassay and glucose by the enzymatic glucose oxidase method. Results Both benzodiazepines induced significant psychotropic effects. The acute insulin responses (AIR were significantly and negatively correlated with the clonazepam plasma concentrations (r = -0.609, P -1 (median and lower limit of effective therapeutic concentrations: 1.37 ± 0.3 versus 2.84 ± 0.60 × 10-2min-1 (P = 0.028 for the coefficient of glucose tolerance (Kg, 2.18 ± 0.29 versus 3.71 ± 0.89 × 10-4?Uml-1min-1 (P = 0.018 for insulin sensitivity (Si and 1.80 ± 0.39 versus 3.59 ± 0.71 × 10-2min-1 (P = 0.028 for glucose effectiveness at basal insulin (Sg. These parameters were not significantly modified when diazepam was administered; plasma levels of this drug however, were below the effective therapeutic concentrations (300 ng ml-1 from min 15 after the end of the perfusion. Conclusion The present results suggest that a benzodiazepine, in particular clonazepam, may alter insulin secretion and insulin sensitivity after a single administration in healthy volunteers.

Lacarelle Bruno

2004-03-01

294

Risk of Complications During Intravenous Heparin Therapy  

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The records of all patients to whom heparin was dispensed by the pharmacy of the University of California Medical Center, San Diego, during the year 1979 were reviewed. A total of 131 patients above age 15 met the inclusion criteria—they had received more than 10,000 units of heparin per 24 hours for at least 24 hours. All 131 patients were administered heparin by continuous intravenous infusion by peristaltic pump. All heparin was porcine heparin from a single commercial source. The daily ...

Nelson, Preston H.; Moser, Kenneth M.; Stoner, Carol; Moser, Kathleen S.

1982-01-01

295

Continuous-infusion adriamycin  

International Nuclear Information System (INIS)

This chapter discusses the diminished cardiotoxicity as well as diminished nausea and vomiting with continuous infusions of adriamycin to patients undergoing radiation therapy, particularly with infusions of 48 hours or longer, and best with 96-hour infusions, the longest duration that has been studied systematically. In breast cancer, data show that more adriamycin is better, but only for a selected subgroup of patients: those with complete remission. The diminished cardiotoxicity makes the use of adriamycin more attractive in the adjuvant situation, where increased safety will decrease the chances of long-term complications and make retreatment easy for cured patients who develop second malignancies

1986-01-01

296

Insulin therapy.  

Science.gov (United States)

Insulin therapy is a vital hormone replacement therapy in type 1 diabetes mellitus. In type 2 diabetes, insulin is indicated if glycaemic goals are not reached by oral anti diabetics, as well as for metabolic detoriation, co-morbidities, surgery, pregnancy or contradictions against oral anti diabetics. Insulin preparations are characterized by the onset of the insulin action, the peak profile and duration of action. Available are short acting, long-acting and premixed preparations of human insulin, and insulin analogues. The gold standard of insulin therapy in type 1 diabetes is functional insulin therapy with a basal-bolus insulin regimen and control and adaption of the therapy by the patient. Various insulin regimens are available for treating patients with type 2 diabetes, including basal insulin supported oral therapy, supplementary mealtime injection of short acting insulin or insulin analogues, conventional insulin therapy or a basal bolus procedure. The various insulin preparations and regimens make it possible to adapt the therapy according to the patient's individual need. PMID:21584767

Lechleitner, Monika; Hoppichler, Friedrich

2011-06-01

297

High-dose insulin therapy for neurogenic-stunned myocardium after stroke.  

Science.gov (United States)

A 44-year-old woman with a history of complicated type 2 diabetes mellitus presented with a diagnosis of right-hemispheric ischaemic stroke. She developed acute respiratory distress with radiological evidence of pulmonary oedema. The ECG showed poorly significant ST-segment changes, with a minimal increase of cardiac biomarkers. Echocardiography showed a severely depressed left ventricular function, with also low values of cardiac output at invasive monitoring. The possibility of neurogenic-stunned myocardium was discussed and a metabolic resuscitation with high-dose insulin was proposed. An intravenous bolus of 80 units of insulin (0.72 IU/kg) was followed by a continuous infusion at the rate of 160 IU/h (1.45 IU/kg/h). The treatment led to a rapid and sustained improvement of the haemodynamic condition and was well tolerated. In comparison with dobutamine, insulin had significant inotropic effects without tachycardia. The patient unfortunately died on day 35, from respiratory complications after poor neurological recovery. PMID:23175002

Devos, Justine; Peeters, André; Wittebole, Xavier; Hantson, Philippe

2012-01-01

298

Evaluation of maternal infusion therapy during pregnancy for fetal development  

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Full Text Available The aim of this project was to study the possible association between maternal infusion treatments during pregnancy and variables of fetal development as well as the occurrence of congenital abnormalities (CA in a case-control design. The large population-based data set of the Hungarian Case?Control Surveillance of Congenital Abnormalities (HCCSCA was evaluated based on the medically recorded infusion treatment during pregnancy. Of 22,843 case pregnant women who had newborns or fetuses with congenital abnormalities, 112 (0.5%, while of 38,151 control pregnant women who had newborn infants without any defects, 262 (0.7%, had infusion treatment during pregnancy. Infusion treatment was more frequent in the control group than in the case group with congenital abnormalities (adjusted POR with 945 95% CI: 0.7, 0.6-0.9 and there was no higher rate of maternal infusion treatments in any congenital abnormality group. Mean gestational age was shorter and mean birth weight was smaller in control newborn infants without CA born to mothers with infusion treatment during pregnancy than in the babies of mothers without infusion treatment. The prevalence of mild intrauterine growth retardation was more frequent in the fetuses of pregnant women with hyperemesis gravidarum treated with infusion. The results of the study suggest that infusion treatment of pregnant women did not associate with a higher risk of congenital abnormalities. In addition, the intravenous infusion of drugs has some, but limited efficacy to prevent the adverse effects of hyperemesis gravidarum and threatened preterm delivery.

2005-10-01

299

Lipid induced insulin resistance affects women less than men and is not accompanied by inflammation or impaired proximal insulin signaling  

DEFF Research Database (Denmark)

AbstractObjective: We have previously shown that overnight fasted women have higher insulin stimulated whole body and leg glucose uptake despite a higher intramyocellular triacylglycerol concentration than men. Women also express higher muscle mRNA levels of proteins related to lipid metabolism than men. We therefore hypothesized that women would be less prone to lipid induced insulin resistance. Research and design methods: Insulin sensitivity of whole body and leg glucose disposal was studied in 16 young well matched healthy men and women infused with intralipid or saline for 7h. Muscle biopsies were obtained before and during a euglycemic hyperinsulinemic (1.42 mU·kg(-1)·min(-1)) clamp. Results: Intralipid infusion reduced whole body glucose infusion rate 26% in women and 38% in men (p<0.05) and insulin stimulated leg glucose uptake was reduced significantly less in women (45%) than men (60%) after intralipid infusion. Hepatic glucose production was decreased during the clamp similarly in women and men irrespective of intralipid infusion. Intralipid did not impair insulin or AMPK signaling in muscle and subcutaneous fat, did not cause accumulation of muscle lipid intermediates, and did not impair insulin stimulated glycogen synthase activity in muscle or increase plasma concentrations of inflammatory cytokines. In vitro glucose transport in giant sarcolemmal vesicles was not decreased by acute exposure to fatty acids. Leg lactate release was increased and respiratory exchange ratio was decreased by intralipid. Conclusion: Intralipid infusion causes less insulin resistance of muscle glucose uptake in women than in men. This insulin resistance is not due to decreased canonical insulin signaling, accumulation of lipid intermediates, inflammation or direct inhibition of glucose transporter activity. A higher leg lactate release and lower glucose oxidation with intralipid infusion may rather suggest a metabolic feed back regulation of glucose metabolism.

Høeg, Louise D; Sjøberg, Kim Anker

2011-01-01

300

A simplified intravenous glucose loading protocol for fluorine-18 fluorodeoxyglucose cardiac single-photon emission tomography  

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In a population of 209 patients undergoing dual-isotope single acquisition (DISA) FDG/sestamibi (MIBI) SPET, we describe the improvements in both image quality and time efficiency using a new short, simple glucose/insulin/potassium (GIK) infusion protocol prior to FDG injection as compared to a conventional oral glucose loading protocol. DISA FDG/MIBI SPET scans were performed in 111 nondiabetic patients after oral loading with 50 g of glucose (group 1). Ninety-eight consecutive nondiabetic patients were subsequently scanned following preparation with a fixed-concentration GIK infusion administered at a standardized rate (group 2). A three-point grading scale was used to assess image quality. The time to FDG injection following glucose administration was significantly shorter for the group 2 patients (39.9{+-}15.6 min; range 20-105 min) than for the group 1 patients (99.5{+-}30.3 min; range 56-270 min) (P<0.0001), representing a 1-h decrease in patient preparation time. More of the group 1 patients (n=30; 27%) required supplemental intravenous boluses of regular insulin than did the group 2 patients (n=13; 13%) (P<0.02). There were more excellent and good quality graded images using the GIK method (group 2) than the more traditional oral loading protocol (group 1) (P<0.02). Nine of 111 scans (8%) in group 1 were uninterpretable, whereas only one of 98 scans (1%) in group 2 was uninterpretable. Standardized infusion of a fixed concentration of GIK prior to FDG administration and continued during myocardial FDG uptake is an effective yet simple method of obtaining consistently good to excellent quality FDG SPET cardiac scans. It is preferable to conventional oral glucose loading due to decreased patient preparation time and improved image quality. The technique is safe and should improve both the clinical use and the cost-effectiveness of FDG SPET imaging for the identification of injured but viable myocardium. (orig.) With 2 figs., 3 tabs., 43 refs.

Martin, W.H.; Jones, R.C.; Delbeke, D.; Sandler, M.P. [Section of Nuclear Medicine, Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, and Vanderbilt University School of Medicine, Nashville, Tennessee (United States)

1997-10-01

 
 
 
 
301

Insulin analogs  

Directory of Open Access Journals (Sweden)

Full Text Available The fear of hypoglycemia that people with diabetes experience is a factor in non-adherence to insulin therapy, which can adversely affect glycemic control and increase the risk of diabetes-associated complications. Insulin analogs are modified forms of human insulin designed to mimic endogenous insulin secretion, and may therefore help to reduce the risk and severity of hypoglycemia. While much evidence exists to demonstrate the efficacy of insulin analogs in blood glucose control, the effects on the incidence of severe hypoglycemia are less clear. This treatment review presents recent studies investigating the effects of insulin analogs on the frequency of hypoglycemia.

Emily Chu

2012-06-01

302

Newer Insulins  

Directory of Open Access Journals (Sweden)

Full Text Available These analogues have shown equal or superiorefficacy and have lower incidence of hypoglycaemia.But insulin analogues are more expensive than humaninsulin. Therefore, these are used as alternative agentsin patients who cannot achieve tight blood glucose control,patients with hypoglycaemia or intolerable events withhuman insulin and in patients who have to start humaninsulin therapy. The proper use of insulin analogues willallow the diabetics greater flexibility in the timing of meals,snacks and exercise which will improve their quality oflife. Other routes of insulin administration are also showingpromise. Inhaled insulin has been approved by FDA.Continued progress in the field of newer insulins ison as well

Jasleen Kaur, Dinesh K. Badyal

2008-07-01

303

The effects of infusions of arginine vasopressin or 1-deamino-8-D-arginine vasopressin on common carotid vascular resistance in conscious, Long Evans rats.  

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1. Intravenous infusions of arginine vasopressin or 1-deamino-8-D-arginine vasopressin (DDAVP) were given to conscious, Long Evans rats chronically instrumented with bilateral, common carotid, pulsed Doppler probes and intravascular catheters. 2. During infusion of vasopressin at 0.3 nmol min-1 there was an increase in common carotid vascular resistance with no change in mean blood pressure or heart rate. Following infusion there was a common carotid vasodilatation. 3. During infusion of vaso...

Gardiner, S. M.; Compton, A. M.; Bennett, T.

1989-01-01

304

Radionuclide venography using continuous Kr-81 m infusion: preliminary note  

International Nuclear Information System (INIS)

Continuous infusion of Kr-81m presents important advantages compared to the commonly used radionuclides for venography. High count rates can be accumulated, and a high resolution collimator can be employed to ensure good quality images. The study can be repeated immediately and multiple views can be performed until a satisfactory result is obtained. The production of radionuclide from a Rb-81--Kr-81m generator suitable for intravenous infusion is almost the same as that which is suitable for ventilation. The same generator can first be used for venography and then for ventilation imaging to complete the work-up patients suspected of having thromboembolic disease

1981-01-01

305

In Vivo Simulations of the Intravenous Dynamics of Submicron Particles of pH-Responsive Cationic Hydrogels in Diabetic Patients  

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A mathematical model describing glucose-dependent pH swelling and insulin release is developed for pH-sensitive cationic hydrogels in which glucose oxidase and catalase have been immobilized and insulin imbibed. Glucose based swelling and insulin release are simulated for intravenously injected particles at various design conditions. The effects of particle size, the number of injected particles, insulin loading, enzyme loading, monomer functional group loading and pKa, and hydrogel crosslink...

Farmer, Terry G.; Edgar, Thomas F.; Peppas, Nicholas A.

2008-01-01

306

Kiovig for primary immunodeficiency: reduced infusion and decreased costs per infusion.  

Science.gov (United States)

Kiovig is a ready-to-use 10% liquid immunoglobulin preparation that is medically indicated for the treatment of primary immunodeficiency. This study aims to conduct an economic evaluation which compares the intravenous immunoglobulin (IVIg) preparations Kiovig, Multigam, and Sandoglobulin from the Belgian societal perspective. As three prospective studies have observed no difference in outcomes, a cost-minimization analysis is considered appropriate to evaluate differences in treatment costs that can arise from IVIgs. A decision-analytic model simulated treatment costs attributed to one infusion. Resource use data were derived from a Dutch costing study. Cost items included immunoglobulin costs, pharmacy administration and nursing costs, mini-forfait for hospital infusion, costs of adverse events, and lost productivity with 2009 as base year. Cost data were identified from published sources and Belgian hospital administrators. A probabilistic sensitivity analysis explored the impact of parameter uncertainty on cost results. Costs per infusion cycle in adult primary immunodeficiency patients were €1,046 (95% confidence interval: €1,006-1,093) with Kiovig; €1,102 (€1,064-1,147) with Multigam; and €1,147 (€1,108-1,193) with Sandoglobulin. The average cost savings per infusion with Kiovig as compared to Multigam and Sandoglobulin amounted to €56 and €101 per infusion. In conclusion, treatment costs with Kiovig were shown to be lower as compared to other IVIgs in Belgium. Reduced costs per infusion were attributed to lower costs associated with treating adverse events and the opportunity cost of nursing time and time off work for working adults. PMID:21570491

Connolly, Mark; Simoens, Steven

2011-09-01

307

Disposition of intravenous radioactive acyclovir  

International Nuclear Information System (INIS)

The kinetic and metabolic disposition of (8-14C)acyclovir (ACV) was investigated in five subjects with advanced malignancy. The drug was administered by 1-hr intravenous infusion at doses of 0.5 and 2.5 mg/kg. Plasma and blood radioactivity-time, and plasma concentration-time data were defined by a two-compartment open kinetic model. There was nearly equivalent distribution of radioactivity in blood and plasma. The overall mean plasma half-life and total body clearance +/- SD of ACV were 2.1 +/- 0.5 hr and 297 +/- 53 ml/min/1.73 m2. Binding of ACV to plasma proteins was 15.4 +/- 4.4%. Most of the radioactive dose excreted was recovered in the urine (71% to 99%) with less than 2% excretion in the feces and only trace amounts in the expired Co2. Analyses by reverse-phase high-performance liquid chromatography indicated that 9-(carboxymethoxymethyl)guanine was the only significant urinary metabolite of ACV, accounting for 8.5% to 14.1% of the dose. A minor metabolite (less than 0.2% of dose) had the retention time of 8-hydroxy-9-[(2-hydroxyethoxy)methyl]guanine. Unchanged urinary ACV ranged from 62% to 91% of the dose. There was no indication of ACV cleavage to guanine. Renal clearance of ACV was approximately three times the corresponding creatinine clearances

1981-01-01

308

Effect of oral antacids on disposition of intravenous enoxacin.  

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The effect of an intensive aluminum-magnesium hydroxide antacid regimen (Maalox TC) on the disposition of intravenous enoxacin was studied in six male and six female volunteers. A single 400-mg dose of enoxacin was administered intravenously over 30 min on two occasions separated by a 1-week washout period. Thirty milliliters of Maalox TC was administered at -8, -2.5, -0.5, 1.5, 3.5, 5.5, 7.5, 9.5, 11.5, 13.5, and 15.5 h relative to the start of one enoxacin infusion. The enoxacin dose in whi...

Nix, D. E.; Lebsack, M. E.; Chapelsky, M.; Sedman, A. J.; Busch, J.; Norman, A.

1993-01-01

309

Behaviour of homologous 125I fibrinogen after thrombin and ancrod infusion in rabbits  

International Nuclear Information System (INIS)

The behaviour of radioactively labelled fibrinogen after infusion of thrombin or ancrod is investigated. Common factors and differences in the behaviour of fibrinogen after infusion of these two enzymes, which act proteolytically on the fibrinogen, are dealt with. Rabbits received an i.v. injection of homologous 125I-fibrinogen 3 days before ancrod or thrombin infusion. On the day of the experiments, one group of animals received an ancrod infusion (1.5 U/kg body weight for 30 minutes), the other a thrombin infusion (600 U/kg body weight for 60 minutes). Intravenous ancrod and thrombin infusions lowered the fibrinogen level to 30% or 50% of the initial value due to intravascular coagulation. About 50% of the 125I fibrinogen was transformed after ancrod exposure into a non-coagulating fraction of fibrinogen derivatives which produces no fibrinolytic decomposition products. (orig./AJ)

1977-01-01

310

Continuous radioisotope infusion  

International Nuclear Information System (INIS)

Continuous infusion of a radioactive marker was used instead of a conventional bolus injection to improve haemodynamic studies. Tc-99m was infused into the blood circulation at a constant rate for 100-300 seconds and the activity in the target structure was measured by a gamma camera with a computer system or by a single detector. The concentration of the marker increased linearly at the same rate throughout the circulating system. Due to variations in transport time from infusion site to different parts of the system the rise of activity occurred at different times. A theory for the calculations was presented and consequently confirmed in a model study. Blood flow patterns in artificial kidneys and alterations in renal blood flow induced by angiotensin were studied. The results are presented as time-function curves or as computer images. This technique can be used to evaluate distributions and alterations of flow in separate parts of a complex circulating system. (author)

1978-01-01

311

Dissociation between fat-induced in vivo insulin resistance and proximal insulin signaling in skeletal muscle in men at risk for type 2 diabetes.  

DEFF Research Database (Denmark)

The effect of short- (2 h) and long-term (24 h) low-grade Intralipid infusion on whole-body insulin action, cellular glucose metabolism, and proximal components of the insulin signal transduction cascade was studied in seven obese male glucose intolerant first degree relatives of type 2 diabetic patients [impaired glucose tolerance (IGT) relatives] and eight matched control subjects. Indirect calorimetry and excision of vastus lateralis skeletal muscle biopsies were performed before and during hyperinsulinemic euglycemic clamps combined with 3[(3)H]glucose. Clamps were performed after 0, 2, or 24 h Intralipid infusion (0.4 ml.kg(-1).min(-1)). Insulin-stimulated glucose disposal decreased approximately 25% after short- and long-term fat infusion in both IGT relatives and controls. Glucose oxidation decreased and lipid oxidation increased after both short- and long-term fat infusion in both groups. Insulin-stimulated glucose oxidation was higher after long-term as compared with short-term fat infusion in control subjects. Short- or long-term infusion did not affect the absolute values of basal or insulin-stimulated insulin receptor substrate-1 tyrosine phosphorylation, tyrosine-associated phosphoinositide 3-kinase (PI 3-kinase) activity, insulin receptor substrate-1-associated PI 3-kinase activity, or Akt serine phosphorylation in IGT relatives or matched controls. In fact, a paradoxical increase in both basal and insulin-stimulated PI 3-kinase activity was noted in the total study population after both short- and long-term fat infusion. Short- and long-term low-grade Intralipid infusion-induced (or enhanced) whole-body insulin resistance and impaired glucose metabolism in IGT relatives and matched control subjects. The fat-induced metabolic changes were not explained by impairment of the proximal insulin signaling transduction in skeletal muscle.

Storgaard, Heidi; Jensen, Christine B

2004-01-01

312

Rockburst prevention by infusion  

Energy Technology Data Exchange (ETDEWEB)

The Sonnenschein seam at Nordstern-Zollverei colliery in the FRG is rock-burst prone; it was decided to carry out preproduction infusion in the Zollverein panel. A total of 34 infusion holes were drilled to depths of 30, 45, 60 and 75m; seam reactions were recorded during drilling. Water at a pressure of 300 bar was pumped into the holes and the holes closed with wooden wedges and polyurethane. During production, the face was monitored by 10m deep test holes along the face. 1 fig.

Reiss, R.; Kasimir, F.; Klammer, G.

1988-01-01

313

Enhanced glycemic responsiveness to epinephrine in insulin-dependent diabetes mellitus is the result of the inability to secrete insulin. Augmented insulin secretion normally limits the glycemic, but not the lipolytic or ketogenic, response to epinephrine in humans.  

Digital Repository Infrastructure Vision for European Research (DRIVER)

To determine if the enhanced glycemic response to epinephrine in patients with insulin-dependent diabetes mellitus (IDDM) is the result of increased adrenergic sensitivity per se, increased glucagon secretion, decreased insulin secretion, or a combination of these, plasma epinephrine concentration-response curves were determined in insulin-infused (initially euglycemic) patients with IDDM and nondiabetic subjects on two occasions: once when insulin and glucagon were free to change (control st...

Berk, M. A.; Clutter, W. E.; Skor, D.; Shah, S. D.; Gingerich, R. P.; Parvin, C. A.; Cryer, P. E.

1985-01-01

314

Adenosine infusion increases plasma levels of VEGF in humans  

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Abstract Background Many in vitro studies have shown that adenosine (Ado) can induce vascular endothelial growth factor (VEGF) mRNA and protein expression and stimulate endothelial proliferation. In the present study, we seek to determine whether Ado can increase circulating levels of VEGF protein in the intact human. Methods Five outpatients 49.3 ± 6.7 years of age and weighing 88.2 ± 8.5 kg were selected. They were given a 6 min intravenous infusion...

Adair Thomas H; Cotten Reid; Gu Jian-Wei; Pryor Janelle S; Bennett Kenneth R; McMullan Michael R; McDonnell Preston; Montani Jean-Pierre

2005-01-01

315

Effect of magnesium infusion on thoracic epidural analgesia  

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Introduction: Patients of lung volume reduction surgery (LVRS) having an ASA status III or more are likely to be further downgraded by surgery to critical levels of pulmonary function. Aim: To compare the efficacy of thoracic epidural block with (0.125%) bupivacaine, fentanyl combination and (0.125%) bupivacaine, fentanyl combination with adjunctive intravenous magnesium infusion for the relief of postoperative pain in patients undergoing LVRS. Methods: Pati...

Gupta Sampa; Mitra Koel; Mukherjee Maitreyee; Roy Suddhadeb; Sarkar Aniruddha; Kundu Sudeshna; Goswami Anupam; Sarkar Uday; Sanki Prakash; Mitra Ritabrata

2011-01-01

316

Mechanism of action of insulin in diabetic patients: a dose-related effect on glucose production and utilisation  

Science.gov (United States)

Six insulin-requiring diabetics were studied after insulin had been withheld for 24 hours. On three separate occasions each received a two-hour infusion of insulin at a low dose (2·6 U/h) and a high dose (10·6 U/h) and an infusion of saline as control. The rates of production and utilisation of glucose were measured isotopically. The rate of fall of plasma glucose concentration was faster on the high-dose infusion of insulin than on the low, whereas the fall in plasma free fatty acids, glycerol, and keton bodies was the same on both insulin infusions. The mechanism whereby the two rates of insulin administration lowered plasma glucose concentration differed: during the low-dose infusion the decrease in the glucose concentration was produced entirely by a fall of hepatic glucose output, whereas during the high-dose insulin infusion the glucose concentration fell because both the rate of glucose production fell and the rate of glucose utilisation rose. In all experiments there was a direct relation between a fall in serum potassium concentration and the fall in plasma glucose concentration irrespective of the mechanism that reduced the glucose concentration. These results indicate that in uncontrolled diabetics low-dose insulin infusions lower the blood glucose concentration entirely by reducing glucose production from the liver and that the effect of insulin on potassium transport is independent of its effect on glucose uptake.

Brown, P M; Tompkins, C V; Juul, S; Sonksen, P H

1978-01-01

317

Intravenous metronidazole for treatment of infections involving anaerobic bacteria.  

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Intravenous metronidazole was administered, either by continuous or intermittent infusion, to 20 patients with infections involving anaerobic bacteria; 14 of the 20 patients were changed to oral administration of metronidazole for completion of therapy. Six of eight patients with infections derived from oropharyngeal bacterial flora were cured; the addition of ampicillin was required in one patient, however, because of an incomplete response to metronidazole. Eight of eleven evaluable patient...

George, W. L.; Kirby, B. D.; Sutter, V. L.; Wheeler, L. A.; Mulligan, M. E.; Finegold, S. M.

1982-01-01

318

Glucose tolerance, insulin release, and insulin binding to monocytes in kidney transplant recipients  

Energy Technology Data Exchange (ETDEWEB)

In order to evaluate glucose tolerance following renal transplantation, intravenous glucose tolerance tests (IVGTT), with evaluation of hormonal responses to the intravenous glucose load and percent specific /sup 125/I-insulin binding to peripheral blood monocytes, were studied in eight clinically stable kidney transplant recipients. For comparison purposes, identical studies were done in eight control subjects and seven clinically stable hemodialysis patients. One transplant recipient was glucose intolerant, with fasting hyperglycemia, elevated HbA1C, and abnormal glucose decay constant. Impaired pancreatic insulin release appeared to be the major factor accounting for his glucose intolerance. The seven glucose-tolerant transplant recipients had significantly increased insulin release during IVGTT compared to control subjects, and significant correlations were found among insulin release, glucose decay constant, and fasting blood sugar in those patients. Insulin binding to monocytes was significantly greater in transplant recipients than control subjects due to an increase in insulin binding capacity per cell. A significant correlation was found between percent specific /sup 125/I-insulin binding and steroid dose, expressed as mg/kg body weight/day, in those patients. Thus, chronic steroid administration does not cause glucose intolerance in transplant recipients who manifest steroid-associated increases in pancreatic insulin release and cellular insulin binding capacity.

Briggs, W.A.; Wielechowski, K.S.; Mahajan, S.K.; Migdal, S.D.; McDonald, F.D.

1982-03-01

319

Attenuated insulin response and normal insulin sensitivity in lean patients with ankylosing spondylitis.  

Science.gov (United States)

Chronic low-grade inflammation is associated with insulin resistance. The aim of this study was to determine insulin response to intravenous glucose load and insulin sensitivity in patients with ankylosing spondylitis (AS). Fourteen nonobese male patients with AS and 14 matched healthy controls underwent frequent-sampling intravenous glucose tolerance test (FSIVGTT). Insulin secretion and insulin sensitivity were calculated using the computer-minimal and homeostasis-model assessment 2 (HOMA2) models. Fasting glucose, insulin, cholesterol, high-density lipoprotein and low-density lipoprotein cholesterol, triglyceride levels, HOMA2, glucose effectiveness, insulin sensitivity and insulin response to FSIVGTT did not differ between patients and controls. Tumor necrosis factor-alpha and interleukin (IL)-6 concentrations tended to be higher in AS patients than in controls. Second-phase beta-cell responsiveness was 37% lower (p = 0.05) in AS patients than in controls. A negative correlation was found between the percentage of beta-cell secretion and IL-6 in all subjects (r = -0.54, p = 0.006). We found normal insulin sensitivity but attenuated glucose utilization in the second phase of FSIVGTT in AS patients. Our results indicate that elevated IL-6 levels may play a pathophysiological role in attenuating beta-cell responsiveness, which may explain the association between elevated IL-6 levels and increased risk for type 2 diabetes. PMID:16366418

Penesova, A; Rovensky, J; Zlnay, M; Dedik, L; Radikova, Z; Koska, J; Vigas, M; Imrich, R

2005-01-01

320

Glucose tolerance, insulin release, and insulin binding to monocytes in kidney transplant recipients  

International Nuclear Information System (INIS)

In order to evaluate glucose tolerance following renal transplantation, intravenous glucose tolerance tests (IVGTT), with evaluation of hormonal responses to the intravenous glucose load and percent specific 125I-insulin binding to peripheral blood monocytes, were studied in eight clinically stable kidney transplant recipients. For comparison purposes, identical studies were done in eight control subjects and seven clinically stable hemodialysis patients. One transplant recipient was glucose intolerant, with fasting hyperglycemia, elevated HbA1C, and abnormal glucose decay constant. Impaired pancreatic insulin release appeared to be the major factor accounting for his glucose intolerance. The seven glucose-tolerant transplant recipients had significantly increased insulin release during IVGTT compared to control subjects, and significant correlations were found among insulin release, glucose decay constant, and fasting blood sugar in those patients. Insulin binding to monocytes was significantly greater in transplant recipients than control subjects due to an increase in insulin binding capacity per cell. A significant correlation was found between percent specific 125I-insulin binding and steroid dose, expressed as mg/kg body weight/day, in those patients. Thus, chronic steroid administration does not cause glucose intolerance in transplant recipients who manifest steroid-associated increases in pancreatic insulin release and cellular insulin binding capacity

1982-01-01

 
 
 
 
321

Auditory brainstem responses during systemic infusion of lidocaine.  

Science.gov (United States)

Auditory brainstem-evoked responses (ABR) to clicks were recorded in unanesthetized restrained cats before, during, and after systemic intravenous infusion of lidocaine hydrochloride. The drug was infused continuously at varying rates. Lidocaine's major effect on ABR was to lengthen latent periods to all wave-form peaks in proportion with the infusion rate. The effect on latent periods was cumulative throughout the auditory brainstem, ie, all interpeak time intervals increased. Increases in ABR latencies were not due to reductions in effective stimulus intensity because lidocaine did not reduce ABR component amplitudes or increase thresholds. The effects of the drug were reversible. The data are consistent with the notion that lidocaine, directly or indirectly, works throughout the auditory brainstem to increase axonal and synaptic conduction times. PMID:7059316

Javel, E; Mouney, D F; McGee, J; Walsh, E J

1982-02-01

322

Continuous infusion with implantable pumps: expanding the radiologist's role.  

Science.gov (United States)

Drug infusion systems attract increasing attention as biomedical technology offers miniaturized devices for targeted delivery of therapeutic substances on an outpatient basis. We have used a totally implantable, subcutaneous pump, externally programmable by radiofrequency link, learning the technique of implantation and management and using various imaging modalities for the diagnosis and control of complications. The procedure for implanting systems for continuous intrathecal analgesia and systemic intravenous chemotherapy is described. Our experience of the latter is made up of 296 implants in 290 patients. The selected infusion pump proved reliable and acceptable to patients and the quality of life, given the reduced drug toxicity, more than good. The complications were few both in frequency and in severity. The setting-up of a long-term infusion system, when major surgery is not needed, can fall within the interventional radiologist's field, partly because of a good cost-benefit ratio. PMID:1906807

Damascelli, B; Bonalumi, M G; Marchianò, A; Spreafico, C; Garbagnati, F; Amadeo, A; Salvetti, M; Frigerio, L F; Piragine, G; Cesa Bianchi, A

1991-01-01

323

Plasma Calcium, Inorganic Phosphate and Magnesium During Hypocalcaemia Induced by a Standardized EDTA Infusion in Cows  

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The intravenous Na2EDTA infusion technique allows effective specific chelation of circulating Ca2+ leading to a progressive hypocalcaemia. Methods previously used were not described in detail and results obtained by monitoring total and free ionic calcium were not comparable due to differences in sampling and analysis. This paper describes a standardized EDTA infusion technique that allowed comparison of the response of calcium, phosphorus and magnesium between 2...

Lsb, Mellau; Rj, Jørgensen; Jmd, Enemark

2001-01-01

324

Assessment of hepatic blood flow in healthy subjects by continuous infusion of indocyanine green.  

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1. The applicability of a continuous infusion of indocyanine green (ICG) to detect changes in apparent hepatic blood flow (HBF) was investigated in six healthy subjects. 2. High-performance liquid chromatography was used to measure ICG concentrations, and the effect of intravenous propranolol (10 mg in 10 min) on HBF was investigated. 3. During 150 min infusions of ICG (1.0 mg min-1) steady-state was reached within about 30 min and thereafter the plasma dye concentration remained essentially ...

Soons, P. A.; Boer, A.; Cohen, A. F.; Breimer, D. D.

1991-01-01

325

Myocardial protein turnover in patients with coronary artery disease. Effect of branched chain amino acid infusion.  

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The regulation of protein metabolism in the human heart has not previously been studied. In 10 postabsorptive patients with coronary artery disease, heart protein synthesis and degradation were estimated simultaneously from the extraction of intravenously infused L-[ring-2,6-3H]phenylalanine (PHE) and the dilution of its specific activity across the heart at isotopic steady state. We subsequently examined the effect of branched chain amino acid (BCAA) infusion on heart protein turnover and on...

Young, L. H.; Mcnulty, P. H.; Morgan, C.; Deckelbaum, L. I.; Zaret, B. L.; Barrett, E. J.

1991-01-01

326

Dissociation of the effects of epinephrine and insulin on glucose and protein metabolism  

International Nuclear Information System (INIS)

The separate and combined effects of insulin and epinephrine on leucine metabolism were examined in healthy young volunteers. Subjects participated in four experimental protocols: (1) euglycemic insulin clamp (+80 microU/ml), (2) epinephrine infusion (50 ng.kg-1.min-1) plus somatostatin with basal replacement of insulin and glucagon, (3) combined epinephrine (50 ng.kg-1.min-1) plus insulin (+80 microU/ml) infusion, and (4) epinephrine and somatostatin as in study 2 plus basal amino acid replacement. Studies were performed with a prime-continuous infusion of [1-14C]leucine and indirect calorimetry. Our results indicate that (1) hyperinsulinemia causes a generalized decrease in plasma amino acid concentrations, including leucine; (2) the reduction in plasma leucine concentration is primarily due to an inhibition of endogenous leucine flux; nonoxidative leucine disposal decreases after insulin infusion; (3) epinephrine, without change in plasma insulin concentration, reduces plasma amino acid levels; (4) combined epinephrine-insulin infusion causes a greater decrease in plasma amino levels than observed with either hormone alone; this is because of a greater inhibition of endogenous leucine flux; and (5) when basal amino acid concentrations are maintained constant with a balanced amino acid infusion, epinephrine inhibits the endogenous leucine flux. In conclusion, the present results do not provide support for the concept that epinephrine is a catabolic hormone with respect to amino acid-protein metabolism. In contrast, epinephrine markedly inhibits insulin-mediated glucose metabolism

1990-01-01

327

Dissociation of the effects of epinephrine and insulin on glucose and protein metabolism  

Energy Technology Data Exchange (ETDEWEB)

The separate and combined effects of insulin and epinephrine on leucine metabolism were examined in healthy young volunteers. Subjects participated in four experimental protocols: (1) euglycemic insulin clamp (+80 microU/ml), (2) epinephrine infusion (50 ng.kg-1.min-1) plus somatostatin with basal replacement of insulin and glucagon, (3) combined epinephrine (50 ng.kg-1.min-1) plus insulin (+80 microU/ml) infusion, and (4) epinephrine and somatostatin as in study 2 plus basal amino acid replacement. Studies were performed with a prime-continuous infusion of (1-14C)leucine and indirect calorimetry. Our results indicate that (1) hyperinsulinemia causes a generalized decrease in plasma amino acid concentrations, including leucine; (2) the reduction in plasma leucine concentration is primarily due to an inhibition of endogenous leucine flux; nonoxidative leucine disposal decreases after insulin infusion; (3) epinephrine, without change in plasma insulin concentration, reduces plasma amino acid levels; (4) combined epinephrine-insulin infusion causes a greater decrease in plasma amino levels than observed with either hormone alone; this is because of a greater inhibition of endogenous leucine flux; and (5) when basal amino acid concentrations are maintained constant with a balanced amino acid infusion, epinephrine inhibits the endogenous leucine flux. In conclusion, the present results do not provide support for the concept that epinephrine is a catabolic hormone with respect to amino acid-protein metabolism. In contrast, epinephrine markedly inhibits insulin-mediated glucose metabolism.

Castellino, P.; Luzi, L.; Del Prato, S.; DeFronzo, R.A. (Univ. of Texas Health Science Center, San Antonio (USA))

1990-01-01

328

Target-controlled infusion systems: role in anaesthesia and analgesia.  

Science.gov (United States)

Drug delivery by target-controlled infusion (TCI) allows automatic adjustments of the infusion rate of a drug to maintain a desired target concentration. Since drug effect is more closely related to blood concentration than to infusion rate, drug delivery via TCI is capable of creating stable blood concentrations of intravenous anaesthetics and analgesics. In this article the concept and history of TCI are described. The rational administration of TCI requires an appropriate pharmacokinetic data set and knowledge of the concentration-effect relationship; therefore, general pharmacokinetic and pharmacodynamic aspects of intravenous anaesthetics and analgesics are also addressed. Intraoperative investigations have demonstrated that TCI drug delivery allows rapid titration to a desired effect. The use of TCI for postoperative analgesia is still experimental, but TCI can, in part, overcome the disadvantages associated with continuous infusions and patient-controlled analgesia regimens in the postoperative period. Although TCI is capable of creating stable blood concentrations, when the target concentration is changed the resulting effect correlates better with a theoretical effect site concentration. The efficacy of TCI systems that can perform effect-site steering are still to be explored. PMID:10709777

van den Nieuwenhuyzen, M C; Engbers, F H; Vuyk, J; Burm, A G

2000-02-01

329

Animal model of rapid crystalloid infusion in rats  

Directory of Open Access Journals (Sweden)

Full Text Available PURPOSE: To describe an animal model of rapid intravenous infusion with different volumes of crystalloid and discuss the clinical findings. METHODS: Fifty six male Wistar rats were used, divided randomly in seven groups (n = 8. The rats of groups 1 to 6 received lactated Ringer´s solution intravenously, in the rate of 25 ml/min, with different volumes proportional to blood volume (BV. The rats of group 0 were submitted to the same procedure, but did not receive the fluid (control group. The data included respiratory rate, heart rate, saturation of peripheral oxygen (SpO2 in two times (before and after the infusion, and upshots (respiratory arrest and death. Dunnett´s test and ANOVA were used. RESULTS: The clinical signs significantly changed in the 2, 2.5 and 3 fold BV groups. The respiratory arrest was observed in the 1.5, 2, 2.5 and 3 fold BV groups, but death was present only in 2.5 and 3 fold BV groups. CONCLUSIONS: The infusion of crystalloid in the same volume of blood volume did not cause significant variation in respiratory and heart rate, saturation of peripheral oxygen and did not induce respiratory arrest. The infusion of a volume of 3 fold blood volume was lethal to all animals.

Flavio Stillitano Orgaes

2013-04-01

330

Lipolytic response to glucose infusion in human subjects  

International Nuclear Information System (INIS)

The authors have determined the effect of various rates of glucose infusion on the rates of release of glycerol (R/sub a/ glycerol), free fatty acids (R/sub a/ FFA), and on energy metabolism in normal human volunteers. Plasma kinetics were determined with use of the stable isotopic tracers D-5-glycerol and [1-"1"3C]palmitate, and energy metabolism was determined by indirect calorimetry. The effect of glucose infusion on R/sub a/ glycerol and R/sub a/ FFA was dose-dependent. At 4 mg x kg"-"1 x min"-"1, both R/sub a/ glycerol and R/sub a/ FFA were suppressed; at 8 mg x kg"-"1 x min"-"1, R/sub a/ FFA was even more depressed, but R/sub a/ glycerol was similar to the value during the 4 mg x kg"-"1 x min"-"1 infusion. At all infusion rates tested, the amount of potential energy available from the sum of the glucose infusion and endogenously mobilized fat was always greater than when no glucose was infused. Glucose decreased fat mobilization by both inhibiting lipolysis and stimulating reesterification, thus causing a significant increase in triglyceride-fatty acid substrate cycling within the adipose tissue. Plasma insulin was determined by radioimmunoassay

1987-01-01

331

The use of U-500 regular insulin in the management of patients with obesity and insulin resistance.  

Science.gov (United States)

The rise in prevalence of obesity and diabetes has created a challenge in managing increasing numbers of patients who require high doses of insulin. This article reviews the published literature on the properties of U-500 insulin and its use in clinical practice. U-500 insulin is likely to have a longer time to peak effect and a longer duration of action than similar doses of U-100 insulin. Evidence for its use in clinical practice rests on retrospective case series, which suggests that the use of U-500 insulin either by multiple daily injections or a continuous subcutaneous insulin infusion is effective in improving glycaemic control. To prevent insulin dosing and administration errors, great care must be taken in providing staff and patient education, and in developing policies for the management of patients on U-500 insulin who are admitted to hospital. PMID:23489348

Jones, P; Idris, I

2013-10-01

332

Intravenous amino acids in third trimester isolated oligohydramnios  

International Nuclear Information System (INIS)

To determine the efficacy of maternal administration of intravenous amino acid solution in improving amniotic fluid volume in cases of isolated oligohydramnios and to observe its impact on mode of delivery and neonatal outcome. Study Design: A prospective case series. Methodology: Forty two women with singleton pregnancy, well established gestational age and clinically and sonographically proven isolated oligohydramnios in the third trimester before 36 weeks were administered amino acid solution intravenously after excluding cases of premature rupture of membranes, congenital anomaly of fetus, maternal pulmonary, cardiovascular and hypertensive disorders, and severe placental insufficiency (raised S/D ratio). Pre-infusion and postinfusion Amniotic fluid Index (AFI) was measured and repeated weekly. Women were followed till delivery. Results: According to repeated measurement analysis of variance, mean pre-infusion AFI was 4.7 cm, mean one week postinfusion AFI was 5.8 cm, mean two week post-infusion AFI was 6.2 cm and mean three week AFI was 6.3 cm (p-value 0.029, significant). Cesarean section became a predominant mode of delivery in this group without a firm evidence of associated fetal compromise. Conclusion: Amino acid infusion is an effective therapy for raising AFI in isolated oligohydramnios in this case series. Liberal use of cesarean section in this selected group should be carefully re-evaluated. (author)

2011-01-01

333

Update on intravenous dipyridamole cardiac imaging in the assessment of ischemic heart disease  

International Nuclear Information System (INIS)

Intravenous dipyridamole is a relative selective coronary vasodilator which, when combined with thallium-201, provides a useful technique to assess myocardial perfusion. The intravenous dipyridamole is administered as an infusion at a rate of 0.14 mg/kg/min for 4 minutes. In the presence of significant coronary artery disease the increase of coronary blood flow is disproportionate between vessels with and without significant coronary lesions, providing the basis for detecting regional differences in flow using thallium-201. The test can be used alone or combined with low level exercise to increase test sensitivity. The test is safe when performed under medical supervision and when patient selection is done appropriately. Most of the side effects induced by dipyridamole infusion are well tolerated by patients and readily reversed with intravenous aminophylline and sublingual nitroglycerin. The average sensitivity and specificity of the dipyridamole thallium scintigraphy test from the major studies are 76% and 70%, respectively. The test is very useful in providing prognostic information in patients who are unable to exercise. A reversible thallium defect after dipyridamole infusion has been shown to be associated with significant mortality and morbidity in patients with documented or suspected coronary artery disease. The use of intravenous dipyridamole has been extended into other modalities of imaging, including 2-dimensional and Doppler echocardiography, to study functional changes in the left ventricular induced by the infusion of intravenous dipyridamole. 52 references

1990-01-01

334

Update on intravenous dipyridamole cardiac imaging in the assessment of ischemic heart disease  

Energy Technology Data Exchange (ETDEWEB)

Intravenous dipyridamole is a relative selective coronary vasodilator which, when combined with thallium-201, provides a useful technique to assess myocardial perfusion. The intravenous dipyridamole is administered as an infusion at a rate of 0.14 mg/kg/min for 4 minutes. In the presence of significant coronary artery disease the increase of coronary blood flow is disproportionate between vessels with and without significant coronary lesions, providing the basis for detecting regional differences in flow using thallium-201. The test can be used alone or combined with low level exercise to increase test sensitivity. The test is safe when performed under medical supervision and when patient selection is done appropriately. Most of the side effects induced by dipyridamole infusion are well tolerated by patients and readily reversed with intravenous aminophylline and sublingual nitroglycerin. The average sensitivity and specificity of the dipyridamole thallium scintigraphy test from the major studies are 76% and 70%, respectively. The test is very useful in providing prognostic information in patients who are unable to exercise. A reversible thallium defect after dipyridamole infusion has been shown to be associated with significant mortality and morbidity in patients with documented or suspected coronary artery disease. The use of intravenous dipyridamole has been extended into other modalities of imaging, including 2-dimensional and Doppler echocardiography, to study functional changes in the left ventricular induced by the infusion of intravenous dipyridamole. 52 references.

Younis, L.T.; Chaitman, B.R. (St. Louis Univ. School of Medicine, MO (USA))

1990-01-01

335

Human Models of Low-Grade Inflammation: Bolus versus Continuous Infusion of Endotoxin?  

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Systemic low-grade inflammation is recognized in an increasing number of chronic diseases. With the aim of establishing an experimental human in vivo model of systemic low-grade inflammation, we measured circulating inflammatory mediators after intravenous administration of Escherichia coli endotoxin (0.3 ng/kg of body weight) either as a bolus injection or as a 4-h continuous intravenous infusion, as well as after saline administration, in 10 healthy male subjects on three separate study day...

Taudorf, S.; Krabbe, K. S.; Berg, R. M. G.; Pedersen, B. K.; Møller, K.

2007-01-01

336

Combined galanin with insulin improves insulin sensitivity of diabetic rat muscles.  

Science.gov (United States)

Although administration of galanin or insulin alone may enhance insulin sensitivity and glucose transporter 4 (GLUT4) trafficking, their cooperative effect on insulin sensitivity is still unclear. In the present study, we evaluated the cooperative effect of both reagents compared with solitary treatment with galanin or insulin in type 2 diabetic rats. Galanin and/or insulin were injected singly or together into type 2 diabetic rats once a day for 15 days. The results indicated that coadministration of both reagents compared with treatment with galanin or insulin alone significantly increased glucose infusion rates in euglycemic-hyperinsulinemic clamp tests, 2-deoxy-[(3)H]d-glucose contents, GLUT4 densities, and pAS160 and protein kinase C activity levels, but reduced blood glucose and insulin levels, as well as retinol-binding protein 4 contents, and did not affect Glut4 (Slc2a4) mRNA expression levels in myocytes. The changes in the ratios of GLUT4 immunoreaction in plasma membranes to total cell membranes of myocytes were higher in the coadministrative group compared with either the insulin or the galanin group. These results indicate that cooperation of the two hormones plays a synergic role to improve GLUT4 translocation and insulin sensitivity. This finding indicates the possibility of combining galanin with insulin with the aim of obtaining better antidiabetic efficacy than that of the canonical treatment with insulin alone. PMID:24501381

Bu, Le; Yao, Qian; Liu, Zhimin; Tang, Wei; Zou, Junjie; Qu, Shen

2014-04-01

337

Role of free fatty acids and insulin in determining free fatty acid and lipid oxidation in man.  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Plasma FFA oxidation (measured by infusion of 14C-palmitate) and net lipid oxidation (indirect calorimetry) are both inhibited by insulin. The present study was designed to examine whether these insulin-mediated effects on lipid metabolism resulted from a decline in circulating FFA levels or from a direct action of the hormone on FFA/lipid oxidation. Nine subjects participated in two euglycemic insulin clamps, performed with and without heparin. During each insulin clamp study insulin was inf...

1991-01-01

338

Reactive hypoglycaemia following GLP-1 infusion in pancreas transplant recipients  

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The aim of the study was to determine whether reactive hypoglycaemia in pancreas transplant recipients that followed administration of glucagon-like peptide-1 (GLP-1) was associated with excessive insulin, insufficient glucagon, or both. Methodology involved six portally drained pancreas recipients who received GLP-1 (1.5 pmol/kg/min) or placebo infusion on randomized occasions during glucose-potentiated arginine testing. The second subject developed symptomatic hypoglycaemia [plasma glucose ...

Rickels, M. R.; Naji, A.

2010-01-01

339

Bioequivalence of oral and intravenous ofloxacin after multiple-dose administration to healthy male volunteers.  

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The bioequivalence of oral and intravenous ofloxacin was investigated after the administration of multiple doses of 400 mg every 12 h to 20 healthy male volunteers in a randomized, crossover, open-label study. Ofloxacin concentrations in plasma were evaluated after 4 days of oral or intravenous (1-h infusion) dosing with a 3-day wash-out period between regimens. As expected, delivery to the systemic circulation took slightly longer after the oral dosing (time to maximum concentration of drug ...

Flor, S. C.; Rogge, M. C.; Chow, A. T.

1993-01-01

340

A new intravenous immunoglobulin (BIVIGAM®) for primary humoral immunodeficiency.  

Science.gov (United States)

Human immunoglobulin G administered intravenously or subcutaneously is used to prevent infections in patients with primary antibody deficiencies. Intravenous immunoglobulin (IVIG) preparations have improved over the years and have evolved from immune serum globulin that is injected intramuscularly or subcutaneously at relatively low doses (100-150 mg/kg per month). IVIG products are currently available in different concentrations and compositions and can deliver up to 2 g/kg or more per infusion with few side effects. This report describes the properties and clinical trial results of BIVIGAM(®), a new IVIG product. We also discuss how improvements in intravenous immunoglobulin manufacturing and formulation have improved clinical outcomes in patients with primary immunodeficiencies, also benefiting patients with other immunological disorders. PMID:24527947

Wasserman, Richard L

2014-03-01

 
 
 
 
341

Roles of insulin, age, and asymmetric dimethylarginine on nitric oxide synthesis in vivo.  

Science.gov (United States)

We tested the effects of insulin on production of nitrous oxide (NO)-related substances (nitrites and nitrates [NOx]) after (15)N-arginine intravenous infusion and on asymmetric dimethylarginine (ADMA) and symmetric dimethylarginine (SDMA) concentrations in conditions reportedly associated with altered NO availability, i.e., aging, hypertension, hypercholesterolemia, and type 2 diabetes mellitus (T2DM). A total of 26 male subjects (age 23-71 years, BMI 23-33 kg/m(2)), some of whom were affected by mixed pathologic features, were enrolled. NOx fractional synthesis rate (FSR) was lower in elderly (P < 0.015) and T2DM subjects (P < 0.03) than in matched control subjects. Hyperinsulinemia generally increased both NOx FSR and absolute synthesis rate (ASR) and reduced NOx, ADMA, and SDMA concentrations. Insulin sensitivity was impaired only in T2DM. With use of simple linear regression analysis across all subjects, age was inversely correlated with both NOx FSR (R(2) = 0.23, P < 0.015) and ASR (R(2) = 0.21, P < 0.02). NOx FSR inversely correlated with both ADMA and SDMA. With use of multiple regression analysis and various models, NOx FSR remained inversely associated with age and ADMA, whereas ASR was inversely associated with age and diabetes. No association with insulin sensitivity was found. We conclude that whole-body NOx production is decreased in aging and T2DM. Age, ADMA concentration, and T2DM, but not insulin resistance, appear as negative regulators of whole-body NOx production. PMID:23474488

Tessari, Paolo; Cecchet, Diego; Artusi, Carlo; Vettore, Monica; Millioni, Renato; Plebani, Mario; Puricelli, Lucia; Vedovato, Monica

2013-08-01

342

The role of insulin glulisine to improve glycemic control in children with diabetes mellitus  

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Glulisine (Apidra®) is a rapid-acting human insulin analog approved for use in children with diabetes mellitus ?4 years of age. Management of children with type 1 diabetes has seen a shift in favor of mimicking normal physiological insulin responses with multiple daily injections or continuous subcutaneous insulin infusions (CSII). Few studies have compared the rapid-acting insulin analogs in this population but limited data indicate that glulisine is as effective as lispro when used in a ...

Lih, Anna; Hibbert, Emily; Wong, Tang; Girgis, Christian M.; Garg, Nidhi; Carter, John N.

2010-01-01

343

What´s cheapest, intravenous iron sucrose- or intravenous iron carboxymaltose treatment in IBD patients? : It dependent on the economic evaluation perspective!  

DEFF Research Database (Denmark)

  What´s cheapest, intravenous iron sucrose- or intravenous iron carboxymaltose treatment in IBD patients? It dependent on the economic evaluation perspective!   Aim: To evaluate the health care cost for intravenous iron sucrose (Venofer®, Vifor) and intravenous iron carboxymaltose (Ferinject®, Vifor) treatment to IBD patients in an outpatient setting.   Background: Intravenous iron sucrose can be given as a maximum of 200 mg Fe++ per infusion vs. intravenous iron carboxymaltose that can be given as a maximum of 1000 mg Fe++ in a single infusion leading to fewer infusions and visits. The drug-cost per mg iron is for iron carboxymaltose approximately double the cost of iron sucrose.   Patients and Methods: Data related to 111 IBD-patients treated with intravenous iron at Aarhus University Hospital from August 2005 until October 2009 was used for the economic evaluation. Analysis included a Budget Impact Analysis (BIA) from a hospital perspective, a Cost Effective Analysis (CEA) from a patient perspective and a Cost Benefit Analysis (CBA) consecutively including 20 IBD patients' willingness-to-pay' (WTP) assessment. BIA and CEA analysis were based on total infusion-doses from 500 mg Fe++ till 1600 mg Fe++. The WTP analysis was based on a total infusion-dose at 1400 mg Fe++. The evaluations are analysed assuming that the effect parameter (quantity of iron delivered) is comparable regardless of the iron formulation given intravenously.   Results: The BIA including price for drug, utensils and ½ hour spend by a nurse per visit; showed approximately 150� extra cost per 1000 mg Fe++ administrated, if iron carboxymaltose was chosen. In contrast the CEA including both BIA-values and patient-related costs (transportation and lost income) showed iron carboxymaltose to be more cost-effective than iron sucrose, due to fewer outpatient setting visits. As IBD-patients could have less income as the average of the background population due to disease activity, sensitivity analysis using a 50% income level weredone, showing the same tendency but less significant. The average patients WTP for a total of iron-dose was to 233� to reduce the numbers of infusion from 7 till 2.    Conclusion: The cost of choosing iron carboxymaltose rather than iron sucrose in treatment of iron deficiency in IBD differs depending of the economic perspective chosen. Only the Budget Impact Analysis showed iron sucrose to be the cheapest. If the patients' perspective is included in the economic evaluation iron carboxymaltose is the most cost-effective.

Bager, Palle; Dahlerup, Jens Frederik

344

Insulin therapy as an adjunct to reperfusion after acute coronary ischemia: a proposed direct myocardial cell survival effect independent of metabolic modulation.  

Science.gov (United States)

Reperfusion therapy has become a practical and effective strategy in the salvage of ischemic myocardium. The direct enhancement of cardiac cellular tolerance against ischemic and reperfusion injury should further improve patient outcome in acute coronary syndromes (ACS). This approach has been explored for many decades, and although we await mortality-weighted randomized clinical trials, the infusion of glucose-insulin-potassium (GIK) has shown promise in protecting post-infarct myocardium. The current dogma is that this cardioprotective effect of GIK acts via the modulation of cardiac and circulating metabolites to provide the heart with an optimal metabolic milieu to resist ischemia and reperfusion injury. This concept of metabolic modulation has gained favor in coronary heart disease, and its efficacy currently is being investigated in stable angina using the new class of partial fatty acid oxidation inhibitors, including trimetazidine and ranolazine. We contend that the mitogen insulin, itself, promotes tolerance against ischemic cell death via the activation of innate cell-survival pathways in the heart. To advance this viewpoint, we will present clinical data that support a dose-dependent effect of insulin's beneficial action in the management of acute myocardial infarction. Furthermore, we present experimental data that identify cell-survival programs that are directly activated by the administration of insulin. Finally, as intravenous insulin therapy is both labor intensive and associated with metabolic perturbations, we propose that the development of pharmaco-therapeutic agents that target downstream cell-survival insulin-activated signaling molecules may be an alternate approach to promote cardioprotection during ACS. PMID:12706939

Sack, Michael N; Yellon, Derek M

2003-04-16

345

Plasma Calcium, Inorganic Phosphate and Magnesium During Hypocalcaemia Induced by a Standardized EDTA Infusion in Cows  

Directory of Open Access Journals (Sweden)

Full Text Available The intravenous Na2EDTA infusion technique allows effective specific chelation of circulating Ca2+ leading to a progressive hypocalcaemia. Methods previously used were not described in detail and results obtained by monitoring total and free ionic calcium were not comparable due to differences in sampling and analysis. This paper describes a standardized EDTA infusion technique that allowed comparison of the response of calcium, phosphorus and magnesium between 2 groups of experimental cows. The concentration of the Na2EDTA solution was 0.134 mol/l and the flow rate was standardized at 1.2 ml/kg per hour. Involuntary recumbency occurred when ionised calcium dropped to 0.39 – 0.52 mmol/l due to chelation. An initial fast drop of ionized calcium was observed during the first 20 min of infusion followed by a fluctuation leading to a further drop until recumbency. Pre-infusion [Ca2+] between tests does not correlate with the amount of EDTA required to induce involuntary recumbence. Total calcium concentration measured by atomic absorption remained almost constant during the first 100 min of infusion but declined gradually when the infusion was prolonged. The concentration of inorganic phosphate declined gradually in a fluctuating manner until recumbency. Magnesium concentration remained constant during infusion. Such electrolyte responses during infusion were comparable to those in spontaneous milk fever. The standardized infusion technique might be useful in future experimental studies.

Enemark JMD

2001-06-01

346

Is pancreatitis a complication of propofol infusion?  

Science.gov (United States)

The effects of bolus and infusion doses of propofol on histopathological changes in the rat pancreas are reported. After obtaining Hospital Ethics Committee approval, 75 female Wistar rats were assigned to three study groups. Groups I (n = 30) and II (n = 30) received 10 mg kg-1 intravenous bolus of propofol; with propofol administered to group II at an infusion rate of 10 mg kg-1 h-1 for 30 min immediately after the bolus doses. Group III (n = 15) was used as the control group. Twenty-four hours after propofol administration blood samples and pancreatic tissue specimens were obtained under ether anaesthesia. Plasma cholesterol, triglyceride, amylase, and lipase levels were studied, and pancreatic tissues were examined under light microscopy. Plasma cholesterol and triglyceride levels were significantly higher in group II compared with the other groups. Differences between the groups in respect of plasma amylase and lipase levels were not statistically significant. Acute pancreatitis was observed under light microscopy, in three rats (10%) in group II, and in one rat (6.6%) in the control group. The pancreatic tissues of group I were normal. The incidence of acute pancreatitis in each of the groups was not significant. It is therefore suggested that, further controlled studies are needed to investigate the relation between pancreatitis and the use of propofol. PMID:10434163

Dönmez, A; Arslan, G; Pirat, A; Demirhan, B

1999-06-01

347

Computed tomography intravenous cholangiography  

Energy Technology Data Exchange (ETDEWEB)

Indications for direct visualization of the bile ducts include bile duct dilatation demonstrated by ultrasound or computed tomography (CT) scanning, where the cause of the bile duct dilatation is uncertain or where the anatomy of bile duct obstruction needs further clarification. Another indication is right upper quadrant pain, particularly in a post-cholecystectomy patient, where choledocholithiasis is suspected. A possible new indication is pre-operative evaluation prior to laparoscopic cholecystectomy. The bile ducts are usually studied by endoscopic retrograde cholangiopancreatography (ERCP), or, less commonly, trans-hepatic cholangiography. The old technique of intravenous cholangiography has fallen into disrepute because of inconsistent bile-duct opacification. The advent of spiral CT scanning has renewed interest in intravenous cholangiography. The CT technique is very sensitive to the contrast agent in the bile ducts, and angiographic and three-dimensional reconstructions of the biliary tree can readily be obtained using the CT intravenous cholangiogram technique (CT IVC). Seven patients have been studied using this CT IVC technique, between February 1995 and June 1996, and are the subject of the present report. Eight further studies have since been performed. The results suggest that CT IVC could replace ERCP as the primary means of direct cholangiography, where pancreatic duct visualization is not required. (authors). 11 refs., 6 figs.

Nascimento, S.; Murray, W.; Wilson, P. [Pittwater Radiology, Dee Why, NSW, (Australia)

1997-08-01

348

Computed tomography intravenous cholangiography  

International Nuclear Information System (INIS)

Indications for direct visualization of the bile ducts include bile duct dilatation demonstrated by ultrasound or computed tomography (CT) scanning, where the cause of the bile duct dilatation is uncertain or where the anatomy of bile duct obstruction needs further clarification. Another indication is right upper quadrant pain, particularly in a post-cholecystectomy patient, where choledocholithiasis is suspected. A possible new indication is pre-operative evaluation prior to laparoscopic cholecystectomy. The bile ducts are usually studied by endoscopic retrograde cholangiopancreatography (ERCP), or, less commonly, trans-hepatic cholangiography. The old technique of intravenous cholangiography has fallen into disrepute because of inconsistent bile-duct opacification. The advent of spiral CT scanning has renewed interest in intravenous cholangiography. The CT technique is very sensitive to the contrast agent in the bile ducts, and angiographic and three-dimensional reconstructions of the biliary tree can readily be obtained using the CT intravenous cholangiogram technique (CT IVC). Seven patients have been studied using this CT IVC technique, between February 1995 and June 1996, and are the subject of the present report. Eight further studies have since been performed. The results suggest that CT IVC could replace ERCP as the primary means of direct cholangiography, where pancreatic duct visualization is not required. (authors)

1997-08-01

349

Effects of metoclopramide on duodenal motility and flow events, glucose absorption, and incretin hormone release in response to intraduodenal glucose infusion.  

Science.gov (United States)

The contribution of small intestinal motor activity to nutrient absorption is poorly defined. A reduction in duodenal flow events after hyoscine butylbromide, despite no change in pressure waves, was associated with reduced secretion of the incretin hormones glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) and a delay in glucose absorption. The aim of this study was to investigate the effect of metoclopramide on duodenal motility and flow events, incretin hormone secretion, and glucose absorption. Eight healthy volunteers (7 males and 1 female; age 29.8 ± 4.6 yr; body mass index 24.5 ± 0.9 kg/m²) were studied two times in randomized order. A combined manometry and impedance catheter was used to measure pressure waves and flow events in the same region of the duodenum simultaneously. Metoclopramide (10 mg) or control was administered intravenously as a bolus, followed by an intraduodenal glucose infusion for 60 min (3 kcal/min) incorporating the ¹?C-labeled glucose analog 3-O-methylglucose (3-OMG). We found that metoclopramide was associated with more duodenal pressure waves and propagated pressure sequences than control (P < 0.05 for both) during intraduodenal glucose infusion. However, the number of duodenal flow events, blood glucose concentration, and plasma 3-[¹?C]OMG activity did not differ between the two study days. Metoclopramide was associated with increased plasma concentrations of GLP-1 (P < 0.05) and GIP (P = 0.07) but lower plasma insulin concentrations (P < 0.05). We concluded that metoclopramide was associated with increased frequency of duodenal pressure waves but no change in duodenal flow events and glucose absorption. Furthermore, GLP-1 and GIP release increased with metoclopramide, but insulin release paradoxically decreased. PMID:20829521

Kuo, Paul; Bellon, Max; Wishart, Judith; Smout, André J; Holloway, Richard H; Fraser, Robert J L; Horowitz, Michael; Jones, Karen L; Rayner, Christopher K

2010-12-01

350

Differential effects of hypothalamic long-chain fatty acid infusions on suppression of hepatic glucose production  

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Our objective was to investigate whether the direct bilateral infusion of the monounsaturated fatty acid (MUFA) oleic acid (OA) within the mediobasal hypothalamus (MBH) is sufficient to reproduce the effect of administration of OA (30 nmol) in the third cerebral ventricle, which inhibits glucose production (GP) in rats. We used the pancreatic basal insulin clamp technique (plasma insulin ?20 mU/ml) in combination with tracer dilution methodology to compare the effect of MBH OA on GP to that...

Ross, R. A.; Rossetti, L.; Lam, T. K. T.; Schwartz, G. J.

2010-01-01

351

Review: intravenous immunoglobulin therapy and thromboembolic complications.  

Science.gov (United States)

Intravenous immunglobulin (IVIg) is used to treat a number of immune-deficiences and autoimmune diseases. Safety concerns related to a number of reported thromboembolic complications prompted us to review the literature. These complications happened mainly in individuals that had risk factors for thromboembolism, like advanced age, previous thromboembolic diseases, bed-ridden, and in individuals in which high doses or high infusion rates of IVIg were administered. The mechanism responsible for these events seems to be a rise in plasma viscosity that can trigger a thromboembolic event, especially in cases in which there is an underlying circulation impairment. Complications can be minimized by using IVIg only in clear-cut indications, weighting risk versus benefit in patients who are at high risk for thromboembolism and by sticking to carefully monitored slow infusion rates. IVIg for the treatment of autoimmune disorders should be administered as a five-day course of 2 g/kg of body weight. Each daily dose of 400 mg/kg should be given in not less than eight hours. PMID:16302674

Katz, U; Shoenfeld, Y

2005-01-01

352

Coal-face infusion. Kohlenstosstraenken  

Energy Technology Data Exchange (ETDEWEB)

Trials with continuous infusion methods were run in 22 collieries. Longwall infusion was used either for the first time or as an alternative to other infusion techniques. Several collieries stepped up the development of long drill holes achieving depths of up to 184 m by increasing drilling water pressure and associated adequate water quantities. A measuring device was used to determine the direction and inclination of the drill holes. Addition of fluorescine sodium to the infusion water allowed the course of the water to be verified across a distance of 70 m. A carriage-type drilling machine was equipped with electric sensors to establish drilling-machine-specific data. New cement mixtures were developed to achieve better drill hole sealing in longwall infusion. New transducers were installed to begin with the acquisition of infusion water quantity data and their transmission to the central mine control station. (orig.).

Becker, H.; Betting, K.; Korth, H.; Stockmann, H.W.; Goeretz, H. (Steinkohlenbergbauverein, Essen (Germany, F.R.). Hauptstelle fuer Staubbekaempfung und Pneumokonioseverhuetung)

1989-01-01

353

Crack Cocaine-Induced Cardiac Conduction Abnormalities Are Reversed by Sodium Bicarbonate Infusion  

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We report a dramatic case of a 19-year-old man with crack cocaine overdose with important clinical complications as cardiac arrest due to ventricular fibrillation and epileptics status. During this intoxication, electrocardiographic abnormalities similar to those found in tricyclic antidepressant poisoning were observed, and they were reversed by intravenous sodium bicarbonate infusion.

Miranda, Carlos Henrique; Pazin-filho, Anto?nio

2013-01-01

354

Actions of prolonged ghrelin infusion on gastrointestinal transit and glucose homeostasis in humans  

DEFF Research Database (Denmark)

Ghrelin is produced by enteroendocrine cells in the gastric mucosa and stimulates gastric emptying in healthy volunteers and patients with gastroparesis in short-term studies. The aim of this study was to evaluate effects of intravenous ghrelin on gastrointestinal motility and glucose homeostasis during a 6-h infusion in humans.

Falkén, Y; Hellström, P M

2010-01-01

355

Thallium-201 infusion imaging  

International Nuclear Information System (INIS)

To test the accuracy of Thallium-201 coronary artery infusion imaging of the earth during rapid changes in blood flow through a major coronary artery, the author performed a study in dogs correlating electromagnetic flow probe recordings with 201Tl scintillation camera acquisitions. Hyperemic vascular response was produced experimentally in a major coronary artery by occlusion and release interventions which altered flow from baseline to zero during occlusion (20 seconds), followed by rapid flow increases approaching three times baseline immediately upon release of the occlusion. Flow returned to the baseline level within 60 seconds following release. Flow was also altered in a controlled fashion by other interventions. Recordings of Thallium uptake in the myocardium were displayed as a time histogram (counts per second squared vs time) which correlated very closely with electromagnetic flow probe recordings of flow (R=o.82-0.97). These experiments demonstrate a high degree of accuracy in Thallium infusion imaging to detect rapid changes in flow through a major coronary artery

1988-01-01

356

ADVERSE EFFECTS OF INTRAVENOUS IMMUNOGLOBULIN THERAPY IN PATIENTS WITH ANTIBODY DEFICIENCY  

Directory of Open Access Journals (Sweden)

Full Text Available Long-term intravenous immunoglobulin (IVIG infusion is an effective treatment for children with humoral immunodeficiencies, already be complicated by systemic ad¬verse effects. In order to determine the adverse effects of intravenous immunoglobulin inpatients with antibody deficiency, 45 immunodeficientpatients receiving intravenous immunoglobulin were studied during a 36-month period at Children's Medical Center. The investigated group included 25 patients with common variable immunodeficiency, 14 patients with X-linked agammaglobulinemia and 6 patients with IgG subclass defi¬ciency. A total of fifty adverse effects occurred through 955 infusions (5.2%. The most frequent immediate adverse effects were mild (40 infusions out of 955 in 22 cases, including: chills, flushing, fever, nausea and headache. Three patients experienced mod¬erate effects (10 infusions out of 955 such as rash, severe headache, joint pain and chest tightness. None of the effects was anaphylactic type. It can be concluded that intravenous immunoglobulin is generally a well-tolerated medical agent for patients with antibody deficiency, but all patients should be monitored by a physician who is familiar with its indications, risks, adverse effects and their appropriate management.

Akefeh Ahmadi Afshar

2003-07-01

357

Efficacy and adverse effects of intravenous lignocaine therapy in fibromyalgia syndrome  

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Abstract Background To investigate the effects of intravenous lignocaine infusions (IV lignocaine) in fibromyalgia. Methods Prospective study of the adverse effects of IV lignocaine in 106 patients with fibromyalgia; retrospective questionnaire study of the efficacy of IV lignocaine in 50 patients with fibromyalgia. Results Prospective study: Two major (pulmonary oedema and supraventricular tachycardia) and 42 minor side-effects were reported. None...

2002-01-01

358

INSULIN ADMINISTRATION IN SEVERE SCORPION ENVENOMING  

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Full Text Available The efficacy of insulin-glucose infusion in reversing myocardial damage, haemodynamic changes, peripheral circulatory failure, and pulmonary oedema was evaluated in 25 victims of venomous scorpion stings from the Rayalaseema region in the south of India. Myocardial damage with peripheral circulatory failure was seen in all scorpion sting victims. Ten of these victims also had pulmonary oedema. All the patients received continuous infusion of regular crystalline insulin at the rate of 0.3 U/g of glucose and glucose at the rate of 0.1 g/kg/h with supplementary potassium as needed, inotropic agents, oxygen, as well as maintenance of fluid, electrolytes and acid-base balance. Insulin-glucose infusion was associated with reversal of cardiovascular and haemodynamic changes, and pulmonary oedema in 24 of the 25 victims. One severely envenomed victim admitted 72 hours after the sting died. The scorpion envenoming syndrome with myocardial damage, cardiovascular disturbances, peripheral circulatory failure, pulmonary oedema, and many other clinical manifestations may cause multi-system organ failure (MSOF. It is characterised by a massive release of catecholamines, angiotensin II, glucagon, cortisol, and inhibition of insulin secretion. Under these altered conditions in the hormonal milieu, scorpion envenoming essentially results in a syndrome of fuel-energy deficits and an inability to use the existing metabolic substrates by vital organs, causing MSOF and death. Administration of insulin-glucose infusion to scorpion sting victims appears to be the physiological basis for the control of the metabolic response when that has become a determinant to survival.

B. YUGANDHAR

1999-01-01

359

INSULIN ADMINISTRATION IN SEVERE SCORPION ENVENOMING  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english The efficacy of insulin-glucose infusion in reversing myocardial damage, haemodynamic changes, peripheral circulatory failure, and pulmonary oedema was evaluated in 25 victims of venomous scorpion stings from the Rayalaseema region in the south of India. Myocardial damage with peripheral circulatory [...] failure was seen in all scorpion sting victims. Ten of these victims also had pulmonary oedema. All the patients received continuous infusion of regular crystalline insulin at the rate of 0.3 U/g of glucose and glucose at the rate of 0.1 g/kg/h with supplementary potassium as needed, inotropic agents, oxygen, as well as maintenance of fluid, electrolytes and acid-base balance. Insulin-glucose infusion was associated with reversal of cardiovascular and haemodynamic changes, and pulmonary oedema in 24 of the 25 victims. One severely envenomed victim admitted 72 hours after the sting died. The scorpion envenoming syndrome with myocardial damage, cardiovascular disturbances, peripheral circulatory failure, pulmonary oedema, and many other clinical manifestations may cause multi-system organ failure (MSOF). It is characterised by a massive release of catecholamines, angiotensin II, glucagon, cortisol, and inhibition of insulin secretion. Under these altered conditions in the hormonal milieu, scorpion envenoming essentially results in a syndrome of fuel-energy deficits and an inability to use the existing metabolic substrates by vital organs, causing MSOF and death. Administration of insulin-glucose infusion to scorpion sting victims appears to be the physiological basis for the control of the metabolic response when that has become a determinant to survival.

YUGANDHAR, B.; RADHA KRISHNA MURTHY, K.; SATTAR, S. A..

360

Rac1 signaling is required for insulin-stimulated glucose uptake and is dysregulated in insulin-resistant murine and human skeletal muscle  

DEFF Research Database (Denmark)

The actin cytoskeleton-regulating GTPase Rac1 is required for insulin-stimulated GLUT4 translocation in cultured muscle cells. However, involvement of Rac1 and its downstream signaling in glucose transport in insulin-sensitive and insulin-resistant mature skeletal muscle has not previously been investigated. We hypothesized that Rac1 and its downstream target, p21-activated kinase (PAK), are regulators of insulin-stimulated glucose uptake in mouse and human skeletal muscle and are dysregulated in insulin-resistant states. Muscle-specific inducible Rac1 knockout (KO) mice and pharmacological inhibition of Rac1 were used to determine whether Rac1 regulates insulin-stimulated glucose transport in mature skeletal muscle. Furthermore, Rac1 and PAK1 expression and signaling were investigated in muscle of insulin-resistant mice and humans. Inhibition and KO of Rac1 decreased insulin-stimulated glucose transport in mouse soleus and extensor digitorum longus muscles ex vivo. Rac1 KO mice showed decreased insulin and glucose tolerance and trended toward higher plasma insulin concentrations after intraperitoneal glucose injection. Rac1 protein expression and insulin-stimulated PAK(Thr423) phosphorylation were decreased in muscles of high fat-fed mice. In humans, insulin-stimulated PAK activation was decreased in both acute insulin-resistant (intralipid infusion) and chronic insulin-resistant states (obesity and diabetes). These findings show that Rac1 is a regulator of insulin-stimulated glucose uptake and a novel candidate involved in skeletal muscle insulin resistance.

Sylow, Lykke; Jensen, Thomas E

2013-01-01