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Sample records for intravenous insulin infusion

  1. Determination of 24-hour insulin infusion pattern by an artificial endocrine pancreas for intravenous insulin infusion with a miniature pump

    DEFF Research Database (Denmark)

    Kølendorf, K; Christiansen, J S; Bojsen, J;

    1981-01-01

    UNLABELLED: Intravenous insulin infusion with a glucose controlled insulin infusion system (GCIIS) is known to restore glucose homeostasis. A simpler approach to improve blood glucose regulation is preprogrammed intravenous insulin infusion with portable pumps without sensor-mediated feedback. We...

  2. A Quadruply-Asymmetric Sigmoid to Describe the Insulin-Glucose Relationship during Intravenous Insulin Infusion

    Directory of Open Access Journals (Sweden)

    Daniel T. Braithwaite

    2014-01-01

    Full Text Available For hospitalized patients requiring intravenous insulin therapy, an objective is to quantify the intravenous insulin infusion rate (IR across the domain of blood glucose (BG values at a single timepoint. The algorithm parameters include low BG (70 mg/dL, critical high BG, target range BG limits, and maintenance rate (MR of insulin infusion, which, after initialization, depends on rate of change of blood glucose, previous IR, and other inputs. The restraining rate (RR is a function of fractional completeness of ascent of BG (FCABG from BG 70 mg/dL to target. The correction rate (CR is a function of fractional elevation of BG (FEBG, in comparison to elevation of a critical high BG, above target. IR = RR + CR. The proposed mathematical model describing a sigmoidal relationship between IR and BG may offer a safety advantage over the linear relationship currently employed in some intravenous glucose management systems.

  3. The direct cost of intravenous insulin infusions to the NHS in England and Wales.

    Science.gov (United States)

    Rajendran, Rajesh; Scott, Anne; Rayman, Gerry

    2015-08-01

    The cost of intravenous insulin infusion to the NHS is unknown. The aim of this study was to estimate the direct cost of insulin infusions to the NHS in England and Wales in the first 24-hour period of infusion. Data from the National Inpatient Diabetes Audit 2013 in the UK were used to estimate the number of insulin infusions in use across England and Wales. Costs were calculated for six models for setting up and maintenance of insulin infusions, depending on the extent of involvement of different healthcare professionals in the UK. In this study, the direct costs of intravenous insulin infusions to the NHS in England and Wales have been estimated to vary from £6.4-8.5 million in the first 24-hour period on infusion. More appropriate use of these infusions could result in substantial cost savings.

  4. Effect of intravenous glucose infusion on renal function in normal man and in insulin-dependent diabetics

    DEFF Research Database (Denmark)

    Frandsen, M; Parving, H H; Christiansen, JS

    1981-01-01

    The effect of intravenous glucose infusion on glomerular filtration rate and renal plasma flow (constant infusion technique using 125I-iothalamate and 131I-hippuran) and on urinary excretion of albumin and beta-2-microglobulin were studied in ten normal subjects and seven metabolically well......-controlled insulin-dependent diabetics. Following glucose infusion in normal subjects (n = 10) blood glucose increased from 4.7 +/- 0.1 to 10.9 +/- 0.4 mmol/l (SEM) (p less than or equal to 0.01). Glomerular filtration rate increased from 116 +/- 2 to 123 +/- 3 ml/mi x 1.73 m2 (p less than or equal to 0.01), while...... no change in renal plasma flow was seen - 552 +/- 11 versus 553 +/- 18 ml/min x 1.73 m2. Volume expansion with intravenous saline infusion in six of the normal subjects induced no changes in blood glucose or kidney function. In seven strictly controlled insulin-dependent diabetics, blood glucose values were...

  5. Pancreatic enzyme secretion during intravenous fat infusion.

    Science.gov (United States)

    Burns, G P; Stein, T A

    1987-01-01

    The nutritional support of patients with pancreatic and high gastrointestinal fistulas and severe pancreatitis frequently involves intravenous fat infusion. There are conflicting reports on the effect of intravenous fat on pancreatic exocrine secretion. In 10 dogs with chronic pancreatic fistulas, pancreatic juice was collected during secretin (n = 10) or secretin + cholecystokinin (n = 4) stimulation, with and without intravenous fat infusion (5 g/hr). The hormonal-stimulated secretion of lipase, amylase, trypsin, total protein, bicarbonate, and water was unchanged during fat infusion. This study supports the use of intravenous fat as a nutritional source when it is desirable to avoid stimulation of the pancreas.

  6. Particulate contaminants of intravenous medications and infusions.

    Science.gov (United States)

    Backhouse, C M; Ball, P R; Booth, S; Kelshaw, M A; Potter, S R; McCollum, C N

    1987-04-01

    Particulate contamination in small volume parenteral medications has been studied and compared with that found in a selection of large volume infusions. Particle counts in 39 commonly used small volume medications and 7 large volume infusions were performed by an automated light blockage method (HIAC) or by optical microscopy. Based on these results and a random survey of drug therapy of intensive care patients, it is concluded that the contribution of intravenous medications to the total particle load received by such patients is likely to be many times greater than from infusion fluids. Until firm evidence regarding the harmful systemic effects of drug particles is available and the manufacturing regulations adjusted appropriately, final in-line filtration of infusions immediately proximal to the intravenous cannula should be considered when drugs are being given intravenously. PMID:2884285

  7. Safety of rapid intravenous of infusion acetaminophen.

    Science.gov (United States)

    Needleman, Steven M

    2013-07-01

    Intravenous acetaminophen, Ofirmev®, is approved for management of mild to moderate pain, management of moderate to severe pain with adjunctive opioids, and reduction of fever. The product is supplied as a 100 mL glass vial. As stated in the prescribing information, it is recommended to be infused over 15 minutes. This recommendation is related to the formulation propacetamol, the prodrug to acetaminophen, approved in Europe, which caused pain on infusion, and data from the clinical development of acetaminophen. The objective of this retrospective chart review study was to show the lack of side effects of rapidly infusing intravenous acetaminophen. Charts of American Society of Anesthesiology (ASA) Class I-III ambulatory surgical patients who received only acetaminophen in the preoperative setting were reviewed for any infusion-related side effects. Using standard binomial proportion analyses and employing SAS/JMP software, all vital signs were analyzed for statistically significant changes between pre- and postinfusion values. One hundred charts were reviewed. Only one patient had pain on infusion, which lasted 10 seconds. No reported side effects or erythema was seen at the injection site. No infusions had to be slowed or discontinued. The median infusion time was 3:41 minutes. Of the vital signs monitored, only the systolic (P < 0.0001) and diastolic (P < 0.0099) blood pressures had statistically significant changes from pre- to postinfusion; however, they were of no clinical relevance. Acetaminophen can be administered as a rapid infusion with no significant infusion-related side effects or complications. PMID:23814378

  8. Low-dose insulin infusions in diabetic patients with high insulin requirements.

    Science.gov (United States)

    Dandona, P; Foster, M; Healey, F; Greenbury, E; Beckett, A G

    1978-08-01

    Six patients with high insulin requirements (range 120-3000 units daily) have been infused with much smaller doses (range 50-63 units daily) of insulin intravenously. All six maintained adequate glucose homoestasis on this regimen. It is suggested that subcutaneous tissue at the site of injection may alter insulin or impair its absorption. Insulin resistance in some patients may be due to these mechanisms.

  9. 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

  10. Conventional insulin vs insulin infusion therapy in acute coronary syndrome diabetic patients

    Institute of Scientific and Technical Information of China (English)

    Caterina; Arvia; Valeria; Siciliano; Kyriazoula; Chatzianagnostou; Gillian; Laws; Alfredo; Quinones; Galvan; Chiara; Mammini; Sergio; Berti; Sabrina; Molinaro; Giorgio; Iervasi

    2014-01-01

    AIM:To evaluate the impact on glucose variability(GLUCV)of an nurse-implemented insulin infusion protocol when compared with a conventional insulin treatment during the day-to-day clinical activity.METHODS:We enrolled 44 type 2 diabetic patients(n=32 males;n=12 females)with acute coronary syndrome(ACS)and randomy assigned to standard a subcutaneous insulin treatment(n=23)or a nurse-implemented continuous intravenous insulin infusion protocol(n=21).We utilized some parameters of GLUCV representing well-known surrogate markers of prognosis,i.e.,glucose standard deviation(SD),the mean dailyδglucose(mean of daily difference between maximum and minimum glucose),and the coefficient of variation(CV)of glucose,expressed as percent glucose(SD)/glu-cose(mean).RESULTS:At the admission,first fasting blood glucose,pharmacological treatments(insulin and/or anti-diabetic drugs)prior to entering the study and basal glycated hemoglobin(HbA1c)were observed in the two groups treated with subcutaneous or intravenous insulin infusion,respectively.When compared with patients submitted to standard therapy,insulin-infused patients showed both increased first 24-h(median 6.9 mmol/L vs 5.7mmol/L P<0.045)and overall hospitalizationδglucose(median 10.9 mmol/L vs 9.3 mmol/L,P<0.028),with a tendency to a significant increase in first 24-h glycaemic CV(23.1%vs 19.6%,P<0.053).Severe hypoglycaemia was rare(14.3%),and it was observed only in 3 patients receiving insulin infusion therapy.HbA1c values measured during hospitalization and 3 mo after discharge did not differ in the two groups of treatment.CONCLUSION:Our pilot data suggest that no real benefit in terms of GLUCV is observed when routinely managing blood glucose by insulin infusion therapy in type 2 diabetic ACS hospitalized patients in respect to conventional insulin treatment

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

    OpenAIRE

    RADERMECKER, Régis; Scheen, André

    2007-01-01

    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...

  12. Enzymuria in neonates receiving continuous intravenous infusion of gentamicin

    DEFF Research Database (Denmark)

    Colding, H; Brygge, K; Brendstrup, L;

    1992-01-01

    with non-treatment periods in the same newborn infant (33 infants). The same tendency applied to AAP. Newborn infants receiving continuous intravenous infusion of gentamicin were not found to be at greater risk of nephrotoxicity than those receiving intermittent gentamicin treatment, using NAG and AAP...

  13. Higher Endogenous Glucose Production during OGTT vs Isoglycemic Intravenous Glucose Infusion

    DEFF Research Database (Denmark)

    Lund, Asger; Bagger, Jonatan I; Christensen, Mikkel;

    2016-01-01

    CONTEXT: Oral glucose ingestion elicits a larger insulin response and delayed suppression of glucagon compared to isoglycemic intravenous (iv) glucose infusion (IIGI). OBJECTIVE: We studied whether these differences translate into effects on endogenous glucose production (EGP) and glucose disposal...... with a concomitant iv glucagon infusion (0.8 ng/kg/min from 0 to 25 min) designed to mimic portal glucagon concentrations during OGTT in the type 2 diabetic group). MAIN OUTCOME MEASURES: Glucose kinetics assessed by the double-tracer technique. RESULTS: Glucose rate of disappearance was higher during the OGTT vs...... IIGIs in the control group, but similar on all days in the diabetic group. Surprisingly, in both groups, EGP was more suppressed during IIGI than during OGTT and exogenous glucagon infusion during IIGI did not restore EGP to the levels observed during OGTT. CONCLUSION: EGP was less suppressed during...

  14. Cardiovascular effects of intravenous ghrelin infusion in healthy young men

    DEFF Research Database (Denmark)

    Vestergaard, Esben Thyssen; Andersen, Niels Holmark; Hansen, Troels Krarup;

    2007-01-01

    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 cardio......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/m2) 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

  15. Effect of perioperative insulin infusion on surgical morbidity and mortality

    DEFF Research Database (Denmark)

    Gandhi, Gunjan Y; Murad, M Hassan; Flynn, Errol David;

    2008-01-01

    To conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) to evaluate the effect of perioperative insulin infusion on outcomes important to patients.......To conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) to evaluate the effect of perioperative insulin infusion on outcomes important to patients....

  16. Splanchnic and renal exchange of infused fructose in insulin-deficient type 1 diabetic patients and healthy controls.

    OpenAIRE

    Björkman, O; Gunnarsson, R.; Hagström, E; Felig, P.; Wahren, J

    1989-01-01

    Fructose raises blood glucose and lactate levels in normal as well as diabetic man, but the tissue origin (liver and/or kidney) of these responses and the role of insulin in determining the end products of fructose metabolism have not been fully established. Splanchnic and renal substrate exchange was therefore examined during intravenous infusion of fructose or saline in six insulin-deficient type I diabetics who fasted overnight and in five healthy controls. Fructose infusion resulted in si...

  17. Effect of Insulin Infusion on Liver Protein Synthesis during Hemodialysis

    DEFF Research Database (Denmark)

    Reinhard, Mark; Frystyk, Jan; Jespersen, Bente;

    2011-01-01

    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...

  18. Multiple intravenous infusions of bone marrow mesenchymal stem cells reverse hyperglycemia in experimental type 2 diabetes rats.

    Science.gov (United States)

    Hao, Haojie; Liu, Jiejie; Shen, Jing; Zhao, Yali; Liu, Huilin; Hou, Qian; Tong, Chuan; Ti, Dongdong; Dong, Liang; Cheng, Yu; Mu, Yiming; Liu, Jianping; Fu, Xiaobing; Han, Weidong

    2013-07-01

    The worldwide rapid increase in diabetes poses a significant challenge to current therapeutic approaches. Single-dose mesenchymal stem cell (MSC) infusion ameliorates hyperglycemia but fails to restore normoglycemia in diabetic animals. We therefore hypothesized that multiple intravenous MSC infusions may reverse hyperglycemia in type 2 diabetes (T2D) rats. We administered serial allogenous bone-marrow derived MSC infusions (1 × 10(6)cells/infusion) via the tail vein once every 2 weeks to T2D rats, induced by high-fat diet and streptozocin (STZ) administration. Hyperglycemia decreased only transiently after a single infusion in early-phase (1 week) T2D rats, but approximated normal levels after at least three-time infusions. This normal blood level was maintained for at least 9 weeks. Serum concentrations of both insulin and C-peptide were dramatically increased after serial MSC infusions. Oral glucose tolerance tests revealed that glucose metabolism was significantly ameliorated. Immunofluorescence analysis of insulin/glucagon staining revealed the restoration of islet structure and number after multiple MSC treatments. When multiple-MSC treatment was initiated in late-phase (5 week) T2D rats, the results were slightly different. The results of this study suggested that a multiple-MSC infusion strategy offers a viable clinical option for T2D patients.

  19. Intravenous lidocaine infusion--a new treatment of chronic painful diabetic neuropathy?

    DEFF Research Database (Denmark)

    Kastrup, J; Petersen, P; Dejgård, A;

    1987-01-01

    In a randomized double-blind, cross-over study the effect of intravenous lidocaine (5 mg/kg body weight) on the symptoms and signs of painful diabetic neuropathy of more than 6 months duration has been evaluated. Using a clinical symptom scale, there was significant beneficial effect 1 and 8 days...... alternative treatment of chronic painful diabetic neuropathy....... after lidocaine infusion compared to after saline infusion (P less than 0.05 and P less than 0.02, respectively). The duration of the individual effect ranged from 3 to 21 days. Lidocaine infusion had no effect on the objective measurements of neuropathy. Intravenous lidocaine infusion seems to be a new...

  20. Population pharmacokinetics of buprenorphine following a two-stage intravenous infusion in healthy volunteers

    DEFF Research Database (Denmark)

    Jensen, Mette Lykke; Foster, David J.R.; Upton, Richard N.;

    2007-01-01

    The aim of this investigation was to characterize the pharmacokinetics of buprenorphine following administration of an intravenous (i.v.) infusion. To date, the population kinetics of buprenorphine has been described for bolus administration only.......The aim of this investigation was to characterize the pharmacokinetics of buprenorphine following administration of an intravenous (i.v.) infusion. To date, the population kinetics of buprenorphine has been described for bolus administration only....

  1. Intravenous paracetamol infusion versus intramuscular tramadol as an intra-partum labor analgesic

    OpenAIRE

    Rashmi Patil; Vivek Rayadurg

    2016-01-01

    We read with interest the article and ldquo;Intravenous paracetamol infusion versus intramuscular tramadol as an intra-partum labor analgesic and rdquo; by Mohan H et al published in November - December 2015, volume 4 issue 6 of International Journal of Reproduction, Contraception, Obstetrics and Gynecology.1 As we read it, we realized that the article is quite similar to another article and ldquo;Intravenous paracetamol infusion versus intramuscular tramadol as an intra-partum labor analge...

  2. First-pass metabolism of ethanol in human beings: effect of intravenous infusion of fructose

    DEFF Research Database (Denmark)

    Parlesak, Alexandr; Billinger, MH; Schäfer, C.;

    2004-01-01

    Intravenous infusion of fructose has been shown to enhance reduced form of nicotinamide adenine dinucleotide reoxidation and, thereby, to enhance the metabolism of ethanol. In the current study, the effect of fructose infusion on first-pass metabolism of ethanol was studied in human volunteers...

  3. Glycemic increase induced by intravenous glucose infusion fails to affect hunger, appetite, or satiety following breakfast in healthy men.

    Science.gov (United States)

    Schultes, Bernd; Panknin, Ann-Kristin; Hallschmid, Manfred; Jauch-Chara, Kamila; Wilms, Britta; de Courbière, Felix; Lehnert, Hendrik; Schmid, Sebastian M

    2016-10-01

    Meal-dependent fluctuations of blood glucose and corresponding endocrine signals such as insulin are thought to provide important regulatory input for central nervous processing of hunger and satiety. Since food intake also triggers the release of numerous gastrointestinal signals, the specific contribution of changes in blood glucose to appetite regulation in humans has remained unclear. Here we tested the hypothesis that inducing glycemic fluctuations by intravenous glucose infusion is associated with concurrent changes in hunger, appetite, and satiety. In a single blind, counter-balanced crossover study 15 healthy young men participated in two experimental conditions on two separate days. 500 ml of a solution containing 50 g glucose or 0.9% saline, respectively, was intravenously infused over a 1-h period followed by a 1-h observation period. One hour before start of the respective infusion subjects had a light breakfast (284 kcal). Blood glucose and serum insulin concentrations as well as self-rated feelings of hunger, appetite, satiety, and fullness were assessed during the entire experiment. Glucose as compared to saline infusion markedly increased glucose and insulin concentrations (peak glucose level: 9.7 ± 0.8 vs. 5.3 ± 0.3 mmol/l; t(14) = -5.159, p hunger, appetite satiety, and fullness did not differ from the control condition throughout the experiment. These findings clearly speak against the notion that fluctuations in glycemia and also insulinemia represent major signals in the short-term regulation of hunger and satiety.

  4. Effect of Insulin Infusion on insulin-like growth factor I (IGF-I) during Hemodialysis

    DEFF Research Database (Denmark)

    Reinhard, Mark; Frystyk, Jan; Bjerre, Mette;

    2012-01-01

    Background: Hemodialysis (HD) is a catabolic procedure probably contributing to the high frequency of protein-energy wasting among patients on maintenance HD. The aim was to investigate the effect of insulin infusion on insulin-like growth factor I (IGF-I) during HD compared with a meal alone...

  5. Intracranial hemodynamics during intravenous infusion of glyceryl trinitrate

    DEFF Research Database (Denmark)

    Iversen, H.K.; Holm, S.; Friberg, L.;

    2008-01-01

    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...

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

    DEFF Research Database (Denmark)

    Jensen, Christine B; Storgaard, Heidi; Holst, Jens Juul;

    2003-01-01

    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......, 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...

  7. Acute hypoglycemic, hypocholesterolemic and hypotriglyceridemic effects of continuous intravenous infusion of a lyophilised aqueous extract of Ajuga iva L. Schreber whole plant in streptozotocin-induced diabetic rats.

    Science.gov (United States)

    El-Hilaly, Jaouad; Tahraoui, Adil; Israili, Zafar H; Lyoussi, Badiâa

    2007-10-01

    The hypoglycemic and hypolipidemic effect of continuous intravenous infusion of a lyophilised aqueous extract of the whole plant Ajuga iva (L.) Schreber (Labiatae) (AI-extract) was investigated in anesthetized normal and streptozotocin (STZ)-induced diabetic rats. The AI-extract was administered to a group of rats by continuous intravenous infusion for 4 h at a dose of 4.2 microg/min/100 g body weight; another group was infused with taurine, the reference compound, at the same dose. In normal rats, AI-extract infusion had no effect on plasma glucose or triglycerides, but plasma cholesterol levels were significantly decreased (22%; P<0.05). However, taurine infusion produced significant hypoglycemic, hypocholesterolemic and hypotriglyceridemic effects (all changes, P<0.05). In STZ-diabetic rats, AI-extract infusion reduced plasma levels of glucose by 24 % (P<0.05), cholesterol by 35% (P<0.01) and triglycerides by 13% (P<0.05). Infusion with taurine produced a greater fall in plasma glucose (72%, P<0.01), cholesterol (54%; P<0.001) and triglyceride (24%; P<0.001) levels. Our results indicate that intravenously administered AI-extract exerts hypoglycemic and hypolipidemic effects in diabetic rats by mechanism(s) which appear to be similar to that of taurine, which involve insulin sensitization or an insulin-like effect. The identity and the exact mechanism(s) of action of the active component(s) of the AI-extract are not known. Ajuga iva appears to be a useful plant in the therapy of diabetes, a condition in which hyperglycemia and dyslipidemia coexist quite often.

  8. Intravenous antibiotics infusion and bacterial resistence: nursing responsability

    OpenAIRE

    Heloisa Helena Karnas Hoefel; Liana Lautert

    2006-01-01

    The success of antibiotics treatment and development of bacterial resistance depend on many factors. The preparation and management of these factors are associated with nursing care. The aim of this paper is review literature about preparation, management and knowledge of intravenous antibiotics errors analyzing possibilities of influence of bacterial resistance prevention by nurses. Methods: a systematic review was done from LiILACS and M...

  9. Renal haemodynamics, sodium and water reabsorption during continuous intravenous infusion of recombinant interleukin-2

    DEFF Research Database (Denmark)

    Geertsen, P F; von der Maase, H; Olsen, Niels Vidiendal;

    1998-01-01

    1. Renal haemodynamics, lithium and sodium clearance were measured in 14 patients treated with recombinant interleukin-2 for metastatic renal cell carcinoma. 2. Patients were studied before and after 72 h of continuous intravenous infusion of recombinant interleukin-2 (18x10(6) i.u..24 h-1.m-2...

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

    DEFF Research Database (Denmark)

    Jensen, Christine B; Storgaard, Heidi; Holst, Jens Juul;

    2003-01-01

    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...... 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...

  11. THE EFFECT OF CONTINUOUS SUBCUTANEOUS INSULIN INFUSION TREATMENT, INSULIN ANALOG, AND HUMAN INSULIN OF CHILDREN WITH DIABETES

    Directory of Open Access Journals (Sweden)

    Elina Petkova

    2015-09-01

    Full Text Available The aim of this study is to evaluate the cost-effectiveness of  continuous subcutaneous insulin infusion (CSII to multiple daily insulin injection (MDI either with analogues or with human insulin, based on the achieved therapeutic results such as changes in glycated hemoglobin level (HbA1c in the various therapies. The study was performed with children with type-1 diabetes in Bulgaria. The objective of this study was to serve for the Bulgarian National Health Fund (NHIF.Methods: A combined retrospective and prospective study was performed at the Endocrinology diabetes and genetic diseases clinic.51 children with type-1 diabetes were observed for 7 months diveded into three group: Group 1- on continuous subcutaneous insulin infusion (CSII; Group 2- on multiple daily insulin analogues injections (MDI and Group 3 – on human insulin (HI.Patient demographic data, age, sex, weight, duration of disease, HbA1c – values before the start of the study and after the end of the observation and type of treatment (CSII; MDI or HI were observed. Cost-effectiveness, sensitivity and statistical analyses are applied to studied long-term therapeutic results.Results: The three groups of observed children do not differ statistically in age and gender. Most of the participants in Group 1 and Group 2 have suffered from diabetes from 5,6 years. The duration of diabetes was lower in the group of human insulin. All studied children are treated. By all of them the results of the treatment improved, but in the Group 1 the improvement of HbA1c is the highest. The average improvement of HbA1c in the Group 1 after the CSII introduction is 1.85, while after the application of analogue insulin is 0,59 and 0,28 respectively in the Group 3 after the treatment on human insulin.The cost of insulin pump, consumables- infusion set and insulin reservoir, blood glucose monitoring system, strips, needles and insulin cost was calculated.The total cost ot the treatment of diabetes

  12. The course of diabetic retinopathy during treatment with continuous subcutaneous insulin infusion

    NARCIS (Netherlands)

    Hooymans, Johanna Martina Maria

    1986-01-01

    The aim of this prospective study was to investigate the effect of normalization of blood sugar regulation by continuous subcutaneous insulin infusion (CSII) on the course of diabetic retinopathy in insulin-dependent (type I) diabetic patients. Zie: Summary

  13. Intravenous antibiotics infusion and bacterial resistence: nursing responsability

    Directory of Open Access Journals (Sweden)

    Heloisa Helena Karnas Hoefel

    2006-12-01

    Full Text Available The success of antibiotics treatment and development of bacterial resistance depend on many factors. The preparation and management of these factors are associated with nursing care. The aim of this paper is review literature about preparation, management and knowledge of intravenous antibiotics errors analyzing possibilities of influence of bacterial resistance prevention by nurses. Methods: a systematic review was done from LiILACS and Medline searching for the word nursing and bacterial resistance, antibiotics control, hospital infections, administration drugs, errors and adverse events. There were chose 58 papers about nursing and/or were basics for international and Brazilian studies. Results: It was described international classifications errors and consequences analyzing their possible influences on antibiotics effects. Based on these knowledge, interventions are recommended to implement safety practice and care.

  14. Safety and feasibility of long-term intravenous sodium nitrite infusion in healthy volunteers.

    Directory of Open Access Journals (Sweden)

    Ryszard M Pluta

    Full Text Available BACKGROUND: Infusion of sodium nitrite could provide sustained therapeutic concentrations of nitric oxide (NO for the treatment of a variety of vascular disorders. The study was developed to determine the safety and feasibility of prolonged sodium nitrite infusion. METHODOLOGY: Healthy volunteers, aged 21 to 60 years old, were candidates for the study performed at the National Institutes of Health (NIH; protocol 05-N-0075 between July 2007 and August 2008. All subjects provided written consent to participate. Twelve subjects (5 males, 7 females; mean age, 38.8±9.2 years (range, 21-56 years were intravenously infused with increasing doses of sodium nitrite for 48 hours (starting dose at 4.2 µg/kg/hr; maximal dose of 533.8 µg/kg/hr. Clinical, physiologic and laboratory data before, during and after infusion were analyzed. FINDINGS: The maximal tolerated dose for intravenous infusion of sodium nitrite was 267 µg/kg/hr. Dose limiting toxicity occurred at 446 µg/kg/hr. Toxicity included a transient asymptomatic decrease of mean arterial blood pressure (more than 15 mmHg and/or an asymptomatic increase of methemoglobin level above 5%. Nitrite, nitrate, S-nitrosothiols concentrations in plasma and whole blood increased in all subjects and returned to preinfusion baseline values within 12 hours after cessation of the infusion. The mean half-life of nitrite estimated at maximal tolerated dose was 45.3 minutes for plasma and 51.4 minutes for whole blood. CONCLUSION: Sodium nitrite can be safely infused intravenously at defined concentrations for prolonged intervals. These results should be valuable for developing studies to investigate new NO treatment paradigms for a variety of clinical disorders, including cerebral vasospasm after subarachnoid hemorrhage, and ischemia of the heart, liver, kidney and brain, as well as organ transplants, blood-brain barrier modulation and pulmonary hypertension. CLINICAL TRIAL REGISTRATION INFORMATION: http

  15. THE EFFECT OF CONTINUOUS SUBCUTANEOUS INSULIN INFUSION TREATMENT, INSULIN ANALOG, AND HUMAN INSULIN OF CHILDREN WITH DIABETES

    OpenAIRE

    Elina Petkova; Valentina Petkova; Guenka Petrova; Maya Konstantinova

    2015-01-01

    The aim of this study is to evaluate the cost-effectiveness of  continuous subcutaneous insulin infusion (CSII) to multiple daily insulin injection (MDI) either with analogues or with human insulin, based on the achieved therapeutic results such as changes in glycated hemoglobin level (HbA1c) in the various therapies. The study was performed with children with type-1 diabetes in Bulgaria. The objective of this study was to serve for the Bulgarian National Health Fund (NHIF).Methods: A combine...

  16. 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)

    Scaife Jes R

    2008-02-01

    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

  17. Intraosseous infusion of the distal phalanx compared to systemic intravenous infusion for marimastat delivery to equine lamellar tissue.

    Science.gov (United States)

    Underwood, Claire; Collins, Simon N; van Eps, Andrew W; Mills, Paul C; Allavena, Rachel E; Bailey, Simon R; Medina Torres, Carlos E; Meizler, Alon; Pollitt, Christopher C

    2015-09-01

    No validated laminitis drug therapy exists, yet pharmaceutical agents with potential for laminitis prevention have been identified. Many of these are impractical for systemic administration but may be effective if administered locally. This study compared intraosseous infusion of the distal phalanx (IOIDP) with systemic intravenous constant rate infusion (CRI) to determine which was more effective for lamellar marimastat delivery. Ultrafiltration probes were placed in both forefeet of five horses to collect lamellar interstitial fluid as lamellar ultrafiltrate (LUF). Marimastat solution (3.5 mg/mL) containing lidocaine (20 mg/mL) was infused by IOIDP at 0.15 mL/min for 12 h. After a 12 h wash-out, marimastat (3.5 mg/mL) and lidocaine were infused by constant rate infusion (CRI) at 0.15 mL/min for 12 h. LUF, plasma and lamellar tissue marimastat concentrations were quantified using UPLC-MS. Zymography was used to establish the inhibitory concentrations of marimastat for equine lamellar matrix metalloproteinases (MMPs). Data were analysed non-parametrically. There was no difference between the steady-state marimastat concentration in lamellar ultrafiltrate (LUF[M]) during IOIDP (139[88-497] ng/mL) and CRI (136[93-157] ng/mL). During IOIDP, there was no difference between marimastat concentrations in the treated foot (139[88-497] ng/mL), the untreated foot (91[63-154] ng/mL) and plasma (101[93-118] ng/mL). LUF[M] after IOIDP and CRI were >IC50 of lamellar MMP-2 and 9, but below the concentration considered necessary for in vivo laminitis prevention. Lamellar drug delivery during IOIDP was inconsistent and did not achieve higher lamellar marimastat concentrations than CRI. Modification or refinement of the IOIDP technique is necessary if it is to be consistently effective. PMID:26073286

  18. Comparative study of intravenous urographic bolus (I.U.B.) and intravenous urographic infusion (I.U.I.) in dogs

    International Nuclear Information System (INIS)

    Two urographic methods were compared: the intravenous urographic bolus (i.u.b.) and the intravenous urographic infusion (i.u.i.). In both methods, two groups of seven healthy adult dogs of both sexes, weighing7.0 to 16.5 kg were used and were anaesthesized with 2% thiopentone sodium in doses of 20 mg/kg via cephalica. In the i.u.b., meglumine diatrizoate (Hypaque-M, 60%) was injected via saphena with a concentration of 282 mg of iodine per mi in doses of 564 mg of iodine per kg. In the i.u.i., meglumine diatrizoate was injected via saphena by drip infusion with a concentration of 200 mg of iodine per mi in doses of 500 mg of iodine per kg. Three series of two X-rays each were taken in ventrodorsal projection 1, 4 and 8 min and left lateral recumbency 30 sec after administering the contrast medium. The X-ray plates obtained were analyzed and compared intra and inter group considering the advance speed of the contrast medium, the radiographic density and outline, and kidney size. The advance speed of the contrast medium was higher in the i.u.i., reaching the kidney, ureter and bladder 1 min after administration in both projections; in ventrodorsal projections in the i.u.b. only the kidneys were reached while in the left lateral recumbency, the kidney and ureters were reached

  19. Clinical Effects of Arsenic Trioxide by Slowing-intravenous Infusion on Acute Promyelocyte Leukemia

    Institute of Scientific and Technical Information of China (English)

    Jin Zhou; Ran Meng; Bao-feng Yang

    2005-01-01

    @@ Although As2O3 is effective in the treatment of acute promyelocytic leukemia (APL), some side effects, such as leukocytosis which can increase the incidence of cerebral hemorrhage and early death rate, often occur during the early stage of As2O3 treatment. In this paper, the advantages of continuously slow intravenous As2O3 infusion on relieving leukocytosis and decreasing the incidence of cerebral hemorrhage and early death rate were observed clinically.

  20. Uptake of iodinated deoxyuridine in a murine melonama following multiple-day intravenous infusions

    International Nuclear Information System (INIS)

    Techniques are described for multi-day intravenous (i.v.) infusions of iodinated deoxyuridine (IdUrd) into mice. Percent incorporation into DNA as a thymidine (Thd) analog is reported, as measured by radioactive tag (125IdUrd) and by neutron activation analysis (NAA). Quantitative measurements of IdUrd incorporation in DNA are requisite for meaningful evaluation of the effects of radiation enhancement resulting from radiation sensitization and the stimulation of Auger cascades (photon activation)

  1. Treatment of metastatic renal cell carcinoma by continuous intravenous infusion of recombinant interleukin-2

    DEFF Research Database (Denmark)

    Geertsen, P F; Hermann, G G; von der Maase, H;

    1992-01-01

    PURPOSE: A single-center phase II study was performed to evaluate the efficacy of recombinant interleukin-2 (rIL-2) administered by continuous infusion to patients with metastatic renal cell carcinoma (RCC). PATIENTS AND METHODS: Thirty-one patients with RCC were entered onto the study. rIL-2...... (Proleukin; Eurocetus Corp, Amsterdam, The Netherlands) was administered intravenously in a dose of 18 x 10(6) IU/m2 per 24 hours. A maximum of two induction cycles and four maintenance cycles were given. Each induction cycle consisted of two rIL-2 infusion periods of 120 hours and 108 hours duration......, respectively; these were separated by a 6-day rest period. Each maintenance cycle consisted of a 120 hours rIL-2 infusion period. RESULTS: Six of 30 assessable patients (20%) responded; two (7%) with a complete response (CR) and four (13%) with a partial response (PR). The response duration for patients...

  2. Intraperitoneal insulin infusion : treatment option for type 1 diabetes resulting in beneficial endocrine effects beyond glycaemia

    NARCIS (Netherlands)

    van Dijk, P R; Logtenberg, S J J; Gans, R O B; Bilo, H J G; Kleefstra, N

    2014-01-01

    Continuous intraperitoneal insulin infusion (CIPII) is a treatment option for patients with type 1 diabetes mellitus who fail to reach adequate glycaemic control despite intensive subcutaneous (SC) insulin therapy. CIPII has clear advantages over SC insulin administration in terms of pharmacokinetic

  3. Pharmacokinetics of midazolam administered concurrently with ketamine after intravenous bolus or infusion in dogs.

    Science.gov (United States)

    Brown, S A; Jacobson, J D; Hartsfield, S M

    1993-12-01

    Midazolam, a water-soluble benzodiazepine tranquilizer, has been considered by some veterinary anaesthesiologists to be suitable as a combination anaesthetic agent when administered concurrently with ketamine because of its water solubility and miscibility with ketamine. However, the pharmacokinetics of midazolam have not been extensively described in the dog. Twelve clinically healthy mixed breed dogs (22.2-33.4 kg) were divided into two groups at random and were administered ketamine (10 mg/kg) and midazolam (0.5 mg/kg) either as an intravenous bolus over 30 s (group 1) or as an i.v. infusion in 0.9% NaCl (2 ml/kg) over 15 min. Blood samples were obtained immediately before the drugs were injected and periodically for 6 h afterwards. Serum concentrations were determined using gas chromatography with electron-capture detection. Serum concentrations were best described using a two-compartment open model and indicated a t1/2-alpha of 1.8 min and t1/2-beta of 27.8 min after i.v. bolus, and t1/2-alpha of 1.35 min and t1/2-beta of 31.6 min after i.v. infusion. The calculated pharmacokinetic coefficient B was significantly smaller after i.v. infusion (429 +/- 244 ng/ml) than after i.v. bolus (888 +/- 130 ng/ml, P = 0.004). Furthermore, AUC was significantly smaller after i.v. infusion (29,800 +/- 6120 ng/h/ml) than after i.v. bolus (42,500 +/- 8460 ng/h/ml, P infusion (17.4 +/- 4.00 ml/min/kg than after i.v. bolus (12.1 +/- 2.24 ml/min/kg, P < 0.05). No other pharmacokinetic value was significantly affected by rate of intravenous administration. PMID:8126758

  4. A small-dose naloxone infusion alleviates nausea and sedation without impacting analgesia via intravenous tramadol

    Institute of Scientific and Technical Information of China (English)

    JIA Dong-lin; NI Cheng; XU Ting; ZHANG Li-ping; GUO Xiang-yang

    2010-01-01

    Background Early studies showed that naloxone infusion decreases the incidence of morphine-related side effects from intravenous patient-controlled analgesia. This study aimed to determine whether naloxone preserved analgesia while minimizing side effects caused by intravenous tramadol administration. Methods Eighty patients undergoing general anesthesia for cervical vertebrae surgery were randomly divided into four groups. All patients received 1 mg/kg tramadol 30 minutes before the end of surgery, followed by a continuous infusion with 0.3 mgkg-1·h-1 tramadol with no naloxone (group I, n=20), 0.05 μg-kg-1·h-1 naloxone (group II, n=20), 0.1 μg·kg-1·h-1 naloxone (group III, n=20) and 0.2 μg·kg-1·h-1 naloxone (group IV, n=20). Visual analog scales (VAS) for pain during rest and cough, nausea five-point scale (NFPS) for nausea and vomiting, and ramsay sedation score (RSS) for sedation were assessed at 2, 6,12, 24 and 48 hours postoperatively. Analgesia and side effects were evaluated by blinded observers. Results Seventy-eight patients were included in this study. The intravenous tramadol administration provided the satisfied analgesia. There was no significant difference in either resting or coughing VAS scores among naloxone groups and control group. Compared with control group, sedation was less in groups II, III, and IV at 6, 12, and 24 hours (P <0.05); nausea was less in groups II, III and IV than group I at 2, 6, 12, 24 and 48 hours postoperatively (P <0.05). The incidence of vomiting in the control group was 35% vs. 10% for the highest dose naloxone group (group IV) (P<0.01). Conclusion A small-dose naloxone infusion could reduce tramadol induced side effects without reversing its analgesic effects.

  5. Effects of Intravenous Ketamine Infusions in a Neuropathic Pain Patient with Lichen Sclerosus et Atrophicus.

    Science.gov (United States)

    Hanna, Ashraf F; Armstrong, Josh S; Smith, Adam J

    2016-01-01

    A patient reported to the Florida Spine Institute (Clearwater, Fla., USA) with severe lichen sclerosus of the anogenital region and legs. The patient's pain presentation was neuropathic with hypersensitivity, allodynia, swelling, and weakness. The patient had failed multiple pain management modalities including opioid therapy, anticonvulsants, and antidepressants. The patient completed a standard intravenous ketamine infusion regimen developed at the Florida Spine Institute and reported complete abolishment of her pain syndrome. For the first time, we report that ketamine infusions also dramatically improved a patient's lichen sclerosus. That ketamine is known to have immunomodulatory properties, and given the clinical observations described in this case report, suggests that ketamine should be explored as a possible new therapeutic option for managing lichen sclerosus, especially in cases that are refractory to conventional therapies. PMID:27462225

  6. Effects of Intravenous Ketamine Infusions in a Neuropathic Pain Patient with Lichen Sclerosus et Atrophicus

    Science.gov (United States)

    Hanna, Ashraf F.; Armstrong, Josh S.; Smith, Adam J.

    2016-01-01

    A patient reported to the Florida Spine Institute (Clearwater, Fla., USA) with severe lichen sclerosus of the anogenital region and legs. The patient's pain presentation was neuropathic with hypersensitivity, allodynia, swelling, and weakness. The patient had failed multiple pain management modalities including opioid therapy, anticonvulsants, and antidepressants. The patient completed a standard intravenous ketamine infusion regimen developed at the Florida Spine Institute and reported complete abolishment of her pain syndrome. For the first time, we report that ketamine infusions also dramatically improved a patient's lichen sclerosus. That ketamine is known to have immunomodulatory properties, and given the clinical observations described in this case report, suggests that ketamine should be explored as a possible new therapeutic option for managing lichen sclerosus, especially in cases that are refractory to conventional therapies. PMID:27462225

  7. First-pass metabolism of ethanol in human beings: effect of intravenous infusion of fructose

    DEFF Research Database (Denmark)

    Parlesak, Alexandr; Billinger, MH; Schäfer, C.;

    2004-01-01

    Intravenous infusion of fructose has been shown to enhance reduced form of nicotinamide adenine dinucleotide reoxidation and, thereby, to enhance the metabolism of ethanol. In the current study, the effect of fructose infusion on first-pass metabolism of ethanol was studied in human volunteers....... A significantly higher first-pass metabolism of ethanol was obtained after administration of fructose in comparison with findings for control experiments with an equimolar dose of glucose. Because fructose is metabolized predominantly in the liver and can be presumed to have virtually no effects in the stomach......, results of the current study support the assumption that only a negligible part of first-pass metabolism of ethanol occurs in the stomach....

  8. A Review of the Security of Insulin Pump Infusion Systems

    OpenAIRE

    Paul, Nathanael; Kohno, Tadayoshi; Klonoff, David C.

    2011-01-01

    Insulin therapy has enabled patients with diabetes to maintain blood glucose control to lead healthier lives. Today, rather than injecting insulin manually using syringes, a patient can use a device such as an insulin pump to deliver insulin programmatically. This allows for more granular insulin delivery while attaining blood glucose control. Insulin pump system features have increasingly benefited patients, but the complexity of the resulting system has grown in parallel. As a result, secur...

  9. Discrepancy between plasma C-peptide and insulin response to oral and intravenous glucose

    DEFF Research Database (Denmark)

    Madsbad, S; Kehlet, H; Hilsted, J;

    1983-01-01

    Plasma insulin, proinsulin, and C-peptide responses to 25 g glucose orally and intravenously administered were measured in 10 healthy males. Plasma insulin response was higher during the oral load in accordance with the "incretin" concept. However, the actual amount of insulin secreted, as measured...... by the plasma C-peptide response, was similar during the two glucose loads. The higher plasma insulin response after oral glucose was not due to crossreactivity with proinsulin in the insulin assay. These results suggest that the higher plasma insulin response during an oral glucose load is due at...

  10. Intravenous paracetamol infusion versus intramuscular tramadol as an intra-partum labor analgesic

    Directory of Open Access Journals (Sweden)

    Rashmi Patil

    2016-09-01

    Full Text Available We read with interest the article and ldquo;Intravenous paracetamol infusion versus intramuscular tramadol as an intra-partum labor analgesic and rdquo; by Mohan H et al published in November - December 2015, volume 4 issue 6 of International Journal of Reproduction, Contraception, Obstetrics and Gynecology.1 As we read it, we realized that the article is quite similar to another article and ldquo;Intravenous paracetamol infusion versus intramuscular tramadol as an intra-partum labor analgesic and rdquo; by Lallar M et al.2 Although the authors quote this article as their reference, the degree of similarity between the two articles is beyond our acceptance. Hence we would like to bring it to your notice. We know that any original research should be encouraged to be published, but the authenticity in style of writing the same should be maintained and plagiarism to such a high extent is not acceptable. [Int J Reprod Contracept Obstet Gynecol 2016; 5(9.000: 3268-3268

  11. Urinary iron excretion induced by intravenous infusion of deferoxamine in ß-thalassemia homozygous patients

    Directory of Open Access Journals (Sweden)

    Boturão-Neto E.

    2002-01-01

    Full Text Available The purpose of the present study was to identify noninvasive methods to evaluate the severity of iron overload in transfusion-dependent ß-thalassemia and the efficiency of intensive intravenous therapy as an additional tool for the treatment of iron-overloaded patients. Iron overload was evaluated for 26 ß-thalassemia homozygous patients, and 14 of them were submitted to intensive chelation therapy with high doses of intravenous deferoxamine (DF. Patients were classified into six groups of increasing clinical severity and were divided into compliant and non-compliant patients depending on their adherence to chronic chelation treatment. Several methods were used as indicators of iron overload. Total gain of transfusion iron, plasma ferritin, and urinary iron excretion in response to 20 to 60 mg/day subcutaneous DF for 8 to 12 h daily are useful to identify iron overload; however, urinary iron excretion in response to 9 g intravenous DF over 24 h and the increase of urinary iron excretion induced by high doses of the chelator are more reliable to identify different degrees of iron overload because of their correlation with the clinical grades of secondary hemochromatosis and the significant differences observed between the groups of compliant and non-compliant patients. Finally, the use of 3-9 g intravenous DF for 6-12 days led to a urinary iron excretion corresponding to 4.1 to 22.4% of the annual transfusion iron gain. Therefore, continuous intravenous DF at high doses may be an additional treatment for these patients, as a complement to the regular subcutaneous infusion at home, but requires individual planning and close monitoring of adverse reactions.

  12. Hypocaloric Enteral Nutrition Protects Against Hypoglycemia Associated with Intensive Insulin Therapy Better Than Intravenous Dextrose

    OpenAIRE

    Kauffmann, Rondi M.; Hayes, Rachel M; Vanlaeken, Amanda H.; Norris, Patrick R; Jose J Diaz; May, Addison K.; Collier, Bryan R.

    2014-01-01

    Intensive insulin therapy treats hyperglycemia but increases the risk of hypoglycemia. Typically, intravenous dextrose is given to prevent hypoglycemia; however, enteral nutrition is preferred. We hypothesized that the provision of hypocaloric enteral nutrition would protect against hypoglycemia. A retrospective analysis was performed evaluating patients treated with intensive insulin therapy comparing the use of enteral nutrition versus a dextrose-only intravenous solution. Nutrition in the ...

  13. Effect of continuous subcutaneous insulin infusion on kidney function and size in IDDM patients

    DEFF Research Database (Denmark)

    Christensen, Cramer; Christiansen, J S; Schmitz, A;

    1987-01-01

    insulin infusion (CSII) (n = 12) or unchanged conventional insulin treatment (CIT) (n = 12). GFR, RPF, and kidney volume were identical but significantly increased above normal values in the two groups at the start of the study. After 24 months of CSII treatment, significant reduction in GFR was seen...

  14. Treatment with continuous subcutaneous insulin infusion is associated with lower arterial stiffness

    DEFF Research Database (Denmark)

    Vestergaard Rosenlund, Signe; Theilade, Simone; Hansen, Tine Willum;

    2014-01-01

    AIMS: To investigate the relationship between arterial stiffness and insulin treatment mode [continuous subcutaneous insulin infusion (CSII) versus multiple daily injections (MDI)] in type 1 diabetes patients. METHODS: Cross-sectional study, from 2009 to 2011, including 601 Caucasian type 1...

  15. INFLUENCE OF INTRAVENOUS DEXMEDETOMIDINE INFUSION ON SUBARACHNOID BLOCK WITH BUPIVACAINE IN ADULT INGUINAL HERNIORRHAPHIES

    Directory of Open Access Journals (Sweden)

    Suhara

    2014-09-01

    Full Text Available INTRODUCTION: Central neuraxial blocks with local anaesthetics are popular techniques of anaesthesia which have been extensively used for lower abdominal surgery. Subarachnoid block is a simple technique which requires a small dose of local anaesthetic to provide rapid and reliable surgical anaesthesia and minimal risk of drug toxicity. Duration of spinal anaesthesia may be prolonged by addition of opioids, clonidine, neostigmine, or vasoconstrictor agents to the local anesthetic drug for better post-op pain relief. Intrathecal addition of a low dose of α2-agonist like clonidine or dexmedetomidine results in significant prolongation of the duration of the sensory and motor blockade induced by hyperbaric bupivacaine. This study is designed to investigate the effects of intravenous dexmedetomidine on the duration of sensory and motor blockade induced by intrathecal administration of bupivacaine, and its associated adverse events. AIMS AND OBJEVCTIVES: To determine effect of intravenous Dexmedetomidine on the duration of analgesia with spinal Bupivacaine for adult patients undergoing herniorrhaphy and to assess the incidence of intra operative side effects, if any. STUDY SETTING: This study was done under the department of Anaesthesiology, Azeezia Medical College from March 2013 to October 2013. STUDY DESIGN: A double blind prospective randomized control study was done.50 adults aged 20 to 60 years scheduled for herniorrhaphies were allocated into two study groups, named A and B using computer generated randomization. INTERPRETATIONS AND CONCLUSION: The duration of analgesia of subarachnoid block with heavy 0.5% bupivacaine with intravenous infusion of saline and dexmedetomidine were compared. Post-operative pain was evaluated by Visual Analogue Scale. Duration of analgesia is the time taken from the administration of the drug to the time when the patient complains of pain of > 50 in Visual Analogue Scale. The duration of analgesia was longest in

  16. Practical Experience with Continuous Subcutaneous Insulin Infusion Therapy in a Pediatric Diabetes Clinic

    OpenAIRE

    O'Connell, Michele A.; Cameron, Fergus J.

    2008-01-01

    Continuous subcutaneous insulin infusion therapy (CSII) is an increasingly popular form of intensive insulin administration in pediatric patients. The use of CSII commenced at our large tertiary referral diabetes clinic as recently as 2002. In the intervening years, demand and enthusiasm from both patients and physicians alike have resulted in a steady ongoing increase in CSII use at our clinic. We currently have >200 active patients using insulin pump therapy. This article reviews our experi...

  17. Efficacy and safety of constant-rate intravenous cyclosporine infusion immediately after heart transplantation.

    Science.gov (United States)

    Schroeder, T J; Myre, S A; Melvin, D B; Van der Bel-Kahn, J; Stephens, G W; Collins, J A; Wolf, R K; Brown, L L; Pesce, A J; First, M R

    1989-01-01

    Oral cyclosporine therapy immediately after heart transplantation is erratic and difficult to predict. The purpose of this study was to evaluate the relative efficacy and safety of cyclosporine when administered by constant-rate infusion immediately after transplantation. Nineteen patients (17 men and two women) aged 50 years (range 25 to 61 years) who weighed 71 +/- 9 kg, participated in the study and received cyclosporine, 7 to 10 mg/hr (117 +/- 15 micrograms/kg/hr). The infusions were initially maintained for 26 +/- 5 hours (range 18 to 42 hours) without adjustments in dosage. Whole blood samples were obtained at hourly intervals for the first 8 to 12 hours and then daily throughout the 7-day study period and were analyzed by high-performance liquid chromatography. Constant-rate cyclosporine infusion resulted in therapeutic blood levels (350 to 450 ng/ml) at 6 hours. These levels remained relatively steady throughout the 7-day infusion, requiring only minimal dosage adjustments. Kidney function was not altered significantly after 7 days of intravenous cyclosporine therapy as evidenced by a mean serum creatinine level of 1.3 mg/dl before therapy and 1.4 mg/dl after therapy. There, however, was a transient rise in serum creatinine level in most patients on the second or third day after transplantation that resolved without a reduction in cyclosporine dosage. The mean endomyocardial biopsy score at 1 week after transplantation was 0.1, and only four of the patients required additional immunosuppressive therapy to treat rejection during the first 6 weeks after transplantation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:2647932

  18. Non-ST Elevation Myocardial Infraction after High Dose Intravenous Immunoglobulin Infusion

    Directory of Open Access Journals (Sweden)

    Meir Mizrahi

    2009-01-01

    Full Text Available Intravenous immunoglobulins (IVIgs are used for several indications, including autoimmune conditions. IVIg treatment is associated with several possible adverse reactions including induction of a hypercoagulable state. We report a 76-year-old woman treated with IVIg for myasthenia gravis, which developed chest pain and weakness following IVIg infusion. The symptoms were associated with ST segment depression in V4–6 and elevated troponin levels. The patient was diagnosed with non-ST elevation myocardial infarction (NSTEMI. The patient had no significant risk factor besides age and a cardiac perfusion scan was interpreted as normal (the patient refused to undergo cardiac catheterization. This case is compatible with IVIg-induced hypercoagulability resulting in NSTEMI. Cardiac evaluation should therefore be considered prior to initiation of IVIg treatment especially in patients with multiple cardiovascular risks.

  19. 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

  20. Effect of peri-operative intravenous infusion of lignocaine on haemodynamic responses to intubation, extubation and post-operative analgesia

    Institute of Scientific and Technical Information of China (English)

    Yu-Mei Peng; An-Min Shao

    2016-01-01

    Objective: To study the effect of peri-operative intravenous infusion of lignocaine on haemodynamic responses to intubation, extubation and post-operative analgesia. Methods:A total of 90 patients performed with elective laparoscopic cholecystectomy under total anesthesia were randomly divided into three groups with 30 patients in each group. In Group A, patients received 6 mL normal saline as bolus over 10 min followed by 6 mL/h infusion, whereas in Group B, patients were intravenously injected with 2%lignocaine at the rate of 1 mg/kg intravenous injection, 10 min later, conducting intravenous infusion at the rate of 1 mg/kg/h until an hour after operation. In Group C, patients were intravenously injected with 2%lignocaine at a rate of 1.5 mL/kg intravenous injection, 10 min later, conducting intravenous infusion at a rate of 1.5 mL/kg/h until an hour after operation. We recorded the heart rate (HR)and mean arterial pressure (MAP)of before infusion lignocaine (T0), before induction (T1), intubation (T2), 3 min after intubation (T3), 10 min after intubation (T4), extubation (T5), 3 min after extubation (T6)and 10 min after extubation (T7). We also recorded the total injection dosage of ketorolac and pentazocine. Results:The HR and MAP of Group A on T2 and T5 were higher than T0, whereas, the HR and MAP in Groups B and C on T2 and T5 were lower than that of in Group A. The pain-free period in Groups B and C was longer than Group A. The ketorolac and pentazocine requirement in Groups B and C were lower than Group A. Conclusions:Patients were administrated with 2%lignocaine before operation at a rate of 1 mg/kg intravenous injection bolus, 10 min later at the rate of 1 mL/kg/h or 1.5 mL/kg intravenous infusion until an hour after operation. Administration of lignocaine can effectively prevent the change of haemodynamics resulting from intubation and extubation. Furthermore, it can significantly relieve the postoperative pain and reduce the usage amount of analgesic

  1. Zinc content of commercial diluents widely used in drug admixtures prepared for intravenous infusion.

    Science.gov (United States)

    Desai, Narendra R; Shah, Syed M; Koczone, Julianna; Vencl-Joncic, Maja; Sisto, Christopher; Ludwig, Stephen A

    2007-01-01

    During ongoing quality improvement efforts with two Wyeth parenteral products, Protonix and Zosyn, we noted that dosing solutions prepared from the products yielded inconsistent results on the United States Pharmacopeia Chapter 788 test for subvisible particulates. This manuscript discusses variables that have a direct impact on intravenous products meeting compendial monograph specifications under conditions that are encountered in the clinical setting. The rubber stoppers of vials used for parenteral products, different parts of commercial admixture bags, and the tubing of the administration sets and devices contain residual amounts of metal ions, plasticizers, and other additives incorparated for specific functions. The transition metal ions, including zinc and copper, may leach into drug products during manufacture and during storage of dosing admixture bags prepared for infusion in hospital pharmacies or clinics. The metal ions may compromise the quality of the infusion admixture through catalytic drug degradation and/or generation of undesirable metal ion complexes, which may convert soluble drug molecules into insoluble particulates. To preserve the quality of the drug product, it is essential that metal ion leachables be controlled proactively during manufacture of the drug product; knowledge of metal ion contents in the commercial diluents use for reconstitution, admixture preparation, and flushing of the administration lines is also critical. PMID:23969523

  2. Effect of intracerebroventricular deuterium oxide on water intake and AVP release induced by intravenous infusion of angiotensin II in sheep.

    Science.gov (United States)

    Hjelmqvist, H; Rundgren, M

    1990-02-01

    The effect of intracerebroventricular (i.c.v.) infusion (0.02 ml min-1) of deuterium oxide (D2O), with NaCl added to isotonicity, on the water intake and arginine vasopressin (AVP) release caused by intravenous (i.v.) infusion of angiotensin II (AII) (4.8 nmol min-1) was studied in euhydrated sheep. The i.c.v. infusion of D2O, which started 80 min before commencement of the AII infusion, induced a water diuresis in four out of six animals and a measurable decrease in plasma AVP concentration. The i.v. infusion of AII effectively stimulated the AVP release and the response was unaffected by prior and simultaneous i.c.v. administration of D2O. However, the water intake measured 2 min after cessation of the AII administration was reduced by 50% when D2O was infused i.c.v. compared to that seen after simply the AII infusion. The inhibitory effect of D2O on AII-induced drinking disappeared rapidly after discontinuation of D2O administration. Compensatory increased drinking was seen during the first post-infusion hour, resulting in an equivalent cumulative intake of water at 60 min post-infusion in the two types of experiments. The present results support the idea that at least some of the cerebral effects of circulating AII on fluid balance are medicated via targets which are simultaneously accessible to influences from the blood and the cerebrospinal fluid. PMID:2156405

  3. Evaluation of first phase insulin secretion by a nateglinide-intravenous glucose insulin release test in newly diagnosed type 2 diabetics

    Institute of Scientific and Technical Information of China (English)

    罗国春

    2006-01-01

    Objective To evaluate the function of the first phase of insulin secretion of pancreatic B cells in newly diagnosed type 2 diabetics using nateglinide-intravenous glucose insulin release test (NG-IVGIRT). Methods NG-IVGIRT and intravenous glucose insulin release test (IVGIRT) were done in 8 patients with newly diagnosed type 2 diabetes mellitus and NG-IVGIRT was done in 8 normal people. Insulin and glucose of blood were deter-

  4. Mesenchymal stem cells are short-lived and do not migrate beyond the lungs after intravenous infusion

    Directory of Open Access Journals (Sweden)

    Elke eEggenhofer

    2012-09-01

    Full Text Available Mesenchymal stem cells (MSC are under investigation as a therapy for a variety of disorders. Although animal models show long term regenerative and immunomodulatory effects of MSC, the fate of MSC after infusion remains to be elucidated. In the present study the localization and viability of MSC was examined by isolation and re-culture of intravenously infused MSC. C57BL/6 MSC (500,000 constitutively expressing DsRed-fluorescent protein and radioactively labeled with Cr-51 were infused via the tail vein in wild type C57BL/6 mice. After 5min, 1h, 24h or 72h, mice were sacrificed and blood, lungs, liver, spleen, kidneys and bone marrow removed. One hour after MSC infusion the majority of Cr-51 was found in the lungs, whereas after 24h Cr-51 was mainly found in the liver. Tissue cultures demonstrated that viable donor MSC were present in the lungs up to 24h after infusion, after which they disappeared. No viable MSC were found in the other organs examined at any time. The induction of ischemia-reperfusion injury in the liver did not trigger the migration of viable MSC to the liver. These results demonstrate that MSC are short-lived after i.v. infusion and that viable MSC do not pass the lungs. Cell debris may be transported to the liver. Long term immunomodulatory and regenerative effects of infused MSC must therefore be mediated via other cell types.

  5. A nationwide study of continuous subcutaneous insulin infusion (CSII) in Denmark

    DEFF Research Database (Denmark)

    Nørgaard, K

    2003-01-01

    AIMS: To record the number of patients treated with continuous subcutaneous insulin infusion (CSII), the attitude to CSII treatment among diabetes care providers and the characteristics of pump users in Denmark. METHODS: A questionnaire was mailed to all departments of endocrinology, internal...

  6. A Review of Insulin-Dosing Formulas for Continuous Subcutaneous Insulin Infusion (CSII) for Adults with Type 1 Diabetes.

    Science.gov (United States)

    King, Allen B; Kuroda, Akio; Matsuhisa, Munehide; Hobbs, Todd

    2016-09-01

    Dosing guidelines for patients with type 1 diabetes using continuous subcutaneous insulin infusion (CSII), which are historically based on clinical experience and retrospective studies of patients consuming an American diet, recommend that basal insulin should represent approximately 50 % of the total daily dose (TDD). Recent prospective studies in the USA and Japan conclude that the more appropriate proportion is closer to 30-40 % of TDD. In addition, currently used formulas for calculating the carbohydrate-to-insulin ratio (CIR) and correction factor (CF) may lead to underdosing of bolus insulin by as much as 12.8-50 % for a hypothetical patient. The discrepancies between traditional formulas and data from newer studies can be accounted for by the more rigorous design of the newer studies (e.g., prospective design, controlled diets, meal omission, and frequent glucose monitoring). International differences in diet composition may also be important to consider when developing dosing recommendations for CSII. PMID:27457238

  7. The regulatory system for diabetes mellitus: Modeling rates of glucose infusions and insulin injections

    Science.gov (United States)

    Yang, Jin; Tang, Sanyi; Cheke, Robert A.

    2016-08-01

    Novel mathematical models with open and closed-loop control for type 1 or type 2 diabetes mellitus were developed to improve understanding of the glucose-insulin regulatory system. A hybrid impulsive glucose-insulin model with different frequencies of glucose infusions and insulin injections was analyzed, and the existence and uniqueness of the positive periodic solution for type 1 diabetes, which is globally asymptotically stable, was studied analytically. Moreover, permanence of the system for type 2 diabetes was demonstrated which showed that the glucose concentration level is uniformly bounded above and below. To investigate how to prevent hyperinsulinemia and hyperglycemia being caused by this system, we developed a model involving periodic intakes of glucose with insulin injections applied only when the blood glucose level reached a given critical glucose threshold. In addition, our numerical analysis revealed that the period, the frequency and the dose of glucose infusions and insulin injections are crucial for insulin therapies, and the results provide clinical strategies for insulin-administration practices.

  8. Study on toxicity of danshensu in beagle dogs after 3-month continuous intravenous infusion.

    Science.gov (United States)

    Li, Guisheng; Gao, Yonglin; Li, Shenjun; Li, Chunmei; Zhu, Xiaoyin; Li, Min; Liu, Zhifeng

    2009-09-01

    Danshensu (3-(3,4-dihydroxyphenyl) lactic acid), a natural phenolic acid, is isolated from root of Salvia miltiorrhiza, and is widely used as a traditional Chinese medicine for treatment of various cardiovascular diseases. In the present study, toxicity of danshensu was evaluated in male and female dogs after 3-month continuous intravenous infusion. Beagle dogs were treated with danshensu at doses of 17, 50, and 150 mg/kg/day, and observed for 90 days followed by recovery periods. Measurements included clinical observations, body weight, food consumption, temperature, electro-cardiography (EGC), hematology, blood chemistry, urinalysis, gross necropsy, organ weight, and histopathology. No significant adverse effects on these parameters were observed. The only treatment-related finding was a hard knot at injection site observed in the 150 mg/kg group after 2-3 weeks continuous administration, and returned to normal after 3-4 days withdrawal. From these results, it might be concluded that danshensu did not produce any significant cumulative toxicity at the doses administered, as reflected by the various parameters investigated. PMID:19778246

  9. Effect of intravenous infusion of glyceryl trinitrate on gastric and small intestinal motor function in healthy humans

    DEFF Research Database (Denmark)

    Madsen, Jan Lysgård; Fuglsang, Stefan; Graff, J

    2006-01-01

    : To examine the effect of intravenous infusion of glyceryl trinitrate on gastric and small intestinal motor function after a meal in healthy humans. METHODS: Nine healthy volunteers participated in a placebo-controlled, double-blind, crossover study. Each volunteer was examined during intravenous infusion...... of glyceryl trinitrate 1 microg/kg x min or saline. A gamma camera technique was used to measure gastric emptying and small intestinal transit after a 1600-kJ mixed liquid and solid meal. Furthermore, duodenal motility was assessed by manometry. RESULTS: Glyceryl trinitrate did not change gastric mean...... trinitrate 1 microg/kg x min does not induce major changes in gastric or small intestinal motor function after a 1600-kJ meal in healthy volunteers....

  10. Long-acting insulin analogues (insulin glargine or determir) and continuous subcutaneous insulin infusion in the treatment of type 1 diabetes mellitus in the paediatric population.

    Science.gov (United States)

    Barrio Castellanos, Raquel

    2005-12-01

    Despite many improvements in the treatment of type 1 diabetes mellitus (DM1), the non-physiological time-action profiles of conventional insulins remain a significant obstacle. In recent years, recombinant DNA technology has been used to design insulin molecules that overcome the limitations of regular and NPH insulin. The rapid insulin analogs used as prandial and the long-acting insulin analogs used as basal simulate physiological insulin profiles more closely than the older conventional insulins. The efficacy of insulin analogs now available for multiple daily injection (MDI) and continuous subcutaneous insulin infusion (CSII) therapy in DM1 has been established in pediatric patients. Insulin pumps have improved since they were first introduced. CSII therapy may provide an effective alternative for selected pediatric patients with DM1. In most studies at pediatric age, CSII therapy resulted in a improvement in HbA1c, a decreased rate of hypoglycemia without an abnormal increase in BMI, and without adversely affecting psychosocial outcomes in children and adolescents with DM1. PMID:16398447

  11. Significant air embolism: A possibility even with collapsible intravenous fluid containers when used with rapid infuser system

    Directory of Open Access Journals (Sweden)

    Deepanjali Pant

    2010-01-01

    Full Text Available Significant venous air embolism may develop acutely during the perioperative period due to a number of causes such as during head and neck surgery, spinal surgery, improper central venous and haemodialysis catheter handling, etc. The current trend of using self collapsible intravenous (IV infusion bags instead of the conventional glass or plastic bottles has several advantages, one of thaem being protection against air embolism. We present a 56-year-old man undergoing kidney transplantation, who developed a near fatal venous air embolism during volume resuscitation with normal saline in collapsible IV bags used with rapid infuser system. To our knowledge, this problem with collapsible infusion bags has not been reported earlier.

  12. Optimal timing of neutron irradiation for boron neutron capture therapy after intravenous infusion of sodium borocaptate in patients with glioblastoma

    International Nuclear Information System (INIS)

    Purpose: A cooperative study in Europe and Japan was conducted to determine the pharmacokinetics and boron uptake of sodium borocaptate (BSH: Na2B12H11SH), which has been introduced clinically as a boron carrier for boron neutron capture therapy in patients with glioblastoma. Methods and Materials: Data from 56 patients with glioblastoma who received BSH intravenous infusion were retrospectively reviewed. The pharmacokinetics were evaluated in 50 patients, and boron uptake was investigated in 47 patients. Patients received BSH doses between 12 and 100 mg/kg of body weight. For the evaluation, the infused boron dose was scaled linearly to 100 mg/kg BSH. Results: In BSH pharmacokinetics, the average value for total body clearance, distribution volume of steady state, and mean residence time was 3.6±1.5 L/h, 223.3±160.7 L, and 68.0±52.5 h, respectively. The average values of the boron concentration in tumor adjusted to 100 mg/kg BSH, the boron concentration in blood adjusted to 100 mg/kg BSH, and the tumor/blood boron concentration ratio were 37.1±35.8 ppm, 35.2±41.8 ppm, and 1.53±1.43, respectively. A good correlation was found between the logarithmic value of Tadj and the interval from BSH infusion to tumor tissue sampling. About 12-19 h after infusion, the actual values for Tadj and tumor/blood boron concentration ratio were 46.2±36.0 ppm and 1.70±1.06, respectively. The dose ratio between tumor and healthy tissue peaked in the same interval. Conclusion: For boron neutron capture therapy using BSH administered by intravenous infusion, this work confirms that neutron irradiation is optimal around 12-19 h after the infusion is started

  13. Rapid Reduction of Severely Elevated Serum Triglycerides with Insulin Infusion, Gemfibrozil and Niacin

    OpenAIRE

    Poonuru, Sujani; Pathak, Sumedha R.; Vats, Hemender S.; Pathak, Ram D.

    2011-01-01

    The conventional methods of treatment of severe hypertriglyceridemia are dietary restriction and lipid lowering medications, mainly fibric acid derivatives. In the medical literature, use of insulin infusion to treat hypertriglyceridemia has not been highlighted sufficiently. We report a 53-year-old male who presented with a four-day history of epigastric pain. The patient’s clinical history was significant for hypertriglyceridemia, type-2 diabetes mellitus with medication noncompliance, obes...

  14. Bioavailability and bioactivity of intravenous vs subcutaneous infusion of growth hormone in GH-deficient patients

    DEFF Research Database (Denmark)

    Laursen, Torben; Møller, Jens; Ørskov, Hans;

    1996-01-01

    of the present study was to evaluate the short-term metabolic effects of GH following i.v. and s.c. delivery. DESIGN AND MEASUREMENTS: In a cross-over design 10 GH-deficient patients were randomized to receive GH (0.03 microgram (0.1 mU/kg/min) as a continuous i.v. or s.c. infusion for 39 hours on two different...... by RIA following both s.c. (P infusion (P infusion (P infusion [159.5 +/- 21.8 (s.c.), 185.2 +/- 27.7 (i.v.), P = 0.......001), and a higher ratio was obtained following i.v. infusion (P infusion resulted in significantly lower mean levels of serum NEFA (P

  15. Intravenous labetolol in treating hypertensive crisis following dexmedetomidine infusion for procedural sedation.

    Science.gov (United States)

    Muthiah, Thilaka; Moni, Amarnath; Mathews, Lailu; Balaji, Sudarshan

    2016-03-01

    Dexmedetomidine is widely used for procedural sedation because of its unique combination of sedation, analgesia, and anxiolysis with minimal respiratory depression. Transient hypertension has been reported during the use of dexmedetomidine which is usually benign and is taken over by the hypotensive response on continuing the infusion. We report a case of hypertensive crisis following dexmedetomidine infusion used for procedural sedation, necessitating discontinuation of the infusion and treatment of hypertension. The dilemmas involved in treating hypertension caused by dexmedetomidine are discussed. PMID:26897444

  16. Intravenous labetolol in treating hypertensive crisis following dexmedetomidine infusion for procedural sedation.

    Science.gov (United States)

    Muthiah, Thilaka; Moni, Amarnath; Mathews, Lailu; Balaji, Sudarshan

    2016-03-01

    Dexmedetomidine is widely used for procedural sedation because of its unique combination of sedation, analgesia, and anxiolysis with minimal respiratory depression. Transient hypertension has been reported during the use of dexmedetomidine which is usually benign and is taken over by the hypotensive response on continuing the infusion. We report a case of hypertensive crisis following dexmedetomidine infusion used for procedural sedation, necessitating discontinuation of the infusion and treatment of hypertension. The dilemmas involved in treating hypertension caused by dexmedetomidine are discussed.

  17. Euglycemic Infusion of Insulin Detemir Compared With Human Insulin Appears to Increase Direct Current Brain Potential Response and Reduces Food Intake While Inducing Similar Systemic Effects

    Science.gov (United States)

    Hallschmid, Manfred; Jauch-Chara, Kamila; Korn, Oliver; Mölle, Matthias; Rasch, Björn; Born, Jan; Schultes, Bernd; Kern, Werner

    2010-01-01

    OBJECTIVE In the treatment of diabetic patients, the long-acting insulin analog insulin detemir is less prone to induce weight gain than other insulin formulations. Assuming that because of its pharmacologic properties, detemir displays stronger central nervous anorexigenic efficacy than human insulin, we compared acute effects of human insulin and detemir on electroencephalography (EEG) measures and food intake. RESEARCH DESIGN AND METHODS Frontocortical EEG direct current (DC) potentials were recorded in 15 healthy men during two hyperinsulinemic-euglycemic clamps that included an insulin bolus injection (human insulin, 17.75 mU/kg body wt; detemir, 90 mU/kg body wt) followed by a steady 90-min infusion (1.0 vs. 2.0 mU · kg−1 · min−1). A higher dosage was chosen for detemir to compensate for its delay in impact relative to human insulin and to elicit similar systemic effects. At 20 min after infusion, subjects were allowed to eat ad libitum from a test buffet. RESULTS Mean glucose infusions to maintain euglycemia (P > 0.93) and blood glucose concentrations (P > 0.34) did not differ between conditions. Detemir infusion induced a negative DC-potential shift, averaging −372.2 μV from 21 to 90 min that was not observed during human insulin infusion (146.5 μV, P = 0.02). Detemir, in comparison with human insulin, reduced subsequent food intake by 303 kcal (1,257 vs. 1,560, P < 0.04). CONCLUSIONS While inducing comparable peripheral effects, detemir exerts stronger acute effects on brain functions than human insulin and triggers a relative decrease in food consumption, suggesting an enhanced anorexigenic impact of detemir compared with human insulin on central nervous networks that control nutrient uptake. PMID:20068139

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

    Directory of Open Access Journals (Sweden)

    Masaru Arima

    2014-03-01

    Full Text Available 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-β 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.

  19. Insulin levels after portal and systemic insulin infusion differ in a dose-dependent fashion

    NARCIS (Netherlands)

    de Vos, P.; de Haan, Bart; Vegter, D.; Hillebrands, J.L.; Strubbe, J.H.; Bruggink, Jan; Schilfgaarde, R. van

    1998-01-01

    The role of the liver in the regulation of systemic insulin levels is not well understood. The reported extraction rates vary between 0 to 85%, and extraction of a constant fraction of 50% of the portally delivered insulin is generally assumed. In the present study, we have investigated the role of

  20. Non-return valves do not prevent backflow and bacterial contamination of intravenous infusions

    NARCIS (Netherlands)

    Ellger, B.; Kiski, D.; Diem, E.; van den Heuvel, I.; Freise, H.; Van Aken, H.; Hinder, F.; Friedrich, A. W.

    2011-01-01

    Non-return valves (NRVs) are designed to avoid backflow of infusion fluid against the designated direction of flow (DDF) when more than one infusion is delivered via one venous access. We tested in vitro whether NRVs reliably prevent flow against the DDF at clinically relevant low flow rates. Since

  1. Effects of large volume, ice-cold intravenous fluid infusion on respiratory function in cardiac arrest survivors.

    Science.gov (United States)

    Jacobshagen, Claudius; Pax, Anja; Unsöld, Bernhard W; Seidler, Tim; Schmidt-Schweda, Stephan; Hasenfuss, Gerd; Maier, Lars S

    2009-11-01

    International guidelines for cardiopulmonary resuscitation recommend mild hypothermia (32-34 degrees C) for 12-24h in comatose survivors of cardiac arrest. To induce therapeutic hypothermia a variety of external and intravascular cooling devices are available. A cheap and effective method for inducing hypothermia is the infusion of large volume, ice-cold intravenous fluid. There are concerns regarding the effects of rapid infusion of large volumes of fluid on respiratory function in cardiac arrest survivors. We have retrospectively studied the effects of high volume cold fluid infusion on respiratory function in 52 resuscitated cardiac arrest patients. The target temperature of 32-34 degrees C was achieved after 4.1+/-0.5h (cooling rate 0.48 degrees C/h). During this period 3427+/-210 mL ice-cold fluid was infused. Despite significantly reduced LV-function (EF 35.8+/-2.2%) the respiratory status of these patients did not deteriorate significantly. On intensive care unit admission the mean PaO(2) was 231.4+/-20.6 mmHg at a F(i)O(2) of 0.82+/-0.03 (PaO(2)/F(i)O(2)=290.0+/-24.1) and a PEEP level of 7.14+/-0.31 mbar. Until reaching the target temperature of fluid is an effective and inexpensive method for inducing therapeutic hypothermia. Resuscitation from cardiac arrest is associated with a deterioration in respiratory function. The infusion of large volumes of cold fluid does not cause a statistically significant further deterioration in respiratory function. A larger, randomized and prospective study is required to assess the efficacy and safety of ice-cold fluid infusion for the induction of therapeutic hypothermia. PMID:19674825

  2. Pharmacokinetic profile of cefbuperazone in healthy Chinese volunteers after single and multiple drip intravenous infusion by HPLC-MS/MS.

    Science.gov (United States)

    Liu, Dongbo; Geng, Taohua; Wang, Yiya; Ding, Li

    2016-09-10

    A selective and reproducible HPLC-MS/MS method was developed and fully validated for the determination of cefbuperazone in human plasma and urine. Samples were prepared using protein precipitation and separated on a Zorbax Eclipse Plus C18 column (2.1×50mm, 3.5μm). The API-4000 mass spectrometer was operated under multiple reaction monitoring mode (MRM) using the electrospray ionization technique. Linearity was achieved from 0.250 to 250μg/mL in plasma and 20.0-5000μg/mL in urine. The method was successfully applied to a pharmacokinetic study of cefbuperazone in healthy Chinese volunteers after drip intravenous infusion of 0.5, 1.0, 2.0g cefbuperazone sodium injection. Cefbuperazone reached a maximum concentration (Cmax) of 44.7±8.1μg/mL, 86.7±12.7μg/mL and 168±14μg/mL in 0.5, 1.0 and 2.0g dose groups respectively, at 60min after the start of infusion. The half-life (t1/2) was between 1.8-1.9h, and the elimination constant (kel) was between 0.36-0.39h(-1). The results proved that cefbuperazone showed linear pharmacokinetic profile in the dose range of 0.5-2.0g without gender difference. Drug accumulation was not observed. Cefbuperazone reached the maximum excretion rate in urine 2h after the start of infusion. About 60.0% of the administered drug was excreted via urine as unchanged form within 12h. The cumulative excretion of cefbuperazone after single drip intravenous infusion was proportional to the administered dose within the range from 0.5g to 2.0g. PMID:27394175

  3. Performance and acceptability of a combined device for insulin infusion and glucose sensing in the home setting

    DEFF Research Database (Denmark)

    Nørgaard, K.; Shin, J.; Welsh, J. B.;

    2015-01-01

    connected to insulin pumps over 15 days (3 days/device) and test capillary blood glucose (SMBG) 7 times/day. The primary endpoint was the percentage of sensor-SMBG paired values within 20% of one another. Subject experiences were assessed via questionnaires. Overall, 74.8% of sensor-SMBG paired values were......The use of sensor-augmented insulin pump (SAP) therapy is increasing. Currently, glucose sensors and insulin infusion cannulas are inserted separately. A new device, MiniMed Duo, combines sensing and infusion capabilities on the same platform and is intended to simplify device insertion and site...

  4. 静脉输液安全通路选择的管理方法与效果%The effect and management of safe intravenous infusion access

    Institute of Scientific and Technical Information of China (English)

    姚晖; 朱建英

    2012-01-01

    目的:通过对静脉输液通路选择进行管理,降低输液相关并发症的发生,提高患者满意度.方法:建立静脉输液安全管理委员会,制定完善的输液管理制度,在全院范围内建立静脉输液传报网络体系,将输液相关并发症降至最低.结果:静脉炎发生率由24.0%降至2.1%(P<0.005);静脉输液外渗发生率由20.0%降至7.3% (P< 0.005).结论静脉输液安全通路选择的管理将输液的危险因素即选用错误途径给药控制在输液治疗活动前,降低了输液的风险,是值得推荐的有效办法.%Objective: To decrease the rate of complications and improve the satisfaction of patients by managing the safe intravenous infusion access. Methods: Set up intravenous infusion safety management committee, optimized management system, build intravenous infusion reporting system network in hospital-wide, and integrated the intravenous infusion safety into the overall nursing quality assessment system. Results: The incidence of phlebitis decreased from 24.0% to 2.1% (P<0.01); the incidence of venous leakage decreased from 20.0% to 7.3% (P<0.005). Conclusion: The management of safe intravenous infusion access can control the risk factors before implementation of the infusion and greatly reduce the risk of intravenous infusion.

  5. Effect of intravenous infusion of iodinated contrast media on the coronary blood flow in dogs

    OpenAIRE

    Abd, Thura T; Asim I. Shafique; Hayder S. Yasir; Jung-Hee Seo; George, Richard T.; Rajat Mittal; Lardo, Albert C.

    2016-01-01

    Background: Coronary computed tomography angiography (CCTA) is obtained using peripheral intravenous iodinated contrast agents (ICA) injection. There is continuing attempts to derive coronary physiological information like coronary blood flow (CBF) and/or fractional flow reserve from CCTA images. However, no data is available regarding the effect of peripheral intravenous injection of ICA on CBF. Methods: A series of 4 experiments was performed using healthy mongrel dogs. All dogs underwen...

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

    Science.gov (United States)

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

    2014-02-01

    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 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.

  7. A Model for the Application of Target-Controlled Intravenous Infusion for a Prolonged Immersive DMT Psychedelic Experience.

    Science.gov (United States)

    Gallimore, Andrew R; Strassman, Rick J

    2016-01-01

    The state of consciousness induced by N,N-dimethyltryptamine (DMT) is one of the most extraordinary of any naturally-occurring psychedelic substance. Users consistently report the complete replacement of normal subjective experience with a novel "alternate universe," often densely populated with a variety of strange objects and other highly complex visual content, including what appear to be sentient "beings." The phenomenology of the DMT state is of great interest to psychology and calls for rigorous academic enquiry. The extremely short duration of DMT effects-less than 20 min-militates against single dose administration as the ideal model for such enquiry. Using pharmacokinetic modeling and DMT blood sampling data, we demonstrate that the unique pharmacological characteristics of DMT, which also include a rapid onset and lack of acute tolerance to its subjective effects, make it amenable to administration by target-controlled intravenous infusion. This is a technology developed to maintain a stable brain concentration of anesthetic drugs during surgery. Simulations of our model demonstrate that this approach will allow research subjects to be induced into a stable and prolonged DMT experience, making it possible to carefully observe its psychological contents, and provide more extensive accounts for subsequent analyses. This model would also be valuable in performing functional neuroimaging, where subjects are required to remain under the influence of the drug for extended periods. Finally, target-controlled intravenous infusion of DMT may aid the development of unique psychotherapeutic applications of this psychedelic agent.

  8. A Model for the Application of Target-Controlled Intravenous Infusion for a Prolonged Immersive DMT Psychedelic Experience.

    Science.gov (United States)

    Gallimore, Andrew R; Strassman, Rick J

    2016-01-01

    The state of consciousness induced by N,N-dimethyltryptamine (DMT) is one of the most extraordinary of any naturally-occurring psychedelic substance. Users consistently report the complete replacement of normal subjective experience with a novel "alternate universe," often densely populated with a variety of strange objects and other highly complex visual content, including what appear to be sentient "beings." The phenomenology of the DMT state is of great interest to psychology and calls for rigorous academic enquiry. The extremely short duration of DMT effects-less than 20 min-militates against single dose administration as the ideal model for such enquiry. Using pharmacokinetic modeling and DMT blood sampling data, we demonstrate that the unique pharmacological characteristics of DMT, which also include a rapid onset and lack of acute tolerance to its subjective effects, make it amenable to administration by target-controlled intravenous infusion. This is a technology developed to maintain a stable brain concentration of anesthetic drugs during surgery. Simulations of our model demonstrate that this approach will allow research subjects to be induced into a stable and prolonged DMT experience, making it possible to carefully observe its psychological contents, and provide more extensive accounts for subsequent analyses. This model would also be valuable in performing functional neuroimaging, where subjects are required to remain under the influence of the drug for extended periods. Finally, target-controlled intravenous infusion of DMT may aid the development of unique psychotherapeutic applications of this psychedelic agent. PMID:27471468

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

    Directory of Open Access Journals (Sweden)

    Garrido A.G.

    2005-01-01

    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.

  10. Continuous intravenous infusion of ampicillin and gentamicin during parenteral nutrition in 88 newborn infants

    DEFF Research Database (Denmark)

    Colding, H; Møller, S; Andersen, G E

    1982-01-01

    Ampicillin and gentamicin were dissolved once a day in an L-amino acid solution especially prepared for parenteral nutrition of newborn infants and infused continuously to 88 infants in whom septicaemia was suspected or had been proved. The mean dosages were 162 and 5.3 mg/kg per 24 hours...

  11. Cardiorespiratory effects of intravenous bolus administration and infusion of ketamine-midazolam in dogs.

    Science.gov (United States)

    Jacobson, J D; Hartsfield, S M

    1993-10-01

    Twelve healthy dogs were used to determine the cardiorespiratory effects of i.v. administered ketamine (10 mg/kg of body weight) and midazolam (0.5 mg/kg). Half the dogs received a ketamine-midazolam combination (K-M) as a bolus over 30 seconds and the other half received the K-M as an infusion over 15 minutes. Induction of anesthesia by use of K-M was good in all dogs. Ketamine-midazolam combination as a bolus or infusion induced minimal cardiorespiratory effects, except for significant (P dogs of the infusion group. Mild and transient respiratory depression was observed in dogs of both groups immediately after administration of K-M, but was greater in dogs of the bolus group than in dogs of the infusion group. Duration of action of K-M for chemical restraint was short. Salivation and defecation were observed in a few dogs. Extreme muscular tone developed in 1 dog after K-M bolus administration. PMID:8250397

  12. Post-reconstitution Stability of Telavancin with Commonly Used Diluents and Intravenous Infusion Solutions

    Directory of Open Access Journals (Sweden)

    Zhengtian Gu, PhD

    2015-12-01

    Conclusions: These results are supportive of a total hold time for reconstituted telavancin in vials plus the time in IV infusion solutions in polyvinyl chloride bags to not exceed 12 hours under ambient conditions and 7 days under refrigeration.

  13. Modeling cerebral arteriovenous lactate kinetics after intravenous lactate infusion in the rat

    NARCIS (Netherlands)

    Leegsma-Vogt, G; van der Werf, T; Venema, K; Korf, J

    2004-01-01

    Venous-arterial lactate differences across the brain during lactate infusion in rats were studied, and the fate of lactate was described with a mathematical model that includes both cerebral and extracerebral kinetics. Ultrafiltration was used to sample continuously and simultaneously arterial and v

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

    Institute of Scientific and Technical Information of China (English)

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

    2008-01-01

    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 1h(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 3h(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.(C)2008 The W3G Press,All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    M. H. Bakhshaei

    2013-04-01

    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

  16. Renal response to intravenous somatostatin in insulin-dependent diabetic patients and normal subjects

    Energy Technology Data Exchange (ETDEWEB)

    Vora, J.; Owens, D.R.; Luzio, S.; Atiea, J.; Ryder, R.; Hayes, T.M.

    1987-05-01

    The acute effects of iv somatostatin (SRIH; 100 micrograms/h) on the urinary flow (Uvol), effective renal plasma flow (RPF), and glomerular filtration rate (GFR) were compared with those of a control infusion of 0.15 M NaCl in nine insulin-dependent diabetic (IDD) patients of less than 10 yr disease duration and six normal subjects (NS). RPF and GFR were measured using a standard primed constant isotope infusion of (/sup 125/I)iodohippurate and (51Cr)chromium EDTA. Uvol, RPF, and GFR were measured during 20-min clearance periods. During the NaCl infusion mean Uvol, RPF, and GFR were 14.1 +/- 0.2 (+/- SEM), 708 +/- 4, and 150 +/- 1 mL/min in the IDD group and 12.7 +/- 0.4, 568 +/- 5, and 110 +/- 2 mL/min in the NS group, respectively. In the IDD patients Uvol, RPF, and GFR decreased from 16.6 +/- 1.8, 670 +/- 30, 146 +/- 4 mL/min pre-SRIH to 9.2 +/- 1, 553 +/- 25 (P less than 0.001), and 130 +/- 5 mL/min, respectively, at 120 min during the SRIH infusion. Similarly, in the NS group mean Uvol, RPF, and GFR were 14.2 +/- 0.6, 552 +/- 15, and 112 +/- 5 mL/min pre-SRIH and decreased to 7.4 +/- 0.6, 422 +/- 7, and 93 +/- 3 mL/min, respectively, after 120 min of the SRIH infusion. SRIH, therefore, had a profound effect on renal function in both IDD patients and NS, resulting in a reduction in RPF, GFR, and, as a consequence, Uvol.

  17. Effect of hepatic glucose production on acute insulin resistance induced by lipid-infusion in awake rats

    Institute of Scientific and Technical Information of China (English)

    Ling Li; Gang-Yi Yang

    2004-01-01

    AIM: To explore the influence of hepatic glucose production on acute insulin resistance induced by a lipid infusion in awake rats.METHODS: A hyperinsulinaemic-euglycaemic clamp was established in awake chronically catheterized rats. Two groups of rats were studied either with a 4-h intraarterial infusion of lipid/heparin or saline. Insulin-mediated peripheral and hepatic glucose metabolism was assessed by hyperinsulinaemiceuglycaemic clamp combined with [3-3H]-glucose infusion.RESULTS: During hyperinsulinaemic-euglycaemic clamp,there was a significant increase in plasma free fatty acid (FFA, from 741.9±50.6 to 2346.4±238.5 μmol/L, P<0.01) in lipid-infused group. The glucose infusion rates (GIR) in the lipid infusion rats, compared to control rats, were significantly reduced (200-240 min average: lipid infusion; 12.6±1.5 vs control; 34.0±1.6 mg/kg.min, P<0.01), declining to - 35%of the corresponding control values during the last time of the clamp (240 min: lipid infusion; 12.0±1.9 vs control;34.7±1.7 mg/kg.min, P<0.0001). At the end of clamp study,the hepatic glucose production (HGP) in control rats was significantly suppressed (88%) from 19.0±4.5 (basal) to 2.3±0.9 mg/kg.min (P<0.01). The suppressive effect of insulin on HGP was significantly blunted in the lipid-infused (P<0.05). The rate of glucose disappearance (GRd) was a slight decrease in the lipid-infused rats compared with controls during the clamp.CONCLUSION: These data suggest that lipid infusion could induces suppression of hepatic glucose production, impairs the abilities of insulin to suppress lipolysis and mediate glucose utilization in peripheral tissue. Therefore, we conclude that lipid-infusion induces an acute insulin resistance in vivo.

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

    Science.gov (United States)

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

    2014-05-01

    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 (PPARα) 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 β-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

  19. Continuous intravenous flumazenil infusion in a patient with chlordiazepoxide toxicity and hepatic encephalopathy

    Directory of Open Access Journals (Sweden)

    Moh′d Al-Halawani

    2015-01-01

    Full Text Available Flumazenil, a benzodiazepine receptor antagonist, is the drug of choice for the diagnosis and treatment of benzodiazepine overdose. We are presenting a patient with chronic alcoholism and alcoholic liver disease, who came with alcohol withdrawal symptoms and treated chlordiazepoxide. Subsequently he developed a prolonged change in mental status that required treatment for benzodiazepine overdose and hepatic encephalopathy with flumazenil infusion for 28 days.

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

    OpenAIRE

    Barton, N W; Furbish, F S; Murray, G. J.; Garfield, M; Brady, R O

    1990-01-01

    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. We report here that weekly i.v. infusions of a macrophage-targeted preparation of human placental glucocer...

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

    OpenAIRE

    Gray, R S; Cowan, P.; Di Mario, U.; Elton, R A; Clarke, B F; Duncan, L J

    1985-01-01

    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...

  2. Serum lipase activity and concentration during intravenous infusions of GLP-1 and PYY3-36 and after ad libitum meal ingestion in overweight men

    DEFF Research Database (Denmark)

    Schmidt, Julie Berg; Sjödin, Anders Mikael; Stevner, Lene Susanne;

    2016-01-01

    To examine the effect on serum lipase activity and protein concentration of intravenous infusions of glucagon-like peptide-1 (GLP-1) and peptide YY (PYY3-36) and of an ad libitum meal in healthy overweight men. Twenty-five healthy, male subjects participated in this randomized, double...... the infusion and after intake of an ad libitum meal for measurement of serum lipase. Serum lipase levels measured by enzyme-linked immunosorbent assay (ELISA) following mono-infusions of GLP-1 and PYY3-36 were comparable to serum lipase levels following placebo (P = 0.054 and P = 0.873, respectively...

  3. 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)

    Storgaard, Heidi; Jensen, Christine B; Vaag, Allan A;

    2003-01-01

    - 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...

  4. Detection of coronary heart disease with 99Tcm-MIBI myocardial perfusion imaging stressed by intravenous infusion of higenamine hydrochloride

    International Nuclear Information System (INIS)

    Objective: To investigate the role of 99Tcm-MIBI MPI stressed by intravenous infusion of higenamine hydrochloride (HG) in detection of coronary heart disease (CHD). Methods: Sixty-two patients with suspected CHD underwent both 99Tcm-MIBI MPI with HG infusion and CAG. CAG was used as the gold standard in diagnosing CHD. The diagnostic sensitivity, specificity, accuracy, positive predictive value and negative predictive value of HG stress studies were evaluated with 99Tcm-MIBI MPI. Results: Using stenosis of the main branch or the first branch with more than 50% stenosis as the diagnostic criteria, 38 patients (61.3%) showed abnormal CAG results, including 24 one-, 9 two-, and 5 three-vessel stenoses. Of the 38 patients (38.7%) with abnormal CAG results, positive results in HG MPI studies were demonstrated in 22 patients. Negative results in HG MPI studies were confirmed in 22 patients among the 24 patients with normal CAG results. For detection of CHD, the diagnostic sensitivity, specificity, accuracy, positive predictive value and negative predictive value of 99Tcm-MIBI MPI with HG infusion were calculated as 57.9% (22/38), 91.7% (22/24), 71.0% (44/62), 91.7% (22/24) and 57.9% (22/38), respectively. Twenty-two patients (35.5%) had side effects during HG stress studies, but no effects were severe. All patients recovered soon after examination. Conclusion: An HG stress study is feasible and safe, and it is a potential method in detection of CHD with 99Tcm-MIBI MPI. (authors)

  5. Blood glucose control in healthy subject and patients receiving intravenous glucose infusion or total parenteral nutrition using glucagon-like peptide 1

    DEFF Research Database (Denmark)

    Nauck, Michael A; Walberg, Jörg; Vethacke, Arndt;

    2004-01-01

    It was the aim of the study to examine whether the insulinotropic gut hormone GLP-1 is able to control or even normalise glycaemia in healthy subjects receiving intravenous glucose infusions and in severely ill patients hyperglycaemic during total parenteral nutrition....

  6. Twenty-four hours of insulin infusion does not lower plasma lipoprotein(a) in healthy men

    NARCIS (Netherlands)

    Riemens, SC; Dullaart, RPF

    2000-01-01

    The effect of 24-h exogenous hyperinsulinaemia on the plasma level of the atherogenic lipoprotein(a) (Lp(a)) is unknown. We evaluated the responses of plasma cholesterol, triglycerides, apolipoprotein (apo) B and Lp(a) during 24-h insulin infusion (180 pmol/kg/h) in 6 healthy men. Plasma total chole

  7. Cardiopulmonary effects of an intravenous infusion of guaifenesin, ketamine, and xylazine in dogs.

    Science.gov (United States)

    Benson, G J; Thurmon, J C; Tranquilli, W J; Smith, C W

    1985-09-01

    A 5% solution of dextrose in water containing 50 mg of guaifenesin, 0.25 mg of xylazine, and 1 mg of ketamine/ml was infused IV at the rate of 2.2 ml X kg-1 X hour-1 in dogs. Heart rate, systemic vascular resistance, mean arterial blood pressure, rate-pressure product, and arterial oxygen tension were not altered significantly from baseline values during 2 hours of anesthesia. Cardiac index was significantly (P less than 0.05) decreased from base-line values. Hypoventilation resulted in increased arterial carbon dioxide tension and decreased arterial pH. After the dogs were given glycopyrrolate, cardiac index returned to base line, and heart rate, mean arterial pressure, and rate-pressure product were significantly greater (P less than 0.05) than base-line values. PMID:3931517

  8. 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

  9. Long-term safety, efficacy and side-effects of continuous subcutaneous insulin infusion treatment for type 1 (insulin-dependent) diabetes mellitus: a one centre experience.

    Science.gov (United States)

    Chantelau, E; Spraul, M; Mühlhauser, I; Gause, R; Berger, M

    1989-07-01

    A follow-up study of 116 Type 1 (insulin-dependent) diabetic patients on long-term continuous subcutaneous insulin infusion was conducted after 4.5 +/- 0.2 years. The average HbA1c-value of these patients decreased by 1% to 6.7 +/- 0.1% during this observation period. Typical side effects of continuous subcutaneous insulin infusion such as skin inflammation at the catheter insertion site occurred with similar frequency as has been reported previously by other authors. Diabetic ketoacidosis (0.14 per patient year) and disabling hypoglycaemia (0.1 per patient year, including 0.05 hypoglycaemic coma per patient-year) occurred at substantially lower rates than in other comparable studies with Type 1 diabetic patients at a similar degree of metabolic control. Subgroup evaluation suggested that a normal (less than 5.6%) HbA1c-value at follow-up was associated with increased incidence of disabling hypoglycaemia, whereas poor metabolic control (HbA1c greater than 7.5%) was associated with increased rates of skin complications and hospital treatment for ketoacidosis. Thus, under the policies of this diabetes centre, continuous subcutaneous insulin infusion has proved to be beneficial to a large proportion of experienced adult Type 1 diabetic patients, who voluntarily had opted for, and continued with, this particular mode of insulin treatment.

  10. Stability studies of lincomycin hydrochloride in aqueous solution and intravenous infusion fluids

    Directory of Open Access Journals (Sweden)

    Czarniak P

    2016-03-01

    Full Text Available Petra Czarniak, Michael Boddy, Bruce Sunderland, Jeff D Hughes School of Pharmacy, Curtin University, Perth, WA, Australia Purpose: The purpose of this study was to evaluate the chemical stability of Lincocin® (lincomycin hydrochloride in commonly used intravenous fluids at room temperature (25°C, at accelerated-degradation temperatures and in selected buffer solutions.Materials and methods: The stability of Lincocin® injection (containing lincomycin 600 mg/2 mL as the hydrochloride stored at 25°C±0.1°C in sodium lactate (Hartmann’s, 0.9% sodium chloride, 5% glucose, and 10% glucose solutions was investigated over 31 days. Forced degradation of Lincocin® in hydrochloric acid, sodium hydroxide, and hydrogen peroxide was performed at 60°C. The effect of pH on the degradation rate of lincomycin hydrochloride stored at 80°C was determined.Results: Lincomycin hydrochloride was found to maintain its shelf life at 25°C in sodium lactate (Hartmann’s solution, 0.9% sodium chloride solution, 5% glucose solution, and 10% glucose solution, with less than 5% lincomycin degradation occurring in all intravenous solutions over a 31-day period. Lincomycin hydrochloride showed less rapid degradation at 60°C in acid than in basic solution, but degraded rapidly in hydrogen peroxide. At all pH values tested, lincomycin followed first-order kinetics. It had the greatest stability near pH 4 when stored at 80°C (calculated shelf life of 4.59 days, and was least stable at pH 2 (calculated shelf life of 0.38 days.Conclusion: Lincocin® injection was chemically found to have a shelf life of at least 31 days at 25°C when added to sodium lactate (Hartmann’s solution, 0.9% sodium chloride solution, 5% glucose solution, and 10% glucose solution. Solutions prepared at approximately pH 4 are likely to have optimum stability. Keywords: lincomycin, stability, pH, intravenous fluids, IV additives

  11. The effect of glucagon infusion on kidney function in short-term insulin-dependent juvenile diabetics

    DEFF Research Database (Denmark)

    Parving, H H; Christiansen, J S; Noer, I;

    1980-01-01

    Kidney function was studied in nine, metabolically well controlled, short-term insulin-dependent male diabetics before and during glucagon infusion of 4 to 5 and 8 to 10 ng/kg/min. Glomerular filtration rate, effective renal plasma flow (steady-state infusion technique, with urinary collections......, using 125I-iothalamate and 131I-iodohippurate), and urinary albumin and beta 2-microglobulin excretion rates were measured. The mean plasma glucagon concentration increased during infusion from 254 +/- 19 pg/ml to 440 +/- 31 pg/ml (low dose) and 730 +/- 52 pg/ml (high dose). Glomerular filtration rate...... increased in all subjects from 133 +/- 5 before the glucagon infusion to 141 +/- 4 with the low dose, and 148 +/- 7 ml/min/1.73 m2 with the high dose (p

  12. Intravenous tissue plasminogen activator in patients with stroke increases the bioavailability of insulin-like growth factor-1

    NARCIS (Netherlands)

    Wilczak, Nadine; Elting, Jan Willem; Chesik, Daniel; Kema, Ido P.; De Keyser, Jacques

    2006-01-01

    Background and Purpose-Insulin-like growth factor (IGF)-1 has potent neuroprotective properties. We investigated the effects of intravenous administration of tissue plasminogen activator (tPA) on serum levels of IGF-1 and IGF-binding protein (IGFBP)-3 in patients with acute ischemic stroke. Methods-

  13. Postoperative analgesia in children: a prospective study in intermittent intramuscular injection versus continuous intravenous infusion of morphine.

    Science.gov (United States)

    Hendrickson, M; Myre, L; Johnson, D G; Matlak, M E; Black, R E; Sullivan, J J

    1990-02-01

    Few advancements in postoperative pain control in children have been made despite longstanding inadequacies in conventional intramuscular analgesic regimens. While overestimating narcotic complication rates, physicians often underestimate efficacious doses, nurses are reluctant to give injections, and many children in pain shy away from shots. This study prospectively focuses on the safety, efficacy, and complication rate of intermittent intramuscular (IM) versus continuous intravenous infusion (IV) of morphine sulfate (MS) in 46 nonventilated children following major chest, abdominal, or orthopedic surgical procedures. Twenty patients assigned to the IM group had a mean age of 6.17 years and a mean weight of 23.0 kg. Twenty-six patients assigned to the IV group had a mean age of 8.74 years and a mean weight of 27.4 kg. The mean IM MS dose was 12.3 micrograms/kg/h while the mean IV dose was 19.8 micrograms/kg/h (P less than .001). Postoperative pain was assessed with a linear analogue scale from 1 to 10 (1, "doesn't hurt"; 10, "worst hurt possible") for 3 days following operation. Using the analysis of covariance (ANACOVA), nurse, parent, and patient mean pain scores in the IV group were significantly lower than those of the IM group when controlled for age, MS dose, and complications (P less than .007). Nurse assessment of pain correlated well with the patient and parent assessments (Pearson correlation coefficients greater than 0.6). Not only did IV infusion give better pain relief than IM injections, but there were no major complications such as respiratory depression. Minor complications in this study (nausea, urinary retention, drowsiness, vomiting, hallucinations, lightheadedness, and prolonged ileus) were not significantly different between IM and IV groups.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:2303987

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

    Directory of Open Access Journals (Sweden)

    Kyu-Jin Chung

    2012-09-01

    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 μg/mL remifentanil simultaneously administered using two separate modulesof a continuous computer-assisted TCI system. The average target concentration was set at2 μg/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.

  15. Influence of an intravenous infusion of amino acids and glucose on the pancreatic exocrine in rats

    Institute of Scientific and Technical Information of China (English)

    FAN Bo-guang 范博广; (A。)ke Andrén-Sandberg

    2004-01-01

    Background A number of reports based on both animal experiments and clinical investigations have pointed out that total parenteral nutrition (TPN) suppresses the function of the exocrine pancreas. Even though pancreatic hypotrophy and dysfunction resulting from TPN may be explained by several mechanisms, the clinically most important cause is that nutrients in circulation affect pancreatic secretion. The effect of nutrients on the exocrine pancreas is still controversial. The aim of the present study was, therefore, to clarify the influence of intravenous amino acids and hypertonic glucose in TPN solution on the exocrine pancreas. Methods Three mixed TPN solutions, consisting of 30% or 50% glucose or of 14% amino acids, were employed. Twenty-four male Sprague-Dawley rats were randomly divided into four groups, six rats in each group, including a control group and one group receiving each of the three TPN solutions. All animals were killed after 10 days of TPN. Body weight, pancreatic content, and enzyme levels in the pancreas were measured. Results Compared with the control group, pancreatic wet weight was lower in all TPN groups. Glucose significantly decreased the content and concentration of pancreatic protein, but amino acids did not alter the concentration of protein. The level of amylase was lower in all parenterally fed groups, with a greater decrease in the groups treated with amino acids and 30% glucose than with 50% glucose. Trypsin levels in all groups receiving TPN were markedly higher than in the control group. Conclusion TPN results in atrophy of the pancreas, but trypsin levels increase with TPN treatment. Glucose elevates the amylase level in the pancreas, while amino acids suppress pancreatic amylase. Amino acids used as a source of protein maintain normal pancreatic protein levels.

  16. In silico evaluation of a control system and algorithm for automated insulin infusion in the ICU setting

    Directory of Open Access Journals (Sweden)

    Olmos Pablo R

    2010-07-01

    Full Text Available Abstract Background It is known that tight control of glucose in the Intensive Care Unit reduces morbidity and mortality not only in diabetic patients but also in those non-diabetics who become transiently hyperglycemic. Taking advantage of a recently marketed subcutaneous glucose sensor we designed an Automatic Insulin Infusion System (AIIS for inpatient treatment, and tested its stability under simulated clinical conditions. Methods The system included: reference glucose, glucose sensor, insulin and glucose infusion controllers and emergency infusion logic. We carried out computer simulations using Matlab/Simulink®, in both common and worst-case conditions. Results The system was capable of controlling glucose levels without entering in a phase of catastrophic instability, even under severe simulated challenges. Care was taken to include in all simulations the 5-10 minute delay of the subcutaneous glucose signal when compared to the real-time serum glucose signal, a well-known characteristic of all subcutaneous glucose sensors. Conclusions When tested in-Silico, a commercially available subcutaneous glucose sensor allowed the stable functioning of a proportional-derivative Automatic Insulin Infusion System, which was able to maintain glucose within acceptable limits when using a well-established glucose response model simulating a patient. Testing of the system in vivo using animal models is now warranted.

  17. Effect of perioperative insulin infusion on surgical morbidity and mortality: systematic review and meta-analysis of randomized trials.7

    DEFF Research Database (Denmark)

    Gandhi, G.Y.; Murad, M.H.; Flynn, D.N.;

    2008-01-01

    infusion vs 48/1476 patients in control group; relative risk, 2.07; 95% CI, 1.29-3.32; 99% CI, 1.09-3.88; I2, 31.5%; 95% CI, 0.0%-59.0%). No significant effect was seen in any other outcomes. The available mortality data represent only 40% of the optimal information size required to reliably detect a......, and Cochrane CENTRAL, from their inception up to May 1, 2006, and included RCTs of perioperative insulin infusion (with or without glucose targets) measuring outcomes in patients undergoing any surgery. Pairs of reviewers working independently assessed the methodological quality and characteristics of...

  18. Role of intravenous amino acid infusion in cases of oligohydramnios and its effect on amniotic fluid index and fetal weight gain

    OpenAIRE

    Pragya Shree; Nupur Mittal; Vaibhav Kanti; Sonia Vishwakarma

    2016-01-01

    Background: Oligohydramnios in early pregnancy is attended by serious consequences to the fetus. Various conditions associated with oligohydramnios increase perinatal mortality and morbidity. Different medical and interventional methods have been tried to treat oligohydramnios. The present study was done to study the effect of intravenous amino acid infusion on amniotic fluid index (A.F.I) and fetal weight gain. Methods: A total of 100 patients of oligohydramnios were studied. They were di...

  19. Continuous intravenous infusion of ATP in humans yields large expansions of erythrocyte ATP pools but extracellular ATP pools are elevated only at the start followed by rapid declines

    OpenAIRE

    Rapaport, Eliezer; Salikhova, Anna; Abraham, Edward H.

    2015-01-01

    The pharmacokinetics of adenosine 5′-triphosphate (ATP) was investigated in a clinical trial that included 15 patients with advanced malignancies (solid tumors). ATP was administered by continuous intravenous infusions of 8 h once weekly for 8 weeks. Three values of blood ATP levels were determined. These were total blood (erythrocyte) and blood plasma (extracellular) ATP pools along with the initial rate of release of ATP into the blood plasma. We found that values related to erythrocyte ATP...

  20. 静脉输液护理管理的理论与实践%Theory and Practice of Nursing Management on Intravenous Infusion

    Institute of Scientific and Technical Information of China (English)

    高波

    2015-01-01

    要保证静脉输液安全,必须强化静脉输液全过程的制度建设,分层次强化护理人员的系统培训,规范护理操作技术,强化静脉输液时护士的安全意识和自我保护意识,完善护理文书的书写和职业暴露防护措施,确保患者和护士的身心健康。%To ensure the safety of intravenous infusion, we must strengthen the institution building of the whole process of intravenous infusion and strengthen the systematic training of nurses at different levels and normalize nursing skills and strengthen safety awareness and self-protection awareness of nurses about intravenous infusion and perfect writing skills and protection measures of occupational exposure, to ensure physical and mental health of patients and nurses.

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

    International Nuclear Information System (INIS)

    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

  2. Diet liberalization and metabolic control in type I diabetic outpatients treated by continuous subcutaneous insulin infusion.

    Science.gov (United States)

    Chantelau, E; Sonnenberg, G E; Stanitzek-Schmidt, I; Best, F; Altenähr, H; Berger, M

    1982-01-01

    In 10 type I diabetic outpatients treated by continuous subcutaneous insulin infusion (CSII), dietary habits and metabolic control were investigated. Under conditions of a conventional diabetes diet (including 5-6 meals per day and a strictly planned meal intake) as well as under a "less restricted diabetes diet" (e.g., free choice of number, timing, and amount of carbohydrate intake) near normoglycemia could be achieved. Mean daily blood glucose levels did not change significantly when the patients' nutrition was alternated between both diets. During the "less restricted diabetes diet," the patients opted for a rather high fat intake (51 +/- 5% fat, 34 +/- 5% carbohydrate, and 15 +/- 2% protein). Despite this unintended dietary behavior, serum lipids and body weight remained normal after an observation period of 4-6 mo. It is concluded that during permanent near normoglycemia achieved by CSII a partial liberalization of the diabetes diet does not introduce any short-term or long-term metabolic risk factors for cardiovascular diseases.

  3. The Various Forms of Insulin Secretion Response to the Intravenous and Oral Administration of Glucose in Non-Insulin-Dependent Diabetes Mellitus

    International Nuclear Information System (INIS)

    On the basis of 68 observations on advanced diabetes mellitus (20 cases), latent diabetes with obesity (12 cases), chemical diabetes with subjective symptoms (26 cases) and 10 observations of obesity without diabetes, the authors have analysed the various forms of insulin secretion response to the intravenous and oral administration of glucose. The response appeared to be totally withdrawn in advanced diabetes mellitus although the patients were still capable of responding to stimulation with glucagon. In the two other forms of diabetes described, the response to stimulation by intravenous administration was less marked than in normal subjects. With oral administration, on the other hand, the response was greater, although the insulin secreted in this case appeared ineffective in cases of obesity but effective in conditions without obesity due to the hypoglycaemic effect. (author)

  4. Does pretreatment of bone marrow mesenchymal stem cells with 5-azacytidine or double intravenous infusion improve their therapeutic potential for dilated cardiomyopathy?

    Science.gov (United States)

    Yang, Sirui; Piao, Jinhua; Jin, Lianhua; Zhou, Yan

    2013-01-01

    Background This study was designed to investigate whether pretreatment of bone marrow mesenchymal stem cells (BMSCs) with 5-azacytidine (5-aza) or double intravenous infusion could enhance their therapeutic potential for dilated cardiomyopathy (DCM). Material/Methods BMSCs were cultured for 2 weeks in the presence or absence of 5-aza and DCM serum. The cultured BMSCs (Groups 1 and 2), 5-aza-induced BMSCs (Groups 3 and 4), and medium alone (model control) were transplanted into 80 female Wistar rats by intravenous tail vein injection. Double infusion of BMSCs with 1-day time-interval was carried out in Groups 2 and 4. Postmortem histological analysis and evaluation of heart function were performed at 4 weeks post-transplantation. Results Some transplanted BMSCs engrafted into myocardial tissue and were positive for cardiac marker troponin T. The hearts containing transplanted BMSCs secreted a larger amount of vascular endothelial growth factor. Cardiac function parameters and serum level of brain natriuretic peptide (BNP) did not differ among Groups 1, 3, and the model control. As compared with model control, BMSC transplantation in Groups 2 and 4 significantly decreased the serum level of BNP and improved cardiac contractile function, as evidenced by reduced left ventricular end-diastolic and end-systolic diameter, elevated ejection fraction, and fractional shortening. Conclusions BMSC transplantation is a promising strategy for the treatment of DCM. Pretreatment of BMSCs with 5-aza and DCM serum does not enhance their therapeutic efficacy, and the double intravenous BMSC infusion method is superior to single infusion for preserving cardiac contractile function in a rat model of DCM. PMID:23314418

  5. Interaction between plastic catheter tubings and regular insulin preparations used for continuous subcutaneous insulin-infusion therapy.

    Science.gov (United States)

    Chantelau, E; Lange, G; Gasthaus, M; Boxberger, M; Berger, M

    1987-01-01

    In search of possible interactions between plastic tubings used for insulin-pump treatment and commercial regular insulin preparations, various catheter sets made from polyvinyl chloride (PVC), polyethylene (PE), and nylon plastics were perfused at 30 degrees C in a laboratory setting for up to 72 h. The perfused insulin solutions were analyzed by high-performance liquid chromatography and atomic absorption spectroscopy. Although no plasticizer, e.g., dioctyl phthalate, or nickel or chromium ions were found in the perfusates, substantial interactions between the plastics and the insulin solutions were detected, extraction of bacteriostatic additives from the insulin solutions in particular. The PVC retained up to 88% of the bacteriostatics from the insulin preparations, whereas PE tubings retained only 10-15%. Whether the loss of preservatives during perfusion through PVC catheters predisposes to cutaneous infections during insulin-pump therapy remains to be shown.

  6. Effect of 4 years subcutaneous insulin infusion treatment on albuminuria, kidney function and HbA1c compared with multiple daily injections

    DEFF Research Database (Denmark)

    Vestergaard Rosenlund, Signe; Hansen, T W; Andersen, Steen;

    2015-01-01

    AIM: The effect of insulin pump [continuous subcutaneous insulin infusion (CSII)] treatment on diabetes complications in a modern clinical setting is largely unknown. We investigated the effect of 4 years CSII treatment on HbA1c, albuminuria and kidney function compared with multiple daily inject...

  7. Intracerebroventricular neuropeptide Y infusion precludes inhibition of glucose and VLDL production by insulin.

    NARCIS (Netherlands)

    Hoek, A.M. van den; Voshol, P.J.; Karnekamp, B.N.; Buijs, R.M.; Romijn, J.A.; Havekes, L.M.; Pijl, H.

    2004-01-01

    Recent evidence demonstrates that hypothalamic insulin signaling is required for inhibition of endogenous glucose production. The downstream mechanisms that are responsible for the effects of hypothalamic insulin receptor activation on hepatic fuel flux remain to be determined. To establish whether

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

    Directory of Open Access Journals (Sweden)

    Manish Ruhela

    2014-06-01

    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

  9. Effect of dietary nitrogen content and intravenous urea infusion on ruminal and portal-drained visceral extraction of arterial urea in lactating Holstein cows

    DEFF Research Database (Denmark)

    Kristensen, Niels Bastian; Storm, Adam Christian; Larsen, Mogens

    2010-01-01

    Urea extraction across ruminal and portal-drained visceral (PDV) tissues were investigated using 9 rumen-cannulated and multi-catheterized lactating dairy cows adapted to low-N (12.9% crude protein) and high-N (17.1% crude protein) diets in a crossover design. The interaction between adaptation...... to dietary treatments and blood plasma concentrations of urea was studied by dividing samplings into a 2.5-h period without urea infusion followed by a 2.5-h period with primed continuous intravenous infusion of urea (0.493 ± 0.012 mmol/kg of BW per h). Cows were sampled at 66 ± 14 and 68 ± 12 d in milk...... and produced 42 ± 1 and 36 ± 1 kg of milk/d with the high-N and low-N diets, respectively. The arterial blood urea concentration before urea infusion was 1.37 and 4.09 ± 0.18 mmol/L with low-N and high-N, respectively. Dietary treatment did not affect the urea infusion-induced increase in arterial urea...

  10. Does overnight normalization of plasma glucose by insulin infusion affect assessment of glucose metabolism in Type 2 diabetes?

    DEFF Research Database (Denmark)

    Staehr, P; Højlund, Kurt; Hother-Nielsen, O;

    2003-01-01

    turnover rates were quantified by adjusted primed-constant 3-3H-glucose infusions, and insulin action was assessed in 4-h euglycaemic, hyperinsulinaemic (40 mU m-2 min-1) clamp studies using labelled glucose infusates (Hot-GINF). RESULTS: Basal plasma glucose levels (mean +/- sd) were 5.5 +/- 0.5 and 10...... from basal rates of Rd, assessment of glucose turnover rates in euglycaemic clamp studies of Type 2 diabetic patients is not dependent on the method by which plasma glucose levels are lowered........7 +/- 2.9 mmol/l in the + ON and - ON studies, respectively, and were clamped at -5.5 mmol/l. Basal rates of glucose production (GP) were similar in the + ON and - ON studies, 83 +/- 13 vs. 85 +/- 14 mg m-2 min-1 (NS), whereas basal rates of glucose disappearance (Rd) were lower in the + ON than in the...

  11. Effect of intravenous injection of dopamine on the bispectral index,entropy index,and sedation score during continuous propofol infusion

    Directory of Open Access Journals (Sweden)

    Tian-long WANG

    2011-11-01

    Full Text Available Objective To examine the effect of an intravenous injection of dopamine on the bispectral index(BIS,entropy index,and sedation score [Observer’s Assessment of Alertness/Sedation(OAAS] during continuous propofol infusion.Methods The present study selected nine patients undergoing an operation under ASA Ⅰ-Ⅱ general anesthesia.Propofol is administered for anesthesia,and plasma/effective concentration(Cp/Ce remained unchanged when OAA/S=2.An intravenous injection of dopamine is then administrated at a single injection dosage of 3 mg to 5 mg.BIS,response entropy(RE,state entropy(SE,OAA/S score,and mean arterial pressure(MAP are recorded 1 min before injection and 1 min to 5 min after injection.Results Cp/Ce is 1.71±0.42 when OAA/S=2.After the intravenous injection of dopamine,BIS increases remarkably in five cases(BIS > 70 in four cases.The increment primarily occurs at 3 and 4 min.The entropy index in nine cases begins to increase at 2min,with this index apparently higher than that before the injection in six cases.The difference between RE and SE increases,and the increment of BIS and the entropy index occurs later than MAP.The OAA/S score ≥4 in five cases.Conclusion Intravenous injection of dopamine results in higher BIS,entropy index,and sedation score during a continuous infusion of propofol when OAA/S=2,thereby having an arousal effect.The entropy index is sensitive in terms of reflecting the arousal effect of dopamine.

  12. Possible activation of auto-immune thyroiditis from continuous subcutaneous infusion of genapol-containing insulin.

    Science.gov (United States)

    Chantelau, E

    2000-09-01

    A case of a type 1 diabetic woman with auto-immune thyroiditis is reported, in whom repeated exposure to insulin containing Genapol(R) (polyethylen-polypropylenglycol) over 3 years reproducibly parallels with an increase of serum TSH (thyroid-stimulating hormone) above the normal limit. Previously, adverse effects of Genapol(R) insulin have been related to its intraperitoneal application, and thought to be restricted to anti-insulin-immunity; activating effects on thyroid auto-immunity have been repeatedly disputed. We suggest that Genapol(R) insulin should be replaced by other insulin preparations with a better safety record.

  13. Modelling the Effect of Exercise on Insulin Pharmacokinetics in "Continuous Subcutaneous Insulin Infusion" Treated Type 1 Diabetes Patients

    DEFF Research Database (Denmark)

    Duun-Henriksen, Anne Katrine; Juhl, Rune; Schmidt, Signe;

    to the realization of the artificial pancreas is the effect of exercise on the insulin and plasma glucose dynamics. In this report, we take the first step towards a population model of exercise effects in type 1 diabetes. We focus on the effect on the insulin pharmacokinetics in continuous subcutaneous insulin...... the dynamics. In the first model, the insulin absorption rate parameter is replaced by a random walk. In the second model, the relationship between the absorption rate and exercise is modelled as a linear dependency, while in the third model this linear relationship depends on the intensity. A Lamperti...... transformation is used to ensure non-negative state values. A special focus is put on the structural identiflability of the base model, while the posterior identiflability is checked for all models from the conditional likelihood profiles. Results: The first model is disregarded due to the small number...

  14. Cardiovascular effects of intravenous bolus administration and infusion of ketamine-midazolam in isoflurane-anesthetized dogs.

    Science.gov (United States)

    Jacobson, J D; Hartsfield, S M

    1993-10-01

    Cardiovascular effects of IV administered ketamine (10 mg/kg) and midazolam (0.5 mg/kg) were determined in 12 healthy isoflurane-anesthetized (1.7% end-tidal concentration) dogs. Six dogs received a ketamine-midazolam combination (K-M) as a bolus over 30 seconds and 6 dogs received K-M as an infusion over 15 minutes. Ketamine-midazolam combination as a bolus and an infusion caused early significant (P dogs of the infusion group and returned to the baseline value near the end of the study. One dog died after K-M bolus administration. Mean maximal decreases from baseline for systemic blood pressure, cardiac index, and stroke index were significantly (P dogs of the bolus group than in dogs of the infusion group; therefore, cardiovascular effects of K-M after infusion were less severe than those after bolus. Base excess and pHa decreased significantly (P infusion group, although similar changes occurred in both groups. Four dogs were maintained with 1.7% end-tidal isoflurane to determine temporal effects of isoflurane; these dogs did not receive K-M. Increases in heart rate, cardiac index, stroke index, and left and right ventricular stroke work indexes were significant (P < 0.05) at various sample collection intervals, particularly during the later stages of the study. Isoflurane anesthesia effectively blocked the cardiostimulatory properties of K-M.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8250398

  15. The application of the Business Process Reengineering strategy in intravenous infusion%流程再造策略在静脉输液中的应用

    Institute of Scientific and Technical Information of China (English)

    刘伟静; 王燕

    2014-01-01

    流程再造理论源自于企业管理领域,它以顾客需求为出发;目前流程再造理论也被广泛应用于医疗系统。本文对1990年1月至2013年11月中英文数据库收录文献进行相关内容的检索,通过分析流程再造策略在静脉输液流程改造过程中的应用,为我国临床护理管理者及研究者灵活应用流程再造理论提供参考。%The Business Process Reengineering originated from the ifeld of business administration which the core idea is customer ifrst. At presently it has been widely used in the health care system. This paper retrieved the related contents in databases both Chinese and English from January 1990 to November 2013. Through the analysis of process reengineering strategies applied in the intravenous infusion process reforming, we not only summed up the intravenous infusion service lfow chart which added in the PIVA department, but also provide the references for the clinical nursing managers and the nursing researchers in our country to apply the theories more lfexible.

  16. 评判性思维在静脉输液中应用的效果评价%Application effect of critical thinking in the intravenous infusion

    Institute of Scientific and Technical Information of China (English)

    谢春雷; 李春霞; 李爱文

    2013-01-01

    目的 探讨评判性思维在静脉输液中的应用效果.方法 选择2012年1~4月在神经外科工作的护士进行评判性思维能力的培养,运用评判性思维在静脉输液过程中进行分析、判断、制定与落实相应护理措施,观察实施评判性思维培训后患者的静脉输液穿刺成功率及患者对护理工作的满意度.结果 对护理人员进行静脉输液评判性思维的培训后,患者的静脉穿刺成功率及患者对护理工作的满意度较培训前明显提高.结论 对护士在静脉输液过程中实施评判性思维培训可有效提高护士的穿刺技能,减少输液肿胀及并发症的发生,提高临床护理质量及患者对护理工作的满意度.%Objective To explore the application effect of critical thinking applied in the intravenous infusion.Methods To give nurses who worked in the Neurosurgery Department from January to April 2012 training lessons of critical thinking so that they could analyze,judge,formulate and implement corresponding nursing measures during the intravenous infusion process through their critical thinking.Then the successful rate of venepuncture for patients and the patients' satisfaction degree with nursing before and after the critical thinking training lessons were observed.Results The successful rate of venepuncture for patients and the patients' satisfaction degree of nursing were apparently improved after the nurses received critical thinking training.The difference was of statistical significance.Conclusions After the implementation of critical thinking training during the intravenous infusion process for nurses,nurses puncture skills is enhanced,infusion swelling and complications are reduced,and the quality of clinical nursing care and patients' satisfaction degree of nursing is improved.

  17. Study on the evaluation of the steps risks in intravenous infusion%静脉输液技术环节风险评价的研究

    Institute of Scientific and Technical Information of China (English)

    毕娜; 王建荣

    2011-01-01

    Objective To evaluate the steps risks of intravenous infusion,so as to provide bases for nursing management decision. Methods A total of 120 nurses from 5 cities were investigated with a self - designed questionnaire about risk probability and risk severity and its probability of causing nursing disputes in 31 different steps of intravenous infusion by 0 - 10 scales. Results The total score of risks of intravenous infusion was 4. 86. The dimension scores of the probability,severity and dispute probability were (5. 12 ±2. 03) , (5.01 ±2. 28) and (4. 39 ±2. 35). In the evaluation of risk probability,the score of the nurses with primary job title was lower than the nurses with middle job title and high job title (P 0.05). Among the 31 steps, there were 12 high - risk steps, 8 mild - risk steps and 11 low - risk steps. Conclusion The risk evaluation of intravenous infusion steps can enhance the safety of intravenous infusion in these aspects of nursing safety management,nursing human resources allocation,avoiding nursing disputes,foreseeing the nursing work,and so on.%目的 通过测量和分析静脉输液操作环节风险,为护理管理决策提供依据.方法 2010年12月至2011年4月,选择5个城市的120名护理人员进行问卷调查,采用0.1~10模拟评分法,测量静脉输液技术31个操作环节产生风险事件的可能性、风险事件的威胁性和纠纷的可能性.结果 静脉输液技术总体风险值为4.86,风险可能性、威胁性和纠纷可能性分别为(5.12 ±2.03)、(5.01±2.28)和(4.39±2.35).对风险可能性的评价,初级职称组低于中级职称组和高级职称组(P<0.05).对风险威胁性和纠纷的可能性3组间比较差异无统计学意义(P>0.05).31个操作环节分为高风险环节12个,中风险环节8个,低风险环节11个.结论 静脉输液环节风险评价可以从护理安全管理、护理人力资源配备、护理纠纷规避和护理工作预见性等方面提高静脉输液技术安全性.

  18. The post-occipital spinal venous sinus of the Nile crocodile (Crocodylus niloticus: Its anatomy and use for blood sample collection and intravenous infusions

    Directory of Open Access Journals (Sweden)

    Jan G. Myburgh

    2014-02-01

    Full Text Available The post-occipital sinus of the spinal vein is often used for the collection of blood samples from crocodilians. Although this sampling method has been reported for several crocodilian species, the technique and associated anatomy has not been described in detail in any crocodilian, including the Nile crocodile (Crocodylus niloticus. The anatomy of the cranial neck region was investigated macroscopically, microscopically, radiographically and by means of computed tomography. Latex was injected into the spinal vein and spinal venous sinus of crocodiles to visualise the regional vasculature. The spinal vein ran within the vertebral canal, dorsal to and closely associated with the spinal cord and changed into a venous sinus cranially in the post-occipital region. For blood collection, the spinal venous sinus was accessed through the interarcuate space between the atlas and axis (C1 and C2 by inserting a needle angled just off the perpendicular in the midline through the craniodorsal cervical skin, just cranial to the cranial borders of the first cervical osteoderms. The most convenient method of blood collection was with a syringe and hypodermic needle. In addition, the suitability of the spinal venous sinus for intravenous injections and infusions in live crocodiles was evaluated. The internal diameter of the commercial human epidural catheters used during these investigations was relatively small, resulting in very slow infusion rates. Care should be taken not to puncture the spinal cord or to lacerate the blood vessel wall using this route for blood collection or intravenous infusions.

  19. 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)

  20. 持续皮下胰岛素输注在人胰岛素过敏患者脱敏治疗中的应用%Application of continuous subcutaneous insulin infusion in desensitization for allergy to recombinant human insulin

    Institute of Scientific and Technical Information of China (English)

    李乃适; 赵维纲; 阳洪波; 李文慧; 邹晓玲; 潘慧; 王良录; 向红丁

    2010-01-01

    Objective To evaluate the values of continuous subcutaneous insulin/rapid insulin analoguc infusion in desensitization for allergy to recombinant human insulin. Methods Two patients allergic to recombinant human insulin received desensitization therapy by continuous subcutaneous insulin lispro infusion. The diluted insulin lispro solution was pumped with initial basal rate of O. O1 U/h, and the basal rate and insulin lispro concentration increased gradually until the insulin dosage for clinical treatment was reached. After that, continuous subcutaneous insulin lispro infusion was replaced by regimen of insulin lispro subcutaneous injection plus oral hypoglycemic agents. Results Local wheals were not observed in both two patients during continuous subcutaneous insulin lispro infusion or during bolus subcutaneous injection of insulin lispro after desensitization. Conclusion The desensitization therapy by continuous subcutaneous insulin/rapid insulin analogue infusion can be applied for allergy to recombinant human insulin.%目的 评价持续皮下胰岛素输注法在人胰岛素过敏患者脱敏治疗中的应用价值.方法 对2例人胰岛素过敏患者采用赖脯胰岛素持续皮下泵入治疗,以0.01 U/h稀释赖脯胰岛素溶液为起始基础率,逐步增加输注速率和浓度直至临床所需剂量,在此基础上调整治疗方案为3餐前皮下注射赖脯胰岛素联合口服药物治疗.结果 2例患者在持续皮下赖脯胰岛素输注治疗的起始及加量过程中均未出现皮肤瘙痒症状,注射局部亦无风团出现;改用餐前皮下赖脯胰岛素注射联合口服药治疗后亦无上述症状出现.结论 持续皮下输注胰岛素或速效胰岛素类似物可用于人胰岛素过敏患者的脱敏治疗.

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

    DEFF Research Database (Denmark)

    Lindgren, Ola; Carr, Richard D; Deacon, Carolyn F;

    2011-01-01

    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 ...

  2. Insulin aspart pharmacokinetics

    DEFF Research Database (Denmark)

    Rasmussen, Christian Hove; Roge, Rikke Meldgaard; Ma, Zhulin;

    2014-01-01

    Background: Insulin aspart (IAsp) is used by many diabetics as a meal-time insulin to control postprandial glucose levels. As is the case with many other insulin types, the pharmacokinetics (PK), and consequently the pharmacodynamics (PD), is associated with clinical variability, both between...... to investigate and quantify the properties of the subcutaneous depot. Data from Brange et al. (1990) are used to determine the effects of insulin chemistry in subcutis on the absorption rate. Intravenous (i.v.) bolus and infusion PK data for human insulin are used to understand and quantify the systemic...... distribution and elimination (Porksen et al., 1997; Sjostrand et al., 2002). PK and PD profiles for type 1 diabetics from Chen et al. (2005) are analyzed to demonstrate the effects of IAsp antibodies in terms of bound and unbound insulin. PK profiles from Thorisdottir et al. (2009) and Ma et al. (2012b...

  3. Mesenchymal stem cells are short-lived and do not migrate beyond the lungs after intravenous infusion

    NARCIS (Netherlands)

    E. Eggenhofer (Elke); V. Benseler (Volker); H.K. Kroemer (Heyo); F. Popp (Felix); E.K. Geissler (Edward); H.J. Schlitt (Hans); C.C. Baan (Carla); M.H. Dahlke (Marc); M.J. Hoogduijn (Martin)

    2012-01-01

    textabstractMesenchymal stem cells (MSC) are under investigation as a therapy for a variety of disorders. Although animal models show long term regenerative and immunomodulatory effects of MSC, the fate of MSC after infusion remains to be elucidated. In the present study the localization and viabili

  4. Analysis of intravenous infusion adverse drug reation reports%静脉输液不良反应报告分析

    Institute of Scientific and Technical Information of China (English)

    徐德洲

    2011-01-01

    Objective To analyze the characteristics and laws of intravenous infusion adverse drug reaction (ADR) reports of out-patient/emergency on 83 cases in our hospital and to provide the reference of rational use of drugs and safe transfusion. Methods A statistical analysis was conducted based on 83 cases of drug intravenous infusion ADR which were reported from January 2009 to February 2011. Results In the 83 cases, women were 44 cases(53.0% ) and elderly patients were 40 cases(48.2% ). The top three drugs of ADR incidence were antimicrobial drugs (54.2%), traditional Chinese medicine injection( 19.3% )and adjuvant therapies and plasma substitute (10.8%). The mainly involving organs were skin, accessories, digestive and nervous system. Conclusions We should pay attention to intravenous infusion ADR of out-patient/emergency. Management of monitoring should be strengthened to ensure safety of drug use.%目的 分析静脉输液药物不良反应(ADR)的发生特点和规律,为临床合理用药、安全输液提供参考。方法 对2009年1月至2011年2月门诊和急诊上报的83例静脉输液ADR报告进行分类统计分析。结果 发生静脉输液ADR的83例患者中,女性[44例(53.0%)]和老年患者[40例(48.2%)]较多见;发生率在前3位的药物依次为抗微生物药[45例(54.2%)]、中药注射剂[16例(19.3%)]和血制品及血浆代用品[9例(10.8%)];主要累及器官为皮肤及附件、消化系统及神经系统等。结论 需重视门急诊静脉输液ADR,加强监测,指导临床合理用药,减少和避免静脉输液ADR的发生,保障用药安全。

  5. Effect of dietary nitrogen content and intravenous urea infusion on ruminal and portal-drained visceral extraction of arterial urea in lactating Holstein cows.

    Science.gov (United States)

    Kristensen, N B; Storm, A C; Larsen, M

    2010-06-01

    Urea extraction across ruminal and portal-drained visceral (PDV) tissues were investigated using 9 rumen-cannulated and multi-catheterized lactating dairy cows adapted to low-N (12.9% crude protein) and high-N (17.1% crude protein) diets in a crossover design. The interaction between adaptation to dietary treatments and blood plasma concentrations of urea was studied by dividing samplings into a 2.5-h period without urea infusion followed by a 2.5-h period with primed continuous intravenous infusion of urea (0.493+/-0.012 mmol/kg of BW per h). Cows were sampled at 66+/-14 and 68+/-12 d in milk and produced 42+/-1 and 36+/-1 kg of milk/d with the high-N and low-N diets, respectively. The arterial blood urea concentration before urea infusion was 1.37 and 4.09+/-0.18 mmol/L with low-N and high-N, respectively. Dietary treatment did not affect the urea infusion-induced increase in arterial urea concentration (1.91+/-0.13 mmol/L). Arterial urea extraction across the PDV and rumen increased from 2.7 to 5.4+/-0.5% and from 7.1 to 23.8+/-2.1% when cows were changed from high-N to low-N, respectively. Urea infusion did not decrease urea extractions, implying that urea transport rates were proportional to arterial urea concentrations. Urea extraction increased more across the rumen wall than across the total PDV for low-N compared with high-N, which implies that a larger proportion of total PDV uptake of arterial urea is directed toward the rumen with decreasing N intake. The ruminal vein - arterial (RA) concentration difference for ammonia increased instantly (first sampling 15 min after initiation of infusion) to the primed intravenous infusion when cows were adapted to the low-N diet. The RA difference for ammonia correlated poorly to the ventral ruminal concentration of ammonia (r=0.55). Relating the RA difference for ammonia to a function of both ruminal ammonia concentration and the RA difference for urea markedly improved the fit (r=0.85), indicating that a large

  6. Comparison of a nurse initiated insulin infusion protocol for intensive insulin therapy between adult surgical trauma, medical and coronary care intensive care patients

    Directory of Open Access Journals (Sweden)

    Kuper Philip J

    2007-08-01

    Full Text Available Abstract Background Sustained hyperglycemia is a known risk factor for adverse outcomes in critically ill patients. The specific aim was to determine if a nurse initiated insulin infusion protocol (IIP was effective in maintaining blood glucose values (BG within a target goal of 100–150 mg/dL across different intensive care units (ICUs and to describe glycemic control during the 48 hours after protocol discontinuation. Methods A descriptive, retrospective review of 366 patients having 28,192 blood glucose values in three intensive care units, Surgical Trauma Intensive Care Unit (STICU, Medical (MICU and Coronary Care Unit (CCU in a quaternary care hospital was conducted. Patients were > 15 years of age, admitted to STICU (n = 162, MICU (n = 110 or CCU (n = 94 over 8 months; October 2003-June 2004 and who had an initial blood glucose level > 150 mg/dL. We summarized the effectiveness and safety of a nurse initiated IIP, and compared these endpoints among STICU, MICU and CCU patients. Results The median blood glucose values (mg/dL at initiation of insulin infusion protocol were lower in STICU (188; IQR, 162–217 than in MICU, (201; IQR, 170–268 and CCU (227; IQR, 178–313; p p = 0.27. Hypoglycemia (BG p = 0.85. Protocol violations were uncommon in all three ICUs. Mean blood glucose 48 hours following IIP discontinuation was significantly different for each population: 142 mg/dL in STICU, 167 mg/dL in MICU, and 160 mg/dL in CCU (p Conclusion The safety and effectiveness of nurse initiated IIP was similar across different ICUs in our hospital. Marked variability in glucose control after the protocol discontinuation suggests the need for further research regarding glucose control in patients transitioning out of the ICU.

  7. Use of Short-Term Real-Time Continuous Glucose Monitoring in Type 1 Diabetes Patients on Continuous Intraperitoneal Insulin Infusion : A Feasibility Study

    NARCIS (Netherlands)

    Logtenberg, Susan J. J.; Kleefstra, Nanne; Groenier, Klaas H.; Gans, Rijk O. B.; Bilo, Henk J. G.

    2009-01-01

    Background: In diabetes, strict glycemic control reduces risk of complications. One mode of therapy is continuous intraperitoneal insulin infusion (CIPII). With CIPII, like all intensified treatment strategies, frequent assessment of glucose levels is mandatory. Real-time (RT)-continuous glucose mon

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

    LENUS (Irish Health Repository)

    Ryan, C Anthony

    2012-02-03

    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.

  9. 正常速度输注万古霉素致红人综合征1例分析%Analysis of 1 Case of Red Man Syndrome after Intravenous Infusion of Vancomycin with Normal Velocity

    Institute of Scientific and Technical Information of China (English)

    叶红; 齐晓涟; 宿英英

    2011-01-01

    目的:提示临床重视正常速度输注万古霉素所致的不良反应.方法:报道我院1例正常速度输注万古霉素致红人综合征(RMS)的病例,并进行综合分析.结果与结论:国内未见有正常速度输注万古霉素致RMS的病例.临床应重视并减免正常速度输注万古霉素所致的RMS.预防RMS的措施主要是控制输注速度,必要时可预防性用药;RMS发生后,首先减慢或停止万古霉素输注,给予补液等对症支持治疗.%OBJECTIVE: To prompt clinical staff to pay attention to adverse drug reactions induced by intravenous infusion of vancomycin with normal velocity. METHODS: 1 case of red man syndrome (RMS) induced by intravenous infusion of vancomy-cin with normal velocity was reported in our hospital, and analyzed comprehensively. RESULTS & CONCLUSIONS: There was no case of RMS induced by intravenous infusion of vancomycin with normal velocity in China. Great importance should be attached to RMS induced by intravenous infusion of vancomycin with normal velocit. Main preventive measure is to control the infusion rate, if necessary, preventive medicine should be adopted; After RMS occurs, we firstly should slow down or stop the vancomycin infusion, then given supportive treatment, such as fluid infusion.

  10. Opioid-free total intravenous anesthesia with propofol, dexmedetomidine and lidocaine infusions for laparoscopic cholecystectomy: a prospective, randomized, double-blinded study

    Directory of Open Access Journals (Sweden)

    Mefkur Bakan

    2015-06-01

    Full Text Available BACKGROUND AND OBJECTIVES: Intraoperative use of opioids may be associated with postoperative hyperalgesia and increased analgesic consumption. Side effects due to perioperative use of opioids, such as postoperative nausea and vomiting may delay discharge. We hypothesized that total intravenous anesthesia consisting of lidocaine and dexmedetomidine as an opioid substitute may be an alternative technique for laparoscopic cholecystectomy and would be associated with lower fentanyl requirements in the postoperative period and less incidence of postoperative nausea and vomiting. METHODS: 80 Anesthesiologists I-II adults were scheduled for elective laparoscopic cholecystectomy. Patients were randomly allocated into two groups to have either opioid-free anesthesia with dexmedetomidine, lidocaine, and propofol infusions (Group DL or opioid-based anesthesia with remifentanil, and propofol infusions (Group RF. All patients received a standard multimodal analgesia regimen. A patient controlled analgesia device was set to deliver IV fentanyl for 6 h after surgery. The primary outcome variable was postoperative fentanyl consumption. RESULTS: Fentanyl consumption at postoperative 2nd hour was statistically significantly less in Group DL, compared with Group RF, which were 75 ± 59 µg and 120 ± 94 µg respectively, while it was comparable at postoperative 6th hour. During anesthesia, there were more hypotensive events in Group RF, while there were more hypertensive events in Group DL, which were both statistically significant. Despite higher recovery times, Group DL had significantly lower pain scores, rescue analgesic and ondansetron need. CONCLUSION: Opioid-free anesthesia with dexmedetomidine, lidocaine and propofol infusions may be an alternative technique for laparoscopic cholecystectomy especially in patients with high risk for postoperative nausea and vomiting.

  11. Dual effect of insulin on plasma volume and transcapillary albumin transport

    DEFF Research Database (Denmark)

    Hilsted, J; Christensen, N J

    1992-01-01

    During the past decade it has been demonstrated that insulin, apart from its effects on metabolism and ion fluxes, has acute effects on the cardiovascular system and capillary permeability. Intravenous infusion of insulin in doses which increase plasma insulin to physiological levels, induced vas...... in a normal transfer of macromolecules from the blood to the extracellular space after food intake. This process may be greatly disturbed in insulin-dependent diabetic patients....

  12. Safety and efficacy of subcutaneous and continuous intravenous infusion rIL-2 in patients with metastatic renal cell carcinoma

    DEFF Research Database (Denmark)

    Geertsen, P F; Gore, M E; Negrier, S;

    2004-01-01

    A retrospective analysis was conducted on data from four open-label, nonrandomised, phase II trials of recombinant interleukin-2 (rIL-2) in patients with metastatic renal cell carcinoma to compare the safety and efficacy of administration by subcutaneous (s.c.) and continuous intravenous (c...... required dose reductions because of toxicity (20 vs 82%). At the doses and within the schedules tested, this comparative analysis did not detect any difference in efficacy between s.c. and c.i.v. administration of rIL-2 in terms of overall survival, duration of response and response rate in patients with...

  13. Blood Glucose Control Using a Novel Continuous Blood Glucose Monitor and Repetitive Intravenous Insulin Boluses: Exploiting Natural Insulin Pulsatility as a Principle for a Future Artificial Pancreas

    Directory of Open Access Journals (Sweden)

    Nils K. Skjaervold

    2013-01-01

    Full Text Available The aim of this study was to construct a glucose regulatory algorithm by employing the natural pulsatile pattern of insulin secretion and the oscillatory pattern of resting blood glucose levels and further to regulate the blood glucose level in diabetic pigs by this method. We developed a control algorithm based on repetitive intravenous bolus injections of insulin and combined this with an intravascular blood glucose monitor. Four anesthetized pigs were used in the study. The animals developed a mildly diabetic state from streptozotocin pretreatment. They were steadily brought within the blood glucose target range of 4.5–6.0 mmol/L in 21 to 121 min and kept within that range for 128 to 238 min (hypoglycemic values varied from 2.9 to 51.1 min. The study confirmed our hypotheses regarding the feasibility of this new principle for blood glucose control, and the algorithm was constantly improved during the study to produce the best results in the last animals. The main obstacles were the drift of the IvS-1 sensor and problems with the calibration procedure, which calls for an improvement in the sensor stability before this method can be applied fully in new studies in animals and humans.

  14. THE FEATURES OF BYOCINETICS OF PLUTONIUM AND OTHERS HEPATO-OSTEOTROPIC RADIONUCLIDES AFTER INTRAVENOUS INFUSION OF SODIUM ETYLENDYAMINTETRAACETAT

    Directory of Open Access Journals (Sweden)

    V. S. Repin

    2013-01-01

    Full Text Available In experimental work with experimental animals it is shown that creation of artificial deficiency of calcium in the blood of rats at the 2-hours infusion of sodium salt EDTA stimulates activation of resorption processes in a skeleton and promotes increase an urine temp excretion of plutonium-239, americium-241 and ittrium-91 whereas the temp of calcium-45 excretion with urine decreases and becomes below the level which was before EDTA intake. Activation of resorption processes begins after12 hours from the moment of EDTA intake and proceeds within 3 days and more. The effect can find practical application in the estimation of radionuclides content in a skeleton by method of indirect dosimetry using the value of excretion with urine velocity.

  15. A common variation of the PTEN gene is associated with peripheral insulin resistance

    DEFF Research Database (Denmark)

    Grinder-Hansen, L; Ribel-Madsen, R; Wojtaszewski, Jørgen;

    2016-01-01

    ). Hepatic and peripheral insulin sensitivity was measured using tracer and euglycaemic-hyperinsulinaemic clamp techniques; insulin secretion was assessed by intravenous glucose tolerance test; and muscle biopsies were taken during insulin infusion from 150 twins for measurement of PI3K and Akt activities....... RESULTS: The minor G allele of PTEN rs11202614 was associated with elevated fasting plasma insulin levels and a decreased peripheral glucose disposal rate, but not with the hepatic insulin resistance index or insulin secretion measured as the first-phase insulin response and disposition index. The single...

  16. Intravenous infusion of ketamine-propofol can be an alternative to intravenous infusion of fentanyl-propofol for deep sedation and analgesia in paediatric patients undergoing emergency short surgical procedures

    Directory of Open Access Journals (Sweden)

    Samit Kumar Khutia

    2012-01-01

    Full Text Available Background: Paediatric patients often present with different painful conditions that require immediate surgical interventions. Despite a plethora of articles on the ketamine-propofol combination, comprehensive evidence regarding the suitable sedoanalgesia regime is lacking due to heterogeneity in study designs. Methods: This prospective, randomized, double-blind, active-controlled trial was conducted in 100 children, of age 3-14 years, American Society of Anesthesiologist physical status IE-IIE, posted for emergency short surgical procedures. Patients were randomly allocated to receive either 2 mL of normal saline (pre-induction plus calculated volume of drug from the 11 mL of ketamine-propofol solution for induction (group PK, n=50 or fentanyl 1.5 μg/kg diluted to 2 mL with normal saline (pre-induction plus calculated volume of drug from the 11 mL of propofol solution for induction (group PF, n=50. In both the groups, the initial bolus propofol 1 mg/kg i.v. (assuming the syringes contained only propofol, for simplicity was followed by adjusted infusion to achieve a Ramsay Sedation Scale score of six. Mean arterial pressure (MAP was the primary outcome measurement. Results: Data from 48 patients in group PK and 44 patients in group PF were available for analysis. Hypotension was found in seven patients (14.6% in group PK compared with 17 (38.6% patients in group PF (P=0.009. Intraoperative MAP was significantly lower in group PF than group PK when compared with baseline. Conclusion: The combination of low-dose ketamine and propofol is more effective and a safer sedoanalgesia regimen than the propofol-fentanyl combination in paediatric emergency short surgical procedures in terms of haemodynamic stability and lesser incidence of apnoea.

  17. Insulin Analogs Versus Human Insulin in the Treatment of Patients With Diabetic Ketoacidosis

    Science.gov (United States)

    Umpierrez, Guillermo E.; Jones, Sidney; Smiley, Dawn; Mulligan, Patrick; Keyler, Trevor; Temponi, Angel; Semakula, Crispin; Umpierrez, Denise; Peng, Limin; Cerón, Miguel; Robalino, Gonzalo

    2009-01-01

    OBJECTIVE To compare the safety and efficacy of insulin analogs and human insulins both during acute intravenous treatment and during the transition to subcutaneous insulin in patients with diabetic ketoacidosis (DKA). RESEARCH DESIGN AND METHODS In a controlled multicenter and open-label trial, we randomly assigned patients with DKA to receive intravenous treatment with regular or glulisine insulin until resolution of DKA. After resolution of ketoacidosis, patients treated with intravenous regular insulin were transitioned to subcutaneous NPH and regular insulin twice daily (n = 34). Patients treated with intravenous glulisine insulin were transitioned to subcutaneous glargine once daily and glulisine before meals (n = 34). RESULTS There were no differences in the mean duration of treatment or in the amount of insulin infusion until resolution of DKA between intravenous treatment with regular and glulisine insulin. After transition to subcutaneous insulin, there were no differences in mean daily blood glucose levels, but patients treated with NPH and regular insulin had a higher rate of hypoglycemia (blood glucose <70 mg/dl). Fourteen patients (41%) treated with NPH and regular insulin had 26 episodes of hypoglycemia and 5 patients (15%) in the glargine and glulisine group had 8 episodes of hypoglycemia (P = 0.03). CONCLUSIONS Regular and glulisine insulin are equally effective during the acute treatment of DKA. A transition to subcutaneous glargine and glulisine after resolution of DKA resulted in similar glycemic control but in a lower rate of hypoglycemia than with NPH and regular insulin. Thus, a basal bolus regimen with glargine and glulisine is safer and should be preferred over NPH and regular insulin after the resolution of DKA. PMID:19366972

  18. 探讨患儿监护人参与查对在儿科静脉输液中的应用%Application of Child’s Guardian Infusion Checklist in Pediatric Intravenous Infusion Therapy

    Institute of Scientific and Technical Information of China (English)

    张英; 荣德明; 谢功群

    2014-01-01

    Objective To investigate the effective management method of pediatric transfusion safety. Methods 5086 patients undergoing intravenous treatment of children were used as a test group, use the method of Child’s guardian in transfusion verification of single sign on. A control group of 4800 cases by routine check, only performed by nurses in fluids infusion executing single sign on. Comparison of two groups of parents satisfaction, nursing defects, nursing complaint occurred, and were analyzed by test. Results The test group parents satisfaction, nursing defects, nursing complaints was significantly better than the control group(P<0. 01). Conclusion In pediatric intravenous infusion in the treatment of child’s guardian in transfusion verification im-plementation of single sign on, the family satisfaction is got rised, defect of nursing, nursing complaints are significantly reduced.%目的:探讨确保小儿输液安全的有效管理方法。方法将5086例接受静脉输液治疗的患儿作为试验组,采用常规查对基础上患儿监护人在输液核查单上签字方法。对照组4800例患儿采用常规查对,仅由执行护士在输液执行单上签字方法。比较两组患儿家长满意度,护理缺陷、护理投诉的发生情况,并进行检验。结果试验组患儿家长满意度、护理缺陷及护理投诉发生情况明显优于对照组,差异有统计学意义( P<0.05)。结论儿科静脉输液治疗中实施患儿监护人在输液核查单上签字,患儿家属满意度提高,因输液导致的护理缺陷、护理投诉明显减少。

  19. ACUTE RENAL EFFECTS OF SOMATOSTATIN ANALOG, OCTREOTIDE, IN INSULIN-DEPENDENT DIABETIC-PATIENTS - ANTAGONISM BY LOW-DOSE GLUCAGON

    NARCIS (Netherlands)

    STEGEMAN, CA; DULLAART, RPF; MEIJER, S; MARBACH, P; SLUITER, WJ

    1993-01-01

    Thirty patients affected by insulin-dependent diabetes mellitus, without overt diabetic nephropathy, were randomly allocated to receive either octreotide (20 mug bolus followed by 10 mug.h-1) or vehicle intravenously over 2 hr. A similar infusion of octreotide with concomitant glucagon infusion (2 t

  20. Insulin

    Science.gov (United States)

    ... Short Acting Humulin N NPH Human Insulin (Human Insulin Isophane Suspension) Intermediate Acting Novolin N NPH Human Insulin (Human Insulin Isophane Suspension) Intermediate Acting Lantus Insulin Glargine Long Acting ...

  1. Research on the Flow Setting Type Infusion Intravenous Amiodarone in Prevention of Phlebitis%流量设定微调式输液器静脉滴注可达龙预防静脉炎的研究

    Institute of Scientific and Technical Information of China (English)

    李兴芳

    2014-01-01

    目的:探讨使用流量设定微调式输液器静脉滴注可达龙预防静脉炎的临床效果。方法将200例需要使用可达龙患者随机分两组, A组100例,B组100例,A组使用流量设定微调式输液器静脉滴注可达龙。B组使用微量注射泵输注可达龙。结果 A组静脉炎发生率明显低于B组对照组。结论使用流量设定微调式输液器静脉滴注可达龙可有效预防静脉炎发生,值得临床推广。%Objective To explore the use of flow set type infusion intravenous amiodarone in prevention of phlebitis curative effect. Methods 200 cases require the use of amiodarone were randomly divided into two groups,100 cases in A group, 100 cases in B group, group A using flow set type infusion intravenous amiodarone, group B using microinjection pump infusion of cordarone. Results in A group, the incidence of phlebitis was significantly lower than the control group. Conclusion using the flow set type infusion intravenous amiodarone may be effective in preventing phlebitis, worthy of clinical application.

  2. Intravenous paracetamol infusion: Superior pain management and earlier discharge from hospital in patients undergoing palliative head-neck cancer surgery

    Directory of Open Access Journals (Sweden)

    Saikat Majumdar

    2014-01-01

    Full Text Available Background: Paracetamol; a cyclooxygenase inhibitor; acts through the central nervous system as well as serotoninergic system as a nonopioid analgesic. A prospective, double-blinded, and randomized-controlled study was carried out to compare the efficacy of preoperative 1g intravenous (iv paracetamol with placebo in providing postoperative analgesia in head-neck cancer surgery. Materials and Methods: From 2008 February to 2009 December, 80 patients for palliative head-neck cancer surgery were randomly divided into (F and (P Group receiving ivplacebo and iv paracetamol, respectively, 5 min before induction. Everybody received fentanyl before induction and IM diclofenac for pain relief at8 hourly for 24 h after surgery. Visual analogue scale (VAS and amount of fentanyl were measured for postoperative pain assessment (24 h. Results and Statistical analysis: The mean VAS score in 1 st , 2 nd postoperative hour, and fentanyl requirement was less and the need for rescue analgesic was delayed in ivparacetamol group which were all statistically significant. Paracetamol group had a shorter surgical intensive care unit (SICU and hospital stay which was also statistically significant. Conclusion: The study demonstrates the effectiveness of ivparacetamol as preemptive analgesic in the postoperative pain control after head-neck cancer surgery and earlier discharge from hospital.

  3. Regional pulmonary perfusion assessed with continuous intravenous infusion of Kr-81m: a comparison with Tc-99m macroaggregates

    International Nuclear Information System (INIS)

    The radioactive gas krypton-81m (T1/2 = 13 sec) can be produced in the gaseous form or in solution by passing air or water over a resin column to which the parent nuclide rubidium-81 (T1/2 = 4.6 hr) is bound. Due to the rapid radioactive decay, a continuous administration of Kr-81m into the inflow of an organ yields a functional image of tracer arrival, that is, regional distribution of flow in that organ. Continuous inhalation of Kr-81m gas therefore produces functional images of pulmonary ventilation. We investigated the feasibility of assessing regional pulmonary blood flow by a continuous i.v. infusion of Kr-81m solution. Krypton-81m ventilation and perfusion images, together with a routine Tc-99m macroaggregate (Tc-HAM) perfusion lung scan, were obtained in 20 patients with various chest disorders. There was excellent agreement between Kr-81m and Tc-HAM perfusion images when the ventilation was not disturbed, as in patients with pulmonary embolism. In the presence of macroscopic ventilation abnormalities, however, the correlation between the Kr-81m perfusion and the Tc-HAM scans is less good. This is understandable because Kr-81m that diffuses into the alveoli will be exhaled unevenly. The main advantages of Kr-81m over Tc-HAM for assessment of pulmonary blood flow are: absolute safety in children, especially in the presence of right-to-left shunts; continuous monitoring during changing clinical and experimental conditions; and low radiation dose

  4. Phase I trial of systemic intravenous infusion of interleukin-13-Pseudomonas exotoxin in patients with metastatic adrenocortical carcinoma

    International Nuclear Information System (INIS)

    Adrenocortical carcinoma (ACC) is a rare but lethal malignancy without effective current therapy for metastatic disease. IL-13-PE is a recombinant cytotoxin consisting of human interleukin-13 (IL-13) and a truncated form of Pseudomonas exotoxin A (PE). The main objectives of this Phase I dose-escalation trial were to assess the maximum-tolerated dose (MTD), safety, and pharmacokinetics (PK) of IL-13-PE in patients with metastatic ACC. Eligible patients had confirmed IL-13 receptor alpha 2 (IL-13Rα2) expressions in their tumors. IL-13-PE at dose of 1–2 μg/kg was administered intravenously (IV) on day 1, 3, and 5 in a 4-week cycle. Six patients received 1 μg/kg and two patients received 2 μg/kg of IL-13-PE. Dose-limiting toxicity was observed at 2 μg/kg, at which patients exhibited thrombocytopenia and renal insufficiency without requiring dialysis. PK analysis demonstrated that at MTD, the mean maximum serum concentration (Cmax) of IL-13-PE was 21.0 ng/mL, and the terminal half-life of IL-13-PE was 30–39 min. Two (25%) of the eight patients had baseline neutralizing antibodies against PE. Three (75%) of the remaining four tested patients developed neutralizing antibodies against IL-13-PE within 14–28 days of initial treatment. Of the five patients treated at MTD and assessed for response, one patient had stable disease for 5.5 months before disease progression; the others progressed within 1–2 months. In conclusion, systemic IV administration of IL-13-PE is safe at 1 μg/kg. All tested patients developed high levels of neutralizing antibodies during IL-13-PE treatment. Use of strategies for immunodepletion before IL-13-PE treatment should be considered in future trials

  5. Increased secretory demand rather than a defect in the proinsulin conversion mechanism causes hyperproinsulinemia in a glucose-infusion rat model of non-insulin-dependent diabetes mellitus.

    OpenAIRE

    Alarcón, C; Leahy, J L; Schuppin, G T; Rhodes, C. J.

    1995-01-01

    Hyperproinsulinemia in non-insulin-dependent diabetes mellitus (NIDDM) is due to an increased release of proinsulin from pancreatic beta cells. This could reside in increased secretory demand placed on the beta cell by hyperglycemia or in the proinsulin conversion mechanism. In this study, biosynthesis of the proinsulin conversion enzymes (PC2, PC3, and carboxypeptidase-H [CP-H]) and proinsulin, were examined in islets isolated from 48-h infused rats with 50% (wt/vol) glucose (hyperglycemic, ...

  6. Study on Steady-State Kinetics for Multiple Intravenous Infusion%周期性静滴给药的稳态动力学研究

    Institute of Scientific and Technical Information of China (English)

    丁勇

    2000-01-01

    The kinetic model for multiple intravenous infusion is a piecewise continuous function. Steady-State characteristics of this model are studied for drugs obeying one-compartment open model. Relationships of blood concentration between single dosing and multiple dosing are derived in this paper, which shows the parameters of Steady-State kinetic model can be predicted by the parameters from single dosing model. Based on these studies, dosage regimens are discussed for clinical application.%对线性一室模型的药物,周期性静滴给药的动力学模型为一分段连续函数,本文对其动态动力学特征进行了研究,得到了稳态浓度的$c-t$方程以及一次给药和多次给药动力学参数之间的关系,为预测稳态浓度提供了依据.在此基础上对给药方案的拟定进行了讨论.

  7. Comparison of the intravenous insulin and oral clonidine tolerance tests for growth hormone secretion. The Health Services Human Growth Hormone Committee.

    OpenAIRE

    1981-01-01

    The plasma growth hormone response to intravenous insulin was compared with that of oral clonidine in a multicentre trial in 64 patients being investigated for short stature. Either test was judged to give a positive result if the maximum plasma growth hormone concentration was at least 20 mU/1. In 42 pairs of tests concordant results were obtained, 19 being positive and 23 negative. In 12 tests only the response to insulin was positive and 10 tests were positive only for clonidine. Clonidine...

  8. 山莨菪碱凝胶防治得力生所致静脉损伤的研究%Research in prevention and treatment of venous injury caused by intravenous infusion of Delisheng with anisodamine gel

    Institute of Scientific and Technical Information of China (English)

    王华; 李德明; 范义凤

    2010-01-01

    目的 探讨山莨菪碱凝胶涂搽防治输注得力生所致静脉损伤的效果.方法 将100例静脉输注得力生的患者随机分为实验组和对照组各50例.实验组患者在静脉输注得力生前3~5 min将2%山莨菪碱凝胶沿静脉走向均匀地涂搽于输液穿刺点上方的皮肤,对照组不做任何处理,观察输注得力生后2组静脉损伤的情况.再对2组有静脉损伤的患者用2%山莨菪碱凝胶涂搽于输液穿刺点上方的皮肤,观察其对静脉损伤的治疗效果.结果 实验组静脉内疼痛的发生率为4%,无静脉输液不畅、输液部位红肿的发生;对照组静脉输液不畅的发生率为34%,局部红肿的发生率为42%,静脉内疼痛的发生率为68%.对照组39例及实验组2例发生静脉损伤患者经过治疗后静脉损伤症状全部消失.结论 2%山莨菪碱凝胶涂搽能有效防治输注得力生所致静脉损伤的发生.%Objective To investigate the effect of prevention and treatment of venous injury caused by intravenous infusion of Delisheng with anisodamine gel.Methods 100 patients with intravenous infusion of Delisheng were randomly divided into the experimental group and the control group,50 patients in each group,and the skin at the top of transfusion puncture points of the patients of the experimental group were evenly embrocated with 2% anisodamine gel along the vein before 3 to 5 minutes of intravenous infusion of Delisheng,while the control group received no treatment.After observing the situation of venous injury,the skin at the top of transfusion puncture points of the positive patients was embrocated with 2% anisodamine gel,and the effect on venous injury was observed.Results The incidence rate of intravenous pain of the experimental group was 4%,there wasn't any occurrence of poor intravenous infusion or swelling of the infusion position.The incidence rate of poor intravenous infusion of the control group was 34% and phlebitis incidence rate was 42%,and

  9. 苦黄注射液静滴致腮腺肿大%Swelling of parotid gland caused by intravenous infusion of Kuhuang injection

    Institute of Scientific and Technical Information of China (English)

    周燕萍; 刘丽萍; 张诗龙; 曹敏雪; 刘淼

    2011-01-01

    1例56岁男性患者,因全身皮肤黏膜中度黄染,给予苦黄注射液30 mL加入0.9%氯化钠注射液100 mL以30滴min-1的速度静滴.用药15 min后患者两侧腮腺肿大,BP 150/110 mm Hg.立即停药,更换输液器,输入0.9%氯化钠注射液100mL,地塞米松磷酸钠注射液5 mg静推,注射用氢化可的松琥珀酸钠100 mg静滴,硝苯地平缓释片20 mg口服,后给予葡萄糖氧化钠注射液缓慢滴注并观察,1h后上述症状和体征消失.%One case of 56-year-old male patient with skin stained midrange yellow all over the body, was given intravenous infusion of 30 mL of Kuhuang injection dissolved in 100 mL of 0.9% sodium chloride injection with the speed of 30 drops per minute. After IS minutes, he appeared bilateral swelling of parotid gland, the blood pressure was 1S0/110 mm Hg. The medicine was stopped immediately, and then symptomatic treatments such as 0.9% sodium chloride injection 100 mL, dexamethasone sodium phosphate injection 5 mg, hydrocortisone sodium succinate for injection 100 mg, nifedipine sustained release tablets 20 mg and so on were given, above mentioned sings and symptoms disappeared after one hour.

  10. 患者静脉输注依托咪酯的群体药代动力学%Population pharmacokinetics of intravenous etomidate infusion in adult patients

    Institute of Scientific and Technical Information of China (English)

    任三姐; 张马忠; 王珊娟

    2013-01-01

    Objective To determine the population pharmacokinetics of intravenous etomidate infusion in adult patients.Methods Twenty-nine ASA Ⅰ or Ⅱ patients of both sexes aged 25-82 yr weighing 45-80 kg received contant-rate infusion of etomidate at 60 μg· kg-1 · min-1 until BIS value dropped to ≤ 40.Arterial blood samples were obtained from radial artery for determination of plasma etomidate concentration before,at 1,3,5 min of continuous etomidate infusion and at 1,3,5,7,10,20,30,45,75,120,180,240,300 and 360 min after termination of etomidate infusion.Population pharmacokinetic model was established by using the software package NONMEM.Population pharmacokinetic parameters were calculated according to etomidate concentrations and covariates including age,height,bodyweight,sex,liver-kidney function etc.using software package NONMEM.Results Pharmacokinetics of etomidate was best described by a three-compartment pharmacokinetic model with age as a covariate affecting systemic clearance (CL1).The typical parameters were:V1 =4.7 L,V2 =11 L,V3 =123L,CL1 =1.28-0.0119 × (Age (yr)-55) L/min,CL2 =1.25 L/min and CL3 =1.08 L/min respectively.Context-sensitive half-time increased with age and steady-state infusion time.Conclusion Pharmacokinetics of etomidate is best described by a three-compartment pharmacokinetic model with age as a covariate affecting systemic clearance (CL1).%目的 评价患者静脉输注依托咪酯的群体药代动力学.方法 择期全麻患者29例,年龄25~82岁,以60μg·kg-1·min-1速率持续静脉输注依托咪酯,直至脑电双频谱指数值<40.于输注依托咪酯前、持续输注1、3、5 min及停药即刻、停止输注后1、3、5、7、10、20、30、45、75、120、180、240、300和360 min时取桡动脉血样,测定血浆药物浓度.采用NONMEM软件建立依托咪酯群体药代学模型,分析年龄、身高、体重等协变量的影响.参数个体间变异性和残差变异性分别采用指数模型

  11. Enhancing the [13C]bicarbonate signal in cardiac hyperpolarized [1‐13C]pyruvate MRS studies by infusion of glucose, insulin and potassium

    DEFF Research Database (Denmark)

    Lauritzen, Mette Hauge; Laustsen, Christoffer; Butt, Sadia Asghar;

    2013-01-01

    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...... 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....... 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...

  12. Continuous subcutaneous infusion of glucagon-like peptide 1 lowers plasma glucose and reduces appetite in type 2 diabetic patients

    DEFF Research Database (Denmark)

    Toft-Nielsen, M B; Madsbad, Sten; Holst, J J

    1999-01-01

    energy intake and on plasma glucose, insulin, glucagon, postprandial lipidemia, blood pressure, heart rate, and basal metabolic rate. RESULTS: The infusion resulted in elevations of the plasma concentrations of intact GLP-1 similar to those observed after intravenous infusion of 1.2 pmol.kg-1.min-1...... fullness was unaffected. No side effects during GLP-1 infusion were recorded except for a brief cutaneous reaction. Basal metabolic rate and heart rate did not change significantly during GLP-1 administration. Both systolic and diastolic blood pressure tended to be lower during the GLP-1 infusion......OBJECTIVE: The gut hormone glucagon-like peptide 1 (GLP-1) has insulinotropic and anorectic effects during intravenous infusion and has been proposed as a new treatment for type 2 diabetes and obesity. The effect of a single subcutaneous injection is brief because of rapid degradation. We therefore...

  13. Evaluation of an Algorithm to Guide Patients With Type 1 Diabetes Treated With Continuous Subcutaneous Insulin Infusion on How to Respond to Real-Time Continuous Glucose Levels

    OpenAIRE

    Jenkins, Alicia J.; Krishnamurthy, Balasubramanium; James D Best; Cameron, Fergus J.; Colman, Peter G.; Farish, Steven; Hamblin, Peter S.; O'Connell, Michele A.; Rodda, Christine; Rowley, Kevin; Teede, Helena; O'Neal, David N

    2010-01-01

    OBJECTIVE To evaluate an algorithm guiding responses of continuous subcutaneous insulin infusion (CSII)–treated type 1 diabetic patients using real-time continuous glucose monitoring (RT-CGM). RESEARCH DESIGN AND METHODS Sixty CSII-treated type 1 diabetic participants (aged 13–70 years, including adult and adolescent subgroups, with A1C ≤9.5%) were randomized in age-, sex-, and A1C-matched pairs. Phase 1 was an open 16-week multicenter randomized controlled trial. Group A was treated with CSI...

  14. Effect of catecholamines and insulin on plasma volume and intravascular mass of albumin in man

    DEFF Research Database (Denmark)

    Hilsted, J; Christensen, N J; Larsen, S

    1989-01-01

    1. The effect of intravenous catecholamine infusions and of intravenous insulin on plasma volume and intravascular mass of albumin was investigated in healthy males. 2. Physiological doses of adrenaline (0.5 microgram/min and 3 microgram/min) increased peripheral venous packed cell volume...... significantly; intravenous noradrenaline at 0.5 microgram/min had no effect on packed cell volume, whereas packed cell volume increased significantly at 3 micrograms of noradrenaline/min. No significant change in packed cell volume was found during saline infusion. 3. During adrenaline infusion at 6 micrograms...... in packed cell volume, plasma volume, intravascular mass of albumin and transcapillary escape rate of albumin during hypoglycaemia may be explained by the combined actions of adrenaline and insulin....

  15. Plasma adiponectin is modestly decreased during 24-hour insulin infusion but not after inhibition of lipolysis by Acipimox

    NARCIS (Netherlands)

    Dullaart, RPF; Riemens, SC; Meinardi, [No Value; Wolffenbuttel, BHR; Sluiter, WJ

    2005-01-01

    Objective. Plasma adiponectin is associated with insulin resistance and atherosclerosis. Adiponectin expression in adipose tissue is up-regulated by peroxisome proliferator-activated receptor (PPAR)-gamma agonist treatment and its plasma level may be affected by insulin. We tested the hypothesis tha

  16. Exenatide augments first- and second-phase insulin secretion in response to intravenous glucose in subjects with type 2 diabetes

    DEFF Research Database (Denmark)

    Fehse, Frauke; Trautmann, Michael; Holst, Jens Juul;

    2005-01-01

    CONTEXT: First-phase insulin secretion (within 10 min after a sudden rise in plasma glucose) is reduced in type 2 diabetes mellitus (DM2). The incretin mimetic exenatide has glucoregulatory activities in DM2, including glucose-dependent enhancement of insulin secretion. OBJECTIVE: The objective o...

  17. The impact of glucose-insulin-potassium infusion in acute myocardial infarction on infarct size and left ventricular ejection fraction [ISRCTN56720616

    Directory of Open Access Journals (Sweden)

    Gosselink AT Marcel

    2005-06-01

    Full Text Available Abstract Background Favorable clinical outcomes have been observed with glucose-insulin-potassium infusion (GIK in acute myocardial infarction (MI. The mechanisms of this beneficial effect have not been delineated clearly. GIK has metabolic, anti-inflammatory and profibrinolytic effects and it may preserve the ischemic myocardium. We sought to assess the effect of GIK infusion on infarct size and left ventricular function, as part of a randomized controlled trial. Methods Patients (n = 940 treated for acute MI by primary percutaneous coronary intervention (PCI were randomized to GIK infusion or no infusion. Endpoints were the creatinine kinase MB-fraction (CK-MB and left ventricular ejection fraction (LVEF. CK-MB levels were determined 0, 2, 4, 6, 24, 48, 72 and 96 hours after admission and the LVEF was measured before discharge. Results There were no differences between the two groups in the time course or magnitude of CK-MB release: the peak CK-MB level was 249 ± 228 U/L in the GIK group and 240 ± 200 U/L in the control group (NS. The mean LVEF was 43.7 ± 11.0 % in the GIK group and 42.4 ± 11.7% in the control group (P = 0.12. A LVEF ≤ 30% was observed in 18% in the controls and in 12% of the GIK group (P = 0.01. Conclusion Treatment with GIK has no effect on myocardial function as determined by LVEF and by the pattern or magnitude of enzyme release. However, left ventricular function was preserved in GIK treated patients.

  18. Long-term effects of continuous subcutaneous infusion versus daily subcutaneous injections of growth hormone (GH) on the insulin-like growth factor system, insulin sensitivity, body composition, and bone and lipoprotein metabolism in GH-deficient adults

    DEFF Research Database (Denmark)

    Laursen, Torben; Gravholt, Claus Højbjerg; Heickendorff, Lene;

    2001-01-01

    injections (inj) in the evening as usual, and 7 received a continuous infusion (inf) of GH by means of a portable pump. The GH dose was kept unchanged before and during the study. Serum levels of insulin-like growth factor I (IGF-I) tended to increase in the patients switched to constant infusion (from 175...... +/- 36 to 209 +/- 50 microg/L), but the differences obtained during the two regimens [+34.3 (inf) vs. -11.9 (inj)] were not significant (P = 0.34). Serum levels of IGF-II (P = 0.71) and IGF-binding protein (IGFBP)-3 (P = 0.75) were identical during the two modes of treatment. Serum levels of IGFBP-1 (P...... for 6 months are comparable with respect to the IGF-IGFBP axis, whereas intermittent exposure may be of importance for the lipolytic effect of GH. The data on insulin sensitivity and lipoproteins suggest that constant GH exposure is as safe as intermittent GH administration....

  19. To Control the Drug Losses of Powder Injection in the Course of Intravenous Infusion%控制粉针剂药物静脉输注过程中的损失量

    Institute of Scientific and Technical Information of China (English)

    王晶锋; 寇爱双; 关银梅; 任爱娟; 梁安鹏

    2001-01-01

    To approach the drug losses in the course of powder injection intravenous infusion, Sodium Cefazolin was determined in the whole course of infusion including quantitative solvent dilution, the losses of empty ampule and rinsing of infusion bottle. It was determined through ultraviolet spectrophotometry. Results showed that in the whole course of infusion, the drug loss was 0. 516 g + 0.09 g.It accounted for 12.9% of total administrative medicine. It also showed that the drug loss was more in randomly using solvent than that in quantitatively solvent dilution and rinsing the empty ampule and infusion bottle once. Suggested that when one infuse powder medicine, one would dilute powder injection with quantitative solvent according to the ampule volume. And it may decrease the drug losses if one rinsed the empty ampule or infusion bottle once.%为进一步探讨静脉输注粉针剂药物过程中药物损失量,以头孢唑啉钠为例,对静脉输注过程、定量溶媒稀释、空药瓶及输液瓶冲中洗1次后药物损失量,采用紫外分光光度法进行测定。结果:静脉输注全过程药物损失量为0.516 g±0.09 g,占用药量的12.9%;随机采样药物损失量高于4ml定量溶媒溶解及冲洗1次空药瓶和输液瓶的药物损失量。提示:在静脉输注粉针剂药物时,应根据药瓶容积定量溶媒稀释、冲洗1次空药瓶及输液瓶,可减少药物损失量。

  20. 联合委员会国际部管理规程在门诊静脉输液中心的应用体会%Application and experience of JCI management order in outpatient intravenous infusion center

    Institute of Scientific and Technical Information of China (English)

    李桂琴

    2010-01-01

    我院自2001年建立门诊静脉输液中心,2003年通过联合委员会国际部(JCI)认证,在实践中不断完善门诊静脉输液的流程.观察自2009年4-6月到我院静脉输液中心接受静脉输液治疗的所有病人,无一例护理差错、护理缺陷和护患纠纷,病人对我院门诊输液护理的满意度达99.99%,另有3名病人对我中心的护理服务提出了更高的要求.JCI是人性化的护理和服务,通过持续不断的质量改进,经验总结和交流,不断完善护理服务体系,保证了门诊静脉输液病人的安全,降低了护理风险,提高了病人满意度.%Since 2001, our hospital established outpatient intravenous infusion center, which was certified through the joint committee on international (global competitiveness of JCI) certification in 2003.All the patients with venous infusion in this certer were observed from April to June in 2009.There wereno nursing error, defects and disputes, the satisfaction was 99.99%.There were 3 patients who put forward higher request.JCI is a kind of humanized service and care.Through continuous quality improvement, experience exchanges, and constantly improvement of nursing service system, the safety of patients in outpatient intravenous infusion was ensured, the risk of nursing was reduced and patient satisfaction was improve.

  1. To investigate the impact facots of dose of drug in intravenous infusion for decision-making%浅析静脉用药过程中影响药物剂量的护理因素及对策

    Institute of Scientific and Technical Information of China (English)

    卢桂华

    2012-01-01

    Objective To investigate the impact facots of dose of drug in intravenous infusion for decision-making. Methods 80 cases used of piperacillin tazobactam were randomly divided into control and experimental groups, using double-blind study, collection residual liquid of the original bottles and infusion tube, calculating drug dose, with daily infusion process in the control group, while strict intervention infusion process in experimental group. Average of drug residues between two groups with t-test. Results In control group, piperacillin tazobactam sodium content of the residual liquid average was(0. 9256 ± 0. 1189) g; experimental group ( 0. 2654 ± 0. 0398 ) g, P = 0. 000, the difference was statistically significant. Conclusion In intravenous drug preparation and the infusion process, strict rules of the nurses to reduce the residual liquid of drug.%目的 探讨静脉治疗过程中影响药物剂量的护理因素及对策.方法 80例输注哌拉西林钠他唑巴坦钠患者随机分为对照组和实验组,并采用双盲研究,收集原药瓶和输液器中的残留液计算残留药物剂量,对照组为护士日常输液流程,实验组为研究人员严格干预下输液流程.两组残留药物平均数进行t检验.结果 对照组残余药液平均含量为(0.9256±0.1189)g;实验组为(0.2654±0.0398)g(P=0.000),差异有统计学意义.结论 静脉药物配制及输液过程中,护理人员严格操作规程,可减少药液的残留.

  2. Adipose Tissue Promotes a Serum Cytokine Profile Related to Lower Insulin Sensitivity after Chronic Central Leptin Infusion

    Science.gov (United States)

    Burgos-Ramos, Emma; Canelles, Sandra; Perianes-Cachero, Arancha; Arilla-Ferreiro, Eduardo; Argente, Jesús; Barrios, Vicente

    2012-01-01

    Obesity is an inflammatory state characterized by an augment in circulating inflammatory factors. Leptin may modulate the synthesis of these factors by white adipose tissue decreasing insulin sensitivity. We have examined the effect of chronic central administration of leptin on circulating levels of cytokines and the possible relationship with cytokine expression and protein content as well as with leptin and insulin signaling in subcutaneous and visceral adipose tissues. In addition, we analyzed the possible correlation between circulating levels of cytokines and peripheral insulin resistance. We studied 18 male Wistar rats divided into controls (C), those treated icv for 14 days with a daily dose of 12 μg of leptin (L) and a pair-fed group (PF) that received the same food amount consumed by the leptin group. Serum leptin and insulin were measured by ELISA, mRNA levels of interferon-γ (IFN-γ), interleukin-2 (IL-2), IL-4, IL-6, IL-10 and tumor necrosis factor-α (TNF-α) by real time PCR and serum and adipose tissue levels of these cytokines by multiplexed bead immunoassay. Serum leptin, IL-2, IL-4, IFN-γ and HOMA-IR were increased in L and TNF-α was decreased in PF and L. Serum leptin and IL-2 levels correlate positively with HOMA-IR index and negatively with serum glucose levels during an ip insulin tolerance test. In L, an increase in mRNA levels of IL-2 was found in both adipose depots and IFN-γ only in visceral tissue. Activation of leptin signaling was increased and insulin signaling decreased in subcutaneous fat of L. In conclusion, leptin mediates the production of inflammatory cytokines by adipose tissue independent of its effects on food intake, decreasing insulin sensitivity. PMID:23056516

  3. 三种泵用胰岛素体外对抗等电点沉淀的研究%In vitro study on resistance towards isoelectric precipitation of insulin products used for continuous subcutaneous insulin infusion

    Institute of Scientific and Technical Information of China (English)

    汤智慧; 金杨红; 母义明; 崔晓飞; 李久旭; 梁潇; 李芳

    2015-01-01

    目的 比较三种市售泵用胰岛素对抗等电点沉淀的效果. 方法 通过加入稀释盐酸的方法模拟pH值下降过程中,用高效液相色谱(HPLC)测定三种胰岛素(重和林 R、诺和灵 R、优泌林 R)等电点沉淀情况. 并采用高斯拟合的方法绘制出沉淀曲线,并得出三种胰岛素发生沉淀时的pH值. 结果 重和林R、诺和灵R和优泌林R在出现10%和90%沉淀时的pH值分别为6. 52和5. 82,6. 85 和6. 00,6. 68 和5. 94. 结论 重和林R开始出现沉淀的pH值最低,对抗等电点的作用最强,其次是优泌林R,诺和灵R最差. 胰岛素等电点会引起胰岛素构象改变发生沉淀,阻塞胰岛素泵,进而引起血糖控制不佳. 但本研究仅在体外比较了胰岛素对抗等电点沉淀的不同,与临床中胰岛素泵堵塞之间作用的机制仍需进一步研究.%Objective To compare the resistance towards isoelectric precipitation of three insulin products used for continuous subcutaneous insulin infusion. Methods The degree of isoelectric insulin precipitation of recombinant human insulin injection( SciLin R) ,Biosynthetic human insulin injection ( Novolin R) ,and recombinant human insulin injection (Humulin R) was examined by HPLC in the simulation of reducing pH with addition of diluted HCl. The modified Gaussian model was used to superimpose the percentage of precipitated insulin versus pH. Results The pH value at the time point of 10% and 90% precipitation occurred was 6. 52 and 5. 82 for SciLin R,6. 85 and 6. 00 for No-volin R,6. 68 and 5. 94 for Humulin R. Conclusion Resistance towards isoelectric precipitation is highest for SciLin R,while the pH value when the precipitation occurred is lowest. The resistance towards isoelectric precipitation of Nov-olin R is lowest. Isoelectric precipitation can alter the pharmacokinetic properties of the insulin and lead to the occlu-sion of the infusion catheter,result in poor control of blood sugar. The article compared the

  4. Aprotinin induced lipohypertrophy and glomerulonephritis in an insulin dependent diabetic.

    Science.gov (United States)

    Dandona, P; Mier, A; Boag, F; Chappell, M; Beckett, A G

    1985-07-01

    In an insulin dependent diabetic who was hyperglycaemic and ketotic despite 3,000 u of insulin injected subcutaneously in 2 divided doses daily, 50 u of intravenous insulin infused over 24 hr restored normal glucose homeostasis. A combination of insulin (800 u) and aprotinin (10,000 u) given twice daily also produced adequate glucose homeostasis for a period of 12 months. The patient then developed local hypertrophy of subcutaneous tissue at the injection site and her diabetic control deteriorated. Non-selective proteinuria followed and she developed nephrotic syndrome. Renal biopsy revealed a membraneous glomerulonephritis with subepithelial immune complexes, appearances consistent with a drug-induced glomerulonephritis. Withdrawal of aprotinin led to a gradual remission of nephrotic syndrome and proteinuria over several months. During this period, her diabetes was well controlled with continuous subcutaneous infusion of insulin at a dose of 500 u/24 hr. This case report demonstrates: the effective use of aprotinin for prolonged periods in insulin dependent diabetics with abnormal absorption of subcutaneously injected insulin; aprotinin induced lipohypertrophy which was not observed when insulin was injected alone; aprotinin-associated glomerulonephritis and nephrotic syndrome; the effective use of CSII--at higher insulin doses--in such patients with subcutaneous malabsorption of insulin.

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

    Science.gov (United States)

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

    2011-07-01

    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-α, 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.

  6. ROLE OF THE SYMPATHOADRENAL SYSTEM IN EXERCISE-INDUCED INHIBITION OF INSULIN-SECRETION - EFFECTS OF ISLET TRANSPLANTATION

    NARCIS (Netherlands)

    HOUWING, H; FRANKEL, KMA; STRUBBE, JH; VANSUYLICHEM, PTR; STEFFENS, AB

    1995-01-01

    The present study was designed to investigate the mechanism leading to inhibition of insulin release during exercise. To investigate the influence of circulating epinephrine and norepinephrine, these catecholamines were infused intravenously in resting islet-transplanted and control rats. The role o

  7. Direct infusion of a variant of insulin-like growth factor-I into the skin of sheep and effects on local blood flow, amino acid utilization and cell replication.

    Science.gov (United States)

    Harris, P M; McBride, B W; Gurnsey, M P; Sinclair, B R; Lee, J

    1993-12-01

    In vivo effects of local infusion of a variant of insulin-like growth factor-I (IGF-I), long-R3-IGF-I, into the skin were investigated using six conscious sheep with food available ad libitum. An artery and vein on the abdominal flank of each animal, as well as the saphenous artery, were catheterized so that infusion of isotopically labelled amino acids, with or without IGF-I, could be used to determine amino acid uptake by arteriovenous difference in combination with blood flow determined by dye dilution. Measurements were made on each animal prior to IGF-I infusion, at hourly intervals for the 4 h of IGF-I infusion into the skin artery, then 2 and 4 h after IGF-I infusion ceased. Numbers of cells replicating in the bulbs of wool follicles in the IGF-I-infused area and in the skin on the contralateral side of each animal were measured after labelling with 5-bromo-2'-deoxyuridine. IGF-I caused a significant increase in the skin blood flow (P IGF-I increased amino acid uptake regardless of whether the skin was in negative or positive amino acid balance prior to infusion. During the recovery period amino acid utilization by skin returned towards preinfusion levels. No effects of IGF-I were found on replicating cell numbers in the bulbs of wool follicles. PMID:8133213

  8. Intravenous iron isomaltoside 1000 administered by high single-dose infusions or standard medical care for the treatment of fatigue in women after postpartum haemorrhage

    DEFF Research Database (Denmark)

    Holm, Charlotte; Thomsen, Lars Lykke; Norgaard, Astrid;

    2015-01-01

    BACKGROUND: Postpartum haemorrhage can lead to iron deficiency with and without anaemia, the clinical consequences of which include physical fatigue. Although oral iron is the standard treatment, it is often associated with gastrointestinal side effects and poor compliance. To date, no published...... randomised controlled studies have compared the clinical efficacy and safety of standard medical care with intravenous administration of iron supplementation after postpartum haemorrhage.The primary objective of this study is to compare the efficacy of an intravenous high single-dose of iron isomaltoside...... 1000 with standard medical care on physical fatigue in women with postpartum haemorrhage. METHODS/DESIGN: In a single centre, open-labelled, randomised trial, women with postpartum haemorrhage exceeding 700 mL will be allocated to either a single dose of 1,200 mg of iron isomaltoside 1000 or standard...

  9. 分析静脉输液中存在的安全隐患与总结有效的防范措施%Safety Hidden Trouble in Intravenous Infusion and Its Effective Preventive Measures

    Institute of Scientific and Technical Information of China (English)

    林燕

    2016-01-01

    Objective To analyze the safety hidden danger of intravenous infusion,and to summarize the effective measures to prevent.Methods Safety hazards in 40 patients in intravenous infusion,the patient's data were retrospectively analyzed,and analysis of security risks for a variety of reasons. Results After effective nursing,the quality of transfusion was improved significantly,the safety of transfusion was guaranteed,and the disputes and the occurrence of medical accidents were reduced.Conclusion In venous transfusion,nursing staff to deal with the possible problems accomplish know fairly well,strictly grasp the patient's indications to the maximum security of transfusion.%目的:分析静脉输液中存在的安全隐患,总结出有效的防范措施。方法选取在静脉输液中发生安全隐患的40例患者,对患者的资料进行回顾性分析,并分析发生安全隐患的各种原因。结果通过有效的护理后显著提高了输液质量,保证了输液的安全,减少了护患纠纷及医疗事故的发生。结论在静脉输液中,护理人员应对可能发生的问题做到心中有数,严格掌握患者的指征,以最大限度地保证输液安全。

  10. Calculi associated with intravenous infusion of ceftriaxone sodium in two infants%婴儿静脉输注头孢曲松钠相关结石2例

    Institute of Scientific and Technical Information of China (English)

    杨景秀; 戈升荣

    2014-01-01

    Two male infants (aged 5 months and 19 days,and 3 months and 19 days,respectively) were given an intravenous infusion of ceftriaxone sodium 0.7 g in 0.9% sodium chloride 100 ml once daily and an intravenous infusion of ceftriaxone sodium 0.6 g in 0.9% sodium chloride 50 ml once daily for bronchitis and infectious diarrhea,respectively.On day 10 and 4,white granules were found on skin surface of the two infants'oschea.There were no inflamed urinary meatus and abnormal results of routine urine tests.The white granules gradually decreased and disappeared after ceftriaxone sodium was withdrawn.%2例男婴(年龄分别为5个月19 d、3个月19 d)分别因支气管炎和感染性腹泻分别给予头孢曲松钠0.7g入0.9%氯化钠注射液100 ml静脉滴注,1次/d和头孢曲松钠0.6g入0.9%氯化钠注射液50 ml静脉滴注,1次/d.分别在用药第10、4天家长发现患儿阴囊处白色颗粒物,附于皮肤表面,尿道口无红肿,尿常规检查无异常.头孢曲松钠停用或减量后,白色颗粒物逐渐减少至消失.

  11. A QUASI EXPERIMENTAL STUDY TO EVALUATE EFFECTIVENESS OF GLYCERIN MAGNESIUM SULPHATE DRESSING ON PHLEBITIS AMONG PATIENTS UNDERGOING PERIPHERAL INTRAVENOUS INFUSION IN SELECTED HOSPITAL,VADODARA

    Directory of Open Access Journals (Sweden)

    Ravindra HN, Patel Krupa D

    2015-07-01

    Full Text Available Introduction: Intravenous therapy is indicated for many reasons. A significant number of patients admitted into hospital receive some forms of intravenous therapy through peripheral venous cannula, which is a common procedure carried out in hospital to allow rapid and accurate administration of medication. However, the intravenous cannulation can have undesirable effects, the most of which is phlebitis, which is due to mechanical, chemical or infectious cause. Method: In this study quasi-experimental research approach was used. Non probability purposive sampling technique was used to select the sample from the selected hospital. The research design adopted for the study was pre-test, post-test control group design. In the present study a sample of 60 hospitalised patients and who met the inclusion criteria was selected from the target population. In this study the instruments used are baseline Performa, structured interview schedule to assess the subjective symptoms and observation scale to observe the objective symptoms. Result: In experimental group post test mean score 1.10, SD was 0.71 respectively. In control group post test mean score 2.53, SD was 0.78 respectively. The obtained value 7.454 statistically was significant at 0.001 levels. So research hypothesis was accepted. So there was significant difference between post intervention phlebitis among the experimental group and control group. Discussion: In the research study findings revealed that Glycerin Magnesium sulphate dressing is highly effective in decrease phlebitis level to the patients.

  12. Pplication of Quality Control Circle in Reducing the Occurrence of Intravenous Infusion among In-patients%品管圈活动在降低住院患者输液外渗发生率中的应用

    Institute of Scientific and Technical Information of China (English)

    朱其华; 冯银平; 梁娣; 朱锐锐; 朱昌敏; 卞士敏; 孙红梅

    2015-01-01

    Objective: To investigate the effect of quality control circle (QCC)activities in reducing the occur-rence rate of intravenous infusion extravasation. Methods:QCC group was established to analyze the reasons and fac-tors influencing the incidence of peripheral extravasation, formulate corresponding activities plan and countermea-sures, and then compare the infusion exosmosis rate, the nurses sense of responsibility and work enthusiasm before and after quality control circle. Results:Before and after QCC the infusion exosmosis rate were 10.5%and 2.9%re-spectively and the difference was statistically significant ( P<0.01). At the same time, the nurses' sense of responsibility and work initiative were improved through participation in quality control circle. Conclusion: The QCC activities could reduce the incidence rate of venous infusion extravasation, improve the nurses sense of responsibility and work enthusiasm and standardize the infusion process, which can assure the nursing safety,and provide better nursing service for patients.%目的:探讨品管圈活动在降低静脉输液外渗发生率中的运用效果。方法:成立品管圈小组,分析影响输液外渗的原因及因素,制订相应的活动计划及实施对策,将活动前后的输液外渗发生率、护理人员的责任心、工作积极性等进行对比。结果:品管圈活动前后输液外渗发生率分别为10.5%、2.9%,差异具有统计学意义(P<0.01);同时通过品管圈活动,提高了护士的责任心、工作积极性等。结论:品管圈活动的开展降低了静脉输液外渗的发生率,提升了护士的责任心、工作积极性等,规范了输液操作流程,在保障护理安全的同时,为患者提供了更优质的护理服务。

  13. Bomba de infusão de insulina em diabetes melito tipo 1 Insulin pump therapy in type 1 diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Raphael Del Roio Liberatore Jr.

    2006-08-01

    Full Text Available OBJETIVO: Rever a experiência com a utilização da bomba de infusão de insulina em crianças e adolescentes, a fim de orientar o pediatra quanto às suas indicações e complicações. FONTE DOS DADOS : Foi realizada revisão sistemática de artigos publicados em literatura que abordassem a utilização da bomba de infusão de insulina, suas indicações, complicações e resposta ao tratamento. Dessa forma, todos os artigos publicados entre 1995 e 2005 foram resgatados através do levantamento em banco de dados MEDLINE e LILACS. As palavras-chave utilizadas foram: insulin pumps, type 1 diabetes mellitus e diabetes mellitus. Foram separados os artigos que, além disso, versassem sobre o assunto na faixa etária descrita SÍNTESE DOS DADOS: O uso da bomba de infusão de insulina em pacientes com diabetes melito tipo 1 não é uma necessidade para todos os pacientes, visto que, com tratamentos intensivos, os resultados conseguidos são muito parecidos, em termos de hemoglobina glicada e de controle de complicações a médio e longo prazo. No entanto, a bomba permite um maior conforto ao paciente, no sentido de que ele não precisa ficar tão restrito a horários rígidos de refeição e pode levar uma vida com melhor qualidade. Um primeiro requisito para quem pretenda usar a bomba é adaptar-se a aparelhos conectados ao corpo e a ter uma rotina de monitorização glicêmica rigorosa, pois, sem isso, as vantagens da bomba serão anuladas. As complicações, com os avanços tecnológicos de que dispomos atualmente, são muito infreqüentes. O custo, no entanto, é maior que nos tratamentos convencionais. CONCLUSÃO: Com a evolução das bombas de infusão e dos monitores de glicemia, incluindo sistemas de monitorização contínua, abre-se caminho para as "bombas inteligentes", e estaremos com um verdadeiro "pâncreas artificial", que pode mesmo ser implantado no paciente, permitindo uma vida com todas as regalias de uma pessoa não diab

  14. Optimization of health-care organization and perceived improvement of patient comfort by switching from intra-venous BU four-times-daily infusions to a once-daily administration scheme in adult hematopoietic stem cell recipients.

    Science.gov (United States)

    Xhaard, A; Rzepecki, P; Valcarcel, D; Santarone, S; Fürst, S; Serrano, D; De Angelis, G; Krüger, W; Scheid, C

    2014-04-01

    Previous studies have shown an equivalent pharmacokinetic profile between four-times-daily (4QD) and once-daily (QD) administration of intra-venous (IV) BU, without increased toxicity. We assess the impact of a switch in IV BU from a 4QD to a QD schedule, in terms of health-care organization, staff working conditions, quality of care dispensed and perceived patient comfort. Clinicians, nurses and pharmacists from nine allogeneic transplantation units in five European countries were interviewed face to face. Overall perception of QD versus 4QD BU was very positive. Both administration schemes were evaluated to be equally efficaciousZ. QD BU was perceived to be safer and more convenient. Clinicians and nurses perceived that patient comfort was improved, due to fewer complications associated with repeated infusions, and avoiding night infusions associated with stress, anxiety and decreased quality of sleep. Switching from 4QD to QD BU had a significant impact on health-care organization, with a better integration in the overall management and usual timelines in the pharmacies and transplantation units. Time spent to prepare and administer BU was significantly reduced, leading to potential financial savings that merit further assessment and would be of particular interest in the current economic climate. PMID:24419513

  15. Biodistribution of boron after intravenous 4-dihydroxyborylphenylalanine-fructose (BPA-F) infusion in meningioma and schwannoma patients: A feasibility study for boron neutron capture therapy.

    Science.gov (United States)

    Kulvik, Martti; Kallio, Merja; Laakso, Juha; Vähätalo, Jyrki; Hermans, Raine; Järviluoma, Eija; Paetau, Anders; Rasilainen, Merja; Ruokonen, Inkeri; Seppälä, Matti; Jääskeläinen, Juha

    2015-12-01

    We studied the uptake of boron after 100 mg/kg BPA infusion in three meningioma and five schwannoma patients as a pre-BNCT feasibility study. With average tumour-to-whole blood boron concentrations of 2.5, we discuss why BNCT could, and probably should, be developed to treat severe forms of the studied tumours. However, analysing 72 tumour and 250 blood samples yielded another finding: the plasma-to-whole blood boron concentrations varied with time, suggesting that the assumed constant boron ratio of 1:1 between normal brain tissue and whole blood deserves re-assessment. PMID:26298436

  16. The study of intravenous infusion mannitol exudation using fresh potatoes compress%静脉输入甘露醇渗出采用新鲜马铃薯外敷的效果研究

    Institute of Scientific and Technical Information of China (English)

    林伟

    2012-01-01

    目的 探讨静脉输入甘露醇渗出采用新鲜马铃薯外敷的效果.方法 将在门诊输液室静脉输入甘露醇渗出的患者60例,随机分为实验组和对照组各30例,实验组给予新鲜马铃薯外敷患处皮肤,对照组给予50%硫酸镁湿敷患处皮肤,疼痛程度采用视觉模拟评分尺进行评分,分别于外敷前及外敷30 min后观察两组患者的疼痛程度及观察两组患者的疗效.结果 实验组患者外敷30 min后疼痛程度较对照组明显减轻,渗出局部组织红、肿、疼痛症状消失快,两者比较(P<0.01),差异有统计学意义.结论 新鲜马铃薯外敷治疗静脉输入甘露醇渗出的疗效比50%硫酸镁湿外敷的疗效显著确切,而且对皮肤组织无刺激,无污染,经济方便,建议临床推广应用.%Objective To explored intravenous infusion mannitol exudation by fresh potatoes compress.Methods The patients with intravenous infusion mannitol exudation in outpatient infusion room were randomly divided into exprimental group and control group,each group was 30 cases,exprimental group was given fresh patato to compress in skin lesion,control group was given 50% magnesium sulfate to wet compress the skin lesion,Using visual analogue scale to score pain intensity,the pain intensity and efficacy of the two group patients before compress and after compress 30 s were observed.Results The pain intensity of exprimental group after compress 30s was released signifiacantly compared with that of control group,and the redness,swelling,pain of leakage local tissue disappeared rapidly had significant differences between the both groups ( P < 0.01 ).Conclusions Fresh potatoes compress to treat intravenous infusion mannitol exudation is markedly exact comparing with 50% magnesium sulfate to wet compress,but no stimulation of the skin tissue,non -polluting,economical and convenient,and adviced to propose and applicate in clinical.

  17. Co-infusion of autologous adipose tissue derived insulin-secreting mesenchymal stem cells and bone marrow derived hematopoietic stem cells: Viable therapy for type III.C. a diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Umang G Thakkar

    2014-12-01

    Full Text Available Transition from acute pancreatitis to insulin-dependent diabetes mellitus (IDDM is a rare manifestation of primary hyperparathyroidism caused by parathyroid adenoma because of impaired glucose tolerance and suppresses insulin secretion. We report the case of a 26-year-old male with pancreatic diabetes caused by parathyroid adenoma induced chronic pancreatitis. He had serum C-peptide 0.12 ng/ml, glutamic acid decarboxylase antibody 5.0 IU/ml, and glycosylated hemoglobin (HbA1C 8.9%, and required 72 IU/day of biphasic-isophane insulin injection for uncontrolled hyperglycemia. We treated him with his own adipose tissue derived insulin-secreting mesenchymal stem-cells (IS-ADMSC along with his bone marrow derived hematopoietic stem cells (BM-HSC. Autologous IS-ADMSC + BM-HSC were infused into subcutaneous tissue, portal and thymic circulation without any conditioning. Over a follow-up of 27 months, the patient is maintaining fasting and postprandial blood sugar levels of 132 and 165 mg/dl, respectively, with HbA1C 6.8% and requiring 36 IU/day of biphasic-isophane insulin. Co-infusion of IS-ADMSC + BM-HSC offers a safe and viable therapy for type III.C.a Diabetes Mellitus.

  18. Co-infusion of autologous adipose tissue derived insulin-secreting mesenchymal stem cells and bone marrow derived hematopoietic stem cells: viable therapy for type III.C. a diabetes mellitus.

    Science.gov (United States)

    Thakkar, Umang G; Vanikar, Aruna V; Trivedi, Hargovind L

    2013-01-01

    Transition from acute pancreatitis to insulin-dependent diabetes mellitus (IDDM) is a rare manifestation of primary hyperparathyroidism caused by parathyroid adenoma because of impaired glucose tolerance and suppresses insulin secretion. We report the case of a 26-year-old male with pancreatic diabetes caused by parathyroid adenoma induced chronic pancreatitis. He had serum C-peptide 0.12 ng/ml, glutamic acid decarboxylase antibody 5.0 IU/ml, and glycosylated hemoglobin (HbA1C) 8.9%, and required 72 IU/day of biphasic-isophane insulin injection for uncontrolled hyperglycemia. We treated him with his own adipose tissue derived insulin-secreting mesenchymal stem-cells (IS-ADMSC) along with his bone marrow derived hematopoietic stem cells (BM-HSC). Autologous IS-ADMSC + BM-HSC were infused into subcutaneous tissue, portal and thymic circulation without any conditioning. Over a follow-up of 27 months, the patient is maintaining fasting and postprandial blood sugar levels of 132 and 165 mg/dl, respectively, with HbA1C 6.8% and requiring 36 IU/day of biphasic-isophane insulin. Co-infusion of IS-ADMSC + BM-HSC offers a safe and viable therapy for type III.C.a Diabetes Mellitus. PMID:24385073

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

    DEFF Research Database (Denmark)

    Vardarli, Irfan; Arndt, Elisabeth; Deacon, Carolyn F;

    2014-01-01

    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...... 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...

  20. Practice of teachers' care about nursing students during intravenous infusion training%静脉输液实训中教师对护生关怀的实践

    Institute of Scientific and Technical Information of China (English)

    李晓环; 卢建文; 张新宇

    2011-01-01

    Objective To observe the impact of teachers' care about nursing students during intravenous infusion training,and to probe into the feasibility of integrating caring education into teaching. Methods Nursing students of four classes from a junior college were randomly divided into an observation group (n=56) and a control group (n = 60). For students in the control group, teachers routinely demonstrated the intravenous infusion procedure. For students in the observation group, teachers practiced caring behaviors to them besides the demonstration of the routine procedure: teachers conducted investigation to comprehend students' cognition about the training, they respected students' choice, embraced their psychological reaction, helped students adjust their anxiety, and provided emotional support. Results The proportion of students who voluntarily acted as puncture recipients, the rate of successful first puncture, and proportion of students who embarked on the journey of a second puncture after a failure in the observation group were significantly higher than those in the control group (P<0. 05 for all). Students in the observation group more actively employed humanistic caring during the training, and their emotional reaction about the procedure were better than the control group. Conclusion The practice of teachers integrating caring into intravenous infusion training helps students better comprehend the caring theory. Teachers should practice caring behaviors as much as possible so as to provide students with more opportunities of feeling the unreserved support and giving concern of humanity.%目的 观察教师在静脉输液实训中给护生实施关怀的效果,探讨在教学中渗透关怀教育的可行性.方法 在实训前将4个班的高职护生分成两组,对照组(60人)行常规操作指导,观察组(56人)在常规操作讲解基础上实施关怀,包括了解护生对实训的认知,尊重护生选择,接纳心理反应,调

  1. Pain management in emergency department: intravenous morphine vs. intravenous acetaminophen

    Directory of Open Access Journals (Sweden)

    Morteza Talebi Doluee

    2015-01-01

    Full Text Available Pain is the most common complaint in emergency department and there are several methods for its control. Among them, pharmaceutical methods are the most effective. Although intravenous morphine has been the most common choice for several years, it has some adverse effects. There are many researches about intravenous acetaminophen as an analgesic agent and it appears that it has good analgesic effects for various types of pain. We searched some electronic resources for clinical trials comparing analgesic effects of intravenous acetaminophen vs. intravenous morphine for acute pain treatment in emergency setting.In two clinical trials, the analgesic effect of intravenous acetaminophen has been compared with intravenous morphine for renal colic. The results revealed no significant difference between analgesic effects of two medications. Another clinical trial revealed that intravenous acetaminophen has acceptable analgesic effects on the post-cesarean section pain when combined with other analgesic medications. One study revealed that administration of intravenous acetaminophen compared to placebo before hysterectomy decreased consumption of morphine via patient-controlled analgesia pump and decreased the side effects. Similarly, another study revealed that the infusion of intravenous acetaminophen vs. placebo after orthopedic surgery decreased the consumption of morphine after the surgery. A clinical trial revealed intravenous acetaminophen provided a level of analgesia comparable to intravenous morphine in isolated limb trauma, while causing less side effects than morphine.It appears that intravenous acetaminophen has good analgesic effects for visceral, traumatic and postoperative pains compare with intravenous morphine.

  2. MATLAB-implemented estimation procedure for model-based assessment of hepatic insulin degradation from standard intravenous glucose tolerance test data.

    Science.gov (United States)

    Di Nardo, Francesco; Mengoni, Michele; Morettini, Micaela

    2013-05-01

    Present study provides a novel MATLAB-based parameter estimation procedure for individual assessment of hepatic insulin degradation (HID) process from standard frequently-sampled intravenous glucose tolerance test (FSIGTT) data. Direct access to the source code, offered by MATLAB, enabled us to design an optimization procedure based on the alternating use of Gauss-Newton's and Levenberg-Marquardt's algorithms, which assures the full convergence of the process and the containment of computational time. Reliability was tested by direct comparison with the application, in eighteen non-diabetic subjects, of well-known kinetic analysis software package SAAM II, and by application on different data. Agreement between MATLAB and SAAM II was warranted by intraclass correlation coefficients ≥0.73; no significant differences between corresponding mean parameter estimates and prediction of HID rate; and consistent residual analysis. Moreover, MATLAB optimization procedure resulted in a significant 51% reduction of CV% for the worst-estimated parameter by SAAM II and in maintaining all model-parameter CV% MATLAB-based procedure was suggested as a suitable tool for the individual assessment of HID process.

  3. Plasma and interstitial fluid pharmacokinetics of enrofloxacin, its metabolite ciprofloxacin, and marbofloxacin after oral administration and a constant rate intravenous infusion in dogs.

    Science.gov (United States)

    Bidgood, T L; Papich, M G

    2005-08-01

    Enrofloxacin and marbofloxacin were administered to six healthy dogs in separate crossover experiments as a single oral dose (5 mg/kg) and as a constant rate IV infusion (1.24 and 0.12 mg/h.kg, respectively) following a loading dose (4.47 and 2 mg/kg, respectively) to achieve a steady-state concentration of approximately 1 microg/mL for 8 h. Interstitial fluid (ISF) was collected with an in vivo ultrafiltration device at the same time period as plasma to measure protein unbound drug concentrations at the tissue site and assess the dynamics of drug distribution. Plasma and ISF were analyzed for enrofloxacin, its active metabolite ciprofloxacin, and for marbofloxacin by high performance liquid chromatography (HPLC). Lipophilicity and protein binding of enrofloxacin were higher than for marbofloxacin and ciprofloxacin. Compared to enrofloxacin, marbofloxacin had a longer half-life, higher Cmax, and larger AUC(0-infinity) in plasma and ISF after oral administration. Establishing steady state allowed an assessment of the dynamics of drug concentrations between plasma and ISF. The ISF and plasma-unbound concentrations were similar during the steady-state period despite differences in lipophilicity and pharmacokinetic parameters of the drugs.

  4. Increased amino acid supply potentiates glucose-stimulated insulin secretion but does not increase β-cell mass in fetal sheep

    OpenAIRE

    Gadhia, Monika M.; Maliszewski, Anne M.; O'Meara, Meghan C.; Thorn, Stephanie R; Lavezzi, Jinny R; Limesand, Sean W.; Hay, William W; Brown, Laura D; Rozance, Paul J.

    2012-01-01

    Amino acids and glucose acutely stimulate fetal insulin secretion. In isolated adult pancreatic islets, amino acids potentiate glucose-stimulated insulin secretion (GSIS), but whether amino acids have this same effect in the fetus is unknown. Therefore, we tested the effects of increased fetal amino acid supply on GSIS and morphology of the pancreas. We hypothesized that increasing fetal amino acid supply would potentiate GSIS. Singleton fetal sheep received a direct intravenous infusion of a...

  5. Thrombocytopenia induced by intravenous infusion of cefuroxime%头孢呋辛静脉滴注致血小板减少

    Institute of Scientific and Technical Information of China (English)

    吴志恒; 杨波

    2011-01-01

    1例70岁女性患者拟行脑膜瘤切除术,术前因肺部感染给予头孢呋辛2 g溶于0.9%氯化钠溶液250 ml,1次/d静脉滴注。用药前血小板166×109/L,用药第2天血小板急剧下降至40×109/L,但无临床出血表现。考虑可能与头孢呋辛有关,遂停用该药,改用氧氟沙星,换药1 d后血小板上升至160×109/L。随后肺部感染好转,手术顺利完成。%A 70-year-old woman was planned to undergo meningeoma resection and received an IV infusion of cefuroxime 2 g dissolved in 250 ml of 0.9% sodium chloride once daily for a lung infection before operation. Her platelet count was 166 × 109/L before drug administration and, on day 2 of treatment, her platelet count rapidly dropped to 40 × 109/L, but no evidence of clinical bleeding. It was considered to be associated with cefuroxime, so the drug was withdrawn and switched to ofloxacin. One day after change to ofloxacin, her platelet count rose to 160 × 109/L. Thereafter, the pulmonary infection improved and the operation completed uneventfully.

  6. Suggestion therapy for peripheral intravenous infusion of potassium liquid causes pain effects%暗示疗法对经外周静脉输入含钾液体引起疼痛的效果观察

    Institute of Scientific and Technical Information of China (English)

    郑小凤; 夏彤; 何丹丹

    2013-01-01

    目的:探讨通过暗示疗法减轻经外周静脉输入含钾液体引起病员局部明显疼痛的效果。方法:随机选择我科输入钾盐的病员80例,将她们分为观察组和对照组进行对比,观察组按照常规输液操作程序,事先告知病员药名、药理作用和用药后的不适;对照组通过暗示疗法告知病员今天不用输入钾盐,不会引起疼痛不适,并取得家属的配合,分散病员对疼痛的注意力。结果:对照组的病员通过暗示的方法能够明显的减轻疼痛,输液速度加快,输液时间降低,差异有统计学意义(P<0.05)。%Objectives Explore through suggestion therapy to alleviate the peripheral pain of patients caused by intravenous infusion of po-tassium -containing liquid local apparent effect .Methods Patients in 80 cases of random choice ,I entered the potash ,divide them into Observ-er Group and control group for comparison ,Observer Group in the usual transfusion procedures ,inform patients in advance of medicine ,Phar-macology and medicine do not apply ;Control group by the suggestion of therapy ,inform the patient without entering potash today will not cause pain ,discomfort ,and families cope with scattered patient attention to pain .Results According to the patient by the suggestion of the group could significantly lessen the pain ,speed infusion ,infusion duration has been decreased (P<0 .05) ,a statistically significant difference .

  7. Norelgestromin/ethinyl estradiol intravenous infusion formulation optimization, stability and compatibility testing: A case study to overcome polysorbate 80 interference in chromatographic analysis.

    Science.gov (United States)

    Abdallah, Inas A; Hammell, Dana C; Hassan, Hazem E; Stinchcomb, Audra L

    2016-06-01

    Norelgestromin/ethinyl estradiol is a progestin/estrogen combination hormonal contraceptive indicated for the prevention of pregnancy in women. The very poor solubility and wettability of these drugs, along with their high potency (adsorption issues), give rise to difficulties in designing intravenous (IV) formulations to assess absolute bioavailability of products containing both drugs. The purpose of this study was to develop an IV formulation, evaluate its stability under different conditions and evaluate its compatibility with IV sets for potential use in absolute bioavailability studies in humans. Also, a selective high-performance liquid chromatography (HPLC) method for quantification of ethinyl estradiol and norelgestromin in polysorbate 80 matrix was developed and validated. Norelgestromin/ethinyl estradiol IV solution was prepared using sterile water for injection with 2.5% ethanol and 2.5% polysorbate 80 as a cosolvent/surfactant system to obtain a final drug solution of 25μg ethinyl estradiol and 252μg norelgestromin from a concentrated stock drug solution. The stabilities of the concentrated stock and IV solutions were assessed after storing them in the refrigerator (3.7±0.6°C) and at room temperature (19.5±0.5°C), respectively. Additional studies were conducted to examine the stability of the IV solution using an Alarias(®) low sorbing IV administration set with and without an inline filter. The solution was allowed to drip at 1mL/min over a 60min period. Samples were obtained at the beginning, middle and end of the 60min duration. The chemical stability was evaluated for up to 10 days. Norelgestromin and ethinyl estradiol concentration, purity, and degradant levels were determined using the HPLC method. The norelgestromin/ethinyl estradiol IV formulation met the chemical stability criteria when tested on day 1 through day 9 (216h). Norelgestromin concentrations assayed in stock and IV solutions were in the range of 90.0-98.5% and 90

  8. Pharmacokinetics and tissue distribution of ginkgolide A, ginkgolide B, and ginkgolide K after intravenous infusion of ginkgo diterpene lactones in a rat model.

    Science.gov (United States)

    Wang, Shuyao; Ouyang, Bingchen; Aa, Jiye; Geng, Jianliang; Fei, Fei; Wang, Pei; Wang, Jiankun; Peng, Ying; Geng, Ting; Li, Yanjing; Huang, Wenzhe; Wang, Zhenzhong; Xiao, Wei; Wang, Guangji

    2016-07-15

    Ginkgo diterpene lactones are compounds that are extracted from the Ginkgo biloba leaf and possess pharmacologic activities with neuroprotective effects. To address the poor bioavailability of ginkgo diterpene lactones, ginkgo diterpene lactone meglumine injection (GDLI) was formulated and is commercially available. In this study, a simple, sensitive and reliable liquid chromatography-tandem mass spectrometry (LC-MS/MS) method was developed and validated for assessing the total amount and the amount of the prototype forms of ginkgolides A (GA), B (GB) and K (GK) in rat plasma and tissues. This method was used to calculate the concentrations of the hydrolysed carboxylic forms and assess the pharmacokinetics of the ginkgolides after intravenous (i.v.) GDLI administration in rats. Generally, all three ginkgolide forms showed dose-dependent plasma concentrations, and no obvious differences in pharmacokinetic parameters, i.e., area under the curve (AUC) of plasma concentration versus time and half-life, were observed after GDLI administration on 7 consecutive days. These ginkgolides primarily existed in the carboxylic form in the plasma, and the systemic concentrations of the carboxylic forms of GA and GB were 11- to 17- and 3- to 4-fold higher than those of their prototype forms, respectively. In contrast, dramatically increased levels of the GA and GB prototype lactones were detected in the liver and heart. GA, GB, and GK were extensively distributed in various organs/tissues; the highest levels were found in the kidneys, liver, and intestine, and the lowest levels were found in the brain. These data suggest that ginkgolides have difficulty crossing the blood-brain barrier and that their targets for protecting against cerebral ischaemia are located outside the central system.

  9. Administration costs of intravenous biologic drugs for rheumatoid arthritis

    OpenAIRE

    Soini, Erkki J.; Leussu, Miina; Hallinen, Taru

    2013-01-01

    Background Cost-effectiveness studies explicitly reporting infusion times, drug-specific administration costs for infusions or real-payer intravenous drug cost are few in number. Yet, administration costs for infusions are needed in the health economic evaluations assessing intravenously-administered drugs. Objectives To estimate the drug-specific administration and total cost of biologic intravenous rheumatoid arthritis (RA) drugs in the adult population and to compare the obtained costs wit...

  10. Comparison of Efficacy between Continuous Subcutaneous Insulin Lispro Infusion and Human Regular Insulin Infusion on Newly-Diagnosed Type 2 Diabetes Patients%持续皮下输注胰岛素及其类似物对新诊断2型糖尿病疗效比较

    Institute of Scientific and Technical Information of China (English)

    肖天梅; 林泽宏; 李乐愚

    2012-01-01

    Objective To compare the efficacy of subcutaneous insulin analogue(insulin Lispro, Humalog) and regular human insulin ( Humulin R) infusion by insulin pump in newly-diagnosed type 2 diabetes patients. Methods Eighty-six cases with newly-diagnosed hospitalized diabetes were randomly divided into two groups,Humalog group and Humulin R group,and received continuous insulin infusion for 2 weeks. The level of fasting blood glucose ,2 h postprandial blood glucose, the lime and the doses of insulin needed for good glycemic control were compared between two groups. The rate of hypoglycemia and pump-related side effects were recorded. Results The time for good fasting glycemic control,good postprandial glycemic control between Humulin R group and Humalog group were (5.77 ± 1.41) d and (3.17 ± 1.36) d(P 0.05) ,but postprandial glucose was significant lowered in Humalog group than that in Huminlin R group(P<;0.05). The mean dose of insulin of Humalog group was lower but not significantly different. The incidence of hypoglycemia was significantly lower in the Humalog group than in the Humulin R group(P <0.05). Conclusion In newly-diagnosed type 2 diabetic patients,the continuous infusion of insulin Lispro or Humulin R can effectively control blood glucose. The use of Humalog proves more effective with better postprandial glucose level, with a shorter time for good glucose control and with a lower incidence of hypoglycemia compared with Humulin R.%目的 比较胰岛素泵持续皮下输注速效胰岛素类似物(赖脯胰岛素,优泌乐)和短效人胰岛素(优泌林R)治疗新诊断的2型糖尿病的疗效差异.方法 86例住院需胰岛素治疗的新诊断2型糖尿病患者,随机分为两组:优泌乐组和优泌林R组,胰岛素泵治疗2周,比较两组患者治疗过程中每日3餐前后和睡前血糖、血糖达标时间、胰岛素量、低血糖发生率及胰岛素泵相关的副作用.结果 优泌林R组和优泌乐组空腹血糖达标时间分别为(5

  11. 全麻患者静脉输注国产阿芬太尼的药代动力学%Pharmacokinetics of intravenously infused domestic alfentanil in patients undergoing general anesthesia

    Institute of Scientific and Technical Information of China (English)

    杨小娟; 吴超然

    2016-01-01

    目的 探讨全麻患者静脉输注国产阿芬太尼的药代动力学.方法 择期全麻下行甲状腺次全切除术患者12例,年龄18~47岁,体重49~ 86 kg,性别不限,ASA分级Ⅰ或Ⅱ级.静脉注射眯达唑仑0.02 mg/kg、阿芬太尼25 μg/kg、异丙酚1.5 mg/kg和罗库溴铵0.8 mg/kg,气管插管后接呼吸机行机械通气,麻醉维持:吸入0.8% ~2.0%七氟醚,静脉输注阿芬太尼1μg· kg-1·min-1,间断静脉注射罗库溴铵10~20 mg,维持BIS值40 ~ 60,手术结束前10 min时停止输注阿芬太尼.分别于麻醉诱导前、静脉输注阿芬太尼1、3、5、8、10、14、20、35、65、95、125 min及停止输注后5、15、30、60、120、180、240、300和360 min时采集静脉血样4 ml,采用高效液相色谱-质谱联用法测定血浆阿芬太尼浓度.采用DAS 3.0软件分析阿芬太尼药代动力学参数.结果 国产阿芬太尼药代动力学适用二室模型描述,其分布半衰期为(1.8±0.8) min,消除半衰期为(91±22) min;稳态分布容积为(0.38±0.12)L/kg;清除率为(4.3±1.6) ml· kg-1·min-1;国产阿芬太尼的消除符合一级消除动力学.结论 全麻患者静脉输注国产阿芬太尼的分布符合二室模型,其消除符合一级消除动力学.%Objective To investigate the pharmacokinetics of intravenously infused domestic alfentanil in the patients undergoing general anesthesia.Methods Twelve American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients of both sexes,aged 18-47 yr,weighing 49-86 kg,scheduled for elective subtotal thyroidectomy under general anesthesia,were enrolled in the study.Anesthesia was induced with iv midazolam 0.02 mg/kg,alfentanil 25 μg/kg,propofol 1.5 mg/kg and rocuronium 0.8 mg/kg.The patients were endotracheally intubated and mechanically ventilated.Anesthesia was maintained with inhalation of 0.8%-2.0% sevoflurane,iv infusion of alfentanil 1 μg · kg-1 · min-1,and intermittent iv boluses of rocuronium 10-20 mg

  12. 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

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

    Energy Technology Data Exchange (ETDEWEB)

    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

    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.

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

    Directory of Open Access Journals (Sweden)

    Passaro Patrizia

    2008-07-01

    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.

  15. What´s cheapest, intravenous iron sucrose- or intravenous iron carboxymaltose treatment in IBD patients?

    DEFF Research Database (Denmark)

    Bager, Palle; Dahlerup, Jens Frederik

      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...

  16. Intravenous lipid and amino acids briskly increase plasma glucose concentrations in small premature infants.

    Science.gov (United States)

    Savich, R D; Finley, S L; Ogata, E S

    1988-07-01

    We determined the glycemic response to intravenous lipid infusion alone, lipid with amino acids, or amino acids alone in 15 very small premature infants receiving constant glucose infusion during early life. Infants who received lipid or lipid and amino acids demonstrated significant increases in glucose compared with infants who received amino acids. The combination of lipid and amino acids resulted in an earlier increase than lipid alone. Although plasma insulin did not change in all three groups, infants who received amino acids alone demonstrated an appropriate increase in glucagon. These data suggest that lipid infusion, a commonly used means of providing nutrition to premature infants, may cause significant disturbances in glucoregulation, particularly when administered with amino acids. PMID:3132930

  17. Medanta insulin protocols in patients undergoing cardiac surgery

    Directory of Open Access Journals (Sweden)

    Beena Bansal

    2014-01-01

    Full Text Available Hyperglycemia is common in patients undergoing cardiac surgery and is associated with poor outcomes. This is a review of the perioperative insulin protocol being used at Medanta, the Medicity, which has a large volume cardiac surgery setup. Preoperatively, patients are usually continued on their preoperative outpatient medications. Intravenous insulin infusion is intiated postoperatively and titrated using a column method with a choice of 7 scales. Insulin dose is calculated as a factor of blood glucose and patient′s estimated insulin sensitivity. A comparison of this protocol is presented with other commonly used protocols. Since arterial blood gas analysis is done every 4 hours for first two days after cardiac surgery, automatic data collection from blood gas analyzer to a central database enables collection of glucose data and generating glucometrics. Data auditing has helped in improving performance through protocol modification.

  18. Determination of Content and Related Substances of Oxaliplatin Intravenous Infusion%奥沙利铂静脉输液的有关物质检查与含量测定

    Institute of Scientific and Technical Information of China (English)

    徐静; 张伟明; 李健和; 易利丹; 彭六保

    2013-01-01

    Objective To establish a HPLC method to determine the oxaliplatin content and the related substances of oxaliplatin intravenous infusion.Methods The HPLC method was adopted to determine the oxaliplatin content and related substances in oxaliplatin intravenous infusion.The Polaris C18-A column (200 mm×4.6 mm; 5 μm) was adopted with methanol-water(10 ∶ 90) as the mobile phase at the flow rate of 0.8 mL/min.The detection wavelength was set at 249 nm.The theoretical plate number was not less than 2 000 according to the peak of oxaliplatin.At the same time,the classic oxidimetry method for the determination of isotonic regulator mannite was established,which using the back titration with sodium thiosulfate titrant.Results The linear relation of oxaliplatin was excellent within the concentration range of 0.10-1.00 g/L(r=0.999 8),the limit of the detection was 0.06 μg.The average recovery rates of oxaliplatin and mannitol were 100.17% (RSD =0.53%) and 100.54% (RSD =0.34%),respectively.Conclusion This method is specific,accurate,sensitive and rapid with the reliable detection Results.%目的 建立测定奥沙利铂静脉输液中有关物质和奥沙利铂含量的高效液相色谱(HPLC)法.方法 采用HPLC法测定奥沙利铂静脉输液的有关物质和奥沙利铂的含量,Polaris C18-A色谱柱(200 mm×4.6 mm,5 μm),流动相为甲醇-水(10∶90),流速为0.8 mL/min,检测波长为249 nm,理论板数按奥沙利铂峰计不低于2 000.等渗调节剂甘露醇采用经典的氧化还原法,用硫代硫酸钠滴定液进行回滴定测定.结果 奥沙利铂进样质量浓度在0.10~1.00 g/L范围与峰面积线性关系良好(r=0.999 8),最低检测限为0.06 μg,平均回收率为100.17%(RSD =0.53%).甘露醇平均回收率为100.54% (RSD =0.34%).结论 该方法专属性好,准确、灵敏、快速,结果可靠.

  19. 骨髓间充质干细胞静脉输注对猕猴细胞免疫功能的影响%Effects on cellular immunity caused by intravenous infusion of allogenic rhesus mesenchymal stem cells

    Institute of Scientific and Technical Information of China (English)

    范传波; 王朝晖; 王磊; 胡锴勋; 刘丽辉; 孙琪云; 边莉; 乌庆超

    2011-01-01

    目的 评价猕猴间充质干细胞( MSC)静脉异体输注后对细胞免疫功能的影响。方法分离培养MSC;不做其他处理,将异体MSC静脉输注给受者猴,通过定期监测外周血象、混合淋巴细胞反应( MLR)、T细胞亚群来判断MSC输注后受者细胞免疫功能的变化。结果成功培养了猕猴的MSC。异体MSC输注后,受者无明显毒性反应、排异表现及血象变化。可以在一定时间内(2周左右)抑制受者T细胞在MLR中的增殖活性,受者猴A2、A3及A4输注MSC的数量分别为4.0×105/kg、1.0×106/kg、2.0×106/kg,在输注后第14天时,MLR的相对反应值(RR)与输注前比较均明显降低,分别从(46.0±2.6)%、( 40.9±2.3)%、(48.3±2.0)%降至(40.4±1.73)%、(33.0±2.1)%、(39.0±1.0)%(F=1O.19,P=0.023;F=2.593,P= 0.013;F= 28.431,P=0.003),输注后第30天时RR均恢复到输注前水平;统计结果显示,抑制程度(△RR)与输注MSC数量呈正相关(F=27.413,P=0.038)。A4是输注MSC数量最多的受者,输注后第14天开始,外周血CD3+、CD3+ CD4+、CD3+CD8+细胞的百分比与输注前相比有所降低,在输注后第30天左右恢复至输注前水平。结论单纯体内输注异体MSC,可以在一定时间内抑制受者T细胞的免疫活性;免疫抑制程度与输注MSC数量呈正相关。MSC特殊的免疫学特性使其具有深远的临床应用价值。%Objective To study the changes of cellular immunity caused by intravenous infusion of allogenic rhesus mesenchymal stem cells (MSCs). Methods MSCs were isolated and cultured. Then the immunomodulatory effects after MSCs infusion were evaluated by means of peripheral blood counts, mixed lymphocyte reaction (MLR) and analysis of lymphocytic subgroup. Results MSCs of rehsus were successfully cultivated. No acute toxicities or GVHD were observed in recipients. No obvious changes of peripheral blood counts were present. Recipients A2, A3, A4 were administered with

  20. Similar insulin secretory response to a gastric inhibitory polypeptide bolus injection at euglycemia in first-degree relatives of patients with type 2 diabetes and control subjects

    DEFF Research Database (Denmark)

    Meier, Juris J; Nauck, Michael A; Siepmann, Nina;

    2003-01-01

    Insulin secretion following the intravenous infusion of gastric inhibitory polypeptide (GIP) is diminished in patients with type 2 diabetes and at least a subgroup of their first-degree relatives at hyperglycemic clamp conditions. Therefore, we studied the effects of an intravenous bolus administ......Insulin secretion following the intravenous infusion of gastric inhibitory polypeptide (GIP) is diminished in patients with type 2 diabetes and at least a subgroup of their first-degree relatives at hyperglycemic clamp conditions. Therefore, we studied the effects of an intravenous bolus...... administration of GIP at normoglycemic conditions in the fasting state. Ten healthy control subjects were studied with an intravenous bolus administration of placebo, and of 7, 20, and 60 pmol GIP/kg body weight (BW), respectively. Forty-five first-degree relatives of patients with type 2 diabetes and 33 matched...... of variance (ANOVA) and Duncan's post hoc tests. Insulin secretion was stimulated after the administration of 20 and of 60 pmol GIP/kg BW in the dose-response experiments (P rise of insulin and C-peptide concentrations in the first...

  1. Insulin glargine overdose

    Directory of Open Access Journals (Sweden)

    Fatma Sari Dogan

    2012-01-01

    Full Text Available Insulin glargine is a long acting novel recombinant human insulin analogue indicated to improve glycemic control, in adults and children with type 1 diabetes mellitus and in adults with type 2 diabetes mellitus. The time course of action of insulins including insulin glargine may vary between individuals and/or within the same individual. Insulin glargine is given as a 24-h dosing regimen and has no documented half-life or peak effect. Hypoglycemia is the most common adverse effect of insulin, including insulin glargine. As with all insulins, the timing of hypoglycemia may differ among various insulin formulations. We present a case of a 76-year-old male insulin-dependent diabetic patient with refractory hypoglycemia secondary to an intentional overdose of insulin glargine. We would like to highlight the necessity of prolonging IV glucose infusion, for a much longer period than expected from pharmacokinetic properties of these insulin analogues after intentional massive overdose.

  2. Efficacy of intravenous infusion of doripenem.

    Science.gov (United States)

    Restrepo, Marcos I

    2009-08-15

    Initial treatment of nosocomial pneumonia (NP), including ventilator-associated pneumonia (VAP), is usually empirical. The use of a broad-spectrum antibiotic regimen to treat NP-VAP that is active against suspected multidrug-resistant pathogens maximizes the likelihood of a favorable outcome. In a post hoc analysis of pooled data from 2 prospective, randomized, open-label, phase 3 NP-VAP trials, doripenem, a new broad-spectrum carbapenem with antipseudomonal activity, demonstrated noninferiority to standard comparator regimens (imipenem and piperacillin-tazobactam) with regard to clinical and microbiological outcomes. In subgroup analyses, doripenem continued to show noninferiority to the comparator drugs in achieving clinical and microbiological cures in populations at high risk of multidrug-resistant infection, such as patients with late-onset VAP (defined as patients who develop VAP >5 days after intubation) or those with NP-VAP caused by Pseudomonas aeruginosa or complicated by bacteremia. Overall, the clinical data indicate that doripenem has the potential to be an important option in the treatment of NP, including VAP.

  3. Continuous subcutaneous insulin infusion for treatment of type Ⅱ diabetes mellitus%胰岛素泵与多次皮下注射强化治疗Ⅱ型糖尿病的疗效对比分析

    Institute of Scientific and Technical Information of China (English)

    钟莉; 黎珂

    2012-01-01

    Objective To compare the effects of continuous subcutaneous insulin infusion (CSII)and multiple daily injections (MDI)as intensive insulin therapy for patients with type Ⅱ diabetes mellitus. Methods 100 patients with type II diabetes mellitus were divided into randomly receive continuous subcutaneous lipro insulin injection group(n= 50) or multiple daily injection with lipro insulin and humulin NPH group(n = 50). Results Group CSII reached blood glucose targets faster than group MDI. Less fluctuation of blood glucose and hypoglycemia was found in group CSII. Patients in group CSII needed less dosage of insulin per body weight. Conclusion Continuous subcutaneous insulin infusion is a better, faster and safer intensive therapy for type Ⅱ diabetes mellitus.%目的 对比持续胰岛素泵强化皮下输注(CSⅡ)和胰岛素多点皮下注射(MDI)在Ⅱ型糖尿病患者强化治疗中的效果.方法 100例Ⅱ型糖尿病患者随机分为CSⅡ和MDI两组,每组各50例,CSⅡ组使用持续胰岛素皮下输注赖脯胰岛素(Lispro Injection)强化治疗;MDI组使用赖脯胰岛素联合精蛋白锌重组人胰岛素中效型(Humulin NPH)多点皮下注射强化治疗,对比分析两组血糖改善情况.结果 CSⅡ组比MDI组控制血糖更理想,血糖波动更小,达标更快,低血糖发生率更低,单位体重胰岛素用量更少,差异均有统计学意义(P<0.05).结论 CSⅡ能更好、更快、更安全地完成Ⅱ型糖尿病的强化治疗,可在临床治疗中推广应用.

  4. Treatment of hyperkalaemia with intravenous salbutamol.

    OpenAIRE

    Murdoch, I A; Dos Anjos, R; Haycock, G B

    1991-01-01

    Thirteen children with hyperkalaemia were treated by intravenous infusions of salbutamol, 4 micrograms/kg over 20 minutes. Reductions in the mean (SD) plasma potassium concentrations, of 1.48 (0.5) and 1.64 (0.5) mmol/l were obtained at 40 and 120 minutes, respectively, after completion of the infusions. No side effects were noted.

  5. Anestesia venosa total em regime de infusão alvo-controlada: uma análise evolutiva Anestesia venosa total en régimen de infusión objeto controlada: un análisis evolutivo Total intravenous anesthesia as a target-controlled infusion: an evolutive analysis

    Directory of Open Access Journals (Sweden)

    Fernando Squeff Nora

    2008-04-01

    ón objeto controlada (IOC. El primer modelo farmacocinético descrito para uso en IOC, fue descrito por Schwilden en 1981. Quedó demostrado a partir de entonces, que era posible mantener la concentración plasmática deseada de un fármaco utilizando bomba de infusión por computador. CONTENIDO: Este artigo quiso dejar sentadas las bases teóricas de la IOC, presentar una propuesta de desarrollo de un vocabulario común en IOC todavía no publicado en Brasil y hacer un análisis crítico de los aspectos actuales de la IOC en el mundo y en Brasil. CONCLUSIONES: La llegada de nuevas bombas de infusión dotadas de los modelos farmacocinéticos del remifentanil, sufentanil y propofol inaugura otro capítulo de la AVT y coloca a Brasil a tono con la tendencia mundial en IOC. Esos sistemas facilitarán la IOC de hipnóticos y opioides concomitantemente. La conclusión más importante, sin embargo, se refiere a la economía en la medida en que los fármacos utilizados en esas bombas no quedarán restrictos a solamente una empresa farmacéutica, como por ejemplo lo que ocurrió con el propofol. Hoy ya disponemos de equipos para la utilización de propofol y opioides en IOC, que aceptan cualquier presentación farmacéutica con la ventaja de poder alterar la concentración del fármaco en la jeringuilla de acuerdo con la dilución que se desee.BACKGROUND AND DOBJECTIVES: Total intravenous anesthesia (TIVA has seen several developments since it was first used. Since the synthesis of the first intravenous anesthetics, with the introduction of barbiturates (1921 and thiopental (1934, TIVA has evolved until the development of TIVA with target-controlled infusion pumps (TCI. The first pharmacokinetic model for the use of TCI was described by Schwilden in 1981. From that moment on, it was demonstrated that it is possible to maintain the desired plasma concentration of a drug using an infusion pump managed by a computer. CONTENTS: The objective of this report was to describe the

  6. Partial intravenous anesthesia in cats and dogs.

    Science.gov (United States)

    Duke, Tanya

    2013-03-01

    The partial intravenous anesthesia technique (PIVA) is used to lower the inspired concentration of an inhalational anesthetic by concurrent use of injectable drugs. This technique reduces the incidence of undesirable side-effects and provides superior quality of anesthesia and analgesia. Drugs commonly used for PIVA include opioids, alpha-2 adrenergic agonists, injectable anesthetic agents, and lidocaine. Most are administered by intravenous infusion.

  7. [Portable elastomeric infusion system applied to patients with knee prosthesis].

    Science.gov (United States)

    Soler, Gemma; Quiles, Olga; Nicolau, Agnes; Faura, Teresa; Moreno, Cristina

    2007-03-01

    An LV infuser consists of an infusion pump which can administer medicines via various methods: intravenous, epidural, subdural, o subcutaneous. Its usefulness is based on the administration of medicines such as oncological drugs and/or analgesic by means of a continuous infusion. PMID:17474369

  8. Glucose Infusion into Exercising Dogs after Confinement: Rectal and Active Muscle Temperatures

    Science.gov (United States)

    Greenleaf, J. E.; Kruk, B.; Nazar, K.; Falecka-Wieczorek, I.; Kaciuba-Uscilko, H.

    1995-01-01

    Intravenous glucose infusion into ambulatory dogs results in attenuation of exercise-induced increase of both rectal and thigh muscle temperatures. That glucose (Glu) infusion attenuates excessive increase in body temperature from restricted activity during confinement deconditioning. Intravenous glucose infusion attenuates the rise in exercise core temperature in deconditioned dogs by a yet undefined mechanism.

  9. Effects of Liraglutide Combined with Short-Term Continuous Subcutaneous Insulin Infusion on Glycemic Control and Beta Cell Function in Patients with Newly Diagnosed Type 2 Diabetes Mellitus: A Pilot Study.

    Science.gov (United States)

    Ke, Weijian; Liu, Liehua; Liu, Juan; Chen, Ailing; Deng, Wanping; Zhang, Pengyuan; Cao, Xiaopei; Liao, Zhihong; Xiao, Haipeng; Liu, Jianbin; Li, Yanbing

    2016-01-01

    The objective of this paper is to investigate the effects of liraglutide in combination with short-term continuous subcutaneous insulin infusion (CSII) therapy on glycemic control and beta cell function in patients with newly diagnosed type 2 diabetes mellitus (T2DM). Thirty-nine eligible newly diagnosed T2DM patients were recruited and randomized to receive either of two therapies: short-term CSII alone (CSII alone group) or CSII in combination with liraglutide (CSII + Lira group) for 12 weeks. Blood glucose control, homeostasis model assessment (HOMA) indices, and acute insulin response (AIR) were compared between the two groups. The patients in CSII + Lira group achieved euglycemia with equivalent insulin dosage in shorter time (1 (0) versus 2 (3) days, P = 0.039). HbA1c at the end of study was comparable between two groups (6.3 ± 0.7% versus 6.0 ± 0.5%, for CSII alone group and CSII + Lira group, resp., P = 0.325). The increment of AIR was higher in CSII + Lira group (177.58 (351.57) μU · min/mL versus 58.15 (51.30) μU · min/mL, P < 0.001). However, after stopping liraglutide, its effect on beta cell function disappeared completely. Liraglutide combined with short-term CSII was effective in further improving beta cell function, but the beneficial effects did not sustain after suspension of the therapy.

  10. The Insulin Pump

    OpenAIRE

    Toews, C. J.

    1985-01-01

    Subcutaneous continuous insulin infusion systems deliver insulin at a basal rate designed to keep blood glucose levels normal in the non-fed state. Additional insulin is delivered at meal time. Pumps can provide near optimal control of blood glucose concentrations in selected, highly motivated patients. The pump provides better diabetic control than once daily insulin injections, although several daily injections can provide comparable control. Optimal control with the pump causes some short-...

  11. Clinical observation of 10% calcium gluconate intravenous infusion in the treatment of vitamin D deficiency rickets%10%葡萄糖酸钙注射液静脉滴注治疗维生素D缺乏性佝偻病的临床观察

    Institute of Scientific and Technical Information of China (English)

    陈彩玲; 苏攀宏

    2015-01-01

    Objective:To explore the clinical effect of 10% calcium gluconate intravenous infusion in the treatment of vitamin D deficiency rickets.Methods:120 patients with vitamin D deficiency rickets were selected.They were divided into the treatment group and the control group with 60 cases in each group.The treatment group was treated with 10 mL 10% calcium gluconate intravenous infusion,and the control group was treated by simple oral vitamin D.We compared the efficacy of two groups.Results:The therapeutic effect of the treatment group was significantly better than that of the control group(P<0.05).Conclusion:The clinical effect of 10% calcium gluconate intravenous infusion in the treatment of vitamin D deficiency rickets was significant.%目的:探讨10%葡萄糖酸钙注射液静脉滴注治疗维生素D缺乏性佝偻病的临床效果.方法:收治维生素D缺乏性佝偻病患儿120例,分为治疗组和对照组各60例,治疗组采用10%的葡萄糖酸钙注射液10 mL静脉滴注,对照组单纯口服维生素D,比较两组疗效.结果:治疗组的治疗效果明显优于对照组(P<0.05).结论:10%的葡萄糖酸钙溶液静脉滴注治疗维生素D缺乏性佝偻病的临床效果显著.

  12. Application effect on the details of management pattern in the process construction of intravenous infusion in pediatric outpatients%细节管理模式用于儿科门诊静脉输液流程构建中的临床价值研究

    Institute of Scientific and Technical Information of China (English)

    徐莹

    2012-01-01

    Objective To investigate the application effect on the details of management pattern in the process construction of intravenous infusion in pediatric outpatients. Methods 300 patients with pediatric outpatient, intravenous infusion who were not implemented detail management pattern were selected in the hospital from November 2010 to May 2011 as the control group. 300 patients with pediatric outpatient intravenous infusion who were implemented detail management pattern were selected in the hospital from June 2011 to December 2011 as the observation group. Nursing efficacy was compared between two groups. Results Wailing lime of process waiting and waiting time of infusion in the observation group were significantly lower than those in the control group. The nurse infusion volume after implementation details of management pattern was significantly higher than thai before implementation details of management pattern. Nurses' service attitude, nurses sense of responsibility, considerate care patients, metasomatic infusion attention, full sendee timeliness, individualized scientific parenting education treatment of environment, safety, the infusion process overall evaluation scores in the observation group were significantly higher than those in the control group. Patient satisfaction in the observation group (96.0%) was significantly higher than that in the control group (83.7%). The differences were statistically significant (P < 0.05). Conclusion The details of management pattern in the process construction of intravenous infusion in pediatric outpatients have remarkable application effect, which not only can shorten the patients waiting time, but also can improve the work efficiency of medical staff and patient satisfaction. That is worthy of clinical use.%目的 探讨细节管理模式在儿科门诊静脉输液流程构建中的应用效果.方法 选取我院2010年11月~2011年5月收治的未实行细节管理模式儿科门诊静脉输液患者300

  13. Attitudes Toward Diabetes Affect Maintenance of Drug-Free Remission in Patients With Newly Diagnosed Type 2 Diabetes After Short-Term Continuous Subcutaneous Insulin Infusion Treatment

    OpenAIRE

    CHEN, Ailing; Huang, Zhimin; Wan, Xuesi; Deng, Wanping; Wu, Jiyan; Li, Licheng; Cai, Qiuling; Xiao, Haipeng; Li, Yanbing

    2012-01-01

    OBJECTIVE Short-term intensive insulin treatment in patients with newly diagnosed type 2 diabetes can improve β-cell function and insulin sensitivity, which results in long-term remission without need for further antidiabetes medication. Patient attitudes toward their disease were assessed using the Diabetes Care Profile (DCP) tool to evaluate the potential impact on maintaining long-term remission. RESEARCH DESIGN AND METHODS Newly diagnosed patients with type 2 diabetes were recruited and t...

  14. Incretins, insulin secretion and Type 2 diabetes mellitus

    DEFF Research Database (Denmark)

    Vilsbøll, Tina; Holst, Jens Møller

    2004-01-01

    When glucose is taken orally, insulin secretion is stimulated much more than it is when glucose is infused intravenously so as to result in similar glucose concentrations. This effect, which is called the incretin effect and is estimated to be responsible for 50 to 70% of the insulin response...... the genes encoding their receptors have been deleted. In patients with Type 2 diabetes, the incretin effect is either greatly impaired or absent, and it is assumed that this could contribute to the inability of these patients to adjust their insulin secretion to their needs. In studies of the mechanism...... of the impaired incretin effect in Type 2 diabetic patients, it has been found that the secretion of GIP is generally normal, whereas the secretion of GLP-1 is reduced, presumably as a consequence of the diabetic state. It might be of even greater importance that the effect of GLP-1 is preserved whereas...

  15. Relationship of Insulin Sensitivity, Insulin Secretion, and Adiposity With Insulin Clearance in a Multiethnic Population

    OpenAIRE

    Lorenzo, Carlos; Hanley, Anthony J.G.; Wagenknecht, Lynne E; Rewers, Marian J.; Stefanovski, Darko; Goodarzi, Mark O.; Haffner, Steven M

    2012-01-01

    OBJECTIVE We aimed to examine insulin clearance, a compensatory mechanism to changes in insulin sensitivity, across sex, race/ethnicity populations, and varying states of glucose tolerance. RESEARCH DESIGN AND METHODS We measured insulin sensitivity index (S I), acute insulin response (AIR), and metabolic clearance rate of insulin (MCRI) by the frequently sampled intravenous glucose tolerance test in 1,295 participants in the Insulin Resistance Atherosclerosis Study. RESULTS MCRI was positive...

  16. Defective insulin secretory response to intravenous glucose in C57Bl/6J compared to C57Bl/6N mice

    Directory of Open Access Journals (Sweden)

    Grace Fergusson

    2014-12-01

    Conclusions: The Bl/6J mouse strain displays impaired insulin secretion. These results have important implications for choosing the appropriate test to assess beta-cell function and background strain in genetically modified mouse models.

  17. Defective insulin secretion by chronic glucagon receptor activation in glucose intolerant mice.

    Science.gov (United States)

    Ahlkvist, Linda; Omar, Bilal; Valeur, Anders; Fosgerau, Keld; Ahrén, Bo

    2016-03-01

    Stimulation of insulin secretion by short-term glucagon receptor (GCGR) activation is well characterized; however, the effect of long-term GCGR activation on β-cell function is not known, but of interest, since hyperglucagonemia occurs early during development of type 2 diabetes. Therefore, we examined whether chronic GCGR activation affects insulin secretion in glucose intolerant mice. To induce chronic GCGR activation, high-fat diet fed mice were continuously (2 weeks) infused with the stable glucagon analog ZP-GA-1 and challenged with oral glucose and intravenous glucose±glucagon-like peptide 1 (GLP1). Islets were isolated to evaluate the insulin secretory response to glucose±GLP1 and their pancreas were collected for immunohistochemical analysis. Two weeks of ZP-GA-1 infusion reduced insulin secretion both after oral and intravenous glucose challenges in vivo and in isolated islets. These inhibitory effects were corrected for by GLP1. Also, we observed increased β-cell area and islet size. We conclude that induction of chronic ZP-GA-1 levels in glucose intolerant mice markedly reduces insulin secretion, and thus, we suggest that chronic activation of the GCGR may contribute to the failure of β-cell function during development of type 2 diabetes.

  18. 优泌乐与优泌林R在初诊2型糖尿病胰岛素泵治疗中的疗效对比%Comparison between the Effects of Insulin Lispro and Humulin R Via Continuous Subcutaneous Insulin Infusion Pump on Hyperglycemia in Newly-diagnosed Type 2 Diabetes

    Institute of Scientific and Technical Information of China (English)

    杨萍; 魏祎; 牛瑶

    2014-01-01

    目的:比较胰岛素泵输注赖脯胰岛素(优泌乐)与重组人胰岛素(优泌林R)治疗初诊2型糖尿病的疗效及安全性。方法:选择45例本院初诊2型糖尿病患者行胰岛素泵强化治疗,并按随机数字表法分为优泌乐组和优泌林R组,比较两组各点血糖、血糖达标时间、血糖达标时胰岛素用量及低血糖发生率。结果:优泌乐组的血糖达标时间较优泌林R组短,胰岛素用量也较少,餐后血糖值更低,差异均有统计学意义(P0.05)。结论:用胰岛素泵输注优泌乐和优泌林R均能安全、有效的控制初诊2型糖尿病高血糖状态,但优泌乐组血糖达标时间更短,餐后血糖控制更佳,所需胰岛素量更少。%Objective:To compare the efficacy and safety of insulin Lispro and Humulin R via continuous subcutaneous insulin infusion pump on hyperglycemia in newly-diagnosed 2 diabetes. Method:45 patients accepted a 2-week course of intensive CsII were selected. They were divided into group A(n=25)and group B(n=20)according to random number table method. The group A was treated with insulin Lispro,the group B was treated with Humulin R. The therapeutic effects were measured after therapy. Result:The time for good glycemia control was shorter in the group A than that in the group B(P0.05). Conclusion:Insulin Lispro via continuous subcutaneous insulin infusion pump is as efficacious and safe as Humulin R in controlling hyperglycemia in newly-diagnosed type 2 diabetes,but insulin Lispro provides a more effective and faster control of postprandial hyperglycemia with less insulin used.

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

    LENUS (Irish Health Repository)

    Doran, J-P

    2012-02-01

    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.

  20. Effect of intravenous infusion team (Ⅳ team) training mode in safety management of PICC%静脉治疗小组培训模式在PICC安全管理中的应用效果

    Institute of Scientific and Technical Information of China (English)

    邓立华; 张瑜; 刁同进

    2013-01-01

    Objective To explore the effect of intravenous infusion team (Ⅳ team) combined with systematic training in safety management of peripherally inserted central catheter (PICC).Methods Totals of 150 PICC patients before training from October 2010 to September 2011 were the control group,and 150 PICC patients after training from October 2011 to September 2012 were the experimental group.Incidence rate of complication and unplanned extubation as well as patients' satisfaction rate were compared between two groups before and after training.Results There were total 10 cases of complication in the experimental group,including 2 cases of catheter infection,3 cases of phlebitis,1 case of catheter separation,2 cases of obstruction and 2 cases of unplanned extubation,while there were total 64 cases of complication in the control group,including 10 cases of catheter infection,15 cases of phlebitis,9 cases of catheter separation,14 cases of obstruction and 16 cases of unplanned extubation,and the difference was statistically significant (x2 =52.30,P <0.01).Patients' satisfaction rate was 88.33% in the control group and 98.3% in the experimental group,and the difference was statistically significant (x2 =4.82,P < 0.05).Conclusions Ⅳ team plays a leading and radiation role in nursing,which can improve safety management of PICC nursing and the overall service level of hospital care.%目的 探讨静脉治疗小组(Ⅳ Team)建立与系统化培训相结合在提高PICC护理安全管理中的应用效果.方法 随机抽取2010年10月至2011年9月培训前PICC置管患者150例为对照组,2011年10月至2012年9月培训后150例为研究组,比较两组患者在培训前后并发症及非计划性拔管等情况的发生率和患者的满意度.结果 研究组患者发生并发症者总计10例,其中导管感染2例,静脉炎3例,导管脱出1例,阻塞2例,非计划性拔管2例;对照组总计64例,其中导管感染10例,静脉炎15例,导管脱出9

  1. Animal experimental study on potato chips external applying to treat intravenous infusion extravasation%土豆片外敷治疗静脉输液外渗的动物实验研究

    Institute of Scientific and Technical Information of China (English)

    荣晓珊; 彭幼清; 魏佑震

    2015-01-01

    Objective:To establish the model of edema in rats and to explore the mechanism of potato chips ex-ternal on treatment of intravenous infusion extravasation.Methods:To selected foot dorsal parts of rat,to give subcutaneous injection of 20% mannitol 0.25 mL.After 10 min,using self control experiment,left and right foot dorsal part respectively as the control group and the experimental group.The experimental group adopted potato chips external applying.The left foot dorsal parts of control group were covered with two layers of plastic films and then applied with potato chips.Every 2 h change potato chips for 8 h intervention.And every 2 h pho-tographs were taken and local changes were observed.And edema local length,width and height were measured by measure gage.Results:After application of potato slices intervention on the edema model,rat local skin swelling subsided.And the experimental group depletion degree was greater than the control group(P <0.05). Conclusion:By subcutaneous injecting of 20% mannitol in rat foot back successfully,a rat model of edema has been established.Fresh potato chips have detumescence effect.%[目的]建立大鼠水肿动物模型并探索土豆片外敷治疗静脉输液外渗的机制。[方法]选取大鼠后足背部位进行皮下注射20%甘露醇0.25 mL,注射药物10 min 后,采用自身对照实验,左右足背部分别为对照组和实验组,实验组采用土豆片外敷,对照组隔两层塑料薄膜后再敷土豆片。每隔2 h 更换1次土豆片,共干预8 h,并每2 h 拍照观察局部变化并用量尺测量水肿局部的长、宽和高。[结果]该水肿模型应用土豆片干预后,大鼠局部皮肤肿胀消退,且实验组消退程度大于对照组(P <0.05)。[结论]通过大鼠足背部皮下注射20%甘露醇成功建立大鼠水肿模型,新鲜土豆片具有消肿作用。

  2. Humanin: a novel central regulator of peripheral insulin action.

    Directory of Open Access Journals (Sweden)

    Radhika H Muzumdar

    Full Text Available BACKGROUND: Decline in insulin action is a metabolic feature of aging and is involved in the development of age-related diseases including Type 2 Diabetes Mellitus (T2DM and Alzheimer's disease (AD. A novel mitochondria-associated peptide, Humanin (HN, has a neuroprotective role against AD-related neurotoxicity. Considering the association between insulin resistance and AD, we investigated if HN influences insulin sensitivity. METHODS AND FINDINGS: Using state of the art clamp technology, we examined the role of central and peripheral HN on insulin action. Continuous infusion of HN intra-cerebro-ventricularly significantly improved overall insulin sensitivity. The central effects of HN on insulin action were associated with activation of hypothalamic STAT-3 signaling; effects that were negated by co-inhibition of hypothalamic STAT-3. Peripheral intravenous infusions of novel and potent HN derivatives reproduced the insulin-sensitizing effects of central HN. Inhibition of hypothalamic STAT-3 completely negated the effects of IV HN analog on liver, suggesting that the hepatic actions of HN are centrally mediated. This is consistent with the lack of a direct effect of HN on primary hepatocytes. Furthermore, single treatment with a highly-potent HN analog significantly lowered blood glucose in Zucker diabetic fatty rats. Based upon the link of HN with two age-related diseases, we examined if there were age associated changes in HN levels. Indeed, the amount of detectable HN in hypothalamus, skeletal muscle, and cortex was decreased with age in rodents, and circulating levels of HN were decreased with age in humans and mice. CONCLUSIONS: We conclude that the decline in HN with age could play a role in the pathogenesis of age-related diseases including AD and T2DM. HN represents a novel link between T2DM and neurodegeneration and along with its analogues offers a potential therapeutic tool to improve insulin action and treat T2DM.

  3. Insulin Analogs Versus Human Insulin in the Treatment of Patients With Diabetic Ketoacidosis

    OpenAIRE

    Umpierrez, Guillermo E.; Jones, Sidney; Smiley, Dawn; Mulligan, Patrick; Keyler, Trevor; Temponi, Angel; Semakula, Crispin; Umpierrez, Denise; Peng, Limin; Cerón, Miguel; Robalino, Gonzalo

    2009-01-01

    OBJECTIVE To compare the safety and efficacy of insulin analogs and human insulins both during acute intravenous treatment and during the transition to subcutaneous insulin in patients with diabetic ketoacidosis (DKA). RESEARCH DESIGN AND METHODS In a controlled multicenter and open-label trial, we randomly assigned patients with DKA to receive intravenous treatment with regular or glulisine insulin until resolution of DKA. After resolution of ketoacidosis, patients treated with intravenous r...

  4. 根本原因分析法在静脉泵泵速调整沟通不足事件中的应用%Application of root cause analysis in inadequate communication in adjusting rate of intravenous infusion pump

    Institute of Scientific and Technical Information of China (English)

    张萌萌; 张婷; 王爽; 赵娟; 翟所迪

    2014-01-01

    Objective To reduce the occurrence of medication error( ME)by analyzing a case of inadequate communication about the rate adjustment of intravenous infusion pump and making improvable plans and carrying out. Methods An ME case of category D was analyzed using root cause analysis ( RCA). The steps were as follows:forming an RCA team,collecting and analyzing relevant information on this ME event,drawing flowcharts to mine the direct causes,drawing fishbone diagram to confirm the root causes,and making improvable plans. Results The event was identified as "inadequate communication about the rate adjustment of intravenous infusion pump". The direct causes included inadequate communication between doctors and nurses,lack of record about the rate adjustment of intravenous infusion pump,and nurses'heavy workload. The root cause was lack of a mechanism of carrying out and recording of the rate adjustment of intravenous infusion pump. The improvable plans contained establishing and standardizing the mechanism of carrying out and recording of the rate adjustment of intravenous infusion pump, introducing intelligent intravenous infusion pump or designing an appropriate record sheet of the rate adjustment of intravenous infusion pump to note the process of rate adjustment,reinforcing learning and training of medical staff on norm and standard procedure. The implement achievements were as follows. Standard procedure and regulatory framework were established,the appropriate record sheet of the rate adjustment of intravenous infusion pump were designed,doctors were asked to implement written statement of the rate adjustment and explain when shift exchange,and the charge nurses were asked to implement signature confirmation after the rate adjustment. Meanwhile,the learning and training of medical staff were carried on to clarify about the roles. After a follow-up observation of pharmacist,the kind of the event did not recur in the wards. Conclusion ME event could be reduced by

  5. Cognitive status of junior pediatric nurses on intravenous infusion of high risk drugs and analysis of its influencing factors%低年资儿科护士对静脉输注高危药物的认知现状与影响因素分析

    Institute of Scientific and Technical Information of China (English)

    杨卫红; 赵丽; 吴月丽

    2015-01-01

    Objective:To probe into the cognitive status quo of junior pediatric nurses on intravenous infusion of high risk drugs and analysis of its influencing factors .Methods:A total of 539 cases of junior pediatric nurses in many hospitals in the region were surveyed by using general questionnaire and intravenous infusion of high risk drugs cognitive questionnaire ,and analyzing the influencing factors .Results:the total cognition score of nurses on intravenous infusion of high risk drugs was 85 .20 ± 6 .33 .Single factor analysis showed that sex ,marital sta‐tus ,educational background ,title ,gender ,age ,working years ,employment way had the influences on total cognition score of nurses on intravenous infusion of high risk drugs (P<0 .05) .Conclusion:The junior pediatric nurses had cognition deficiency on intravenous infusion of high risk drugs ,and it was related to employment way ,marital status ,working years and title .The hospital should take the targeted management training posi‐tively and improve the cognition level of junior pediatric nurses .%[目的]探讨低年资儿科护士对静脉输注高危药物的认知现状与影响因素。[方法]采用一般情况调查表和静脉输注高危药物认知调查表对选取的本地区多家医院儿科低年资护士539人进行调查,并分析其影响因素。[结果]护士对于静脉输注高危药物的认知总分为85.20分±6.33分。单因素分析显示,性别、婚姻状况、学历、职称、性别、聘用形式、年龄、工作年限都对静脉输注高危药物认知总分有影响(P<0.05);多因素逐步回归分析结果显示,聘用形式、婚姻状况、工作年限与职称对护士的静脉输注高危药物认知有影响(P<0.05)。[结论]低年资儿科护士静脉输注高危药物的认知存在不足,与护士的聘用形式、婚姻状况、工作年限与职称有关,医院应积极进行有针对性的管理培训,提高低年资护士的认知水平。

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

    Science.gov (United States)

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

    2008-12-17

    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 pK(a), and hydrogel crosslinking ratio on insulin release and glucose sensitivity are investigated in order to optimally design the device for use. Increased insulin infusion is shown to result from increasing the number of circulating gels, increasing the collapsed particle size, or by decreasing the crosslinking ratio of the system. Release duration is shown to be dependent only upon the particle size and the achievable diffusion coefficient of the system. Glucose sensitivity, as measured by gluconic acid production and by the system pH, are functions of glucose oxidase loading and the concentration and pK(a) of the monomer used in the hydrogel.The necessarily submicron particle size results in very rapid device insulin depletion. When the device is designed without considering constraints, the resulting release profile resembles that of an on/off switching mechanism. Future work will focus on simulations of swelling and release when the device is implanted in an alternative administration site. PMID:20428328

  7. 音乐放松疗法对静脉点滴安宝孕妇焦虑、抑郁情绪的影响%Influence of music relaxation therapy on the anxiety and depression of pregnant women with intravenous infusion of Anpo

    Institute of Scientific and Technical Information of China (English)

    彭惠诗; 余一海; 卢敏; 欧阳卫贞; 刘全弟

    2015-01-01

    Objective To explore the influence of music relaxation therapy on the anxiety and depression of pregnant women with intravenous infusion of Anpo. Methods 60 pregnant women with intravenous infusion of Anpo from February 2013 to January 2014 were randomly divided into control group(30 cases) and research group(30 cases). Patients in the control group were accepted conventional nurisng. Patients in re-search group were accepted music relaxation therapy as well as the actions of control group. Assess and compare the SAS scores and SDS score before intervention ,after seven days and forteen days with the Zung self rating anxiety scale and Zung depression self rating scale. Results The research group’s SAS scores and SDS scores after seven days and forteen days were higher than those of the control group(P<0. 05). Conclusion Music relaxation therapy can significantly improve the anxiety and depression situation of pregnant women with intravenous infu-sion of Anpo. Music relaxation therapy can also help pregnant women improve the self-confidence and overcome the disturbances in psycho-logical and physiological.%目的:探讨音乐放松疗法改善静脉点滴安宝孕妇焦虑和抑郁情绪的效果。方法将2013年2月~2014年1月在本院接受安宝治疗的60例孕妇随机分为对照组(30例)和实验组(30例)。对照组接受常规护理,实验组接受常规护理并采用音乐放松疗法。于用药前、用药后第7天、第14天,分别采用Zung焦虑自评量表、Zung抑郁自评量表对孕妇的焦虑、抑郁情绪进行评分并比较。结果用药后第7、第14天实验组孕妇的焦虑及抑郁评分均优于对照组,比较差异具有统计学意义(P<0.05)。结论音乐放松疗法可以明显改善静脉点滴安宝孕妇焦虑、抑郁情绪,帮助孕妇克服心理、生理的干扰,增强其自信心。

  8. Central resistance to the inhibitory effects of leptin on stimulated insulin secretion with aging.

    Science.gov (United States)

    Muzumdar, Radhika H; Ma, Xiaohui; Yang, Xiaoman; Atzmon, Gil; Barzilai, Nir

    2006-09-01

    Aging is associated with resistance to the effects of leptin on food intake and energy homeostasis. We examined if old rats were resistant to the effects of leptin on glucose stimulated insulin secretion. When leptin was infused intravenously (0.5 microg/kg/min) under hyperglycemic clamp conditions (11 mM) in young (n=5) and old rats (n=10, 5 ad libitum fed and five with surgical removal of visceral fat), glucose stimulated insulin secretion was significantly decreased by 44% in the young rats, but not in old rats (31.8+/-2.8 to 17.9+/-1.0 versus 33.7+/-1.4 versus 31.0+/-1.7 and 24.7+/-1.6 versus 21.0+/-2.8 in young versus old versus old VF- respectively, p<0.01). To identify if the resistance to leptin is secondary to impaired transport across the blood brain barrier (BBB), we infused leptin into the third ventricle (intra-cerebro ventricular, ICV). ICV infusion of leptin elicited a partial effect on glucose stimulated insulin secretion in the old (25.7+/-2.5 to 15.4+/-2.4 versus 24.4+/-2.4 to 19.0+/-2.0 in young versus old, respectively) suggesting that part of the leptin resistance was beyond the BBB. Resistance to the effects of leptin on insulin secretion in aging may protect against the onset of diabetes in old subjects. PMID:16122839

  9. Comparison of glucose-insulin-thallium-201 infusion single photon emission computed tomography (SPECT), stress-redistribution-reinjection thallium-201 SPECT and low dose dobutamine echocardiography for prediction of reversible dysfunction

    International Nuclear Information System (INIS)

    The usefulness of glucose-insulin-thallium-201 (GI-Tl) infusion single photon emission computed tomography (SPECT) in predicting reversible dysfunction has not been evaluated, so the present study recruited 20 patients with regional ischemic dysfunction for investigation. All patients underwent GI-Tl SPECT, post-stress Tl reinjection imaging and low dose dobutamine echocardiography. The diagnostic accuracy of these 3 techniques in predicting functional recovery was evaluated by receiver operating characteristic (ROC) analysis. In segments with functional recovery, regional Tl activities of GI-Tl SPECT were significantly higher than those of reinjection imaging (p<0.05), although there were no significant differences in segments without recovery. The area under the ROC curve for GI-Tl SPECT (0.75±0.06) was greater than that for reinjection imaging (0.68±0.07). The optimal cutoff values to identify viable myocardium were considered to be 55% of peak activity for GI-Tl SPECT and 50% for reinjection imaging. At this cutoff point, the sensitivity and specificity for detection of functional recovery were, respectively, 85% and 61% for GI-Tl SPECT, and 73% and 61% for reinjection imaging. Dobutamine echocardiography had the same sensitivity (85%), but lower specificity (48%) than GI-Tl SPECT. Continuous infusion of GI-Tl solution enhances regional Tl uptake compared with conventional post-stress reinjection imaging. This study suggests that GI-Tl SPECT is superior to reinjection imaging and dobutamine echocardiography in predicting functional recovery after ischemic left ventricular dysfunction. (author)

  10. INFUSION LOUNGE

    Institute of Scientific and Technical Information of China (English)

    2009-01-01

    Infusion Lounge——颇具亚洲风情的的夜店——坐落于旧金山市区大受追捧的联合广场之上,福森酒店之下。此夜店兼具了酒吧与餐厅的功能,它将提供加州与亚洲风味融为一体的佳肴及优雅的环境和一流的服务。Infusion Lounge不仅为旧金山当地,也将为整个行业重新定义高消费夜生活的概念。

  11. 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

    Directory of Open Access Journals (Sweden)

    Adriano Bonfim Carregaro

    2010-07-01

    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.

  12. 静脉输液实地操作考核对新护士临床综合能力培养的影响%Impact of the asseement of actual operation of intravenous infusion on the training of clinical comprehensive abilities of new nurses

    Institute of Scientific and Technical Information of China (English)

    张权; 尹继云; 段峰; 王晓霞; 刘星星

    2014-01-01

    Objective:To explore the effective training model of the clinical comprehensive abilities of junior nurses through the assee -ment of the new nurses in actual operation of intravenous infusion .Methods:The actual operation of the new nurses ( employed for 3 months in the same year ) in intravenous infusion was examined and assessed ,and the individual ,team and collevtive training program and continu-ous improvement plan was developed according to the exposed problems in the assessment and 11 relevant items in clinical work and com-bined with patient satisfaction and colleague appraisal ,then the same assessment was respectively made again half a year and one year lat -er.Results:The defects of working index exposed in the actual operation of intravenous infusion from high to low were as follows :the safety consciousness in nursing care ,aseptic concept ,first aid ability ,humanistic care ,the initiative study consciousness ,ability of communication with patients,prevention of occupational exposure ,working efficiency,adaptability,consciousness of hospital infection and venipuncture a-bility,the 11 relevant items in clinical work of new nurses significantly improved after training (P<0.05).Conclusion:The asseement of the new nurses in actual operation of intravenous infusion can effectively and rapidly improve the comprehensive ability of new nurses .%目的:通过对新护士以静脉输液实地操作考核为管理切入点,探索使低年资护士尽快胜任临床工作的有效培养模式。方法:对当年上岗满3个月的新护士进行输液法实地操作考核,针对其中静脉输液法的考核中暴露出的问题,与临床相关的11项工作指标进行一一对应评估,结合患者满意度测评和科室同事评价,制定出个人、小组和集体培训计划和持续改进计划并组织实施,半年和1年后分别进行相同方式的评价。结果:入科3个月新护士在静脉输液操作中出现的工作指标缺

  13. Effective observation on prevention for mismatched intravenous infusion by patients' participation in double-identity confirmation%患者参与身份双重确认在预防静脉输液差错中的应用效果

    Institute of Scientific and Technical Information of China (English)

    龚春兰; 文国英; 谢欣倩; 宋梅芳; 赖微; 韦雪

    2012-01-01

    目的 为提高患者身份识别的准确性,规范核对细节,有效预防静脉输液差错.方法 采用随机数字表法,选取2008年9月至2011年5月住院的2713例患者,分为对照组和观察组.对照组患者1410例,静脉输液42026组,采用常规输液查对的流程确认身份;观察组患者1303例,静脉输液41102组,除常规输液查对流程外,让患者说出自己的姓名和年龄并由患者或家属参与亲自查看输液瓶标签上姓名,确认身份.观察两组患者输液穿刺或更换输液瓶时因身份识别而发生临界差错的患者例数和静脉输液组数.结果 对照组患者身份识别准确1 404例,发生临界差错6例,观察组患者身份识别准确1 303例,发生临界差错0例,两组比较差异具有统计学意义(P =0.032);对照组身份识别准确42020组,发生临界差错6组,观察组身份识别准确41 102组,发生临界差错0组,两者比较差异具有统计学意义(P=0.031).结论 患者亲自参与双重身份确认能有效预防静脉输液差错.%Objective To improve the accuracy of patient' s identification and normalize the checking details for preventing from the error intravenous ( i.v.) infusion.Methods Participants who were eligible for this study from Department of Orthopedics,Nanxishan Hospital of Guangxi Zhuang Autonomous Region were assigned to control group and observational group by random number method.The control group included 1 410 patients which had 42 026 set intravenous infusion solutions and confirmed identity by the traditional procedure.The observation group included 41 102 set intravenous infusion solutions in 1 303 patients.In observational group,we confirmed patients' identity by speaking out their name and age and looking over the patient' s label on the infusion bottle by their family members along with the traditional procedure.The number of patients and i.v.solutions set regarding borderline errors of identification during venepuncture or replacing

  14. Anestesi Infus Gravimetrik Ketamin dan Propofol pada Anjing (THE GRAVIMETRIC INFUSION ANAESTHESIA WITH KETAMINE AND PROPOFOL IN DOGS)

    OpenAIRE

    I Gusti Ngurah Sudisma; Setyo Widodo; Dondin Sajuthi; Harry Soehartono

    2014-01-01

    This study aim was to evaluate quality of anaesthesia by using gravimetric infusion anaesthesia withketamine and propofol in dogs. The quality of anaesthesia, duration of actions, and the physiological responsseof anaesthesia were evaluated in twenty domestic dogs. Anaesthesia was induced intramuscularly withatropine (0.03 mg/kg)-xylazine (2 mg/kg) (AX), intravenously ketamine-propofol (KP) (4 mg/kg), andmaintained with continuous intravenous infusion with pre-mixed propofol (P) and normal sa...

  15. Analysis of a Case of Unknown Floss in Intravenous Drug Infusion by Clinical Pharmacists%临床药师对1例静脉输液中不明絮状物的分析

    Institute of Scientific and Technical Information of China (English)

    韩毓博; 程指民; 刘艳; 李湘晖

    2013-01-01

    OBJECTIVE: To provide new strategy for clinical pharmacists participating in clinic medication practice to deal with medication dispute caused by unknown floss in infusion of cinepazide maleate. METHODS: The unknown floss was isolated during infusion of cinepazide maleate under sterile condition, and then cultured in agar medium under low temperature. The unknown floss was observed under inverted microscope, and the components were determined by infrared spectroscopy scanning after low temperature drying. The components of unknown floss were determined, and its reasons were analyzed. RESULTS: Infrared spectroscopy scanning showed that the floss displayed classic structural characteristics of saccharide, protein, fatty acid and nucleic acid. Clustering filamentous fungi were seen in the agar culture. Both the floss and the floss culture showed black cross-linked hy-pha with torous spores under the microscope. The morphology observation assisted to prove that fungi contamination existed in the cinepazide maleate infusion. The unknown floss was fungi. CONCLUSIONS: In order to avoid infusion accident, precision filter infusion set should be used and the infusion tube should be rinsed routinely in the interval of two infusions.%目的:通过分析1例马来酸桂哌齐特输液中不明絮状物进而解决用药纠纷,为临床药师参与临床用药实践提供新思路.方法:将马来酸桂哌齐特输液过程中出现的不明絮状物在无菌条件下分离,分别利用营养琼脂低温培养,倒置显微镜下形态观察,以及低温干燥后进行红外光谱扫描等手段,确定絮状物成分,并分析原因.结果:红外光谱分析显示该絮状物具有糖类、蛋白质、脂肪酸和核酸的典型结构特征.琼脂培养基也培养出了成簇的丝状真菌,倒置显微镜下可见该培养物与不明絮状物性状相同,均现黑色交错丝状菌丝,其上还有膨出的孢子,进而从形态学上进行了辅

  16. Current use of intraosseous infusion in Danish emergency departments: a cross-sectional study

    DEFF Research Database (Denmark)

    Molin, Rune; Hallas, Peter; Brabrand, Mikkel;

    2010-01-01

    Intraosseous infusion (IOI) is recommended when intravenous access cannot be readily established in both pediatric and adult resuscitation. We evaluated the current use of IOI in Danish emergency departments (EDs).......Intraosseous infusion (IOI) is recommended when intravenous access cannot be readily established in both pediatric and adult resuscitation. We evaluated the current use of IOI in Danish emergency departments (EDs)....

  17. Insulin signaling and glucose transport in insulin resistant human skeletal muscle

    OpenAIRE

    Karlsson, Håkan KR

    2005-01-01

    Insulin resistance in skeletal muscle is a hallmark feature of Type 2 diabetes mellitus. The overall aim of this thesis was to investigate downstream intermediates in the insulin signaling pathway in an attempt to characterize the molecular mechanism of skeletal muscle insulin resistance in Type 2 diabetes. Skeletal muscle biopsies were obtained from healthy and Type 2 diabetic subjects before and after an in vivo hyperinsulinemic infusion. Insulin infusion increased the...

  18. 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)

    Gjesing, Anette Marianne Prior; Hornbak, Malene; Allin, Kristine H.;

    2014-01-01

    ∈±∈SE: 0.49∈±∈0.14) and beta cell responsiveness to glucose (h 2∈±∈SE: 0.66∈±∈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......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...

  19. Cost-minimization of mabthera intravenous versus subcutaneous administration

    NARCIS (Netherlands)

    Bax, P.; Postma, M.J.

    2013-01-01

    Objectives: To identify and compare all costs related to preparing and administrating MabThera for the intravenous and subcutaneous formulations in Dutch hematological patients. The a priori notion is that the costs of subcutaneous MabThera injections are lower compared to intravenous infusion due t

  20. 静脉滴注丙种球蛋白联合低分子肝素联合治疗42例复发性流产临床疗效观察%Intravenous infusion of gamma globulin combined with low molecular heparin in treatment of recurrent miscarriage

    Institute of Scientific and Technical Information of China (English)

    桑艳萍; 徐静; 李艳红

    2013-01-01

    Objectives:To investigate clinical efficacy and safety of intravenous infusion of gamma globulin and LMWH in treating recurrent miscarriage.Methods:84 recurrent miscarriage patients of anti-cardiolipin antibodies (ACA)-positive were randomly divided into experimental group and control group.Patients in the experimental group were treated with intravenous infu sion of gamma globulin combing low-molecular-weight heparin while the control group was given the traditional miscarriage treatment such as progesterone combined with HCG.Tocolytic.The success rate and the incidence of adverse effect in the two groups were compared.Results:Tocolysis rate of the experimental group was 81.0%.the control group 31.0%,which was much lower (p < 0.05).Patients in the two groups had no serious adverse reactions.Conclusions:Intravenous infusion of gamma globulin and LMWH treatment can be used among ACA positive patients with recurrent miscarriage after overall considering its efficacy and safety.%目的:探讨静脉滴注丙种球蛋白联合低分子肝素对于复发性流产孕妇的临床疗效及安全性.方法:将本院收治的84例抗心磷脂抗体(ACA)阳性的复发性流产患者随机分为实验组和对照组,实验组患者给予静脉滴注丙种球蛋白联合低分子肝素治疗,对熙组患者给予黄体酮联合HCG的传统保胎治疗,比较两组患者保胎成功率及不良反应的发生情况.结果:实验组保胎成功率81.0%,对照组保胎成功率31.0%,实验组保胎成功率显著高于对照组(P<0.05).两组患者均无严重不良反应发生.结论:对于ACA阳性的复发性流产患者,静脉滴注丙种球蛋白联合低分子肝素疗效显著且安全性高,值得临床推广应用.

  1. Massive Levemir (Long-Acting Insulin Overdose: Case Report

    Directory of Open Access Journals (Sweden)

    Mamatha Oduru

    2012-01-01

    Full Text Available 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 in the first 12 hours after admission. These were managed with oral glucose, IM glucagon, and further dextrose boluses. Blood electrolytes and pH were monitored throughout. Insulin overdoses are relatively common and often occur with an excess of other drugs or alcohol which can enhance its action. Overdoses can result in persistent hypoglycaemia, liver enzyme derangement, electrolyte abnormalities, and neurological damage. Overall mortality is 2.7% with prognosis poorest in patients who are admitted with decreased Glasgow Coma scale (GCS 12 hours after overdose.

  2. Anestesia venosa total com infusão alvo-controlada de remifentanil e propofol para ablação de fibrilação atrial Anestesia venosa total con infusión objeto-controlada de remifentanil y propofol para ablación de la fibrilación atrial Total intravenous anesthesia with target-controlled infusion of remifetanil and propofol for ablation of atrial fibrillation

    Directory of Open Access Journals (Sweden)

    Fernando Squeff Nora

    2009-12-01

    choice of anesthesia, monitors, and anesthesiologic care for this procedure performed outside the surgical center has not been described. The objective of this report was to describe an anesthesia technique for ablation of AF. CASE REPORT: This is a 49-year old female weighing 73 kg, 155 cm, and ASA II due to hypertension. The patient was monitored with a 12-lead ECG, pulse oximetry, heart rate, bispectral electroencephalography for BIS measurement, suppression rate (SR, and SEF95, and mean arterial pressure (MAP. Intravenous target-controlled infusion (TCI of propofol with a target of 4 µg.mL-1, intravenous TCI of remifentanil with a target of 3 ng.mL-1, and intravenous bolus of rocuronium 0.2 mg.kg-1 were used for induction of anesthesia. The pharmacokinetic model of propofol described by Marsh was used and incorporated into the propofol PFS pump®. The pharmacokinetic model of remifentanil described by Minto was incorporated into the Alaris PK® infusion pump. Local effector, or biophase, concentrations corresponded to the information obtained from the infusion pumps and represented predictive measurements of the concentrations of both drugs on their sites of action. The concentrations of propofol and remifentanil were regulated according to BIS and MAP, respectively. CONCLUSIONS: Total intravenous anesthesia for ablation of AF can be a safe option considering the lack of electrophysiological changes in accessory pathways. The literature on this subject is scarce and new publications could justify, or not, this type of anesthesia during ablation of AF.

  3. Randomized Trial of Infusion Set Function: Steel Versus Teflon

    OpenAIRE

    Patel, Parul J.; Benasi, Kari; Ferrari, Gina; Evans, Mark G.; Shanmugham, Satya; Wilson, Darrell M.; Buckingham, Bruce A.

    2014-01-01

    Background: This study compared infusion set function for up to 1 week using either a Teflon® (Dupont™, Wilmington, DE) catheter or a steel catheter for insulin pump therapy in type 1 diabetes mellitus.

  4. Inhaled insulin: overview of a novel route of insulin administration

    Directory of Open Access Journals (Sweden)

    Lucy D Mastrandrea

    2010-01-01

    Full Text Available Lucy D MastrandreaDepartment of Pediatrics, School of Medicine and Biochemical Sciences, University at Buffalo, Buffalo, NY, USAAbstract: 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 therapy is burdensome for many patients. This review will discuss pulmonary delivery of insulin via inhalation. The safety of inhaled insulin as well as the efficacy in comparison to subcutaneous insulin in the various populations with diabetes are covered. In addition, the experience and pitfalls that face the development and marketing of inhaled insulin are discussed.Keywords: glycemic control, hemoglobin A1c, inhalation, insulin, type 1 diabetes, type 2 diabetes

  5. Epidermolysis bullosa due to an intravenous infusion of cefathiamidine combined with mezlocillin%头孢硫脒联合美洛西林静脉滴注诱发大疱性表皮松解症

    Institute of Scientific and Technical Information of China (English)

    杨青; 李璠; 胡冰

    2011-01-01

    l例7岁女童为预防术后感染给予头孢硫脒2.0g加入0.9%氯化钠溶液100 ml中静脉滴注,1次/d;美洛西林2.0g加入5%葡萄糖注射液100 ml中静脉滴注,1次/d,共用药9d.停药第2天,患儿出现全身瘙痒,伴散在皮疹、低热.之后皮疹进行性加重,呈弥散性紫红色,表面可见水疱、部分糜烂,以躯干为主,伴口腔黏膜、眼结膜糜烂及脓性渗出,遂入院.给予阿奇霉素、夫西地酸、甲泼尼龙、人免疫球蛋白及外用药治疗.患儿皮肤症状逐渐好转,2周后痊愈出院.%A 7-year-old girl received an IV infusion of cefathiamidine 2.0 g in 0.9% sodium chloride 100 ml once daily and an IV infusion of mezlocillin 2. 0 g dissolved in 0. 5% glucose 100 ml once daily for nine days for preventing infection after surgery. On day 2 after withdrawl, the patient developed generalized pruritus accompanied by sporadic rashes and low-grade fever. Subsequently, her rash progressively worsen and became purple and more extensive; vesicles with erosion were seen on the lesion surface; the rash mainly involved her trunk, and erosion and purulent exudation were noted in the oral and conjunctival mucosa. She was then hospitalised and treated with azithromycin, fusidic acid, methylprednisolone, human immunoglobulin, and drugs for external use. Her symptoms of skin improved gradually and, two weeks later, she recovered and was discharged.

  6. 调查分析影响小儿静脉输液穿刺成功的因素及控制措施%Investigation and Analysis of the Factors Affecting the Success of Pediatric Intravenous Infusion and the Control Measures

    Institute of Scientific and Technical Information of China (English)

    李玉秀

    2014-01-01

    目的:调查了解哪些因素会影响小儿静脉穿刺的成功率以及控制成功率的措施。方法随机抽取该院接诊的130例儿童静脉输液穿刺失败的案例进行回顾性分析,了解影响因素,探讨控制策略。结果在影响小儿静脉输液穿刺成功的因素中,患儿个体因素最重要,占到26.9%,其次分别是环境影响22.3%、护士个体原因17.6%、穿刺技法问题16.1%、家长个体原因13.8%、关系默契程度10%、其他因素5.3%。结论要提升护士的技能经验,改善现场环境,联合家长配合来做好穿刺工作。%Objective To investigate and understand what factors will affect the success rate of venipuncture in children as well as the success rate of the control measures. Methods 130 cases of failing pediatric intravenous infusion in our hospital were randomly selected and analyzed retrospectively for understanding the influencing factors and discussing the control measures. Results Of the factors affecting the success of pediatric intravenous infusion, the individual factors of children were the most important, accounting for 26.9%, followed by the environmental impact, which accounted for 22.3%, individual factors of nurses, which accounted for 17.6%, puncture technique problems, which accounted for 16.1%, individual factors of parents, which accounted for 13.8%, the degree of relation tacit understanding, which accounted for 10%, other factors, which accounted for 5.3%. Conclusion Enhancing the skill experience of nurses, improving the working environment combined with the coordination of the parents are contributing to the well accomplishment of puncture.

  7. 预先静注帕瑞昔布钠对硬膜外麻醉后寒战的预防效果分析%The Analysis of the Preventive Effects to Shivering after Epidural Anesthesia by Beforehand Parecoxib Intravenous Infusion

    Institute of Scientific and Technical Information of China (English)

    刘曙光

    2013-01-01

    Objective: To investigate and analyze the preventive effects to shivering after epidural anesthesia by beforehand parecoxib intravenous infusion.Methods:74 patients received selective operation and epidural anesthesia were randomly assigned to test and control group, which had 37 patients. During the operation, the occurrence of shivering, heart rate (HR) and mean artery pressure (MAP) were recorded.Results:The occurrence of shivering in the control and test group were 51.4%and 27.1%, respectively. It was significantly higher in control group than in test group (P<0.05). The HR and MAP in control group were statistically significantly different from those in test group (P<0.05). Conclusion: Beforehand parecoxib intravenous infusion has satisfactory preventive effects to shivering after epidural anesthesia.%  目的:探讨分析预先静注帕瑞昔布钠对硬膜外麻醉后寒战的预防效果。方法:随机抽取74例择期行硬膜外麻醉手术治疗的患者,并将他们分为对照组和试验组,每组分别37例。观察并记录手术过程中两组患者寒战发生情况、心率(HR)及平均动脉压(MAP)。结果:两组寒战发生率分别为51.4%和27.1%,对照组明显高于试验组(P<0.05);对照组HR及MAP与试验组比较,差异有统计学意义(P<0.05)。结论:预先静注帕瑞昔布钠对硬膜外麻醉后寒战有良好的预防效果。

  8. Protective effect of continuous intravenous infusion of Isoproterenol on myocardial mitochondria of early septic rats and the corresponding mechanism%持续输注异丙肾上腺素对早期脓毒症大鼠心肌线粒体的保护作用及其机制

    Institute of Scientific and Technical Information of China (English)

    谢美燕; 项丹; 吕娟娟; 郑贵浪; 黄锦达; 刘翠; 曾其毅

    2015-01-01

    Objective To investigate the protective effect of continuous intravenous infusion of Isoproterenol (ISO)on myocardial mitochondria of early septic rats and the corresponding mechanism.Methods Thirty Sprague Dawley (SD)rats were randomly divided into 5 groups (6 cases per group):control group,endotoxin group,ISO small-dose group,ISO medium-dose group and ISO large-dose group.Endotoxin group and ISO intervene group received same management apart from drug intervention:receiving intravenous injection of lipopolysaccharide (LPS)10 mg/kg followed by an continuous intravenous infusion of 9 g/L saline 1 mL/h or ISO 0.06 μg/(kg · min),0.30 μg/(kg · min)and 0.60 μg/(kg · min).Control group received intraperitoneal injection and continuous intravenous infusion with the same amount of 9 g/L saline.The primary endpoint of the study was 24 hours after injection of 9 g/L saline or LPS.Serum creatine kinase (CK) and creatine kinase isoenzyme (CK-MB),oxidative and nitrosative stress levels and swelling of isolated heart mitochondrion were detected.The pathological changes of the myocardium and morphologic changes of the heart mitochondria were observed through light microscope and scanning electron microscope,respectively.Results The levels of CK,CK-MB,nitric oxide (NO) content,inducible nitric oxide synthase (iNOS) activity and malondialdehyde (MDA)content in endotoxin group were increased compared with control group (all P < 0.05),while the superoxide dismutase (SOD) activity decreased [(11.543 ± 1.080) U/mg prot vs (9.892 ±0.815) U/mg prot,P <0.05].The morphology of the heart mitochondria significantly changed (such as swelling,disordered arrangement,crest fracture,fusion and cavitations,and so on).ISO intervention significantly decreased the levels of CK,CK-MB and mitochondrial swelling (all P < 0.05) and increased the SOD activity (all P < 0.05).The levels of NO content,iNOS activity and MDA content were significantly decreased in small-dose group [(10.823

  9. Developing a System for Integraded Automatic Control of Mutiple Infusion Pumps : The Multiplex infusion system

    NARCIS (Netherlands)

    Doesburg, Frank

    2013-01-01

    Most errors in ICUs are related to intravenous (IV) therapy. Previous studies suggested that hard to operate infusion pumps and the high cognitive workload for ICU nurses contribute to these errors. Conventional IV therapy requires separate lumens for incompatible IV drugs. This often requires the p

  10. Review of pharmacokinetic models for target controlled infusions in anesthesia

    Directory of Open Access Journals (Sweden)

    Subash Kennedy Sivasubramaniam

    2014-06-01

    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

  11. In vivo characterization of insulin uptake by dog renal cortical epithelium

    International Nuclear Information System (INIS)

    In vivo 125I-labeled insulin uptake by dog renal tubular epithelium was studied using the single-pass multiple indicator dilution (MID) method and analyzed by a computer-assisted model of transcapillary exchange and substrate-cell interaction. Anesthetized dogs received an intrarenal arterial bolus of multiple tracers: [3H]dextran greater than 70 kDa (plasma reference), [14C]inulin (extracellular reference), and 125I-insulin. Rapid serial sampling of the renal venous and urine outflows was performed. The renal venous outflow curves of 125I-insulin fell below [14C]inulin implying postglomerular extraction and antiluminal membrane (ALM) uptake. The fractional urine recovery of 125I-insulin was less than 0.03, indicating luminal tubular uptake of filtered hormone. After intravenous infusion of unlabeled insulin, repeat MID runs with tracer revealed saturable ALM uptake as evidenced by the 125I-insulin renal venous outflow curves approaching [14C]inulin. Luminal tubular uptake was unchanged and therefore unsaturable. The 125I-insulin renal venous data were studied using three mathematical models, incorporating postglomerular reversible binding, irreversible binding or transport. The best fit was obtained using the transport model. The modeling analysis is consistent with either uptake into a virtual epithelial membrane space (i.e., insulin never enters the cell but binds to or is distributed along the ALM) or insulin actually enters the intracellular compartment. In vivo uptake of 125I-insulin ALM is characterized by a Km of 15.44 nM

  12. One-year metreleptin improves insulin secretion in patients with diabetes linked to genetic lipodystrophic syndromes.

    Science.gov (United States)

    Vatier, C; Fetita, S; Boudou, P; Tchankou, C; Deville, L; Riveline, Jp; Young, J; Mathivon, L; Travert, F; Morin, D; Cahen, J; Lascols, O; Andreelli, F; Reznik, Y; Mongeois, E; Madelaine, I; Vantyghem, Mc; Gautier, Jf; Vigouroux, C

    2016-07-01

    Recombinant methionyl human leptin (metreleptin) therapy was shown to improve hyperglycaemia, dyslipidaemia and insulin sensitivity in patients with lipodystrophic syndromes, but its effects on insulin secretion remain controversial. We used dynamic intravenous (i.v.) clamp procedures to measure insulin secretion, adjusted to insulin sensitivity, at baseline and after 1 year of metreleptin therapy, in 16 consecutive patients with lipodystrophy, diabetes and leptin deficiency. Patients, with a mean [± standard error of the mean (s.e.m.)] age of 39.2 (±4) years, presented with familial partial lipodystrophy (n = 11, 10 women) or congenital generalized lipodystrophy (n = 5, four women). Their mean (± s.e.m.) BMI (23.9 ± 0.7 kg/m(2) ), glycated haemoglobin levels (8.5 ± 0.4%) and serum triglycerides levels (4.6 ± 0.9 mmol/l) significantly decreased within 1 month of metreleptin therapy, then remained stable. Insulin sensitivity (from hyperglycaemic or euglycaemic-hyperinsulinaemic clamps, n = 4 and n = 12, respectively), insulin secretion during graded glucose infusion (n = 12), and acute insulin response to i.v. glucose adjusted to insulin sensitivity (disposition index, n = 12), significantly increased after 1 year of metreleptin therapy. The increase in disposition index was related to a decrease in percentage of total and trunk body fat. Metreleptin therapy improves not only insulin sensitivity, but also insulin secretion in patients with diabetes attributable to genetic lipodystrophies. PMID:26584826

  13. The Effects of Anti-insulin Antibodies and Cross-reactivity with Human Recombinant Insulin Analogues in the E170 Insulin Immunometric Assay

    OpenAIRE

    Kim, Serim; Yun, Yeo Min; Hur, Mina; Moon, Hee Won; Kim, Jin Q

    2011-01-01

    Background Insulin assays are affected by varying degrees of interference from anti-insulin antibodies (IAs) and by cross-reactivity with recombinant insulin analogues. We evaluated the usefulness of the E170 insulin assay by assessing IA effects and cross-reactivity with 2 analogues. Methods Sera were obtained from 59 type 2 diabetes patients receiving continuous subcutaneous insulin infusion and 18 healthy controls. Insulin levels were determined using an E170 analyzer. To investigate the e...

  14. Defective insulin response of cyclic adenosine monophosphate-dependent protein kinase in insulin-resistant humans.

    OpenAIRE

    Kida, Y; Nyomba, B L; Bogardus, C; Mott, D M

    1991-01-01

    Insulin-stimulated glycogen synthase activity in human muscle correlates with insulin-mediated glucose disposal and is reduced in insulin-resistant subjects. Inhibition of the cyclic AMP-dependent protein kinase (A-kinase) is considered as a possible mechanism of insulin action for glycogen synthase activation. In this study, we investigated the time course of insulin action on human muscle A-kinase activity during a 2-h insulin infusion in 13 insulin-sensitive (group S) and 7 insulin-resista...

  15. Effect of Intravenous Dexmedetomldine Combined with Propofol Using Target - controlled Infusion (TCI) in Endoscopic Retrograde Cholangiopancreatography(ERCP) Anesthesia%右美托咪啶复合丙泊酚靶控输注在ERCP诊疗麻醉中的应用

    Institute of Scientific and Technical Information of China (English)

    张云珍; 习建华; 陈淑萍; 程远; 卫法泉; 杨慧芳

    2012-01-01

    目的 评价右美托咪啶复合丙泊酚靶控输注在内镜逆行胰胆管造影(ERCP)检查取石术麻醉中的有效性和安全性.方法 麻醉下行ERCP患者76例,随机分为两组,右美托咪啶复合丙泊酚靶控输注组38例(D组),靶控输注丙泊酚组38例(P组).观察输注右美托咪啶前(T0)、诱导入睡(T1)、插镜(T2)、套石(T3)、退镜(T4)、睁眼(T5)时的HR、MAP、RR、Sp02,所需丙泊酚浓度、苏醒时间、不良反应发生率、术中镇静评分及术后患者满意度.结果 P组T1时点MAP、RR较T0时点显著下降(P<0.01),组间比较P组T1时点MAP、RR较D组T1时点下降(P<0.05);D组T1~T3时点HR较T0时点下降(P<0.05或P<0.01).P组丙泊酚所需浓度明显高于D组(P<0.01),D组患者呼吸抑制、术中体动发生率低于P组(P<0.05),D组镇静评分优于P组(P<0.05),D组患者心动过缓的发生率高于P组(P<0.05),两组患者苏醒时间、术后恶心呕吐差异无统计学意义(P>0.05).结论 ERCP诊疗麻醉中右美托咪啶复合丙泊酚靶控输注可以提供良好的镇静,节俭丙泊酚的用量、无明显的呼吸抑制,不影响患者的清醒.是一种安全、有效的麻醉方法.%Objective To evaluate the efficacy and safety of intravenous dexmedetomidine combined with propofol using target - controlled infusion (TCI) in endoscopic retrograde cholangiopancreatography ( ERCP) anesthesia. Methods Seventy six patients undergoing ERCP were randomly divided into two groups ; dexmedetomidine combined with propofol using target - controlled infusion (TCI) group (group D,n =38) and propofol using target -controlled infusion(TCI) group ( group P,n =38). The HR,MAP,RR and SpO2were detected at the following 6 time points: before infusion of dexmedetomidine( TO), after - induction (Tl), inserting endoscope (T2), hitching -up stone (T3), withdrawing endoscope (T4 ), opening eyes ( T5). The plasma concentration of propofol, awakening time, adverse events incidence

  16. 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

    OpenAIRE

    Chevassus, Hugues; Mourand, Isabelle; Molinier, Nathalie; Lacarelle, Bruno; Brun, Jean-Frédéric; Petit, Pierre

    2004-01-01

    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 ye...

  17. 糖尿病开展胰岛素泵连续皮下输注的临床意义%Clinical significance of continuous subcutaneous insulin infusion for diabetes

    Institute of Scientific and Technical Information of China (English)

    陈俏蓉

    2014-01-01

    Objective To explore the differences of clinical curative effect of continuous subcutaneous insulin infusion (CSII) and multiple subcutaneous insulin injection (MSII) on blood sugar control for patients with diabetes type 2 and to accumulate experience for the treatment of the disease.Methods78 patients with diabetes type 2 who were admitted to the department of endocrinology in our hospital from March 2010 to September 2013 were selected. They were allocated to a research group and a control group according to random number table, with 39 patients in each group. The research group received CSII and the control group received MSII. FBG, 2hBG, HbA1C, insulin dosage and incidence of adverse events before and after the treatment in the two groups were recorded.ResultsAt the end of the fourth treatment week, FBG and 2hBG in the research group were both lower than those in the control group (P0.05). Recovery time of blood sugar in the research group was shorter than that in the control group (P<0.05), and the insulin dosage was less than that in the control group (P<0.05). Incidence of hypoglycemia and dawn phenomenon were both lower than those in the control group (P<0.05). Conclusion Compared with MSII, CSII for patients with diabetes type 2 has a better effect of blood sugar control, less insulin dosage, a low incidence of adverse events and a satisfactory clinical effect.%目的:探讨2型糖尿病患者采取胰岛素泵连续皮下输注(CSⅡ)与多次胰岛素皮下注射(MSⅡ)对血糖控制的临床疗效差异,并为该病治疗积累经验。方法选取我院内分泌科于2010年3月~2013年9月收治的78例2型糖尿病患者,利用随机数字表法进行分组,分别设为研究组和对照组,每组各39例。其中研究组开展CSⅡ治疗,对照组开展MSⅡ治疗。记录两组患者在治疗前后空腹血糖(FBG)、餐后2h血糖(2hBG)、糖化血红蛋白(HbA1C)及胰岛素用量、不良反应

  18. Clinical application of insulin pumps in the management of insulin dependent diabetes.

    OpenAIRE

    Greene, S.A.; Smith, M. A.; Baum, J D

    1983-01-01

    Seven volunteers aged 12.0 to 17.9 years participated in a trial to compare conventional insulin treatment with continuous open loop (pump) insulin infusion. After 6 weeks of conventional treatment followed by 6 weeks of insulin pump treatment, 4 children chose to manage their diabetes permanently by means of the insulin pump. The mean blood glucose concentration (based on home blood glucose monitoring) while on conventional insulin treatment showed no appreciable change during the 6 weeks' t...

  19. Biological activity of C-peptide on the skin microcirculation in patients with insulin-dependent diabetes mellitus.

    OpenAIRE

    Forst, T; Kunt, T; Pohlmann, T.; Goitom, K; Engelbach, M; Beyer, J.; Pfützner, A.

    1998-01-01

    19 insulin-dependent diabetes mellitus (IDDM) patients participated in a randomized double-blind crossover investigation to investigate the impact of human C-peptide on skin microvascular blood flow. The investigation was also carried out with 10 healthy volunteers. Blood pressure, heart rate, blood sugar, and C-peptide levels were monitored during a 60-min intravenous infusion period of C-peptide (8 pmol kg-1 min-1) or saline solution (154 mmol liter-1 NaCl), and 30 min after stopping the in...

  20. Adverse Reaction Following Intravenous Immunoglobulin in Primary Immunodeficiency Patients

    Directory of Open Access Journals (Sweden)

    J. Ghaffari, M.D.+

    2007-01-01

    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.

  1. 系统评价区域灌注和全身给药治疗重症急性胰腺炎的效果%Comparison on continuous regional arterial infusion and intravenous administration in the treatment of severe acute pancreatitis: A systematic review

    Institute of Scientific and Technical Information of China (English)

    李宝华; 王文辉; 周怀琪

    2013-01-01

    Objective To assess the clinical effectiveness of continuous regional arterial infusion (CRAI) and intravenous administration in the treatment of severe acute pancreatitis (SAP). Methods The database such as PubMed, Cochrane Library, EMbase, CNKI, and CBM were searched to collect randomized controlled trials (RCTs) from the establishment to July 2012, and articles about CRAI and intravenous administration in the treatment of SAP were retrieved. Studies were screened, data were extracted, and the methodological quality was assessed. Meta-analyses were conducted by using Rev-Man 5. 0 software. Results A total of 10 RCTs involving 597 patients were included. Results of Meta-analysis showed that CRAI was better than intravenous administration in the cure rates (OR=3. 42, 95%CI [2. 14, 5. 45], P<0. 00001), the rates of surgical intervention (OR=0. 39, 95%CI [0. 23, 0. 64], P=0. 0002), the secondary infection rates (OR=0. 24, 95%CI [0. 14, 0.42], P<0. 00001) and the complications morbidity rates (OR=0.28, 95%CI [0.13, 0.59], P = 0. 0009). Conclusion There are differences in the modes of administration between CARI and intravenous administration. CARI is superior to intravenous administration in the aspects of cure rate, rate of surgical intervention, secondary infection rates and complications and morbidity rates.%目的 系统评价持续性区域动脉灌注(CRAI)和全身给药治疗重症急性胰腺炎(SAP)的临床疗效.方法 计算机检索PubMed、Cochrane Library、EMbase、CNKI、CBM,同时手工检索相关期刊和会议论文集,均从建库至2012年7月,查找关于CRAI和全身给药治疗SAP的临床对照试验研究.按照纳入与排除标准选择试验、提取资料和评价其方法质量学后,采用RevMan manager 5.0软件进行Meta分析.结果 共纳入10个研究,597例患者.Meta分析结果显示:①治愈率:两种给药方式差异有统计学意义[OR=3.42,95%CI(2.14,5.45),P<0.00001];②中转手术率:两种给药方

  2. Intravenous immunoglobulin treatment for secondary recurrent miscarriage

    DEFF Research Database (Denmark)

    Christiansen, Ole Bjarne; Larsen, E. C.; Egerup, P.;

    2015-01-01

    OBJECTIVE: To determine whether infusions with intravenous immunoglobulin (IVIg) during early pregnancy increase live birth rate in women with secondary recurrent miscarriage compared with placebo. DESIGN: A single-centre, randomised, double-blind, placebo-controlled trial. SETTING: A tertiary...... centre for recurrent miscarriage in Copenhagen, Denmark. POPULATION: A group of 82 women with unexplained secondary recurrent miscarriage and at least four miscarriages. METHODS: Women were randomly assigned to repeated infusions with IVIg or placebo (albumin) from the time of positive pregnancy test to......, IVIg did not increase the live birth rate in patients with secondary recurrent miscarriage and the treatment cannot be recommended in clinical practice....

  3. Subcutaneous insulin substitution in insulin-dependent diabetes mellitus. Pharmacokinetic and pharmacodynamic studies.

    Science.gov (United States)

    Olsson, P O

    1987-01-01

    Determination of free and total insulin with radioimmunoassay, after precipitation of endogenous insulin antibodies with polyethylene glycol, was evaluated. Insulin substitution in insulin-dependent diabetic patients was investigated, embracing the 24 h free insulin and glucose profiles with different regimens, the miscibility of insulin preparations, the overnight metabolic control, and bolus doses of different size with infusion pumps. In the free and total insulin assay precipitation of immunoglobulins with polyethylene glycol was almost complete and the recovery was high. Compared to immediately precipitated and assayed plasma samples at 37 degrees C, free insulin slightly decreased in immediately processed serum (20 degrees C), and also in plasma after 3 h at 20 degrees C. In stored (-20 degrees C) unprecipitated plasma samples free insulin increased after 4 weeks and also in serum samples after 26 weeks, whereas stored PEG-supernates were stable. In healthy controls a low basal insulin was found, increasing about tenfold postprandially. No morning rise in free insulin or glucose was found. The 24 h free insulin profile was strikingly unphysiological with 1 or 2 dose regimens; there was preprandial and nocturnal hyperinsulinaemia but absence of meal-related free insulin peaks. A considerable glucose rise was found after breakfast. Intensive regimens with conventional injections or infusion pumps, gave 24 h free insulin profiles that were similar to the physiological. However, the prandial peaks were retarded; and hyperinsulinaemia was shown with infusion pumps during daytime. An immediate loss of regular insulin was demonstrated after mixture with semisynthetic human lente insulin in vitro and in vivo, but not after mixture with biosynthetic human NPH insulin. The morning glucose control was similar with a bedtime injection of intermediate-acting insulin or continuous subcutaneous insulin infusion, but less hyperinsulinaemia overnight was found with the

  4. Exogenous glucose administration impairs glucose tolerance and pancreatic insulin secretion during acute sepsis in non-diabetic mice.

    Directory of Open Access Journals (Sweden)

    Yoshio Watanabe

    Full Text Available OBJECTIVES: The development of hyperglycemia and the use of early parenteral feeding are associated with poor outcomes in critically ill patients. We therefore examined the impact of exogenous glucose administration on the integrated metabolic function of endotoxemic mice using our recently developed frequently sampled intravenous glucose tolerance test (FSIVGTT. We next extended our findings using a cecal ligation and puncture (CLP sepsis model administered early parenteral glucose support. METHODS: Male C57BL/6J mice, 8-12 weeks, were instrumented with chronic indwelling arterial and venous catheters. Endotoxemia was initiated with intra-arterial lipopolysaccharide (LPS; 1 mg/kg in the presence of saline or glucose infusion (100 µL/hr, and an FSIVGTT was performed after five hours. In a second experiment, catheterized mice underwent CLP and the impact of early parenteral glucose administration on glucose homeostasis and mortality was assessed over 24 hrs. MEASUREMENTS: AND MAIN RESULTS: Administration of LPS alone did not impair metabolic function, whereas glucose administration alone induced an insulin sensitive state. In contrast, LPS and glucose combined caused marked glucose intolerance and insulin resistance and significantly impaired pancreatic insulin secretion. Similarly, CLP mice receiving parenteral glucose developed fulminant hyperglycemia within 18 hrs (all > 600 mg/dl associated with increased systemic cytokine release and 40% mortality, whereas CLP alone (85 ± 2 mg/dL or sham mice receiving parenteral glucose (113 ± 3 mg/dL all survived and were not hyperglycemic. Despite profound hyperglycemia, plasma insulin in the CLP glucose-infused mice (3.7 ± 1.2 ng/ml was not higher than sham glucose infused mice (2.1 ± 0.3 ng/ml. CONCLUSIONS: The combination of parenteral glucose support and the systemic inflammatory response in the acute phase of sepsis induces profound insulin resistance and impairs compensatory pancreatic insulin

  5. Human insulin: study of safety and efficacy in man.

    OpenAIRE

    Owens, D R; Jones, M. K.; Hayes, T M; Heding, L G; Alberti, K G; Home, P. D.; Burrin, J M; Newcombe, R G

    1981-01-01

    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...

  6. Effect of potassium and hypomagnesemia on insulin in the bovine

    Energy Technology Data Exchange (ETDEWEB)

    Lentz, D.E.; Madsen, F.C.; Miller, J.K.; Hansard, S.L.

    1976-01-01

    Grass tetany in cattle has been associated with the consumption of early spring forages high in potassium (K) and low in magnesium (Mg). Alterations in serum Mg and K may affect intermediary carbohydrate metabolism, resulting in hypoglycemia and ketosis that often accompany grass tetany. We investigated these interrelationships by infusing potassium chloride (KCl) intravenously in normal (plasma Mg greater than 2.1 mg/100 ml) and Mg-deficient (plasma Mg less than .7 mg/100 ml) 9-month-old Holstein bull calves and intraruminally into nonpregnant, nonlactating Holstein cows. Plasma levels of both K and immunoreactive insulin (IRI) were elevated (P less than .01) by 1.14, 2, and 3 percent KCl (51, 64, and 135 mg K/kg) in calves and by 550 g KCl (440 mg K/kg body weight) in cows. Plasma K was lower (P less than .01) and IRI higher (P less than .01) in Mg-deficient calves than in normal calves during 2 percent KCl infusion. These results suggest that prolonged elevation of K and insulin in ruminants could lead to a series of metabolic disturbances that may play an important role in the etiology of grass tetany.

  7. Study Design for the IMMEDIATE (Immediate Myocardial Metabolic Enhancement During Initial Assessment and Treatment in Emergency Care) Trial: A Double-blind Randomized Controlled Trial of Intravenous Glucose, Insulin, and Potassium (GIK) for Acute Coronary Syndromes in Emergency Medical Services

    Science.gov (United States)

    Selker, Harry P.; Beshansky, Joni R.; Griffith, John L.; D’Agostino, Ralph B.; Massaro, Joseph M.; Udelson, James E.; Rashba, Eric J.; Ruthazer, Robin; Sheehan, Patricia R.; Desvigne-Nickens, Patrice; Rosenberg, Yves D.; Atkins, James M.; Sayah, Assaad J.; Aufderheide, Tom P.; Rackley, Charles E.; Opie, Lionel H.; Lambrew, Costas T.; Cobb, Leonard A.; MacLeod, Bruce A.; Ingwall, Joanne S.; Zalenski, Robert J.; Apstein, Carl S.

    2014-01-01

    Background Experimental studies suggest that metabolic myocardial support by intravenous (IV) glucose, insulin, and potassium (GIK) reduces ischemia-induced arrhythmias, cardiac arrest, mortality, progression from unstable angina pectoris (UAP) to acute myocardial infarction (AMI), and MI size. However, trials of hospital administration of IV GIK to patients with ST elevation MI (STEMI) have generally not shown favorable effects, possibly due to the GIK intervention taking place many hours after ischemic symptom onset. A trial of GIK used in the very first hours of ischemia has been needed, consistent with the timing of benefit seen in experimental studies. Objective The Immediate Myocardial Metabolic Enhancement During Initial Assessment and Treatment in Emergency care (IMMEDIATE) Trial tested whether, if given very early, GIK could have the impact seen in experimental studies. Accordingly, distinct from prior trials, IMMEDIATE tested the impact of GIK 1) in patients with acute coronary syndromes (ACS), rather than only AMI or STEMI, and 2) administered in prehospital emergency medical service (EMS) settings, rather than later, in hospitals, following emergency department evaluation. Design IMMEDIATE was an EMS-based randomized placebo-controlled clinical effectiveness trial conducted in 13 cities across the US which enrolled 911 participants. Eligible were patients age 30 or older for whom a paramedic performed a 12-lead electrocardiogram (ECG)to evaluate chest pain or other symptoms suggestive of ACS for whom electrocardiograph-based ACI-TIPI (acute cardiac ischemia time-insensitive predictive instrument) indicated a > 75% probability of ACS, and/or the TPI (thrombolytic predictive instrument) indicated presence of a STEMI, or if local criteria for STEMI notification of receiving hospitals were met. Prehospital IV GIK or placebo was started immediately. Pre-specified were the primary endpoint of progression of ACS to infarction, and as major secondary endpoints

  8. Infusão intravenosa de vasopressina causa efeitos cardiovasculares adversos dose-dependentes em cães anestesiados Infusión intravenosa de vasopresina causa efectos cardiovasculares adversos dependientes de la dosis en canes anestesiados Vasopressin intravenous infusion causes dose dependent adverse cardiovascular effects in anesthetized dogs

    Directory of Open Access Journals (Sweden)

    Luiz Cláudio Martins

    2010-02-01

    Full Text Available FUNDAMENTO: A arginina-vasopressina (AVP tem sido amplamente utilizada no tratamento do choque vasodilatador. Entretanto, há muitas questões relativas ao seu uso clínico, especialmente em altas doses, pois sua utilização pode estar associada a efeitos cardíacos adversos. OBJETIVO: Investigar os efeitos cardiovasculares da AVP em infusão IV contínua nos parâmetros hemodinâmicos em cães. MÉTODOS: Dezesseis cães saudáveis sem raça definida, anestesiados com pentobarbital, receberam um cateter intravascular e foram aleatoriamente designados para dois grupos: controle (solução salina - placebo; n=8 e AVP (n=8. O grupo do estudo recebeu infusão de AVP por três períodos consecutivos de 10 minutos a doses logaritmicamente progressivas (0,01; 0,1 e 1,0 U/kg/min, a intervalos de 20 minutos. A frequência cardíaca (HR e as pressões intravasculares foram continuamente registradas. O debito cardíaco foi medido através do método de termodiluição. RESULTADOS: Nenhum efeito hemodinâmico significante foi observado durante a infusão de 0,01 U/kg/min de AVP, mas com as doses mais altas, de 0,1 e 1,0U/kg/min, houve um aumento progressivo na pressão arterial média (PAM e índice de resistência vascular sistêmica (IRVS, com significante diminuição na frequência cardíaca (FC e índice cardíaco (IC. Com a dose de 1,0 U/kg/min, também foi observado um aumento significante no índice de resistência vascular pulmonar (IRVP, principalmente devido à diminuição no IC. CONCLUSÃO: A AVP em doses entre 0,1 e 1,0 U/kg/min resultou em significantes aumentos na PAM e no IRVS, com efeitos inotrópicos e cronotrópicos negativos em animais saudáveis. Embora essas doses sejam de 10 a 1.000 vezes maiores do que as rotineiramente utilizadas no tratamento do choque vasodilatador, nossos dados confirmam que a AVP deveria ser usada cuidadosamente e sob rígida monitoração hemodinâmica na prática clínica, especialmente se doses maiores do

  9. Marrow Stromal Cell Infusion Rescues Hematopoiesis in Lethally Irradiated Mice despite Rapid Clearance after Infusion

    Directory of Open Access Journals (Sweden)

    Xiaodong Yang

    2012-01-01

    Full Text Available Marrow stromal cells (MSCs, also termed mesenchymal stem cells have been proposed as a promising cellular therapy for tissue injury including radiation-induced marrow failure, but evidence for a direct effect is lacking. To assess the effects of MSCs on survival after lethal irradiation, we infused syngeneic MSCs (either as immortalized MSCs clones or primary MSCs intravenously into wild-type C57/Bl6 mice within 24 hours of lethal total body irradiation (TBI. Mice receiving either of the MSC preparations had significantly improved survival when compared to controls. In vivo imaging, immune histochemistry, and RT-PCR employed to detect MSCs indicated that the infused MSCs were predominantly localized to the lungs and rapidly cleared following infusion. Our results suggest that a single infusion of MSCs can improve survival after otherwise lethal TBI but the effect is not due to a direct interaction with, or contribution to, the damaged marrow by MSCs.

  10. Infusion thrombophlebitis: a prospective comparison of 645 Vialon and Teflon cannulae in anaesthetic and postoperative use.

    Science.gov (United States)

    Gaukroger, P B; Roberts, J G; Manners, T A

    1988-08-01

    A prospective study of the incidence and severity of infusion thrombophlebitis in peripheral intravenous infusions used for anaesthetic and postoperative purposes in 645 patients was conducted over a four-month period. Conditions of insertion were carefully controlled while ward management was according to standard practice. A total of 330 polyurethane Vialon and 315 FEP-A Teflon cannulae were used. The results show that the nature of the cannula was the single most important factor in the incidence and severity of infusion thrombophlebitis, Vialon cannulae being associated with a 46% lower incidence than the Teflon type. Less important but significant factors included intravenous antibiotics, duration of infusion, cannula tip damage and caesarean section. Factors not associated with infusion thrombophlebitis included potassium therapy, blood transfusion or site of insertion in the upper limb. Heparinisation increased duration of infusion without affecting the incidence of infusion thrombophlebitis. PMID:3189736

  11. Evaluation of 99m Tc-MIBI myocardial perfusion imaging with intravenous infusion of adenosine triphosphate in diagnosis of coronary artery disease%静脉注射三磷酸腺苷99mTc-MIBI心肌灌注显像诊断冠心病的评价

    Institute of Scientific and Technical Information of China (English)

    何青; 姚稚明; 于雪; 屈婉莹; 孙福成; 季福绥; 许锋; 钱贻简

    2002-01-01

    目的评价三磷酸腺苷(ATP)药物负荷99mTc-MIBI 心肌灌注断层显像在诊断冠心病中的可行性、安全性和特异性.方法共263例临床诊断为冠心病的病人.所有病人都行ATP负荷的99mTc-MIBI心肌灌注显像(0.16 mg/kg/min, 5 min)检查. 在静脉注射ATP 3分钟时静脉注射20 mCi的99mTc-MIBI, 60分钟后行心肌断层显像.再于48小时后静脉注射99mTc-MIBI 20 mCi, 行静息心肌灌注断层显像.51例病人在2周内行冠状动脉造影以评价ATP介入心肌灌注断层显像诊断冠心病的准确性.在静脉注射ATP的过程中仔细地观察心脏的和非心脏的反应.结果所有病人都完成整个ATP负荷试验.尽管有58.9% 的病人有不同类型的副作用发生,但其程度都不严重.无任何病人需要氨茶碱.最为严重的副作用是II度II型房室传导阻滞(4/263 ),但其持续时间均短暂.ATP介入心肌灌注断层显像诊断冠心病的敏感性和特异性分别为97.1%和82.4%.结论对于不能完成运动试验的病人,ATP负荷心肌灌注断层显像是安全、可行的诊断冠心病的影像学技术.%Objective To evaluate the feasibility, safety and diagnostic accuracy of pharmacologic stress of 99m Technetium-MIBI single-photon emission computed tomography (SPECT) with intravenous adenosine triphosphate (ATP) in patients with suspected coronary artery disease.Methods The study group included 263 patients who were suspected of having coronary artery disease. All patients underwent 99m Tc-MIBI myocardial perfusion imaging with ATP infusion (0.16 mg/kg body weight per min for 5 min). 20 mCi of 99m Tc-MIBI were injected 3 minutes after the start of ATP infusion. Myocardial SPECT images were obtained 60 minutes later. Then, two days later, 20 mCi of 99m Tc-MIBI were administered at rest and myocardial SPECT was repeated. 51 patients also underwent coronary angiography within two weeks for evaluation of sensitivity and specificity of ATP-myocardial perfusion

  12. Pressão arterial, respostas metabólicas e autonômicas à insulina e infusão de intralipid® em pacientes chagásicos Presión arterial, respuestas metabólicas y autonómicas a la insulina e infusión de intralipid® en pacientes chagásicos Blood pressure, metabolic and autonomic responses to insulin and intralipid® infusion in chagasic patients

    Directory of Open Access Journals (Sweden)

    Claudia Cristina Soares Silva

    2012-03-01

    con la forma indefinida de la Enfermedad de Chagas y 12 voluntarios sanos. RESULTADOS: La presión arterial basal y la frecuencia cardíaca fueron similares en los dos grupos. Los niveles plasmáticos de noradrenalina estaban ligeramente más elevados en el grupo de pacientes chagásicos. Después del Test de Tolerancia a la Insulina (TTI, se produjo una ostensible disminución en la glucosa de los dos grupos. La Infusión de ILH trajo como consecuencia el aumento de la presión arterial en ambos grupos, pero no hubo ningún cambio significativo en la noradrenalina plasmática. El componente de Baja Frecuencia (BF, fue similar y aumentó de forma parecida en ambos grupos. El componente de Alta Frecuencia (AF se presentó con un menor nivel en el grupo chagásico. CONCLUSIONES: Los pacientes con una forma indeterminada de la Enfermedad de Chagas, presentaron un aumento en la actividad simpática al momento basal y una respuesta inadecuada a la insulina. También tuvieron un menor componente de alta frecuencia y de sensibilidad barorrefleja, que fue perjudicado en el momento basal y durante la infusión de intralipid® y heparina.BACKGROUND: Intralipid and heparin infusion results in increased blood pressure and autonomic abnormalities in normal and hypertensive individuals. OBJECTIVE: To evaluate insulin sensitivity and the impact of Intralipid and heparin (ILH infusion on hemodynamic, metabolic, and autonomic response in patients with the indeterminate form of Chagas' disease. METHODS: Twelve patients with the indeterminate form of Chagas' disease and 12 healthy volunteers were evaluated. RESULTS: Baseline blood pressure and heart rate were similar in both groups. Plasma noradrenaline levels were slightly increased in the Chagas' group. After insulin tolerance testing (ITT, a significant decline was noted in glucose in both groups. ILH infusion resulted in increased blood pressure in both groups, but there was no significant change in plasma noradrenaline. The low

  13. 早期应用小剂量地塞米松对中重度烧伤全身炎症反应的影响%Effects of Moderate and Severe Burns Systemic Inflammatory Response by Early Intravenous Infusion of Low Dose Dexamethasone

    Institute of Scientific and Technical Information of China (English)

    李维珊; 柯昌能; 邓雪峰

    2014-01-01

    Objective:To investigate effects of moderate and severe burns systemic inflammatory response by early intravenous infusion of low dose dexamethasone.Method:25 adult burn patients were selected as the treatment group, and treatment by early application of low-dose dexamethasone in addition to conventional anti shock. Usage was the dose of 20 mg, intravenous drip, 1 times a day, a total of 3 days. 25 adult burn patients were selected as the control group, and given conventional anti shock treatment. The TNF-α, IL-1, IL-6 concentration differences of two groups were compared after first day, second days, third days, fourth days, fifth days, sixth days and seventh day.Result:TNF-α, IL-1, IL-6 plasma concentrations in the treatment group were significantly lower than those in the control group, the differences were statistically significant (P<0.05).Conclusion:There are the obvious inhibitory actions for systemic inflammatory response used by early application of low-dose dexamethasone on moderate and severe burns.%目的:探讨早期应用小剂量地塞米松对中重度烧伤患者全身炎症反应的影响。方法:选取25例成年中重烧伤患者作为治疗组,常规抗休克治疗外,早期应用小剂量地塞米松20 mg,静滴,1次/d,共3 d;另选取25例成年中重烧伤患者作为对照组,采用常规抗休克治疗。比较烧伤后第1、2、3、4、5、6、7天两组血浆中TNF-α、IL-1、IL-6浓度的差异。结果:治疗组血浆TNF-α、IL-1、IL-6浓度均显著低于对照组,差异均有统计学意义(P<0.05)。结论:早期应用小剂量地塞米松对中重度烧伤所致的全身反应综合征有明显的抑制作用,可在烧伤早期短期应用。

  14. DEVELOPMENT OF DOMESTIC INFUSION DRUGS BASED ON PARACETAMOL

    OpenAIRE

    Almakaeva L.G.; Naumenok L.G.; Begunova N.V.; Dolya V.G.; Almakaev M.S

    2016-01-01

    The intravenous form of paracetamol compared with oral more reliably supports effective drug concentration in blood plasma that promotes a higher therapeutic effect. Recent studies have confirmed that the use of the intravenous form of paracetamol to deal with postoperative pain multimodal analgesia modes results in reducing the frequency and quantity of opioids administered , and, as a consequence, its associated side effects. The drug Paracetamol , infusion solution 10 mg / ml to 100 ml gl...

  15. Anaphylactic shock and cardiac arrest caused by thiamine infusion

    OpenAIRE

    Juel, Jacob; Pareek, Manan; Langfrits, Christian Sigvald; Jensen, Svend Eggert

    2013-01-01

    Parenteral thiamine has a very high safety profile. The most common adverse effect is local irritation; however, anaphylactic or anaphylactoid reactions may occur, mostly related to intravenous administration. We describe a 44-year-old man, a chronic alcoholic, who was admitted with alcohol intoxication and developed cardiac arrest due to anaphylactic shock following intravenous thiamine infusion. The patient was successfully resuscitated after 15 min and repeated epinephrine administrations....

  16. 地特胰岛素加三餐前速效胰岛素与胰岛素泵短期强化治疗对2型糖尿病的疗效比较%Comparison of the efficacy between basal insulin detemir with pre-meal insulin aspart and continuous subcutaneous insulin infusion (CSII) in type 2 diabetes

    Institute of Scientific and Technical Information of China (English)

    邢莉; 申虎威

    2012-01-01

    Objective To compare the efficacy and safety between insulin aspart combined with insulin detemir and insulin pump in the intensified therapy of patients with type 2 diabetes mellitus (T2DM). Methods 68 patients with T2DM were randomly divided into two groups. The patients in group A were given insulin aspart combined with insulin detemir, and the patients in group B received insulin pump therapy with insulin aspart. Time to target glucose, insulin dosage and hypoglycaemia incidence before and after 3 months therapy were measured and compared in both groups. Results After 3 month's therapy,the HbA1c(%) levels significantly decreased in both groups[group A: (10. 1 + 0. 2) vs (7. 2+ 0. L);group B:(10. 2+ 0. 3) vs (7. 1+ 0. 2),P0. 05), but hospitalization cost was obviously lower in group A than group B[(19. 71+2. 03) vs (39. 83+6. 23) ¥/d,P<0. 05]. Conclusion Insulin detemir combined with pre-meals insulin aspart could imitate the physiological insulin secretion and control the hyperglycemia effectively with reduced hypoglycemia risk and less cost of hospitalization.%目的 对比基础—餐时胰岛素与胰岛素泵在T2DM治疗中的有效性和安全性. 方法 将68例T2DM患者随机分为两组,A组采用三餐前门冬胰岛素联合睡前地特胰岛素治疗,B组采用胰岛素泵(使用门冬胰岛素)降糖治疗.治疗3个月后对比两组血糖控制情况、血糖达标所需要的时间、胰岛素用量、低血糖发生率等情况. 结果 两组治疗后HbA1c、HPG、2hFG均较治疗前显著下降(P<0.01),而FC-P、2hC-P均较治疗前明显升高(P<0.01).上述指标两组之间无统计学差异(P>0.05).两组血糖达标时间、日治疗剂量及低血糖发生率均无统计学差异(P>0.05),但A组的日治疗费用明显低于B组(P<0.05).结论 地特胰岛素联合三餐前门冬胰岛素强化治疗能有效模拟人生理胰岛素分泌,有效控制高血糖,且效价比优于胰岛素泵强化治疗.

  17. 舒血宁注射液与疏血通注射液治疗急性缺血性脑卒中的有效性及安全性对比研究%Study on effect and safety of treatment of acute ischemic stroke compared Shuxuening with Shuxuetong by in-travenous infusion

    Institute of Scientific and Technical Information of China (English)

    高音; 石云琼; 胡玉莉

    2015-01-01

    目的:比较舒血宁注射液与疏血通注射液治疗急性缺血性脑卒中的疗效和安全性,以期提高临床诊治水平。方法选取2012-05—2013-05110例急性缺血性脑卒中患者为研究对象,分成2组,分别予舒血宁注射液与疏血通注射液治疗,观察临床效果和安全性。结果2组治疗前和治疗1、2周后在收缩压、舒张压、心率、体温上比较差异无统计学意义(P均>0.05);NIH-NINDS评分上,2组治疗14 d在椎基底动脉梗死评分、空腹血糖患者评分比较舒血宁注射液优于疏血通注射液(P<0.05),在颈内动脉系统梗死评分上比较差异无统计学意义(P>0.05),在高同型半胱氨酸评分上疏血通注射液优于舒血宁注射液(P<0.05)。结论对急性缺血性脑卒中治疗,要结合梗死部位、血糖和血同型半胱氨酸选择何种药物。%Objective To investigate effect and safety of treatment of acute ischemic stroke compared Shuxuening with Shuxuetong by intravenous infusion in order to improve the clinical diagnosis and treatment.Methods 110 patients with acute ischemic stroke patients selected for the study from May 2012 to May 2013 were divided into two groups ,which were respec-tively given therapy of Shuxuening and Shuxueotong by intravenous infusion. Clinical effects and safety between two groups were observed before and after treatment.Results Before treatment and after treatment at first and second week in two groups , the differences of systolic blood pressure ,diastolic blood pressure ,heart rate ,and temperature all had no statistical significance (P>0.05). In NIH-NINDS scores ,the scores of vertebral basilar artery infarction and fasting plasma glucose in 14-day treat-ment in Shuxuening group were significant prior to that in Shuxuetong group (P0.05). The scores of high homocystein in Shuxuetong group were better than that in Shuxuening group (P< 0.05).Conclusion For acute ischemic stroke

  18. Familiality of physical and metabolic characteristics that predict the development of non-insulin-dependent diabetes mellitus in Pima Indians

    Energy Technology Data Exchange (ETDEWEB)

    Sakul, H.; Cardon, L. [Sequana Therapeutics, Inc., La Jolla, CA (United States); Pratley, R. [National Inst. of Health, Phoenix, AZ (United States)] [and others

    1997-03-01

    Susceptibility to non-insulin-dependent diabetes mellitus (NIDDM) is largely genetically determined. In Pima Indians, obesity, insulin resistance, and a low acute insulin response (AIR) to an intravenous glucose infusion are each predictors of the disease. To ascertain whether these phenotypes are genetically determined, we estimated their familiarity in nondiabetic Pima Indians with a maximum-likelihood method. Percentage body fat (PFAT) was highly familial (h{sup 2} = .76), whereas waist/thigh circumference ratio (W/T ratio) was not significantly familial after controlling for PFAT (h{sup 2} = .16). AIR was also highly familial (h{sup 2} = .80 at 10 min), even after controlling for PFAT and insulin action (h{sup 2} = .70). Insulin action at physiologic plasma insulin concentrations was familial (h{sup 2} = .61) but less so after controlling for PFAT and W/T ratio (h{sup 2} = .38). At maximally stimulating insulin concentrations, insulin action was familial (h{sup 2} = .45) and was less influenced by controlling for PFAT and W/T ratio (h{sup 2} = .49). We conclude that in Pima Indians (1) PFAT and AIR are highly familial traits, (2) central distribution of fat is not a familial trait when controlled for PFAT, (3) 38%-49% of the variance in insulin action, independent of the effect of obesity, is familial, and (4) PFAT, AIR, and insulin action are useful traits to study genetic susceptibility to NIDDM. Because genetic parameter estimates are applicable only to the populations from which they were estimated, it is important to determine whether these estimates of familiarities in Pima Indians can be confirmed in other populations before the utility of these traits in searching for NIDDM susceptibility genes in those populations can be fully advocated. 31 refs., 3 tabs.

  19. New Insulin Delivery Recommendations.

    Science.gov (United States)

    Frid, Anders H; Kreugel, Gillian; Grassi, Giorgio; Halimi, Serge; Hicks, Debbie; Hirsch, Laurence J; Smith, Mike J; Wellhoener, Regine; Bode, Bruce W; Hirsch, Irl B; Kalra, Sanjay; Ji, Linong; Strauss, Kenneth W

    2016-09-01

    Many primary care professionals manage injection or infusion therapies in patients with diabetes. Few published guidelines have been available to help such professionals and their patients manage these therapies. Herein, we present new, practical, and comprehensive recommendations for diabetes injections and infusions. These recommendations were informed by a large international survey of current practice and were written and vetted by 183 diabetes experts from 54 countries at the Forum for Injection Technique and Therapy: Expert Recommendations (FITTER) workshop held in Rome, Italy, in 2015. Recommendations are organized around the themes of anatomy, physiology, pathology, psychology, and technology. Key among the recommendations are that the shortest needles (currently the 4-mm pen and 6-mm syringe needles) are safe, effective, and less painful and should be the first-line choice in all patient categories; intramuscular injections should be avoided, especially with long-acting insulins, because severe hypoglycemia may result; lipohypertrophy is a frequent complication of therapy that distorts insulin absorption, and, therefore, injections and infusions should not be given into these lesions and correct site rotation will help prevent them; effective long-term therapy with insulin is critically dependent on addressing psychological hurdles upstream, even before insulin has been started; inappropriate disposal of used sharps poses a risk of infection with blood-borne pathogens; and mitigation is possible with proper training, effective disposal strategies, and the use of safety devices. Adherence to these new recommendations should lead to more effective therapies, improved outcomes, and lower costs for patients with diabetes.

  20. Factors predictive of intravenous fluid administration errors in Australian surgical care wards

    OpenAIRE

    Han, P; Coombes, I.; B. Green

    2005-01-01

    Background: Intravenous (IV) fluid administration is an integral component of clinical care. Errors in administration can cause detrimental patient outcomes and increase healthcare costs, although little is known about medication administration errors associated with continuous IV infusions.

  1. Peripheral intravenous line (image)

    Science.gov (United States)

    A peripheral intravenous line is a small, short plastic catheter that is placed through the skin into a vein, ... or foot, but occasionally in the head. A peripheral intravenous line is used to give fluids and ...

  2. Inhaled insulin: overview of a novel route of insulin administration

    OpenAIRE

    Lucy D Mastrandrea

    2010-01-01

    Lucy D MastrandreaDepartment of Pediatrics, School of Medicine and Biochemical Sciences, University at Buffalo, Buffalo, NY, USAAbstract: 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 contro...

  3. Investigations into the absorption of insulin and insulin derivatives from the small intestine of the anaesthetised rat.

    Science.gov (United States)

    McGinn, B J; Morrison, J D

    2016-06-28

    Experiments have been undertaken to determine the extent to which cholic acid conjugates of insulin were absorbed from the small intestine of anaesthetised rats by means of the bile salt transporters of the ileum. The measure used to assess the absorption of the cholyl-insulins was the amount of hypoglycaemia following infusion into the small intestine. Control experiments involving infusion of natural insulin into the ileum showed either nil absorption or absorption of a small amount of insulin as indicated by transient dip in the blood glucose concentration. However, when insulin was co-infused with the bile salt taurocholate, this was followed by a marked hypoglycaemic response which was specific to the ileum and did not occur on infusion into the jejunum. When the two cholyl conjugates of insulin were tested viz. B(29)-Lys-cholyl-insulin and B(1)-Phe-cholyl-insulin, both were biologically active as indicated by hypoglycaemic responses on systemic injection, though their potency was about 40% of that of natural insulin. While there was no evidence for the absorption of B(29)-Lys-cholyl-insulin when infused into the ileum, B(1)-Phe-cholyl-insulin did cause a long lasting hypoglycaemic response, indicating that absorption had occurred. Since the hypoglycaemic response was blocked on co-infusion with taurocholate and was absent for infusion of the conjugate into the jejunum, these results were taken as evidence that B(1)-Phe-cholyl-insulin had been taken up by the ileal bile salt transporters. This would indicate that B(1)-Phe-cholyl-insulin is worthy of further investigation for use in an oral insulin formulation.

  4. Haemolytic anaemia as a complication to intravenous immunoglobulin infusion

    DEFF Research Database (Denmark)

    Markvardsen, Lars Høj; Harbo, Thomas; Christiansen, Ingelise;

    . 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...

  5. Lipid infusion and intravenous access in newborn infants

    Institute of Scientific and Technical Information of China (English)

    Dominique Haumont

    2010-01-01

    @@ The spectacular development of neonatal intensive care since the 1960s allowed a drop in neonatal mortality of very-low-birth-weight (VLBW) infants from 50% to less than 15% in the last decade.1 However 15% to 25% of the VLBW infants will present neurodevelopment impairment in the following fields: motor function,vision, auditory function, cognition, behaviour, attention deficit and hyperactivity disorders, visual-motor integration and language.2,3 Compared to their term pairs there is substantial scientific evidence of altered early brain development.

  6. Periferic intravenous infusion of fenoldopam through an elastomeric pump

    OpenAIRE

    Quaranta, T; Cornaggia, G; Turi, S; Mizzi, A; Zangrillo, A

    2009-01-01

    Introduction Fenoldopam has been used to protect renal function in critically ill patients and in those undergoing major surgery, where a possible damage of kidney is expected. Numerous randomized studies and meta-analysis demonstrated the efficacy of fenoldopam in this setting. We performed this study to demonstrate the feasibility of administering fenoldopam, trough an elastomeric pump connected to a peripheral vein, to patients undergoing nephron sparing surgery. Materials and Methods Twen...

  7. [Insulin therapy for type 1 diabetes mellitus: past and present].

    Science.gov (United States)

    Pires, Antonio Carlos; Chacra, Antonio Roberto

    2008-03-01

    The discovery of insulin can be considered the milestone of diabetes mellitus history and a great achievement for its treatment. The first insulin available was the regular. Afterwards, Hagedorn added the protamine to the insulin, thus, creating the NPH insulin. In the 1950s an insulin free of protamine was synthesized: the lente insulin. With the advent of molecular biology, synthetic human insulin was synthesized using recombinant DNA technology. Most recently several types of insulin analogues were available, providing the patients with better metabolic control. Type 1 diabetes mellitus treatment includes plain substitution and individualization for short-acting plus long-acting insulin according to the physician's assistance, besides regular practice of physical activities and diet orientations. In type 1 diabetes mellitus the insulin of low variability is the best choice since basal/bolus insulin therapy or continuous subcutaneous insulin infusion pump can mimetize the physiological release of insulin by beta cells. PMID:18438537

  8. Insulin Secretagogues

    Science.gov (United States)

    ... Your Body in Balance › Insulin Secretagogues Fact Sheet Insulin Secretagogues March, 2012 Download PDFs English Espanol Editors ... medicines can help you stay healthy. What are insulin secretagogues? Insulin secretagogues (pronounced seh-KREET-ah-gogs) ...

  9. Palmitoleic acid reduces intramuscular lipid and restores insulin sensitivity in obese sheep

    Directory of Open Access Journals (Sweden)

    Duckett SK

    2014-11-01

    Full Text Available Susan K Duckett, Gabriela Volpi-Lagreca, Mariano Alende, Nathan M LongAnimal and Veterinary Sciences Department, Clemson University, Clemson, SC, USAAbstract: Obese sheep were used to assess the effects of palmitoleic (C16:1 cis-9 acid infusion on lipogenesis and circulating insulin levels. Infusion of 10 mg/kg body weight (BW/day C16:1 intravenously in obese sheep reduced (P<0.01 weight gain by 77%. Serum palmitoleic levels increased (P<0.05 in a linear manner with increasing levels of C16:1 infusion. Cis-11 vaccenic (C18:1 cis-11 acid, a known elongation product of palmitoleic acid, was also elevated (P<0.05 in serum after 14 days and 21 days of infusion. Plasma insulin levels were lower (P<0.05 (10 mg/kg BW/day C16:1 than controls (0 mg/kg BW/day C16:1 at 14 days and 28 days of infusion. Infusion of C16:1 resulted in linear increases in tissue concentrations of palmitoleic, cis-11 vaccenic, eicosapentaenoic, and docosapentaenoic acids in a dose-dependent manner. Total lipid content of the semitendinosus (ST muscle and mesenteric adipose tissue was reduced (P<0.01 in both 5 mg/kg and 10 mg/kg BW C16:1 dose levels. Total lipid content and mean adipocyte size in the longissimus muscle was reduced (P<0.05 in the 10 mg/kg BW C16:1 dose level only, whereas total lipid content and adipocyte size of the subcutaneous adipose tissue was not altered. Total lipid content of the liver was also unchanged with C16:1 infusion. Palmitoleic acid infusion upregulated (P<0.05 acetyl-CoA carboxylase (ACC, fatty acid elongase-6 (ELOVL6, and Protein kinase, AMP-activated, alpha 1 catalytic subunit, transcript variant 1 (AMPK mRNA expressions in liver, subcutaneous adipose, and ST muscle compared to the controls. However, mRNA expression of glucose transporter type 4 (GLUT4 and carnitine palmitoyltransferase 1b (CPT1B differed between tissues. In the subcutaneous adipose and liver, C16:1 infusion upregulated (P<0.05 GLUT4 and CPT1B, whereas these genes were

  10. Intravenous iron therapy: how far have we come?

    Directory of Open Access Journals (Sweden)

    Rodolfo Delfini Cançado

    2011-12-01

    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.

  11. Intravenous iron therapy: how far have we come?

    Science.gov (United States)

    Cançado, Rodolfo Delfini; Muñoz, Manuel

    2011-01-01

    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. PMID:23049364

  12. Insulin Sensitivity and Insulin Clearance are Heritable and Have Strong Genetic Correlation in Mexican Americans

    OpenAIRE

    Goodarzi, Mark O; Langefeld, Carl D.; Xiang, Anny H.; Chen, Yii-Der I.; Guo, Xiuqing; Hanley, Anthony J. G.; Raffel, Leslie J.; Kandeel, Fouad; Thomas A Buchanan; Norris, Jill M.; Fingerlin, Tasha E.; Lorenzo, Carlos; Rewers, Marian J; Haffner, Steven M.; Donald W Bowden

    2014-01-01

    Objective We describe the GUARDIAN (Genetics UndeRlying DIAbetes in HispaNics) consortium, along with heritability estimates and genetic and environmental correlations of insulin sensitivity and metabolic clearance rate of insulin (MCRI). Design and Methods GUARDIAN is comprised of seven cohorts, consisting of 4336 Mexican-American individuals in 1346 pedigrees. Insulin sensitivity (SI), MCRI, and acute insulin response (AIRg) were measured by frequently sampled intravenous glucose tolerance ...

  13. Anaphylactic shock and cardiac arrest caused by thiamine infusion

    DEFF Research Database (Denmark)

    Juel, Jacob; Pareek, Manan; Langfrits, Christian Sigvald;

    2013-01-01

    intoxication and developed cardiac arrest due to anaphylactic shock following intravenous thiamine infusion. The patient was successfully resuscitated after 15 min and repeated epinephrine administrations. He was discharged in good health after 14 days. This case report emphasises both the importance...

  14. Insulin Neuroprotection and the Mechanisms

    Institute of Scientific and Technical Information of China (English)

    Li-Yun Yu; Yu Pei

    2015-01-01

    Objective:To analyze the mechanism of neuroprotection of insulin and which blood glucose range was benefit for insulin exerting neuroprotective action.Data Sources:The study is based on the data from PubMed.Study Selection:Articles were selected with the search terms "insulin","blood glucose","neuroprotection","brain","glycogen","cerebral ischemia","neuronal necrosis","glutamate","γ-aminobutyric acid".Results:Insulin has neuroprotection.The mechanisms include the regulation of neurotransmitter,promoting glycogen synthesis,and inhibition of neuronal necrosis and apoptosis.Insulin could play its role in neuroprotection by avoiding hypoglycemia and hyperglycemia.Conclusions:Intermittent and long-term infusion insulin may be a benefit for patients with ischemic brain damage at blood glucose 6-9 mmol/L.

  15. Insulin and Insulin Resistance

    OpenAIRE

    Wilcox, Gisela

    2005-01-01

    As obesity and diabetes reach epidemic proportions in the developed world, the role of insulin resistance and its consequences are gaining prominence. Understanding the role of insulin in wide-ranging physiological processes and the influences on its synthesis and secretion, alongside its actions from the molecular to the whole body level, has significant implications for much chronic disease seen in Westernised populations today. This review provides an overview of insulin, its history, stru...

  16. Intravenous lipids for preterm infants: a review.

    Science.gov (United States)

    Salama, Ghassan Sa; Kaabneh, Mahmmoud Af; Almasaeed, Mai N; Alquran, Mohammad Ia

    2015-01-01

    Extremely low birth weight infants (ELBW) are born at a time when the fetus is undergoing rapid intrauterine brain and body growth. Continuation of this growth in the first several weeks postnatally during the time these infants are on ventilator support and receiving critical care is often a challenge. These infants are usually highly stressed and at risk for catabolism. Parenteral nutrition is needed in these infants because most cannot meet the majority of their nutritional needs using the enteral route. Despite adoption of a more aggressive approach with amino acid infusions, there still appears to be a reluctance to use early intravenous lipids. This is based on several dogmas that suggest that lipid infusions may be associated with the development or exacerbation of lung disease, displace bilirubin from albumin, exacerbate sepsis, and cause CNS injury and thrombocytopena. Several recent reviews have focused on intravenous nutrition for premature neonate, but very little exists that provides a comprehensive review of intravenous lipid for very low birth and other critically ill neonates. Here, we would like to provide a brief basic overview, of lipid biochemistry and metabolism of lipids, especially as they pertain to the preterm infant, discuss the origin of some of the current clinical practices, and provide a review of the literature, that can be used as a basis for revising clinical care, and provide some clarity in this controversial area, where clinical care is often based more on tradition and dogma than science. PMID:25698888

  17. Metabolic effects of cortisol, ACTH, adrenalin and insulin in the marsupial sugar glider, Petaurus breviceps.

    Science.gov (United States)

    Bradley, A J; Stoddart, D M

    1990-11-01

    The effects of cortisol, ACTH, adrenalin and insulin on indices of carbohydrate, fat and protein metabolism were investigated in the conscious marsupial sugar glider Petaurus breviceps. Short-term i.v. infusion of cortisol at dose rates of 0.02, 0.2 and 1.0 mg/kg per h caused the plasma glucose concentration to rise sharply from the normal range of 3.3-4.4 to 8.1-8.7 mmol/l at the end of the infusion period without significant alteration in plasma free fatty acid (FFA), amino acid or urea concentrations. Infusions of ACTH at dose rates of 0.02, 0.06 and 0.45 IU/kg per h caused a similar rise in plasma glucose concentration; however, this was now accompanied by an elevation in plasma FFA concentration, but again without significant changes in either plasma amino acid or urea concentrations. Infusion of adrenalin at 10 micrograms/kg per h caused an increase in the plasma concentrations of both glucose and FFA. Intravenous injections of 0.15 IU insulin/kg caused a rapid and marked decrease in the plasma glucose concentration within 30 min and an increase in the plasma free cortisol concentration. Associated with this change was a marked rise in the plasma concentration of both FFA and free cortisol. The rise in free cortisol was, however, significantly reduced by infusion of glucose. Pretreatment with five daily i.m. injections of 1 mg cortisol acetate/kg, which produced an increase in plasma free cortisol concentration to near the maximum of the physiological range, caused a marked reduction in insulin sensitivity. Cortisol pretreatment caused an increase in the plasma FFA and amino acid concentrations. Petaurus breviceps is highly sensitive to the metabolic effects of glucocorticoids and is similar in this respect to the brush-tailed possum Trichosurus vulpecula. The interactive effects between insulin and glucocorticoids on carbohydrate, fat and protein metabolism in Petaurus breviceps are similar to those shown by Trichosurus vulpecula and some eutherian mammals

  18. Treating gastrointestinal cancer by intervention, intraperitoneal hyperthermic perfusion chemotherapy, intravenous micro-pump chemotherapy

    International Nuclear Information System (INIS)

    157 cases of gastrointestinal cancer patients after resection were randomly divided into treated group and control group. The treated group (intraperitoneal hyperthermic perfusion chemotherapy combined with postoperative continuous intraarterial infusion and intravenous micro-pump chemotherapy) consisted of 72 cases, the control group (Intravenous chemotherapy), 85 cases. The peritoneal and hepatic metastasis rates and 3 a survival rate were studied. The intraperitoneal hyperthermic perfusion chemotherapy combined with the postoperative continuous intraarterial infusion and intravenous micro-pump chemotherapy is an effective way to control the recurrence on the peritoneal and hepatic metastasis of advanced gastrointestinal neoplasms after operation. (authors)

  19. Programming of glucose-insulin homoeostasis

    DEFF Research Database (Denmark)

    Kongsted, Anna Hauntoft; Tygesen, M. P.; Husted, Sanne Vinter;

    2014-01-01

    AIM: Exposure to adverse intra-uterine conditions can predispose for metabolic disorders later in life. By using a sheep model, we studied (i) how programming of glucose-insulin homoeostasis during late gestation is manifested later in life depending on the early post-natal dietary exposure and (ii......-carbohydrate-high-fat (HCHF) diet until around puberty. Offspring remaining thereafter (exclusively females) were fed a moderate diet until young adulthood. RESULTS: LOW lambs had increased insulin secretory responses during intravenous glucose tolerance tests indicative of reduced insulin sensitivity. HCHF lambs were...... hypertriglyceridaemic, 75% had mild pancreatic collagen infiltration, and their acute insulin secretory response and insulin clearance during intravenous glucose and insulin tolerance tests, respectively, were reduced. However, NORM-HCHF in contrast to LOW-HCHF lambs had normal glucose tolerance, indicating that later...

  20. Infusion of Mesenchymal Stem Cells Ameliorates Hyperglycemia in Type 2 Diabetic Rats

    OpenAIRE

    Si, Yiling; Zhao, Yali; Hao, Haojie; Liu, Jiejie; Guo, Yelei; Mu, Yiming; Shen, Jing; Cheng, Yu; Fu, Xiaobing; Han, Weidong

    2012-01-01

    Infusion of mesenchymal stem cells (MSCs) has been shown to effectively lower blood glucose in diabetic individuals, but the mechanism involved could not be adequately explained by their potential role in promoting islet regeneration. We therefore hypothesized that infused MSCs might also contribute to amelioration of the insulin resistance of peripheral insulin target tissues. To test the hypothesis, we induced a diabetic rat model by high-fat diet/streptozotocin (STZ) administration, perfor...

  1. Ovarian tumors secreting insulin.

    Science.gov (United States)

    Battocchio, Marialberta; Zatelli, Maria Chiara; Chiarelli, Silvia; Trento, Mariangela; Ambrosio, Maria Rosaria; Pasquali, Claudio; De Carlo, Eugenio; Dassie, Francesca; Mioni, Roberto; Rebellato, Andrea; Fallo, Francesco; Degli Uberti, Ettore; Martini, Chiara; Vettor, Roberto; Maffei, Pietro

    2015-08-01

    Combined ovarian germ cell and neuroendocrine tumors are rare. Only few cases of hyperinsulinism due to ovarian ectopic secretion have been hypothesized in the literature. An ovarian tumor was diagnosed in a 76-year-old woman, referred to our department for recurrent hypoglycemia with hyperinsulinism. In vivo tests, in particular fasting test, rapid calcium infusion test, and Octreotide test were performed. Ectopic hyperinsulinemic hypoglycemia was demonstrated in vivo and hypoglycemia disappeared after hysteroadnexectomy. Histological exam revealed an ovarian germ cell tumor with neuroendocrine and Yolk sac differentiation, while immunostaining showed insulin positivity in neuroendocrine cells. A cell culture was obtained by tumoral cells, testing Everolimus, and Pasireotide. Insulin was detected in cell culture medium and Everolimus and Pasireotide demonstrated their potentiality in reducing insulin secretion, more than controlling cell viability. Nine cases of hyperinsulinism due to ovarian ectopic secretion reported in literature have been reviewed. These data confirm the ovarian tissue potentiality to induce hyperinsulinemic hypoglycemic syndrome after neoplastic transformation. PMID:25896552

  2. Insulin facilitates transport of macromolecules and nutrients to muscles

    DEFF Research Database (Denmark)

    Christensen, N J; Hilsted, J

    1993-01-01

    We previously showed that intravenous insulin increased plasma noradrenaline during euglycemia and without concomitant changes in plasma adrenaline. Insulin decreased plasma volume and increased the fractional escape rate of albumin from plasma. In normal subjects, oral glucose increased heart ra...... the blood to the extracellular space after food intake. This process may be greatly disturbed in insulin-dependent diabetic patients....

  3. Detection of coronary heart disease with 99Tcm-MIBI myocardial perfusion imaging stressed by intravenous infusion of higenamine hydrochloride%盐酸去甲乌药碱负荷99Tcm-MIBI心肌灌注显像在冠心病诊断中的价值

    Institute of Scientific and Technical Information of China (English)

    曹艳; 王自正; 王峰; 张乐乐; 王晓雯; 邵国强; 孟庆乐; 杨瑞

    2012-01-01

    Objective To investigate the role of 99Tcm-MIBI MPI stressed by intravenous infusion of higenamine hydrochloride (HG) in detection of coronary heart disease (CHD).Methods Sixty-two patients with suspected CHD underwent both 99Tcm-MIBI MPI with HG infusion and CAG.CAG was used as the gold standard in diagnosing CHD.The diagnostic sensitivity,specificity,accuracy,positive predictive value and negative predictive value of HG stress studies were evaluated with 99Tcm-MIBI MPI.Results Using stenosis of the main branch or the first branch with more than 50% stenosis as the diagnostic criteria,38 patients (61.3%) showed abnormal CAG results,including 24 one-,9 two-,and 5 three-vessel stenoses.Of the 38 patients(38.7%) with abnormal CAG results,positive results in HG MPI studies were demonstrated in 22 patients.Negative results in HG MPI studies were confirmed in 22 patients among the 24 patients with normal CAG results.For detection of CHD,the diagnostic sensitivity,specificity,accuracy,positive predictive value and negative predictive value of 99Tcm-MIBI MPI with HG infusion were calculated as 57.9%(22/38),91.7%(22/24),71.0%(44/62),91.7%(22/24) and 57.9%(22/38),respectively.Twenty-two patients (35.5%) had side effects during HG stress studies,but no effects were severe.All patients recovered soon after examination.Conclusion An HG stress study is feasible and safe,and it is a potential method in detection of CHD with 99Tcm-MIBI MPI.%目的 评估盐酸去甲乌药碱(HG)负荷MPI对冠心病的诊断价值.方法 62例疑诊冠心病患者行HG负荷-静息99Tcm-MIBI MPI和CAG.以CAG结果为“金标准”,计算HG负荷显像诊断冠心病的灵敏度、特异性准确性、阳性预测值和阴性预测值.结果 以冠状动脉(简称冠脉)主支或其一级分支狭窄≥50%作为诊断标准,62例患者中CAG阳性38例(61.3%),阴性24例(38.7%);阳性者中单支病变24例,双支病变9例,三支病变5例.CAG

  4. [Intravenous monoanesthesia and antianesthetics in emergency surgery].

    Science.gov (United States)

    D'iachenko, P K; Kostiuchenko, A L

    1984-04-01

    Profiles of using the intravenous mononarcosis (sodium hydroxybutyrate, viadryl , ketamin , sombrevin, seduxen) in urgent surgery and traumatology are analyzed. Choice of certain narcotics is motivated for patients with blood loss and shock, intoxication, insufficiency of kidneys, adrenals and liver, cardio-vascular and respiratory disorders. The problem of antinarcotics is considered with reference to the efficiency of specific (bemegride, gutimine , amtizol , cytochrome "C") and nonspecific ( osmodiuretics , infusion media containing thawing water) antinarcotics . A preliminary assessment of the efficiency of different drugs of antinarcotic action is given.

  5. [Terminology concerning intravenous ports].

    Science.gov (United States)

    Młynarski, Rafał; Kłosińska, Katarzyna; Cichostępski, Dariusz; Dilling, Monika; Domke, Beata; Duraj, Marian; Fenikowski, Dariusz; Fuss, Julia; Góraj, Elwira; Grudzień, Paweł; Grzegorczyk, Iwona; Grzesiak, Joanna; Hasak, Liudmila; Janc, Jarosław; Kąkol, Michał; Kiluk, Marek; Kłobukowski, Wojciech; Leś, Jarosław; Leśnik, Patrycja; Lukasiewicz, Sergiusz; Małas, Tadeusz; Malczewska, Agnieszka; Mierzejewski, Marek; Misiak, Małgorzata; Nicpoń, Jakub; Pyrek, Beata; Rojek, Elżbieta; Siemiaszko, Anna; Siemiaszko, Grzegorz; Sieracki, Andrzej; Smiatacz, Marek; Sobczyk, Agnieszka; Starzec, Wioletta; Voloboyeva, Anna; Zdyb, Andrzej

    2015-01-01

    Ports are more and more often applied with patients requiring the permanent intravenous access, not only in the cancer treatment. Very devices, as well as procedures associated with applying them are determined in the heterogeneous way. Therefore during the last conference "Intravenous Port--implantation, care, complications" an attempt to systematize the applied terminology was made. PMID:26094345

  6. Intravenous paracetamol (acetaminophen).

    Science.gov (United States)

    Duggan, Sean T; Scott, Lesley J

    2009-01-01

    Intravenous paracetamol (rINN)/intravenous acetaminophen (USAN) is an analgesic and antipyretic agent, recommended worldwide as a first-line agent for the treatment of pain and fever in adults and children. In double-blind clinical trials, single or multiple doses of intravenous paracetamol 1 g generally provided significantly better analgesic efficacy than placebo treatment (as determined by primary efficacy endpoints) in adult patients who had undergone dental, orthopaedic or gynaecological surgery. Furthermore, where evaluated, intravenous paracetamol 1 g generally showed similar analgesic efficacy to a bioequivalent dose of propacetamol, and a reduced need for opioid rescue medication. In paediatric surgical patients, recommended doses of intravenous paracetamol 15 mg/kg were not significantly different from propacetamol 30 mg/kg for the treatment of pain, and showed equivocal analgesic efficacy compared with intramuscular pethidine 1 mg/kg in several randomized, active comparator-controlled studies. In a randomized, noninferiority study in paediatric patients with an infection-induced fever, intravenous paracetamol 15 mg/kg treatment was shown to be no less effective than propacetamol 30 mg/kg in terms of antipyretic efficacy. Intravenous paracetamol was well tolerated in clinical trials, having a tolerability profile similar to placebo. Additionally, adverse reactions emerging from the use of the intravenous formulation of paracetamol are extremely rare (<1/10 000). [table: see text]. PMID:19192939

  7. Monosodium glutamate (MSG-obese rats develop glucose intolerance and insulin resistance to peripheral glucose uptake

    Directory of Open Access Journals (Sweden)

    Hirata A.E.

    1997-01-01

    Full Text Available Different levels of insulin sensitivity have been described in several animal models of obesity as well as in humans. Monosodium glutamate (MSG-obese mice were considered not to be insulin resistant from data obtained in oral glucose tolerance tests. To reevaluate insulin resistance by the intravenous glucose tolerance test (IVGTT and by the clamp technique, newborn male Wistar rats (N = 20 were injected 5 times, every other day, with 4 g/kg MSG (N = 10 or saline (control; N = 10 during the first 10 days of age. At 3 months, the IVGTT was performed by injecting glucose (0.75 g/kg through the jugular vein into freely moving rats. During euglycemic clamping plasma insulin levels were increased by infusing 3 mU . kg-1 . min-1 of regular insulin until a steady-state plateau was achieved. The basal blood glucose concentration did not differ between the two experimental groups. After the glucose load, increased values of glycemia (P<0.001 in MSG-obese rats occurred at minute 4 and from minute 16 to minute 32. These results indicate impaired glucose tolerance. Basal plasma insulin levels were 39.9 ± 4 µU/ml in control and 66.4 ± 5.3 µU/ml in MSG-obese rats. The mean post-glucose area increase of insulin was 111% higher in MSG-obese than in control rats. When insulinemia was clamped at 102 or 133 µU/ml in control and MSG rats, respectively, the corresponding glucose infusion rate necessary to maintain euglycemia was 17.3 ± 0.8 mg . kg-1 . min-1 for control rats while 2.1 ± 0.3 mg . kg-1 . min-1 was sufficient for MSG-obese rats. The 2-h integrated area for total glucose metabolized, in mg . min . dl-1, was 13.7 ± 2.3 vs 3.3 ± 0.5 for control and MSG rats, respectively. These data demonstrate that MSG-obese rats develop insulin resistance to peripheral glucose uptake

  8. Use of cold intravenous fluid to induce hypothermia in a comatose child after cardiac arrest due to a lightning strike.

    Science.gov (United States)

    Kim, Young-Min; Jeong, Ju-Hwan; Kyong, Yeon-Young; Kim, Han-Joon; Kim, Ji-Hoon; Park, Jeong-Ho; Park, Kyu-Nam

    2008-11-01

    We report a case in which mild hypothermia was induced successfully using a cold intravenous fluid infusion in a 12-year-old boy who was comatose following 21 min of cardiac arrest caused by a lightning strike. PMID:18805616

  9. Insulin Test

    Science.gov (United States)

    ... especially as a result of taking non-human (animal or synthetic) insulin, these can interfere with insulin testing. In this case, a C-peptide may be performed as an alternative way to evaluate insulin production. Note also that ...

  10. Target controlled infusion etomidate for total intravenous anesthesia in the elderly undergoing hip arthroplasty surgery%靶控输注依托咪酯用于老年人髋关节手术全身麻醉维持效果观察

    Institute of Scientific and Technical Information of China (English)

    刘红霞; 冉庆; 王津龙

    2012-01-01

    ,were scheduled for hip arthroplasty surgery. They were randomly divided into 3 groups (20 in each): group F received etomidate combined with fentanyl,group R received etomidate with remifentanil and group S received etomidate with sufentanil. All patients were induced with midazolam 50μg/kg-1,fentanyl 4 μg/kg-1,vecuroniuml00 μg/kg-1 and etomidate300 μg/kg-1 stepwise,then intubated and ventilated mechanically. To keep BIS 40-60,anesthesia was maintained with TCI etomidate 1 - 2 μg/mL in all patients,combined with fentanyl 1 -2 μg/(kg·h) as an intravenous bolus intermittently in group F,with remifentanil 0.5 - 1μg/(kg·min) infused continuously in group R,with sufentanil 0.5 - 5 μg/kg-1 as a bolus intravenously 5 min prior to skin incision in group S. Following variables were recorded including mean arterial blood pressure (MAP),heart rate (HR) before and after induction (baseline T0、T1),3 min after intubation ( T2 ); skin incision ( T3 ) ,periosteal detaching ( T4 ) ,eye - opening time ,extubation time,duration of operation,length of stay in PACU,OAA/S scores(5 = fully awake,1 = asleep) immediately and at 30,60 min after extubation and the moment leaving PACU,adverse events during operation and stay in PACU. Results Compared with baseline,MAP and HR at Tl in all groups were lower. MAP was higher at T3,T4 in groups F and S. HR was higher in group F,and HR was lower in groups R and S. MAP and HR at T3,T4 in group R were lower than those in group F. Compared with group S,MAP at T3,T4 in group R were lower. HR at T3,T4 in group S were lower than those in group F(P<0.05orP<0.01). Eye - opening time,extubation time and length of stay in PACU were shorter,and the OAA/S scores immediately and at 30 min after extubation were higher in group R than those in groups F and S,also in group F than that in group S(P<0. 01 or P<0. 05). The incidence of restlessness was higher in group R than that in groups F and S (P < 0. 05). Conclusion Total intravenous anesthesia of etomidate

  11. 短期胰岛素泵强化治疗对初诊2型糖尿病患者预后及胰岛β细胞功能的影响%Prognosis and islet β cell function in newly diagnosed type 2 diabetic patients treated with short-term subcutaneous insulin infusion

    Institute of Scientific and Technical Information of China (English)

    邢倩; 白然; 蒋召芹; 王爽; 王咏波

    2012-01-01

    [目的]观察经2周短期应用胰岛素泵治疗的初诊2型糖尿病(T2DM)1年后的血糖控制情况、胰岛β细胞功能及胰岛素敏感性变化.[方法]初诊2型糖尿病患者32例经持续皮下胰岛素输注(CSII)强化治疗2~4周后,继之分别以胰岛素、口服降糖药(OHA)、单纯生活方式控制血糖,观察1年后的血糖控制情况、胰岛β细胞功能及胰岛素敏感性的差别.[结果]CSII治疗2周期间胰岛素用量差异有显著性意义(P<0.05);3组治疗后1年的FPG、2hPBG、HbA1c、FCP、2hCP、HOMA-β、HOMA-IR平均值各组间比较,差异无显著性意义(P>0.05);1年后转归为:18例(56.25%)仅予生活方式干预;14例(43.75%)予OHA,无1例应用胰岛素.[结论]对伴有明显高血糖的初诊T2DM患者应用短期CSII治疗,1年后不需再用胰岛素治疗,且多数患者不需应用任何降糖药物,仍可获得满意血糖控制,胰岛β细胞功能得到恢复.%[Objective] To investigate the long - term (1 year) efficacy and effects on beta - cell function and insulin sensitivity in newly diagnosed type 2 diabetic patients treated with short - term continuous subcutaneous intensive insulin therapy. [Methods] A total of thirty - two newly diagnosed type 2 diabetic patients with fasting plasma glucose (FPG) 311.1 mmol/L, glycoslated hemoglobin (HbAlc) S 9% were enrolled. After two weeks intensive therapy of continuous subcutaneous insulin infusion and one year later, body mass index (BMI), FPG, HbAlc and 2 hour postprandial blood glucose (2hPBG) , fasting C peptide (FCP) and 2 hours C peptide (2hCP) after seventy - five grams oral glucose load were recorded. Homeostasis model assessment - insulin resistance (HOMA - IR) and homeostasis model assessment - pancreatic beta-cell (HOMA - β) were calculated to evaluate insulin resistance. [Results] One year later, there is no statistical difference in the mean values of FPG and 2hPBG after 2 weeks CSII therapy. HbAl c and HOMA - IR

  12. [Insulin as an anabolic: hypoglycemia in the bodybuilding world].

    Science.gov (United States)

    Konrad, C; Schüpfer, G; Wietlisbach, M; Gerber, H

    1998-07-01

    Excessive body building may be dangerous. To promote athletic performance and to improve physical appearance many of the body builders abuse anabolic-androgenic steroids and other drugs. The abuse of insulin as an anabolic medication in this athletic community was followed by a case of severe hypoglycaemia in a body builder. A 30-year old male presented with cerebral symptoms of hypoglycaemia. Directly before an international competition he tried to stimulate muscle growth by using the hypoglycaemic stimulus to the growth hormone. To achieve this he injected 70 IE of a short-acting insulin subcutaneously, resulting in severe hypoglycaemia. After the initial administration of intravenous glucose by the paramedics, he lost consciousness and showed signs of convulsions. After orotracheal intubation by an emergency physician, despite of ongoing infusion of glucose the blood glucose concentration remained low as measured in the out-of-hospital setting. Finally administration of additional glucose and glucagon in the intensive care unit was able to stabilize the metabolic system. In any case of severe hypoglycaemia, repetitive measurements of blood glucose even in the prehospital setting should be performed to detect the hypoglycaemia especially if athletes are concerned.

  13. Safety and feasibility of countering neurological impairment by intravenous administration of autologous cord blood in cerebral palsy

    OpenAIRE

    Lee Young-Ho; Choi Kyung; Moon Jin; Jun Hyun-Joo; Kang Hye-Ryeong; Oh Se-In; Kim Hyung; Um Jang; Kim Mi; Choi Yun; Lee Young-Jun; Kim Hee-Jin; Lee Jong-Hwa; Son Su; Choi Soo-Jin

    2012-01-01

    Abstract Backgrounds We conducted a pilot study of the infusion of intravenous autologous cord blood (CB) in children with cerebral palsy (CP) to assess the safety and feasibility of the procedure as well as its potential efficacy in countering neurological impairment. Methods Patients diagnosed with CP were enrolled in this study if their parents had elected to bank their CB at birth. Cryopreserved CB units were thawed and infused intravenously over 10~20 minutes. We assessed potential effic...

  14. A variant in the G6PC2/ABCB11 locus is associated with increased fasting plasma glucose, increased basal hepatic glucose production and increased insulin release after oral and intravenous glucose loads

    DEFF Research Database (Denmark)

    Rose, C S; Grarup, N; Krarup, N T;

    2009-01-01

    An association between elevated fasting plasma glucose and the common rs560887 G allele in the G6PC2/ABCB11 locus has been reported. In Danes we aimed to examine rs560887 in relation to plasma glucose and serum insulin responses following oral and i.v. glucose loads and in relation to hepatic glu...... glucose production during a hyperinsulinaemic-euglycaemic clamp. Furthermore, we examined rs560887 for association with impaired fasting glycaemia (IFG), impaired glucose tolerance (IGT), type 2 diabetes and components of the metabolic syndrome.......An association between elevated fasting plasma glucose and the common rs560887 G allele in the G6PC2/ABCB11 locus has been reported. In Danes we aimed to examine rs560887 in relation to plasma glucose and serum insulin responses following oral and i.v. glucose loads and in relation to hepatic...

  15. Model Predictive Control Algorithms for Pen and Pump Insulin Administration

    OpenAIRE

    Boiroux, Dimitri; Jørgensen, John Bagterp; Poulsen, Niels Kjølstad; Madsen, Henrik

    2012-01-01

    Despite recent developments within diabetes management such as rapidacting insulin, continuous glucose monitors (CGM) and insulin pumps, tight blood glucose control still remains a challenge. A fully automated closedloop controller, also known as an artificial pancreas (AP), has the potential to ease the life and reduce the risk of acute and chronic diabetic complications. However, the noise associated to CGMs, the long insulin action time for continuous subcutaneous infusion of insulin (CSII...

  16. Human insulin: DNA technology's first drug.

    Science.gov (United States)

    The, M J

    1989-11-01

    The history, biologic activity, and immunogenicity of human insulin are described. Recombinant human insulin first entered clinical trials in humans in 1980. At that time, the A and B chains of the insulin molecule were produced separately and then combined by chemical techniques. Since 1986, a different recombinant process has been used. The human genetic coding for proinsulin is inserted into Escherichia coli cells, which are then grown by fermentation to produce proinsulin. The connecting peptide is cleaved enzymatically from proinsulin to produce human insulin. Studies indicate that there are no important differences between pork insulin and human insulin in terms of therapeutic efficacy and disposition after intravenous administration. Recombinant human insulin has a faster onset of action and lower immunogenicity than pork or beef insulin. Diabetic patients may have an improvement in glucose concentrations when their therapy is switched from animal-source insulin to human insulin. Such a change usually requires a dosage adjustment, which must be determined by a physician. Pharmacists are responsible for educating patients concerning all insulin products and for preventing patients from interchanging insulin products. The availability of human insulin as the first pharmaceutical product manufactured through recombinant DNA technology, however, has had little effect on the pharmacist's role in the care of such patients. The production of human insulin through recombinant DNA technology represents an important advance in the treatment of patients with diabetes. PMID:2690608

  17. Xylitol prevents NEFA-induced insulin resistance in rats

    Science.gov (United States)

    Kishore, P.; Kehlenbrink, S.; Hu, M.; Zhang, K.; Gutierrez-Juarez, R.; Koppaka, S.; El-Maghrabi, M. R.

    2013-01-01

    Aims/hypothesis Increased NEFA levels, characteristic of type 2 diabetes mellitus, contribute to skeletal muscle insulin resistance. While NEFA-induced insulin resistance was formerly attributed to decreased glycolysis, it is likely that glucose transport is the rate-limiting defect. Recently, the plant-derived sugar alcohol xylitol has been shown to have favourable metabolic effects in various animal models. Furthermore, its derivative xylulose 5-phosphate may prevent NEFA-induced suppression of glycolysis. We therefore examined whether and how xylitol might prevent NEFA-induced insulin resistance. Methods We examined the ability of xylitol to prevent NEFA-induced insulin resistance. Sustained ~1.5-fold elevations in NEFA levels were induced with Intralipid/heparin infusions during 5 h euglycaemic–hyperinsulinaemic clamp studies in 24 conscious non-diabetic Sprague-Dawley rats, with or without infusion of xylitol. Results Intralipid infusion reduced peripheral glucose uptake by ~25%, predominantly through suppression of glycogen synthesis. Co-infusion of xylitol prevented the NEFA-induced decreases in both glucose uptake and glycogen synthesis. Although glycolysis was increased by xylitol infusion alone, there was minimal NEFA-induced suppression of glycolysis, which was not affected by co-infusion of xylitol. Conclusions/interpretation We conclude that xylitol prevented NEFA-induced insulin resistance, with favourable effects on glycogen synthesis accompanying the improved insulin-mediated glucose uptake. This suggests that this pentose sweetener has beneficial insulin-sensitising effects. PMID:22460760

  18. 两性霉素B静脉和雾化联合给药治疗肺曲霉病1例报告%The intravenous infusion of amphotericin B combined with aerosol inhalation for pulmonary aspergillosis:1 case report

    Institute of Scientific and Technical Information of China (English)

    杨玉亚; 叶晓芬; 蔡映云

    2014-01-01

    1例47岁男性患者因“肺曲霉病”住院治疗。因抗真菌药敏试验显示耐药或用药后治疗效果欠佳及肝功能异常而先后停用卡泊芬净和伏立康唑。换用两性霉素B脂质体静脉滴注治疗病灶吸收缓慢,且肾功能有受损趋势。给予联合两性霉素B(AmB)雾化吸入治疗,因出现呛咳、咽痛等局部刺激症状而停用。临床药师认为两性霉素B雾化吸入疗效好,安全性高,局部药物浓度维持时间长,虽然局部不良反应发生率较高,但降低吸入药物浓度可以避免或减轻不良反应。建议继续联合雾化吸入两性霉素B。临床医生采纳临床药师意见,减低雾化吸入两性霉素B的浓度,待患者耐受后再逐渐提高浓度和剂量。联合给药2周后,咳嗽症状基本消失。复查纤支镜示支气管腔病灶显著减少。随访肾功能无进一步恶化。%A 47-year-old man was hospitalized for pulmonary aspergillosis. The use of caspofungin and voriconazole were gradually stopped because the antifungal susceptibility test indicated resistance to caspofungin, the therapeutic efifcacy was unsatisfactory and hepatic dysfunction occurred to him owing to the treatment of voriconazole. Amphotericin B (AmB) liposome was used instead by intravenous infusion. Consequently, lesions were slowly absorbed, however it’s likely to impair his renal function. The patient had local irritations such as bucking and pharyngalgia when aerosol AmB inhalation was coadministrated. So taking aerosol AmB inhalation was also stopped. Clinical pharmacist considers that aerosol inhalation of AmB has better curative effect and safety, and its local concentration can be maintained for a long time. Although the incidence rate of local adverse reaction is higher, it could be avoided or relieved by reducing the inspired concentration. So clinical pharmacist advised to continue the combination therapy with aerosol AmB inhalation, and the

  19. Peripheral intravenous line - infants

    Science.gov (United States)

    PIV - infants; Peripheral IV - infants; Peripheral line - infants; Peripheral line - neonatal ... A peripheral intravenous line (PIV) is a small, short, plastic tube, called a catheter. A health care provider puts ...

  20. An investigation of the pathophysiological mechanisms of hydrofluoric acid intoxication in rats and pigs. Interim report concerning the results of phase 2.1: The effect of sodium fluoride infusion on the plasma concentrations of lactate and magnesium

    NARCIS (Netherlands)

    Boink ABTJ; de Wildt DJ; de Jong Y; de Groot G; Vaessen HAMG; Meulenbelt J; van Dijk A; Vosmeer H

    1990-01-01

    From a previous study it was concluded that intravenous infusion of sodium fluoride (NaF) in rats is a suitable model to study the toxicity of hydrofluoric acid. In this supplementary study we investigated the effect of intravenous infusion of a high and low dose of NaF (120 and 25 mg.kg -1.hr -1

  1. Incorrect Prescription of Intravenous Paracetamol in a Pediatric Patient

    OpenAIRE

    Örün, E; Polat, A; Andan, H; Çizmeci, N; Tufan, N

    2013-01-01

    Intravenous (IV) paracetamol is widely used for the treatment of pain and fever, when there is a clinical indication for an IV route. A 16-month-old girl weighing 12 kg had undergone anterior open reduction for developmental dysplasia of the hip. Twenty-four hours after the operation, IV paracetamol (Perfalgan® 10 mg/ml) infusion was started for the postoperative pain management. After 12 hours’ infusion, she has developed nausea, vomiting and agitation. The liver function tests were found to...

  2. Intravenous ferric carboxymaltose for the treatment of iron deficiency anemia

    Science.gov (United States)

    Friedrisch, João Ricardo; Cançado, Rodolfo Delfini

    2015-01-01

    Nutritional iron deficiency anemia is the most common deficiency disorder, affecting more than two billion people worldwide. Oral iron supplementation is usually the first choice for the treatment of iron deficiency anemia, but in many conditions, oral iron is less than ideal mainly because of gastrointestinal adverse events and the long course needed to treat the disease and replenish body iron stores. Intravenous iron compounds consist of an iron oxyhydroxide core, which is surrounded by a carbohydrate shell made of polymers such as dextran, sucrose or gluconate. The first iron product for intravenous use was the 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 use intravenous iron for the treatment of iron deficiency anemia over many years. Intravenous ferric carboxymaltose is a stable complex with the advantage of being non-dextran-containing and a very low immunogenic potential and therefore not predisposed to anaphylactic reactions. Its properties permit the administration of large doses (15 mg/kg; maximum of 1000 mg/infusion) in a single and rapid session (15-minute infusion) without the requirement of a test dose. The purpose of this review is to discuss some pertinent issues in relation to the history, pharmacology, administration, efficacy, and safety profile of ferric carboxymaltose in the treatment of patients with iron deficiency anemia. PMID:26670403

  3. Immunological effects of a hyperinsulinaemic euglycaemic insulin clamp in healthy males

    DEFF Research Database (Denmark)

    Kappel, M; Dela, F; Barington, T;

    1998-01-01

    were increased from baseline (9.0 microU/ml) to 49.1 microU/ml after 1 h of insulin infusion (step I) and to 1281 microU/ml (step II) after 2 h of infusion. As control experiments infusions of isotonic saline were performed. The unstimulated natural killer (NK) cell activity among blood mononuclear...

  4. Insulin pumps.

    Science.gov (United States)

    Pickup, J

    2011-02-01

    The last year has seen a continued uptake of insulin pump therapy in most countries. The USA is still a leader in pump use, with probably some 40% of type 1 diabetic patients on continuous subcutaneous insulin infusion (CSII), but the large variation in usage within Europe remains, with relatively high use (> 15%) in, for example, Norway, Austria, Germany and Sweden and low use (companies or funding from national health services, the availability of sufficient diabetes nurse educators and dietitians trained in pump procedures, and clear referral pathways for the pump candidate from general practitioner or general hospital to specialist pump centre. There are now several comprehensive national guidelines on CSII use (see ATTD Yearbook 2009) but more work needs to be done in unifying uptake and ensuring all those who can benefit do so. Technology developments recently include increasing use of pumps with continuous glucose monitoring (CGM) connectivity (see elsewhere in this volume) and the emergence of numerous manufacturers developing so-called 'patch pumps', often for the type 2 diabetes market. Interestingly, the evidence base for CSII in this group is not well established, and for this reason the selected papers on CSII in this section include several in this area. The use of CSII in diabetic pregnancy is a long-established practice, in spite of the lack of evidence that it is superior to multiple daily injections (MDI), and few randomised controlled trials have been done in recent years. Several papers in this field this year continue the debate about the usefulness of CSII in diabetic pregnancy and are reviewed here. It is pleasing to see more research on the psychosocial aspects of CSII during the year, both from the point of view of how psychological beliefs influence outcomes on CSII (is there a type of patient who does particularly well or poorly on CSII?) and how CSII affects psychological factors like mood, behaviour and quality of life. Quality of

  5. Inhaled Insulin Is Associated with Prolonged Enhancement of Glucose Disposal in Muscle and Liver in the Canine

    OpenAIRE

    Edgerton, Dale S.; Cherrington, Alan D.; Neal, Doss W.; Scott, Melanie; Lautz, Margaret; Brown, Nancy; Petro, Jeff; Hobbs, Charles H.; Leach, Chet; Del Parigi, Angelo; Strack, Thomas R

    2009-01-01

    Diabetic patients treated with inhaled insulin exhibit reduced fasting plasma glucose levels. In dogs, insulin action in muscle is enhanced for as long as 3 h after insulin inhalation. This study was designed to determine whether this effect lasts for a prolonged duration such that it could explain the effect observed in diabetic patients. Human insulin was administered via inhalation (Exubera; n = 9) or infusion (Humulin R; n = 9) in dogs using an infusion algorithm that yielded matched plas...

  6. Changes in platelet function, blood coagulation and fibrinolysis during insulin-induced hypoglycaemia in juvenile diabetics and normal subjects

    DEFF Research Database (Denmark)

    Dalsgaard-Nielsen, J; Madsbad, S; Hilsted, J

    1982-01-01

    in the diabetics after hypoglycaemia, whereas no changes were seen in the control group. The activated partial thromboplastin time (APTT) was reduced in both groups and significantly lower in the diabetics than in the controls 120 min after insulin infusion. Fibrinogen and factor VIII R:Ag increased after insulin...... infusion; highest values were seen in the diabetics. The euglobulin clot lysis time (ELT) was reduced in both groups during insulin infusion; 120 min after end of insulin infusion ELT was significantly longer in the diabetics than in the control group.......Haemostatic parameters were assessed before insulin induced hypoglycaemia and 0, 1 and 2 hr after discontinuation of insulin infusion in 7 non-diabetics, aged 28 (22-31) years (mean and range), and 8 juvenile diabetics, aged 31 (27-35) years, with a mean duration of diabetes of 4 years...

  7. Insulin: pancreatic secretion and adipocyte regulation.

    Science.gov (United States)

    Baumgard, L H; Hausman, G J; Sanz Fernandez, M V

    2016-01-01

    Insulin is the primary acute anabolic coordinator of nutrient partitioning. Hyperglycemia is the main stimulant of insulin secretion, but other nutrients such as specific amino acids, fatty acids, and ketoacids can potentiate pancreatic insulin release. Incretins are intestinal hormones with insulinotropic activity and are secreted in response to food ingestion, thus integrating diet chemical composition with the regulation of insulin release. In addition, prolactin is required for proper islet development, and it stimulates β-cell proliferation. Counterintuitively, bacterial components appear to signal insulin secretion. In vivo lipopolysaccharide infusion acutely increases circulating insulin, which is paradoxical as endotoxemia is a potent catabolic condition. Insulin is a potent anabolic orchestrator of nutrient partitioning, and this is particularly true in adipocytes. Insulin dictates lipid accretion in a dose-dependent manner during preadipocyte development in adipose tissue-derived stromal vascular cell culture. However, in vivo studies focused on insulin's role in regulating adipose tissue metabolism from growing, and market weight pigs are sometimes inconsistent, and this variability appears to be animal, age and depot dependent. Additionally, porcine adipose tissue synthesizes and secretes a number of adipokines (leptin, adiponectin, and so forth) that directly or indirectly influence insulin action. Therefore, because insulin has an enormous impact on agriculturally important phenotypes, it is critical to have a better understanding of how insulin homeostasis is governed.

  8. Intravenous immunoglobulin treatment in patients with chronic inflammatory demyelinating polyneuropathy.

    OpenAIRE

    van Doorn, P. A.

    1994-01-01

    Intravenous immunoglobulin (IVIg) treatment is shown to be effective in a selected group of patients with a chronic inflammatory demyelinating polyneuropathy (CIDP). The proportion of patients that improve after IVIg treatment varies between studies. Because 40% of a group of IVIg treated CIDP patients needed intermittent IVIg infusions to maintain their improved clinical condition, it is expected that IVIg is effective, at least in this subgroup of patients. However, the proportion of patien...

  9. Effects of intraperitoneal insulin versus subcutaneous insulin administration on sex hormone-binding globulin concentrations in patients with type 1 diabetes mellitus

    NARCIS (Netherlands)

    Boering, M; van Dijk, P R; Logtenberg, S J J; Groenier, K H; Wolffenbuttel, B H R; Gans, R O B; Kleefstra, N; Bilo, H J G

    2016-01-01

    AIMS: Elevated sex hormone-binding globulin (SHBG) concentrations have been described in patients with type 1 diabetes mellitus (T1DM), probably due to low portal insulin concentrations. We aimed to investigate whether the route of insulin administration, continuous intraperitoneal insulin infusion

  10. Superselective arterial infusion and concomitant radiotherapy

    International Nuclear Information System (INIS)

    Superselective arterial infusion for patients with advanced head and neck cancer has been increasingly applied in Japan. We analyzed our experiences and evaluated the efficacy and safety of this treatment. Through October 1999 to March 2002, 29 patients, ranging in age between 33 and 71 years (median 52 years), received superselective intra-arterial infusion therapy of cisplatin (100-120 mg/m2/week) with simultaneous intravenous infusion of thiosulfate for neutralizing cisplatin toxicity, and conventional concomitant extrabeam radiotherapy (65 Gy/26 f/6.5 weeks). Four patients were diagnosed with stage III and 25 with stage IV. Thirteen patients were considered contraindicated for surgery, and the other 16 patients rejected radical surgery. Primary tumor sites included paranasal sinus (11 patients), hypopharynx (7), oropharynx (6), oral cavity (4), and parotid gland (1). During the median follow-up period of 20 months, there was no apparent recurrence in 14 (48.3%) of 29 patients. Eleven (37.9%) patients died of disease, and three (10.3%) were alive with disease. In twenty-one patients (72.4%) the primary lesions were well-controlled. Acute toxic effects were moderate, and severe toxic events occurred in four cases, namely, methicillin-resistant staphylococcus aureus (MRSA) pneumonia, sepsis, tetraplasia, and osteoradionecrosis. We confirmed the effectiveness and safety of superselective arterial infusion and concomitant radiotherapy. Furthermore, we must establish the optimal procedures and schedule, as well as the indications for this treatment. This treatment protocol may improve the prognosis of patients with unresectable disease and patients rejecting surgical treatment. Further study in this particular area is needed. (author)

  11. Superselective arterial infusion and concomitant radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Homma, Akihiro; Suzuki, Fumiyuki; Inuyama, Yukio; Fukuda, Satoshi [Hokkaido Univ., Sapporo (Japan). School of Medicine

    2003-05-01

    Superselective arterial infusion for patients with advanced head and neck cancer has been increasingly applied in Japan. We analyzed our experiences and evaluated the efficacy and safety of this treatment. Through October 1999 to March 2002, 29 patients, ranging in age between 33 and 71 years (median 52 years), received superselective intra-arterial infusion therapy of cisplatin (100-120 mg/m{sup 2}/week) with simultaneous intravenous infusion of thiosulfate for neutralizing cisplatin toxicity, and conventional concomitant extrabeam radiotherapy (65 Gy/26 f/6.5 weeks). Four patients were diagnosed with stage III and 25 with stage IV. Thirteen patients were considered contraindicated for surgery, and the other 16 patients rejected radical surgery. Primary tumor sites included paranasal sinus (11 patients), hypopharynx (7), oropharynx (6), oral cavity (4), and parotid gland (1). During the median follow-up period of 20 months, there was no apparent recurrence in 14 (48.3%) of 29 patients. Eleven (37.9%) patients died of disease, and three (10.3%) were alive with disease. In twenty-one patients (72.4%) the primary lesions were well-controlled. Acute toxic effects were moderate, and severe toxic events occurred in four cases, namely, methicillin-resistant staphylococcus aureus (MRSA) pneumonia, sepsis, tetraplasia, and osteoradionecrosis. We confirmed the effectiveness and safety of superselective arterial infusion and concomitant radiotherapy. Furthermore, we must establish the optimal procedures and schedule, as well as the indications for this treatment. This treatment protocol may improve the prognosis of patients with unresectable disease and patients rejecting surgical treatment. Further study in this particular area is needed. (author)

  12. 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

    OpenAIRE

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

    2010-01-01

    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 lid...

  13. Auditory function after continuous infusion of gentamicin to high-risk newborns

    DEFF Research Database (Denmark)

    Colding, H; Andersen, E A; Prytz, S;

    1989-01-01

    Audiometry was performed at four years of age in 69 of 105 surviving children who had received continuous intravenous infusion of gentamicin during neonatal intensive care. A hearing loss of 20 dB was found in 2 of them (3%), corresponding to that shown in other studies of survivors following...... neonatal intensive care. Free field audiometry performed in another 7 children and questionnaires returned from 13 of the remaining 29 gave no suspicion of hearing loss. Thus there is no indication that continuous 24 hours intravenous infusion of gentamicin causes more hearing impairment than intermittent...

  14. Effect of acetaminophen and fluvastatin on post-dose symptoms following infusion of zoledronic acid

    OpenAIRE

    Silverman, S. L.; Kriegman, A.; Goncalves, J.; Kianifard, F; Carlson, T.; Leary, E.

    2010-01-01

    Summary A randomized, double-blind, placebo-controlled study assessed the efficacy of acetaminophen or fluvastatin in preventing post-dose symptoms (increases in body temperature or use of rescue medication) following a single infusion of the intravenous (IV) bisphosphonate zoledronic acid (ZOL). Acetaminophen, but not fluvastatin, significantly reduced the incidence and severity of post-dose symptoms. Introduction Transient symptoms including myalgia and pyrexia have been reported post-infus...

  15. Elimination of ascorbic acid after high-dose infusion in prostate cancer patients

    DEFF Research Database (Denmark)

    Nielsen, Torben Kjær; Højgaard, Martin; Andersen, Jon Thor Trærup;

    2015-01-01

    Treatment with high-dose intravenous (IV) ascorbic acid (AA) is used in complementary and alternative medicine for various conditions including cancer. Cytotoxicity to cancer cell lines has been observed with millimolar concentrations of AA. Little is known about the pharmacokinetics of high dose...... infusion stop in prostate cancer patients with normal kidney function. We propose a regimen with a bolus loading followed by a maintenance infusion based on the calculated clearance....

  16. Central melanocortin receptors regulate insulin action

    OpenAIRE

    Obici, Silvana; Feng, Zhaohui; Tan, Jianzhen; Liu, LiSen; Karkanias, George; Rossetti, Luciano

    2001-01-01

    Energy balance and insulin action are tightly coregulated. Leptin regulates energy intake and expenditure partly by modulation of the melanocortin pathway in the hypothalamus. Here we demonstrate potent effects of the melanocortin pathway on insulin action and body distribution of adiposity. Conscious rats received week-long infusions of either a melanocortin receptor agonist, α-melanocyte-stimulating hormone (α-MSH), or antagonist, SHU9119, in the third cerebral ventricle while food intake w...

  17. The Effect of Intravenous Citalopram on the Neural Substrates of Obsessive-Compulsive Disorder.

    Science.gov (United States)

    Bhikram, Tracy P; Farb, Norman A S; Ravindran, Lakshmi N; Papadopoulos, Yousef G; Conn, David K; Pollock, Bruce G; Ravindran, Arun V

    2016-01-01

    This study investigated the effect of an intravenous serotonin reuptake inhibitor on the neural substrates of obsessive-compulsive disorder (OCD), as intravenous agents may be more effective in treating OCD than conventional oral pharmacotherapy. Eight OCD subjects and eight control subjects received alternate infusions of citalopram and placebo during functional magnetic resonance imaging, in a randomized, symptom-provocation, crossover design. Compared with baseline, OCD subjects displayed significant changes in prefrontal neural activity after the citalopram infusion relative to placebo, and these changes correlated with reductions in subjective anxiety. PMID:27019066

  18. Follow-up of newly-diagnosed type 2 diabetic patients treated with short-term continuous subcutaneous insulin infusion%短期胰岛素泵治疗初诊2型糖尿病患者的随访研究

    Institute of Scientific and Technical Information of China (English)

    郎江明; 王甫能; 陈发胜; 叶建红; 陈苹; 魏爱生

    2008-01-01

    Objective To investigate the therapeutic and adverse effects of short-term continuous subcutaneous insulin infusion (CSII) in patients with newly-diagnosed type 2 diabetes mellitus. Methods By way of follow-up and retrospective study, 256 patients with newly-diagnosed type 2 diabetes mellitus receiving two weeks of CSII therapy were analyzed in our diabetes center. The parameters, such as blood glucose level after two-week CSII therapy, time needed to control hyperglycemia, insulin dosage and the rate of hypoglycemic episodes were observed and recorded. Results The optimal glycemic control rates after 3 days, 7 days, 2 weeks were 46.7%, 78.4%, 92.2% respectively. The remission rates of patients who maintained optimal glycemic control at the third, sixth, twelfth, twenty-fourth and thirty-sixth months and more than 48 months after withdrawal of insulin were 75%, 64.8%, 53.5%, 30.9%, 10.2% and 0%, respectively. In patients with a period of remission over 3 months,the daily total insulin requirement on the day of withdrawal of CSII was less than that in patients with remission less than 3 months (P<0.01). The duration of remission was negatively correlated to daily insulin requirement on the day of CSII withdrawal(r=-0.63, P<0.01). Conclusion Patients with newly-diagnosed type 2 diabetes mellitus can quickly achieve optimal glycemic control by CSII. CSII may decrease glucotoxicity to pancreatic β cells and delay the deterioration of β-cell function .%目的 观察短期应用胰岛素泵治疗初诊2型糖尿病的中远期疗效及不良反应.方法 观察、随访、回顾性分析256例初诊2型糖尿病患者经胰岛素泵(CSII)强化治疗2周后控制血糖情况、不服用药物血糖达标(空腹血糖:3.9~7.0 mmol/L,餐后2h血糖:3.9~10.0 mmol/L)持续时间(缓解期)等.结果 CSII治疗3 d血糖达标率46.7%,7 d达标率78.4%,2周达标率92.2%;拆除胰岛素泵缓解期超过3个月的患者共192例(75%),超过6个月166例(64.8%),

  19. 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)

  20. Insulin Injection

    Science.gov (United States)

    ... or buttocks. Do not inject insulin into muscles, scars, or moles. Use a different site for each ... you are using insulin.Alcohol may cause a decrease in blood sugar. Ask your doctor about the ...

  1. Insulin secretion in lipodystrophic HIV-infected patients is associated with high levels of nonglucose secretagogues and insulin resistance of beta-cells

    DEFF Research Database (Denmark)

    Haugaard, Steen B; Andersen, Ove; Storgaard, Heidi;

    2004-01-01

    lipodystrophy (controls). Thirty minutes before start of the clamp, a bolus of glucose was injected intravenously to stimulate endogenous insulin secretion. Insulin sensitivity index (SiRd) was estimated from glucose tracer analysis. LIPO displayed increased basal ISR (69%), clamp ISR (114%), basal insulin (130...

  2. Glycemic Control and Chronic Dosing of Rhesus Monkeys with a Fusion Protein of Iduronidase and a Monoclonal Antibody Against the Human Insulin Receptor

    Science.gov (United States)

    Boado, Ruben J.; Hui, Eric Ka-Wai; Lu, Jeff Zhiqiang

    2012-01-01

    Hurler's syndrome, or mucopolysaccharidosis type I, is a lysosomal storage disorder caused by mutations in the gene encoding the lysosomal enzyme iduronidase (IDUA). The disease affects both peripheral tissues and the central nervous system (CNS). Recombinant IDUA treatment does not affect the CNS, because IDUA does not cross the blood-brain barrier (BBB). To enable BBB penetration, human IDUA was re-engineered as an IgG-IDUA fusion protein, where the IgG domain is a genetically engineered monoclonal antibody (MAb) against the human insulin receptor (HIR). The HIRMAb penetrates the brain from the blood via transport on the endogenous BBB insulin receptor and acts as a molecular Trojan horse to deliver the fused IDUA to the brain. Before human testing, the HIRMAb-IDUA fusion protein was evaluated in a 6-month weekly dosing toxicology study at doses of 0, 3, 9, and 30 mg/kg/week of the fusion protein administered to 40 rhesus monkeys. The focus of the present study is the effect of chronic high dose administration of this fusion protein on plasma glucose and long-term glycemic control. The results show that the HIRMAb has weak insulin agonist activity and causes hypoglycemia at the high dose, 30 mg/kg, after intravenous infusion in normal saline. When dextrose is added to the saline infusion solution, no hypoglycemia is observed at any dose. An intravenous glucose tolerance test performed at the end of the 6 months of chronic treatment showed no change in glucose tolerance at any dose of the HIRMAb-IDUA fusion protein. PMID:22822036

  3. Oral Insulin

    OpenAIRE

    Kalra Sanjay; Kalra Bharti; Agrawal Navneet

    2010-01-01

    Abstract Oral insulin is an exciting area of research and development in the field of diabetology. This brief review covers the various approaches used in the development of oral insulin, and highlights some of the recent data related to novel oral insulin preparation.

  4. 硬膜外输注地塞米松-布比卡因-芬太尼混合液联合牛痘疫苗致炎兔皮提取物治疗重度带状疱疹神经痛的效果%Efficacy of epidural infusion of a mixture of bupivacaine-fentanyl-dexamethasone on top of intravenous extract from rabbit skin inflamed by vaccinia virus for severe herpetic neuralgia

    Institute of Scientific and Technical Information of China (English)

    任玉娥; 刘玉华; 刘广召; 齐伟光; 杜玉敏; 丛海静

    2012-01-01

    目的 评价硬膜外输注地塞米松-布比卡因-芬太尼混合液联合牛痘疫苗致炎兔皮提取物治疗重度带状疱疹神经痛的效果.方法 带状疱疹神经痛患者48例,性别不限,年龄45-92岁,疼痛视觉模拟评分(VAS)> 6分,采用随机数字表法,将其随机分为2组(n=24):常规药物组(C组)与硬膜外阻滞联合牛痘疫苗致炎兔皮提取物组(T组).2组治疗期间均静脉输注牛痘疫苗致炎兔皮提取物6 ml/d,C组还口服阿米替林和加巴喷丁,T组选择带状疱疹病毒感染最严重的脊神经节段的相应椎间隙硬膜外穿刺,硬膜外输注药物配方0.075%布比卡因、芬太尼2μg/ml和地塞米松50 μg/ml,生理盐水稀释至100ml,速率2~5 ml/h,连续10d,维持VAS评分≤4分.记录硬膜外给药期间与硬膜外给药相关不良反应和带状疱疹后神经痛的发生情况.结果 与C组比较,T组尿潴留和带状疱疹后神经痛的发生率降低(p<0.05或0.01).T组未见其他不良反应.结论 硬膜外输注地塞米松-布比卡因-芬太尼混合液联合牛痘疫苗致炎兔皮提取物可有效地缓解严重带状疱疹神经痛,预防带状疱疹后神经痛的发生,且安全性良好.%Objective To evaluate the efficacy of epidural infusion of a mixture of bupivacaine-fentanyl-dexamethasone on top of intravenous extract from rabbit skin inflamed by vaccinia virus (ERSVV) for severe herpetic neuralgia.Methods Forty-eight patients of both sexes with severe herpetic neuralgia aged 45-92 yr were randomly divided into 2 groups (n =24 each):control group (group C) and test group( group T).Both groups received intravenous ERSVV 6 ml/d.Group C received oral amitriptyline and gabapentin,while the group T received epidural infusion of 100 ml of a mixture of 0.075% bupivacaine,fentanyl 2 μg/ml and dexamethasone 50 μg/ml in normal saline at 2-5 ml/h,once a day for 10 days and VAS score was maintained≤4.Epidural puncture was performed at the spinal segments

  5. The SWITCH study (sensing with insulin pump therapy to control HbA(1c))

    DEFF Research Database (Denmark)

    Conget, Ignacio; Battelino, Tadej; Giménez, Marga;

    2011-01-01

    injections. However, there is still a proportion of subjects using continuous subcutaneous insulin infusion in whom goals for metabolic control are far from achieved or benefits of this type of insulin therapy are transient. The SWITCH (Sensing With Insulin pump Therapy to Control HbA(1c) [hemoglobin A1c...

  6. Intrahippocampal Insulin Improves Memory in a Passive-Avoidance Task in Male Wistar Rats

    Science.gov (United States)

    Babri, Shirin; Badie, Hamid Gholamipour; Khamenei, Saeed; Seyedlar, Mehdi Ordikhani

    2007-01-01

    The main impacts of insulin favor the peripheral organs. Although it functions as a neuropeptide, insulin possesses also some central effects. The aim of this study was to determine the effect of intrahippocampal infusion of insulin on passive avoidance learning in healthy male rats. Thirty male wistar rats were divided into three groups (n = 10…

  7. Efficacy and safety of pretransplant conditioning regimens with intravenous infusion of busulfan once daily and cyclophosphamide in patients undergoing allogeneic stem cell transplantation%异基因造血干细胞移植患者白消安每日一次静脉滴注联合环磷酰胺预处理方案的疗效及安全性

    Institute of Scientific and Technical Information of China (English)

    冀冰心; 苏力; 赵弘; 惠吴函; 孙婉玲; 徐娟

    2013-01-01

    目的 评价异基因造血干细胞移植(Allo-HSC)治疗中应用白消安每日1次静脉滴注联合环磷酰胺预处理方案的疗效和安全性. 方法 收集首都医科大学宣武医院2004年1月至2012年6月以白消安/环磷酰胺(Bu/Cy)为预处理方案进行Allo-HSC治疗连续病例的病历资料进行回顾性分析.将患者分为口服组[2004年1月至2006年6月住院患者,口服白消安4.0 mg/(kg·d),共3 d]和静脉组[2006年7月至2012年6月住院患者,静脉滴注白消安3.2 mg/(kg·d),共3 d].记录2组患者不良反应发生率、造血功能重建情况及生存率. 结果 共收集到患者50例,静脉组34例,口服组16例.2组患者性别、年龄、输入细胞数差异无统计学意义(P>0.05).静脉组患者口腔黏膜炎、胃肠道反应、肝损害发生率均明显低于口服组[11.7% (4/34)比43.8% (7/16),17.6% (6/34)比50.0%(8/16),20.6%(7/34)比50.0%(8/16),均P<0.05];未发现肝静脉闭塞病及癫痫等不良反应发生.静脉组和口服组患者均获得造血重建,2组外周血中性粒细胞计数≥0.5×109/L和血小板计数≥20×109/L所需时间差异无统计学意义[(14.3 ±3.5)d比(15.6±4.0)d,(17.5±5.0)d比(19.0±6.7)d,均P>0.05].静脉组和口服组患者5年生存率分别为(69.5±12.1)%和(62.5±12.1)%,组间差异无统计学意义(P>0.05). 结论 恶性血液病的Allo-HSC治疗中预处理方案采用白消安每日1次静脉滴注联合环磷酰胺较口服白消安有更好的安全性,而且疗效确切.%Objective To evaluate the efficacy and safety of pretransplant conditioning regimens with intravenous (Ⅳ) infusion of busulfan once daily and cyclophosphamide in patients undergoing allogeneic stem cell transplantation allo-HSCT.Methods The data of consecutive patients treated with a conditioning regimen with busulfan and cyclophosphamide (Bu/Cy) before undergoing allo-HSCT in Xuanwu Hospital of Capital Medical University from January 2004 to June

  8. Immunology of infusion reactions in the treatment of patients with acute lymphoblastic leukemia.

    Science.gov (United States)

    Asselin, Barbara

    2016-07-01

    Infusion reactions are potentially dose-limiting adverse events associated with intravenous administration of several common agents used to treat patients with acute lymphoblastic leukemia. True clinical hypersensitivity reactions are antibody-mediated and can occur only after repeated exposure to an antigen. Conversely, anaphylactoid infusion reactions are nonantibody-mediated and often occur on the initial exposure to a drug. Cytokine-release syndrome comprises a subset of nonantibody-mediated infusion reactions associated with the use of monoclonal antibodies and immune therapies. Clinical symptoms of hypersensitivity reactions and nonantibody-mediated infusion reactions heavily overlap and can be difficult to distinguish in practice. Regardless of the underlying mechanism, any infusion reaction can negatively affect treatment efficacy and patient safety. These events require prompt response, and potentially, modification of subsequent therapy. PMID:27086555

  9. Prediction of the insulin sensitivity index using Bayesian networks

    DEFF Research Database (Denmark)

    Bøttcher, Susanne Gammelgaard; Dethlefsen, Claus

    The insulin sensitivity index () can be used in assessing the risk of developing type 2 diabetes. An intravenous study is used to determine using Bergmans minimal model. However, an intravenous study is time consuming and expensive and therefore not suitable for large scale epidemiological studies....... In this paper we learn the parameters and structure of several Bayesian networks relating measurements from an oral glucose tolerance test to the insulin sensitivity index determined from an intravenous study on the same individuals. The networks can then be used in prediction of from an oral glucose tolerance...

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1982-03-01

    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.

  11. Theophylline: constant-rate infusion predictions.

    Science.gov (United States)

    Mesquita, C A; Sahebjami, H; Imhoff, T; Thomas, J P; Myre, S A

    1984-01-01

    This study was undertaken to evaluate a method of prospectively estimating appropriate aminophylline infusion rates in acutely ill, hospitalized patients with bronchospasm. Steady-state serum theophylline concentrations (Css), clearances (Cl), and half-lives (t1/2) were estimated by the Chiou method using serum concetrantions obtained 1 and 6 h after the start of a constant-rate intravenous aminophylline infusion in 10 male patients averaging 57 years of age. Using an enzyme-multiplied immunoassay (EMIT) system for theophylline analysis, pharmacokinetic estimations were excellent for Css (r = 0.9103, p less than 0.01) and Cl (r = 0.9750, p less than 0.01). The mean estimation errors were 9.4% (range 0.8-21.5) for Css and 12.3% (range 1.3-28.0) for Cl. There was no correlation between patient age and Cl. This method is useful for rapidly individualizing aminophylline therapy in patients with acute bronchospasm. PMID:6740734

  12. 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

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

    Directory of Open Access Journals (Sweden)

    Enemark JMD

    2001-06-01

    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.

  14. II Infused Mice

    Directory of Open Access Journals (Sweden)

    Justin L. Wilson

    2012-01-01

    Full Text Available The anti-inflammatory properties of PPAR-α plays an important role in attenuating hypertension. The current study determines the anti-hypertensive and anti-inflammatory role of PPAR-α agonist during a slow-pressor dose of Ang II (400 ng/kg/min. Ten to twelve week old male PPAR-α KO mice and their WT controls were implanted with telemetry devices and infused with Ang II for 12 days. On day 12 of Ang II infusion, MAP was elevated in PPAR-α KO mice compared to WT (161±4 mmHg versus 145±4 mmHg and fenofibrate (145 mg/kg/day reduced MAP in WT + Ang II mice (134±7 mmHg. Plasma IL-6 levels were higher in PPAR-α KO mice on day 12 of Ang II infusion (30±4 versus 8±2 pg/mL and fenofibrate reduced plasma IL-6 in Ang II-treated WT mice (10±3 pg/mL. Fenofibrate increased renal expression of CYP4A, restored renal CYP2J expression, reduced the elevation in renal ICAM-1, MCP-1 and COX-2 in WT + Ang II mice. Our results demonstrate that activation of PPAR-α attenuates Ang II-induced hypertension through up-regulation of CYP4A and CYP2J and an attenuation of inflammatory markers such as plasma IL-6, renal MCP-1, renal expression of ICAM-1 and COX-2.

  15. Sodium retention and insulin treatment in insulin-dependent diabetes mellitus

    DEFF Research Database (Denmark)

    Nørgaard, K; Feldt-Rasmussen, B

    1994-01-01

    The hypothesis that total body exchangeable sodium (ENa) is elevated in type 1 (insulin-dependent) diabetic patients with short-duration diabetes and no signs of microangiopathy was tested. Also tested was whether peripheral hyperinsulinaemia, in terms of the amounts of insulin injected...... newly diagnosed diabetic patients (aged 20-35 years, median 27 years) who were studied on two occasions on different insulin doses. Study 3 was a 12-month prospective intervention study of 21 type 1 diabetic patients with incipient nephropathy, who had been randomized either to receive continuous...... subcutaneous insulin infusion for improvement of glycaemic control or to remain on conventional insulin treatment. In study 1, ENa was higher in short-duration type 1 diabetic men than in controls (3003 +/- 325 vs 2849 +/- 207 mEq/1.73 m2, P insulin dose (r = 0...

  16. Efficacy of Intravenous Immunoglobulin in Neurological Diseases.

    Science.gov (United States)

    Lünemann, Jan D; Quast, Isaak; Dalakas, Marinos C

    2016-01-01

    Owing to its anti-inflammatory efficacy in various autoimmune disease conditions, intravenous immunoglobulin (IVIG)-pooled IgG obtained from the plasma of several thousands individuals-has been used for nearly three decades and is proving to be efficient in a growing number of neurological diseases. IVIG therapy has been firmly established for the treatment of Guillain-Barré syndrome, chronic inflammatory demyelinating polyneuropathy, and multifocal motor neuropathy, either as first-line therapy or adjunctive treatment. IVIG is also recommended as rescue therapy in patients with worsening myasthenia gravis and is beneficial as a second-line therapy for dermatomyositis and stiff-person syndrome. Subcutaneous rather than intravenous administration of IgG is gaining momentum because of its effectiveness in patients with primary immunodeficiency and the ease with which it can be administered independently from hospital-based infusions. The demand for IVIG therapy is growing, resulting in rising costs and supply shortages. Strategies to replace IVIG with recombinant products have been developed based on proposed mechanisms that confer the anti-inflammatory activity of IVIG, but their efficacy has not been tested in clinical trials. This review covers new developments in the immunobiology and clinical applications of IVIG in neurological diseases.

  17. Initial pharmacology and toxicology of intravenous desmethylmisonidazole

    Energy Technology Data Exchange (ETDEWEB)

    Coleman, C.N. (Stanford Univ., CA); Wasserman, T.H.; Phillips, T.L.; Strong, J.M.; Urtasun, R.C.; Schwade, J.G.; Johnson, R.J.; Zagars, G.

    1982-03-01

    Since January 1981, 52 patients have entered the Radiaton Therapy Oncology Group Phase I trial with intravenous (i.v.) desmethylmisonidazole (DMM). DMM is less lipophilic than misonidazole (MISO) and theoretically will be less neurotoxic due to lower penetration into neural tissue and more rapid elimination. The drug is administered intravenously to achieve the maximum drug concentration in tumor for a given dose. The protocol slowly escalates the total dose of drug administered. At this time the planned dose on the three week schedule is 1 g/m/sup 2/ twice weekly to a total dose of 17.5g/m/sup 2/. The preliminary plasma pharmacokinetic data demonstrates high peak plasma levels within five minutes of the end of the drug infusion. Compared to MISO the percent of DMM excreted in the urine is increased, 63% vs 10%, and the elimination half-life is decreased: DMM, i.v. 5.3h; MISO, i.v. 9.3h; MISO, oral 10 to 13h. Neurotoxicity has been observed in approximately 30% of patients given a cumulative dose of >11g/m/sup 2/. This is in comparison to a 50% incidence in RTOG Phase 1 study with oral MISO at doses of 12g/m/sup 2/. There is not sufficient data to evaluate the relationship between neurotoxicity and drug exposure. Further patient accrual on this study is required to better define the properties of DMN.

  18. Triacylglycerol infusion improves exercise endurance in patients with mitochondrial myopathy due to complex I deficiency

    NARCIS (Netherlands)

    Roef, MJ; de Meer, K; Reijngoud, DJ; Straver, HWHC; de Barse, M; Kalhan, SC; Berger, R

    2002-01-01

    Background: A high-fat diet has been recommended for the treatment of patients with mitochondrial myopathy due to complex I (NADH dehydrogenase) deficiency (CID). Objective: This study evaluated the effects of intravenous infusion of isoenergetic amounts of triacylglycerol or glucose on substrate ox

  19. Stability and compatibility of ceftazidime administered by continuous infusion to intensive care patients.

    OpenAIRE

    Servais, Hélène; Tulkens, Paul M.

    2001-01-01

    The stability and compatibility of ceftazidime have been examined in the context of its potential use in concentrated solutions for continuous infusion in patients suffering from severe nosocomial pneumonia and receiving other intravenous medications by the same route. Ceftazidime stability in 4 to 12% solutions was found satisfactory (

  20. Localization of thermogenesis induced by single infusion of ephedrine in dog

    DEFF Research Database (Denmark)

    Madsen, J; Bülow, J; Larsen, O G;

    1993-01-01

    The localization of the thermogenic effect of ephedrine (1 mg.kg-1 infused intravenously over 10 min.) was studied in 6 fasted dogs anaesthetized with etorfin-acepromazin-N2O. Three experiments were performed in each animal to determine the effect of ephedrine on a) splanchnic oxygen uptake, b...

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

    DEFF Research Database (Denmark)

    Falkén, Y; Hellström, P M; Sanger, G J;

    2010-01-01

    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....

  2. Chronic exposure to free fatty acid reduces pancreatic beta cell insulin content by increasing basal insulin secretion that is not compensated for by a corresponding increase in proinsulin biosynthesis translation.

    OpenAIRE

    Bollheimer, L. C.; Skelly, R H; Chester, M W; McGarry, J D; Rhodes, C. J.

    1998-01-01

    The pancreatic beta cell normally maintains a stable balance among insulin secretion, insulin production, and insulin degradation to keep optimal intracellular stores of the hormone. Elevated levels of FFA markedly enhance insulin secretion; however, the effects of FFA on insulin production and intracellular stores remain unclear. In this study, twofold elevation in total circulating FFA effected by infusion of lard oil and heparin into rats for 6 h under normoglycemic conditions resulted in ...

  3. Portal infusion of escitalopram enhances hepatic glucose disposal in conscious dogs

    OpenAIRE

    An, Zhibo; Moore, Mary C.; Winnick, Jason J.; Farmer, Ben; Neal, Doss W.; Lautz, Margaret; Smith, Marta; Rodewald, Tiffany; Cherrington, Alan D.

    2009-01-01

    To examine whether escitalopram enhances net hepatic glucose uptake during a hyperinsulinemic hyperglycemic clamp, studies were performed in conscious 42-h-fasted dogs. The experimental period was divided into P1 (0–90 min) and P2 (90–270 min). During P1 and P2 somatostatin (to inhibit insulin and glucagon secretion), 4X basal intraportal insulin, basal intraportal glucagon, and peripheral glucose (2X hepatic glucose load) were infused. Saline was infused intraportally during P1 in all groups...

  4. ADVERSE EFFECTS OF INTRAVENOUS IMMUNOGLOBULIN THERAPY IN PATIENTS WITH ANTIBODY DEFICIENCY

    Directory of Open Access Journals (Sweden)

    A. Aghamohammadi

    2003-09-01

    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.

  5. INTERACTION OF ORG-9426 AND SOME OF THE CLINICALLY USED INTRAVENOUS ANESTHETIC AGENTS IN THE CAT

    NARCIS (Netherlands)

    KHUENLBRADY, KS; AGOSTON, S; MILLER, RD

    1992-01-01

    The interaction of ORG 9426, a new non-depolarizing neuromuscular blocking agent, with intravenous anaesthetic drugs (fentanyl, thiopental, midazolam, droperidol and etomidate) has been investigated in cats. During an infusion of one of the above anaesthetics, the ED95 dose was determined by titrati

  6. Safety and Efficacy of Repeated-Dose Intravenous Ketamine for Treatment-Resistant Depression

    NARCIS (Netherlands)

    aan het Rot, Marije; Collins, Katherine A.; Murrough, James W.; Perez, Andrew M.; Reich, David L.; Charney, Dennis S.; Mathew, Sanjay J.

    2010-01-01

    Background: A single subanesthetic (intravenous) IV dose of ketamine might have rapid but transient antidepressant effects in patients with treatment-resistant depression (TRD). Here we tested the tolerability, safety, and efficacy of repeated-dose open-label IV ketamine (six infusions over 12 days)

  7. Safety of poly (ethylene glycol-coated perfluorodecalin-filled poly (lactide-co-glycolide microcapsules following intravenous administration of high amounts in rats

    Directory of Open Access Journals (Sweden)

    Katja B. Ferenz

    2014-01-01

    Intravenous infusion of high amounts of PFD-filled PLGA microcapsules was tolerated temporarily but associated with severe side effects such as hypotension and organ damage. Short-chained PVA displays excellent biocompatibility and thus, can be utilized as emulsifier for the preparation of drug carriers designed for intravenous use.

  8. Insulin sensitivity and hemodynamic responses to insulin in Wistar-Kyoto and spontaneously hypertensive rats.

    Science.gov (United States)

    Pître, M; Nadeau, A; Bachelard, H

    1996-10-01

    The insulin-mediated vasodilator effect has been proposed as an important physiological determinant of insulin action on glucose disposal in normotensive humans. The present study was designed to further examine the acute regional hemodynamic effects of insulin in different vascular beds and to explore the relationships between insulin vascular effects and insulin sensitivity during euglycemic hyperinsulinemic clamps in conscious normotensive Wistar-Kyoto (WKY) rats and spontaneously hypertensive rats (SHR). The rats were instrumented with intravascular catheters and pulsed Doppler flow probes to measure blood pressure, heart rate, and regional blood flows. In WKY rats, the euglycemic infusion of insulin (4 and 16 mU.kg-1.min-1) causes vasodilations in renal and hindquarter vascular beds but no changes in mean blood pressure, heart rate, or superior mesenteric vascular conductance. In contrast, in SHR, the same doses of insulin produce vasoconstrictions in superior mesenteric and hindquarter vascular beds and, at high doses, increase blood pressure. Moreover, at the lower dose of insulin tested, we found a reduction in the insulin sensitivity index in the SHR compared with the WKY rats. The present findings provide further evidence for an association between insulin sensitivity and insulin-mediated hemodynamic responses.

  9. Inhaled insulin: A “puff” than a “shot” before meals

    Directory of Open Access Journals (Sweden)

    Dick B. S. Brashier

    2015-01-01

    Full Text Available Diabetes is a metabolic disorder characterized by relative or absolute deficiency of insulin, resulting in hyperglycemia. The main treatment of diabetes relies on subcutaneous insulin administration by injection or continuous infusion to control glucose levels, besides oral hypoglycemic agents for type 2 diabetes. Novel routes of insulin administration are an area of research in the diabetes field as insulin injection therapy is burdensome and painful for many patients. Inhalational insulin is a potential alternative to subcutaneous insulin in the management of diabetes. The large surface area, good vascularization, immense capacity for solute exchange and ultra-thinness of the alveolar epithelium facilitates systemic delivery of insulin via pulmonary administration. Inhaled insulin has been recently approved by Food and Drug Administration (FDA. It is a novel, rapid-acting inhaled insulin with a pharmacokinetic profile that is different from all other insulin products and comparatively safer than the previous failed inhaled insulin (Exubera.

  10. Combining insulins for optimal blood glucose control in type I and 2 diabetes: focus on insulin glulisine.

    Science.gov (United States)

    Ulrich, Heather; Snyder, Benjamin; Garg, Satish K

    2007-01-01

    Normalization of blood glucose is essential for the prevention of diabetes mellitus (DM)-related microvascular and macrovascular complications. Despite substantial literature to support the benefits of glucose lowering and clear treatment targets, glycemic control remains suboptimal for most people with DM in the United States. Pharmacokinetic limitations of conventional insulins have been a barrier to achieving treatment targets secondary to adverse effects such as hypoglycemia and weight gain. Recombinant DNA technology has allowed modification of the insulin molecule to produce insulin analogues that overcome these pharmacokinetic limitations. With time action profiles that more closely mimic physiologic insulin secretion, rapid acting insulin analogues (RAAs) reduce post-prandial glucose excursions and hypoglycemia when compared to regular human insulin (RHI). Insulin glulisine (Apidra) is a rapid-acting insulin analogue created by substituting lysine for asparagine at position B3 and glutamic acid for lysine at position B29 on the B chain of human insulin. The quick absorption of insulin glulisine more closely reproduces physiologic first-phase insulin secretion and its rapid acting profile is maintained across patient subtypes. Clinical trials have demonstrated comparable or greater efficacy of insulin glulisine versus insulin lispro or RHI, respectively. Efficacy is maintained even when insulin glulisine is administered post-meal. In addition, glulisine appears to have a more rapid time action profile compared with insulin lispro across various body mass indexes (BMIs). The safety and tolerability profile of insulin glulisine is also comparable to that of insulin lispro or RHI in type 1 or 2 DM and it has been shown to be as safe and effective when used in a continuous subcutaneous insulin infusion (CSII). In summary, insulin glulisine is a safe, effective, and well tolerated rapid-acting insulin analogue across all BMIs and a worthy option for prandial

  11. Adiponectin Inhibits Insulin Function in Primary Trophoblasts by PPARα-Mediated Ceramide Synthesis

    OpenAIRE

    Aye, Irving L M H; Gao, Xiaoli; Weintraub, Susan T.; Jansson, Thomas; Powell, Theresa L.

    2014-01-01

    Maternal adiponectin (ADN) levels are inversely correlated with birth weight, and ADN infusion in pregnant mice down-regulates placental nutrient transporters and decreases fetal growth. In contrast to the insulin-sensitizing effects in adipose tissue and muscle, ADN inhibits insulin signaling in the placenta. However, the molecular mechanisms involved are unknown. We hypothesized that ADN inhibits insulin signaling and insulin-stimulated amino acid transport in primary human trophoblasts by ...

  12. [Continuous-infusion ketamine].

    Science.gov (United States)

    Mancini, P G; Caggese, G; Di Fabio, A; Di Nino, G F; Cocchi, V

    1980-08-01

    An investigation was made of the employment of ketamin as the sole anaesthetic in general surgery, using continuous infusion of a 1% solution for both induction and maintenance in 118 cases. ECG was monitored and arterial pressure was measured invasively. Central venous pressure was also determined in 10 cases. Changes in serum enzyme values during and after surgery were examined in 35 patients. Blood samples were withdrawn before induction, after the return to consciousness, and 24 hr after the operation. Side-effects were common, but slight. Five patients suffered from nightmares, but these were persons with marked imaginative activity and a melancholic nature. Cardiocirculatory function was satisfactory. In particular, peripheral perfusion was excellent in all cases.

  13. Infusion's greenfield subsidiary in Poland

    NARCIS (Netherlands)

    C. Williams; W. van Eerde; D. The

    2012-01-01

    The president of Infusion Development Corporation was reviewing the progress of the new subsidiary the company had set up 15 months earlier in Krakow, Poland. The purpose of the subsidiary was to work with other Infusion offices around the world to provide innovative software development services to

  14. The glucagon-like peptide-1 metabolite GLP-1-(9-36) amide reduces postprandial glycemia independently of gastric emptying and insulin secretion in humans

    DEFF Research Database (Denmark)

    Meier, Juris J; Gethmann, Arnica; Nauck, Michael A;

    2006-01-01

    Glucagon-like peptide 1 (GLP-1) lowers glycemia by modulating gastric emptying and endocrine pancreatic secretion. Rapidly after its secretion, GLP-1-(7-36) amide is degraded to the metabolite GLP-1-(9-36) amide. The effects of GLP-1-(9-36) amide in humans are less well characterized. Fourteen...... healthy volunteers were studied with intravenous infusion of GLP-1-(7-36) amide, GLP-1-(9-36) amide, or placebo over 390 min. After 30 min, a solid test meal was served, and gastric emptying was assessed. Blood was drawn for GLP-1 (total and intact), glucose, insulin, C-peptide, and glucagon measurements......-(7-36) amide administration]. GLP-1-(7-36) amide reduced fasting and postprandial glucose concentrations (P gastric emptying (P

  15. Application Analysis of Amiodarone Intravenous Infusion in the Treatment of Rapid Arrhythmia in the Treatment of%胺碘酮静脉滴注在急诊快速心律失常治疗中的应用分析

    Institute of Scientific and Technical Information of China (English)

    崔玉华

    2014-01-01

    Objetc ive To analyze the clinical effects and side effects in the treatment of rapid arrhythmia in the treat -ment of amiodarone intravenous drip.Methods 60 cases of patients with tachyarrhythmia , for the treatment of amioda-rone, and observe the changes of blood pressure , the analysis of cardiac index before and after the treatment of patients and treatment.Results After intravenous injection of amiodarone treatment , the total effective rate was 85%;a total of 6 cases of adverse reactions in patients with blood pressure , cardiac index;patients after treatment was significantly lower than that before treatment , the difference is obvious ( P<0.05 ).Conclusions Intravenous amiodarone in the treatment of patients with tachyarrhythmia , it has obvious curative effect, less adverse reaction , the patient side effects were mild , safe and reliable , and lower the cost of treatment to patients.%目的:分析胺碘酮静脉滴注在急诊快速心律失常治疗中的临床效果及不良反应。方法选取60例快速型心律失常患者,对其使用胺碘酮进行治疗,分析并观察患者治疗效果及治疗前后血压、心律等指标变化状况。结果经胺碘酮静脉滴注治疗,治疗总有效率为85.0%;共6例患者出现不良反应;患者治疗后的血压、心律指标显著低于治疗前,差异明显( P<0.05)。结论胺碘酮静脉滴注治疗快速型心律失常患者,具有显著的治疗效果,不良反应较小,对患者的毒副作用较轻,安全可靠,且治疗费用较低更易于患者接受。

  16. Phase I study of intravenous iododeoxyuridine as a clinical radiosensitizer

    International Nuclear Information System (INIS)

    Twenty-four patients with locally advanced (19 patients) or metastatic (5 patients) tumors were treated in a Phase I study combining constant intravenous infusions of iododeoxyuridine (IUdR) and hyperfractionated radiation therapy. IUdR was given as a constant infusion for 12 hours/day for two separate 14-day infusion periods in most patients. The dose of IUdR was escalated from 250 to 1200 mg/m2/12-hour infusion in this study. The initial tumor volume was treated to 45 Gy/1.5 Gy BID/3 weeks followed by a cone-down boost to 20-25 Gy/1.25 Gy BID/2 weeks after a planned 2-week break. THe IUdR infusion preceded the initial and cone-down irradiation by 1 week. Local acute toxicity (within the radiation volume) was uncommon and few patients required an alteration of the planned treatment schedule. Two patients developed late local toxicity with one patient showing clinical signs of radiation hepatitis and another patient developing a large bowel obstruction that required surgical bypass. Dose-limiting systemic toxicity was confined to the bone marrow with moderate to severe thrombocytopenia developing on Day 10-14 of infusions at 1200 mg/m2/12 hours. Mild stomatitis and partial alopecia occurred in some patients at this dose level. No systemic skin toxicity was seen. Pharmacology studies revealed steady-state arterial plasma levels of IUdR of 1 to 8 X 10(-6) M over the dose range used. In vivo IUdR incorporation into tumors was studied in three patients with high-grade sarcomas using an anti-IUdR monoclonal antibody and immunohistochemistry and demonstrated incorporation in up to 50-70% of tumor cells. The preliminary treatment results, particularly in patients with unresectable sarcomas, are encouraging

  17. Phase I study of intravenous iododeoxyuridine as a clinical radiosensitizer

    Energy Technology Data Exchange (ETDEWEB)

    Kinsella, T.J.; Russo, A.; Mitchell, J.B.; Collins, J.M.; Rowland, J.; Wright, D.; Glatstein, E.

    1985-11-01

    Twenty-four patients with locally advanced (19 patients) or metastatic (5 patients) tumors were treated in a Phase I study combining constant intravenous infusions of iododeoxyuridine (IUdR) and hyperfractionated radiation therapy. IUdR was given as a constant infusion for 12 hours/day for two separate 14-day infusion periods in most patients. The dose of IUdR was escalated from 250 to 1200 mg/m2/12-hour infusion in this study. The initial tumor volume was treated to 45 Gy/1.5 Gy BID/3 weeks followed by a cone-down boost to 20-25 Gy/1.25 Gy BID/2 weeks after a planned 2-week break. THe IUdR infusion preceded the initial and cone-down irradiation by 1 week. Local acute toxicity (within the radiation volume) was uncommon and few patients required an alteration of the planned treatment schedule. Two patients developed late local toxicity with one patient showing clinical signs of radiation hepatitis and another patient developing a large bowel obstruction that required surgical bypass. Dose-limiting systemic toxicity was confined to the bone marrow with moderate to severe thrombocytopenia developing on Day 10-14 of infusions at 1200 mg/m2/12 hours. Mild stomatitis and partial alopecia occurred in some patients at this dose level. No systemic skin toxicity was seen. Pharmacology studies revealed steady-state arterial plasma levels of IUdR of 1 to 8 X 10(-6) M over the dose range used. In vivo IUdR incorporation into tumors was studied in three patients with high-grade sarcomas using an anti-IUdR monoclonal antibody and immunohistochemistry and demonstrated incorporation in up to 50-70% of tumor cells. The preliminary treatment results, particularly in patients with unresectable sarcomas, are encouraging.

  18. Temocillin efficacy in experimental Klebsiella pneumoniae meningitis after infusion into rabbit plasma to simulate antibiotic concentrations in human serum.

    OpenAIRE

    Woodnutt, G.; Catherall, E J; Kernutt, I; Mizen, L

    1988-01-01

    An infusion system was developed to simulate in the plasma of rabbits the concentrations of temocillin in human serum measured after administration of a 2-g intravenous bolus dose. The efficacy of therapy with this infusion against experimental Klebsiella pneumoniae meningitis was compared with that of a conventional bolus dose to the animals. The marked difference between the elimination half-life (t1/2) of temocillin in rabbit plasma and human serum (0.3 and 5 h, respectively) was reflected...

  19. Transfer of Intestinal Microbiota From Lean Donors Increases Insulin Sensitivity in Individuals With Metabolic Syndrome

    NARCIS (Netherlands)

    Vrieze, A.; Nood, van E.; Holleman, F.; Heilig, G.H.J.; Zoetendal, E.G.; Vos, de W.M.

    2012-01-01

    Alterations in intestinal microbiota are associated with obesity and insulin resistance. We studied the effects of infusing intestinal microbiota from lean donors to male recipients with metabolic syndrome on the recipients' microbiota composition and glucose metabolism. Subjects were assigned rando

  20. Anaphylactic shock and cardiac arrest caused by thiamine infusion.

    Science.gov (United States)

    Juel, Jacob; Pareek, Manan; Langfrits, Christian Sigvald; Jensen, Svend Eggert

    2013-01-01

    Parenteral thiamine has a very high safety profile. The most common adverse effect is local irritation; however, anaphylactic or anaphylactoid reactions may occur, mostly related to intravenous administration. We describe a 44-year-old man, a chronic alcoholic, who was admitted with alcohol intoxication and developed cardiac arrest due to anaphylactic shock following intravenous thiamine infusion. The patient was successfully resuscitated after 15 min and repeated epinephrine administrations. He was discharged in good health after 14 days. This case report emphasises both the importance of recognising the symptoms of anaphylaxis and the fact that facilities for treating anaphylaxis and cardiopulmonary resuscitation should be available when thiamine or for that matter, any drug is given in-hospital. PMID:23853017

  1. Intravenous Fluid Generation System

    Science.gov (United States)

    McQuillen, John; McKay, Terri; Brown, Daniel; Zoldak, John

    2013-01-01

    The ability to stabilize and treat patients on exploration missions will depend on access to needed consumables. Intravenous (IV) fluids have been identified as required consumables. A review of the Space Medicine Exploration Medical Condition List (SMEMCL) lists over 400 medical conditions that could present and require treatment during ISS missions. The Intravenous Fluid Generation System (IVGEN) technology provides the scalable capability to generate IV fluids from indigenous water supplies. It meets USP (U.S. Pharmacopeia) standards. This capability was performed using potable water from the ISS; water from more extreme environments would need preconditioning. The key advantage is the ability to filter mass and volume, providing the equivalent amount of IV fluid: this is critical for remote operations or resource- poor environments. The IVGEN technology purifies drinking water, mixes it with salt, and transfers it to a suitable bag to deliver a sterile normal saline solution. Operational constraints such as mass limitations and lack of refrigeration may limit the type and volume of such fluids that can be carried onboard the spacecraft. In addition, most medical fluids have a shelf life that is shorter than some mission durations. Consequently, the objective of the IVGEN experiment was to develop, design, and validate the necessary methodology to purify spacecraft potable water into a normal saline solution, thus reducing the amount of IV fluids that are included in the launch manifest. As currently conceived, an IVGEN system for a space exploration mission would consist of an accumulator, a purifier, a mixing assembly, a salt bag, and a sterile bag. The accumulator is used to transfer a measured amount of drinking water from the spacecraft to the purifier. The purifier uses filters to separate any air bubbles that may have gotten trapped during the drinking water transfer from flowing through a high-quality deionizing cartridge that removes the impurities in

  2. Pharmacokinetics of oral and intravenous melatonin in healthy volunteers

    DEFF Research Database (Denmark)

    Andersen, Lars P H; Werner, Mads U; Rosenkilde, Mette M;

    2016-01-01

    BACKGROUND: The aim was to investigate the pharmacokinetics of oral and iv melatonin in healthy volunteers. METHODS: The study was performed as a cohort crossover study. The volunteers received either 10 mg oral melatonin or 10 mg intravenous melatonin on two separate study days. Blood samples were...... collected at different time points following oral administration and short iv infusion, respectively. Plasma melatonin concentrations were determined by RIA technique. Pharmacokinetic analyses were performed by "the method of residuals" and compartmental analysis. The pharmacokinetic variables: k a, t 1...... max after short iv infusion of melatonin was 389,875.0 (174,775.0-440,362.5) pg ml(-1). Mean t 1/2 elimination was 39.4 (3.6) min, mean V d 1.2 (0.6) l kg(-1) and mean CL 0.0218 (0.0102) l min(-1) kg(-1). CONCLUSIONS: This cohort crossover study estimated pharmacokinetics of oral and iv melatonin...

  3. [Experiences with intravenous sulprostone administration in massive postpartal hemorrhage].

    Science.gov (United States)

    Schönegg, W; Wessel, J; Schmidt-Gollwitzer, K

    1987-11-01

    Forty-three patients at the University Gynecology Clinic in Charlottenburg were given the prostaglandin E2 derivative sulprostone for severe postpartal hemorrhage. It was administered intravenously in a dose of 1.7 mcg/min (100 mcg/100 ml/h), with short-term increases to three times this amount in isolated cases. The drug proved highly efficacious (rapid onset and lasting effect). In 80% of the cases there were no side effects. Rises in body temperature occurred in six patients and in one patient a venous irritation developed in the arm into which the drug was infused. An RDS occurred, though it was considered that there was not necessarily a causal connection between this and the sulprostone infusion. In the authors' experience this drug has an established place in the treatment of atonic postpartal hemorrhage emergencies.

  4. Intravenous pamidronate in the treatment of osteoporosis associated with corticosteroid dependent lung disease: an open pilot study.

    OpenAIRE

    Gallacher, S. J.; Fenner, J A; Anderson, K.; Bryden, F M; Banham, S W; Logue, F C; Cowan, R. A.; Boyle, I T

    1992-01-01

    BACKGROUND: Bisphosphonates have been shown to be effective agents in the treatment of postmenopausal osteoporosis. Because corticosteroid associated osteoporosis is often associated with increased bone turnover, the effect of intermittent intravenous infusions of pamidronate on this condition has been investigated. METHODS: Seventeen patients (five male) with chronic corticosteroid dependent lung disease (15 asthma, two sarcoidosis) were treated with infusions of 30 mg pamidronate once every...

  5. Effect of intravenous dexmedetomidine (1 and micro;g/kg) in obtunding the pressor response to laryngoscopy and tracheal intubation compared to intravenous preservative free 2% lignocaine (1.5mg/kg)

    OpenAIRE

    Saibaba Samala; Pradeep S. Indurkar

    2016-01-01

    Background: Haemodynamic variation during layngoscopy/intubation is always a matter of concern for Anesthesiologists. A stable circulatory system is the wish of all performing general anaesthesia. Hence an acceptable and easy method needs to be established to prevent the haemodynamic variations. Our aim was to evaluate the effect of intravenous Dexmedetomidine (1 and micro;g/kg) infusion in obtunding the pressor response to laryngoscopy and tracheal intubation compared to intravenous preserva...

  6. Successful treatment of refractory Trichomonas vaginalis infection using intravenous metronidazole.

    Science.gov (United States)

    Hawkins, Isobel; Carne, Christopher; Sonnex, Christopher; Carmichael, Andrew

    2015-08-01

    Trichomonas vaginalis is a sexually transmitted protozoan infection resulting in a vulvo-vaginitis and altered vaginal discharge in symptomatic women. Since its introduction in the 1960 s, metronidazole has been the first-line drug for trichomonal infection. Other nitroimidazoles, such as tinidazole, are used as alternative regimens with similar activity but at a greater expense. Treatment failure usually represents patient non-compliance or reinfection, although metronidazole resistance has previously been documented. Sensitivity testing is currently not available in the UK. Patients with disease unresponsive to first-line treatments pose a major challenge, as therapeutic options are limited. This case looks at a patient with refractory disease over an 18-month period, where intravenous infusion of metronidazole resulted in cure after multiple previous therapy failures. There is limited evidence to endorse the use of intravenous metronidazole, and this case report provides further support for its efficacy.

  7. Insulin infusion reduces hepatocyte growth factor in lean humans

    DEFF Research Database (Denmark)

    de Courten, Barbora; de Courten, Maximilian; Dougherty, Sonia;

    2013-01-01

    OBJECTIVE: Plasma Hepatocyte Growth Factor (HGF) is significantly elevated in obesity and may contribute to vascular disease, metabolic syndrome or cancer in obese individuals. The current studies were done to determine if hyperinsulinemia increases plasma HGF. MATERIALS/METHODS: Twenty-two parti...

  8. Treatment of Severe Hypertriglyceridemia with Continuous Insulin Infusion

    OpenAIRE

    Yesica Rodríguez Santana; Andrea Nimo Román; Iker García Sáez; José Manuel López Alvarez; Eduardo Consuegra Llapur; Rafael González Jorge

    2011-01-01

    Severe hypertriglyceridemia (SH) represents a therapeutic emergency because of the possibility of developing cardiovascular events and hyperlipemic acute pancreatitis (PA). Most patients with SH suffer primary or genetic abnormality in lipid metabolism in combination with a precipitating factor such as uncontrolled diabetes mellitus, alcoholism, and drug intake. The standard treatment of hypertriglyceridemia (HTG) with omega 3 fatty acids and fibrates, along with dietary changes, has no effec...

  9. Technical hazards of using nutritive mixtures in bags for cyclical intravenous nutrition: comparison with standard intravenous nutrition in 48 gastroenterological patients.

    OpenAIRE

    Messing, B.; Beliah, M; Girard-Pipau, F; Leleve, D; Bernier, J J

    1982-01-01

    Three methods for dispensing nutritional solutions are compared in 48 patients with gastrointestinal diseases on intravenous nutrition during 3582 days. The protocol for intravenous nutrition applied by the nursing team and the solutions used were the same in the three groups. In group A standard bottles were used, while in group B, 31PVC-disposable bags were used--with fat emulsion included (group B1) or with fat excluded (group B2). When fat was excluded from the bags it was infused separat...

  10. Newer insulin analogues and inhaled insulin

    OpenAIRE

    Girish C; Manikandan S; Jayanthi M

    2006-01-01

    Diabetes is a metabolic disease with high prevalence worldwide. Exogenous insulin is used in the management of this condition. The development of human insulin has provided tighter control of glycaemia in diabetic patients. Insulin analogues like insulin lispro and aspart were developed to closely match its profile with physiological secretion. The newer additions to this armamentarium are insulin glulisine, insulin detemir and albulin.Insulin glulisine is a short acting analogue with a rapid...

  11. Intravenous heparin dosing strategy in hospitalized patients with atrial dysrhythmias.

    Science.gov (United States)

    Roswell, Robert O; Greet, Brian; Shah, Sunny; Bernard, Samuel; Milin, Alexandra; Lobach, Iryna; Guo, Yu; Radford, Martha J; Berger, Jeffrey S

    2016-08-01

    Patients with non-valvular atrial fibrillation (AF) have an elevated stroke risk that is 2-7 times greater than in those without AF. Intravenous unfractionated heparin (UFH) is commonly used for hospitalized patients with atrial fibrillation and atrial flutter (AFL) to prevent stroke. Dosing strategies exist for intravenous anticoagulation in patients with acute coronary syndromes and venous thromboembolic diseases, but there are no data to guide providers on a dosing strategy for intravenous anticoagulation in patients with AF/AFL. 996 hospitalized patients with AF/AFL on UFH were evaluated. Bolus dosing and initial infusion rates of UFH were recorded along with rates of stroke, thromboemobolic events, and bleeding events as defined by the International Society on Thrombosis and Haemostasis criteria. Among 226 patients included in the analysis, 76 bleeding events occurred. Using linear regression analysis, initial rates of heparin infusion ranging from 9.7 to 11.8 units/kilogram/hour (U/kg/h) resulted in activated partial thromboplastin times that were within therapeutic range. The median initial infusion rate in patients with bleeding was 13.3 U/kg/h, while in those without bleeding it was 11.4 U/kg/h; p = 0.012. An initial infusion rate >11.0 U/kg/h yielded an OR 1.95 (1.06-3.59); p = 0.03 for any bleeding event. Using IV heparin boluses neither increased the probability of attaining a therapeutic aPTT (56.1 vs 56.3 %; p = 0.99) nor did it significantly increase bleeding events in the study (35.7 vs 31.3 %; p = 0.48). The results suggest that higher initial rates of heparin are associated with increased bleeding risk. From this dataset, initial heparin infusion rates of 9.7-11.0 U/kg/h without a bolus can result in therapeutic levels of anticoagulation in hospitalized patients with AF/AFL without increasing the risk of bleeding. PMID:26951166

  12. Safety and feasibility of countering neurological impairment by intravenous administration of autologous cord blood in cerebral palsy

    Directory of Open Access Journals (Sweden)

    Lee Young-Ho

    2012-03-01

    Full Text Available Abstract Backgrounds We conducted a pilot study of the infusion of intravenous autologous cord blood (CB in children with cerebral palsy (CP to assess the safety and feasibility of the procedure as well as its potential efficacy in countering neurological impairment. Methods Patients diagnosed with CP were enrolled in this study if their parents had elected to bank their CB at birth. Cryopreserved CB units were thawed and infused intravenously over 10~20 minutes. We assessed potential efficacy over 6 months by brain magnetic resonance imaging (MRI-diffusion tensor imaging (DTI, brain perfusion single-photon emission computed tomography (SPECT, and various evaluation tools for motor and cognitive functions. Results Twenty patients received autologous CB infusion and were evaluated. The types of CP were as follows: 11 quadriplegics, 6 hemiplegics, and 3 diplegics. Infusion was generally well-tolerated, although 5 patients experienced temporary nausea, hemoglobinuria, or urticaria during intravenous infusion. Diverse neurological domains improved in 5 patients (25% as assessed with developmental evaluation tools as well as by fractional anisotropy values in brain MRI-DTI. The neurologic improvement occurred significantly in patients with diplegia or hemiplegia rather than quadriplegia. Conclusions Autologous CB infusion is safe and feasible, and has yielded potential benefits in children with CP.

  13. Human insulin dynamics in women: a physiologically based model.

    Science.gov (United States)

    Weiss, Michael; Tura, Andrea; Kautzky-Willer, Alexandra; Pacini, Giovanni; D'Argenio, David Z

    2016-02-01

    Currently available models of insulin dynamics are mostly based on the classical compartmental structure and, thus, their physiological utility is limited. In this work, we describe the development of a physiologically based model and its application to data from 154 patients who underwent an insulin-modified intravenous glucose tolerance test (IM-IVGTT). To determine the time profile of endogenous insulin delivery without using C-peptide data and to evaluate the transcapillary transport of insulin, the hepatosplanchnic, renal, and peripheral beds were incorporated into the circulatory model as separate subsystems. Physiologically reasonable population mean estimates were obtained for all estimated model parameters, including plasma volume, interstitial volume of the peripheral circulation (mainly skeletal muscle), uptake clearance into the interstitial space, hepatic and renal clearance, as well as total insulin delivery into plasma. The results indicate that, at a population level, the proposed physiologically based model provides a useful description of insulin disposition, which allows for the assessment of muscle insulin uptake.

  14. Effect of tumor necrosis factor-alpha infusion on the incretin effect in healthy volunteers

    DEFF Research Database (Denmark)

    Nielsen, Signe Tellerup; Lehrskov-Schmidt, Louise; Krogh-Madsen, Rikke;

    2013-01-01

    Type 2 diabetes mellitus (T2DM) is associated with peripheral insulin resistance, impaired incretin effect, and increased plasma levels of tumor necrosis factor-alpha (TNF-α). Whereas TNF-α infusion at a dose that induces systemic inflammation in healthy volunteers has been demonstrated to induce...

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

    DEFF Research Database (Denmark)

    Høeg, Louise D; Sjøberg, Kim Anker; Jeppesen, Jacob;

    2011-01-01

    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

  16. 静脉输注核黄素致新生儿局部不良反应的观察和护理体会%Observation and nursing experience on the local adverse reactions of the newborn induced by the intravenous infusion of riboflavin

    Institute of Scientific and Technical Information of China (English)

    杨妩媚

    2014-01-01

    Objective:to grasp the treatment methods for the new born after the use of the riboflavin subcutaneous fluid extravasations.Methods:to pose an individualized use of hirudoid ointment,phento lamine,and magnesium sulfate on the newborn according to the concrete situations.Results:the selected pa-tients received good Results:and no scarring.Conclusions:infusing the riboflavin sodium phosphate to the newborn is prone to the local adverse reactions.But through the active observation and reasonable care measures,the patient newborn can achieve good results.%目的:针对新生儿使用核黄素后液体皮下外渗,了解处理的方法。方法:根据具体反映情况,针对性使用喜疗妥软膏,酚妥拉明,硫酸镁等。结果:所选病例均取的良好效果,无疤痕形成。结论:新生儿输注核黄素磷酸钠容易发生局部不良反应,但通过积极的观察和合理的护理措施,都能取得良好的效果。

  17. 静脉输注核黄素致新生儿局部不良反应的观察和护理体会%Observation and nursing experience on the local adverse reactions of the newborn induced by the intravenous infusion of riboflavin

    Institute of Scientific and Technical Information of China (English)

    杨妩媚

    2014-01-01

    目的:针对新生儿使用核黄素后液体皮下外渗,了解处理的方法。方法根据具体反应情况,针对性使用多磺酸粘多糖乳膏、酚妥拉明、硫酸镁等。结果所选病例均取得良好效果,无瘢痕形成。结论新生儿输注核黄素磷酸钠容易发生局部不良反应,但通过积极的观察和合理的护理措施,都能取得良好的效果。%Objective To grasp the treatment methods for the new born after the use of the riboflavin subcutaneous fluid extravasations.Methods To pose an individualized use of hirudoid ointment, phento lamine, and magnesium sulfate on the newborn according to the concrete situations.Results The selected patients received good results and no scarring.Conclusion Infusing the riboflavin sodium phosphate to the newborn is prone to the local adverse reactions. But through the active observation and reasonable care measures, the patient newborn can achieve good results.

  18. Anti-insulin antibody test

    Science.gov (United States)

    Insulin antibodies - serum; Insulin Ab test; Insulin resistance - insulin antibodies; Diabetes - insulin antibodies ... You appear to have an allergic response to insulin Insulin no longer seems to control your diabetes

  19. 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)

    Storgaard, Heidi; Jensen, Christine B; Björnholm, Marie;

    2004-01-01

    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 ...

  20. Continuous Regional Arterial Infusion Therapy for Acute Necrotizing Pancreatitis Due to Mycoplasma pneumoniae Infection in a Child

    International Nuclear Information System (INIS)

    A case of acute necrotizing pancreatitis due to Mycoplasma pneumoniae infection was treated in an 8-year-old girl. She experienced acute pancreatitis during treatment for M. pneumoniae. Contrast-enhanced computed tomographic scan revealed necrotizing pancreatitis. The computed tomographic severity index was 8 points (grade E). A protease inhibitor, ulinastatin, was provided via intravenous infusion but was ineffective. Continuous regional arterial infusion therapy was provided with gabexate mesilate (FOY-007, a protease inhibitor) and meropenem trihydrate, and the pancreatitis improved. This case suggests that infusion therapy is safe and useful in treating necrotizing pancreatitis in children.

  1. Prolonged fever after Infliximab infusion

    Institute of Scientific and Technical Information of China (English)

    Jennifer; Katz; Michael; Frank

    2012-01-01

    Pharmacologic management for ulcerative colitis (UC) has recently been expanded to include antitumor necrosis factor (TNF) therapy for severe disease. Infliximab, a chimeric monoclonal antibody directed again TNF α was first tested in patients with Crohn’s disease. In addition to serious infections, malignancy, drug induced lupus and other autoimmune diseases, serum sickness-like reactions, neurological disease, and infusion reactions further complicate the use of Infliximab. We report a case of prolonged fever after Infliximab infusion to treat steroid refractory UC.

  2. Use of insulin in diabetes: a century of treatment.

    Science.gov (United States)

    Shahani, Savita; Shahani, Lokesh

    2015-12-01

    Insulin is a key player in the control of hyperglycaemia for patients with type 1 diabetes mellitus and selected patients with type 2 diabetes mellitus. There have been many advances in insulin drug delivery from its first administration as a crude pancreatic extract till today. The traditional and most predictable method for administration of insulin is by subcutaneous injection. Currently available insulin delivery systems include insulin syringes, infusion pumps, jet injectors, and pens. The major drawback of insulin therapy is its invasive nature. Non-invasive delivery of insulin has long been a major goal for the treatment of diabetes mellitus. Although there have been improvements in insulin therapy since it was first conceived, it is still far from mimicking the physiological secretion of pancreatic β-cells, and research to find new insulin formulations and new routes of administration continues. This article reviews the emerging technologies, including insulin inhalers, insulin buccal spray, insulin pill, islet cell transplant, and stem cell therapy, as treatment options for diabetes mellitus.

  3. Ultrasonography versus intravenous urography

    International Nuclear Information System (INIS)

    The present study was performed to compare the clinical value of urography and ultrasonography in a non-selected group of patients referred for urography to a university hospital. The conslusions and clinical implications of the study are as follows: Intravenous urography remains the cornerstone imaging examination in the evaluation of ureteral calculi. Ultrasonography is a valuable adjunct in cases of non- visualization of the kidneys, in distal obstruction and known contrast media allergy. When women with recurrent urinary tract infection are referred for imaging of the urinary tract, ultrasonography should be used. Ultrasonography should replace urography for screening of non-acute hydronephrosis like in female genital cancer and benign prostate hyperplasia. There is good correlation between urography and ultrasonography in assessing the degree of hydronephrosis. However, more researh on the relationship between hydronephrosis and obstruction is necessary. Ultrasonography should be used as the only imaging method of the upper urinary tract in patients with microscopic hematuria. In patients less than 50 years with macroscopic hematuria, ultrasonography should be used as the only imaging of the upper urinary tract, and an examination of the urinary bladder should be included. In patients over 50 years, urography supplied with ultrasonography should be used, but more research is necessary on the subject of imaging method and age. 158 refs

  4. Sup(13)C NMR studies of glucose disposal in normal and non-insulin-dependent diabetic humans

    International Nuclear Information System (INIS)

    To examine the extent to which the defect in insulin action in subjects with non-insulin-dependent diabetes mellitus (NIDDM) can be accounted for by impairment of muscle glycogen synthesis, we performed combined hyperglycemic-hyperinsulinemic clamp studies with [13C]glucose in five subjects with NIDDM and in six age- and weight-matched healthy subjects. The rate of incorporation of intravenously infused [1-13C]glucose into muscle glycogen was measured directly in the gastrocnemius muscle by means of a nuclear magnetic resonance (NMR) spectrometer with a 15.5 min time resolution and a 13C surface coil. The steady-state plasma concentrations of insulin and glucose were similar in both study groups. The mean (±SE) rate of glycogen synthesis, as determined by 13C NMR, was 78±28 and 183±39 μmol-glucosyl units (kg muscle tissue (wet mass))-1 min-1 in the diabetic and normal subjects, respectively. The mean glucose uptake was markedly reduced in the diabetic as compared with the normal subjects. The mean rate of non-oxidative glucose metabolism was 22±4 μmol kg-1 min-1 in the diabetic subjects and 42±4 μmol kg-1 min-1 in the normal subjects. When these rates are extrapolated to apply to the whole body, the synthesis of muscle glycogen would account for most of the total-body glucose uptake and all of the non-oxidative glucose metabolism in both normal and diabetic subjects. We conclude that muscle glycogen synthesis is the principal pathway of glucose disposal in both normal and diabetic subjects and that defects in muscle glycogen synthesis have a dominant role in the insulin resistance that occurs in persons with NIDDM. (author)

  5. Summarize Nursing Experience of the Tumor Patients by Using Auto Chemotherapy Pump Continuous Intravenous Infusion in 5-FU (5-fluorouracil)Chemotherapy%总结肿瘤患者应用全自动化疗泵持续静脉输注5-FU(5-氟尿嘧啶)化疗的护理经验

    Institute of Scientific and Technical Information of China (English)

    魏美霞

    2013-01-01

    Objective:To observe the fully automatic continuous chemotherapy pump infusion of 5-FU(5-fluorouracil)chemotherapy in tumor patients,summarize nursing experience in the use of automatic chemotherapy pump.Method:70 cases patients with using automatic chemotherapy pump continuous infusion of 5-FU chemotherapy were given clinical care packet observation,the observation group was given health education path table during chemotherapy nursing,the intervention control group was given traditional health education.Compared patients during chemotherapy toxicity and nursing satisfaction.Result:The observation group during chemotherapy toxicity was significantly less than that of the control group,the difference was satistically significant between the groups(P<0.01),discharge patient care satisfaction of the observation group was higher than that in the control group,the difference was statistically significant between the groups(P<0.01).Conclusion:Health education path table nursing intervention during chemotherapy can reduce various toxicities during chemotherapy and improve patient satisfaction with care work.%  目的:观察全自动化疗泵持续静脉输注5-FU(5-氟尿嘧啶)化疗在肿瘤患者中的应用,总结全自动化疗泵使用中的护理经验。方法:对70例使用全自动化疗泵持续静脉输注5-FU化疗的患者进行临床护理分组观察,观察组采用健康教育路径表进行化疗期间的护理干预,对照组采用传统健康宣教。对两组患者化疗过程中的毒副反应以及护理满意度进行比较。结果:观察组化疗期间出现的毒副反应明显少于对照组,比较差异有统计学意义(P<0.01),出院时患者对护理满意度观察组亦高于对照组,比较差异有统计学意义(P<0.01)。结论:采用健康教育路径表进行化疗期间的护理干预,能够减少化疗期间的各类毒副反应,并提高患者对护理工作的满意度。

  6. Acute kidney injury due to single time overdosage intravenous infusion of amoxicillin and clavulanate potassium:report of 2 cases%单次超剂量静脉滴注阿莫西林克拉维酸钾致急性肾损伤2例

    Institute of Scientific and Technical Information of China (English)

    李心蕾; 唐红波; 冯欣

    2016-01-01

    Two female patients who aged 42 and 33 years with adenomyosis and hysteromyoma, respectively were hospitalized for surgical treatment. They had not history of kidney disease. They developed the symptoms of nausea,vomit,hematuresis,hypourocrinia,and slight puffy swelling after the second and fourth times of IV infusion of amoxicillin and clavulanate potassium 2. 4 g,respectively. Laboratory examination showed the increase of serum creatinine( Scr)and urea nitrogen( BUN)( case 1:Scr 423μmol/ L,BUN 7. 2 mmol/ L;case 2:Scr 443 μmol/ L,BUN 6. 8 mmol/ L). Amoxicillin and clavulanate potassium were stopped to use in both patients immediately and symptomatic treatments which included those for relieving vomiting,hemostasis,diuresis,and fluid infusion were given to them. The two patients were transferred to another hospital' s nephrology department for hemodialysis on day 5 and 3 of receiving amoxicillin and clavulanate potassium,respectively. The two patients' urine volume,levels of Scr and BUN were returned to normal on day 18 and 20 after transferring,respectively(case 1:Scr 49 μmol/ L,BUN 4. 1 mmol/ L;case 2:Scr 55 μmol/ L,BUN 5. 1mmol/ L).%2例女性患者(年龄分别为42和33岁)分别因子宫腺肌症和子宫肌瘤入院手术治疗,均无肾病史,分别于第2和第4次静脉滴注阿莫西林克拉维酸钾2.4 g 后出现恶心、呕吐、血尿、尿量减少、轻度水肿等症状,实验室检查示 Scr 和 BUN 异常(例1:Scr 423μmol/ L,BUN 7.2 mmol/ L;例2:Scr 443μmol/ L,BUN 6.8 mmol/ L)。2例患者均立即停用阿莫西林克拉维酸钾,接受止吐、止血、利尿和补液等对症治疗,并分别于用药后第5和第3天转外院肾内科进行血液透析。2例患者的尿量、Scr和 BUN 分别于转院后第18和第20天恢复正常(例1:Scr 49μmol/ L,BUN 4.1 mmol/ L;例2:Scr 55μmol/ L,BUN 5.1 mmol/ L)。

  7. Systemic and regional hemodynamic effects of enalaprilat infusion in experimental normotensive sepsis

    Directory of Open Access Journals (Sweden)

    L. Rahal

    2006-09-01

    Full Text Available Angiotensin-converting enzyme inhibitors have been shown to improve splanchnic perfusion in distinct shock states. We hypothesized that enalaprilat potentiates the benefits of early fluid resuscitation in severe experimental sepsis, particularly in the splanchnic region. Anesthetized and mechanically ventilated mongrel dogs received an intravenous infusion of live Escherichia coli over a period of 30 min. Thereafter, two interventions were performed: fluid infusion (normal saline, 32 mL/kg over 30 min and enalaprilat infusion (0.02 mg kg-1 min-1 for 60 min in randomized groups. The following groups were studied: controls (fluid infusion, N = 4, E1 (enalaprilat infusion followed by fluid infusion, N = 5 and E2 (fluid infusion followed by enalaprilat infusion, N = 5. All animals were observed for a 120 min after bacterial infusion. Mean arterial pressure, cardiac output (CO, portal vein blood flow (PVBF, systemic and regional oxygen-derived variables, and lactate levels were measured. Rapid and progressive reductions in CO and PVBF were induced by the infusion of live bacteria, while minor changes were observed in mean arterial pressure. Systemic and regional territories showed a significant increase in oxygen extraction and lactate levels. Widening venous-arterial and portal-arterial pCO2 gradients were also detected. Fluid replacement promoted transient benefits in CO and PVBF. Enalaprilat after fluid resuscitation did not affect systemic or regional hemodynamic variables. We conclude that in this model of normotensive sepsis inhibition of angiotensin-converting enzyme did not interfere with the course of systemic or regional hemodynamic and oxygen-derived variables.

  8. Home infusion program for Fabry disease: experience with agalsidase alfa in Argentina

    Directory of Open Access Journals (Sweden)

    Isaac Kisinovsky

    2013-02-01

    Full Text Available Fabry disease is an X-linked lysosomal storage disorder caused by inherited deficiency of the enzyme α-galactosidase A. Enzyme replacement treatment using agalsidase alfa significantly reduces pain, improves cardiac function and quality of life, and slows renal deterioration. Nevertheless, it is a life-long treatment which requires regular intravenous infusions and entails a great burden for patients. Our objective was to evaluate retrospectively the safety and tolerability of the home infusion of agalsidase alfa in patients with Fabry disease in Argentina. We evaluated all the patients with Fabry disease who received home infusion with agalsidase alfa 0.2 mg/kg between January 2005 and June 2011. The program included 87 patients; 51 males (mean age: 30 years and 36 females (mean age: 34 years. A total of 5229 infusions (mean: 59 per patient; range: 1-150 were administered. A total of 5 adverse reactions were seen in 5 patients (5.7% of patients and 0.9% of the total number of infusions. All were mild in severity and resolved by reducing the rate of infusion and by using antihistaminics. All these 5 patients were positive for IgG antibodies, but none of them presented IgE antibodies and none suffered an anaphylactic shock. In our group 18 patients were switched from agalsidase beta to agalsidase alfa without complications. Home infusion with agalsidase alfa is safe, well tolerated and is associated to high compliance.

  9. Insulin Receptor Antibody-α-N-Acetylglucosaminidase Fusion Protein Penetrates the Primate Blood-Brain Barrier and Reduces Glycosoaminoglycans in Sanfilippo Type B Fibroblasts.

    Science.gov (United States)

    Boado, Ruben J; Lu, Jeff Zhiqiang; Hui, Eric Ka-Wai; Lin, Huilan; Pardridge, William M

    2016-04-01

    Mucopolysaccharidosis Type IIIB (MPSIIIB) is caused by mutations in the gene encoding the lysosomal enzyme, α-N-acetylglucosaminidase (NAGLU). MPSIIIB presents with severe disease of the central nervous system, but intravenous NAGLU enzyme replacement therapy has not been developed because the NAGLU enzyme does not cross the blood-brain barrier (BBB). A BBB-penetrating form of the enzyme was produced by re-engineering NAGLU as an IgG-enzyme fusion protein, where the IgG domain is a monoclonal antibody (mAb) against the human insulin receptor (HIR). The HIRMAb traverses the BBB via transport on the endogenous insulin receptor and acts as a molecular Trojan horse to ferry the fused NAGLU across the BBB from blood. The NAGLU was fused to the carboxyl terminus of each heavy chain of the HIRMAb via an extended 31-amino acid linker, and the fusion protein is designated HIRMAb-LL-NAGLU. The fusion protein retains high affinity binding to the HIR, and on a molar basis has an enzyme activity equal to that of recombinant human NAGLU. Treatment of MPSIIIB fibroblasts with the fusion protein normalizes intracellular NAGLU enzyme activity and reduces sulfate incorporation into intracellular glycosoaminoglycan. The fusion protein is targeted to the lysosomal compartment of the cells as shown by confocal microscopy. The fusion protein was radiolabeled with the [(125)I]-Bolton-Hunter reagent and injected intravenously in the adult Rhesus monkey. The fusion protein was rapidly cleared from plasma by all major peripheral organs. The high brain uptake of the fusion protein, 1% injected dose/brain, enables normalization of brain NAGLU enzyme activity with a therapeutic dose of 1 mg/kg. The HIRMAb-LL-NAGLU fusion protein is a new treatment of the brain in MPSIIIB, which can be administered by noninvasive intravenous infusion. PMID:26910785

  10. Hypersensitivity reactions to intravenous iron: guidance for risk minimization and management

    Science.gov (United States)

    Rampton, David; Folkersen, Joergen; Fishbane, Steven; Hedenus, Michael; Howaldt, Stefanie; Locatelli, Francesco; Patni, Shalini; Szebeni, Janos; Weiss, Guenter

    2014-01-01

    Intravenous iron is widely used for the treatment of iron deficiency anemia when oral iron is inappropriate, ineffective or poorly tolerated. Acute hypersensitivity reactions during iron infusions are very rare but can be life-threatening. This paper reviews their frequency, pathogenesis and risk factors, and provides recommendations about their management and prevention. Complement activation-related pseudo-allergy triggered by iron nanoparticles is probably a more frequent pathogenetic mechanism in acute reactions to current formulations of intravenous iron than is an immunological IgE-mediated response. Major risk factors for hypersensitivity reactions include a previous reaction to an iron infusion, a fast iron infusion rate, multiple drug allergies, severe atopy, and possibly systemic inflammatory diseases. Early pregnancy is a contraindication to iron infusions, while old age and serious co-morbidity may worsen the impact of acute reactions if they occur. Management of iron infusions requires meticulous observation, and, in the event of an adverse reaction, prompt recognition and severity-related interventions by well-trained medical and nursing staff. PMID:25420283

  11. Early enhancements of hepatic and later of peripheral insulin sensitivity combined with increased postprandial insulin secretion contribute to improved glycemic control after Roux-en-Y gastric bypass

    DEFF Research Database (Denmark)

    Bojsen-Møller, Kirstine N; Dirksen, Carsten; Jørgensen, Nils Bruun;

    2014-01-01

    to an intravenous glucose-glucagon challenge as well as an oral glucose load. Already within 1 week, RYGB reduced basal glucose production, improved basal hepatic insulin sensitivity and increased insulin clearance highlighting the liver as an important organ responsible for the early effects on glucose metabolism...

  12. Anestesia venosa total em infusão alvo-controlada associada a bloqueio do nervo femoral para meniscectomia do joelho por acesso artroscópico Anestesia venosa total en infusión objeto-controlada asociada al bloqueo del nervio femoral para meniscectomía de la rodilla por acceso artroscópico Target-controlled total intravenous anesthesia associated with femoral nerve block for arthroscopic knee meniscectomy

    Directory of Open Access Journals (Sweden)

    Fernando Squeff Nora

    2009-04-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: O aumento da popularidade de técnicas operatórias minimamente invasivas reduziu os tempos de recuperação de procedimentos que, anteriormente, eram associados a período de internação longo. Este trabalho apresenta técnica de anestesia geral venosa total com propofol e remifentanil combinada a bloqueio do nervo femoral, por acesso perivascular inguinal. MÉTODO: Foram incluídos 90 pacientes submetidos à artroscopia do joelho para meniscectomias. A indução anestésica foi feita com propofol em infusão alvo-controlada (IAC (alvo = 4 µg.mL-1 e com remifentanil em IAC (alvo = 3 ng.mL-1. As alterações das concentrações de propofol e remifentanil eram realizadas de acordo com a eletroencefalografia bispectral (BIS e a pressão arterial média (PAM. A ventilação era mecânica e controlada a volume e a via aérea mantida com máscara laríngea. Os valores das concentrações no local efetor de propofol e remifentanil eram obtidos através dos modelos farmacocinéticos dos fármacos, inseridos nas bombas de IAC e corresponderam a concentrações preditivas. Local efetor refere-se à área de ação dos fármacos. O tempo de alta hospitalar compreendeu o espaço de tempo entre a chegada do paciente na sala de recuperação até o momento da alta. RESULTADOS: As concentrações médias no local efetor (ng.mL-1, máximas e mínimas, de remifentanil foram de 3,5 e 2,4, respectivamente. As concentrações médias no local efetor (µg.mL-1, máximas e mínimas de propofol, foram respectivamente de 3,1 e 2,6. A vazão média de infusão de propofol e de remifentanil foi de 8,54 mg.kg-1.h-1 e de 0,12 µg.kg-1.min-1 , respectivamente. Os tempos de alta hospitalar foram, em média, de 180min. CONCLUSÕES: Todos os pacientes foram mantidos dentro dos parâmetros estabelecidos.JUSTIFICATIVA Y OBJETIVOS: El aumento de la popularidad de técnicas operatorias mínimamente invasivas, redujo los tiempos de recuperación de

  13. Morphine, morphine-6-glucuronide and morphine-3-glucuronide pharmacokinetics in newborn infants receiving diamorphine infusions

    OpenAIRE

    Barrett, D A; Barker, D. P.; N. Rutter; Pawula, M.; Shaw, P N

    1996-01-01

    1The pharmacokinetics of morphine, morphine-6-glucuronide (M6G) and morphine-3-glucuronide (M3G) were studied in 19 ventilated newborn infants(24–41 weeks gestation) who were given a loading dose of 50 μg kg−1 or 200 μg kg−1 of diamorphine followed by an intravenous infusion of 15 μg kg−1 h−1 of diamorphine. Plasma concentrations of morphine, M3G and M6G were measured during the accrual to steady-state and at steady state of the diamorphine infusion.

  14. Influence of circulating epinephrine on absorption of subcutaneously injected insulin

    International Nuclear Information System (INIS)

    Effects of epinephrine (Epi) infusion on the absorption of subcutaneously injected 125I-labeled soluble human insulin (10 U) from the thigh or the abdomen were studied in 16 healthy subjects and from the thigh in 10 insulin-dependent diabetic (IDDM) patients. Epi was infused at 0.3 (high dose) or 0.1 (low dose; healthy subjects) nmol.kg-1.min-1 i.v., resulting in arterial plasma Epi levels of approximately 6 and 2 nM, respectively. Saline was infused on a control day. Insulin absorption was measured as disappearance of radioactivity from the injection site and as appearance of plasma immunoreactive insulin (IRI). Adipose tissue blood flow was measured with the 133Xe clearance technique. First-order disappearance rate constants of 125I from the thigh depot decreased approximately 40-50% during the high dose of Epi compared with control (P less than .001). The corresponding decrease from the abdominal depot was approximately 40% (P less than .001), whereas no significant change was found during the low Epi dose. IRI fell compared with control in all groups at the high Epi dose. The Epi-induced depression of insulin absorption occurred despite unaltered or even slightly increased subcutaneous blood flow. The results indicate that circulating Epi at levels seen during moderate physical stress depresses the absorption of soluble insulin from subcutaneous injection sites to an extent that might be important for glycemic control in IDDM patients. Furthermore, dissociation is found between changes in insulin absorption and subcutaneous blood flow during Epi infusion, suggesting that factors other than blood flow may also influence the absorption of subcutaneously injected insulin

  15. Estabilidad de parecoxib en dilución con otros fármacos y administración en perfusión continua IV para el control del dolor postoperatorio Stability of parecoxib in dilution with other drugs and administered in continuous intravenous infusion for the management of postoperative pain

    Directory of Open Access Journals (Sweden)

    P. Acín

    2007-04-01

    con sudoración (3%, 1 con desorientación (0,8% y 7 con somnolencia y mareo (6% 3 de ellos con interrupción del tratamiento. En cuanto a las náuseas y/o vómitos: 18 pacientes necesitaron rescate antiemético, y en 3, hubo que suspender el tratamiento. El grado de satisfacción del paciente fue: muy satisfactorio en 56 pacientes (47,5%; satisfactorio en 46 (39%, deficiente en 10 (8,5% y suspendido el tratamiento en 6 (5% por efectos secundarios. Conclusiones: La posibilidad de utilizar parecoxib sólo o unido a otros fármacos en perfusión continua IV para el tratamiento del dolor agudo postoperatorio, es una opción a considerar.Objective: To evaluate the stability of parecoxib in a portable elasto-meric pump system for IV infusión in dilution with opioids (morphine chloride, pethidine or tramadol, antiemetics and saline solution during 24 hours in the postoperative period; as well as to verify the analgesic result, the incidence of side effects and the degree of satisfaction in patients undergoing major surgery that were eligible for treatment with these drugs. Material and Methods: The infuser pump is a light disposable device with an elas-tomeric deposit to administer the medication. Several tests combining parecoxib, opioids, antiemetics and saline solution were carried out and its stability was demonstrated during 24 hours. The mixture was then observed in several occasions and was shown that the dilution always remained stable, clear, with no particles and transparent; therefore it was decided to use that combination in the IV infuser for the treatment of postoperative pain, always under the anaesthesiologist supervisión. A total of 118 patients were studied, 46 women (39% and 72 men studied (61%, ASA ITV, mean age 59.75 +/- 14.25 (18-89; 92 (78% underwent general surgery procedures and 26 (22% urologic ones. The filling of infuser according to ASA, age and type of surgery of the patient, was made with: parecoxib 80 mg + metoclopramide CL H 20 or 30 mg

  16. Intravenous ferric carboxymaltose for the treatment of iron deficiency anemia

    Directory of Open Access Journals (Sweden)

    João Ricardo Friedrisch

    2015-12-01

    Full Text Available ABSTRACT Nutritional iron deficiency anemia is the most common deficiency disorder, affecting more than two billion people worldwide. Oral iron supplementation is usually the first choice for the treatment of iron deficiency anemia, but in many conditions, oral iron is less than ideal mainly because of gastrointestinal adverse events and the long course needed to treat the disease and replenish body iron stores. Intravenous iron compounds consist of an iron oxyhydroxide core, which is surrounded by a carbohydrate shell made of polymers such as dextran, sucrose or gluconate. The first iron product for intravenous use was the 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 use intravenous iron for the treatment of iron deficiency anemia over many years. Intravenous ferric carboxymaltose is a stable complex with the advantage of being non- dextran-containing and a very low immunogenic potential and therefore not predisposed to anaphylactic reactions. Its properties permit the administration of large doses (15 mg/kg; maximum of 1000 mg/infusion in a single and rapid session (15-minute infusion without the requirement of a test dose. The purpose of this review is to discuss some pertinent issues in relation to the history, pharmacology, administration, efficacy, and safety profile of ferric carboxymaltose in the treatment of patients with iron deficiency anemia.

  17. Decrease in glucose-stimulated insulin secretion with aging is independent of insulin action.

    Science.gov (United States)

    Muzumdar, Radhika; Ma, Xiaohui; Atzmon, Gil; Vuguin, Patricia; Yang, Xiaoman; Barzilai, Nir

    2004-02-01

    While the incidence of diabetes increases with age, a decrease in beta-cell function independent of age-related insulin resistance has not been conclusively determined. We studied insulin secretion (by hyperglycemic clamp) in 3-, 9-, and 20-month-old chronically catheterized, awake, Sprague Dawley (SD) rats (n = 78). Insulin action was modulated in a group of old rats by caloric restriction (CR) or by surgical removal of visceral fat (VF-). During the first 2 h of the clamp (11 mmol/l glucose), insulin secretion and insulin resistance (S(i hyper clamp)) demonstrated the characteristic hyperbolic relationship. However, after hyperglycemia for an additional 2 h, the ability to maintain insulin secretion, commensurate with the degree of insulin resistance, was decreased in all aging rats (P < 0.05). Increasing plasma glucose levels to 18 mmol/l glucose, after clamp at 11 mmol/l, increased insulin secretion by approximately threefold in young rats, but failed to induce similar magnitude of response in the aging rats ( approximately 50%). However, elevation of plasma free fatty acid (FFA) levels by twofold (by intralipid infusion during 11 mmol/l glucose clamp) resulted in a robust, approximate twofold response in both young and old rats. Thus, prolonged stimulation by hyperglycemia unveiled a functional defect in insulin secretion with aging. This age-related defect is independent of insulin action and is specific to glucose and not FFAs. We suggest that prolonged hyperglycemic stimulation can be a tool to identify functional defects in insulin secretion, particularly in the context of the hyperbolic relationship with insulin action, in elderly subjects or those at risk for type 2 diabetes. PMID:14747296

  18. Insulin stimulates muscle protein synthesis in neonates during endotoxemia despite repression of translation initiation

    Science.gov (United States)

    Skeletal muscle protein synthesis is reduced in neonatal pigs in response to endotoxemia. To examine the role of insulin in this response, neonatal pigs were infused with endotoxin (LPS, 0 and 10 µg•kg(-1)•h(-1)), whereas glucose and amino acids were maintained at fasting levels and insulin was clam...

  19. EFFECTS OF GLUCOSE-INFUSION ON HORMONE-SECRETION AND HEPATIC GLUCOSE-PRODUCTION DURING HEAVY EXERCISE

    NARCIS (Netherlands)

    WIERSMA, MML; VISSING, J; STEFFENS, AB; GALBO, H

    1993-01-01

    Blood-borne metabolic feedback vs. neural feedforward regulation of glucose homeostasis during exercise was investigated by infusing glucose and [H-3]glucose for glucose appearance determination intravenously in rats running for 20 min at 28 m/min [almost-equal-to 85% of maximal 02 consumption (VO2m

  20. Blood Samples of Peripheral Venous Catheter or The Usual Way: Do Infusion Fluid Alters the Biochemical Test Results?

    Science.gov (United States)

    Taghizadeganzadeh, Mahboobeh; Yazdankhahfard, Mohammadreza; Farzaneh, Mohammadreza; Mirzaei, Kamran

    2016-01-01

    Background: Most blood tests require venous blood samples. Puncturing the vein also causes pain, infection, or damage to the blood, and lymph flow, or long-term healing. This study aimed to determine and compare the biochemical laboratory value of the blood samples that were provided through: peripheral vein infusion (PVI) receiving continuous intravenous fluid; and the usual method of blood sampling. Methods: This is an interventional, quasi-experimental, and controlled study. The selected study sample included 60 patients, who were hospitalized during 2014, in the Internal Medicine, part of Martyrs of Persian Gulf, teaching hospital at Bushehr. Three blood samples were taken from each patient that were provided through PVI line (5 ml blood collected at beginning of IVC and then another 5 cc), and another case was prepared by common blood sampling (control). All the samples were analyzed in terms of sodium, potassium, urea and creatinine using SPSS Ver.19 software, by paired t-test and Pearson’s correlation coefficients. Results: There was a statistically significant difference between the amount of sodium and potassium in the first blood samples taken from the intravenous infusion line and vein puncture. However, no significant differences were found among the biochemical amount in the second blood samples taken from the intravenous infusion line and vein puncture. Conclusions: We can use blood samples taken from peripheral intravenous infusion lines after 5cc discarding from the first part of the sample for measuring the value of sodium, potassium, urea and creatinine.

  1. EFFECT OF INTRAOPERATIVE ESMOLOL INFUSION ON POSTOPERATIVE ANALGESIA IN LAPAROSCOPIC CHOLECYSTECTOMY PATIENTS: A RANDOMISED CONTROLLED TR IAL

    OpenAIRE

    Shreya; Sabyasachi; Sekhar Ranjan

    2015-01-01

    BACKGROUND: Laparoscopic cholecystectomy, gaining worldwide popularity, can be performed on a short stay basis if postoperative pain is adequately addressed. Our present study determines the effect of intraoperative infusion of intravenous esmolol primarily in terms of postoperative analgesia and intraoperative haemodynamic stability. METHODS: 60 ASAPS 1 and 2 patients undergoing elective laparoscopic cholecystectomy were included in this randomi s ed, prospec...

  2. Increased interaction with insulin receptor substrate 1, a novel abnormality in insulin resistance and type 2 diabetes

    DEFF Research Database (Denmark)

    Caruso, Michael; Ma, Danjun; Msallaty, Zaher;

    2014-01-01

    Insulin receptor substrate 1 (IRS1) is a key mediator of insulin signal transduction. Perturbations involving IRS1 complexes may lead to the development of insulin resistance and type 2 diabetes (T2D). Surprisingly little is known about the proteins that interact with IRS1 in humans under health...... and disease conditions. We used a proteomic approach to assess IRS1 interaction partners in skeletal muscle from lean healthy control subjects (LCs), obese insulin-resistant nondiabetic control subjects (OCs), and participants with T2D before and after insulin infusion. We identified 113 novel endogenous IRS1...... of proteins in OCs and/or T2D patients exhibited increased associations with IRS1 compared with LCs under the basal and/or insulin-stimulated conditions, revealing multiple new dysfunctional IRS1 pathways in OCs and T2D patients. This novel abnormality, increased interaction of multiple proteins with IRS1...

  3. Cost-minimization analysis favours intravenous ferric carboxymaltose over ferric sucrose for the ambulatory treatment of severe iron deficiency.

    Directory of Open Access Journals (Sweden)

    Xavier Calvet

    Full Text Available OBJECTIVE: Intravenous iron is widely used to treat iron deficiency in day-care units. Ferric carboxymaltose (FCM allows administration of larger iron doses than iron sucrose (IS in each infusion (1000 mg vs. 200 mg. As FCM reduces the number of infusions required but is more expensive, we performed a cost-minimization analysis to compare the cost impact of the two drugs. MATERIALS AND METHODS: The number of infusions and the iron dose of 111 consecutive patients who received intravenous iron at a gastrointestinal diseases day-care unit from 8/2007 to 7/2008 were retrospectively obtained. Costs of intravenous iron drugs were obtained from the Spanish regulatory agencies. The accounting department of the Hospital determined hospital direct and indirect costs for outpatient iron infusion. Non-hospital direct costs were calculated on the basis of patient interviews. In the pharmacoeconomic model, base case mean costs per patient were calculated for administering 1000 mg of iron per infusion using FCM or 200 mg using IS. Sensitivity analysis and Monte Carlo simulation were performed. RESULTS: Under baseline assumptions, the estimated cost of iron infusion per patient and year was €304 for IS and €274 for FCM, a difference of €30 in favour of FCM. Adding non-hospital direct costs to the model increased the difference to €67 (€354 for IS vs. €287 for FCM. A Monte Carlo simulation taking into account non-hospital direct costs favoured the use of FCM in 97% of simulations. CONCLUSION: In this pharmacoeconomic analysis, FCM infusion reduced the costs of iron infusion at a gastrointestinal day-care unit.

  4. [Hypogonadotropic hypogonadism and delayed puberty: differential diagnosis using the LH-RH-infusion test].

    Science.gov (United States)

    Vierhapper, H

    1983-08-26

    Serum concentrations of LH and FSH were determined during an intravenous infusion of LH-RH (200 micrograms, t = 4 hours) in 8 patients (age: 15 to 20 years) with delayed sexual maturation and retarded bone age. Four patients who by clinical criteria were later recognized as suffering from hypogonadotropic hypogonadism (HH) presented during the infusion of LH-RH with only a small response of LH (and, in three cases, of FSH). In 3 patients with HH a deficiency of endogenous LH-RH due to a hypothalamic defect was suggested by an enhanced secretion of LH and FSH during a second LH-RH infusion test performed after priming of the pituitary by pulsatile, subcutaneous infusions of LH-RH (50 micrograms/night for 9 consecutive nights). The fourth patient with HH, who suffered from a pituitary adenoma, failed to display this enhanced secretion of gonadotropins following pituitary priming by intermittent administration of LH-RH. As compared with the patients with HH, 4 patients in whom puberty, although delayed, later occurred spontaneously (pubertas tarda, PT), presented with a considerably more pronounced secretion of LH and FSH during the infusion of LH-RH, and priming by intermittent subcutaneous LH-RH failed to achieve further enhancement of the secretion of LH and FSH during a second infusion test in these patients. The intravenous infusion of LH-RH in combination with a protocol of pituitary priming offers a possibility of distinguishing patients with delayed puberty from those with various forms of hypogonadotropic hypogonadism. PMID:6417915

  5. Effect of intravenous or oral sodium chlorate administration on the fecal shedding of Escherichia coli in sheep

    Science.gov (United States)

    The effect of gavage or intravenous (i.v.) administration of sodium chlorate salts on the fecal shedding of generic Escherichia coli in wether lambs was studied. To this end, 9 lambs (27 +/- 2.5 kg) were administered 150 mg NaClO3 per kg BW by gavage or i.v. infusion in a cross-over design with sal...

  6. Proximity to Delivery Alters Insulin Sensitivity and Glucose Metabolism in Pregnant Mice.

    Science.gov (United States)

    Musial, Barbara; Fernandez-Twinn, Denise S; Vaughan, Owen R; Ozanne, Susan E; Voshol, Peter; Sferruzzi-Perri, Amanda N; Fowden, Abigail L

    2016-04-01

    In late pregnancy, maternal insulin resistance occurs to support fetal growth, but little is known about insulin-glucose dynamics close to delivery. This study measured insulin sensitivity in mice in late pregnancy at day 16 (D16) and near term at D19. Nonpregnant (NP) and pregnant mice were assessed for metabolite and hormone concentrations, body composition by DEXA, tissue insulin signaling protein abundance by Western blotting, glucose tolerance and utilization, and insulin sensitivity using acute insulin administration and hyperinsulinemic-euglycemic clamps with [(3)H]glucose infusion. Whole-body insulin resistance occurred in D16 pregnant dams in association with basal hyperinsulinemia, insulin-resistant endogenous glucose production, and downregulation of several proteins in hepatic and skeletal muscle insulin signaling pathways relative to NP and D19 values. Insulin resistance was less pronounced at D19, with restoration of NP insulin concentrations, improved hepatic insulin sensitivity, and increased abundance of hepatic insulin signaling proteins. At D16, insulin resistance at whole-body, tissue, and molecular levels will favor fetal glucose acquisition, while improved D19 hepatic insulin sensitivity will conserve glucose for maternal use in anticipation of lactation. Tissue sensitivity to insulin, therefore, alters differentially with proximity to delivery in pregnant mice, with implications for human and other species. PMID:26740602

  7. Fat overload syndrome after the rapid infusion of SMOFlipid emulsion.

    Science.gov (United States)

    Hojsak, Iva; Kolaček, Sanja

    2014-01-01

    Fat overload syndrome is a well-known complication of intravenous lipid emulsion therapy. It is characterized by headaches, fever, jaundice, hepatosplenomegaly, respiratory distress, and spontaneous hemorrhage. Other symptoms include anemia, leukopenia, thrombocytopenia, low fibrinogen levels, and coagulopathy. Several reports in the literature describe fat overload syndrome caused by rapid infusion of lipid emulsions, all with soybean-based lipid emulsions. We report fat overload syndrome in a 2-year-old girl with short bowel syndrome on home parenteral nutrition. Fat overload syndrome occurred as a result of accidental, very rapid infusion of a 20% soy oil, medium-chain triglyceride, olive and fish oil-based lipid emulsion (SMOFlipid) that showed the same complications seen with an earlier lipid emulsion (Intralipid). The patient was successfully treated with supportive care combining fluid infusion, transfusion of platelets, and substitution of serum albumin (0.5 g/kg/d) and fresh-frozen plasma (10 mL/kg). In the next couple of days, she received extra platelets, erythrocyte transfusion, and filgrastim (Neupogen; 5 µg/kg/d) due to a very low leukocyte count. To the best of our knowledge, this is the first case of fat overload syndrome caused by SMOFlipid emulsion described in the literature. PMID:23520135

  8. Reconstituted high-density lipoprotein infusion modulates fatty acid metabolism in patients with type 2 diabetes mellitus

    DEFF Research Database (Denmark)

    Drew, BG; Carey, AL; Natoli, AK;

    2011-01-01

    of endogenous fat stores. rHDL infusion inhibits fasting-induced lipolysis and oxidation in patients with type 2 diabetes, potentially through both AMPK activation in adipose tissue and elevation of plasma insulin. The phospholipid component of rHDL also has the potentially undesirable effect of increasing...... investigated the effect of rHDL infusion on fatty acid oxidation and lipolysis. Thirteen patients with type 2 diabetes received separate infusions of rHDL and placebo in a randomized, cross-over study. Fatty acid metabolism was assessed using steady-state tracer methodology, and plasma lipids were measured...

  9. Ex Vivo and In Vivo Regulation of Lipocalin-2, a Novel Adipokine, by Insulin

    OpenAIRE

    Tan, Bee K.; Adya, Raghu; Shan, Xiaoye; Syed, Farhatullah; Lewandowski, Krzysztof C.; O'Hare, John P.; Randeva, Harpal S

    2009-01-01

    OBJECTIVE—Lipocalin-2, a novel adipokine, has been shown to be elevated in obese, insulin-resistant, and diabetic subjects. We therefore sought to study the ex vivo and in vivo effects of insulin on lipocalin-2 levels in humans. RESEARCH DESIGN AND METHODS—We investigated the in vivo effects of insulin (hyperinsulinemia) on circulating lipocalin-2 levels by enzyme-linked immunosorbent assay via a prolonged insulin-glucose infusion. The ex vivo effect of insulin on adipose tissue lipocalin-2 p...

  10. Continuous infusion versus daily injections of growth hormone (GH) for 4 weeks in GH-deficient patients

    DEFF Research Database (Denmark)

    Laursen, Torben; Jørgensen, Jens Otto Lunde; Jakobsen, Grethe;

    1995-01-01

    effects with constant and pulsatile GH delivery. This study was carried out to compare the metabolic effects of longer term continuous infusion vs. daily injections of GH. Thirteen GH-deficient patients were studied in a cross-over design. The patients were randomized to receive GH as a continuous sc...... infusion by means of a portable pump for 1 month and as daily sc injections (at 1900 h) for another month. An average daily GH dosage (+/- SEM) of 3.15 +/- 0.27 IU was administered during both periods. Steady state 24-h profiles of GH, IGF-I, IGF-binding proteins (IGFBPs), insulin, glucose, lipid.......35 (infusion); P infusion induced higher nighttime than daytime GH levels (P = 0.01), indicating a diurnal variation in the absorption or clearance of GH. Serum IGF-I levels (micrograms per L) were slightly higher (P infusion [312...

  11. Efficacy of bolus intravenous iron treatment in peritoneal dialysis patients

    Directory of Open Access Journals (Sweden)

    Jovanović Nataša

    2005-01-01

    Full Text Available Introduction. Normocytic, normochromic anemia is one of the first signs of chronic renal failure and it is common in patients on chronic dialysis treatment. It causes decrease in oxygen supply to tissues, increases cardiac minute volume, causes left ventricular hyperthrophy, cardiac insufficiency, disorders related to cognitive functions and immune response, and increases morbidity and mortality rates. The leading cause of anemia in patients on chronic peritoneal dialysis (PD is iron depletion and most patients on PD need oral or parenteral iron supplementation. The aim of this study was to evaluate our first experience with bolus intravenous ferrogluconate therapy in patients on chronic peritoneal dialysis at the Nephrology Clinic of the Clinical Center of Serbia (CCS. Material and Methods. We examined 11 patients, 7 males and 4 females, mean-age 49 years (range 31 to 68 years on chronic PD. All patients received blood transfusions, oral or intramuscular iron supplementation before 465 to 665 mg ferrogluconate therapy was given in 500 ml. saline intravenous infusion; 5 of them were on erythropoietin therapy and 2 of them started with EPO therapy after the ferrogluconate therapy. Results. The blood count improved during the first 3 months after application of bolus intravenous iron therapy (ferrogluconate; erythropoietin dose was not increased during the follow-up. Some patients suffered from side effects during infusion and 6 patients received the complete treatment. Discussion. Blood count improves in a number of patients affected by end-stage renal disease during the first months on continuous ambulatory peritoneal dialysis (CAPD treatment. But a large number of patients on chronic CAPD treatment are iron-depleted and they require oral or parenteral substitution. Side effects and complications of intravenous iron therapy were not severe and only one patient suffered from allergic manifestations. Ferremia and blood count improved in patients

  12. Role of changes in insulin and glucagon in glucose homeostasis in exercise.

    OpenAIRE

    Wolfe, R R; Nadel, E. R.; Shaw, J H; Stephenson, L A; Wolfe, M H

    1986-01-01

    This experiment was performed to determine if plasma glucose homeostasis is maintained in normal human volunteers during light exercise (40% maximal oxygen consumption [VO2 max]) when changes in insulin and glucagon are prevented. Hormonal control was achieved by the infusion of somatostatin, insulin, and glucagon. Glucose kinetics and oxidation rates were determined with stable isotopic tracers of glucose, and by indirect calorimetry. Two different rates of replacement of insulin and glucago...

  13. Potent induction immunotherapy promotes long-term insulin independence after islet transplantation in type 1 diabetes

    OpenAIRE

    Bellin, Melena D.; Barton, Franca B.; Heitman, Andrew; Alejandro, Rodolfo; Hering, Bernhard J.

    2012-01-01

    The seemingly inexorable decline in insulin independence after islet transplant alone (ITA) has raised concern about its clinical utility. We hypothesized that induction immunosuppression therapy determines durability of insulin independence. We analyzed the proportion of insulin independent patients following final islet infusion in four groups of ITA recipients according to induction immunotherapy: University of Minnesota recipients given FcR nonbinding anti-CD3 antibody alone or T cell dep...

  14. Intraoperative esmolol infusion reduces postoperative analgesic consumption and anaesthetic use during septorhinoplasty: a randomized trial

    OpenAIRE

    Nalan Celebi; Elif A. Cizmeci; Ozgur Canbay

    2014-01-01

    Background and objectives: Esmolol is known to have no analgesic activity and no anaesthetic properties; however, it could potentiate the reduction in anaesthetic requirements and reduce postoperative analgesic use. The objective of this study is to evaluate the effect of intravenous esmolol infusion on intraoperative and postoperative analgesic consumptions as well as its effect on depth of anaesthesia. Methods: This randomized-controlled double blind study was conducted in a tertiary care ...

  15. Programmable Infusion Pumps in ICUs: An Analysis of Corresponding Adverse Drug Events

    OpenAIRE

    Nuckols, Teryl K; Bower, Anthony G.; Paddock, Susan M.; Hilborne, Lee H.; Wallace, Peggy; Rothschild, Jeffrey M; Griffin, Anne; Fairbanks, Rollin J; Carlson, Beverly; Panzer, Robert J.; Brook, Robert H.

    2007-01-01

    Background Patients in intensive care units (ICUs) frequently experience adverse drug events involving intravenous medications (IV-ADEs), which are often preventable. Objectives To determine how frequently preventable IV-ADEs in ICUs match the safety features of a programmable infusion pump with safety software (“smart pump”) and to suggest potential improvements in smart-pump design. Design Using retrospective medical-record review, we examined preventable IV-ADEs in ICUs before and after 2 ...

  16. Central insulin and macronutrient intake in the rat

    NARCIS (Netherlands)

    Chavez, M; Riedy, CA; VanDijk, G; Woods, SC; Riedy, Christine A.; Woods, Stephen C.

    1997-01-01

    When rats are maintained on a standard laboratory diet, the infusion of low doses of insulin into the cerebroventricular system causes a reduction of food intake and body weight. It was recently reported that, if rats are maintained on a high-fat diet (56% calories as fat), they are insensitive to t

  17. Kontinuierliche intravenöse Verabreichung von Vancomycin bei Patienten der Intensivtherapiestation

    OpenAIRE

    Nowack, Marisa Claudia Michelle

    2016-01-01

    Das Ziel dieser Dissertation ist es, die kontinuierliche intravenöse Gabe von Vancomycin bei schwer kranken Patienten auf der internistischen Intensivstation im Vergleich zu einer intermittierenden Infusion zu analysieren und zu bewerten. Durchgeführt wurde dazu eine retrospektive Kohortenstudie mit 239 Patienten. Unsere Ergebnisse zeigen, dass bei diesen Patienten eine kontinuierliche Gabe von Vancomycin ausreichend ist, um die Zielserumspiegelkonzentrationen zu erzielen. Allerdings führte ...

  18. Combining insulins for optimal blood glucose control in type 1 and 2 diabetes: focus on insulin glulisine

    Directory of Open Access Journals (Sweden)

    Heather Ulrich

    2007-07-01

    lispro or RHI in type 1 or 2 DM and it has been shown to be as safe and effective when used in a continuous subcutaneous insulin infusion (CSII. In summary, insulin glulisine is a safe, effective, and well tolerated rapid-acting insulin analogue across all BMIs and a worthy option for prandial glucose control in type 1 or 2 DM.Keywords: glycemic control, glycosylated hemoglobin A1c (HbA1c, rapid-acting insulin analogues, type 1 diabetes mellitus, type 2 diabetes mellitus, insulin glulisine, body mass index (BMI

  19. Amino acid infusion during anesthesia attenuates the surgery induced decline in IGF-1 and diminishes the "diabetes of injury"

    Directory of Open Access Journals (Sweden)

    Eksborg Staffan

    2007-01-01

    Full Text Available Abstract Background Surgery, commonly performed after an overnight fast, causes a postoperative decline in the anabolic and glucose lowering insulin-like growth factor-1 (IGF-1. Clinical fasting studies have exhibited a positive correlation between IGF-1 and nitrogen balance during different conditions. A perioperative amino acid infusion changes nitrogen balance and might thereby influence serum IGF-1. We hypothesized that amino acid infusion would enhance IGF-1 and thereby might influence glucose homeostasis after surgery. In this study we examined two different regimes of perioperative amino acids infusion. Methods 24 females scheduled for abdominal hysterectomy were randomized into three groups; Ringer's solution infusion throughout anesthesia (Group B, amino acid infusion throughout anesthesia (Group C and amino acid infusion 1 hour before anesthesia and during 1.5 hrs of surgery (Group D. Six female volunteers, who were not operated, but received the same amino acids infusion after fasting, served as controls (Group A. Fasting levels of IGF-1, Insulin-like growth factor binding protein-1 (IGFBP-1, insulin and P-glucose were studied prior to, and four days following, operation. Homeostasis model assessment (HOMA was used as an index of insulin resistance. Non-parametric statistical methods were used. Results During the study the Ringer-group exhibited a decrease in IGF-1 and an increase in insulin and plasma glucose after surgery. Within the other groups there were no significant alterations over time after surgery, with the exception of a postoperative decrease in IGF-1 in group D. Group C had higher IGF-1 levels compared to group B on all days. Also, group D had higher IGF-1 levels than group B on day 2 – 4. From baseline to the first postoperative day there was a significant increase in HOMA and IGFBP-1 in groups B and C. These changes were not found in group D, in which insulin, glucose, HOMA and IGFBP-1 did not change. Amino acid

  20. Infusion of radionuclides throughout pregnancy

    International Nuclear Information System (INIS)

    This work is part of a long-term study to examine the cancer incidence in the offspring of mice exposed to 239Pu or 147Pm throughout pregnancy. The need to model the human intake scenario and the possibility of a critical period during uterine development necessitates constant availability of radionuclides throughout pregnancy. Various methods (multiple daily injections, infusion by external cannula and infusion by indwelling osmotic pump) have been examined and osmotic infusion pumps chosen. These pumps result in a near-constant blood concentration for up to 21 days. Part of the study is the estimation of dose to the critical haemopoietic tissues of the pup from a knowledge of the radionuclide distribution and kinetics. At present the distribution has been followed from birth to 180 days. Activity in the suckling pups at 7 days old is around 1 percent of the infused activity, though most of this is accounted for by the contents of the stomach and gastrointestinal tract. The liver and femur account for around 0.025 percent and 0.012 percent respectively per pup. Activity increases in both liver and femur during lactation after which both concentration and activity fall with time. Long-term studies with the pups of dams exposed to a range of 239Pu concentrations between 0-70 kBq/kg are underway. Correlation of average organ dose with tumour incidence will be determined at completion of the life-span study. (Author) 39 refs., 5 tabs., 6 figs

  1. Clinical observation of transgastrointestinal fluid infusion in the treatment of diabetic ketosis, ketoacidosis and hypertonia%经胃肠道补液联合静脉补液治疗糖尿病酮症、酮症酸中毒、高渗昏迷的临床观察

    Institute of Scientific and Technical Information of China (English)

    楚敏

    2012-01-01

    目的 探讨通过胃肠道补液联合静脉补液治疗糖尿病并发酮症、酮症酸中毒或高渗的有效性.方法 在应用胰岛素的同时足量的胃肠道补液,每日补液量2 000~6 000 mL,辅以静脉输液每日500~2 000 mL,持续7d.观察尿量、血气分析、血糖、尿酮及血钠的变化.结果 32例患者的相关指标均得到明显改善以至痊愈.结论 经胃肠道补液,是治疗糖尿病并发酮症、酮症酸中毒和高渗的有效方法.%Objective To investigate the efficacy of transgastrointestinal fluid infusion in diabetic ketosis, ketoacidosis and hypertonia. Methods On the basis of insulin application, fluid infusion through gastrointestinal tract, 2000 to 6000ml per day, were supplemented by intravenous infusion 500 to 2000ml per day. The period of treatment was 7 days. The changes of urine volume, blood gas analysis, blood sugar, urinary ketone and serum sodium per day were observed. Results The correlation index of all cases were improved significantly after the therapy. Conclusion The transgastrointestinal fluid infusion is safe and effective in diabetic ketosis, ketoacidosis and hypertonia.

  2. Insulin Detemir is Not Transported Across the Blood-Brain Barrier

    OpenAIRE

    Banks, William A.; Morley, John E.; Lynch, Jessica L.; Lynch, Kristin M.; Mooradian, Arshag D.

    2010-01-01

    Insulin detemir has a different profile of action on the central nervous system (CNS) than human insulin. It has been hypothesized that this is caused by an altered ability of insulin detemir to cross the blood-brain barrier (BBB). Here, we measured the permeability of the BBB to insulin detemir. We labeled insulin detemir with radioactive iodine (I-Det) and examined its ability to cross the BBB of the mouse. Permeation was assessed after intravenous injection and by brain perfusion in the pr...

  3. Correlations between insulin sensitivity and bone mineral density in non-diabetic men

    DEFF Research Database (Denmark)

    Abrahamsen, Bo; Rohold, A; Henriksen, J E;

    2000-01-01

    AIMS: To investigate relationships between bone mineral density (BMD), insulin secretion and insulin sensitivity, controlling for body composition, in view of data suggesting that hyperglycaemia [corrected] leads to decreased osteoblast proliferation and a negative calcium balance and that insulin...... sensitivity (Si) was estimated as the rate of glucose disappearance divided by the area under the insulin curve during an intravenous glucose tolerance test. RESULTS: Insulin and C-peptide levels were not correlated with BMD, but Si was a significant predictor of femur (log, r = 0.35) and WB BMD (log r = 0...

  4. Glucose-stimulated prehepatic insulin secretion is associated with circulating alanine, triglyceride, glucagon, lactate and TNF-alpha in patients with HIV-lipodystrophy

    DEFF Research Database (Denmark)

    Haugaard, S B; Andersen, O; Pedersen, S B;

    2006-01-01

    OBJECTIVES: We examined whether insulin-resistant lipodystrophic HIV-infected patients with known high fasting prehepatic insulin secretion rates (FISRs) displayed alterations in first-phase prehepatic insulin response to intravenous glucose (ISREG0-10 min). METHODS: Eighteen normoglycaemic lipod...

  5. Glucose-stimulated prehepatic insulin secretion is associated with circulating alanine, triglyceride, glucagons, lactate and TNF-alfa in patients with HIV-lipodystrophy

    DEFF Research Database (Denmark)

    Haugaard, Steen B; Andersen, Ove; Pedersen, SB;

    2006-01-01

    OBJECTIVES: We examined whether insulin-resistant lipodystrophic HIV-infected patients with known high fasting prehepatic insulin secretion rates (FISRs) displayed alterations in first-phase prehepatic insulin response to intravenous glucose (ISREG0-10 min). METHODS: Eighteen normoglycaemic lipod...

  6. PACAP-38 infusion causes sustained vasodilation of the middle meningeal artery in the rat

    DEFF Research Database (Denmark)

    Bhatt, Deepak K; Gupta, Saurabh; Olesen, Jes;

    2014-01-01

    BACKGROUND: In healthy human volunteers and in migraineurs, pituitary adenylate cyclase-activating polypeptide-38 (PACAP-38) infusion caused sustained vasodilation of the middle meningeal artery (MMA) and an immediate as well as a delayed headache. All the study subjects experienced facial flushing....... Mast cells (MCs) might have a role in the long-lasting effect of PACAP-38 infusion. We hypothesized that in mast cell-depleted (MCD) rats the vascular responses to PACAP-38 would be lesser than in control rats because of a lack of vasodilatory products released during MC degranulation. METHODS: MCs...... were depleted by chronic treatment with compound 48/80. The effect of 20 minutes' intravenous (i.v.) infusion of calcitonin gene-related peptide (CGRP), PACAP-38, PACAP(6-38) (PAC-1 receptor antagonist) and PACAP-27 on the diameter of the MMA and on mean arterial blood pressure (MABP) in control...

  7. Association between timing of zoledronic acid infusion and hip fracture healing

    DEFF Research Database (Denmark)

    Colón-Emeric, C; Nordsletten, L; Olson, S;

    2011-01-01

    evident effect on fracture healing, even when the drug is infused in the immediate postoperative period. INTRODUCTION: Intravenous zoledronic acid 5 mg (ZOL) given after a hip fracture reduces secondary fracture rates and mortality. It has been postulated that bisphosphonates may affect healing if given...... soon after a fracture. We sought to determine whether the timing of ZOL infusion affected the risk of delayed hip fracture healing. METHODS: In the HORIZON Recurrent Fracture Trial, patients were randomized within 90 days of a low-trauma hip fracture to receive either once-yearly ZOL (n = 1...... = 0.44). There was no interaction by timing of infusion, and nonunion rates were similar even when ZOL was given within 2 weeks of hip fracture repair. NSAID use was significantly associated with delayed fracture healing (OR, 2.55; 95% CI, 1.49-4.39; p 

  8. Apoptotic cell infusion treats ongoing collagen-induced arthritis, even in the presence of methotrexate, and is synergic with anti-TNF therapy

    OpenAIRE

    Bonnefoy, Francis; Daoui, Anna; Valmary-Degano, Séverine; Toussirot, Eric; Saas, Philippe; Perruche, Sylvain

    2016-01-01

    Background Apoptotic cell-based therapies have been proposed to treat chronic inflammatory diseases. The aim of this study was to investigate the effect of intravenous (i.v.) apoptotic cell infusion in ongoing collagen-induced arthritis (CIA) and the interaction of this therapy with other treatments used in rheumatoid arthritis (RA), including methotrexate (MTX) or anti-TNF therapy. Methods The effects of i.v. apoptotic cell infusion were evaluated in a CIA mouse model in DBA/1 mice immunized...

  9. In vivo tracking of 111In-oxine labeled mesenchymal stem cells following infusion in patients with advanced cirrhosis

    International Nuclear Information System (INIS)

    Background: Several animal and few human studies suggest the beneficial role of bone marrow mesenchymal stem cells (MSCs) in liver cirrhosis. However, little is known about the fate of MSCs after infusion in cirrhotic patients. We evaluated stem cell biodistribution after peripheral infusion of MSCs in four cirrhotic patients. Methods: After three passages of MSCs, the patients received a total of 250-400x106 cells, of which only 50% of the cells were labeled. Specific activities of 0.21-0.67 MBq/106 cells were maintained for the injected labeled MSCs. Planar whole-body acquisitions (anterior/posterior projections) were acquired immediately following infusion as well as at 2 h, 4 h, 6 h, 24 h, 48 h, 7th and 10th days after cell infusion. Results: After intravenous infusion, the radioactivity was first observed to accumulate in the lungs. During the following hours to days, the radioactivity gradually increased in the liver and spleen, with spleen uptake exceeding that in the liver in all patients. Region-of-interest analysis showed that the percentage of cells homing to the liver (following decay and background corrections and geometric mean calculation) increased from 0.0%-2.8% at immediately post-infusion images to 13.0-17.4% in 10th-day post-infusion. Similarly, the residual activities in the spleen increased from 2.0%-10.2% at immediately post-infusion images to 30.1%-42.2% in 10th-day post-infusion. During the same period, the residual activities in the lungs decreased from 27.0-33.5% to 2.0-5.4%. Conclusion: The infusion of MSCs labeled with 111In-oxine through a peripheral vein is safe in cirrhosis. Cell labeling with 111In-oxine is a suitable method for tracking MSC distribution after infusion.

  10. Therapeutics of Diabetes Mellitus: Focus on Insulin Analogues and Insulin Pumps

    Directory of Open Access Journals (Sweden)

    Vasiliki Valla

    2010-01-01

    Full Text Available Aim. Inadequately controlled diabetes accounts for chronic complications and increases mortality. Its therapeutic management aims in normal HbA1C, prandial and postprandial glucose levels. This review discusses diabetes management focusing on the latest insulin analogues, alternative insulin delivery systems and the artificial pancreas. Results. Intensive insulin therapy with multiple daily injections (MDI allows better imitation of the physiological rhythm of insulin secretion. Longer-acting, basal insulin analogues provide concomitant improvements in safety, efficacy and variability of glycaemic control, followed by low risks of hypoglycaemia. Continuous subcutaneous insulin infusion (CSII provides long-term glycaemic control especially in type 1 diabetic patients, while reducing hypoglycaemic episodes and glycaemic variability. Continuous subcutaneous glucose monitoring (CGM systems provide information on postprandial glucose excursions and nocturnal hypo- and/or hyperglycemias. This information enhances treatment options, provides a useful tool for self-monitoring and allows safer achievement of treatment targets. In the absence of a cure-like pancreas or islets transplants, artificial “closed-loop” systems mimicking the pancreatic activity have been also developed. Conclusions. Individualized treatment plans for insulin initiation and administration mode are critical in achieving target glycaemic levels. Progress in these fields is expected to facilitate and improve the quality of life of diabetic patients.

  11. Comparison of the effects of recombinant human insulin-like growth factor-I and insulin on glucose and leucine kinetics in humans.

    OpenAIRE

    Laager, R; Ninnis, R; Keller, U

    1993-01-01

    To compare the metabolic effects of elevated plasma concentrations of IGF-I and insulin, overnight-fasted normal subjects were studied twice, once receiving IGF-I and once insulin at doses that resulted in identical increases in glucose uptake during 8-h euglycemic clamping. Recombinant human IGF-I or insulin were infused in one group at high doses (30 micrograms/kg per h IGF-I or 0.23 nmol/kg per h insulin) and in another group at low doses (5 micrograms/kg per h IGF-I or 0.04 nmol/kg per h ...

  12. Isotonic saline in elderly men: an open-labelled controlled infusion study of electrolyte balance, urine flow and kidney function.

    Science.gov (United States)

    Hahn, R G; Isacson, M Nyberg; Fagerström, T; Rosvall, J; Nyman, C R

    2016-02-01

    Isotonic saline is a widely-used infusion fluid, although the associated chloride load may cause metabolic acidosis and impair kidney function in young, healthy volunteers. We wished to examine whether these effects also occurred in the elderly, and conducted a crossover study in 13 men with a mean age of 73 years (range 66-84), who each received intravenous infusions of 1.5 l of Ringer's acetate and of isotonic saline. Isotonic saline induced mild changes in plasma sodium (mean +1.5 mmol.l(-1) ), plasma chloride (+3 mmol.l(-1) ) and standard bicarbonate (-2 mmol.l(-1) ). Three hours after starting the infusions, 68% of the Ringer's acetate and 30% of the infused saline had been excreted (p 700 mOsmol.kg(-1) ) and/or creatinine (> 7 mmol.l(-1) ), was a strong factor governing the responses to both fluid loads.

  13. Anestesi Infus Gravimetrik Ketamin dan Propofol pada Anjing (THE GRAVIMETRIC INFUSION ANAESTHESIA WITH KETAMINE AND PROPOFOL IN DOGS

    Directory of Open Access Journals (Sweden)

    I Gusti Ngurah Sudisma

    2014-08-01

    Full Text Available This study aim was to evaluate quality of anaesthesia by using gravimetric infusion anaesthesia withketamine and propofol in dogs. The quality of anaesthesia, duration of actions, and the physiological responsseof anaesthesia were evaluated in twenty domestic dogs. Anaesthesia was induced intramuscularly withatropine (0.03 mg/kg-xylazine (2 mg/kg (AX, intravenously ketamine-propofol (KP (4 mg/kg, andmaintained with continuous intravenous infusion with pre-mixed propofol (P and normal saline containing2 mg/ml of propofol and 2 mg/ml of ketamine (K. Domestic stray dogs were randomly divided into fivegroups. Groups AXKP-K2P2, AXKP-K4P4, and AXKP-K6P6 were treated with ketamine-propofol the dose0.2 mg/kg/minute, 0.4 and 0.6 mg/kg/minute respectively, while group AXKP-P4 was given propofol 0.4 mg/kg/minute and group AXKP-I was given isoflurane 1-2%. Heart rate (HR, respiratory rate (RR,electrocardiogram (ECG, blood oxygen saturation (SpO2, end tidal CO2 (ET CO2, and capillary refill time(CRT were measured. No significant difference (P>0.05 found between the groups in anaesthetion times.All groups showed rapid and smooth inductions, prolonged surgical stage, and rapid recovery. Groups AXKPK2P2and AXKP-K4P4 showed minimal physiological effect on the dogs. The HR, RR, ET CO2, SpO2, CRT,and ECG wave were stabl. Combination of AXKP-K6P6 induced SpO2 depression, increased and instabilityof HR, RR and ET CO2. Groups AXKP-P4 showed decreased of HR and respiratory depression. All anaestheticcombinations showed no significant influence (P>0.05 on the electricity of the dog’s heart. The combinationof ketamine-propofol at dose 0.2 and 0.4 mg/kg/minute were found to be better as an application formaintaining anaesthesia by gravimetric continuous intravenous infusion. The method is a suitablealternative for inhalation anaesthesia in dogs.

  14. Total intravenous general anesthesia with laryngeal mask airway for transurethral resection of bladder tumor

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Objective: To observe the advantage of total intravenous anesthesia for transurethral resection of bladder tumor (TURBT). Methods: Sixty ASA Ⅰ-Ⅱ patients undergoing TURBT were randomly assigned to 2 groups. Spinal anesthesia with 0.75% pure bupivacaine (8-12 mg) was applied to patients in Group Ⅰ (n= 30). Patients in Group Ⅱ (n=30) received total intravenous anesthesia with continuous infusion of Propofol and Remifentanil; and a laryngeal mask was used to ensure the airway and ventilation. BP, HR, SPO2 and pertinent side effects were monitored and recorded. Results: The patients in group Ⅱ experienced more stable hemodynamics than those in group Ⅰ. Obturator nerve reflex was observed in 15 (50.0%) patients in Group Ⅰ, but none (0%) in Group Ⅱ (P<0.01). Conclusion: Total intravenous anesthesia with laryngeal mask is a safe, reliable, controllable and simple manual for patient undergoing TURBT.

  15. Localized infusion of IGF-I results in skeletal muscle hypertrophy in rats

    Science.gov (United States)

    Adams, G. R.; McCue, S. A.

    1998-01-01

    Insulin-like growth factor I (IGF-I) peptide levels have been shown to increase in overloaded skeletal muscles (G. R. Adams and F. Haddad. J. Appl. Physiol. 81: 2509-2516, 1996). In that study, the increase in IGF-I was found to precede measurable increases in muscle protein and was correlated with an increase in muscle DNA content. The present study was undertaken to test the hypothesis that direct IGF-I infusion would result in an increase in muscle DNA as well as in various measurements of muscle size. Either 0.9% saline or nonsystemic doses of IGF-I were infused directly into a non-weight-bearing muscle of rats, the tibialis anterior (TA), via a fenestrated catheter attached to a subcutaneous miniosmotic pump. Saline infusion had no effect on the mass, protein content, or DNA content of TA muscles. Local IGF-I infusion had no effect on body or heart weight. The absolute weight of the infused TA muscles was approximately 9% greater (P muscles. IGF-I infusion resulted in significant increases in the total protein and DNA content of TA muscles (P hypertrophied TA was similar to that of the contralateral muscles. These results suggest that IGF-I may be acting to directly stimulate processes such as protein synthesis and satellite cell proliferation, which result in skeletal muscle hypertrophy.

  16. Insulin Resistance and Prediabetes

    Science.gov (United States)

    ... Disease Organizations (PDF, 293 KB). Alternate Language URL Insulin Resistance and Prediabetes Page Content On this page: ... Nutrition Points to Remember Clinical Trials What is insulin? Insulin is a hormone made in the pancreas, ...

  17. Symptomatic intravenous antipyretic therapy: efficacy of metamizol, diclofenac, and propacetamol.

    Science.gov (United States)

    Oborilová, Andrea; Mayer, Jirí; Pospísil, Zdenek; Korístek, Zdenek

    2002-12-01

    Fever is a common symptom in cancer patients. The most frequent causes of fever are infections, malignancy itself, various medications, transfusions, and allergy. Although it is necessary to treat the cause of fever, if possible, symptomatic fever management is also important. Surprisingly, little attention is paid to this topic in the medical literature, despite the fact that it is a very frequent problem. In order to support symptomatic fever therapy, we wanted to study the patients' discomfort accompanying fever and the beneficial effects of the symptomatic fever management. To the best of our knowledge, there is an absence of studies in this area, despite the fever discomfort can be an important reason for the antipyretic treatment, mainly in cancer patients. In this non-randomized open label pilot study, three intravenous antipyretics were tested in five groups of patients: diclofenac (75 mg, brief intravenous [IV] infusion) vs. metamizol (2500 mg or 1000 mg, brief IV infusion) vs. propacetamol (2000 mg or 1000 mg, slow IV injection or brief IV infusion). The study included 254 febrile episodes mainly in hemato-oncological patients with axillary temperature at least 38 degrees C. The main study endpoints were: changes in axillary temperature, improvement in patient comfort, and number and nature of adverse events. To support justification for symptomatic fever management in febrile patients, we asked the first 45 study subjects to fill in a questionnaire concerning their opinions about fever, fever-associated discomfort, and relief upon antipyretic therapy. All study medications had a significant antipyretic effect. However, metamizol at the dose 2500 mg was considered as the most effective, while propacetamol at the dose 1000 mg showed the lowest antipyretic efficacy. Concerning tolerability and adverse events, there were significant differences among the treatment groups. Diclofenac and metamizol (both 2500 mg and 1000 mg) were tolerated at best. All tested

  18. Concentrated insulins: the new basal insulins

    Directory of Open Access Journals (Sweden)

    Lamos EM

    2016-03-01

    Full Text Available Elizabeth M Lamos,1 Lisa M Younk,2 Stephen N Davis3 1Division of Endocrinology, Diabetes and Nutrition, 2Department of Medicine, University of Maryland School of Medicine, 3Department of Medicine, University of Maryland Medical Center, Baltimore, MD, USA Introduction: Insulin therapy plays a critical role in the treatment of type 1 and type 2 diabetes mellitus. However, there is still a need to find basal insulins with 24-hour coverage and reduced risk of hypoglycemia. Additionally, with increasing obesity and insulin resistance, the ability to provide clinically necessary high doses of insulin at low volume is also needed. Areas covered: This review highlights the published reports of the pharmacokinetic (PK and glucodynamic properties of concentrated insulins: Humulin-R U500, insulin degludec U200, and insulin glargine U300, describes the clinical efficacy, risk of hypoglycemic, and metabolic changes observed, and finally, discusses observations about the complexity of introducing a new generation of concentrated insulins to the therapeutic market. Conclusion: Humulin-R U500 has a similar onset but longer duration of action compared with U100 regular insulin. Insulin glargine U300 has differential PK/pharmacodynamic effects when compared with insulin glargine U100. In noninferiority studies, glycemic control with degludec U200 and glargine U300 is similar to insulin glargine U100 and nocturnal hypoglycemia is reduced. Concentrated formulations appear to behave as separate molecular entities when compared with earlier U100 insulin analog compounds. In the review of available published data, newer concentrated basal insulins may offer an advantage in terms of reduced intraindividual variability as well as reducing the injection burden in individuals requiring high-dose and large volume insulin therapy. Understanding the PK and pharmacodynamic properties of this new generation of insulins is critical to safe dosing, dispensing, and administration

  19. INTRAVENOUS DEXMEDETOMIDINE FOR LABOUR ANALGESIA IN WOMEN WITH PREECLAMPSIA

    Directory of Open Access Journals (Sweden)

    Nidhi

    2016-06-01

    Full Text Available BACKGROUND Parenteral opioids and sedatives are the most frequently prescribed agents for women in labour in many poor resource settings. These have shown poor pain relief and a lot of side effects in both the mother and the foetus. In patients with severe pre-eclampsia who are already haemodynamically compromised labour pains and delivery can result in haemodynamic instability, which can compromise both the mother and the neonate. Dexmedetomidine is a highly selective α-2 agonist, which when used in recommended dose in the form of an infusion has several desirable properties like sedation, anxiolysis, sympatholysis, analgesia, decreased anaesthetic requirements, maintains cardiovascular stability and provides a smooth recovery. AIM The aim of this study was to study the haemodynamic effects of intravenous dexmedetomidine when used in patients with severe pre-eclampsia for labour analgesia. MATERIALS AND METHODS The study was conducted in the Department of Obstetrics and Gynaecology of Bundelkhand Medical College, Sagar, between January 2015 and December 2016; 40 labouring patients with severe pre-eclampsia were included in the study; 20 each were allocated to the study and control group. The study group received intravenous Dexmedetomidine in the recommended doses (1 ug/kg loading dose over 10-15 minutes followed by an infusion at 0.2-0.7 ug/kg/hour when in active labour, while the control group received Intravenous Fentanyl. The two groups were compared regarding the duration of labour, the mode of delivery, the neonatal outcome, the onset and duration of analgesia and maternal haemodynamic parameters during labour and delivery. The data obtained in this study was tabulated and analysed using the Chi-square test and the Z test with p value of 0.05 taken as significant. RESULTS It was found out that the group of patients who received Dexmedetomidine were more haemodynamically stable during labour and delivery; there was significant pain relief

  20. Insulin signaling, inflammation, and lipolysis in subcutaneous adipose tissue of transition dairy cows either overfed energy during the prepartum period or fed a controlled-energy diet.

    Science.gov (United States)

    Mann, S; Nydam, D V; Abuelo, A; Leal Yepes, F A; Overton, T R; Wakshlag, J J

    2016-08-01

    Adipose tissue mobilization is a hallmark of the transition period in dairy cows. Cows overfed energy during the dry period have higher concentrations of nonesterified fatty acids (NEFA) and β-hydroxybutyrate (BHB) compared with cows fed a controlled-energy diet prepartum. The reason for an increase in blood NEFA concentrations at the level of adipose tissue in cows overfed energy has not been fully elucidated. One hypothesis is that cows with high BHB concentrations suffer from adipose tissue-specific insulin resistance, leading to higher rates of adipose tissue mobilization in the postpartum period. To test this hypothesis, subcutaneous adipose tissue biopsies of cows overfed energy in excess of predicted requirements by 50% in the dry period, and that had high concentrations of blood BHB postpartum (group H; n=12), were used. Findings were compared with results of biopsies from cows fed a controlled-energy diet and with low BHB concentrations postpartum (group C; n=12) to create the biggest contrast in BHB concentrations. Subcutaneous adipose tissue biopsies were obtained before and 60 min after an intravenous glucose challenge (0.25 g/kg of glucose) at 28 and 10 d before expected calving as well as on d 4 and 21 postpartum. Phosphorylation of protein kinase B, extracellular signal-regulated kinase, and hormone-sensitive lipase was determined before and after glucose infusion by Western blot. Western blot was also used to assess the baseline protein abundance of peroxisome proliferator-activated receptor gamma and insulin receptor β-subunit. In addition, gene expression of fatty acid synthase, adiponectin, monocyte chemoattractant protein 1, and tumor necrosis factor α was determined by real-time quantitative reverse-transcription PCR. Backfat thickness was determined in the thurl area by ultrasonography. Cows in group H showed a greater degree of lipogenesis prepartum, but no differences were found in lipolytic enzyme activity postpartum compared with cows

  1. Chronic TNF-α Neutralization Does Not Improve Insulin Resistance or Endothelial Function in “Healthy” Men with Metabolic Syndrome

    OpenAIRE

    Wascher, Thomas C; Lindeman, Jan HN; Sourij, Harald; Kooistra, Teake; Pacini, Giovanni; Roden, Michael

    2010-01-01

    The possible contribution of tumor necrosis factor-α (TNF-α) to the development of obesity-associated insulin resistance in humans is still controversial. Our study investigated the effect of TNF-α neutralization on insulin resistance in healthy, obese and insulin resistant men. We performed a prospective, randomized, double-blind placebo-controlled trial in nine young, healthy obese male subjects with metabolic syndrome and insulin resistance. Volunteers received three infusions (wks 0, 2 an...

  2. The environmental impact of health care: implications for infusion nursing.

    Science.gov (United States)

    Lipkin, Noelle Claire

    2012-01-01

    Health care provision is a dangerous business. Health professionals recognize the potential for miscommunication, medication errors, and other possible threats to patient safety. Less evident are the hazards to the environment inherent in the everyday practice of patient care. This article addresses 3 areas of practice in which infusion nurses can make a positive impact on the environment: preferable intravenous (IV) supply purchasing, proper management of electronic equipment (including purchasing, servicing, and disposal), and appropriate medication use and disposal practices. The article aims to inform IV nurses of the alarming environmental effects that the health care industry has on the environment and to suggest a clear, direct course of action to improve our environmental impact. PMID:22498487

  3. Counterregulatory hormones in insulin-treated diabetic patients admitted to an accident and emergency department with hypoglycaemia

    DEFF Research Database (Denmark)

    Hvidberg, A; Christensen, N J; Hilsted, Jannik

    1998-01-01

    The aim of the study was (1) to describe hormone responses in insulin-induced hypoglycaemia and (2) to investigate if a combined treatment with intravenous glucose and intramuscular glucagon (group A) would improve glucose recovery as compared to treatment with intravenous glucose alone (group B...

  4. Recommendations for Insulin Dose Calculator Risk Management

    Science.gov (United States)

    2014-01-01

    Several studies have shown the usefulness of an automated insulin dose bolus advisor (BA) in achieving improved glycemic control for insulin-using diabetes patients. Although regulatory agencies have approved several BAs over the past decades, these devices are not standardized in their approach to dosage calculation and include many features that may introduce risk to patients. Moreover, there is no single standard of care for diabetes worldwide and no guidance documents for BAs, specifically. Given the emerging and more stringent regulations on software used in medical devices, the approval process is becoming more difficult for manufacturers to navigate, with some manufacturers opting to remove BAs from their products altogether. A comprehensive literature search was performed, including publications discussing: diabetes BA use and benefit, infusion pump safety and regulation, regulatory submissions, novel BAs, and recommendations for regulation and risk management of BAs. Also included were country-specific and international guidance documents for medical device, infusion pump, medical software, and mobile medical application risk management and regulation. No definitive worldwide guidance exists regarding risk management requirements for BAs, specifically. However, local and international guidance documents for medical devices, infusion pumps, and medical device software offer guidance that can be applied to this technology. In addition, risk management exercises that are algorithm-specific can help prepare manufacturers for regulatory submissions. This article discusses key issues relevant to BA use and safety, and recommends risk management activities incorporating current research and guidance. PMID:24876550

  5. Efficacy and safety of intravenous iron sucrose in treating adults with iron deficiency anemia

    Directory of Open Access Journals (Sweden)

    Rodolfo Delfini Cançado

    2011-12-01

    Full Text Available BACKGROUND: Iron deficiency is the most common disorder in the world, affecting approximately 25% of the world`s population and the most common cause of anemia. OBJECTIVE: To evaluate the efficacy and safety of intravenous iron sucrose (IS in the treatment of adults with iron deficiency anemia METHODS: Eighty-six adult patients with iron deficiency anemia, who had intolerance or showed no effect with oral iron therapy, received a weekly dose of 200 mg of intravenous iron sucrose until the hemoglobin level was corrected or until receiving the total dose of intravenous iron calculated for each patient RESULTS: The mean hemoglobin and serum ferritin levels were 8.54 g/dL and 7.63 ng/mL (pre-treatment and 12.1 g/dL and 99.0 ng/mL (post-treatment (p-value < 0.0001, respectively. The average increases in hemoglobin levels were 3.29 g/dL for women and 4.58 g/dL for men; 94% of male and 84% of female patients responded (hemoglobin increased by at least 2 g/dL to intravenous iron therapy. Correction of anemia was obtained in 47 of 69 (68.1% female patients and in 12 of 17 male (70.6% patients. A total of 515 intravenous infusions of iron sucrose were administered and iron sucrose was generally well tolerated with no moderate or serious adverse drug reactions recorded by the investigators. CONCLUSIONS: Our data confirm that the use of intravenous iron sucrose is a safe and effective option in the treatment of adult patients with iron deficiency anemia who lack satisfactory response to oral iron therapy. Intravenous iron sucrose is well tolerated and with a clinically manageable safety profile when using appropriate dosing and monitoring. The availability of intravenous iron sucrose would potentially improve compliance and thereby reduce morbidities from iron deficiency.

  6. Efficacy and safety of intravenous iron sucrose in treating adults with iron deficiency anemia

    Science.gov (United States)

    Cançado, Rodolfo Delfini; de Figueiredo, Pedro Otavio Novis; Olivato, Maria Cristina Albe; Chiattone, Carlos Sérgio

    2011-01-01

    Background Iron deficiency is the most common disorder in the world, affecting approximately 25% of the world`s population and the most common cause of anemia. Objective To evaluate the efficacy and safety of intravenous iron sucrose (IS) in the treatment of adults with iron deficiency anemia Methods Eighty-six adult patients with iron deficiency anemia, who had intolerance or showed no effect with oral iron therapy, received a weekly dose of 200 mg of intravenous iron sucrose until the hemoglobin level was corrected or until receiving the total dose of intravenous iron calculated for each patient Results The mean hemoglobin and serum ferritin levels were 8.54 g/dL and 7.63 ng/mL (pre-treatment) and 12.1 g/dL and 99.0 ng/mL (post-treatment) (p-value < 0.0001), respectively. The average increases in hemoglobin levels were 3.29 g/dL for women and 4.58 g/dL for men; 94% of male and 84% of female patients responded (hemoglobin increased by at least 2 g/dL) to intravenous iron therapy. Correction of anemia was obtained in 47 of 69 (68.1%) female patients and in 12 of 17 male (70.6%) patients. A total of 515 intravenous infusions of iron sucrose were administered and iron sucrose was generally well tolerated with no moderate or serious adverse drug reactions recorded by the investigators. Conclusions Our data confirm that the use of intravenous iron sucrose is a safe and effective option in the treatment of adult patients with iron deficiency anemia who lack satisfactory response to oral iron therapy. Intravenous iron sucrose is well tolerated and with a clinically manageable safety profile when using appropriate dosing and monitoring. The availability of intravenous iron sucrose would potentially improve compliance and thereby reduce morbidities from iron deficiency. PMID:23049360

  7. Metabolic and Endocrine Profiles in Response to Systemic Infusion of Fructose and Glucose in Rhesus Macaques

    OpenAIRE

    Adams, Sean H.; Stanhope, Kimber L.; Grant, Ryan W.; Cummings, Bethany P.; Havel, Peter J.

    2008-01-01

    Diurnal patterns of circulating leptin concentrations are attenuated after consumption of fructose-sweetened beverages compared with glucose-sweetened beverages, likely a result of limited postprandial glucose and insulin excursions after fructose. Differences in postprandial exposure of adipose tissue to peripheral circulating fructose and glucose or in adipocyte metabolism of the two sugars may also be involved. Thus, we compared plasma leptin concentrations after 6-h iv infusions of saline...

  8. Intravenous ampicillin pharmacokinetics in the third trimester of pregnancy.

    Science.gov (United States)

    Kubacka, R T; Johnstone, H E; Tan, H S; Reeme, P D; Myre, S A

    1983-01-01

    The pharmacokinetics of a single dose of intravenous ampicillin were studied in nine patients during their third trimester of pregnancy. Each volunteer was given either 500 mg (5.7-8.8 mg/kg) or 1 g (15.4-21.4 mg/kg) of sodium ampicillin by rapid infusion. Postinfusion plasma concentration-time curves followed biexponential decay in all subjects. Calculated parameters included a mean plasma distribution volume of 177.1 +/- 97.5 ml/kg, tissue or peripheral distribution volume of 246.2 +/- 143.9 ml/kg, elimination half-life of 1.60 +/- 0.51 h, and total body clearance of 4.59 +/- 1.48 ml/min/kg. Dose-dependent disposition was not observed. Gestation-specific drug therapy research during pregnancy is discussed. PMID:6845399

  9. Preparation of intravenous cholesterol tracer using current good manufacturing practices.

    Science.gov (United States)

    Lin, Xiaobo; Ma, Lina; Racette, Susan B; Swaney, William P; Ostlund, Richard E

    2015-12-01

    Studies of human reverse cholesterol transport require intravenous infusion of cholesterol tracers. Because insoluble lipids may pose risk and because it is desirable to have consistent doses of defined composition available over many months, we investigated the manufacture of cholesterol tracer under current good manufacturing practice (CGMP) conditions appropriate for phase 1 investigation. Cholesterol tracer was prepared by sterile admixture of unlabeled cholesterol or cholesterol-d7 in ethanol with 20% Intralipid(®). The resulting material was filtered through a 1.2 micron particulate filter, stored at 4°C, and tested at time 0, 1.5, 3, 6, and 9 months for sterility, pyrogenicity, autoxidation, and particle size and aggregation. The limiting factor for stability was a rise in thiobarbituric acid-reacting substances of 9.6-fold over 9 months (P manufacturing methods can be achieved in the academic setting and need to be considered for critical components of future metabolic studies.

  10. Preparation of intravenous cholesterol tracer using current good manufacturing practices.

    Science.gov (United States)

    Lin, Xiaobo; Ma, Lina; Racette, Susan B; Swaney, William P; Ostlund, Richard E

    2015-12-01

    Studies of human reverse cholesterol transport require intravenous infusion of cholesterol tracers. Because insoluble lipids may pose risk and because it is desirable to have consistent doses of defined composition available over many months, we investigated the manufacture of cholesterol tracer under current good manufacturing practice (CGMP) conditions appropriate for phase 1 investigation. Cholesterol tracer was prepared by sterile admixture of unlabeled cholesterol or cholesterol-d7 in ethanol with 20% Intralipid(®). The resulting material was filtered through a 1.2 micron particulate filter, stored at 4°C, and tested at time 0, 1.5, 3, 6, and 9 months for sterility, pyrogenicity, autoxidation, and particle size and aggregation. The limiting factor for stability was a rise in thiobarbituric acid-reacting substances of 9.6-fold over 9 months (P manufacturing methods can be achieved in the academic setting and need to be considered for critical components of future metabolic studies. PMID:26416797

  11. Pharmacokinetics and Brain Uptake in the Rhesus Monkey of a Fusion Protein of Arylsulfatase A and a Monoclonal Antibody Against the Human Insulin Receptor

    Science.gov (United States)

    Boado, Ruben J.; Lu, Jeff Zhiqiang; Hui, Eric K.-W.; Sumbria, Rachita K.; Pardridge, William M.

    2014-01-01

    Metachromatic leukodystrophy (MLD) is a lysosomal storage disorder of the brain caused by mutations in the gene encoding the lysosomal sulfatase, arylsulfatase A (ASA). It is not possible to treat the brain in MLD with recombinant ASA, because the enzyme does not cross the blood-brain barrier (BBB). In the present investigation, a BBB-penetrating IgG-ASA fusion protein is engineered and expressed, where the ASA monomer is fused to the carboxyl terminus of each heavy chain of an engineered monoclonal antibody (MAb) against the human insulin receptor (HIR). The HIRMAb crosses the BBB via receptor-mediated transport on the endogenous BBB insulin receptor, and acts as a molecular Trojan horse to ferry the ASA into brain from blood. The HIRMAb-ASA is expressed in stably transfected Chinese hamster ovary cells grown in serum free medium, and purified by protein A affinity chromatography. The fusion protein retains high affinity binding to the HIR, EC50 = 0.34 ± 0.11 nM, and retains high ASA enzyme activity, 20 ± 1 units/mg. The HIRMAb-ASA fusion protein is endocytosed and triaged to the lysosomal compartment in MLD fibroblasts. The fusion protein was radio-labeled with the Bolton-Hunter reagent, and the [125I]-HIRMAb-ASA rapidly penetrates the brain in the Rhesus monkey following intravenous administration. Film and emulsion autoradiography of primate brain shows global distribution of the fusion protein throughout the monkey brain. These studies describe a new biological entity that is designed to treat the brain of humans with MLD following non-invasive, intravenous infusion of an IgG-ASA fusion protein. PMID:23192358

  12. High-dose diazepam facilitates core cooling during cold saline infusion in healthy volunteers.

    Science.gov (United States)

    Hostler, David; Northington, William E; Callaway, Clifton W

    2009-08-01

    Studies have suggested that inducing mild hypothermia improves neurologic outcomes after traumatic brain injury, major stroke, cardiac arrest, or exertional heat illness. While infusion of cold normal saline is a simple and inexpensive method for reducing core temperature, human cold-defense mechanisms potentially make this route stressful or ineffective. We hypothesized that intravenous administration of diazepam during a rapid infusion of 30 mL.kg-1 of cold (4 degrees C) 0.9% saline to healthy subjects would be more comfortable and reduce core body temperature more than the administration of cold saline alone. Fifteen subjects received rapidly infused cold (4 degrees C) 0.9% saline. Subjects were randomly assigned to receive, intravenously, 20 mg diazepam (HIGH), 10 mg diazepam (LOW), or placebo (CON). Main outcomes were core temperature, skin temperature, and oxygen consumption. Data for the main outcomes were analyzed with generalized estimating equations to identify differences in group, time, or a group x time interaction. Core temperature decreased in all groups (CON, 1.0 +/- 0.2 degrees C; LOW, 1.4 +/- 0.2 degrees C; HIGH, 1.5 +/- 0.2 degrees C), while skin temperature was unchanged. Mean (95% CI) oxygen consumption was 315.3 (253.8, 376.9) mL.kg-1.min-1 in the CON group, 317.9 (275.5, 360.3) in the LOW group, and 226.1 (216.4, 235.9) in the HIGH group. Significant time and group x time interaction was observed for core temperature and oxygen consumption (p < 0.001). Administration of high-dose diazepam resulted in decreased oxygen consumption during cold saline infusion, suggesting that 20 mg of intravenous diazepam may reduce the shivering threshold without compromising respiratory or cardiovascular function. PMID:19767791

  13. Impact of Computerized Order Entry to Pharmacy Interface on Order-Infusion Pump Discrepancies

    Directory of Open Access Journals (Sweden)

    Rebecca A. Russell

    2015-01-01

    Full Text Available Background. The ability of safety technologies to decrease errors, harm, and risk to patients has yet to be demonstrated consistently. Objective. To compare discrepancies between medication and intravenous fluid (IVF orders and bedside infusion pump settings within a pediatric intensive care unit (PICU before and after implementation of an interface between computerized physician order entry (CPOE and pharmacy systems. Methods. Within a 72-bed PICU, medication and IVF orders in the CPOE system and bedside infusion pump settings were collected. Rates of discrepancy were calculated and categorized by type. Results were compared to a study conducted prior to interface implementation. Expansion of PICU also occurred between study periods. Results. Of 455 observations, discrepancy rate decreased for IVF (p=0.01 compared to previous study. Overall discrepancy rate for medications was unchanged; however, medications infusing without an order decreased (p<0.01, and orders without corresponding infusion increased (p<0.05. Conclusions. Following implementation of an interface between CPOE and pharmacy systems, fewer discrepancies between IVF orders and infusion pump settings were observed. Discrepancies for medications did not change, and some types of discrepancies increased. In addition to interface implementation, changes in healthcare delivery and workflow related to ICU expansion contributed to observed changes.

  14. Low flow measurement for infusion pumps: implementation and uncertainty determination of the normalized method

    International Nuclear Information System (INIS)

    Intravenous drug delivery is a standard practice in hospitalized patients. As the blood concentration reached depends directly on infusion rate, it is important to use safe devices that guarantee output accuracy. In pediatric intensive care units, low infusion rates (i.e. lower than 10.0 ml/h) are frequently used. Thus, it would be necessary to use control programs to search for deviations at this flow range. We describe the implementation of a gravimetric method to test infusion pumps in low flow delivery. The procedure recommended by the ISO/IEC 60601-2-24 standard was used being a reasonable option among the methods frequently used in hospitals, such as infusion pumps analyzers and volumetric cylinders. The main uncertainty sources affecting this method are revised and a numeric and graphic uncertainty analysis is presented in order to show its dependence on flow. Additionally, the obtained uncertainties are compared to those presented by an automatic flow analyzer. Finally, the results of a series of tests performed on a syringe infusion pump operating at low rates are shown.

  15. Intravenous Pamidronate for Refractory Lymphedema

    OpenAIRE

    Beigi, A A; Sadeghi, A M; Masoudpour, H; Shirazinejad, S; Mottaghi, P

    2011-01-01

    Background Based on beneficial reports of pamidronate use for reflex sympathetic dystrophy in reduction of pain and swelling, this drug can be studied as a novel treatment for refractory lymphedema. This study aims to determine the effectiveness of pamidronate on lymphedema and its possible side effects. Methods Twelve cases of lower limb refractory lymphedema were enrolled. They received intravenous pamidronate monthly for 3 consecutive months and were followed by measuring any discomfort wi...

  16. Cholestatic hepatitis with intravenous ceftriaxone

    Directory of Open Access Journals (Sweden)

    Inderpal Kaur

    2011-01-01

    Full Text Available Drug-induced liver injury is a major health problem. Its predominant forms include acute hepatitis, cholestasis, and a mixed pattern. Ceftriaxone is a third-generation cephalosporin and is widely used in the postoperative period due to its wider spectrum, longer half-life, and better tissue penetrability. Earlier cases of high aminotransferase levels and hepatitis have also been reported with the use of ceftriaxone. Here we report a case of cholestatic hepatitis with intravenous ceftriaxone.

  17. Intraoperative esmolol infusion reduces postoperative analgesic consumption and anaesthetic use during septorhinoplasty: a randomized trial

    Directory of Open Access Journals (Sweden)

    Nalan Celebi

    2014-09-01

    Full Text Available Background and objectives: Esmolol is known to have no analgesic activity and no anaesthetic properties; however, it could potentiate the reduction in anaesthetic requirements and reduce postoperative analgesic use. The objective of this study is to evaluate the effect of intravenous esmolol infusion on intraoperative and postoperative analgesic consumptions as well as its effect on depth of anaesthesia. Methods: This randomized-controlled double blind study was conducted in a tertiary care hospital between March and June 2010. Sixty patients undergoing septorhinoplasty were randomized into two groups. History of allergy to drugs used in the study, ischaemic heart disease, heart block, bronchial asthma, hepatic or renal dysfunction, obesity and a history of chronic use of analgesic or β-blockers were considered cause for exclusion from the study. Thirty patients received esmolol and remifentanil (esmolol group and 30 patients received normal saline and remifentanil (control group as an intravenous infusion during the procedure. Mean arterial pressure, heart rate, and bispectral index values were recorded every 10min. Total remifentanil consumption, visual analogue scale scores, time to first analgesia and total postoperative morphine consumption were recorded. Results: The total remifentanil consumption, visual analogue scale scores at 0, 20 and 60 min, total morphine consumption, time to first analgesia and the number of patients who needed an intravenous morphine were lower in the esmolol group. Conclusions: Intravenous infusion of esmolol reduced the intraoperative and postoperative analgesic consumption, reduced visual analogue scale scores in the early postoperative period and prolonged the time to first analgesia; however it did not influence the depth of anaesthesia.

  18. DEVELOPMENT OF DOMESTIC INFUSION DRUGS BASED ON PARACETAMOL

    Directory of Open Access Journals (Sweden)

    Almakaeva L.G.

    2016-06-01

    Full Text Available The intravenous form of paracetamol compared with oral more reliably supports effective drug concentration in blood plasma that promotes a higher therapeutic effect. Recent studies have confirmed that the use of the intravenous form of paracetamol to deal with postoperative pain multimodal analgesia modes results in reducing the frequency and quantity of opioids administered , and, as a consequence, its associated side effects. The drug Paracetamol , infusion solution 10 mg / ml to 100 ml glass bottles is a drug - generic . His qualitative and quantitative composition is developed from the study of literature data about the drug - similar to " Perfalhan , 10 mg / ml solution for infusion in 100 mL " company Bristol - Myers Squibb, France and experimental work. The aim of our study is development and support of the national composition of the infusion of the drug on the basis of paracetamol, selection of excipients that provide stability of the active substances. Materials and methods. The object of the study was the substance of paracetamol manufactured by Zhejiang Kangle Pharmaceutical Co. , Ltd, China. During the work conducted qualitative and quantitative monitoring sample preparation for indicators of stability: pH content of the active ingredient , transparency, color, impurities , contamination by the methods described in the SFU [and nor- ral documentation to the drug . One potential factor of instability is the effect of paracetamol oxygen, due to the presence in the molecule of paracetamol and -NH possibility of oxidation. Results and Discussion. Paracetamol is derived atsetamina . Substance acetylation are p - aminophenol with acetic anhydride . Saturated aqueous solution has a pH of paracetamol - ment about 6 . Paracetamol is a crystalline white powder , sparingly soluble in water, soluble in 96% alcohol, very slightly soluble in metilenhloride . . Active substance enters in comparison drug in the concentration of 10 mg/ml. Stable

  19. Boron biodistribution after boronophenylalanine-fructose (BPA-F) infusion

    Energy Technology Data Exchange (ETDEWEB)

    Kallio, M.; Kulvik, M.; Laakso, J.; Ruokonen, I.; Vaehaetalo, J.; Faerkkilae, M. [University of Helsinki (Finland); Rasilainen, M.; Jaerviluoma, E. [Helsinki University Central Hospital, Pharmacy, Helsinki (Finland)

    2000-10-01

    In vivo dynamic tissue boron concentration measurements are not available for BNCT in clinical settings. Whole blood boron concentrations and converting factors are currently used in stead to estimate the boron concentrations in the target tissues and the ensuing radiation doses. We studied with ICP-AES the boron concentrations in blood after 2 hour intravenous infusions of BPA-F in 8 patients (290 mg/kg). As BPA-F is water soluble we calculated respective doses per lean body weight (LBW) (360 - 471 mg/kg) - the peak plasma concentrations and area under plasma boron concentration time curve correlated with the mg/LBW dose, but not with dose per skin surface area (mg/m{sup 2}). The mean boron concentrations in plasma, whole blood and red cells at the infusion were 32.1 {+-} 3.3, 23.3 {+-} 2.4 and 9.5 {+-} 2.8, respectively. LBW doses should be considered to ensure more homogenous dosing and BNCT irradiation. (author)

  20. Anaphylactoid reactions after infusion of radiographic contrast media

    Energy Technology Data Exchange (ETDEWEB)

    Ring, J.; Rothenberger, K.H.

    1984-05-18

    Pathophysiology and Prophylaxis: Anaphylactoid reactions after infusion of radiographic contrast media (RCM) do not occur infrequently (5-20%). The pathophysiology of these reactions is not totally clear. In the majority of the reactions, immunological mechanisms do not seem to play a role; rather pseudo-allergic mechanisms are involved, namely the direct liberation of vasoactive mediator substances (e.g. histamine) or activation of the complement, coagulation or kallikrein-kinin system. For the prophylaxis of RCM-induced reactions, different drugs have been recommended such as antihistamines, gluco-corticosteroids, adrenergic agents, epsilonaminocaproic acid, psychopharmaca or hypnotic suggestion. In a controlled randomized study with 800 patients undergoing intravenous urography, the efficacy of 3 different pretreatment schedules (H1-antagonists, combined H1 + H2-antagonists, prednisolone) was compared to a placebo control. It was found that the application of combined H1- and H2-antagonists 5 minutes prior to RCM infusion significantly reduced the frequency of objective anaphylactoid reactions. Neither H1-antagonists alone nor prednisolone (250 mg) showed an effect in this study.