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Bin Jie Zhu-Ming Jiang Marie T. Nolan David T. Efron Shai-Nan Zhu Kang Yu Jens Kondrup 《Nutrition (Burbank, Los Angeles County, Calif.)》2010,26(11-12):1088-1093
ObjectiveTo evaluate the impact of nutritional support on clinical outcomes in patients at nutritional risk defined by the Nutritional Risk Screening 2002.MethodsIn this prospective cohort study, hospitalized patients from three departments in Johns Hopkins Hospital in Baltimore and two teaching hospitals in Beijing were recruited from March 2007 to May 2008. Data were collected on the nutritional risk screening, application of parenteral nutrition and enteral nutrition, surgery, complications, and length of stay.ResultsThere were 1831 patients recruited, with 45.2% of them at nutritional risk. Of the “at-risk” patients, the complication rate was significantly lower in the nutritional-support group than in the no-support group (20.3% versus 28.1%, P = 0.009), mainly because of the lower rate of infectious complications (10.5% versus 18.9%, P < 0.001). Subgroup analysis showed the complication rate was significantly lower in the enteral nutrition group (P < 0.001) but not in the parenteral nutrition group (P = 0.29) when compared with the no-support group. Of the patients without nutritional risk, the complication rate was not different between the nutritional-support group and the no-support group (P = 0.10). Multivariate analysis showed nutritional support was a protective factor for complications in at-risk patients when adjusted for confounders (odds ratio 0.54, P < 0.001). No difference in length of stay was found.ConclusionThe findings suggested that nutritional support was beneficial to the patients at nutritional risk according to Nutritional Risk Screening 2002 by a lower complication rate. 相似文献
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Bimal Malhotra Richard Sachse Nolan Wood 《European journal of clinical pharmacology》2009,65(6):551-560
Purpose To assess drug–drug interactions of fesoterodine with cytochrome P450 (CYP) 3A4 inhibitor (ketoconazole), inducer (rifampicin),
and substrates (ethinylestradiol and levonorgestrel).
Methods Effects of ketoconazole 200 mg twice daily and rifampicin 600 mg twice daily on fesoterodine 8 mg once daily were investigated
in CYP2D6 extensive metabolizers (EMs) and poor metabolizers (PMs) based on 5-hydroxymethyl tolterodine (5-HMT) pharmacokinetics
(principal active fesoterodine metabolite and CYP3A4 substrate). Effects of fesoterodine 8 mg versus placebo once daily on
ethinylestradiol and levonorgestrel were investigated based on oral contraceptive pharmacokinetics and on pharmacodynamic
effects on progesterone, luteinizing hormone, follicle-stimulating hormone, and estradiol plasma levels.
Results Compared with fesoterodine alone, coadministration of fesoterodine with ketoconazole resulted in increases in mean 5-HMT maximum
concentration in plasma (Cmax; from 3.0 to 6.0 ng/mL in EMs and from 6.4 to 13.4 ng/mL in PMs) and mean area under the plasma concentration time curve
(AUC; from 38.2 to 88.3 ng h/mL in EMs and 88.3 to 217.2 ng h/mL in PMs). Coadministration of festerodine with rifampicin
resulted in decreases in mean 5-HMT Cmax (from 5.2 to 1.5 ng/mL in EMs and from 6.8 to 1.9 ng/mL in PMs) and mean AUC (from 62.4 to 14.4 ng h/mL in EMs and from 87.8
to 19.6 ng h/mL in PMs). Fesoterodine did not affect oral contraceptive pharmacokinetics or pharmacodynamics or the suppression
of ovulation.
Conclusions Fesoterodine dosage should not exceed 4 mg once daily when taken concomitantly with potent CYP3A4 inhibitors. Coadministration
of CYP3A4 inducers with fesoterodine may produce subtherapeutic 5-HMT exposures. No dose adjustment is necessary for concomitant
use of fesoterodine with oral contraceptives.
Funding for this study was provided by Schwarz Biosciences GmbH, and Pfizer Inc. 相似文献
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The mouse bagpipe gene controls development of axial skeleton, skull, and spleen 总被引:6,自引:0,他引:6
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Laura A. Lettice Lorna A. Purdie Geoffrey J. Carlson Fiona Kilanowski Julia Dorin Robert E. Hill 《Proceedings of the National Academy of Sciences of the United States of America》1999,96(17):9695-9700
The mouse Bapx1 gene is homologous to the Drosophila homeobox containing bagpipe (bap) gene. A shared characteristic of the genes in these two organisms is expression in gut mesoderm. In Drosophila, bap functions to specify the formation of the musculature of the midgut. To determine the function of the mammalian cognate, we targeted a mutation into the Bapx1 locus. Bapx1, similar to Drosophila, does have a conspicuous role in gut mesoderm; however, this appears to be restricted to development of the spleen. In addition, Bapx1 has a major role in the development of the axial skeleton. Loss of Bapx1 affects the distribution of sclerotomal cells, markedly reducing the number that appear ventromedially around the notochord. Subsequently, the structures in the midaxial region, the intervertebral discs, and centra of the vertebral bodies, fail to form. Abnormalities are also found in those bones of the basal skull (basioccipital and basisphenoid bones) associated with the notochord. We postulate that Bapx1 confers the capacity of cells to interact with the notochord, effecting inductive interactions essential for development of the vertebral column and chondrocranium. 相似文献
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As the emphasis on individualised patient care increased in a large ICU, it was decided to apply the nursing process. This article describes how the process was adapted to suit the unit's special needs. 相似文献
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