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Level Monitoring (level + monitoring)
Selected AbstractsMycophenolate Blood Level Monitoring: Recent ProgressAMERICAN JOURNAL OF TRANSPLANTATION, Issue 7 2009T. Van Gelder The concentration,effect relationship for mycophenolic acid (MPA), and the high variability in MPA concentrations in patients on standard dose mycophenolate mofetil (MMF) therapy, for some centers has provided enough evidence to implement therapeutic drug monitoring (TDM) for MMF in daily practice. Two randomized trials Adaption de Posologie du MMF en Greffe Renale (APOMYGRE) and fixed-dose versus concentration controlled (FDCC) investigated the added benefit of TDM for MMF in renal transplant recipients. The APOMYGRE study showed a significant reduction in the incidence of acute rejection in concentration-controlled patients, while the FDCC study had a negative outcome, despite a similar study design. Although it was expected that these prospective trials would give the final answer to the question of whether or not TDM for MMF would be of benefit, it seems that the studies have not had much impact on patient management. Several trials have shown the importance of early adequate exposure to MPA in the first week after transplantation. As it will be hard to improve MPA exposure with TDM, this early, ongoing study now investigates the use of an increased starting dose. The increased starting dose will avoid underexposure to MPA in higher proportions of patients shortly after transplantation but may result in more toxicity in patients with MPA exposures exceeding the upper threshold of the therapeutic window. [source] Response of waterbird species to fluctuating water levels in tropical coastal wetlandsAFRICAN JOURNAL OF ECOLOGY, Issue 3 2010Francis Gbogbo Abstract Recent upsurges in the incidence of dam construction over rivers for farming and hydro electric power in the West African sub-region is a known promoter of fluctuating water levels on tropical coastal wetlands. Waterbirds, being one of the dominant fauna on wetlands, are key species that can be affected by fluctuating water levels. Waterbird census and water level monitoring at four coastal wetlands in Ghana revealed that different guilds (species assemblages) of waterbirds responded differently to fluctuating water levels. The populations density of birds in guilds 1 (ducks and cormorants), 3 (tactile surface foraging waders), 4 (pelagic foraging waders) and 5 (stalking herons and egrets) significantly (P < 0.05) increased linearly with decreasing water levels. The population density of birds in guilds 2 (visual surface foraging waders) and 7 (fishing terns) responded significantly (P < 0.05) in a second order polynomial function with optimum numbers occurring when water levels were neither too high nor too low. As far as farming and energy requirement are met from these dams, it is important that the ecological needs of waterbirds on wetlands are incorporated into the management of these dams so as to maintain appropriate water levels beneficial to waterbird populations. Résumé En Afrique de l'Ouest, la multiplication récente des constructions de barrages sur des cours d'eau pour les exploitations agricoles et la fourniture d'électricité est un facteur connu des fluctuations du niveau d'eau dans les zones humides côtières tropicales. Les oiseaux d'eau, éléments dominants de la faune des zones humides, sont des espèces clés qui peuvent être touchées par la fluctuation du niveau de l'eau. Les recensements des oiseaux d'eau et le suivi du niveau de l'eau dans quatre zones humides côtières du Ghana ont révélé que des guildes (assemblages d'espèces) différentes répondaient différemment à la fluctuation du niveau de l'eau. La densité de population des oiseaux dans les guildes 1 (canards et cormorans), 3 (échassiers se nourrissant en surface grâce aux corpuscules tactiles du bec), 4 (échassiers se nourrissant en profondeur) et 5 (hérons et aigrettes qui pêchent à l'affût) augmentait significativement (P < 0,05) de façon linéaire lorsque le niveau de l'eau baissait. La population des oiseaux des guildes 2 (échassiers chassant à vue à la surface) et 7 (sternes pêcheuses) répondait significativement (P < 0,05) dans une fonction polynômiale du 2d degré, les nombres optimum s'observant lorsque le niveau de l'eau n'est ni trop haut ni trop bas. À partir du moment où les exigences de l'agriculture et de l'énergie sont satisfaites grâce à ces barrages, il est important que les besoins écologiques des oiseaux d'eau des zones humides soient intégrés dans la gestion de ces barrages de façon à maintenir des niveaux d'eau favorables aux populations d'oiseaux d'eau. [source] Blood ribavirin concentration in high-dose ribavirin for adenovirus-induced haemorrhagic cystitis , a case reportJOURNAL OF CLINICAL PHARMACY & THERAPEUTICS, Issue 1 2008M. Homma PhD Summary Blood ribavirin concentration was monitored after the administration of high-dose oral ribavirin in a case of adenovirus-induced haemorrhagic cystitis post-stem-cell transplantation. Combination use of intravenous gamma immunoglobulin (15 g/3 days) and high-dose ribavirin (RBV; 9000 mg/4 days) provided plasma ribavirin concentration of 24·3 ,m and achieved virus eradication. High level of erythrocyte ribavirin (1085 ,m; mostly as phosphorylated metabolites) with long half-life (15 days) caused severe anaemia, which required several blood transfusions for 2 weeks after the cessation of the ribavirin treatment. It was suggested that blood transfusion and intensive haemoglobin level monitoring is necessary for at least 4 weeks after the RBV, because of the high accumulation of phosphorylated ribavirin in erythrocytes even after stopping ribavirin administration. [source] A simple and rapid high-performance liquid chromatographic (HPLC) method for 5-fluorouracil (5-FU) assay in plasma and possible detection of patients with impaired dihydropyrimidine dehydrogenase (DPD) activityJOURNAL OF CLINICAL PHARMACY & THERAPEUTICS, Issue 4 2004J. Ciccolini PharmD PhD Summary Background:, Dihydropyrimidine dehydrogenase (DPD) gene polymorphism may lead to severe toxicity with 5-fluorouracil (5-FU), a major anticancer drug extensively used in clinical oncology. Drug monitoring combined with early detection of patients at risk would enable timely dose adaptation so as to maintain drug concentrations within a therapeutic window. However, the best method to identify such patients remains to be determined. Objective:, The aim of this study was to develop a rapid and simple high-performance liquid chromatographic (HPLC) method for estimating uracil/dihydrouracil (U/UH2) ratio in plasma, as an index of DPD status, and for assaying 5-FU as part of drug level monitoring. Method:, Assay of 5-FU, and U/UH2 detection were performed on a HPLC system equipped with UV detector. Analytes were separated at room temperature using a 5 ,m particles, 25 cm RP-18 X-Terra column. The mobile-phase consisted of a KH2PO4 salt solution (0·05 m) + 0·1% triethylamine (TEA) pumped at 0·4 mL/min. Detection of 5-FU and 5-bromouracil were performed at 254 nm; U and UH2 elution was monitored at 210 nm. Results:, The method was sensitive and specific for assaying 5-FU within the 5,500 ng/mL concentration range, which covers exposure levels currently met in clinical practice. The method was simple, and relatively cheap, and rapid, with an analytical run time of about 30 min. Data from a patient with 5-FU toxicity suggest that the method was capable of identifying DPD metabolic phenotype in cancer patients, based on measurement of plasma U/UH2 ratio. Conclusion:, The method described should be suitable both for detecting patients at high risk of 5-FU toxicity, and for drug level monitoring during chemotherapy. [source] | ||||||||||