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1.
Environ Sci Technol ; 52(20): 11573-11582, 2018 10 16.
Artigo em Inglês | MEDLINE | ID: mdl-30222337

RESUMO

We used natural mercury (Hg) stable isotopes to investigate the Hg cycle in a rainforest soil catena (French Guiana) partially gold-mined during the early 1950s. Litterfall showed homogeneous Δ199Hg values [-0.18 ± 0.05‰, i.e., a modern gaseous elemental Hg (GEM) isotopic signature]. After litter decomposition, Hg bound to organic matter (OM) is mixed with Hg from pristine (-0.55 ± 0.22‰) or gold-mined (-0.09 ± 0.16‰) mineral materials. Negative Δ199Hg values in deep pristine mineral horizons (-0.60 ± 0.16‰) suggest the transfer of Hg bound to dissolved OM depleted in odd isotopes due to mass-independent fractionation during Hg abiotic reduction. Perennial palm tree leaves collected above gold-mined and pristine soil recorded contrasting Δ199Hg signatures likely resulting from GEM re-emission processes from soils and leaf surfaces. Upslope, soil δ202Hg signatures showed a negative shift (ε ∼ -1‰) with depth attributed to mass-dependent fractionation during Hg sorption and complexation onto iron oxides and dissolved OM. Downslope, higher δ202Hg values in soils resulted from hydromorphy [lower humification, greater Hg(II) reduction, etc.]. The unique Hg isotopic signatures of Amazonian soils probably result in multistep fractionation processes during pedogenesis (millions of years) and in a potentially different Hg isotopic signature of preanthropogenic background GEM.


Assuntos
Mercúrio , Solo , Monitoramento Ambiental , Florestas , Guiana Francesa , Ouro , Isótopos de Mercúrio , Mineração
2.
Phys Rev Lett ; 117(21): 214102, 2016 Nov 18.
Artigo em Inglês | MEDLINE | ID: mdl-27911557

RESUMO

We prove that any nonzero inertia, however small, is able to change the nature of the synchronization transition in Kuramoto-like models, either from continuous to discontinuous or from discontinuous to continuous. This result is obtained through an unstable manifold expansion in the spirit of Crawford, which features singularities in the vicinity of the bifurcation. Far from being unwanted artifacts, these singularities actually control the qualitative behavior of the system. Our numerical tests fully support this picture.

3.
Phys Rev Lett ; 112(13): 133001, 2014 Apr 04.
Artigo em Inglês | MEDLINE | ID: mdl-24745411

RESUMO

We propose to use a cloud of laser-cooled atoms in a quasi-two-dimensional trap to investigate a nonequilibrium collapse phase transition in the presence of a gravitational-like interaction. Using theoretical arguments and numerical simulations, we show that, like in two-dimensional gravity, a transition to a collapsed state occurs below a critical temperature. In addition and as a signature of the nonequilibrium nature of the system, persistent particle currents, dramatically increasing close to the phase transition, are observed.

4.
J Geophys Res Atmos ; 128(3): e2022JD037479, 2023 Feb 16.
Artigo em Inglês | MEDLINE | ID: mdl-37034455

RESUMO

Emissions of methane (CH4) in the Permian basin (USA) have been derived for 2019 and 2020 from satellite observations of the Tropospheric Monitoring Instrument (TROPOMI) using the divergence method, in combination with a data driven method to estimate the background column densities. The resulting CH4 emission data, which have been verified using model data with known emissions, have a spatial resolution of approximately 10 km. The CH4 emissions show moderate spatial correlation with the locations of oil and gas production and drilling activities in the Permian basin, as well as with emissions of nitrogen oxides (NOx). Analysis of the emission maps and time series indicates that a significant fraction of methane emissions in the Permian basin is from frequent widespread emissions sources, rather than from a few infrequent very large unplanned releases, which is important considering possible CH4 emission mitigation strategies. In addition to providing spatially resolved emissions, the divergence method also provides the total emissions of the Permian basin and its main sub-basins. The total CH4 emission of the Permian is estimated as 3.0 ± 0.7 Tg yr-1 for 2019, which agrees with other independent estimates based on TROPOMI data. For the Delaware sub-basin, it is estimated as 1.4 ± 0.3 Tg yr-1 for 2019, and for the Midland sub-basin 1.2 ± 0.3 Tg yr-1. In 2020 the emissions are 9% lower compared to 2019 in the entire Permian basin, and respectively 19% and 27% for the Delaware and Midland sub-basins.

5.
Eur J Neurol ; 19(5): 703-11, 2012 May.
Artigo em Inglês | MEDLINE | ID: mdl-22136117

RESUMO

BACKGROUND AND PURPOSE: Headache disorders are very common, but their monetary costs in Europe are unknown. We performed the first comprehensive estimation of how economic resources are lost to headache in Europe. METHODS: From November 2008 to August 2009, a cross-sectional survey was conducted in eight countries representing 55% of the adult EU population. Participation rates varied between 11% and 59%. In total, 8412 questionnaires contributed to this analysis. Using bottom-up methodology, we estimated direct (medications, outpatient health care, hospitalization and investigations) and indirect (work absenteeism and reduced productivity at work) annual per-person costs. Prevalence data, simultaneously collected and, for migraine, also derived from a systematic review, were used to impute national costs. RESULTS: Mean per-person annual costs were €1222 for migraine (95% CI 1055-1389; indirect costs 93%), €303 for tension-type headache (TTH, 95% CI 230-376; indirect costs 92%), €3561 for medication-overuse headache (MOH, 95% CI 2487-4635; indirect costs 92%), and €253 for other headaches (95% CI 99-407; indirect costs 82%). In the EU, the total annual cost of headache amongst adults aged 18-65 years was calculated, according to our prevalence estimates, at €173 billion, apportioned to migraine (€111 billion; 64%), TTH (€21 billion; 12%), MOH (€37 billion; 21%) and other headaches (€3 billion; 2%). Using the 15% systematic review prevalence of migraine, calculated costs were somewhat lower (migraine €50 billion, all headache €112 billion annually). CONCLUSIONS: Headache disorders are prominent health-related drivers of immense economic losses for the EU. This has immediate implications for healthcare policy. Health care for headache can be both improved and cost saving.


Assuntos
Efeitos Psicossociais da Doença , Transtornos da Cefaleia/economia , Custos de Cuidados de Saúde/estatística & dados numéricos , Adolescente , Adulto , Idoso , Custos e Análise de Custo , Estudos Transversais , Europa (Continente)/epidemiologia , Feminino , Transtornos da Cefaleia/diagnóstico , Transtornos da Cefaleia/epidemiologia , Transtornos da Cefaleia/terapia , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Adulto Jovem
6.
Br J Anaesth ; 107(6): 899-910, 2011 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-21873632

RESUMO

BACKGROUND: Patients receiving anti-platelet agents for secondary cardiovascular prevention frequently require non-cardiac surgery. A substantial proportion of these patients have their anti-platelet drug discontinued before operation; however, there is uncertainty about the impact of this practice. The aim of this study was to compare the effect of maintenance or interruption of aspirin before surgery, in terms of major thrombotic and bleeding events. METHODS: Patients treated with anti-platelet agents for secondary prevention and undergoing intermediate- or high-risk non-cardiac surgery were included in this multicentre, randomized, placebo-controlled, trial. We substituted non-aspirin anti-platelets with aspirin (75 mg daily) or placebo starting 10 days before surgery. The primary outcome was a composite score evaluating both major thrombotic and bleeding adverse events occurring within the first 30 postoperative days weighted by their severity (weights were established a priori using a Delphi consensus process). Analyses followed the intention-to-treat principle. RESULTS: We randomized 291 patients (n=145, aspirin group, and n=146, placebo group). The most frequent surgical procedures were orthopaedic surgery (52.2%), abdominal surgery (20.6%), and urologic surgery (15.5%). No significant difference was observed neither in the primary outcome score [mean values (SD)=0.67 (2.05) in the aspirin group vs 0.65 (2.04) in the placebo group, P=0.94] nor at day 30 in the number of major complications between groups. CONCLUSIONS: In these at-risk patients undergoing elective non-cardiac surgery, we did not find any difference in terms of occurrence of major thrombotic or bleeding events between preoperative maintenance or interruption of aspirin.


Assuntos
Aspirina/uso terapêutico , Procedimentos Cirúrgicos Eletivos , Inibidores da Agregação Plaquetária/uso terapêutico , Hemorragia Pós-Operatória/induzido quimicamente , Cuidados Pré-Operatórios , Trombose/prevenção & controle , Idoso , Aspirina/administração & dosagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
7.
J Headache Pain ; 12(5): 541-9, 2011 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-21660430

RESUMO

The Eurolight project is the first at European Union level to assess the impact of headache disorders, and also the first of its scale performed by collaboration between professional and lay organizations and individuals. Here are reported the methods developed for it. The project took the form of surveys, by structured questionnaire, conducted in ten countries of Europe which together represented 60% of the adult population of the European Union. In Lithuania, the survey was population-based. Elsewhere, truly population-based studies were impractical for reasons of cost, and various compromises were developed. Closest to being population-based were the surveys in Germany, Luxembourg, the Netherlands, Italy and Spain. In Austria, France and UK, samples were taken from health-care settings. In addition in the Netherlands, Spain and Ireland, samples were drawn from members of national headache patient organizations and their relatives. Independent double data-entry was performed prior to analysis. Returned questionnaires from 9,269 respondents showed a moderate female bias (58%); of respondents from patients' organizations (n = 992), 61% were female. Mean age of all respondents was 44 years; samples from patients' organizations were slightly older (mean 47 years). The different sampling methods worked with differing degrees of effectiveness, as evidenced by the responder-rates, which varied from 10.8 to 90.7%. In the more population-based surveys, responder-rates varied from 11.3 to 58.8%. We conclude that the methodology, although with differences born of necessity in the ten countries, was sound overall, and will provide robust data on the public ill-health that results from headache in Europe.


Assuntos
Efeitos Psicossociais da Doença , Cefaleia/epidemiologia , Projetos de Pesquisa , Adulto , Europa (Continente)/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários
8.
Phys Rev E ; 102(5-1): 052208, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33327081

RESUMO

We propose a classification of bifurcations of Vlasov equations, based on the strength of the resonance between the unstable mode and the continuous spectrum on the imaginary axis. We then identify and characterize a new type of generic bifurcation where this resonance is weak, but the unstable mode couples with a stable mode and a Casimir invariant of the system to form a size-3 Jordan block. We derive a three-dimensional reduced noncanonical Hamiltonian system describing this bifurcation. Comparison of the reduced dynamics with direct numerical simulations on a test case gives excellent agreement. We finally discuss the relevance of this bifurcation to specific physical situations.

9.
J Geophys Res Atmos ; 124(1): 387-413, 2019 Jan 16.
Artigo em Inglês | MEDLINE | ID: mdl-31007989

RESUMO

Global multiconstituent concentration and emission fields obtained from the assimilation of the satellite retrievals of ozone, CO, NO2, HNO3, and SO2 from the Ozone Monitoring Instrument (OMI), Global Ozone Monitoring Experiment 2, Measurements of Pollution in the Troposphere, Microwave Limb Sounder, and Atmospheric Infrared Sounder (AIRS)/OMI are used to understand the processes controlling air pollution during the Korea-United States Air Quality (KORUS-AQ) campaign. Estimated emissions in South Korea were 0.42 Tg N for NO x and 1.1 Tg CO for CO, which were 40% and 83% higher, respectively, than the a priori bottom-up inventories, and increased mean ozone concentration by up to 7.5 ± 1.6 ppbv. The observed boundary layer ozone exceeded 90 ppbv over Seoul under stagnant phases, whereas it was approximately 60 ppbv during dynamical conditions given equivalent emissions. Chemical reanalysis showed that mean ozone concentration was persistently higher over Seoul (75.10 ± 7.6 ppbv) than the broader KORUS-AQ domain (70.5 ± 9.2 ppbv) at 700 hPa. Large bias reductions (>75%) in the free tropospheric OH show that multiple-species assimilation is critical for balanced tropospheric chemistry analysis and emissions. The assimilation performance was dependent on the particular phase. While the evaluation of data assimilation fields shows an improved agreement with aircraft measurements in ozone (to less than 5 ppbv biases), CO, NO2, SO2, PAN, and OH profiles, lower tropospheric ozone analysis error was largest at stagnant conditions, whereas the model errors were mostly removed by data assimilation under dynamic weather conditions. Assimilation of new AIRS/OMI ozone profiles allowed for additional error reductions, especially under dynamic weather conditions. Our results show the important balance of dynamics and emissions both on pollution and the chemical assimilation system performance.

10.
J Nonlinear Sci ; 28(1): 235-268, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29367810

RESUMO

We provide a numerical study of the macroscopic model of Barré et al. (Multiscale Model Simul, 2017, to appear) derived from an agent-based model for a system of particles interacting through a dynamical network of links. Assuming that the network remodeling process is very fast, the macroscopic model takes the form of a single aggregation-diffusion equation for the density of particles. The theoretical study of the macroscopic model gives precise criteria for the phase transitions of the steady states, and in the one-dimensional case, we show numerically that the stationary solutions of the microscopic model undergo the same phase transitions and bifurcation types as the macroscopic model. In the two-dimensional case, we show that the numerical simulations of the macroscopic model are in excellent agreement with the predicted theoretical values. This study provides a partial validation of the formal derivation of the macroscopic model from a microscopic formulation and shows that the former is a consistent approximation of an underlying particle dynamics, making it a powerful tool for the modeling of dynamical networks at a large scale.

11.
J Thromb Haemost ; 5(12): 2360-7, 2007 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-17908282

RESUMO

BACKGROUND: In view of recent substantial changes in the management of orthopedic surgery patients, a study was performed in order to update data on the epidemiology of venous thromboembolism (VTE) in patients undergoing lower limb arthroplasty according to contemporary practise. METHODS: We performed a prospective observational study of a cohort of consecutive patients hospitalized for total hip or knee replacement in June 2003. The primary study outcome was the incidence of symptomatic VTE at 3 months. All events were adjudicated by an independent critical event committee. RESULTS: Data from 1080 patients (mean age 68.0 years) were available; 63.2% were undergoing total hip replacement and 36.8% total knee replacement. Pharmacological thromboprophylaxis was administered for a mean time of 36 days. Injectable antithrombotics were used in more than 99% of patients, irrespective of the type of surgery. The incidence of the primary study outcome was 1.8% (20 events; 95% CI: 1.0-2.6%). The incidences were 1.3% and 2.8% in hip and knee surgery patients, respectively. There were two pulmonary embolisms, both in knee surgery patients; neither was fatal. Thirty-five per cent of VTEs occurred after hospital discharge. An age of at least 75 years and the absence of ambulation before hospital discharge were the only significant (P < 0.05) predictors of VTE. The rate of clinically significant bleeding was 1.0% and the rate of death was 0.9%. CONCLUSIONS: The incidence of symptomatic VTE after lower limb arthroplasty is low, even if there is still a need to improve thromboprophylaxis, notably in patients undergoing knee arthroplasty.


Assuntos
Artroplastia de Quadril/efeitos adversos , Artroplastia do Joelho/efeitos adversos , Embolia Pulmonar/epidemiologia , Tromboembolia Venosa/epidemiologia , Fatores Etários , Idoso , Artroplastia de Quadril/estatística & dados numéricos , Artroplastia do Joelho/estatística & dados numéricos , Feminino , Fibrinolíticos/efeitos adversos , Fibrinolíticos/uso terapêutico , França/epidemiologia , Hemorragia/induzido quimicamente , Hemorragia/epidemiologia , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Vigilância da População , Estudos Prospectivos , Embolia Pulmonar/etiologia , Embolia Pulmonar/fisiopatologia , Embolia Pulmonar/prevenção & controle , Fatores de Risco , Fatores de Tempo , Resultado do Tratamento , Tromboembolia Venosa/etiologia , Tromboembolia Venosa/fisiopatologia , Tromboembolia Venosa/prevenção & controle , Caminhada
12.
Rev Neurol (Paris) ; 163(2): 222-30, 2007 Feb.
Artigo em Francês | MEDLINE | ID: mdl-17351541

RESUMO

INTRODUCTION: Executive dysfunction is regularly reported in patients with Alzheimer's disease. Nevertheless few studies have focused on planning ability in this neurodegenerative disease. OBJECTIVES: This study aimed to investigate the formulation and the execution of plans in Alzheimer's disease using an ecological planning subtask derived from the Behavioural Assessment of the Dysexecutive Syndrome test battery, the "Zoo Map Test". There are two trials. The first trial consists of a "high demand" version of the subtask in which the subjects must plan in advance the order in which they will visit designated locations in a zoo (formulation level). In the second, or "low demand" version, the subject is simply required to follow a concrete externally imposed strategy to reach the locations to visit (execution level). The test was given to 16 patients with Alzheimer's disease and 13 normal elderly subjects. RESULTS: The two way ANOVAs mainly showed more difficulties in patients with Alzheimer's disease than in healthy elderly in both conditions. The difference between formulation and execution was greater in patients with Alzheimer's disease than in healthy elderly. Planning impairments mainly correlated with behavioural changes (in particular motivational changes) observed by patient's relatives. CONCLUSION: These results suggest that patients with Alzheimer's disease have some problems to mentally develop logical strategies and to execute complex predetermined plans, which are partially related to behavioural changes.


Assuntos
Doença de Alzheimer/psicologia , Tomada de Decisões , Testes Neuropsicológicos , Idoso , Feminino , Humanos , Masculino , Mapas como Assunto , Motivação , Inquéritos e Questionários
13.
Phys Rev E Stat Nonlin Soft Matter Phys ; 73(1 Pt 1): 011108, 2006 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-16486123

RESUMO

Anisotropic classical Heisenberg models with all-to-all spin coupling display a topological nonconnectivity threshold (TNT) for any number N of spins. Below this threshold, the energy surface is disconnected in two components with positive and negative total magnetizations, respectively, so that magnetization cannot reverse its sign and ergodicity is broken, even at finite N. Here, we solve the model in the microcanonical ensemble, using a recently developed method based on large deviation techniques, and show that a phase transition is present at an energy higher than the TNT energy. In the energy range between the TNT energy and the phase transition, magnetization changes sign stochastically and its behavior can be fully characterized by an average magnetization reversal time. The time scale for magnetic reversal can be computed analytically, using statistical mechanics. Numerical simulations confirm this calculation and further show that the magnetic reversal time diverges with a power law at the TNT threshold, with a size-dependent exponent. This exponent can be computed in the thermodynamic limit N-->(infinity), by the knowledge of entropy as a function of magnetization, and turns out to be in reasonable agreement with finite numerical simulations. We finally generalize our results to other models: Heisenberg chains with distance-dependent coupling, small 3D clusters with nearest-neighbor interactions, metastable states. We conjecture that the power-law divergence of the magnetic reversal time scale might be a universal signature of the presence of a TNT.

14.
Phys Rev E ; 93: 042207, 2016 04.
Artigo em Inglês | MEDLINE | ID: mdl-27176293

RESUMO

We study nonoscillating bifurcations of nonhomogeneous steady states of the Vlasov equation, a situation occurring in galactic models, or for Bernstein-Greene-Kruskal modes in plasma physics. Through an unstable manifold expansion, we show that in one spatial dimension the dynamics is very sensitive to the initial perturbation: the instability may saturate at small amplitude-generalizing the "trapping scaling" of plasma physics-or may grow to produce a large-scale modification of the system. Furthermore, resonances are strongly suppressed, leading to different phenomena with respect to the homogeneous case. These analytical findings are illustrated and extended by direct numerical simulations with a cosine interaction potential.

15.
Pharmacogenetics ; 6(5): 403-15, 1996 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-8946472

RESUMO

Human alpha 1-acid glycoprotein (AAG), a plasma drug transport protein, has three main genetic variants, the A variant and the F1 and S variants, which are encoded by two different genes. The binding of disopyramide, methadone, dipyridamole, chlorpromazine, lignocaine and progesterone to the two main gene products of AAG-the A variant and a mixture of the F1 and S variants (60% F1 and 40% S)-separated by chromatography from native commercial AAG, a mixture of almost equal proportions of the F1, S and A variants, was studied by equilibrium dialysis. A selective binding of disopyramide and methadone to the A variant and a preferential binding of dipyridamole to the F1S variant mixture were found. Lignocaine and chlorpromazine had a slight preference for binding to the A variant and to the F1S mixture, respectively, but progesterone showed no selectivity with regard to any of the variants of AAG. The differences in drug-binding demonstrated between the A variant and the F1S mixture confirmed those of a previous study, in which a selective binding of imipramine to the A variant and of warfarin and mifepristone to the F1S mixture have been found. These results indicate specific drug transport roles for each AAG variant, according to its separate genetic origin. The results of control binding experiments performed with (unfractionated) commercial AAG and the series of tested ligands concurred with that for the separate AAG variants, with respect to the proportion of the A variant (27%) and that of the F1 and S variants (73%) in the commercial protein. In addition, disopyramide, methadone, dipyridamole, chlorpromazine, lignocaine and progesterone were used in equilibrium dialysis displacement experiments to study interactions on binding sites labelled with imipramine for the A variant and with warfarin for the F1S variant mixture. The four latter ligands were found to competitively inhibit the binding of warfarin to the F1S variant mixture and all of them that of imipramine to the A variant. The ligands association constants to each AAG variant obtained from such inhibitory experiments were comparable to those determined in the direct binding studies. As the stochlometry of the interactions of the A variant and the F1S variants, respectively, with their specific ligands was approximately one (1), it was concluded that these ligands bind to each of these variants via a single common binding site. These results indicate that the AAG molecule would have for its ligands at least two separate binding sites, showing different specificity and localization, and not one site, as it is generally assumed. The possible pharmacological and clinical consequences of the binding results with the separate AAG variants are discussed.


Assuntos
Proteínas de Transporte/metabolismo , Variação Genética , Orosomucoide/metabolismo , Preparações Farmacêuticas/metabolismo , Ligação Competitiva , Proteínas de Transporte/genética , Clorpromazina/metabolismo , Dipiridamol/metabolismo , Disopiramida/metabolismo , Humanos , Lidocaína/metabolismo , Ligantes , Metadona/metabolismo , Orosomucoide/genética , Progesterona/metabolismo
16.
Clin Pharmacol Ther ; 58(2): 185-91, 1995 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-7648768

RESUMO

The pharmacokinetic-pharmacodynamic relationship of rocuronium at the laryngeal adductor muscles and the adductor pollicis was determined in eight patients during general anesthesia. Rocuronium was administered as an infusion at a rate of 100 micrograms.kg-1.min-1 over 5 minutes. The half-life of transport between plasma and biophase (effect compartment) was significantly shorter at the adductor laryngeal muscles (2.7 +/- 0.6 minutes, mean +/- SD) than at the adductor pollicis (4.4 +/- 1.5 minutes, p = 0.003). The concentration in the effect compartment producing 50% of the maximum effect was significantly greater at the adductor laryngeal muscles (1424 +/- 148 micrograms.L-1) than at the adductor pollicis (823 +/- 157 micrograms.L-1, p = 0.0001). The shorter onset of neuromuscular blockade at the laryngeal muscles than at the adductor pollicis may be explained by a faster transfer rate at the laryngeal adductor muscles neuromuscular junction than at the adductor pollicis neuromuscular junction.


Assuntos
Androstanóis/farmacologia , Músculos/efeitos dos fármacos , Fármacos Neuromusculares não Despolarizantes/farmacologia , Polegar , Prega Vocal , Adulto , Androstanóis/farmacocinética , Meia-Vida , Humanos , Pessoa de Meia-Idade , Músculos/metabolismo , Fármacos Neuromusculares não Despolarizantes/farmacocinética , Rocurônio
17.
Thromb Haemost ; 81(1): 22-5, 1999 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-10348714

RESUMO

Consecutive patients undergoing total hip replacement in 43 centres were randomly assigned to receive blindly either enoxaparin (40 mg) or tinzaparin (4,500 anti-Factor IU Xa), as once daily subcutaneous injections. The first injection was administered 12 h preoperatively. Efficacy was assessed by bilateral venography performed 12-14 days postoperatively. Efficacy and safety were blindly and centrally adjudicated. Among the 499 patients included, 440 had a venogram. The total incidence of DVTs was 44 (20.1%) of the 219 patients of the enoxaparin group and 48 (21.7%) of the 221 patients of the tinzaparin group. The upper limit of the 80% confidence interval of the difference between the two treatment groups was less than 5.0%. Therefore according to the protocol's specifications equivalence was shown. Proximal DVTs occurred in 10.5% of the enoxaparin group (23 patients) and in 9.5% (21 patients) of the tinzaparin group. No overt major bleeding was observed. One patient in the enoxaparin group developed severe thrombocytopenia and died. The LMWH tinzaparin appears clinically to be as effective and safe as enoxaparin in the prophylaxis of deep vein thrombosis after total hip replacement, at the doses used and under the conditions of this study.


Assuntos
Artroplastia de Quadril , Enoxaparina/administração & dosagem , Fibrinolíticos/administração & dosagem , Heparina de Baixo Peso Molecular/administração & dosagem , Complicações Pós-Operatórias/prevenção & controle , Tromboflebite/prevenção & controle , Adulto , Idoso , Método Duplo-Cego , Enoxaparina/efeitos adversos , Feminino , Heparina de Baixo Peso Molecular/efeitos adversos , Humanos , Injeções Subcutâneas , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Tinzaparina
18.
Clin Pharmacokinet ; 19(3): 218-29, 1990 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-2203581

RESUMO

Part I of this article, which appeared in the previous issue of the Journal, discussed the implications of variations in plasma protein levels in a number of diseases: hepatic and renal disease, acute myocardial infarction, burns, cancer, diabetes mellitus, hyperlipidaemia and inflammatory diseases. In Part II the authors continue their review with a further range of disease states, and consider their import for drug dosages.


Assuntos
Proteínas Sanguíneas/metabolismo , Preparações Farmacêuticas/administração & dosagem , Animais , Humanos , Distúrbios Nutricionais/metabolismo , Farmacocinética , Doenças da Glândula Tireoide/metabolismo
19.
Clin Pharmacokinet ; 19(2): 147-59, 1990 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-2199129

RESUMO

Many diseases appear to lead to a decrease of drug plasma binding due either to hypoalbuminaemia or to a modification of albumin structure. In other diseases, the binding of a drug may increase due to elevated concentrations of alpha 1-acid glycoprotein or lipoproteins. However that may be, the free fraction of a drug may vary in different pathologies. But an increase or decrease of the drug free fraction does not automatically mean an increase or decrease of the free drug concentration. Whatever the drug, a variation in the volume of distribution more or less proportional to the variation in the plasma free fraction can be expected. With respect to the clearance, the problem is much more complex and depends on the hepatic extraction ratio of drug. If the extraction is related to the free fraction (fu) of drug, a variation in fu will lead to a variation in the total drug concentration but no variation in the free drug concentration and no change in the pharmacological effect. If the extraction of a drug is dependent on hepatic flow, a variation in fu will lead to a change in the free drug concentration (with no change in the total drug concentration) and hence changes in the pharmacological effect. The aim of this article is to review the literature concerning disease-induced variations in plasma protein levels during the past 10 years. Finally, possible implications for drug dosage regimens are discussed generally from examples studies in the literature.


Assuntos
Proteínas Sanguíneas/metabolismo , Doença , Animais , Relação Dose-Resposta a Droga , Tratamento Farmacológico , Humanos
20.
Clin Pharmacokinet ; 11(4): 336-42, 1986.
Artigo em Inglês | MEDLINE | ID: mdl-3757392

RESUMO

The volumes of distribution of many acidic drugs have been shown to be close to that of their binding protein, i.e. serum albumin. The distribution of basic drugs mainly bound to alpha 1-acid glycoprotein (AAG) can be questioned with respect to its dependency upon the distribution of this plasma protein. So, a pharmacokinetic study was performed in 7 subjects with human 125I-labelled alpha 1-acid glycoprotein. The steady-state volume of distribution was found to be 5.37 +/- 0.82L. The central volume was 3.23 +/- 0.33L, close to that of plasma volume and the peripheral volume was 2.14 +/- 0.63L. These data allowed the establishment of an equation giving access to the volume of distribution of a basic drug by relating its unbound fraction to physiological distribution of alpha 1-acid glycoprotein. The values yielded by this equation show that the actual and calculated volumes of distribution of basic drugs mainly bound to AAG are discrepant. This protein is thus not the main factor controlling the distribution of basic drugs within the body.


Assuntos
Orosomucoide/metabolismo , Adulto , Humanos , Injeções Intravenosas , Cinética , Pessoa de Meia-Idade , Orosomucoide/sangue , Ligação Proteica
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