RESUMEN
BACKGROUND: Although aminoglycosides are often used as treatment for Gram-negative infections, optimal dosing regimens remain unclear, especially in ICU patients. This is due to a large between- and within-subject variability in the aminoglycoside pharmacokinetics in this population. OBJECTIVE: This review provides comprehensive data on the pharmacokinetics of aminoglycosides in patients hospitalized in the ICU by summarizing all published PopPK models in ICU patients for amikacin, gentamicin, and tobramycin. The objective was to determine the presence of a consensus on the structural model used, significant covariates included, and therapeutic targets considered during dosing regimen simulations. METHOD: A literature search was conducted in the Medline/PubMed database, using the terms: 'amikacin', 'gentamicin', 'tobramycin', 'pharmacokinetic(s)', 'nonlinear mixed effect', 'population', 'intensive care', and 'critically ill'. RESULTS: Nineteen articles were retained where amikacin, gentamicin, and tobramycin pharmacokinetics were described in six, 11, and five models, respectively. A two-compartment model was used to describe amikacin and tobramycin pharmacokinetics, whereas a one-compartment model majorly described gentamicin pharmacokinetics. The most recurrent significant covariates were renal clearance and bodyweight. Across all aminoglycosides, mean interindividual variability in clearance and volume of distribution were 41.6% and 22.0%, respectively. A common consensus for an optimal dosing regimen for each aminoglycoside was not reached. CONCLUSIONS: This review showed models developed for amikacin, from 2015 until now, and for gentamicin and tobramycin from the past decades. Despite the growing challenges of external evaluation, the latter should be more considered during model development. Further research including new covariates, additional simulated dosing regimens, and external validation should be considered to better understand aminoglycoside pharmacokinetics in ICU patients.
RESUMEN
Anhedonia, the loss or decline of the ability to enjoy pleasure, is an important clinical characteristic of schizophrenia. Schizotypal traits refer to the appearance of subclinical symptoms of schizophrenia across normal people. Still, few studies have investigated chemosensory anhedonia in schizophrenia patients and schizotypy individuals. Seventy-one schizophrenia patients (SCZ), 162 schizotypy individuals (SCT) as selected by the Schizotypal Personality Questionnaire (SPQ), and 182 healthy controls (HC) participated in our study. We used the Positive and Negative Syndrome Scale (PANSS) to measure the clinical symptoms of schizophrenia patients. All participants completed the Chemosensory Pleasure Scale (CPS), which was used to assess participants' smell and taste hedonic capacities. We found that the three groups differed in chemosensory anhedonia. The SCZ group presented more severe chemosensory anhedonia than the SCT group, and the SCT group presented more severe chemosensory anhedonia than the HC group. We also found that chemosensory hedonic capacity was negatively correlated with negative schizotypal traits in the SCT group. Our results suggested that chemosensory anhedonia is an important characteristic of schizophrenia spectrum disorders.
RESUMEN
Anhedonia, or the inability to experience pleasure, is a key clinical feature of many mental disorders such as depression and schizophrenia. Although various valid measurements of anhedonia and pleasure experience exist, no scales exist that quantify smell and taste pleasure experiences. The Chemosensory Pleasure Scale (CPS) was therefore designed to assess the hedonic capacity for smell and taste pleasure. We examined the reliability and validity of the CPS in our study. First, we conducted exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) to identify and examine the structure of the CPS. Second, the CPS's validity and test-retest stability were investigated. The CPS was correlated with other measurements of anhedonia and pleasure experience. Furthermore, the empirical validity of CPS was also examined in our study. The results indicated that the CPS is a reliable and valid measure for assessing an individual's hedonic capacity for smell and taste pleasure in nonclinical samples. Further application of the CPS for various populations is also discussed herein, especially for patients with mental disorders such as depression, schizophrenia, and autism.
