1,720,977 research outputs found
[Pharmacokinetics of antibiotics in Continuous Renal Replacement Therapies (CRRT)]
No full textIn the critically ill patient, acute kidney injury (AKI) is frequently associated with infective complications requiring appropriate antimicrobial treatment. AKI and multiple organ dysfunction syndrome can affect the pharmacokinetic parameters of many drugs. Furthermore, the start of renal replacement therapy (RRT) is an additional variable to be taken into consideration to avoid inappropriate antimicrobial therapy. Continuous renal replacement therapies (CRRT) are widely adopted in the intensive care unit (ICU) and antibiotics that are significantly eliminated by the kidney are likely to be removed during RRT. Generally, drug-dosing adjustments are required if the extracorporeal clearance accounts for more than 25-30% of the total body clearance. The molecular weight cutoffs of the more widely used membranes are much higher than the molecular weight of most drugs. Therefore, molecular size will not be a limitation for the removal of the unbound fraction of the antibiotics most commonly used in ICU patients. However, CRRTs are still not standardized and the impact of RRT on plasma drug concentrations can be substantially different depending on the CRRT modality (diffusive, convective or both), membrane characteristics and delivered dialysis dose. In any case, drug-dosing adjustments should be based on the knowledge of the pharmacokinetic and pharmacodynamic properties of the different classes of antimicrobials, taking into account that high extracorporeal clearances could lead to drug underexposure in clinical conditions where appropriate antibiotic treatment is essential
Continuous renal replacement therapies (CRRT) will remain the most widely adopted dialysis modality in the critically ill.
No full textNegli ultimi 10-15 anni, la disponibilità di apparecchiature dedicate alle CRRT ha facilitato la diffusione di queste metodiche nelle UTI. Allo stato attuale, non esiste una chiara evidenza su quale debba essere la terapia sostitutiva ottimale nel paziente critico con IRA e la scelta della metodica non può derivare da ipotetici vantaggi in termini di “outcomes” ma deve basarsi su criteri prevalentemente clinici. Nel paziente ipercatabolico, le CRRT e le SLED consentono di ottenere un controllo metabolico paragonabile ma alcuni studi non controllati hanno suggerito una migliore stabilità emodinamica in corso di CRRT, intesa come ridotta necessità di incrementare il dosaggio di inotropi e valori più elevati di pressione arteriosa media. Il rischio di complicanze emorragiche è tendenzialmente maggiore con le CRRT ma in particolari situazioni cliniche, caratterizzate da rischio emorragico elevato, il trattamento può essere eseguito senza anticoagulanti o utilizzando protocolli alternativi. Tra le diverse opzioni, l’anticoagulazione regionale con citrato sembra essere la più promettente e l’introduzione di protocolli semplificati potrebbe portare alla sua definitiva affermazione come metodica di scelta nel paziente ad alto rischio emorragico. La presenza di una discrepanza tra dose dialitica prescritta e dose somministrata è spesso riportata come svantaggio delle CRRT. A dimostrazione che questa caratteristica non è peculiare delle CRRT, in un recente studio, finalizzato alla valutazione dell’impatto prognostico della dose dialitica, il Kt/V desiderato è stato ottenuto solo nel 67-69% dei trattamenti IHD. Numerosi studi hanno messo a confronto i costi delle diverse terapie sostitutive. Dall’analisi dei dati emerge che le CRRT hanno costi più elevati delle IHD e delle SLED. Tuttavia, l’entità della spesa relativa alle SLED potrebbe variare considerevolmente in relazione al modello organizzativo della struttura ospedaliera ed alla necessità di dedicare a queste terapie personale infermieristico specializzato. Inoltre, i costi delle CRRT potrebbero essere almeno in parte giustificati da vantaggi logistici e organizzativi. Il conseguimento di ulteriori sviluppi nelle caratteristiche dei monitors per CRRT, nell’ottimizzazione dei protocolli di anticoagulazione e nelle possibilità di “personalizzazione” delle soluzioni di dialisi/reinfusione potrà contribuire a mantenere, anche nei prossimi anni, il ruolo prevalente di queste metodiche nel trattamento del paziente critico con IRA, soprattutto nelle fasi di maggiore instabilità emodinamica
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Full text linkWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
koamabayili/VECTRON-author-checklist: VECTRON author checklist
No full textWe have done our best to complete the author checklist relating to the use of animals in the hut study. Note that the objective for the hut study was to evaluate the IRS treatment applications for residual efficacy against Anopheles mosquitoes, including the local An. coluzzii mosquito population. Cows were only used to attract mosquitoes into the huts and no tests were carried out directly on the cows. The author checklist is intended for use with studies where experiments are carried out on animals, which is why we have had such difficulty in completing this for the hut study, as many of the questions do not relate to how the cows were used
Author-wise bibliometric analysis based on entropy.
No full textAuthor-wise bibliometric analysis based on entropy.</p
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