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Xin Zhong Chen - One of the best experts on this subject based on the ideXlab platform.
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the ed50 and ED95 of oxytocin infusion rate for maintaining uterine tone during elective caesarean delivery a dose finding study
BMC Pregnancy and Childbirth, 2020Co-Authors: Xiao Wei Qian, Dan M Drzymalski, Chang Cheng Lv, Luyang Wang, Xin Zhong ChenAbstract:Background The 90% effective dose (ED90) of oxytocin infusion has been previously estimated to be 16.2 IU h− 1. However, bolus administration of oxytocin prior to the infusion may decrease the infusion dose required. The aim of this study was to estimate the ED95 for oxytocin infusion after a bolus at elective caesarean delivery (CD) in nonlaboring parturients.
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the ed50 and ED95 of oxytocin infusion rate for maintaining uterine tone during elective caesarean delivery a dose finding study
BMC Pregnancy and Childbirth, 2020Co-Authors: Xiao Wei Qian, Dan M Drzymalski, Luyang Wang, Fei He Guo, Xin Zhong ChenAbstract:The 90% effective dose (ED90) of oxytocin infusion has been previously estimated to be 16.2 IU h− 1. However, bolus administration of oxytocin prior to the infusion may decrease the infusion dose required. The aim of this study was to estimate the ED95 for oxytocin infusion after a bolus at elective caesarean delivery (CD) in nonlaboring parturients. We performed a randomized, triple blinded study in 150 healthy termparturients scheduled for elective CD under epidural anaesthesia. After delivery of the infant and i.v. administration of 1 IU oxytocin as a bolus, Participants were randomized to receive oxytocin infusion at a rate of 0, 1, 2, 3, 5, or 8 IU h− 1, to be given for a total of 1 h. Uterine tone assessed by the blinded obstetrician as either adequate or inadequate. Secondary outcomes included estimated blood loss (EBL), requirement for supplemental uterotonic agents, and development of side effects. The 95% effective dose (ED95) of oxytocin infusion was estimated to be 7.72 IU h− 1 (95% confidence interval 5.80–12.67 IU h− 1). With increasing oxytocin infusion rate, the proportion of parturients who needed rescue oxytocin bolus or secondary uterotonic agents decreased. No significant among-group differences in the EBL and oxytocin-related side effects were observed. In parturients who receive a 1 IU bolus of oxytocin during elective cesarean delivery, an infusion rate of oxytocin at 7.72 IU h− 1 will produce adequate uterine tone in 95% of parturients. These results suggest that the total dose of oxytocin administered in the postpartum period can be decreased when administered as an infusion after oxytocin bolus.
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comparison of the ed50 and ED95 of intrathecal bupivacaine in parturients undergoing cesarean delivery with or without prophylactic phenylephrine infusion a prospective double blind study
Regional Anesthesia and Pain Medicine, 2018Co-Authors: Fei Xiao, Dan M Drzymalski, Yinfu Zhang, Lizhong Wang, Xin Zhong ChenAbstract:Background and Objectives While prophylactic phenylephrine infusions during cesarean delivery are often used to counteract the sympathectomy associated with spinal anesthesia, their use has been associated with decreased rostral spread of local anesthetic. The purpose of this study was to determine the median effective dose (ED50) and 95% effective dose (ED95) of intrathecal hyperbaric bupivacaine for cesarean delivery in the presence and absence of prophylactic phenylephrine infusion. Methods One hundred healthy parturients undergoing elective cesarean delivery under combined spinal-epidural anesthesia were enrolled in this randomized, double-blind, dose-finding study to determine ED50 and ED95. Subjects were randomly assigned to receive prophylactic phenylephrine or control (saline) infusion with injection of 6, 7.5, 9, 10.5, or 12 mg intrathecal hyperbaric bupivacaine. An effective dose was defined as achieving a T5 sensory level within 10 minutes of intrathecal drug administration without the need for epidural supplementation. Results The ED50 of intrathecal hyperbaric bupivacaine was 10.0 mg (95% confidence interval [CI], 5.9–11.4 mg) with prophylactic phenylephrine infusion and 7.9 mg (95% CI, 2.3–9.4 mg) in the control group. The ED95 of intrathecal hyperbaric bupivacaine was 14.1 mg (95% CI, 12.3–37.6 mg) with prophylactic phenylephrine infusion and 11.7 mg (95% CI, 9.9–22.8 mg) in the control group. Conclusions The administration of prophylactic phenylephrine infusion results in higher intrathecal hyperbaric bupivacaine dosing requirements in parturients undergoing cesarean delivery. Clinical Trial Registration This study was registered at the Chinese Clinical Trial Registry, identifier ChiCTR-TRC-16008938.
Dan M Drzymalski - One of the best experts on this subject based on the ideXlab platform.
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the ed50 and ED95 of oxytocin infusion rate for maintaining uterine tone during elective caesarean delivery a dose finding study
BMC Pregnancy and Childbirth, 2020Co-Authors: Xiao Wei Qian, Dan M Drzymalski, Chang Cheng Lv, Luyang Wang, Xin Zhong ChenAbstract:Background The 90% effective dose (ED90) of oxytocin infusion has been previously estimated to be 16.2 IU h− 1. However, bolus administration of oxytocin prior to the infusion may decrease the infusion dose required. The aim of this study was to estimate the ED95 for oxytocin infusion after a bolus at elective caesarean delivery (CD) in nonlaboring parturients.
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the ed50 and ED95 of oxytocin infusion rate for maintaining uterine tone during elective caesarean delivery a dose finding study
BMC Pregnancy and Childbirth, 2020Co-Authors: Xiao Wei Qian, Dan M Drzymalski, Luyang Wang, Fei He Guo, Xin Zhong ChenAbstract:The 90% effective dose (ED90) of oxytocin infusion has been previously estimated to be 16.2 IU h− 1. However, bolus administration of oxytocin prior to the infusion may decrease the infusion dose required. The aim of this study was to estimate the ED95 for oxytocin infusion after a bolus at elective caesarean delivery (CD) in nonlaboring parturients. We performed a randomized, triple blinded study in 150 healthy termparturients scheduled for elective CD under epidural anaesthesia. After delivery of the infant and i.v. administration of 1 IU oxytocin as a bolus, Participants were randomized to receive oxytocin infusion at a rate of 0, 1, 2, 3, 5, or 8 IU h− 1, to be given for a total of 1 h. Uterine tone assessed by the blinded obstetrician as either adequate or inadequate. Secondary outcomes included estimated blood loss (EBL), requirement for supplemental uterotonic agents, and development of side effects. The 95% effective dose (ED95) of oxytocin infusion was estimated to be 7.72 IU h− 1 (95% confidence interval 5.80–12.67 IU h− 1). With increasing oxytocin infusion rate, the proportion of parturients who needed rescue oxytocin bolus or secondary uterotonic agents decreased. No significant among-group differences in the EBL and oxytocin-related side effects were observed. In parturients who receive a 1 IU bolus of oxytocin during elective cesarean delivery, an infusion rate of oxytocin at 7.72 IU h− 1 will produce adequate uterine tone in 95% of parturients. These results suggest that the total dose of oxytocin administered in the postpartum period can be decreased when administered as an infusion after oxytocin bolus.
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comparison of the ed50 and ED95 of intrathecal bupivacaine in parturients undergoing cesarean delivery with or without prophylactic phenylephrine infusion a prospective double blind study
Regional Anesthesia and Pain Medicine, 2018Co-Authors: Fei Xiao, Dan M Drzymalski, Yinfu Zhang, Lizhong Wang, Xin Zhong ChenAbstract:Background and Objectives While prophylactic phenylephrine infusions during cesarean delivery are often used to counteract the sympathectomy associated with spinal anesthesia, their use has been associated with decreased rostral spread of local anesthetic. The purpose of this study was to determine the median effective dose (ED50) and 95% effective dose (ED95) of intrathecal hyperbaric bupivacaine for cesarean delivery in the presence and absence of prophylactic phenylephrine infusion. Methods One hundred healthy parturients undergoing elective cesarean delivery under combined spinal-epidural anesthesia were enrolled in this randomized, double-blind, dose-finding study to determine ED50 and ED95. Subjects were randomly assigned to receive prophylactic phenylephrine or control (saline) infusion with injection of 6, 7.5, 9, 10.5, or 12 mg intrathecal hyperbaric bupivacaine. An effective dose was defined as achieving a T5 sensory level within 10 minutes of intrathecal drug administration without the need for epidural supplementation. Results The ED50 of intrathecal hyperbaric bupivacaine was 10.0 mg (95% confidence interval [CI], 5.9–11.4 mg) with prophylactic phenylephrine infusion and 7.9 mg (95% CI, 2.3–9.4 mg) in the control group. The ED95 of intrathecal hyperbaric bupivacaine was 14.1 mg (95% CI, 12.3–37.6 mg) with prophylactic phenylephrine infusion and 11.7 mg (95% CI, 9.9–22.8 mg) in the control group. Conclusions The administration of prophylactic phenylephrine infusion results in higher intrathecal hyperbaric bupivacaine dosing requirements in parturients undergoing cesarean delivery. Clinical Trial Registration This study was registered at the Chinese Clinical Trial Registry, identifier ChiCTR-TRC-16008938.
Edward T. Riley - One of the best experts on this subject based on the ideXlab platform.
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the ed50 and ED95 of intrathecal isobaric bupivacaine with opioids for cesarean delivery
Anesthesiology, 2005Co-Authors: Brendan Carvalho, Marie Durbin, Sheila E Cohen, Yehuda Ginosar, David R Drover, Edward T. RileyAbstract:Background: The ideal intrathecal isobaric bupivacaine dose for cesarean delivery anesthesia is uncertain. While small doses (5–9 mg) of bupivacaine may reduce side effects such as hypotension, they potentially increase spinal anesthetic failures. This study determined the ED50 and ED95 of intrathecal isobaric bupivacaine (with adjuvant opioids) for cesarean delivery. Methods: After institutional review board approval and written informed consent were obtained, 48 parturients undergoing elective cesarean delivery under combined spinal– epidural anesthesia were enrolled in this double-blind, randomized, doseranging study. Patients received a 5-, 6-, 7-, 8-, 9-, 10-, 11-, or 12-mg intrathecal isobaric bupivacaine dose with 10 g fentanyl and 200 g morphine. Overall anesthetic success was recorded when no intraoperative epidural supplement was required during the cesarean delivery. ED50 and ED95 values for overall anesthetic success were determined using a logistic regression model. Results: ED50 and ED95 values for overall anesthetic success were 7.25 and 13.0 mg, respectively. No advantages for low doses could be demonstrated with regard to hypotension, nausea, vomiting, pruritus, or maternal satisfaction, although this study was underpowered to detect significant differences in secondary outcome variables. Conclusions: The ED50 and ED95 values (7.25 and 13.0 mg, respectively) for intrathecal isobaric bupivacaine in this circumstance are similar to values the authors determined recently for hyperbaric bupivacaine using similar methodology. These ED50 and ED95 values are significantly higher than those advocated in previous reports in which success was claimed using lower intrathecal bupivacaine doses. The current study used stricter criteria to define “successful” anesthesia and support the use of larger bupivacaine doses to ensure adequate patient comfort.
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ed50 and ED95 of intrathecal hyperbaric bupivacaine coadministered with opioids for cesarean delivery
Anesthesiology, 2004Co-Authors: Yehuda Ginosar, Sheila E Cohen, Edward Mirikatani, David R Drover, Edward T. RileyAbstract:BackgroundSuccessful cesarean delivery anesthesia has been reported with use of small doses (5–9 mg) of intrathecal bupivacaine coadministered with opioids. This double-blind, randomized, dose-ranging study determined the ED50 and ED95 of intrathecal bupivacaine (with adjuvant opioids) for cesarean
Xiao Wei Qian - One of the best experts on this subject based on the ideXlab platform.
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the ed50 and ED95 of oxytocin infusion rate for maintaining uterine tone during elective caesarean delivery a dose finding study
BMC Pregnancy and Childbirth, 2020Co-Authors: Xiao Wei Qian, Dan M Drzymalski, Chang Cheng Lv, Luyang Wang, Xin Zhong ChenAbstract:Background The 90% effective dose (ED90) of oxytocin infusion has been previously estimated to be 16.2 IU h− 1. However, bolus administration of oxytocin prior to the infusion may decrease the infusion dose required. The aim of this study was to estimate the ED95 for oxytocin infusion after a bolus at elective caesarean delivery (CD) in nonlaboring parturients.
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the ed50 and ED95 of oxytocin infusion rate for maintaining uterine tone during elective caesarean delivery a dose finding study
BMC Pregnancy and Childbirth, 2020Co-Authors: Xiao Wei Qian, Dan M Drzymalski, Luyang Wang, Fei He Guo, Xin Zhong ChenAbstract:The 90% effective dose (ED90) of oxytocin infusion has been previously estimated to be 16.2 IU h− 1. However, bolus administration of oxytocin prior to the infusion may decrease the infusion dose required. The aim of this study was to estimate the ED95 for oxytocin infusion after a bolus at elective caesarean delivery (CD) in nonlaboring parturients. We performed a randomized, triple blinded study in 150 healthy termparturients scheduled for elective CD under epidural anaesthesia. After delivery of the infant and i.v. administration of 1 IU oxytocin as a bolus, Participants were randomized to receive oxytocin infusion at a rate of 0, 1, 2, 3, 5, or 8 IU h− 1, to be given for a total of 1 h. Uterine tone assessed by the blinded obstetrician as either adequate or inadequate. Secondary outcomes included estimated blood loss (EBL), requirement for supplemental uterotonic agents, and development of side effects. The 95% effective dose (ED95) of oxytocin infusion was estimated to be 7.72 IU h− 1 (95% confidence interval 5.80–12.67 IU h− 1). With increasing oxytocin infusion rate, the proportion of parturients who needed rescue oxytocin bolus or secondary uterotonic agents decreased. No significant among-group differences in the EBL and oxytocin-related side effects were observed. In parturients who receive a 1 IU bolus of oxytocin during elective cesarean delivery, an infusion rate of oxytocin at 7.72 IU h− 1 will produce adequate uterine tone in 95% of parturients. These results suggest that the total dose of oxytocin administered in the postpartum period can be decreased when administered as an infusion after oxytocin bolus.
Klausmichael Debatin - One of the best experts on this subject based on the ideXlab platform.
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Chemotherapeutic drugs sensitize pre-B ALL cells for CD95- and cytotoxic T-lymphocyte-mediated apoptosis.
Leukemia, 1999Co-Authors: C Posovszky, Claudia Friesen, Ingrid Herr, Klausmichael DebatinAbstract:The CD95 (APO-1/Fas) system plays an important role in lymphocyte homeostasis and contributes to anticancer drug-induced apoptosis in some tumor cells. Most childhood B-lineage ALL cells are constitutively resistant towards CD95-induced death. We report here that chemotherapeutic drugs, such as doxorubicin, cytarabine, methotrexate and 6-mercaptopurine, sensitize CD95-resistant pre-B-ALL cell lines for CD95- and lymphokine-activated killer (LAK)-induced cell death. Enhanced susceptibility in drug-treated cells was found to be associated with increased expression of CD95 mRNA and surface expression of CD95 protein, as well as loss of Bcl-xL protein and disturbance of mitochondrial function. Low level activation of caspases and cleavage of poly(ADP-ribose) polymerase following CD95 triggering was strongly increased in drug pre-treated cells. Furthermore, drug pre-treated cells could be rescued from CD95-mediated apoptosis by blocking the CD95-signaling pathway with a FADD-dominant negative expression construct. Our data suggest that chemotherapeutic drugs may sensitize pre-B ALL cells by at least two mechanisms: (1) by increasing CD95 expression; and (2) by lowering the threshold for apoptotic signals. These findings may explain the effectiveness of low-dose chemotherapy and indicate an active role for key molecules of apoptosis and the immune system during chemotherapy of leukemia.
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deficient activation of the cd95 apo 1 fas system in drug resistant cells
Leukemia, 1997Co-Authors: Claudia Friesen, Klausmichael Debatin, Simone FuldaAbstract:The molecular mechanisms for sensitivity and resistance of tumor cells towards chemotherapy are only partially understood. In chemosensitive leukemias and solid tumors, anticancer drugs have been shown to induce apoptosis. We previously identified activation of the CD95 (APO-1/Fas) receptor/CD95 ligand (CD95/CD95-L) system as a key mechanism for drug-induced apoptosis. Here, we show that therapeutic concentrations of doxorubicin, methotrexate and cytarabine also induce apoptosis via activation of the CD95 system in primary leukemia cells in vivo. CD95-resistant and doxorubicin-resistant leukemia and neuroblastoma cells display cross-resistance for induction of cell death. Down-regulation of CD95 expression was found in drug-resistant and CD95-resistant cell lines. Furthermore, up-regulation of CD95-L, previously shown to mediate drug-induced apoptosis in a variety of tumor cells, was completely blocked in doxorubicin-resistant cells. The prototype caspase (ICE/Ced-3 protease) substrate, poly(ADP-ribose)polymerase (PARP), was cleaved in sensitive, but not in resistant tumor cells following CD95 triggering or drug treatment. Since failure to activate CD95-L was not due to decreased drug uptake or increased drug efflux, non-multi-drug resistance (non-MDR) mechanisms are involved in this type of resistance. These findings suggested that an intact CD95 system plays a key role in determining sensitivity or resistance towards anticancer therapy.
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involvement of the cd95 apo 1 fas receptor ligand system in drug induced apoptosis in leukemia cells
Nature Medicine, 1996Co-Authors: Claudia Friesen, Ingrid Herr, Peter H Krammer, Klausmichael DebatinAbstract:Cytotoxic drugs used in chemotherapy of leukemias and solid tumors cause apoptosis in target cells. In lymphoid cells the CD95 (APO-1/Fas)/CD95 ligand (CD95-L) system is a key regulator of apoptosis. Here we describe that doxorbicin induces apoptosis via the CD95/CD95-L system in human leukemia T-cell lines. Doxorubicin-induced apoptosis was completely blocked by inhibition of gene expression and protein synthesis. Also, doxorbicin strongly stimulates CD95-L messenger RNA expression in vitro at concentrations relevant for therapy in vivo. CEM and jurkat cells resistant to CD95-mediated apoptosis were also resistant to doxorbicin-induced apoptosis . Furthermore, doxorbicin-induced apoptosis was inhibited by blocking F(ab')2 anti-APO-1 (anti-CD95) antibody fragments. Expression of CD95-L mRNA and protein in vitro was also stimulated by other cytotoxic drugs such as methotrexate. The finding that apoptosis caused by anticancer drugs may be mediated via the CD95 system provides a new molecular insight into resistance and sensitivity toward chemotherapy in malignancies.
