Steady state

稳态
  • 文章类型: Journal Article
    与任务相关的研究一直报告说,听语音会激活大脑的颞叶和前额叶区域。然而,从静息状态形式处理语音时,听觉和语言网络的功能组织如何不同还不是很清楚。通常发育中的婴儿的语言网络组织知识可以作为重要的生物标志物来理解听力障碍婴儿预期的网络级破坏。我们假设语言网络的拓扑差异可以在两个实验条件(1)完全沉默(休息)和(2)响应重复的连续语音(稳定)中使用功能连通性度量来表征。30名听力正常的婴儿(14名男性和16名女性,年龄:7.8±4.8个月)纳入本研究。在两个实验条件下,从与言语和语言处理相关的双侧颞叶和前额叶区域记录了大脑活动:静息状态和稳态。使用图论分析表征了功能语言网络的拓扑差异。归一化的全局效率和聚类系数被用作功能整合和隔离的度量,分别。我们发现总的来说,婴儿的语言网络在休息和稳定状态下都展示了经济小世界组织。此外,与稳态相比,语言网络在静息状态下表现出更高的功能整合和更低的功能隔离。对6个月或6个月以下及6个月以上婴儿的发育影响进行的二次分析显示,在静息和稳态中功能整合和分离的拓扑差异可以在生命的前6个月后可靠地检测到。在静息状态下观察到的更高的功能整合表明,在没有语音刺激的情况下,婴儿的语言网络可以促进跨分布式语言区域的更有效的并行信息处理。此外,稳态下较高的功能隔离表明,语音信息处理发生在语言网络中紧密互连的专门区域内。
    Task-related studies have consistently reported that listening to speech sounds activate the temporal and prefrontal regions of the brain. However, it is not well understood how functional organization of auditory and language networks differ when processing speech sounds from its resting state form. The knowledge of language network organization in typically developing infants could serve as an important biomarker to understand network-level disruptions expected in infants with hearing impairment. We hypothesized that topological differences of language networks can be characterized using functional connectivity measures in two experimental conditions (1) complete silence (resting) and (2) in response to repetitive continuous speech sounds (steady). Thirty normal-hearing infants (14 males and 16 females, age: 7.8 ± 4.8 months) were recruited in this study. Brain activity was recorded from bilateral temporal and prefrontal regions associated with speech and language processing for two experimental conditions: resting and steady states. Topological differences of functional language networks were characterized using graph theoretical analysis. The normalized global efficiency and clustering coefficient were used as measures of functional integration and segregation, respectively. We found that overall, language networks of infants demonstrate the economic small-world organization in both resting and steady states. Moreover, language networks exhibited significantly higher functional integration and significantly lower functional segregation in resting state compared to steady state. A secondary analysis that investigated developmental effects of infants aged 6-months or below and above 6-months revealed that such topological differences in functional integration and segregation across resting and steady states can be reliably detected after the first 6-months of life. The higher functional integration observed in resting state suggests that language networks of infants facilitate more efficient parallel information processing across distributed language regions in the absence of speech stimuli. Moreover, higher functional segregation in steady state indicates that the speech information processing occurs within densely interconnected specialized regions in the language network.
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  • 文章类型: Journal Article
    我们在热流中考虑三种不同的系统:理想气体,一种范德华气体,和理想气体的二元混合物。我们通过可移动的墙将每个系统内部分为两个子系统。我们证明了墙壁运动的方向,释放后,在恒定边界条件下,由与平衡热力学dU-dQ≤0相同的不等式确定。平衡和非平衡定律之间的唯一区别是净热量变化的依赖性,DatQ,系统的状态参数。我们证明,在理想气体和范德华气体都在热流中引入引力场时,相同的不等式是有效的。当我们考虑气体颗粒可渗透的厚壁并推导热流中的阿基米德原理时,这仍然是正确的。最后,我们考虑理想气体的Couette(剪切)流。在这个系统中,内壁的运动方向遵循不等式dE-dQ-dws≤0,其中dE是总能量的无穷小变化(内部加动力学),而dE是与环境交换的无穷小功由于施加在流动气体上的剪切力。最终,我们在非平衡热力学第二定律的一般框架内综合了所有这些情况。
    We consider three different systems in a heat flow: an ideal gas, a van der Waals gas, and a binary mixture of ideal gases. We divide each system internally into two subsystems by a movable wall. We show that the direction of the motion of the wall, after release, under constant boundary conditions, is determined by the same inequality as in equilibrium thermodynamics dU-đQ≤0. The only difference between the equilibrium and non-equilibrium laws is the dependence of the net heat change, đQ, on the state parameters of the system. We show that the same inequality is valid when introducing the gravitational field in the case of both the ideal gas and the van der Waals gas in the heat flow. It remains true when we consider a thick wall permeable to gas particles and derive Archimedes\' principle in the heat flow. Finally, we consider the Couette (shear) flow of the ideal gas. In this system, the direction of the motion of the internal wall follows from the inequality dE-đQ-đWs≤0, where dE is the infinitesimal change in total energy (internal plus kinetic) and đWs is the infinitesimal work exchanged with the environment due to the shear force imposed on the flowing gas. Ultimately, we synthesize all these cases within a general framework of the second law of non-equilibrium thermodynamics.
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  • 文章类型: Journal Article
    叠加定律是一阶线性药代动力学关系的基础。大多数药物,因此,单剂量后可以通过一阶或线性过程来描述,可以叠加以了解多剂量方案的行为。然而,在许多情况下,药物在多次给药后可能会表现出行为,从而导致容量受限或饱和的非线性动力学,并且叠加定律被推翻。这篇综述提供了实用指南,以了解静脉和口服给药后单次和多次给药方案的方程式和计算。它还为ADME过程中的饱和以及随之而来的浓度-时间曲线下面积的变化提供了药学基础,这代表了可能导致功效和/或毒性作用调节的药物暴露。药代动力学学家必须隐含地理解叠加的原理,这是药物开发过程中药物行为和处置的核心原则。
    The law of superposition underpins first-order linear pharmacokinetic relationships. Most drugs, therefore, after a single dose can be described by first-order or linear processes, which can be superposed to understand multiple-dose regimen behavior. However, there are a number of situations where drugs could display behaviors after multiple dosing that leads to capacity-limited or saturation non-linear kinetics and the law of superposition is overruled. This review presents a practical guide to understand the equations and calculations for single and multiple-dosing regimens after intravenous and oral administration. It also provides the pharmaceutical basis for saturation in ADME processes and the consequent changes in the area under the concentration-time curve, which represents drug exposure that can lead to the modulation of efficacy and/or toxic effects. The pharmacokineticist must implicitly understand the principles of superposition, which are a central tenet of drug behavior and disposition during drug development.
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  • 文章类型: Journal Article
    多氯二苯并对二恶英/呋喃(PCDD/Fs)是以气相和颗粒相存在于大气中的半挥发性有机化合物(SVOCs),长期持续存在,对环境和人类健康构成高风险。在这项研究中,PCDD/F测量是在2022年6月至2023年4月期间在市区进行的。为了了解PCDD/Fs的命运,研究了气体/颗粒(G/P)分配。尽管已经开发了各种模型来确定SVOC的G/P划分,PCDD/Fs通常仅使用logKp-logPL0、Junge-Pankow和Harner-Bidleman模型。在这项研究中,九种不同的型号(Junge-Pankow,Harner-Bidleman,Dachs-Eisenreich,李马杨,pp-LFER,mp-pp-LFER,QSPR,logKp-logPL0,logKp-logKOA)用于确定G/P分区。据我们所知,pp-LFER,本研究首次对PCDD/Fs的mp-pp-LFER和QSPR模型进行了评估。此外,模型在均衡(EQ)内的性能,在这项研究中,首次研究了PCDD/Fs的非平衡(NE)和最大分配(MP)域。因此,基于EQ域吸收的模型,发现NE域中的吸附以及MP域中的吸附和吸收机制可有效解释G/P跃迁。确定在G/P划分中不存在平衡情况。Junge-Pankow,pp-LFER,Li-Ma-Yang和QSPR模型对颗粒分数值的预测不足,而其他模型显示出较高的预测曲线。Li-Ma-Yang模型显示了与测量的颗粒分数值最接近的结果,并确定沉积机制在PCDD/Fs的G/P分配中具有不可忽视的重要性。其中一种新型号,pp-LFER模型,在高logKOA值下显示出显著的成功。mp-pp-LFER模型,高估了吸附机制的贡献,与测量值相比,显示出非常高的预测曲线。
    Polychlorinated dibenzo-p-dioxins/furans (PCDD/Fs) are semi-volatile organic compounds (SVOCs) existing in the atmosphere in the gas and particulate phase, remain persistent for a long time and pose a high risk to the environment and human health. In this study, PCDD/F measurements were made in an urban area between June 2022 and April 2023. In order to understand the fate of PCDD/Fs, the gas/particle (G/P) partitioning was studied. Although various models have been developed to determine the G/P partitioning of SVOCs, only logKp-logPL0, Junge-Pankow and Harner-Bidleman models are generally used for PCDD/Fs. In this study, nine different models (Junge-Pankow, Harner-Bidleman, Dachs-Eisenreich, Li-Ma-Yang, pp-LFER, mp-pp-LFER, QSPR, logKp-logPL0, logKp-logKOA) were employed to determine the G/P partitioning. To the best of our knowledge, pp-LFER, mp-pp-LFER and QSPR models were evaluated for PCDD/Fs for the first time in this study. In addition, the performance of the models within the equilibrium (EQ), non-equilibrium (NE) and maximum partitioning (MP) domain was investigated for PCDD/Fs for the first time in this study. Accordingly, models based on absorption in the EQ domain, adsorption in the NE domain and adsorption and absorption mechanisms in the MP domain were found to be effective in explaining the G/P transitions. It was determined that there is no equilibrium situation in the G/P partitioning. The Junge-Pankow, pp-LFER, Li-Ma-Yang and QSPR models under-predicted the particle fraction values while the other models showed a high prediction profile. The Li-Ma-Yang model showed the closest results to the measured particle fraction values, and it determined that deposition mechanisms are of non-negligible importance in the G/P partitioning of PCDD/Fs. One of the new models, the pp-LFER model, has shown remarkable success at high logKOA values. The mp-pp-LFER model, which overestimated the contribution of the adsorption mechanism, showed a very high prediction profile compared to the measured values.
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  • 文章类型: Journal Article
    本文报道了胶束表面电荷对阴离子中辛可宁指示(C2)荧光团的光物理性质的影响,十二烷基硫酸钠(SDS),表面活性剂在前胶束,在室温下水相中的胶束和胶束后浓度。在本体水溶液中C2+的荧光最大值中,边缘激发红移(EERS)的幅度为1897cm-1,在SDS的情况下,观察到它是1984厘米-1。C2+的荧光衰减曲线在胶束系统中符合多指数函数。SDS中C2寿命的增加归因于由于在胶束-水界面处掺入C2而导致的辐射速率的增加。测定的动态淬火常数的值为16.9M-1。探针分子在胶束系统中的位置已经被各种光谱参数证明是合理的,例如介电常数,ET(30),粘度,EERS,平均荧光衰减时间,辐射和非辐射速率常数。所有实验结果表明,C2分子与SDS胶束强烈结合,并位于胶束-水界面。SDS中C2的结合常数(Kb)(3.85×105M-1)表明,静电力介导电荷探针-胶束缔合。
    This paper reports the influence of surface charge of the micelles on to the photophysical properties of a cinchonine dication (C2+) fluorophore in anionic, sodium dodecylsulphate (SDS), surfactant at premicellar, micellar and post-micellar concentrations in aqueous phase at room temperature. The magnitude of edge excitation red shift (EERS) in the fluorescence maximum of C2+ in bulk water solution is 1897 cm- 1 whereas, in the case of SDS it is observed to be 1984 cm- 1. The fluorescence decay curve of C2+ fits with multi exponential functions in the micellar system. The increase in lifetime of C2+ in SDS has been attributed to the increase in radiative rate due to the incorporation of C2+ at the micelle -water interface. The value of dynamic quenching constant determined is 16.9 M- 1. The location of the probe molecule in micellar systems has been justified by a variety of spectral parameters such as dielectric constant, ET (30), viscosity, EERS, average fluorescence decay time, radiative and non-radiative rate constants. All experimental results suggest that the C2+ molecule binds strongly with the SDS micelles and resides at micellar-water interface. The binding constant (Kb) calculated (3.85 × 105 M- 1) for C2+ in SDS revealed that the electrostatic forces mediate charge probe-micelle association.
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  • 文章类型: Journal Article
    了解“热”的动力学,非辐射等离子体激元衰变产生的高能电子对于优化光催化和能量转换的应用至关重要。这项研究提出了等离子体金属中电子动力学的分析,专注于连续波(CW)照明期间的稳态行为。使用非弹性光谱技术,我们量化了激发过程中不同载体种群的温度和寿命。一个重要的发现是热电子寿命随着电子温度的降低而单调增加。我们还观察到,与带间激发相比,带内激发期间热电子温度增加了1.22倍,载流子寿命相应增加了2.34倍。假设带间激发过程中的较短寿命是由于非热空穴和热电子的直接复合所致,强调稳态动力学。我们的结果有助于弥合超快和稳态光谱学之间的知识鸿沟,提供优化等离子体应用的关键见解。
    Understanding the dynamics of \"hot\", highly energetic electrons resulting from nonradiative plasmon decay is crucial for optimizing applications in photocatalysis and energy conversion. This study presents an analysis of electron kinetics within plasmonic metals, focusing on the steady-state behavior during continuous-wave (CW) illumination. Using an inelastic spectroscopy technique, we quantify the temperature and lifetimes of distinct carrier populations during excitation. A significant finding is the monotonic increase in hot electron lifetime with decreases in electronic temperature. We also observe a 1.22× increase in hot electron temperature during intraband excitation compared to interband excitation and a corresponding 2.34× increase in carrier lifetime. The shorter lifetimes during interband excitation are hypothesized to result from direct recombination of nonthermal holes and hot electrons, highlighting steady-state kinetics. Our results help bridge the knowledge gap between ultrafast and steady-state spectroscopies, offering critical insights for optimizing plasmonic applications.
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  • 文章类型: Journal Article
    蛋白质合成的延伸阶段是一个循环的,稳态过程。因此,它的方向性取决于伴随的化学反应的热力学,强烈支持伸长。它的不可逆性是通过与这些反应的耦合来保证的,而是随着它的展开而发生的任何构象变化的结果。它也随之而来,总的来说,伸长率与任何步骤的正向速率常数都不成比例,包括它的最后,机械化学步骤,易位。相反,伸长率的倒数应该与那些速率常数的倒数成线性关系。当十年前进行的实验结果来测量相反的易位力对伸长率的影响时,根据这些发现重新解释,很明显,在进行这些实验的条件下,易位是限速的,这很可能是布朗棘轮过程,如前所述(刘,etal.,2014年,eLIFE3,e03406)。
    The elongation phase of protein synthesis is a cyclic, steady-state process. It follows that its directionality is determined by the thermodynamics of the accompanying chemical reactions, which strongly favor elongation. Its irreversibility is guaranteed by its coupling to those reactions, rather being a consequence of any of the conformational changes that occur as it unfolds. It also follows that, in general, the rate of elongation is not proportional to the forward rate constants of any of its steps, including its final, mechano-chemical step, translocation. Instead, the reciprocal of the rate of elongation should be linearly related to the reciprocal of those rate constants. When the results of experiments done a decade ago to measure the effect that forces opposing translocation have on the rate of elongation are reinterpreted in light of these findings, it becomes clear that translocation was rate limiting under conditions in which those experiments were done, and that it is likely to be a Brownian ratchet process, as was concluded earlier.
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  • 文章类型: Journal Article
    废活性污泥(WAS)在厌氧共消化(AcoD)中有着广泛的应用。尽管如此,AcoD系统保持稳定的机制,特别是在营养紧张的条件下,被低估了。在这项研究中,重新评估了WAS在营养紧张的WAS-食品废物AcoD系统中的作用.我们的研究结果表明,基于WAS的共消化增加了甲烷产量(20-60%),因为WAS通过建立基于核心生态位的微生物平衡来支持此类系统的恢复力。碳利用研究表明,如果满足以下两个条件,则可以实现微生物生态位平衡:1)水解效率大于50%;2)产酸至水解和产酸至水解效率均超过0.5。宏基因组组装基因组(MAG)分析表明,多种代谢特性增强了微生物生态位平衡,通过融合模式使系统具有弹性和效率,有助于酸生成和乙酸生成。这项研究的发现为WAS对AcoD的生态影响提供了新的见解。
    There have been extensive applications of waste activated sludge (WAS) in anaerobic co-digestion (AcoD). Nonetheless, mechanisms through which AcoD systems maintain stability, particularly under nutrient-stressed conditions, are under-appreciated. In this study, the role of WAS in a nutrient-stressed WAS-food waste AcoD system was re-evaluated. Our findings demonstrated that WAS-based co-digestion increased methane production (by 20-60%) as WAS bolsters such systems\' resilience via establishing a core niche-based microbial balance. The carbon utilization investigation suggested a microbial niche balance is attainable if two conditions are satisfied: 1) hydrolysis efficiency is greater than 50%; and 2) both the acidogenesis-to-hydrolysis and acetogenesis-to-hydrolysis efficiencies surpass 0.5. Metagenomic assembly genome (MAG) analysis indicated that the versatile metabolic characteristics strengthened the microbial niche balance, rendering the system resilient and efficient through a syntrophic mode, contributing to both acidogenesis and acetogenesis. The findings of this study provide new insights into the ecological effects of WAS on AcoD.
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  • 文章类型: Journal Article
    污染点源对周围环境和人类的有害影响长期以来一直是环境研究的重点。当考虑到排放点周围半挥发性有机化合物(SVOCs)的局部大气扩散时,重要的是要考虑气体/颗粒(G/P)分配的动态过程,这涉及从初始状态到稳定状态的过渡。在这项研究中,我们开发了一个模型,可以预测SVOCsG/P划分的动态过程,特别是考虑到排放的影响。重要的是要注意,颗粒相(CP)和气相(CG)中SVOCs浓度的动态过程显着不同。这些差异是由于两个关键因素的影响而产生的:排放中SVOCs的颗粒比例(Φ0)和辛醇-空气分配系数(KOA)。通过将其对G/P分配商(KP)的极值的预测与从稳态模型获得的结果进行比较来评估我们模型的有效性。值得注意的是,特征时间(tC),用于评估SVOCs达到稳态所需的时间尺度,CP和CG的KOA表现出不同的变化。此外,CP和CG的tC值差异很大,显著受Φ0影响。对于一些具有高KOA值的SVOCs,大约需要35小时才能达到稳定状态。此外,发现达到稳态95%(t95≈3tC)的时间可以达到大约105小时。该持续时间足以使化学物质从其排放位置分散到周围区域。因此,在当地大气传输研究中,考虑G/P划分的动态过程至关重要。此外,φ0的影响应纳入未来研究的G/P划分的动态过程。
    The deleterious impact of pollution point sources on the surrounding environment and human has long been a focal point of environmental research. When considering the local atmospheric dispersion of semi-volatile organic compounds (SVOCs) around the emission sites, it is essential to account the dynamic process for the gas/particle (G/P) partitioning, which involves the transition from an initial state to a steady state. In this study, we have developed a model that enables the prediction of the dynamic process for G/P partitioning of SVOCs, particularly considering the influence from emission. It is important to note that the dynamic processes of the concentrations of SVOCs in particle phase (CP) and in gas phase (CG) differ significantly. These differences arise due to the influence of two critical factors: particulate proportion of SVOCs in the emissions (ϕ0) and octanol-air partitioning coefficient (KOA). The validity of our model was assessed by comparing its predictions of the extremum value of the G/P partitioning quotient (KP) with the results obtained from the steady-state model. Remarkably, the characteristic time (tC), used to evaluate the timescale required for SVOCs to reach steady state, demonstrated different variations with KOA for CP and CG. Additionally, the values of tC were quite different for CP and CG, which were markedly influenced by ϕ0. For some SVOCs with high KOA values, it took approximately 35 h to reach steady state. Furthermore, it was found that the time to achieve 95 % of steady state (t95 ≈ 3tC) could reach approximately 105 h. This duration is sufficient for chemicals to disperse from their emission site to the surrounding areas. Therefore, it is crucial to consider the dynamic process of G/P partitioning in local atmospheric transport studies. Moreover, the influence of ϕ0 should be incorporated into future investigations examining the dynamic process of G/P partitioning.
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  • 文章类型: Journal Article
    背景:Makena(己酸17-羟孕酮)于2011年在加速批准途径下被FDA批准用于预防复发性自发性早产,但未进行基本药代动力学或药效学(阶段1和阶段2)研究。当时,没有剂量-反应或浓度-反应数据.治疗浓度未知。这些数据的缺乏质疑17-羟孕酮己酸酯的给药方案是否被优化。
    目的:本研究的目的是通过分析评估己酸17-羟孕酮药理学的三个数据集来评估17-羟孕酮的给药方案:母胎医学Omega3研究,产科-胎儿药理学研究单位研究和产科-胎儿药理学研究中心研究。如果可以识别出不适当的给药方案,这些信息可以为未来的妊娠药物治疗研究提供信息。
    方法:使用Omega3研究的数据来确定血浆浓度是否与自发性早产风险相关,以及是否可以确定阈值浓度。来自产科-胎儿药理学研究单位研究的数据用于确定17-羟基孕酮己酸酯的半衰期,并开发模型以模拟各种给药方案的药物浓度。来自产科-胎儿药理学研究中心研究的数据用于确定剂量和安全性结果之间的关系。
    结果:对Omega3数据集的分析表明,随着17-羟孕酮己酸酯的对数增加,自发性早产的风险降低[比值比(95CI)0.04(0.00-0.90)]。稳态浓度>9ng/ml(相当于在25-28周时>8ng/ml)与自发性早产的最低风险相关[风险比(95CI)0.52(0.27-0.98,p=0.04)];在接受250mg每周剂量的受试者中,有25%未达到该浓度。在产科-胎儿药理学研究单位研究中,17-羟孕酮己酸酯的校正半衰期(中位数和IQR)为14.0(11.5-17.2)天.模拟表明,每周250毫克的剂量,>5每周注射需要达到9ng/ml的目标;然而,半衰期最短的那些(对应于较高的清除率),从未达到目标9ng/ml浓度。在75%的科目中,每周500mg的负荷剂量持续2周,然后每周250mg达到并在两周内保持9ng/ml的浓度,但在半衰期最短的25%中,浓度超过9ng/ml目标仅3周。在产科-胎儿药理学研究中心的研究中,所有65名接受每周500mg剂量的受试者均超过9ng/ml稳态。
    结论:己酸17-羟孕酮的给药方案不充分。药物浓度与自发性早产之间存在显著的负相关。当浓度超过9ng/ml时,风险最低,但25%接受250mg每周剂量的女性永远不会达到并保持这一浓度。该药物的长半衰期需要负荷剂量以迅速达到治疗浓度。省略确定适当剂量的基本药理学研究可能会损害17-羟基孕酮己酸酯的有效性。未来的妊娠药物治疗试验必须首先完成基础药理学研究。
    BACKGROUND: Makena (17-hydroxyprogesterone caproate) was approved by the United States Food and Drug Administration for the prevention of recurrent spontaneous preterm birth in 2011 under the accelerated approval pathway, but fundamental pharmacokinetic or pharmacodynamic (Phase 1 and Phase 2) studies were not performed. At the time, there were no dose-response or concentration-response data. The therapeutic concentration was not known. The lack of such data brings into question the dosing regimen for 17-hydroxyprogesterone caproate and if it was optimized.
    OBJECTIVE: The purpose of this study was to evaluate the dosing regimen for 17-hydroxyprogesterone by analyzing 3 data sets in which the 17-hydroxyprogesterone caproate pharmacology was evaluated, namely the Maternal-Fetal Medicine Omega 3 study, the Obstetric-Fetal Pharmacology Research Units study, and the Obstetrical-Fetal Pharmacology Research Centers study. If an inappropriate dosing regimen could be identified, such information could inform future studies of pharmacotherapy in pregnancy.
    METHODS: Data from the Omega 3 study were used to determine if plasma concentration was related to spontaneous preterm birth risk and if a threshold concentration could be identified. Data from the Obstetric-Fetal Pharmacology Research Units study were used to determine the half-life of 17-hydroxyprogesterone caproate and to develop a model to simulate drug concentrations with various dosing regimens. Data from the Obstetrical-Fetal Pharmacology Research Centers study were used to determine the relationship between dose and safety outcomes.
    RESULTS: Analysis of the Omega 3 data set indicated that the risk for spontaneous preterm birth decreased as the log concentration of 17-hydroxyprogesterone caproate increased (odds ratio, 0.04; 95% confidence interval, 0.00-0.90). A steady state concentration of >9 ng/mL (equivalent to >8 ng/mL at 25-28 weeks) was associated with the lowest risk for spontaneous preterm birth (hazard ratio, 0.52; 95% confidence interval, 0.27-0.98; P=.04); this concentration was not achieved in 25% of subjects who received the 250 mg weekly dose. In the Obstetrical-Fetal Pharmacology Research Units study, the adjusted half-life (median and interquartile range) of 17-hydroxyprogesterone caproate was 14.0 (11.5-17.2) days. Simulations indicated that with the 250 mg weekly dose, >5 weekly injections were required to reach the 9 ng/mL target; however, those with the shortest half-life (corresponding to higher clearance), never reached the targeted 9 ng/mL concentration. In 75% of subjects, a loading dose of 500 mg weekly for 2 weeks followed by 250 mg weekly achieved and maintained the 9 ng/mL concentration within 2 weeks but in those 25% with the shortest half-life, concentrations exceeded the 9 ng/mL target for only 3 weeks. In the Obstetrical-Fetal Pharmacology Research Centers study, all 65 subjects who received a weekly dose of 500 mg exceeded the 9 ng/mL steady state.
    CONCLUSIONS: The dosing regimen for 17-hydroxyprogesterone caproate was inadequate. There is a significant inverse relationship between drug concentration and spontaneous preterm birth. The risk was lowest when the concentration exceeded 9 ng/mL, but 25% of women who received the 250 mg weekly dose never reached or maintained this concentration. The drug\'s long half-life necessitates a loading dose to achieve therapeutic concentrations rapidly. The omission of basic pharmacologic studies to determine the proper dosing may have compromised the effectiveness of 17-hydroxyprogesterone caproate. Future pharmacotherapy trials in pregnancy must first complete fundamental pharmacology studies.
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