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Search Results: 1 - 10 of 13176 matches for " Eric Diconne "
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Continuous infusion of ceftazidime in critically ill patients undergoing continuous venovenous haemodiafiltration: pharmacokinetic evaluation and dose recommendation
Christophe Mariat, Christophe Venet, Fran?ois Jehl, Sandrine Mwewa, Vesna Lazarevic, Eric Diconne, Nathalie Fonsale, Anne Carricajo, Stéphane Guyomarc'h, Régine Vermesch, Gérald Aubert, Roselyne Bidault, Jean-Claude Bertrand, Fabrice Zeni
Critical Care , 2005, DOI: 10.1186/cc3993
Abstract: Seven critically ill patients were prospectively enrolled in the study. CVVHDF was performed using a 0.6 m2 AN69 high-flux membrane and with blood, dialysate and ultrafiltration flow rates of 150 ml/min, 1 l/hour and 1.5 l/hour, respectively. Based on a predicted haemodiafiltration clearance of 32.5 ml/min, all patients received a 2 g loading dose of ceftazidime, followed by a 3 g/day continuous infusion for 72 hours. Serum samples were collected at 0, 3, 15 and 30 minutes and at 1, 2, 4, 6, 8, 12, 24, 36, 48 and 72 hours; dialysate/ultrafiltrate samples were taken at 2, 8, 12, 24, 36 and 48 hours. Ceftazidime concentrations in serum and dialysate/ultrafiltrate were measured using high-performance liquid chromatography.The mean (± standard deviation) elimination half-life, volume of distribution, area under the concentration-time curve from time 0 to 72 hours, and total clearance of ceftazidime were 4 ± 1 hours, 19 ± 6 l, 2514 ± 212 mg/h per l, and 62 ± 5 ml/min, respectively. The mean serum ceftazidime steady-state concentration was 33.5 mg/l (range 28.8–36.3 mg/l). CVVHDF effectively removed continuously infused ceftazidime, with a sieving coefficient and haemodiafiltration clearance of 0.81 ± 0.11 and 33.6 ± 4 mg/l, respectively.We conclude that a dosing regimen of 3 g/day ceftazidime, by continuous infusion, following a 2 g loading dose, results in serum concentrations more than four times the minimum inhibitory concentration for all susceptible pathogens, and we recommend this regimen in critically ill patients undergoing CVVHDF.The β-lactam antibiotics are known to exhibit little concentration-dependent activity. The maximal killing rate occurs when antibiotic concentrations have reached four to five times the minimum inhibitory concentration (MIC) for the causative pathogens [1], and higher concentrations do not significantly enhance the bactericidal activity. Conversely, an increase in the time for which free β-lactam serum levels are above the MIC is likely
Prognostic consequences of borderline dysnatremia: pay attention to minimal serum sodium change
Michael Darmon, Eric Diconne, Bertrand Souweine, Stéphane Ruckly, Christophe Adrie, Elie Azoulay, Christophe Clec'h, Ma?té Garrouste-Orgeas, Carole Schwebel, Dany Goldgran-Toledano, Hatem Khallel, Anne-Sylvie Dumenil, Samir Jamali, Christine Cheval, Bernard Allaouchiche, Fabrice Zeni, Jean-Fran?ois Timsit
Critical Care , 2013, DOI: 10.1186/cc11937
Abstract: Observational study on a prospective database fed by 13 intensive care units (ICUs). Unselected patients with ICU stay longer than 48 h were enrolled over a 14-year period were included in this study. Mild to severe hyponatremia were defined as serum sodium concentration < 135, < 130, and < 125 mmol/L respectively. Mild to severe hypernatremia were defined as serum sodium concentration > 145, > 150, and > 155 mmol/L respectively. Borderline hyponatremia and hypernatremia were defined as serum sodium concentration between 135 and 137 mmol/L or 143 and 145 respectively.A total of 11,125 patients were included in this study. Among these patients, 3,047 (27.4%) had mild to severe hyponatremia at ICU admission, 2,258 (20.3%) had borderline hyponatremia at ICU admission, 1,078 (9.7%) had borderline hypernatremia and 877 (7.9%) had mild to severe hypernatremia. After adjustment for confounder, both moderate and severe hyponatremia (subdistribution hazard ratio (sHR) 1.82, 95% CI 1.002 to 1.395 and 1.27, 95% CI 1.01 to 1.60 respectively) were associated with day-30 mortality. Similarly, mild, moderate and severe hypernatremia (sHR 1.34, 95% CI 1.14 to 1.57; 1.51, 95% CI 1.15 to 1.99; and 2.64, 95% CI 2.00 to 3.81 respectively) were independently associated with day-30 mortality.One-third of critically ill patients had a mild to moderate dysnatremia at ICU admission. Dysnatremia, including mild changes in serum sodium concentration, is an independent risk factor for hospital mortality and should not be neglected.Dysnatremia is a common finding at ICU admission [1-3]. Abnormal serum sodium concentrations are known to adversely affect physiologic function and an increasing body of evidence suggests that dysnatremia may be associated with adverse outcome [1-4]. Critically ill patients are particularly exposed to dysnatremia due to the nature of the disease leading to ICU admission and to lack of free access to water [2,4,5]. Up to one-third of critically ill patients have a dys
A Tale of Two Motives: Endogenous Time Preference, Cash-in-Advance Constraints and Monetary Policy  [PDF]
Eric Kam
Modern Economy (ME) , 2013, DOI: 10.4236/me.2013.46045

This paper demonstrates the effects of modeling an endogenous rate of time preference and two cash-in-advance constraints. If the constraint is levied on consumption and capital goods, time preference effects are neutral and cash-in-advance constraint effects invert the Tobin Effect. If the constraint applies solely to consumption goods, opposing motives are offsetting and monetary policy is super neutral.

Targeting Phosphodiesterase 4 to Block the Link between Acute Exacerbation of Chronic Obstructive Pulmonary Disease and the Metabolic Complications  [PDF]
Eric Cho
Journal of Biosciences and Medicines (JBM) , 2015, DOI: 10.4236/jbm.2015.311007
Abstract: The metabolic disorders such as obesity and diabetes are found to be more frequent in chronic obstructive pulmonary disease (COPD). The chronic systemic inflammation orchestrated by macrophages constitutes one critical pathophysiological process underlying both acute exacerbation of COPD (AECOPD) and its metabolic complications such as obesity and diabetes. The cyclic adenosine monophosphate (cAMP) signaling controlled by phosphodiesterase (PDE) 4 is a pivotal intracellular modulator for macrophages functions in immune inflammatory response underlying AECOPD as well as obesity and diabetes. Targeting PDE4/cAMP signaling has been suggested to be effective in treating AECOPD or the metabolic disorders of obesity and diabetes. It is therefore reasonable to hypothesize that the chronic systemic inflammation can be a critical link between AECOPD and the metabolic disorders and targeting the PDE4/cAMP signaling can be effective to block this link between AECOPD and the associated metabolic complications.
Community Knowledge and Perceptions about Buruli Ulcers in Obom Sub-District of the Ga South Municipality in the Greater Accra Region of Ghana  [PDF]
Eric Koka
Advances in Applied Sociology (AASoci) , 2018, DOI: 10.4236/aasoci.2018.89037
Abstract: Community knowledge and perceptions of the cause and consequently the appropriate measure to remedy an ailment determine whom people turn to for advice, help, information and treatment when bogged down with a disease. The role that community plays in the etiology, explanation, prognosis and treatment seeking behaviour cannot be underscored, because it provides indepth information on the burden of the disease, the local understanding of the causes of the disease and therefore its management. The purpose of the study was to describe community knowledge and perceptions about Buruli ulcer (BU) and how to prevent Buruli ulcer in the Obom sub-district of Ghana. Survey questionnaire was used as an instrument for data collection to solicit information on community knowledge and perceptions of Buruli ulcer in the communities. In selecting respondents for the community survey, systematic sampling was used to select 300 respondents for the study. The study revealed a high level of knowledge about Buruli ulcer in the selected endemic communities. However, Buruli ulcer patients were perceived as people who have been bewitched (36.7%). Others (21%) blamed them as people who did not take good care of themselves while another 11.1% saw Buruli ulcer infected people as having normal wounds. Findings therefore show that although there was a high knowledge of signs and symptoms of Buruli ulcer among community members in the Obom sub-district, their understandings and interpretations of its causative factors varied from those of the biomedical understandings. Based on the results of the study, it is recommended that community outreach and education on the treatment and management of Buruli ulcer should be continued on a sustainable basis in the endemic communities.
Child Migration and Dropping Out of Basic School in Ghana: The Case of Children in a Fishing Community  [PDF]
Eric Daniel Ananga
Creative Education (CE) , 2013, DOI: 10.4236/ce.2013.46057

The government of Ghana’s effort on increasing access to basic education led to removal of school fees, introduction of capitation grants, school feeding and free school uniforms. While such moves have been applauded leading to improved access, child migration remains a barrier to educational access for children living in fishing communities in Ghana. This paper presents the experiences of schoolchildren who drop out of school as a result of child labour and seasonal migration. The central questions of the study are how and why migration acts as a barrier to education of children who had initial access. The paper presents in-depth analysis of qualitative data. The findings presented in the paper demonstrate that children enroll and attend school until they begin to migrate during mid-school sessions resulting in their exclusion from basic school. The paper concludes by highlighting some policy implications of children’s seasonal migration during school sessions and access to basic school in Ghana.

Extremes of Severe Storm Environments under a Changing Climate  [PDF]
Elizabeth Mannshardt, Eric Gilleland
American Journal of Climate Change (AJCC) , 2013, DOI: 10.4236/ajcc.2013.23A005

One of the more critical issues in a changing climate is the behavior of extreme weather events, such as severe tornadic storms as seen recently in Moore and El Reno, Oklahoma. It is generally thought that such events would increase under a changing climate. How to evaluate this extreme behavior is a topic currently under much debate and investigation. One approach is to look at the behavior of large scale indicators of severe weather. The use of the generalized extreme value distribution for annual maxima is explored for a combination product of convective available potential energy and wind shear. Results from this initial study show successful modeling and high quantile prediction using extreme value methods. Predicted large scale values are consistent across different extreme value modeling frameworks, and a general increase over time in predicted values is indicated. A case study utilizing this methodology considers the large scale atmospheric indicators for the region of Moore, Oklahoma for Class EF5 tornadoes on May 3, 1999 and more recently on May 20, 2013, and for the class EF5 storm in El Reno, Oklahoma on May 31, 2013.

Look Ma, We’re Still Theorizing: The Continued Search for Theoretical Integration  [PDF]
Kathleen Waggoner, Eric Roark
Sociology Mind (SM) , 2014, DOI: 10.4236/sm.2014.41009

In this paper, we explore the often-fractured attempt at theoretical integration within contemporary sociological thought. Theoretical integration was a goal of the early pioneers of sociology but has since been discounted by many as unattainable idealistic vision. We challenge this virtually universal assessment. The belief that theoretical integration is beyond grasp has been owed to a number of debates within contemporary sociological thought, including but not limited to, those surrounding human nature and rationality. We conclude our paper with a proposal for a new direction forward and a hopeful starting place for a promising integrated sociological perspective.

Practical Applications of Cosmology to Human Society  [PDF]
Eric J. Chaisson
Natural Science (NS) , 2014, DOI: 10.4236/ns.2014.610077
Abstract: Complex systems throughout Nature display structures and functions that are built and maintained, at least in part, by optimal energies flowing through them—not specific, ideal values, rather ranges in energy rate density below which systems are starved and above which systems are destroyed. Cosmic evolution, as a physical cosmology that notably includes life, is rich in empirical findings about many varied systems that can potentially help assess global problems facing us here on Earth. Despite its grand and ambitious objective to unify theoretical understanding of all known complex systems from big bang to humankind, cosmic evolution does have useful, practical applications from which humanity could benefit. Cosmic evolution’s emphasis on quantitative data analyses might well inform our attitudes toward several serious issues now challenging 21st-century society, including global warming, smart machines, world economics, and cancer research. This paper comprises one physicist’s conjectures about each of these applied topics, suggesting how energy-flow modeling can guide our search for viable solutions to real-world predicaments confronting civilization today.

Mobile-Learning Potential Effects on Teachers’ Initial Professional Development in Cameroon: Curriculum Perspective  [PDF]
Eric Len-Kibinkiri
Creative Education (CE) , 2014, DOI: 10.4236/ce.2014.513132

This study examines the relationship between mobile-learning and teachers’ initial professional development in Cameroon, more specifically the relationship between access to telephone resources and teachers’ professional development, use of multimedia telephone and teachers’ professional development, mobile-learning environment and teachers’ professional development.The incessant penetration of mobile phones in schools, and the need for a teaching strategy that can help institutions address their learning problems motivated the researcher to carry out this study. In order to proceed, three hypotheses were formulated to guide the study. A survey of two hundred (200) student-teachers drawn from three (3) primary government teacher training colleges and three higher teacher training colleges was carried out. Data were collected using a questionnaire. Pearson correlation coefficient, t-test and mediated regression were used to analyse the research hypotheses. Findings revealed that m-learning has a significant influence on teachers’ initial professional development. Results further suggest that attitude towards learning with a multimedia telephone has a direct impact on teachers’ professional development. Based on these findings, recommendations are made to teacher education institutions and education stake-holders to develop a positive attitude towards m-learning, redefined their interaction strategies, above all, adopt teaching and learning strategies that are innovative, dynamic and multidimensional.

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