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Intravenous Iron Dextran as a Component of Anemia Management in Chronic Kidney Disease: A Report of Safety and Efficacy
Lenar Yessayan,Ankur Sandhu,Anatole Besarab,Alexy Yessayan,Stan Frinak,Gerard Zasuwa,Jerry Yee
International Journal of Nephrology , 2013, DOI: 10.1155/2013/703038
Abstract: Objective. We aimed to demonstrate safety and efficacy of intravenous (IV) low molecular weight iron dextran (LMWID) during treatment of anemic stage 3 and 4 chronic kidney disease (CKD) patients. Methods. Efficacy data was obtained by retrospective chart review of 150 consecutively enrolled patients. Patients were assigned per protocol to oral or IV iron, with IV iron given to those with lower iron stores and/or hemoglobin. Iron and darbepoetin were administered to achieve and maintain hemoglobin at 10–12?g/dL. Efficacy endpoints were mean hemoglobin and change in iron indices approximately 30 and 60 days after enrollment. Safety data was obtained by retrospective review of reported adverse drug events (ADEs) following 1699 infusions of LMWID (0.5–1.0?g). Results. Mean hemoglobin, iron saturation, and ferritin increased significantly from baseline to 60 days in patients assigned to LMWID (hemoglobin: 11.3 versus 9.4?g/dL; iron saturation: 24% versus 12.9%; ferritin: 294.7 versus 134.7?ng/mL; all ). Iron stores and hemoglobin were maintained in the group assigned to oral iron. Of 1699 iron dextran infusions, three ADEs occurred. Conclusions. Treatment of anemia in CKD stages 3 and 4 with LMWID and darbepoetin is efficacious. The serious ADE rate was 0.06% per infusion. 1. Introduction Erythropoiesis is optimized in chronic kidney disease by treatment with iron and erythropoiesis-stimulating agents (ESAs). For end-stage renal disease patients on hemodialysis, intravenous (IV) iron is more efficacious than oral iron [1–3]. Potential advantages of IV iron include direct iron delivery to bone marrow and tissue stores, large-dose delivery, and elimination of frequent gastrointestinal side effects associated with oral iron treatment [4–8]. Among IV iron formulations, iron isomaltoside, ferric carboxymaltose, and the iron dextrans (IDs) can be administered in total dose infusion (TDI). Both ferric gluconate and iron sucrose can be safely administered as a bolus or short infusion at doses up to 250?mg and 300?mg, respectively. Higher doses of either drug as a bolus or short infusion have been associated with unpleasant vasoactive and gastrointestinal symptoms [9, 10]. However, accelerated regimens of high-dose IV iron sucrose (500?mg over 3 hours) have been demonstrated to be safe in several studies [11–13]. The safety and efficacy of ID in nondialysis chronic kidney disease (ND-CKD) is less well reported, especially for the low molecular weight iron dextran (LMWID) INFeD [14]. Imferon, Dexferrum, and INFeD are the IDs that have been used in the USA. The first
The Chancellor’s New Robes: Online Education  [PDF]
Stan Braude, Jon Merrill
Creative Education (CE) , 2013, DOI: 10.4236/ce.2013.47A2009
Abstract: Online education is being rapidly embraced as a cash cow for reputable universities. Although there are legitimate advantages to online learning, the data on learning outcomes are scarce. We point out the reasons why high quality, live classes are unlikely to be replaced by online alternatives. However, we do describe the poor teaching practices that can be inexpensively replaced by online courses. We finally point out that best practices and high quality online education are expensive and cannot generate the revenue expected by university administrators.
The role of the ubiquitination-proteasome pathway in breast cancer: Ubiquitin mediated degradation of growth factor receptors in the pathogenesis and treatment of cancer
Stan Lipkowitz
Breast Cancer Research , 2002, DOI: 10.1186/bcr541
Abstract: Inappropriate activity of growth factor receptors such as the epidermal growth factor receptor (EGFR) family, which comprises EGFR, ErbB-2/Her2/Neu, ErbB-3/Her3, and ErbB-4/Her4, is associated with the development of a wide variety of human cancers, including breast cancer [1]. An understanding of the mechanisms that negatively regulate growth factor signaling, and characterization of the function of such negative regulators in both normal and transformed cells can lead to identification of therapeutic targets for treatment of human cancers. Indeed, there are data to suggest that some existing therapies may act, at least in part, to enhance such negative regulatory mechanisms (although they were not developed specifically to enhance receptor degradation). In the present review, the role of ubiquitination in the negative regulation of growth factor receptor signaling is discussed. Much of the information regarding downregulation of growth factor receptors has been generated by studies of EGFR. However, the basic mechanisms described for EGFR are likely to regulate signaling by many growth factor receptors. Evidence is also presented that suggests that tumor cells may subvert the ubiquitin-based negative regulation of growth factor receptors. In addition, therapeutic options are discussed.Ubiquitin is a highly conserved, 76-amino-acid protein that can be covalently conjugated to the lysine residues on a wide assortment of proteins and thus regulate their function (for review [2]). Ubiquitination of proteins occurs via sequential activation and conjugation of ubiquitin to target proteins by the ubiquitin-activating enzyme, a ubiquitin-conjugating enzyme, and a ubiquitin protein ligase (E3) [2]. The E3 protein confers specificity to the ubiquitination process and directs the conjugation of ubiquitin to one or more lysines of the specific target protein. Ubiquitin can form multi-ubiquitin chains, in which the first ubiquitin is attached via an isopeptide linkage to a lys
Desafiar a reforma escolar empresarial... e dez sinais esperan?osos de resistência
Karp, Stan;
Educa??o & Sociedade , 2012, DOI: 10.1590/S0101-73302012000200006
Abstract: this essay summarizes the american education entrepreneur reformers most important characteristics, their bonds to big business and it also shows this policy's main visible consequences. moreover, the essay lists ten types of reactions from parents, students, teachers, voters, organized unions, scholars and others that are being developed to fight these proposals.
Contributions to the Knowledge on Staphylinids (Coleoptera: Staphylinidae) in Some Riparian Ecosystems of South-Eastern Romania
Melania Stan
Travaux du Muséum National d'Histoire Naturelle "Grigore Antipa" , 2011, DOI: 10.2478/v10191-011-0026-y
Abstract: The diversity of the staphylinid fauna is investigated in some riparian ecosystems along rivers of south-east Romania: the Danube, Prut, Siret, Buz u. 94 staphylinid species and subspecies were identified from 23 investigated sites. Thecturota marchii (Dodero) is a new record for the Romanian fauna. Leptobium dimidiatum (Grideli), a rare species, is recorded from a new site, the second record from Romania.
Experimental Interfaces Involving Visual Grouping During Browsing
Stan Ruecker
Partnership : the Canadian Journal of Library and Information Practice and Research , 2006,
Abstract: This paper provides a brief overview of a number of experimental interface design projects being carried out collaboratively by teams of researchers at the University of Alberta and elsewhere. One goal of this interface research is to explore the principles of rich-prospect browsing interfaces, which I have defined (Author 2003) as those where some meaningful representation of every item in a collection is combined with tools for manipulating the display. Often this manipulation is for the purposes of carrying out some portion of a research task: the interfaces lend themselves to exploratory and synthetic activities, such as knowledge discovery and hypothesis formulation. The projects summarized here begin with a browsing prototype originally designed for the task of pill identification (Given et al. 2005) but subsequently extended into a prototype for browsing conference delegates and other groups of people (Author et al. 2006). Another is a nuanced system based on the mandala (Cheypesh et al. 2006) intended for examining any collection that has been encoded with an XML schema, using combinations of attractors selected by the user from the available tags. Next is the set of specialized interfaces for the Orlando Project (Orlando Team 2006), intended to provide a set of discrete entry points into the deeply-encoded electronic history of women’s writing in the British Isles. Our project on tabular interfaces provides a variety of spaces designed to assist the user in using thesauri for multilingual query enhancement (Anvik et al. 2006). The final project described below is NORA (Unsworth 2004), which relies on the power of the D2K data-mining tools at the National Centre for Supercomputing Applications at the University of Illinois at Urbana-Champaign to give humanities scholars a workspace for exploring the system-identified features of common documents and further documents that have been recommended by the system. Each of these projects are discussed within the framework of visualizations involving browsing through dynamic grouping.
The Discourse on the “Crisis of the Health Care System” and the New Governance Model of Health Care in Quebec
Sabina Stan
Suvremene Teme : Contemporary Issues , 2009,
Abstract: During the last decade, public discourse on the “crisis of the health care system” in Quebec and Canada soared to the extent that the crisis has come to be seen by many Quebeckers and Canadians as an enduring feature of their health care sector. Based on analysis of articles from the Quebec written media, the article shows that the crisis discourse contributes to promote a market-like governance model of the health care sector and to foster the acceptanceof market-oriented health care policies.
In Search of Intelligent Life ...
Stan Rowe
Ecology and Society , 2002,
Much More than Ecological Scale and “Nature Knowing Best” Hiding in Environmental Decisions
Stan Rowe
Ecology and Society , 2003,
Viorica Stan
Studia Universitatis Vasile Goldis Arad, Seria Stiinte Economice , 2011,
Abstract: Crossing the centuries, the idea of balance concerned that minds who tried to provideanswers to economic problems of man since ancient times. Fundamental aspiration ofmankind in general, economists in particular, appear to be to "balance" and to "bestpossible".
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