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  • 1
    ISSN: 1432-198X
    Keywords: Spiroergometric testing ; Physical performance ; aerobic capacity ; Lactate metabolism ; Chronic renal failure ; Dialysis ; Transplantation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Maximal physical performance (Wmax), maximal oxygen consumption ( $$\dot V$$ O2max), maximal carbon dioxide production ( $$\dot V$$ CO2max) and blood lactate (L) levels were measured in 34 paediatric patients with chronic renal failure (CRF) and 25 controls by spiroergometric testing on a bicycle ergometer. No patient was treated with erythropoietin. The workload was increased step-wise by 0.5 W/3 min up to a Wmax determined from the attainment of $$\dot V$$ O2max. In patients on conservative treatment (CT), on haemodialysis (HD) and after transplantation (TP) median Wmax per kilogram body weight was reduced to 76%, 73% and 73% of controls (C), respectively. In CT and HD patients $$\dot V$$ O2max and $$\dot V$$ CO2max were decreased to an even higher extent. The ventilatory anaerobic threshold, calculated from the levelling off of the respiratory equivalent $$\dot V$$ E/ $$\dot V$$ O2) during increasing workload, was only slightly higher in patients than in C when related to Wmax (NS). The physiological rise in L during exercise was blunted in CRF; 72% of patients on CT or HD did not exceed the expected threshold L level of 4 mmol/l; after TP the L changes normalized. The findings indicate that most children and adolescents with CRF are able to attain maximal physical performance but both the aerobic and the anaerobic capacity are often reduced. Preliminary findings indicate that treatment of renal anaemia with erythropoietin is able to considerably improve Wmax and $$\dot V$$ O2max in paediatric HD patients.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Pharmaceutical research 17 (2000), S. 583-588 
    ISSN: 1573-904X
    Keywords: bioequivalence ; absorption rate ; extended-release ; mean absorption time ; relative dispersion
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology
    Notes: Abstract Purpose. The sensitivity and effectiveness of indirect metrics proposedfor the assessment of comparative absorption rates in bioequivalencestudies [C max , T max , partial AUC(AUC p ), feathered slope (SL f ), interceptmetric (I)] were originally tested by assuming first-order absorption.The present study re-evaluates their sensitivity performances using themore realistic inverse Gaussian (IG) model characterizing the inputprocess for oral drug administration. Methods. Simulations were performed for both the first-order orexponential model (EX) which is determined by only one parameter, themean absorption time (MAT = 1/k a ), and the IG model, whichadditionally contains a shape parameter, the relative dispersion of absorptiontime distribution (CV 2 A ). Kinetic sensitivities (KS) of the indirectmetrics were evaluated from bioequivalence trials (error free data)generated with various ratios of the true parameters (MAT and CV 2 A ) of thetwo formulations. Results. The behavior of the metrics was similar with respect tochanges in MAT ratios with both models: KS was low with C max ,moderate with SL f and AUC p , and high with I and T max followingcorrection for apparent lag time (T lag ). Changes of the shape parameterCV 2 A , however, were not detectable by C max , T max , SL f , and AUC p .Changes in both MAT and CV 2 A were well reflected by I with CV 2 A - ratio〉 1. I exhibited approximately full KS also with CV 2 A - ratio 〈1 when a correction was first applied for the apparent lag time. Conclusions. The time profile of absorption rates is insufficientlycharacterized by only one parameter (MAT). Indirect metrics which aresensitive enough to detect changes in the scale and shape of the inputprofile could be useful for bioequivalence testing. Among the testedmeasures, I is particularly promising when a correction is appliedfor T lag .
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    Pharmaceutical research 13 (1996), S. 1547-1553 
    ISSN: 1573-904X
    Keywords: pharmacokinetics ; input model ; bioavailability ; absorption rate ; extended release
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology
    Notes: Abstract Purpose. Flexible parametric models describing the input process after extravascular drug administration are needed for the assessment of absorption rate and the use of population methods in bioavailability and bioequivalence studies. Methods. The oral concentration-time curve modeled as the product of the input and disposition function in the Laplace domain was obtained by numerical inversion methods for parameter estimation. The utility of the inverse Gaussian input density was examined using bioavailability data of an extended-release dosage form. Measures of rate of absorption and the cumulative absorbed amount profile were defined in terms of the estimated model parameters. Results. Accurate estimation of absorption parameters was achieved by simultaneous fitting of the extravascular and intravascular data (describing the latter by a triexponential function). The new input function allowed a direct estimation of both extent of absorption and mean absorption time. Conclusions. The findings suggest that the inverse Gaussian density is a useful input function. Its flexibility may reduce the effect of model misspecification in parameter estimation. All parameters can be readily interpreted in terms of the absorption process.
    Type of Medium: Electronic Resource
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