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Biomedical subjects

T Deutsch

Publications and source records attributed to T Deutsch.

At least 37 records · Page 2Linked to original sources
PubMed1992

An interactive, educational model for insulin dosage and dietary adjustment in type I diabetes mellitus.

Joe Daniels is a 41 year old, 76kg male, insulin-treated diabetic patient who was diagnosed as being diabetic in 1972, at the age of 22. Joe recently found that he was having hypoglycaemic symptoms. Using self-monitoring blood glucose equipment glycaemic levels below 3.0 mmol/l were recorded at least once a week while hyperglycaemic readings (> 16 mmol/l) were observed 2-3 times per week. Joe came into hospital to have his glycaemic control improved as doctors were concerned about the risks of him suffering a serious hypoglycaemic attack. Using some of the data collected by Joe while in hospital we will demonstrate how a computer model of glucose-insulin interaction in type I diabetes can be used interactively to teach diabetic patients about their diabetes and educate them to adjust their own insulin injections and diet.

Adult↗
PubMed1992

AIDA: an automated insulin dosage advisor.

A prototype computer system utilising a model of carbohydrate metabolism linked to an expert system is described. The prototype which integrates quantitative and qualitative computational methodologies can be used to predict blood glucose profiles and adjust insulin doses in type I diabetic subjects.

Blood Glucose↗
PubMed1989

The principles and prototyping of a knowledge-based diabetes management system.

This paper describes the principles and prototyping of a computer-based system being developed to assist in the management of diabetes mellitus. Unlike other approaches based upon mathematical modelling or the use of computer algorithms, this system adopts one derived from artificial intelligence, seeking to incorporate the dynamics of glucose and insulin in a manner which reflects their clinical importance. The resultant logical model (qualitative algebra) defines the relationships between changes in insulin dose and site and time of injection and glycaemic response. In this manner the computer-based system, implemented in Prolog, can be used to provide advice concerning insulin therapy by means of making qualitative predictions of patient outcome of blood glucose profile resulting from alternative insulin regimens.

Blood Glucose↗
PubMed1985

Long-term intermittent netilmicin therapy of chronic pyelonephritis: a pharmacokinetic and clinical study.

A trial was conducted with long-term intermittent netilmicin therapy in six patients suffering from chronic pyelonephritis. Netilmicin was given in full dose for a period of 3-10 days (2-6 mg/kg/day), followed by 2 mg/kg doses once or twice weekly for 3-6 months. Individual doses were determined by computer based on the age, sex, lean body weight and serum creatinine concentrations of the patients. During the full-dose period of treatment netilmicin concentrations in serum were between 2 and 16 mg/l in serum and between 50 and 200 mg/l in urine. During intermittent treatment serum levels remained below 2 mg/l (except for 8-12 hours after dosing); in the urine concentrations were permanently in therapeutic ranges (150-4 mg/l). Renal tissue levels were simulated. Six to 12 months after long-term netilmicin treatment all patients are abacteriuric and free from symptoms. No auditory or renal toxic effects occurred.

Adult↗
PubMed1983

A calculator package for pharmacokinetic application.

A calculator program package is given for the computation of the parameters of two different pharmacokinetic models: the 'one compartment open model' with first order absorption, and the 'two compartment open model' with rapid intravenous injection, using the peeling method. If parameters are known, simulation of these systems can be done for single and repetitive doses. The package includes an area under curve (AUC) program for the evaluation of clearance. The algorithms were applied for TI 58,59 and HP 97 calculators and they can be widely used in clinical practice.

Computers↗
PubMed1981

Comparative bioavailability of three commercial acetaminophen tablets.

Four different acetaminophen products (three tablets and one liquid) were evaluated for their in vitro properties and in vivo comparative bioavailability. The in vivo properties included assay, hardness, thickness, friability, weight variation, content uniformity, disintegration, and dissolution. A statistically significant variation was observed in friability, disintegration, and dissolution. The dissolution rates were determined in 0.1 N HCl under sink conditions, and the T50% value for Brand A was 50 min while the values for Brands B and C were 1 min. The in vivo evaluation was completed in four subjects with a urinary excretion experiment using a crossover design. The calculated elimination half-lives were 4.12, 2.77, 3.14. amd 2 h for Brands A, B, and C and the standard, respectively. The relative bioavailabilities (with respect to solution) were 82, 87, and 92% for Brands A, B, and C, respectively. The mean amount excreted with Brand A was less than the reference at all time points, although it was not significant. Comparison of the in vitro and in vivo data for the three tablets indicated that the rate and amount of acetaminophen excreted may be related to the dissolution rate.

Acetaminophen↗
PubMedDate not supplied

The fate of drotaverine-acephyllinate in rat and man. II. Human pharmacokinetics of drotaverine-14C-acephyllinate.

Pharmacokinetics of Drotaverine-Acephyllinate, Chinoin was investigated in seven male volunteers using 14C labelled drug. Drotaverine-Acephyllinate was administered at a 100 mg single oral dose. Measurements of total radioactivity showed that the drug was absorbed completely and was eliminated by renal and biliary routes. Within 72 hours 39.9 +/- 9.9% and 47.1 +/- 4.9% of the dose were recovered in the urine and faeces respectively. Experimental results were interpreted on the basis of a complex linear compartment model. The structural identifiability of the model was proved by computer analysis, and the pharmacokinetic parameters were determined.

Administration, Oral↗
PubMedDate not supplied

Computer-assisted diabetic management: a complex approach.

This paper describes the architecture of, and the main reasoning methods involved in, a computer system developed to assist in diabetic management. The system integrates (i) a database module used for blood glucose monitoring, (ii) an interpreter module used to analyse the adequacy of diet and insulin treatment for diabetics, and (iii) an advisory module suggesting alterations in diet and/or insulin regimen in order to improve glycaemic control. The analysis of blood glucose profiles and hypoglycaemic episodes, as well as the suggestions for altered diet and insulin therapy, are based on qualitative and quantitative models of insulin effect and carbohydrate absorption using meal-time related glucose balance and distance from the preselected target (DFT) glucose values as focal concepts in the reasoning process. During the sequence of consultations with the system, a dynamic model of carbohydrate metabolism is gradually adjusted in order to constitute an appropriate simulation for the specific patient. This model is used to confirm the suggestions made by the ADVISOR program and to assist the health care professional in selecting the best control action by predicting the blood glucose profiles resulting from alternative control policies.

Algorithms↗
PubMedDate not supplied

An integrated approach for the computer-assisted treatment of diabetic patients on insulin.

A prototype computer system has been developed to provide advice on the day-to-day adjustment of carbohydrate intake and insulin regimen in the insulin-dependent diabetic patient. The system also produces a 24-h simulation of the patient's blood glucose profile based on these adjustments. Advice is generated by a qualitative knowledge-based system which suggests what the next step in improving glycaemic control might be for a given patient, e.g. 'decrease morning short-acting insulin by 2 units'. The quantitative simulator module contains two different mathematical models. The first is a non-linear model in differential equation form which consists of a one-compartment glucose model linked to a model with free and bound insulin compartments. This physiological model is solved by a general-purpose simulation engine. The second is a linear systems model which uses a transfer function to describe the insulin input/blood glucose response relationship for individual diabetic patients. Results of a preliminary medical validation are presented.

Blood Glucose↗
PubMedDate not supplied

Validation of a metabolic prototype to assist in the treatment of insulin-dependent diabetes mellitus.

This paper describes the principles and prototyping of a computer system to assist in the treatment of patients with insulin-dependent (type 1) diabetes mellitus. The system adopts a mixed approach involving rule-based qualitative algebra and a dynamic mathematical model to define the relationships between insulin dosage, diet and glycaemic response. The rule-based system (KBS), implemented in PROLOG, can be used to generate qualitative therapeutic advice. These suggestions are quantified and rank-ordered by the use of a mathematical model of glucose-insulin interaction in type 1 diabetes mellitus, with parameters adjusted for individual patients. In this paper an overview of the integrated prototype, linking the KBS and model, is provided and a case study used to demonstrate the principles of the system in operation. The results of verification and validation work performed on the KBS are described.

Blood Glucose↗