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PubMedDate not supplied

A simple method for dosage regimen adjustment.

To demonstrate the usefulness of a recently published nomogram method for clinical pharmacokinetics two examples for dosage regimen adjustment (gentamicin and digoxin) are given. Excellent agreement was obtained between the results derived from the nomogram and those by conventional calculation. The nomogram reduces the otherwise necessary use of logarithms and exponential functions to drawing of straight lines and the four basic mathematic functions.

Adult↗

PubMed1991

Analysis of one-dimensional gels and two-dimensional Serwer-type gels on the basis of the extended Ogston model using personal computers.

This report presents the stand-alone computer application ELPHOFIT, a software package for the analysis of gel electrophoretic data based on Ferguson plots. Either conventional one-dimensional gels or two-dimensional agarose gels (Serwer-type) can be evaluated. Special emphasis is on the latter gel type, which has been applied previously for the separation of DNA, intact viruses and polydisperse meningitis vaccines. ELPHOFIT is designed for Macintosh PCs and for the IBM XT, AT, PS/2 and compatibles. The program operates interactively with the user, who determines the course of evaluation. Data input is in the format of files providing values of gel electrophoretic migration distances or particle mobility (absolute or relative). Data processing involves a simultaneous least-square curve fitting algorithm (Newton-Gauss, Marquardt-Levenberg) which uses equations derived from the extended Ogston model. Functions are fit to the database by adjusting their variables, representing physical parameters of the gel and the electrophoresed particle. The program output consists of tables and graphics accompanied by an explanatory text providing the following information: (i) radius and free mobility of the electrophoresed particle, (ii) fiber radius, length and volume, mean or median pore radius of the gel, (iii) linear Ferguson plots, (iv) iso-free-mobility/iso-size nomogram for two-dimensional gels, (v) confidence ellipses, (vi) required parameters for image processing program GELFIT and (vii) goodness-of-fit and other statistical parameters, such as standard errors, dependency values, root-mean-square (RMS) error and determination coefficient. Other features of the program are (i) simulation of Serwer-type two-dimensional electrophoresis, (ii) standardization according to size, or size and free mobility, (iii) the conversion of particle radii to molecular (or particle) weight and vice versa, (iv) interconversion of DNA size specifications, i.e. the number of base pairs and the geometric mean radii, (v) computation of gel concentration for optimal resolution of two components, (vi) option to obtain a session record, (viii) option to establish a data output file containing the information of generated graphics (IBM only) and (ix) a text editing facility, e.g., for creating data files. Graphics (Macintosh version, PICT format) and text output files (both IBM and Macintosh versions, standard ASCII format) generated by ELPHOFIT are compatible with commercially available software.

Computers↗

PubMed1994

Prediction of maximal aerobic power in man: a nomographic approach.

Direct estimation of maximal aerobic power is an intricate procedure and requires the facility of a well-equipped laboratory. Attempts have been made, therefore, to develop linear and nonlinear regression equations for its indirect assessment, but many biomedical scientists have difficulty in using these statistically based equations. Bearing this in mind, this paper constructs two nomograms for predicting maximal aerobic power. The first nomogram, based on cardiorespiratory strains, is more precise but requires the facility of an equipped laboratory owing to the involvement of some physiological variables; the second nomogram, based on the two variables body weight and time for a 3.2 km run, does not require any laboratory facility for prediction of maximal aerobic power. Both nomograms have limited validity. The first is most reliable in the range 1.83-3.28 l.min-1; the second is best in the range 1.76-3.06 l.min-1 of maximal aerobic power.

Body Weight↗

PubMed1999

A graphic nomogram for warfarin dosage adjustment.

We assessed the ability of a graphic nomogram to adjust steady-state warfarin dosages and to predict international normalized ratios (INR) after a dosage change, compared with an anticoagulation clinic pharmacist and a Bayesian regression computer program. Study subjects were 108 men and 3 women receiving warfarin anticoagulation. In all patients the median absolute errors in predicted INR values for the nomogram, computer program, and pharmacist were 0.33, 0.46, and 0.48, respectively. The nomogram was significantly more precise than both other methods (p=0.036). In a subset of 50 patients who required dosage reductions, the median absolute INR prediction errors for the nomogram, computer program, and pharmacist were 0.35, 0.54, and 0.48 respectively. The nomogram was significantly more precise than the pharmacist (p=0.005) and computer (p=0.002). The ability to provide more precise dosage reductions of warfarin may be of clinical importance in light of current recommendations for higher-intensity warfarin therapy and maintenance of higher INR values. Prospective validation of the performance of this nomogram in a routine clinical setting is warranted.

Adult↗

PubMed1992

Relationship between colloid osmotic pressure and plasma protein concentration in cattle, horses, dogs, and cats.

The relationship between colloid osmotic pressure (COP) and protein concentration was investigated for purified proteins and plasma samples obtained from cattle, horses, dogs, and cats. At equivalent concentrations, bovine albumin exerted a COP that exceeded that of gamma-globulins by a mean factor of 4.4. Similar relationships between COP and protein were observed in the other species. Consequently, for a given total protein concentration, COP was dependent on the albumin/gamma-globulins ratio. A commonly used nomogram for estimating COP from protein concentration, the Landis-Pappenheimer equation, did not provide reliable results for plasma samples from these species.

Animals↗

PubMed2004

Placental thickness in the first half of pregnancy.

PURPOSE: This study was conducted to establish normal values of placental thickness during the first half of pregnancy. METHODS: Normal pregnant women with singleton pregnancies between 8 and 20 weeks of gestation were recruited into the study. All the newborns were normal at birth. Placental thickness was measured perpendicularly through the thickest part of the placenta on transabdominal scans. The placental thickness data were analyzed for mean, standard deviation, 95% confidence interval, and 2.5(th), 5(th), 50(th), 95(th), and 97.5(th) percentile for each week of gestational age. The best-fit mathematical model was derived by regression analysis. RESULTS: The total number of measurements was 333 and the number of measurements for each week of gestational age ranged from 9 to 37. Regression analysis yielded the following linear equation of the relationship: placental thickness (in mm) = gestational age (in weeks) x 1.4-5.6 (r = 0.82). CONCLUSION: We have established a nomogram for placental thickness. This resource may be a useful aid in the early detection of placental abnormalities, such as hydropic placenta secondary to hemoglobin Bart's disease.

Adult↗

PubMed2025

Paternally Expressed Gene 10 Promoter Methylation Level as a Predictor of HBeAg Seroconversion in Chronic Hepatitis B Patients.

The management of chronic hepatitis B (CHB) encounters challenges like suboptimal antiviral response and the lack of predictive biomarkers. In this study, the role of paternally expressed gene 10 (PEG10) in hepatitis B e antigen (HBeAg) seroconversion (HBeAg SC) was explored to identify a therapeutic target and predictive model. In total, 349 participants were recruited, and 141 HBeAg-positive patients were followed up after 48 weeks of antiviral therapy. Key genes were screened by machine learning algorithms (BORUTA, RF and LASSO). PEG10 mRNA, promoter methylation and plasma levels were examined. The effect of PEG10 was assessed by logistic regression, and HBeAg SC was predicted by nomograms. HBeAg-positive patients showed markedly elevated PEG10 mRNA expression (p < 0.001), which correlated strongly with major virological markers such as HBV DNA (r = 0.520, p < 0.001), HBeAg (r = 0.490, p < 0.001) and HBsAg (r = 0.400, p < 0.001). In addition, HBeAg-positive patients exhibited a significant reduction in PEG10 promoter methylation levels compared with controls (p < 0.001). According to logistic regression analysis, PEG10 promoter methylation status was an independent predictor of HBeAg SC. The predictive nomogram incorporating PEG10 promoter methylation ratio (PMR), albumin (ALB), aspartate aminotransferase (AST) and HBeAg demonstrated excellent clinical predictive value (area under curve (AUC) = 0.895,95% confidence interval (CI): 0.808 ~ 0.963). The methylation status of the PEG10 promoter represents a promising biomarker for the prediction of HBeAg SC in patients with CHB. CLINICAL TRIAL REGISTRATION: Not applicable.

Humans↗

PubMed1993

The definition and measurement of acetabular orientation.

The orientation of an acetabulum or an acetabular prosthesis may be described by its inclination and anteversion. Orientation can be assessed anatomically, radiographically, and by direct observation at operation. The angles of inclination and anteversion determined by these three methods differ because they have different spatial arrangements. There are therefore three distinct definitions of inclination and anteversion. This paper analyses the differences between the definitions and provides nomograms to convert from one to another. It is recommended that the operative definitions be used to describe the orientation of prostheses and that the anatomical definitions be used for dysplastic acetabula.

Acetabulum↗

PubMed2001

Ambulatory blood pressure monitoring in children with a solitary kidney - a comparison between unilateral renal agenesis and uninephrectomy.

BACKGROUND: In experimental animals, a reduction in renal mass leads to glomerulosclerosis of the residual parenchyma and eventual renal failure. In humans, however, data on the influence of nephrectomy or agenesis on future functional parameters and hypertension are as yet controversial. OBJECTIVE: To evaluate blood-pressure patterns in children with a solitary kidney as a result of either unilateral renal agenesis (URA) or uninephrectomy (UNX) and correlate them to the increase in size of the remaining kidney. METHODS: Twenty-eight children with a solitary kidney were divided into two groups: the URA group, with 18 subjects (13 male and five female, with a mean age of 9.6 +/- 3.9 years), and the UNX group, which contained 10 subjects (four male and six female, with a mean age of 14.0 +/- 2.7 years). The mean time since nephrectomy was 8.7 years. Each study group was assigned an age-, weight- and height-matched control group. In all subjects, ambulatory blood pressure monitoring was performed using the SpaceLabs model no. 90207. Daytime and night-time were defined as 0800-2200 h and 2200-0800 h, respectively. Urinalysis, serum creatinine and urea results were recorded for all the study group participants. The size of the remaining kidney was determined by ultrasound examination. The percentage increase in kidney size, as calculated from standard kidney-length-against-age nomograms was correlated to the percentage deviation from normal blood pressure values. RESULTS: The mean 24 h, daytime and night-time systolic blood pressure (SBP) readings were significantly higher in children in the URA group than in those in the corresponding control group (111.4 +/- 7.5 mmHg versus 106.9 +/- 6.7 mmHg, P < 0.004; 115.2 +/- 3.1 mmHg versus 110.7 +/- 3.4 mmHg, P < 0.004; and 105.2 +/- 2.6 mmHg versus 101.2 +/- 1.8 mmHg, P < 0.002, respectively). Daytime heart rate was found to be significantly reduced (84.4 +/- 5.2 versus 87.8 +/- 8.2 beats/min, P < 0.04). In the UNX group, 24 h mean, systolic and diastolic blood pressure (DBP), as well as heart rate, did not differ from control values. Daytime systolic and diastolic blood pressures were higher than those of the controls (119.8 +/- 4.0 mmHg versus 115.5 +/- 3.8 mmHg, P < 0.02; and 72.7 +/- 4.0 mmHg versus 70.0 +/- 11.0 mmHg, P < 0.02, respectively). Nocturnal dipping was present in all groups and was of equal magnitude in the corresponding control groups. The mean 24 h diastolic blood pressure load was significantly greater in URA patients than in controls (19.6 versus 10.8%, respectively, P < 0.01). In the UNX group, the blood pressure loads were similar to those of controls. The percentage increase in length of the remaining kidney was found to correlate positively with the percentage delta increase in both systolic and diastolic blood pressure. CONCLUSIONS: Compared with the age-, height- and weight-matched controls, the children with a solitary kidney caused by URA had an elevated mean 24 h SBP. In contrast, those with UNX had mean 24 h blood pressure values similar to those of their controls. A rise in SBP was, however, seen in both groups during the daytime hours. Thus, the presence of a solitary kidney, for whatever reason, may be pathogenetically linked to a raised blood pressure, and this linkage may be more pronounced in URA. The delta increase in size of the remaining kidney may serve as a prognostic indicator of blood pressure elevation.

Adolescent↗

PubMed2006

Heparin dosing and therapeutic activated partial thromboplastin times (aPTT) in acute coronary syndrome (ACS).

This study assessed the current practices of heparin dosing and determined the extent of therapeutic activated partial thromboplastin times (aPTT) achieved, utilising a standard heparin nomogram in the coronary care unit and step-down cardiac ward of a health care facility in South Australia. The study also examined the effect of actual body weight (ABW), body mass index (BMI), smoking, concomitant intravenous glycerine trinitrate, age, gender and creatinine levels, individually, on the time taken to attain a therapeutic aPTT in acute coronary syndrome (ACS) patients receiving a heparin infusion. A retrospective correlational research design was utilised to include the collection of quantitative data from 66 men and women of all ages and background consecutively admitted into the coronary care unit and the step-down cardiac ward and receiving a continuous heparin infusion. The quantitative data included demographic details plus all information regarding treatment and results of heparin therapy from the patients' medical records. Descriptive analysis of the data revealed 32% of the participants attained a therapeutic level with the first aPTT taken and that, successively, 35% and 45% of the participants attained a therapeutic level with the second and third aPTT taken. The majority of participants were found to be outside of the therapeutic range at any one time during the study. A generalised linear model (log-binomial model) applied to the data revealed that increased ABW (p=0.002), creatinine levels (p=0.033) and, in particular, BMI (p=0.000) were significant risk factors that contributed to the failure of participants attaining a therapeutic aPTT level. Age (p=0.668), gender (p=0.623), smoking (p=0.993) and the use of concomitant intravenous glycerine trinitrate (p=0.897) did not have a significant effect on the time to reach a therapeutic aPTT. The results provide noteworthy information for the re-evaluation of the use of the standard heparin nomogram. A robust randomised clinical trial is required to further examine BMI as the best predictor for heparin requirements in ACS patients receiving a heparin infusion.

Acute Disease↗

PubMed1994

Steady state feedback in mammalian phototransduction illustrated by a nomogram.

Published data characterizing the four reactions responsible for the Ca(2+)-mediated negative feedback in mammalian rod phototransduction were used to generate graphs which are combined in a circular fashion so that the y-axis of one serves as the x-axis of the next. The nomogram thus created makes it possible to determine by inspection the steady state situation in darkness, and the quasi-steady state situations that pertain shortly after exposure to light of different intensities. The results predicted by the nomogram suggest that Ca(2+)-mediated negative feedback is responsible for the Weber-Fechner relationship between stimulus and response.

1-Methyl-3-isobutylxanthine↗

PubMed2002

Cerebellar growth in normal fetuses of multiple gestations.

OBJECTIVE: The purpose of this study was to compare the cerebellar growth in twin and triplet gestations with cerebellar growth in singleton pregnancies. METHODOLOGY: An ultrasound study was conducted in a population of normal pregnant women with singleton, twin and triplet gestations. Routine ultrasound examinations were performed in healthy pregnant women: 951 women with singleton pregnancies; 151 with twin gestations; and 28 with triplet gestations. Although multiple biometric parameters were measured throughout the course of pregnancy, in this study a single measurement (the last measurement before delivery) of the transverse cerebellar diameter (TCD) was used from each patient for statistical analysis. Growth of the TCD was determined in the multiple gestations and compared with growth in singleton pregnancies. RESULTS: A statistically significant relationship was found between TCD and gestational age in all three groups (singleton, twin A and B, and triplets) respectively: R2 = 0.963; R2 = 0.980; R2 = 0.977. No statistical difference was found between the three sets of normative measurements. CONCLUSIONS: There was no significant difference observed in cerebellar growth among singleton and multiple gestations. Therefore, nomograms previously established for singleton pregnancies may be useful to assess growth in multifetal pregnancies.

Adolescent↗

PubMed2000

Pharmacokinetic-pharmacodynamic evaluation of ceftazidime continuous infusion vs intermittent bolus injection in septicaemic melioidosis.

AIMS: Experimental studies have suggested that constant intravenous infusion would be preferable to conventional intermittent bolus administration of beta-lactam antibiotics for serious Gram-negative infections. Severe melioidosis (Burkholderia pseudomallei infection) carries a mortality over 40% despite treatment with high dose ceftazidime. The aim of this study was to measure the pharmacokinetic and pharmacodynamic effects of continuous infusion of ceftazidime vs intermittent bolus dosing in septicaemic melioidosis. METHODS: Patients with suspected septicaemic melioidosis were randomised to receive ceftazidime 40 mg kg(-1) 8 hourly by bolus injection or 4 mg kg(-1) h(-1) by constant infusion following a 12 mg kg(-1) priming dose and pharmacokinetic and pharmacodynamic parameters were compared. RESULTS: Of the 34 patients studied 16 (59%) died. Twenty patients had cultures positive for B. pseudomallei of whom 12 (60%) died. The median MIC90 of B. pseudomallei was 2 mg l(-1), giving a minimum target concentration (4*MIC) of 8 mg l(-1). The median (range) estimated total apparent volume of distribution, systemic clearance and terminal elimination half-lives of ceftazidime were 0.468 (0.241-0. 573) l kg(-1), 0.058 (0.005-0.159) l kg(-1) h(-1) and 7.74 (1.95-44.71) h, respectively. Clearance of ceftazidime and creatinine clearance were correlated closely (r = 0.71; P < 0.001) and there was no evidence of significant nonrenal clearance. CONCLUSIONS: Simulations based on these data and the ceftazidime sensitivity of the B. pseudomallei isolates indicated that administration by constant infusion would allow significant dose reduction and cost saving. With conventional 8 h intermittent dosing to patients with normal renal function, plasma ceftazidime concentrations could fall below the target concentration but this would be unlikely with a constant infusion. Correction for renal failure, which is common in patients with meliodosis is Clearance = k(*) creatinine clearance where k = 0.72. Calculation of a loading dose gives median (range) values of loading dose, DL of 18.7 mg kg(-1) (9.5-23) and infusion rate I = 3.5 mg k(-1) h(-1) (0.4-13) (which equals 84 mg kg(-1) day(-1)). A nomogram for adjustment in renal failure is given.

Adult↗

PubMed1982

The possible correlation of intra-ocular pressure and the volume of the anterior chamber.

An investigation is made into the correlation between anterior chamber volume and intra-ocular pressure. It is suggested that patients can be screened for possible ocular hypertension by measuring their corneal radii and the depth of their anterior chamber. A nomogram shows which combinations of the parameters may lead to ocular hypertension and thus indicates which patients need to be investigated at greater length.

Adolescent↗

PubMed1981

[Potential use of mathematical methods for predicting the surgical treatment results in renovascular hypertension].

The duration of the case history was determined in 16 patients with vasorenal hypertension caused by unilateral lesion of the renal arteries, as well as renal activity in peripheral and reno-venous blood, Tmax and T1/2 according to the findings of renography, and blood flow in the renal artery before and after reconstruction according to the results of intraoperative flow measurement. The set of characteristics obtained was used in prognosing the parameters of arterial pressure (AP) in the postoperative period by means of regression analysis. The relative root-mean-square error in prognosing systolic AP was 15% and diastolic AP 20%. Nomograms for determining AP parameters according to the combination of characteristics were elaborated.

Adult↗

PubMed2002

Assessment of clinical and pathologic characteristics predisposing to disease recurrence following radical prostatectomy in men with pathologically organ-confined prostate cancer.

OBJECTIVE: To identify risk factors for biochemical failure after radical prostatectomy (RP) in men with pathologically organ-confined (OC) prostate cancer (PCa). METHODS: Clinical and pathological characteristics of 331 consecutive men with pT2N0 PCa treated solely with RP were used in Cox proportional hazard models to identify independent predictors of prostate specific antigen (PSA) failure (PSA > or = 0.1 ng/ml). All pathologic specimens were step sectioned at 3 mm. RESULTS: Twelve patients (3.6%) failed at a median follow-up of 26 months (range 0.2-99.6 months) and 120 men remained at risk 3 years after RP. In univariate Cox models PSA (P < 0.001), percentage of high-grade cancer (P < 0.001) total and high-grade cancer volume (P = 0.001 and P < 0.0001, respectively) and RP Gleason sum (P = 0.003) represented significant predictors of PSA failure. Clinical stage (P = 0.4), surgical margin status (P = 0.3), age (P = 0.2), and pathologic evidence of unilateral versus bilateral PCa (P = 0.6) failed to reveal significance. In receiver operator curve (ROC) analyses, high-grade cancer volume achieved highest outcome predictive accuracy (area under the curve (AUC 0.93)), which was not exceeded by Cox regression-based nomogram combining serum PSA, RP Gleason sum, margin status and pathologic evidence of unilateral versus bilateral PCa (AUC 091). Predictive accuracy of this multivariate nomogram was not enhanced by adding total cancer volume (AUC 0.93), high-grade cancer volume (AUC 0.90), or percentage of high-grade cancer (AUC 0.90). CONCLUSIONS: In pT2N0 PCa high-grade cancer volume appears to represent the most important pathologic factor for prediction of outcome following RP. However, similar predictive accuracy may be achieved by combining routinely available tumor characteristics.

Area Under Curve↗

PubMed2003

Volumetric assessment of normal fetal lungs using three-dimensional ultrasound.

We attempted to construct normal reference centiles of fetal lung volume (LV) for clinical application by using three-dimensional (3-D) ultrasound (US) during normal gestation. A prospective study was performed on 195 healthy fetuses with gestational age (GA) ranging from 20 to 40 weeks for the assessment of fetal LV using a 3-D US volume scanner with a mixture of cross-sectional and serial measurements. Polynomial regression analysis was calculated to find the best-fit model between GA, right lung volume (RLV), left lung volume (LLV) and total lung volume (TLV). In addition, common fetal growth parameters, such as biparietal diameter (BPD), occipitofrontal diameter (OFD), head circumference (HCi), abdominal circumference (ACi), femur length (FL) and estimated fetal weight (EFW) were also measured to demonstrate the correlations between RLV, LLV, TLV and these parameters. Our results showed that RLV, LLV and TLV were highly correlated with GA. Using GA as the independent variable and RLV, LLV and TLV as the dependent variable, the best-fit regression equations were: RLV (mL) = 0.067 GA(2) - 1.2464 GA + 2.7825 (r = 0.95, n = 173, p < 0.0001), LLV (mL) = 0.0573 GA(2) - 1.599 GA + 12.454 (r = 0.95, n = 159, p < 0.0001) and TLV (mL) = 0.1263 GA(2) - 2.982 GA + 17.448 (r = 0.96, n = 152, p < 0.0001). For clinical use, a chart of normal growth centiles of fetal LV in utero was then calculated based on this equation. Furthermore, RLV, LLV and TLV were also highly correlated with the common fetal growth parameters during normal gestation (all p < 0.0001). In conclusion, the 3-D US nomograms of the fetal lung volume established in this study can be utilized as useful references in prenatal detection of fetal pulmonary pathologic status and relevant abnormalities.

Anthropometry↗

PubMed2026

POFUT1 Serves as an Independent Prognostic Factor and Therapeutic Target by Activating the PI3K/AKT Pathway in Glioma.

OBJECTIVE: Protein O-fucosyltransferase 1 (POFUT1) has been implicated in several malignancies, but its functional and prognostic significance in glioma remains insufficiently defined. This study evaluated whether POFUT1 expression is associated with glioma progression, patient outcome, and PI3K/AKT pathway activity. METHODS: Public glioma transcriptome datasets from The Cancer Genome Atlas (TCGA) and Chinese Glioma Genome Atlas (CGGA) were analyzed and compared with clinical samples collected from 123 glioma patients. POFUT1 protein levels in clinical specimens were determined by immunohistochemical staining, and its association with patient outcome was analyzed using survival curves. In vitro, glioma cell growth, motility, and invasiveness were examined using MTT and Transwell assays. The effect of POFUT1 on tumor formation was further tested in a subcutaneous xenograft model. RNA sequencing, KEGG pathway enrichment, and pharmacological inhibition were then used to explore the mechanism linking POFUT1 to PI3K/AKT signaling. RESULTS: POFUT1 expression was higher in glioma than in normal brain tissue and increased with tumor grade. Patients with high POFUT1 levels had shorter overall survival, and multivariate Cox analyses supported POFUT1 as an independent prognostic indicator. Incorporating POFUT1 into a nomogram improved prediction of 1-, 3-, and 5-year survival. Functionally, POFUT1 knockdown reduced glioma cell growth, motility, invasion, and xenograft expansion, whereas POFUT1 overexpression produced the opposite phenotype. Transcriptomic and protein analyses indicated that POFUT1 enhanced PI3K/AKT signaling. The PI3K inhibitor LY294002 weakened the tumor-promoting effects caused by POFUT1 overexpression. CONCLUSION: POFUT1 as a key driver of glioma malignancy, predominantly through activating the PI3K-AKT signaling pathway. These findings highlight POFUT1 as a promising novel therapeutic target for aggressive glioma.

Glioma↗