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PubMed1992

Isoleucine requirements of the chicken: requirement for maintenance.

1. The maintenance requirement of adult male cockerels for isoleucine was measured by nitrogen balance. Measured amounts of a diet first-limiting in isoleucine were fed by tube each day for 6 d to give a range of intakes of from 0 to 100 mg isoleucine/kg body weight. A nitrogen-free diet containing energy, vitamins and both major and trace minerals was offered ad libitum during that time. Two series of diets were used, an unbalanced series, as described above, and a balanced series, in which synthetic L-isoleucine was added to each diet in the unbalanced series. Excreta were collected in bags during the last 3 d of the balance period and the N content of the excreta was analysed on wet, homogenised samples. 2. The resultant linear regressions were not statistically different for the unbalanced and the balanced series indicating that the response measured was to isoleucine. The pooled regression equation was: N retention = -144.14 (+/- 8.5) + 2.421 (+/- 0.19)I where I is the intake of isoleucine in mg/kg body weight day. The isoleucine required to maintain the body at zero N retention was therefore calculated to be 60 (+/- 3.2) mg/kg body weight day. 3. A case has been made for the expression of the amino acids required for maintenance to be in terms not of body weight but scaled according to the degree of maturity of the animal, and on this basis the amount of isoleucine required for maintenance was calculated to be 300 mg per unit of maintenance protein (Pm 0.73 mu) per day.

Amino Acids↗
PubMed1983

Narcotic maintenance for chronic pain. Medical and legal guidelines.

Narcotic maintenance may be needed to relieve chronic pain in ambulatory patients who fail to respond to other pain therapies. Oral, long-acting narcotics are preferred, and nonnarcotic pain therapies can be administered simultaneously to reduce the narcotic dosage. To legally undertake narcotic maintenance, the physician must document the presence of an incurable, painful medical condition. We recommend that the patient give informed consent, since narcotic maintenance may lead to dependence and addiction. When done properly, narcotic maintenance is an appropriate medical-legal procedure that is safe and may provide humanitarian pain relief.

Analgesics↗
PubMedDate not supplied

Attitudes toward methadone maintenance: implications for HIV prevention.

Attitudes of opioid users toward methadone maintenance were studied using semi-structured field interviews. One hundred and sixty-one heroin and speedball users in San Antonio, Texas, were interviewed between 1989 and 1992. Users were classified according to whether or not they had ever been on methadone maintenance. Opioid users who had never been on methadone maintenance were more likely to express a negative attitude toward methadone maintenance than users who had been on it (50% versus 30%). Sources of negative attitudes fell into the following categories: (1) general societal disapproval of addictive drugs, including methadone; (2) prior experience with 12 Step groups or abstinence-based treatment programs; (3) previous forced rapid detoxification from methadone in jail; and (4) observation of methadone maintained peers who continued to use drugs. Very few respondents reported adverse effects from methadone itself as a source of negative attitudes. Sources of positive attitudes included: (1) prior successful treatment with methadone; and (2) observation of methadone patients who stopped using drugs.

Acquired Immunodeficiency Syndrome↗
PubMed2001

Prednisolone maintenance dose in relation to starting dose in the treatment of polymyalgia rheumatica and temporal arteritis. A prospective two-year study in 273 patients.

OBJECTIVE: To describe the maintenance dose and annual cessation rate of oral corticosteroids in relation to the starting dose in patients with polymyalgia rheumatica (PMR) and temporal arteritis (TA). METHODS: A prospective two-years observational study of 273 patients with PMR and TA followed by rheumatologists. RESULTS: Mean daily maintenance dose of prednisolone during the first and second year was 5.7 mg and 4.3 mg for PMR, 6.6 mg and 4.1 mg for TA, and 8.3 mg and 4.7 mg for PMR with TA. There was a strong association between the initial dose and maintenance dose. The rate of steroid cessation after two years in PMR was 24%, in TA 16%, and in PMR with TA 5%. CONCLUSION: Low initial dose of prednisolone is associated with low maintenance dose. This is important as the majority of patients with PMR and TA will be treated for more than two years.

Aged↗
PubMed1999

Long-term weight maintenance after an intensive weight-loss program.

OBJECTIVE: This prospective study assessed long-term weight maintenance of patients completing an intensive very-low-calorie diet (VLCD) weight-loss program. SUBJECTS: Individuals who had completed the 12-week core education program and lost > or = 10 kg were recruited. RESULTS: Of 154 eligible subjects, follow-up weights were obtained at > or = 2 years in 112 subjects (72.7%, 72 women, 40 men). Subjects had an average initial body mass index of 37.3 kg/m2 and an average weight loss of 29.7 kg in five months. Six hundred and forty-five follow-up weights (median, five per subject) were obtained over two to seven years of follow-up from clinic visits (70%) and self-report by telephone or mail (30%). Subjects regained an average of 2.5% per month of their lost weight during the first two to three years of follow-up; however, their weight stabilized over the next four years. Subjects regained an average of 73.4% of their weight loss during the first three years. The average weight loss maintained for 112 subjects was 22.8% of initial weight loss after an average of 5.3 years of follow-up. When successful weight maintenance was defined as maintaining a weight loss of 5% or 10% of initial (pre-treatment) body weight, 40% were maintaining a 5% weight loss at five years and 25% were maintaining a weight loss of 10% at 7 years. Multiple regression analyses suggested that age had a significant (p=0.004) and positive effect on weight maintenance. CONCLUSIONS: This study suggests that weight maintenance after an intensive VLCD program is improving but still needs intensive efforts to enable most individuals to maintain a substantial percentage of their weight loss long-term.

Adult↗
PubMed2003

Acute and maintenance treatment of atopic dermatitis in children - two comparative studies with fluticasone propionate (0.05%) cream.

BACKGROUND: Two multicentre, randomised, parallel group, double-blind, comparative studies in children (2-14 yr) evaluated fluticasone propionate (FP) 0.05% cream for both acute and maintenance treatment of moderate to severe atopic dermatitis (AD). METHODS: One study compared FP with hydrocortisone (HC) 1% cream (FP 70, HC 67) and the other with hydrocortisone butyrate (HCB) 0.1% cream (FP 67, HCB 62). Treatments were applied twice daily, for 2-4 weeks until the AD was stabilised, and thereafter intermittently ('as required') for up to 12 weeks. RESULTS: The primary outcome measure, Total AD Score, recorded at the end of the acute and maintenance phases, was significantly lower (indicating improvements in disease severity) following treatment with FP compared with either HC or HCB (acute phase difference vs. HC, -2.39, 95%CI -3.47, -1.31; p<0.001 and vs. HCB, -1.25, 95%CI -2.46, -0.05; p=0.042) and (maintenance phase difference vs. HC, -1.88, 95%CI -3.20, -0.56; p=0.006 and vs. HCB, -1.39, 95%CI -2.72, -0.05; p=0.042). In both studies treatments were equally well tolerated with no visible signs of skin atrophy. CONCLUSION: In both the acute and longer term management of AD in children, FP demonstrated a high level of efficacy and maintenance of disease control with a tolerability similar to HC 1%, a lower potency corticosteroid.

Acute Disease↗
PubMed2002

The impact of maintenance and design for ventilation systems.

Ventilation systems need to be designed to include access for cleaning and preventive maintenance. Without such access, the exhaust volume will deteriorate. Because of access difficulties and the many demands on their time, plant managers are sometimes errant in performing proper preventive maintenance. Three surveys measuring workers' exposures to methylene chloride were conducted at the same furniture stripping facility. A new ventilation system was installed for the first survey, resulting in an exhaust volume of 2900 cfm and worker exposure to methylene chloride of 59 ppm (geometric mean). Immediately after the first survey, the gasoline-powered fan was replaced by a smaller capacity electrically powered fan. Deterioration in the ventilation system was seen after seven years. Problems included clogged slots, paint chips and sawdust deposits in plenums, and a loose and frayed fan belt. The second survey indicated a reduction in exhaust volume to 1060 cfm and increased worker exposure to 330 ppm. With the smaller capacity fan still in place, the system was otherwise upgraded to allow for easier access and maintenance was performed. The third survey showed that the ventilation system performance was better (exhaust volume improved to 2080 cfm) and the worker exposures were reduced to 73 ppm. This study shows the benefits of designing for preventive maintenance and the necessity of keeping the ventilation systems clean.

Air Pollutants, Occupational↗
PubMedDate not supplied

Inpatient initiation of buprenorphine maintenance vs. detoxification: can retention of opioid-dependent patients in outpatient counseling be improved?

Buprenorphine-naloxone is an office-based opioid agonist released in 2003 in the United States for the maintenance of heroin- and other opioid-dependent patients. Concern has been raised that the medication will distract or otherwise inhibit patients from participating in a holistic recovery program or abstinence-based counseling. Using a retrospective chart review, the first thirty opioid-dependent patients induced on buprenorphine maintenance therapy in an inpatient detoxification unit were compared to thirty age- and gender-matched patients who underwent detoxification (with a tramadol taper) and referral to intensive outpatient treatment. The clinical outcomes were a comparison of completion rates for an intensive outpatient program (IOP) and retention in treatment after twelve weeks of aftercare therapy. Patients induced on buprenorphine maintenance over three days had similar relief of withdrawal symptoms to patients detoxified from opioids over five days with tramadol. Patients maintained on buprenorphine had a markedly increased initiation of IOP and remained in outpatient treatment longer than patients who were detoxified (8.5 wks vs. 0.4 wks, p < 0.001). This study indicates that induction and maintenance on buprenorphine may be more effective than detoxification for engaging and retaining patients in abstinence-based comprehensive outpatient addiction treatment.

Administration, Sublingual↗
PubMed2006

Hydrocarbon-based weapons maintenance compounds produce evidence of contact hypersensitivity in BALB/c mice.

Unprotected dermal contact with weapons maintenance materials is highly probable during cleaning and maintenance of firearms. Several weapons maintenance materials of interest to the Department of Defense were evaluated for their irritating and sensitizing potential in a modified local lymph node assay (LLNA). Female BALB/c mice (n = 5) were topically exposed to Break-Free CLP, Royco 634, TW-25B, MC-25, or MC-2500. All compounds tested produced a positive response for irritancy and lymphocyte proliferation. Break-Free CLP and Royco 634 produced the greatest dermal irritation and highest LLNA stimulation index. Phenotyping of draining lymph node cells from animals treated with Break-Free CLP suggest that this material induces T-cell-mediated contact sensitization (Type IV hypersensitivity) in mice. These findings support the recommendation that persons handling or using weapons maintenance materials should protect their skin from repeated contact by wearing appropriate personal protective equipment.

Animals↗
PubMed1978

[A new method for testing the quality of food protein for maintenance metabolism. 1. Investigations into the amount of 15N excreted via the urine of 15N-labelled young rats fed various proteins].

Over a period of 7 days, 38 experimental rats were fed a casein diet with a supplementation of 6.6 mg 15N-excess (15N') in the form of ammonium acetate. From the 5th experimental day, groups of 4 or 5 rats each were fed, over 5 days, different protein carriers to meet the meintenance requirement (115 kcal/kg body weight 0.75). The 15N-excretion via the urine, in terms of % of N absorbed from the food protein, served as yardstick of protein quality under maintenance conditions. The least 15N-excretion rates were reciprocally relativated for this maximum value (reciprocal 15N excretion biological value). The least 15N-excretion values from the 2nd to the 5th experimental days allowed to establish the following order for protein quality under maintenance conditions: fish meal, casein, wheat, whole egg, soybean (assayprotein), yeast peas, gelatin. The very good quality of the wheat protein for the maintenance state is seen in relation with the high content of glutamic acid (33.5 g/16 g N) and aspartic acid (5.7 g/16 gN). The found lysine content of the wheat protein (3.1 g/16 g N) proved sufficient for maintenance conditions.

Animals↗
PubMed1990

[The effect of the protein level of feed on the energy maintenance requirement of rats during the course of growth and after the conclusion of the intensive growth phase using different feeding regimens].

In two experiments with male Wistar rats energy metabolism was measured on the feeding level of maintenance in the course of growth and in various adult periods after the application of feed mixtures with various protein-carbohydrate quotas (10, 40 and 70% crude protein) according to two different feeding regimes. While there was a change of protein levels between the animal groups in periods 1 to 3 and 8 to 10 from one period to the other, the protein levels in periods 4 to 7 and 11 to 13 remained the same for each animal group. Irrespective of the feeding regime, a dependence of the energy maintenance requirement on the nutrients according to the expected values was measured, which result from the different efficiency of ATP synthesis in the oxidative degradation of the nutrients. On an average of the periods maintenance requirement amounted to 357 +/- 21, 399 +/- 16 and 443 +/- 28 kJ/kg LW0.75.d (experiment 1) and 350 +/- 29, 383 +/- 34 and 442 +/- 30 kJ/kg LW0.75.d (experiment 2) for 10, 40 and 70% crude protein in the feed. The relation between the maintenance requirement values was 100:112:124 and 100:109:126. This contrasts with the relative expected values of 100:108:115 and 100:109:116.

Adenosine Triphosphate↗
PubMed2003

Parental status of women injection drug users and entry to methadone maintenance.

This article examines patterns of methadone maintenance treatment entry among 9018 adult women injection drug users (IDUs), with special attention to parental-status differences. The data originate from a statewide drug-treatment database covering all women IDUs who entered drug treatment in the State of Massachusetts over a four-year period. Through the use of logistic regression analysis, the study found that among these women IDUs, those who resided with their children were significantly more likely to enter methadone maintenance than women who were mothers but did not reside with their children. Mothers residing with their children were 73% more likely to enter methadone maintenance than mothers who do not reside with their children. The authors discuss specific programmatic and policy implications including the need to determine whether methadone maintenance should be promoted as an alternative drug treatment option in order to preserve family unification or promote family reunification.

Adolescent↗
PubMed2005

Blimp-1 is required for maintenance of long-lived plasma cells in the bone marrow.

Long-lived plasma cells, residing primarily in the bone marrow, continuously secrete antibody and provide an important component of humoral memory. However, when such cells secrete autoantibodies or become transformed, they can be pathogenic. We have shown recently that the transcriptional repressor B lymphocyte-induced maturation protein 1 (Blimp-1) is required for the formation of plasma cells. To determine what role Blimp-1 might play in maintenance of plasma cells, we generated mice in which the gene encoding Blimp-1 could be deleted in an inducible manner. Deletion of Blimp-1 either in vitro or in vivo leads to loss of previously formed B220(LO)CD138(HI) plasma cells. Using BrdU incorporation, we confirmed that Blimp-1 is required for the maintenance of nondividing, long-lived plasma cells in the bone marrow. Blimp-1 is also required for long-term maintenance of antigen-specific immunoglobulin in serum. Thus Blimp-1 is required not only for the formation but also for the maintenance of long-lived plasma cells. This finding provides the possibility of new drug design strategies for autoimmunity and multiple myeloma focused on blocking Blimp-1 expression or activity.

Animals↗
PubMed1980

Chemical energetics of force development, force maintenance, and relaxation in mammalian smooth muscle.

High-energy phosphate utilization (delta approximately P) associated with force development, force maintenance, and relaxation has been determined during single isometric tetani in the rabbit taenia coli. ATP resynthesis from glycolysis and respiration was stopped without deleterious effects on the muscle. At 18 degrees C and a muscle length of 95% l0, the resting rate of energy utilization is 1.8 +/- 0.2 nmol/g . s-1, or 0.85 +/- 0.2 mmol approximately P/mol of total creatine (Ct) . s-1, where Ct = 2.7 mumol/g wet wt. During the initial 25 s of stimulation when force is developed, the average rate of delta approximately P was -8.2 +/- 0.8 mmol/mol Ct . s-1, some four times greater than during the subsequent 35 s of force maintenance, when the rate was -2.0 +/- 0.6 mmol approximately P/mol Ct . s-1. The energy cost of force redevelopment (0 to 95% P0) after a quick release from the peak of a tetanus is very low compared with the initial force development. Therefore, the high rate of energy utilization during force development is not due only to internal work done against the series elasticity nor to any high rate of cross-bridge cycling inherently associated with force development. The high economy of force maintenance compared with other muscle types is undoubtedly due to a slower cross-bridge cycle time. The energy utilization during 45 s of relaxation was not statistically significant, and integral of Pdt/delta approximately P was higher during relaxation than during force maintenance in the stimulated muscle.

Adenosine Triphosphate↗
PubMed1998

Phase II trial of recombinant IFN-alpha2a with etoposide/cisplatin induction and interferon/megestrol acetate maintenance in extensive small cell lung cancer.

Previous data suggested interaction of cisplatin with interferon (IFN) in non-small cell lung cancer and a possible effect of IFN in maintaining remission in small cell lung cancer (SCLC). This study was designed to further examine the effect of IFN in the treatment of extensive disease (ED) SCLC. Forty previously untreated patients with performance status (PS) of 0-2 (Zubrod scale) were treated with etoposide (100 mg/m2 for 3 days), cisplatin (25 mg/m2 for 3 days) (EP), and recombinant IFN-alpha2a (rIFN-alpha2a) (5 x 10(6) U/m2 for 3 days) for six cycles (induction), followed by rIFN-alpha2a (5 x 10(6) U/m2) thrice weekly and megestrol acetate (40 mg q.i.d.) as maintenance therapy for 6 months or until progressive disease or intolerable toxicity was documented. Patients were 25 men (62%) and 15 women (38%), median age 58 (28-76), median Zubrod performance status 1 (0-2). Major sites of metastasis include liver (55%), bone (42%), bone marrow (25%), and adrenal gland (18%). Of 40 eligible patients accrued to this trial, 35 were evaluable for response, and 37 were evaluable for toxicity. There were 3 complete and 28 partial responses, for an overall response rate of 89%. With 39 of 40 patients followed until death, median survival (Kaplan-Meier) is estimated at 46 weeks (95% CI range 35-55). Twenty patients completed six cycles of induction, and 16 received maintenance therapy, median 2 cycles (range 1-3). Major toxicity during induction included grade 4 granulocytopenia in 24%, grade 2-3 nausea or vomiting or both in 41%, grade 2 fatigue in 24%, grade 2 anorexia in 22%, and grade 2-3 renal insufficiency in 9% of 175 total courses of chemotherapy administered. Toxicity during the maintenance phase was notable for grade 2-3 fatigue in 43%, grade 2-3 anorexia in 24%, grade 2-3 weight loss in 10%, and grade 3-4 anemia in 17% of 30 courses. There were no treatment-related deaths. The addition of rIFN-alpha2a to EP in induction chemotherapy of ED SCLC, followed by rIFN-alpha2a and megestrol acetate maintenance therapy, was reasonably well tolerated. The complete and overall response rates and duration of remission and survival appear to be similar to those generally obtained with EP alone in similar patients.

Adult↗
PubMed1985

Interval nitrogen excretion and maintenance nitrogen requirements for parenteral nutrition in primates.

This paper discusses a regression technique for determining maintenance nitrogen requirements in well-nourished primates (M fascicularis) on total parenteral nutrition. Animals were administered a continuous glucose infusion, and parenteral nitrogen intake was varied at constant time intervals in a random order (from 0 to 1 g nitrogen/kg/day). Interval nitrogen balance (intake minus urinary nitrogen output) was plotted against interval nitrogen intake. The x-intercept was defined as the maintenance nitrogen requirement. First, 24-h intervals were used at a nonprotein caloric intake of 85 kcal/kg/day (approximately 175% of primate resting energy expenditure) and the nutritional adequacy of the estimated requirement evaluated prospectively. Next, 8-h balance intervals were used and the maintenance nitrogen requirements predicted by this abbreviated technique were compared to those obtained using the longer method. Finally, the short-interval technique was repeated at two other levels of continuous glucose infusion (60 kcal/kg/day and 8 kcal/kg/day) and the effect on predicted nitrogen requirement examined. Maintenance parenteral nitrogen requirements for primates may be determined in 48 h using the abbreviated techniques.

Animals↗
PubMed1997

McCollum Award Lecture, 1996: protein-energy malnutrition in maintenance dialysis patients.

There is a high prevalence of protein-energy malnutrition in patients with chronic renal failure who are undergoing maintenance dialysis therapy. The high prevalence of malnutrition is a potentially serious problem because indexes of protein-energy malnutrition are powerful predictors of mortality in maintenance dialysis patients. Although the data do not prove that improving nutritional intake will reduce mortality, nonrandomized studies suggest that provision of addition amino acids and energy to such patients is associated with reduced mortality. There are many causes for protein-energy malnutrition in maintenance dialysis patients. Among the three most important factors are the nutritional status of the patient before commencing dialysis therapy, inadequate protein and energy intakes after they become dialysis patients, and acute and chronic illnesses. Improving the nutrient intake of maintenance dialysis patients is a challenging task because most chronic renal failure patients with malnutrition are anorectic, and dietary counseling has had limited success at increasing their nutrient intake. Other methods for improving nutritional status in adults, infants, and children with chronic renal failure that have been tried with varying degrees of success include increasing the dose of dialysis and the use of food supplements and tube feeding. Less well-proven techniques for the treatment of protein-energy malnutrition include intradialytic parenteral nutrition. The use of appetite stimulants and such growth factors as rhGH and rhIGF-I are still in the experimental stage.

Adult↗
PubMed1990

Normalization of increased sodium sensitivity by maintenance hemodialysis.

Blood pressure (BP) becomes more sodium and body fluid sensitive as renal function deteriorates. Thus, hypertension in chronic renal failure is mostly of the sodium sensitive type. We studied whether the increased sodium sensitivity (SS) can be restored to normal on the maintenance phase of hemodialysis (HD) therapy. Body weight (BW) and BP (specifically, mean arterial pressure [MAP]) were measured after HD and before the next HD, and the body fluid sensitivity (BFS) was calculated as the ratio of changes in these factors on both introduction and maintenance phases in HD patients (n = 56) who were not taking any antihypertensive drugs (BFS = delta MAP/delta BW). In a preliminary study, the amount of interdialytic sodium intake (QNa+) was measured (n = 30), and SS was calculated as the ratio of the change in MAP to QNa+ (SS = delta MAP/QNa+). Interdialytic BW gain (3.1 +/- 0.1 kg) was correlated with the amount of sodium intake (136 +/- 17 mEq), resulting in a positive relationship between BFS and SS (r = 0.79, P less than .0001). Therefore, BFS was used as an index of SS. As a whole, BFS decreased from the introduction to the maintenance phase (6.5 +/- 1.0 to 3.5 +/- 0.6 mm Hg/L, P less than .01). This decrease was marked (6.2 +/- 1.1 to 2.9 +/- 0.6 mm Hg/L, P less than .01) in patients (n = 46) whose BP was normalized in the maintenance phase, while not significant (7.9 +/- 1.9 to 6.3 +/- 1.3 mm Hg/L) in patients (n = 10) whose BP was still high.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗