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Long-acting octreotide and prolonged-release lanreotide formulations have different pharmacokinetic profiles.

Single-dose pharmacokinetic (PK) profiles and multiple-dose PK modeling were compared for long-acting octreotide (20 or 60 mg) and prolonged-release lanreotide (90 or 120 mg) over 91 days; steady-state profiles were simulated. All treatments were well tolerated. Octreotide 20-mg profile showed increased concentration on day 1, lag from days 2 to 6, then prolonged plateau phase (days 11-41); 60-mg PK was dose proportional. Lanreotide 90-mg profile showed C(max) on day 1 then elimination (apparent t1/2 25.5 days); 120-mg profile was underproportional. Steady-state PK of octreotide 20 mg/28 d suggested a C(mean) of 1216 rhog/mL (range, 1065-1585) with low fluctuation index (43%). Steady-state PK of lanreotide 90 mg/28 d suggested a C(mean) of 4455 rhog/mL (range, 2499-9279) with high fluctuation index (152%). Long-acting octreotide had more predictable PK than prolonged-release lanreotide. Simulated steady-state profiles suggest long-acting octreotide could be optimized to meet individual patient needs. In contrast, prolonged-release lanreotide requires exposure constantly above the therapeutic target to enable monthly long-term therapy.

Abdominal Pain↗

Comparison of pregnancy mood profiles in gestational diabetes and preexisting diabetes.

PURPOSE: This study sought to answer the following questions: How does intensified diabetes management affect the patient's mood profile? Is there a relationship between levels of glycemic control and emotional profile? Which factors distinguish the emotional profile of women with pregestational diabetes from women with newly diagnosed gestational diabetes? METHODS: A secondary analysis was conducted of women with newly diagnosed gestational diabetes (GDM), pregestational diabetes (PGDM), and nondiabetic controls. Those with diabetes were treated with an intensified approach. All participants responded to a questionnaire measuring bipolar subjective mood states. The relation between diabetes types, glucose characteristics during pregnancy, and mood were analyzed. RESULTS: The mood profile was significantly associated with level of glycemic control in GDM women (comparable to controls). PGDM women were not affected by either level of glycemic control or diabetes class categories. The number of glucose determinations, marital status, and maternal age were related to mood profile for GDM women. CONCLUSIONS: Because women with GDM and PGDM present different mood profiles in pregnancy, customized medical/behavioral goals may be needed to enhance compliance and optimize perinatal outcome.

Affect↗

Cognitive processes in criminal profile construction: a preliminary study.

This study undertook an empirically based examination of the cognitive processes associated with the accurate construction of a criminal psychological profile. This was accomplished by comparing the abilities of profilers and nonprofilers in two simulated profiling exercises that measured both profile accuracy and an individual's performance on various tests of memory and comprehension related to the case materials presented in each exercise. The results of these experiments suggest that an incremental relationship exists between comprehension of the case materials and accuracy of the profiles generated. In addition, the findings provide some tentative indications that the comprehension of case material in a narrative (i.e., written) format is an integral cognitive function to proficient profiling.

Adolescent↗

Sport-specific performance factor profiling: fencing as a prototype.

A musculoskeletal profiling study was done on 24 members of the U. S. Pan American and Olympic fencing squads. This was presented as a methodological prototype for future, more comprehensive sport profiling studies. It is proposed that sport-specific profiling data have practical application in the following areas: 1. The identification of physical deficiencies in an athlete, using his or her sport profile as a comparative standard. This would apply to general pre- and postseason screening as well as to medical complaint-related examinations. 2. Providing objective, sport-specific criteria for determining when an injured athlete has recovered to the extent that he or she is adequately prepared to return to play. Rehabilitation goals for full recovery can also be defined. 3. Increasing the efficacy and efficiency of training techniques. 4. The prospective identification of superior performance potential in athletes at early competitive levels. If sport profiles were developed for the major participant sports at several competitive levels, the profiling system as described here could have significant application to a large number of athletes in a variety of playing situations.

Adult↗

Administration of potentially antiandrogenic pesticides (procymidone, linuron, iprodione, chlozolinate, p,p'-DDE, and ketoconazole) and toxic substances (dibutyl- and diethylhexyl phthalate, PCB 169, and ethane dimethane sulphonate) during sexual differentiation produces diverse profiles of reproductive malformations in the male rat.

Antiandrogenic chemicals alter sexual differentiation by a variety of mechanisms, and as a consequence, they induce different profiles of effects. For example, in utero treatment with the androgen receptor (AR) antagonist, flutamide, produces ventral prostate agenesis and testicular nondescent, while in contrast, finasteride, an inhibitor of 5 alpha-dihydrotestosterone (DHT) synthesis, rarely, if ever, induces such malformations. In this regard, it was recently proposed that dibutyl phthalate (DBP) alters reproductive development by a different mechanism of action than flutamide or vinclozolin (V), which are AR antagonists, because the male offsprings display an unusually high incidence of testicular and epididymal alterations--effects rarely seen after in utero flutamide or V treatment. In this study, we present original data describing the reproductive effects of 10 known or suspected anti-androgens, including a Leydig cell toxicant ethane dimethane sulphonate (EDS, 50 mg kg-1 day-1), linuron (L, 100 mg kg-1 day-1), p,p'-DDE (100 mg kg-1 day-1), ketoconazole (12-50 mg kg-1 day-1), procymidone (P, 100 mg kg-1 day-1), chlozolinate (100 mg kg-1 day-1), iprodione (100 mg kg-1 day-1), DBP (500 mg kg-1 day-1), diethylhexyl phthalate (DEHP, 750 mg kg-1 day-1), and polychlorinated biphenyl (PCB) congener no. 169 (single dose of 1.8 mg kg-1). Our analysis indicates that the chemicals discussed here can be clustered into three or four separate groups, based on the resulting profiles of reproductive effects. Vinclozolin, P, and DDE, known AR ligands, produce similar profiles of toxicity. However, p,p'-DDE is less potent in this regard. DBP and DEHP produce a profile distinct from the above AR ligands. Male offsprings display a higher incidence of epididymal and testicular lesions than generally seen with flutamide, P, or V even at high dosage levels. Linuron treatment induced a level of external effects consistent with its low affinity for AR [reduced anogenital distance (AGD), retained nipples, and a low incidence of hypospadias]. However, L treatment also induced an unanticipated degree of malformed epididymides and testis atrophy. In fact, the profile of effects induced by L was similar to that seen with DBP. These results suggest that L may display several mechanisms of endocrine toxicity, one of which involves AR binding. Chlozolinate and iprodione did not produce any signs of maternal or fetal endocrine toxicity at 100 mg kg-1 day-1. EDS produced severe maternal toxicity and a 45% reduction in size at birth, which resulted in the death of all neonates by 5 days of age. However, EDS only reduced AGD in male pups by 15%. Ketoconazole did not demasculinize or feminize males but rather displayed anti-hormonal activities, apparently by inhibiting ovarian hormone synthesis, which resulted in delayed delivery and whole litter loss. In summary, the above in vivo data suggest that the chemicals we studied alter male sexual differentiation via different mechanisms. The anti-androgens V, P, and p,p'-DDE produce flutamide-like profiles that are distinct from those seen with DBP, DEHP, and L. The effects of PCB 169 bear little resemblance to those of any known anti-androgen. Only in depth in vitro studies will reveal the degree to which one can rely upon in vivo studies, like those presented here, to predict the cellular and molecular mechanisms of developmental toxicity.

Aminoimidazole Carboxamide↗

Resistance profiles of cyclic and linear inhibitors of HIV-1 protease.

Resistance to anti-HIV protease drugs is a major problem in the design of AIDS drugs with long-term efficacy. To identify structural features associated with a certain resistance profile, the inhibitory properties of a series of symmetric and asymmetric cyclic sulfamide, cyclic urea and linear transition-state analogue inhibitors of HIV-1 protease were investigated using wild-type and mutant enzyme. To allow a detailed structure-inhibition analysis, enzyme with single, double, triple and quadruple combinations of G48V, V82A, 184V and L90M substitutions was used. Kinetic analysis of the mutants revealed that catalytic efficiency was 1-30% of that for the wild-type enzyme, a consequence of reduced kcat in all cases and an increased KM for all mutants except for the G48V enzyme. The overall structure-inhibitory profiles of the cyclic compounds were similar, and the inhibition of the V82A, 184V and G48V/L90M mutants were less efficient than of the wild-type enzyme. The greatest increase in Ki was generally observed for the 184V mutant and least for the G48V/L90M mutant, and additional combinations of mutations did not result in improved inhibition profiles for the cyclic compounds. An extended analysis of additional mutants, and including a set of linear compounds, showed that the profile was unique for each compound, and did not reveal any general structural features associated with a certain inhibition profile. The effects of structural modifications in the inhibitors, or of mutations, were not additive and they differed depending on their context. The results demonstrate the difficulties in predicting resistance, even for closely related compounds, and designing compounds with improved resistance profiles.

Drug Resistance, Viral↗

Clinical impact of the differentiation profile assessed by immunophenotyping in patients with diffuse large B-cell lymphoma.

To analyze the relationship between immunophenotyping profile and main clinicopathological features and outcome in diffuse large B-cell lymphoma (DLBCL), we studied 128 patients (59 men, 69 women; median age 65 years) consecutively diagnosed with de novo DLBCL in a single institution. Cells from each patient were immunostained with CD20, CD79a, CD5, CD10, bcl-6, MUM1, CD138, bcl-2, p53, p27, and Ki-67 antibodies. Four immunophenotyping profiles were distinguished according to the pattern of differentiation: germinal center-CD10(+) (GC-CD10(+); CD10(+)/Bcl-6(+)/MUM1(-)/CD138(-)), germinal center-CD10(-) (GC-CD10(-); CD10(-)/Bcl-6(+)/ MUM1(-)/CD138(-)), post-germinal center (pGC; CD10(-)/bcl-6(+/-)/ MUM1(+)/CD138(-)), and plasmablastic (CD10(-)/bcl-6(-)/MUM1(+)/CD138(+)). Rearrangement of bcl-2 was studied by polymerase chain reaction (PCR) in 57 patients. Single-antigen expression was as follows: CD5, 2%; CD10, 21%; bcl-6, 72%; MUM1, 54%; CD138, 2%; bcl-2, 59%; p53, 28%; p27, 40%. Distribution according to differentiation profiles was as follows: GC-CD10(+), 24 patients, GC-CD10-, 30 patients; pGC, 60 patients; plasmablastic, 2 patients; other patterns, 12 patients. The pGC profile was associated with primary nodal presentation and immunoblastic morphology, whereas GC-CD10(+) tumors showed disseminated disease, centroblastic morphology, bcl-2 rearrangement, and lower Ki-67 proliferative index. GC-CD10(-) patients more often presented with primary extranodal origin, early stage, normal lactic acid dehydrogenase (LDH) levels, and low or low/intermediate International Prognostic Index (IPI) scores than the others. However, no significant difference was found in terms of response or overall survival (OS) according to these profiles. Expression of bcl-2 was associated with advanced stage, high or high-intermediate IPI, and poor OS. Expression of bcl-2 maintained predictive value in multivariate analysis, with stage and LDH. In conclusion, differentiation profile was associated with particular clinicopathological features but was not essential to predicting outcome in DLBCL patients.

Adult↗

Deleterious effects of increased body weight associated with intensive insulin therapy for type 1 diabetes: increased blood pressure and worsened lipid profile partially negate improvements in life expectancy.

OBJECTIVE: Weight gain is an unwanted side effect of improved glycaemic control in type 1 diabetes, associated with increased blood pressure (BP) and worsening lipid profiles. While improved glycaemic control per se should improve long-term patient outcomes, increases in BP and worsening lipid profiles may counteract these benefits. The aim of this modelling study was to assess whether the increased body weight and associated worsening of lipid profile and blood pressure would negate the improvements in glycaemic control seen with intensive therapy in patients with type 1 diabetes. METHODS: A validated diabetes model projected life expectancy (LE), quality-adjusted LE (QALE) and total lifetime costs of complications in type 1 diabetes cohorts with the characteristics of patients from the Diabetes Control and Complications Trial (DCCT). The following four cohorts (A-D) were created based on increased body weight under either conventional or intensive therapy: A) conventional glycaemic control in the subgroup with lowest weight-gain quartile after 6.5 years (HbA1c increased by 11% from baseline); B) conventional control in the highest weight-gain quartile (no change in HbA1c from baseline); C) intensive control in the lowest quartile of weight gain (with 16.1% decrease in HbA1c, but no increase in weight or associated BP, and improved lipid profile); D) intensive control in the highest quartile of weight gain (with 21% decrease in HbA1c, increased systolic BP of 6 mmHg, and worsened lipid profile). Data were derived from DCCT and other published sources. RESULTS: Intensive control, even with weight gain, led to major improvements in LE and QALE, and reduction in costs of complications versus conventional therapy. Intensive therapy with no weight increase led to a higher LE (increased by 0.57 years) and higher QALE (increased by 0.28 years) and lower costs of complications (reduced by 523 dollars/patient), compared to intensive therapy with the highest quartile of weight gain. CONCLUSIONS: Concerns about weight gain should not deter intensive insulin therapy. However, the value of improving glycaemic control without increasing body weight (and associated increased BP and worsening of lipid profile) has been confirmed.

Blood Pressure↗

Patient stratification based on prednisolone-vincristine-asparaginase resistance profiles in children with acute lymphoblastic leukemia.

PURPOSE: To confirm the prognostic value of a drug resistance profile combining prednisolone, vincristine, and l-asparaginase (PVA) cytotoxicity in an independent group of children with acute lymphoblastic leukemia (ALL) treated with a different protocol and analyzed at longer follow-up compared with our previous study of patients treated according to the Dutch Childhood Leukemia Study Group (DCLSG) ALL VII/VIII protocol. PATIENTS AND METHODS: Drug resistance profiles were determined in 202 children (aged 1 to 18 years) with newly diagnosed ALL who were treated according to the German Cooperative Study Group for Childhood Acute Lymphoblastic Leukemia (COALL)-92 protocol. RESULTS: At a median follow-up of 6.2 years (range, 4.1 to 9.3 years), the 5-year disease-free survival probability (pDFS) rate +/- SE was 69% +/- 7.0%, 83% +/- 4.4%, and 84% +/- 6.8% for patients with resistant (PVA score 7 to 9), intermediate-sensitive (PVA score 5 to 6), and sensitive (SPVA score 3 to 4) profiles, respectively (sensitive and intermediate-sensitive v resistant, P </=.05). Resistant patients were at increased risk of an early event (nonresponse or relapse within 2.5 years of diagnosis) compared with sensitive and intermediate-sensitive patients (P =.03). The profile did not identify patients at higher risk of late relapse, which was also observed for DCLSG ALL-VII/VIII patients now analyzed at a median of 7.5 years of follow-up (range, 4.4 to 10.8 years). Despite being nondiscriminative for late relapses, the resistant profile was still the strongest prognostic factor for COALL-92 patients in a multivariate analysis including known risk factors (P =.07). CONCLUSION: Drug resistance profiles identify patients at higher risk of early treatment failures and may, therefore, be used to improve risk-group stratification of children with ALL.

Adolescent↗

MMPI cannot say scores: normative data and degree of profile distortion.

Few previous studies have investigated MMPI Cannot Say scores (the number of items people omit in completing the MMPI). Study 1 examined the frequency of occurrence of omitted items in three different populations. A significantly higher proportion of complete MMPI answer sheets (no omitted items) was found among job applicants than among two psychiatric groups, and the vast majority of test subjects in all three groups responded to all items. Study 2 investigated the degree of profile distortion introduced by randomly omitting various numbers of MMPI items from complete answer sheets. As more MMPI items were omitted, there was a progressive reduction in the elevation of the MMPI profile, but several different analyses failed to reveal a definite point at which the number of omitted items clearly became excessive. Changes in the profile's high-point pair were sometimes produced by numbers of omitted items previously considered to be expected in a "normal" MMPI record. This type of profile distortion could alter significantly the interpretation of a profile. Changes were therefore suggested in the T-score values for the Cannot Say scale given on the standard profile.

Ambulatory Care↗

A comparison of MMPI profiles of heroin addicts based on multiple methods of classification.

MMPI profiles of 442 male narcotic addicts in a drug treatment program were classified according to one of three methods: (a) highest 2-point code, (b) cluster analysis, and (c) concordance with common actuarial rules of profile fit. Profiles were then compared with those previously reported in the research literature. While each method resulted in slightly different perspectives, each reported modal profiles analogous to the 49'/94', 42'/24', and 48'/84' profiles. A frequency table of 33 different profiles by rates per thousand were presented as prototypal base rates for future comparison.

Adult↗

The role of elevation, scatter, and shape in MMPI profiles.

The contribution of profile elevation, scatter, and shape to differences between Minnesota Multiphasic Personality Inventory (MMPI) profiles was studied in psychiatric, normal, and mixed samples. Average between profile differences were smallest within the normal sample and largest within the mixed sample. Overall, the role of shape was most important, with elevation making a smaller but significant contribution to profile differences. Scatter was of minimal importance. Systems proposed by Skinner (1976) and Lorr (1982) were found to account for a large part of the variance due to shape, and these systems also were successful in classifying individual MMPI profiles. Advantages and applications of such systems in the analysis and description of profile data were discussed.

Journal Article↗

Comparability of MMPI-2 scales and profiles over time.

This study investigated Minnesota Multiphasic Personality Inventory-2 (MMPI-2; Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) scale and profile comparablilty for MMPI-2 profiles completed on 2 separate occasions by mental health patients receiving treatment at a Veterans Affairs Medical Center (n = 114). Patients were predominantly men (96.5%), with an average age of 44.08 and an average of 12.39 years of education at the time of initial testing. MMPI-2 tests were completed on 2 separate occasions as a routine part of treatment with a mean interval between test administrations of 688 days. Findings were analyzed for the complete sample and for 3 subsamples with different test-retest intervals. MMPI-2 scale test-retest correlation coefficients for the entire sample ranged from .48 to .69 for the Basic scales, .49 to .80 for the Supplementary scales, and .56 to .78 for the Content scales with scale high-point agreement = 38.60%, high 2-point agreement = 16.67%, and high 3-point agreement = 19.30%. High-point agreement for subsets of participants with well-defined high points, 2-points and 3-points was 41.07%, 27.50%, and 25.93% respectively. Pearson r correlation coefficients for T scores across the Basic scales for pairs of profiles averaged .78, suggesting similarity of profile shape across testing occasions. MMPI-2 profiles were also examined in relation to Skinner and Jackson's 3 modal MMPI profile types.

Adult↗

Calculation of computed tomography dose index to effective dose conversion factors based on measurement of the dose profile along the fan shaped beam.

The variation in computed tomography dose index (CTDI) to effective dose conversion factors between different types of CT scanner is large (i.e. a factor of about 2 due to differences in beam shaping filters). Consequently, scanner specific conversion factors have to be applied. For some types of scanner, however, detailed information on the construction of beam shaping filters is not provided by the manufacturers. It is of interest to investigate the use of measured dose profiles for the calculation of conversion factors. Based upon measured dose profiles, two appropriate photon spectra selected on the basis of measured half value layers, gender specific adult phantoms Adam and Eva, and the Monte Carlo neutron and photon radiation transport code (MCNP), organ and effective dose conversion factors are calculated. To validate the method, a comparison is made between results for measured and calculated beam profiles for a Philips Tomoscan 350. The results in terms of effective dose per slice per unit of CTDI are compared with published data. Relative difference in conversion factors per slice averaged over all slices used for the calculations is 13 +/- 4% between the two spectra, 10.2 +/- 0.2% between measured and calculated beam profiles and 50 +/- 191% between the phantoms of different gender. The relative difference between the averaged results for the Adam and Eva phantoms and published results for a hermaphrodite phantom is on average equal to or less than 15 +/- 13%, depending on the spectrum and beam profile used, although larger differences can occur for specific slices. It is concluded that CTDI to effective dose conversion factors can be derived on the basis of measured beam profiles.

Humans↗

Relative-humidity profiling in the troposphere with a Raman lidar.

We describe a Raman-lidar-based approach to acquiring profiles of the relative humidity of air. For this purpose we combined in one instrument the Raman-lidar techniques that are used for the profiling of water vapor and temperature. This approach enabled us to acquire, for the first time to our knowledge, vertical profiles of relative humidity through the entire troposphere exclusively from Raman-lidar data. The methods applied to determining the water-vapor mixing ratio, temperature, and relative humidity and the corresponding uncertainties caused by systematic errors and signal noise are presented. The lidar-derived profiles are compared with profiles measured with radiosondes. Radiosonde observations are also used to calibrate the Raman lidar. Close agreement of the profiles of relative humidity measured with lidar and those measured with radiosonde demonstrates the potential of this novel approach.

Journal Article↗

Measurement of profiles along a circle on two flat surfaces by use of a Fizeau interferometer with no standard.

A method for measuring profiles along a circle on a flat surface with no standard is described. For the measurement, two unknown surfaces are placed almost parallel, and the distance between them is measured many times along a circle by rotation of one of the surfaces. Profiles of the two surfaces can be determined from the distance data. In this study the measuring method is explained: The space between two surfaces measured with a Fizeau interferometer. Four measuring experiments are carried out for determining the profile of a precision-grade half-mirror; in each experiment a different ordinary mirror with unknown profile is used as the second mirror. Profiles of the precise mirrors obtained by these experiments agree closely, with deviations of approximately 2 nm. A similar experiment with many concentric circles was carried out with a precise half-mirror and another precise mirror. Although the profiles of many concentric circles were independent of one another, the result shows that the high-frequency component of a whole plane can be estimated.

Journal Article↗

Index profiling of anisotropic graded-index planar waveguides from effective indices.

We present a method for recovering the refractive-index profile of an anisotropic graded-index waveguide from the effective indices by using a cubic spline interpolation function. The first and second derivatives of cubic splines are continuous to ensure a smooth index profile, which is consistent with practical graded-index distributions. A straightforward iteration with an exact dispersion equation to verify the interpolated profile makes this method easy and reliable for application. This approach is proved by numerical analysis of several typical index distributions and experimental examples showing that the refractive-index profiles in anisotropy can be reconstructed close to the exact profile. Waveguides with both more modes (more than four guiding modes) and fewer modes (two to four) can be universally profiled with good accuracy.

Journal Article↗

Biphasic cerebral blood flow velocity profile in patients with aneurysmal subarachnoid hemorrhage.

INTRODUCTION: Increases in cerebral blood flow velocity (CBFV) as measured by transcranial Doppler (TCD) sonography are reflective of cerebral vasospasm in patients with aneurysmal subarachnoid hemorrhage (SAH). In serial TCD measurements, some patients exhibit CBFV temporal profiles with two peaks (biphasic). The significance of this finding remains unclear. This retrospective case-control study was conducted to investigate the characteristics and possible predictors of biphasic CBFV profiles. METHODS: Biphasic CBFV profiles were identified in serial TCD examinations (every 1-2 days) of 182 consecutive patients admitted for aneurysmal SAH based on CBFV profiles of the middle cerebral artery on the side of higher maximum velocity. Patients undergoing angioplasty were excluded. Patients meeting these criteria (study patients) were compared to control patients matched for age and Hunt and Hess grade. RESULTS: Eighteen patients (9.9%) demonstrated biphasic CBFV profiles. The first CBFV (134 +/- 11 cm/second) peak occurred on post-SAH day 6 +/- 1, and the second peak (148 +/- 12 cm/second) on day 13 +/- 1. Study patients more often exhibited focal (p < 0.05) symptoms at the time of the first peak. No patient deteriorated neurologically at the time of the second peak. No correlation was observed between CBVF and mean arterial pressure or central venous pressure trends. CONCLUSION: Serial TCD assessment identifies patients with SAH and a biphasic CBFV temporal profile. Although the second peak usually is not associated with a worsening of symptoms, these patients were more likely to exhibit clinical symptoms during the first CBFV peak.

Blood Flow Velocity↗