Bayesian forecasting of aminoglycoside dosing requirements in obese patients: influence of subpopulation versus general population pharmacokinetic parameters as the internal estimates.

An aminoglycoside Bayesian forecaster was evaluated in obese patients. This study assessed the influence of replacing the program-supplied general population parameters (GPP) with obese population parameters (OPP) determined from the study population (n = 26). After entering the required patient information and the first peak and trough levels, patient-specific pharmacokinetic parameters were generated by the Bayesian program based on GPP.

Predicting need for pharmacokinetic consultation follow-up using discriminant analysis.

A discriminant function that predicts whether a patient will require more than one intervention by the pharmacokinetic consultation service (PCS) was derived and evaluated prospectively. In phase 1, peak and trough serum aminoglycoside concentrations were evaluated for each of the 150 patients. The patients were then classified into either group 1 or group 2.

Clinical assessment of a two-compartment Bayesian forecasting method for lidocaine.

The predictive performance of a two-compartment Bayesian forecasting method for lidocaine (L) was evaluated concurrently with lidocaine therapy in 46 hospitalized patients; 14 of these patients presented with congestive heart failure (CHF). Using an HP-85 microcomputer, demographic and dose-concentration information obtained during continuous lidocaine therapy was used to forecast subsequent lidocaine concentrations. One lidocaine concentration was obtained within each of the three intervals following initiation of lidocaine infusions: I1 (1-6 h), I2 (6-12 h), and I3 (greater than 12 h).

Accuracy of three methods for predicting concentrations of free phenytoin.

Predictions of free (unbound) serum phenytoin concentration by three methods were compared with results obtained by the Abbott TDx Free Phenytoin ultrafiltration and fluorescence-polarization immunoassay technique. Data were obtained for hospitalized adults who had been receiving phenytoin for at least five days and were free of renal or hepatic disease. Total phenytoin concentration was determined, and free phenytoin concentration was measured in ultrafiltrate at 25 degrees C.

An aggressive surgical approach to bile duct cancer.

Fifty-five patients with bile duct carcinoma have been treated at the Vanderbilt University, Metropolitan Nashville General, and Baptist Hospitals since 1957. Thirty-eight per cent (21) of the patients had tumors arising in the upper third of the bile duct; eight (15%) were in the middle third, and ten (18%) were in the lower third. In 12 instances, the malignant process involved both the middle and lower thirds of the bile duct, and in four cases, the extent of the tumor was too great to determine its origin.