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T O'Hara

Publications and source records attributed to T O'Hara.

11 recordsLinked to original sources

A new approach to modelling the relationship between in vitro and in vivo drug dissolution/absorption.

A major goal of the pharmaceutical scientist is finding a relationship between an in vitro characteristic of an oral dosage form and its in vivo performance. One such relationship between drug dissolution (or absorption) in vivo and that in vitro is known as an 'in vitro-in vivo correlation' (IVIVC) whose importance stems from the fact that it may be used to minimize the number of human studies required during product development, assist in setting meaningful in vitro dissolution specifications and justify biowaivers for scale-up and post approval changes. A number of ways of describing an IVIVC have been reported with 'level A' being the most informative and therefore most desirable. In the majority of cases reported to date, both the model and the statistical methods employed for level A IVIVC are very simplistic. The model assumes that the rate and extent of dissolution in vivo are the same as those in vitro. The statistical methods ignore the repeated measures nature of the data and use a response variable as an independent variable without accounting for measurement error. This paper describes some new models which include the simple model as a special case. The modelling approach is based on considering the time at which a drug molecule enters solution (in vitro or in vivo) to be a random variable. The in vitro and in vivo distributions are then related to one another using a proportional odds, proportional hazards or proportional reversed hazards model. The models can be extended by adding a linear time component which describes a time varying relationship. Following the addition of random effects to these structural models in order to account for the repeated measures nature of the data collected, the models may be described as generalized linear mixed effects models. The models were fitted to some data sets using a maximum likelihood based method and the results indicate that these models have potential for describing an in vitro-in vivo relationship which cannot be described using the currently available models.

Absorption↗

Discussion

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Journal Article↗

Level A in vivo-in vitro correlation: nonlinear models and statistical methodology.

Some new nonlinear models for the relationship between the fraction of drug dose dissolved (absorbed) in vivo and that dissolved in vitro are described. The models are empirical in nature and are generalizations of the linear model that, at present, is the most commonly used model. The modeling approach is based on considering the time at which a drug molecule goes into solution (in vitro or in vivo) to be a random variable and relating the distribution functions using proportional odds, proportional hazards, and proportional reversed hazards models. The models are further extended by allowing the parameter that relates in vivo and in vitro to be a function of time. A statistical model for the data is developed and used as the basis for a statistical methodology for fitting these models. The methods are shown to be generalized linear mixed effects model (GLMM) methods. The models are fitted to some data sets, and the results demonstrate that these models have potential.

Models, Statistical↗

Impairment of growth and immune function of avocet chicks from sites with elevated selenium, arsenic, and boron.

Avocets (Recurvirostra americana) hatched from eggs collected from the south Central Valley of California (USA) were studied to determine the impact of elevated concentrations of selenium, arsenic, and boron on the immune system and growth to maturity. Corcoran ponds were the reference site with low selenium (1.2 ppb) and arsenic (29 ppb) (boron not measured). Westfarmers Pond had elevated concentrations of selenium (319 ppb), arsenic (127 ppb), and boron (109 ppm). Pryse ponds also had elevated selenium, arsenic, and boron concentrations (13.9 ppb, 1,100 ppb, and 29.4 ppm, respectively). Size at hatch was significantly reduced (P < or = 0.05) in birds from Westfarmers and Pryse ponds. The growth rate was faster, but mean adult size was reduced in birds from Pryse ponds. Avocet chicks from Pryse and Westfarmers ponds exposed solely through in ovo transfer of these elements had significantly increased heterophil:lymphocyte ratios. The phagocytic activity of macrophages also was significantly reduced in these birds, and Pryse Pond birds had an increased proliferative ability of lymphocytes in the presence of concanavalin A, a T-cell mitogen. Avocet chicks (< or = 5 wk old) were captured from the various ponds and the same morphometric and immune function measurements made. The birds that were most severely impacted by exposure to these compounds were those that were collected from Pryse ponds.

Animals↗

Relative carnitine insufficiency in children with type I diabetes mellitus.

Recognizing the similarity of type I diabetes mellitus to inborn errors of metabolism that have responded to carnitine therapy, we initiated a study of 54 children with type I diabetes mellitus. Examining a fasting blood sample for levels of carnitine, glucose, and glycosylated hemoglobin A1c, and a urine sample for levels of ketones and glucose, we found 13 children were deficient of free carnitine (less than 20 mumol/L) and 30 had elevated acyl carnitine levels (greater than 11 mumol/L). Statistical tests confirmed a significant difference between the diabetic population and normal population for reduced free carnitine, elevated acyl carnitine, and an elevated ratio of acyl carnitine to free carnitine. Also, a significant correlation was found between the levels of urine glucose and ketones and the level of acyl carnitine. Our data indicate that carnitine deficiency and relative insufficiency may be an overlooked component in the management of diabetes.

Adolescent↗

Prolonged hypoperfusion in the cerebral cortex following cardiac arrest and resuscitation in dogs.

Increasing cerebral vascular resistance and brain perfusion failure occur within 90 minutes following cardiac arrest and resuscitation. This study followed cortical perfusion for 18 hours after a 15-minute cardiac arrest. Six dogs were anesthetized with ketamine and gallamine and then mechanically ventilated. They were instrumented for arterial pressure, central venous pressure, and regional cerebral cortical blood flow (rCCBF) determined by thermodilution. A left thoracotomy and pericardiotomy were done. Two dogs served as non-arrest controls. Cardiac arrest was produced in four dogs with an intravenous bolus of KCl at 1 mEq/kg. After 15 minutes of cardiac arrest, the animals were resuscitated with internal massage, NaHCO3, epinephrine, and internal defibrillation. Cortical blood flow was followed for 18 hours. Arterial core temperature was never less than 35 C. Pre-arrest cortical blood flows were 0.86 cc/min/g (+/- 0.11). The two control animals had stable rCCBF (0.74 +/- 0.17) for all determinations during the 18-hour follow-up period. Determinations of rCCBF from 6 to 18 hours in post-arrest animals were 7% to 14% of pre-arrest values. We conclude that the post-resuscitation perfusion failure in the cortex is prolonged. Any potential for neuronal recovery, unless perfusion is protected, would not be realized given this phenomenon.

Animals↗

Early amelioration of neurologic deficit by lidoflazine after fifteen minutes of cardiopulmonary arrest in dogs.

A prospective, controlled, blind study was done to test the effect of a calcium entry blocker on the neurologic integrity of dogs after cardiopulmonary arrest. Ten male mongrel dogs were anesthetized, prepared with sterile technique, and instrumented for pulmonary arterial (PA) and systematic arterial pressure monitoring. A left thoracotomy and pericardotomy were performed. Cardiac arrest was produced by injecting KCl (1 mEq/kg) through the PA line, and the respirator was stopped. Full arrest was maintained for 15 minutes. Thereafter, the dogs were resuscitated with ventilation, internal massage, fluids, bicarbonate, epinephrine, and internal defibrillation. All dogs were resuscitated within 6 to 10 minutes. Five control dogs received saline placebo, and five dogs were treated with lidoflazine (1 mg/kg) IV drip immediately post resuscitation. All dogs were scored neurologically every two hours by a deficit grading scale. All treated dogs had spontaneous ventilation, reactive pupils and corneals, voluntary movements, and responses to tactile stimulation at 12 hours post resuscitation. Four of five control dogs had maximum deficit scores without improvement. The difference in neurologic scores between the treated and control groups became increasingly divergent with time, and was statistically significant (P less than .05) by four hours post resuscitation. Thus the calcium antagonist lidoflazine produces improvement in neurologic recovery in the first 12 hours after cardiopulmonary arrest in dogs.

Animals↗

Clear federal strategy is emerging for cost control.

The author states that the purpose of governmental cost containment initiatives is to gain control over hospital capital expenditures, utilization, payment and quality assurance. He suggests that the costs of hospital operation should be completely re-examined stating that the reform of the hospital payment system is emerging as the energizing factor which will stimulate proper allocation of capital resources and effective utilization and quality assurance. O'Hare outlines the potential of the federal strategy. Recent legislation (PL 93-641 and PL 95-142) has mandated that hospital financial and statistical data be made available to federal agencies. He concludes that a dominant federal role in cost containment strategy threatens to abolish individual differences between institutions and their ability to be responsive to local needs. The author urges hospital leadership to take a more active position in implementing a cost containment strategy.

Capital Expenditures↗