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基于种族、CRP和血药浓度进行氯氮平成人个体化剂量滴定降低不良反应国际指南(全译)
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作者 Jose de Leon Georgios Schoretsanitis +101 位作者 Robert L.Smith Espen Molden Anssi Solismaa Niko Seppäla Miloslav Kopecek Patrik Svancer Ismael O.lmos Carina Ricciardi Celso Iglesias-Garcia Ana Iglesias-Alonso Edoardo Spina Can-Jun Ruan Chuan-Yue Wang Gang Wang Yi-Lang Tang Shih-Ku Lin Hsien-Yuan Lane Yong Sik Kim Se Hyun Kim Anto P.Rajkumar Dinora F.González-Esquivel Helgi Jung-Cook Trino Baptista Christopher Rohde Jimmi Nielsen Hélène Verdoux Clelia Quiles Emilio J.Sanz Carlos De las Cuevas Dan Cohen Peter E.J.Schulte Aygun Ertugrul A.Elif Anil Yagcoglu Nitin Chopra Betsy McCollum Charles Shelton Robert O.Cotes Arun R.Kaithi John M.Kane Saeed Farooq Chee H.Ng John Bilbily Christoph Hiemke Carlos López-Jaramillo Ian McGrane Fernando Lana Chin B.Eap Manuel Arrojo-Romero Flavian Stefan Radulescu Erich Seifritz Susanna Every-Palmer Chad A.Bousman Emmanuel Bebawi Rahul Bhattacharya Deanna L.Kelly Yu Otsuka Judit Lazary Rafael Torre Agustin Yecora Mariano Motuca Sherry Kit Wa Chan Monica Zolezzi Sami Ouanes Domenico De Berardis Sandeep Grover Ric M.Procyshyn Richard A.Adebayo Oleg O.Kirilochev Andrey Soloviev Konstantinos N.Fountoulakis Alina Wilkowska Wiestaw Jerzy Cubala muhammad ayub Alzira Silva Raphael M.Bonelli José María Villagrán-Moren Benedicto Crespo-Facorro Henk Temmingh Eric Decloedt Maria Rosel Pedro Hiroyoshi Takeuchi Masaru Tsukahara Gerhard Gründer Marina Sagud Andreja Celofiga Dragana Ignjatovic Ristic Bruno Bertolucci Ortiz Helio Elkis António JoséPacheco Palha Adrián Lerena Emilio Fernandez-Egea Dan Siskind Abraham Weizman Rim Masmoudi Shamin Mohd Saffian Jonathan G.Leung Peter F.Buckley Stephen R.Marder Leslie Citrome Oliver Freudenreich Christoph U.Correll Daniel J.Müller 《中华精神科杂志》 北大核心 2026年第2期87-113,共27页
本国际指南提议,在全球范围内的氯氮平药品说明书中加入基于种族背景的给药剂量与滴定方案,以完善氯氮平药品说明书。美国药品不良反应数据库显示,氯氮平在美国属于第三大毒性药物,在世界范围内所致肺炎造成的死亡人数是其所致粒细胞缺... 本国际指南提议,在全球范围内的氯氮平药品说明书中加入基于种族背景的给药剂量与滴定方案,以完善氯氮平药品说明书。美国药品不良反应数据库显示,氯氮平在美国属于第三大毒性药物,在世界范围内所致肺炎造成的死亡人数是其所致粒细胞缺乏或心肌炎死亡人数的4倍多。氯氮平治疗参考浓度范围窄(稳态谷浓度范围:350~600 ng/ml),随着浓度的增加,不良反应和毒性反应也可能增加。氯氮平主要由细胞色素P4501A2酶(Cytochrome P4501A2,CYP1A2)代谢,因此女性非吸烟者需要的剂量最低,而男性吸烟者需要的剂量最高。合并使用CYP1A2酶抑制剂(如口服避孕药、丙戊酸)、肥胖或感染(C反应蛋白浓度升高)可能与CYP1A2的表型转换为慢代谢型有关。亚裔(译者注:指地理分布从巴基斯坦到日本的人群)或美洲原住民印第安人的CYP1A2活性较低,需要较低的氯氮平剂量就能达到350 ng/ml的浓度。在美国,氯氮平的推荐日剂量为300~600 mg/d。氯氮平缓慢个体化滴定给药可以预防给药早期不良反应(包括晕厥、心肌炎和肺炎等)。本指南为美国住院患者提供了6项个体化滴定方案建议:①慢代谢型的亚裔/美洲原住民(如肥胖或合用丙戊酸),需要最低治疗剂量(minimum therapeutic dose,MTD)75~150 mg/d;②正常代谢型的亚裔/美洲原住民,需要MTD为175~300 mg/d;③慢代谢型的欧洲/西亚裔(如肥胖或合用丙戊酸),需要MTD为100~200 mg/d;④正常代谢型的欧洲/西亚裔(West Asian ethnicity)(译者注:涵盖伊朗、伊拉克、沙特阿拉伯、土耳其等国家),需要MTD为250~400 mg/d;⑤除亚裔或美洲原住民以外的慢代谢型美国人(如肥胖或合用丙戊酸),需要MTD为150~300 mg/d;⑥除亚裔或美洲原住民以外的正常代谢型美国人,需要MTD为300~600 mg/d。使用氯氮平治疗的患者,在服药前和服药后至少4周,需每周监测C反应蛋白来判断是否存在感染,包括由氯氮平滴定速度过快导致的感染。 展开更多
关键词 原住民-美国大陆族裔、亚洲大陆族裔-氯氮平 不良反应-氯氮平 血液-氯氮平 代谢-氯氮平 治疗用途-氯氮平 不良反应-CYP1A2-药物说明书-欧洲大陆族裔-感染-炎症-死亡率 药物效应-性别-吸烟
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Potentially harmful metals,and health risk evaluation in groundwater of Mardan,Pakistan:Application of geostatistical approach and geographic information system 被引量:6
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作者 Abdur Rashid muhammad ayub +7 位作者 Asif Javed Sardar Khan Xubo Gao Chengcheng Li Zahid Ullah Tariq Sardar Juma muhammad Shahla Nazneen 《Geoscience Frontiers》 SCIE CAS CSCD 2021年第3期597-608,共12页
This study investigates the values of pH,total dissolved solids(TDS),elevation,oxidative reduction potential(ORP),temperature,and depth,while the concentrations of Br,and potentially harmful metals(PHMs)such as Cr,Ni,... This study investigates the values of pH,total dissolved solids(TDS),elevation,oxidative reduction potential(ORP),temperature,and depth,while the concentrations of Br,and potentially harmful metals(PHMs)such as Cr,Ni,Cd,Mn,Cu,Pb,Co,Zn,and Fe in the groundwater samples.Moreover,geographic information system(GIS),XLSTAT,and IBM SPSS Statistics 20 software were used for spatial distribution modeling,principal component analysis(PCA),cluster analysis(CA),and Quantile-Quantile(Q-Q)plotting to determine groundwater pollution sources,similarity index,and normal distribution reference line for the selected parameters.The mean values of pH,TDS,elevation,ORP,temperature,depth,and Br were 7.2,322 mg/L,364 m,188 mV,29.6℃,70 m,0.20 mg/L,and PHMs like Cr,Ni,Cd,Mn,Cu,Pb,Co,Zn,and Fe were 0.38,0.26,0.08,0.27,0.36,0.22,0.04,0.43 and 0.86 mg/L,respectively.PHMs including Cr(89%),Cd(43%),Mn(23%),Pb(79%),Co(20%),and Fe(91%)exceeded the guideline values set by the world health organization(WHO).The significant R^(2)values of PCA for selected parameters were also determined(0.62,0.67,0.78,0.73,0.60,0.87,-0.50,0.69,0.70,0.74,-0.50,0.70,0.67,0.79,0.59,and-0.55,respectively).PCA revealed three geochemical processes such as geogenic,anthropogenic,and reducing conditions.The mineral phases of Cd(OH)_(2),Fe(OH)_(3),FeOOH,Mn_(3)O_(4),Fe_(2)O_(3),MnOOH,Pb(OH)_(2),Mn(OH)_(2),MnO_(2),and Zn(OH)_(2)(-3.7,3.75,9.7,-5.8,8.9,-3.6,2.2,-4.6,-7.7,-0.9,and 0.003,respectively)showed super-saturation and under-saturation conditions.Health risk assessment(HRA)values for PHMs were also calculated and the values of hazard quotient(HQ),and hazard indices(HI)for the entire study area were increased in the following order:Cd>Ni>Cu>Pb>Mn>Zn>Cr.Relatively higher HQ and HI values of Ni,Cd,Pb,and Cu were greater than one showing unsuitability of groundwater for domestic,agriculture,and drinking purposes.The long-term ingestion of groundwater could also cause severe health concerns such as kidney,brain dysfunction,liver,stomach problems,and even cancer. 展开更多
关键词 GROUNDWATER Potential harmful metals Health risk indices Cluster analysis Mineral phases
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Effect of rare earth and transition metal La-Mn substitution on electrical properties of co-precipitated M-type Ba-ferrites nanoparticles 被引量:4
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作者 muhammad ayub Iftikhar Hussain Gul +1 位作者 Khalid Nawaz Khurram Yaqoob 《Journal of Rare Earths》 SCIE EI CAS CSCD 2019年第2期193-197,共5页
In the current research work Ba_(1-x)La)xMn)yFe_(12-y)O_(19) hexa-ferrite nanoparticles of different compositions were synthesized using chemical co-precipitation technique. The structural properties were explored usi... In the current research work Ba_(1-x)La)xMn)yFe_(12-y)O_(19) hexa-ferrite nanoparticles of different compositions were synthesized using chemical co-precipitation technique. The structural properties were explored using X-ray diffractions(XRD), scanning electron microscopy(SEM) and Fourier transmission infrared spectroscopy(FTIR). XRD indexed pattern confirms the formation of M-type hexagonal phase. The crystallite size of synthesized samples ranges from 13 to 34 ± 2 nm. FTIR peaks observe also confirmed the presence of metaloxygen bond of the desired product. The position of peak at 467 cm^(-1) corresponds to A_2 u vibration for octahedral Fe(4+)-O and peak position E1 u corresponds to vibration of Fe(3+)O4 octahedral bonds. The band v_1 in range(677-559 cm^(-1)) and v_2 in frequency range(356-419 cm^(-1)) are associated to A and B sites.Dielectric properties of all compositions were measured with frequency. The dielectric constant, loss and tangent loss decrease from 26 to 9, 25 to 2 and 0.94 to 0.14, respectively with frequency. DC electrical resistivity is increased with dopant concentration increasing from 2.15 × 10~4 to 1.92 ×10~5 Ω·cm. 展开更多
关键词 CO-PRECIPITATION ELECTRICAL properties Dielectric X-ray diffraction RARE earths
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