Terms Of Body Surface Area Research Articles

Myelosuppression Caused by Nanoparticle Albumin-Bound Paclitaxel in the Northern Chinese Population and the Role of Body Composition.

The aim of this study was to examine the relationship between lean body mass (LBM) and the incidence and severity of neutropenia in patients with malignant tumors from Northern China who have received nanoparticle albumin-bound paclitaxel. Twenty-six patients with pathologically confirmed malignant tumors were prospectively included in this study. These 26 patients were divided into Group A (sarcopenia) and Group B (nonsarcopenia). Group A comprised 50% (13/26) of the patients, while Group B comprised the other 50% (13/26). There was no statistically significant difference between both groups in terms of body surface area (P = .052). The incidence of neutropenia in Group A was 76.9% compared to 61.5% in Group B (P = .0673). The incidence of Grade 3 and severe neutropenia was 76.9% versus 61.5% in Groups A and B, respectively (P = .645). These 26 patients were divided into Groups 1 and 2 based on the administered nab-paclitaxel dose per kilogram of LBM, with both groups receiving a body surface area dose of 260 mg/m2 . Group 1 received a nab-paclitaxel dose of 14.19 mg/kg of LBM, whereas Group 2 received 11.37 mg/kg of LBM. In Group 1, the incidence of neutropenia was 71.4%, whereas it was 66.7% in Group 2. Grade 3 or higher neutropenia incidence was 28.6% in Group 1 versus 16.7% in Group 2. Patients with sarcopenia in northern China experienced a higher incidence of severe neutropenia after receiving nab-paclitaxel than patients without sarcopenia. Higher drug dose intensity per unit of LBM may be a contributing factor.

Comparison of growth response and adverse reaction according to growth hormone dosing strategy for children with short stature: LG Growth Study

ObjectiveGrowth hormone (GH) dosage in children is conventionally determined either by body weight (BW) or body surface area (BSA). However, there is no consensus on the calculation method for proper GH treatment dose. We aimed to compare growth response and adverse reactions between BW- and BSA-based GH treatment doses for children with short statures. DesignData from 2284 GH-treated children were analyzed. Distributions of BW- and BSA-based GH treatment doses and their association with growth response parameters, including changes in height, height standard deviation score (SDS), body mass index (BMI), and safety parameters, such as changes in insulin-like growth factor (IGF)-I SDS and adverse events, were investigated. ResultsThe mean BW-based doses were close to the recommended dose's upper limit in participants with GH deficiency and idiopathic short stature, while they were below the recommended dose in patients with Turner syndrome (TS). As age and BW increased, BW-based dose decreased, whereas BSA-based dose increased. Gain in height SDS was positively associated with BW-based dose in the TS group and negatively associated with BW in all groups. Despite having a lower BW-based dose, the overweight/obese groups had a higher BSA-based dose and higher frequencies of children with high IGF-I and adverse events than those of the normal-BMI group. ConclusionsIn children of older age or with high BW, BW-based doses can be overdosed in terms of BSA. and BW-based dose positively correlated with height gain only in the TS group. BSA-based doses represent an alternative dosing strategy in children who are overweight/obese.

Nail disease in psoriatic arthritis. Data from the Russian Psoriatic Arthritis Registry

Nail disease in psoriatic arthritis. Data from the Russian Psoriatic Arthritis Registry

Efficacy and safety of a topical moisturizer containing linoleic acid and ceramide for mild-to-moderate psoriasis vulgaris: A multicenter randomized controlled trial.

Psoriasis is a chronic, recurrent skin disease requiring long‐term management. Agents that repair the skin's barrier function are invaluable additives in topical treatments of psoriasis. This multicenter, randomized, controlled trial evaluated the efficacy and safety of a linoleic acid‐ceramide‐containing moisturizer (LA‐Cer) for mild‐to‐moderate psoriasis vulgaris. We randomized 178 patients from both northern and southern regions of China into two groups: 81 patients in the control group received mometasone furoate (MF, 0.1%) cream, while MF in combination with LA‐Cer was administered to 86 patients in the treatment group for 4 weeks. The LA‐Cer‐MF group maintained the use of moisturizer after topical glucocorticoid administration. The primary endpoint, Psoriasis Area and Severity Index 50 (PASI 50) response, revealed the superiority of LA‐Cer‐MF with lower relapse rates at week 8. The use of the LA‐Cer‐containing moisturizer as maintenance therapy resulted in a continuous improvement in the clinical state in terms of body surface area, PASI, investigators' assessment of skin dryness and desquamation, and Physician Global Assessment of Psoriasis score, and in the patients' quality of life. Thus, the LA‐Cer‐containing moisturizer is a promising agent to prevent and treat psoriasis as it enhances the therapeutic effect induced by topical glucocorticoids and delays relapse.

Dasatinib as Salvage Therapy for Steroid Refractory and Imatinib Resistant or Intolerant Sclerotic Chronic Graft-versus-Host Disease

Sclerotic chronic graft-versus-host disease (scGVHD) is a severe form of this disease that resembles systemic sclerosis and has limited and disappointing treatment options. Tyrosine kinase inhibitors (TKI) targeting up-regulated profibrotic pathways, such as imatinib mesylate, have been proposed as a potential therapeutic approach for patients with scGVHD. Dasatinib, a second-generation TKI with a well-established safety and efficacy profile in chronic myeloid leukemia patients, who are refractory or intolerant to imatinib, has also shown potent antifibrotic effects. We present here the first direct clinical evidence, from 3 patients treated in a small single-center series, suggesting that dasatinib can be a therapeutic option for patients with severe scGVHD resistant or intolerant to imatinib. All patients achieved partial response, with improvement in scGHVD target organs severity, joint mobility, lung impairment, and deep fibrotic lesions. This clinical response has remained stable or continued to improve after a median of 22 months (20-25) on dasatinib treatment, with very good tolerance. In addition, corticosteroids could be discontinued or significantly reduced in all patients. This clinical evidence suggests that dasatinib could be a safe and effective alternative for scGVHD patients refractory to corticosteroids and resistant or intolerant to imatinib. Based on these preliminary findings, and in order to address appropriate patient selection, time of intervention, and choice of drug, future larger studies should more formally establish the efficacy and safety of second-generation TKI for the treatment of scGVHD.

Fire walking in Singapore—A study of the distribution of burns

Fire walking is a religious ritual practiced by predominantly Indians and some Chinese living in Singapore. Eighteen new cases of burns, directly related to a firewalking ceremony on 05 October 09, were studied as to the pattern of burns. Burns on the soles of the feet occurred in 17 patients. All these injuries were superficial or partial thickness burns. There were no deep dermal burns. The extent of burns ranged from 0.25% to 1.5% of body surface area. Burns due to falls accounted for one casualty. He sustained a mixture of deep dermal and partial thickness burns, and the extent of burns was 20% of body surface area. A new classification for the distribution of burns related to fire walking was developed based on the mechanism of injury. It was predictive of the anatomical distribution of burns, the extent of burns (in terms of body surface area), the depth of burns and the general severity of the injury: I Burns on the soles of the feet. This was the commonest form of injury. The surface area affected was not much – 1.5% at most. The burns were superficial. The foot was anatomically differentiated into the weight bearing and the non weight bearing parts. II Burns due to falls. Such injuries tended to be extensive and they could be deep. III Burns due to other practices: a fire walker carrying hot coals in his hands may sustain burns on the palms of the hands.

Determination of initial i.v. CYA dosage to achieve target AUC values in pediatric hematopoietic stem cell transplant patients

In solid organ transplantation, CYA dosing is based on the area under the concentration vs time curve (AUC(inf)). This study aimed to develop a guideline for the initial i.v. CYA dose for pediatric hematopoietic SCT (HSCT) patients to achieve the target AUC(inf) recommended in solid organ transplantation. Whole-blood CYA concentrations were determined in 24 patients (0.5-16.9 years) after the first i.v. dose given over 2 h, 1 day before HSCT. The i.v. CYA dose predicted to achieve an AUC(inf) of 4200 microg x h/l was calculated for each patient and expressed as a function of each patient's actual weight and body surface area (BSA). In patients <or=9 and >9 years of age, the mean i.v. CYA dose predicted to achieve the target AUC was 2.6+/-0.94 and 2.1+/-1.21 mg/kg, respectively. When these doses were expressed in terms of BSA, the mean dose was 65+/-23.1 and 68+/-35.0 mg/m(2) in children <or=9 and >9 years of age, respectively. In children 0.5-17 years of age undergoing HSCT, we recommend an initial i.v. CYA dose of 65 mg/m(2) infused over 2 h to achieve an AUC(inf) of approximately 4200 microg x h/l.

Expressing glomerular filtration rate in terms of extracellular fluid volume.

Glomerular filtration rate (GFR) is routinely calculated from the second exponential of the bi-exponential plasma clearance of filtration markers such as Cr-51 EDTA and Tc-99m DTPA. By ignoring the first exponential, true GFR is overestimated, an error which increases with increasing GFR. The rate constant, lambda 2, of the second exponential represents the rate at which glomerular filtration 'turns over' the extracellular fluid (ECF) and so closely approximates GFR/ECF volume. Again, the error in the estimation of this ratio increases with increasing GFR, although in this case it underestimates the true ratio. Expressing GFR in terms of ECF volume, rather than in terms of body surface area, offers considerable technical and physiological advantages. The relationship between GFR/ECF volume and lambda 2, over a wide range of renal function, expressed as a second order polynomial, was GFR/ECF volume = -0.093 + 1.06 lambda 2 + 0.009 lambda 2(2) ml.min-1.l-1. The corresponding relationship between 'true' GFR (C1) and approximate GFR (i.e. based only on the second exponential--C2) was C1 = -0.58 + 1.012C2 -0.0011 C2(2) ml.min-1 For any level of renal function, the error in GFR/ECF volume, expressed as lambda 2, is less than the error in GFR expressed as C2. Since GFR may change as a direct result of a change in ECF volume, it is physiologically more relevant, and technically very much easier, to express GFR in terms of ECF volume rather than body surface area.

Plasma dexamethasone levels in children given the dexamethasone suppression test

To determine whether children who demonstrate dexamethasone suppression test (DST) nonsuppression have lower plasma dexamethasone levels than DST suppressors, we administered the DST to 73 patients ranging in age from 5–14 years. Plasma dexamethasone levels and postdexamethasone cortisol levels were measured at 4:00 pm on day 2. We found: (1) DST nonsuppressors had significantly lower plasma dexamethasone levels ( p < 0.03) than suppressors; similar trends were observed when the population was divided into depressed and nondepressed patients; (2) mg/m 2 dose of dexamethasone was directly correlated with plasma dexamethasone ( p < 0.003) and inversely correlated with postdexamethasone plasma cortisol levels ( p < 0.04); and (3) a statistically significant inverse correlation between plasma dexamethasone levels and postdexamethasone cortisol levels ( p < 0.04). Our findings show that plasma dexamethasone levels are important in evaluating DST results in psychiatrically disturbed children and suggest that dexamethasone dosage for use in the DST in children might be better calculated in terms of body surface area.

Single dose dexamethasone suppression test in children: dose relationship to body size.

We have performed an overnight single dose dexamethasone suppression test in 15 children at different dosages to determine the minimum dose required to suppress the 0800 h serum cortisol level. With a dexamethasone dose of 0.1 mg/m2 two of seven children showed suppression. When the dose was increased to 0.3 mg/m2 all of six patients showed suppression as did three given dexamethasone 0.5 mg/m2. We recommend that doses of dexamethasone should be calculated in terms of body surface area when assessing the hypothalamo-pituitary axis in children and that a dose of 0.3 mg/m2 should be used for suppression tests.

Effect upon Brain Weight and Cholesterol Content of Maintaining Rats of Various Ages at Constant Weight

Rats weighing 400 g were maintained at constant weight for 500 days. Their diet consisted of 14 g/day for the first 150 days and 13 g/day thereafter. A second group of rats weighing 350 g was fed 11.5 g/day for 400 days; at the end of the experiment, these rats weighed 382 g. Under these conditions, the increase in brain weight and in quantity and concentration of cholesterol in the brain as a function of time was identical to that observed in the control rats fed ad libitum. Rats weighting 250 g fed 8.5 g/day for 200 days showed a body weight increase of 16 g. Up to the age of 115 days, the evolution of brain weight in terms of time did not differ from that observed in control rats. Rats weighting 100 g and fed 4.5 g/day showed an increase of 28 g after 300 days. The increase in brain weight and in brain cholesterol content as a function of time was less than that observed in the control rats. A curve deduced from these results has the practical interest of indicating the daily energy requirement for maintaining rats at a chosen constant weight. Expressed in terms of body surface area, the daily energy intake appears constant. It was also observed that, when conditions of minimal economy are imposed upon the adult rat, brain nutrition is not modified. But for young rats (100 g),brain development under these nutrtional conditions is affected.

Body Surface Area Teaching in Pediatrics

To the Editor:— Much literature has appeared in recent years on the subject of body surface area (BSA). 1-8 In spite of the fact that various textbooks and brochures present drug dosage in terms of BSA, there has been, to our knowledge, no considered attempt to learn how widely the subject is being taught in medical schools. In the opinion of the authors, use of BSA as a gauge for dosage, both of pharmaceutical products and of water and electrolytes, offers the advantages of simplicity and accuracy, and, therefore, efficacy and safety. Use of BSA does not, of course, involve a principle basically different from that employed in the use of body weight. Rather, it represents a rational convenience that makes it far easier for the physician to remember doses, is particularly useful in the case of frequently used drugs, and through its very simplicity helps avoid error. We conducted

Observations on the taxonomy and biology of Tylenchorhynchus macrurus (Goodey, 1932) Filipjev, 1936 and Tylenchorhynchus icarus sp.nov.

The large and small forms of Tylenchorhynchus macrurus are distinguished as separate species. The large form becomes T. icarus and differs from the small form, T. macrurus in the greater number of annules on the female tail, longer stylet and slimmer body. The oxygen consumption of both species is similar when assessed in terms of body surface area. Soil samples from the field indicated that (a) greatest concentrations of T. icarus occurred at about 5 cm. depth, (b) few occurred below 24 cm., the depth of the top soil, and (c) numbers of T. icarus in the top 5 cm. of soil decreased during dry periods and increased after rain. T. icarus migrates to the wet end of a moisture gradient and has maximum mobility in soil at a moisture content corresponding to field capacity and at 20° C. T. icarus survived osmotic pressure equivalent to 1 m urea for 4 days. Their oxygen consumption increased with increasing osmotic pressure but in 1 m urea there was a decline which was even more pronounced in 2 m urea. Of a population of T. icarus 35% survived for 32 weeks in soil with plants. In damp sand at 10° C, oxygen consumption was steady for 32 weeks but after 48 weeks the nematodes were dead. It is suggested that the free-living stages of plant parasitic nematodes have similar migratory habits.

CLINICAL CALORIMETRY

In this paper there will be presented the results of calorimetric observations made in a case of chronic lymphatic leukemia, both before and after vigorous Roentgen-ray therapy, and also after exposure to radium. The basal metabolism in leukemia will be discussed and the effect of irradiation thereon. The literature contains but few observations of this sort. Those by Grafe, 1 Magnus-Levy, 2 Kraus, 3 and Bohland 4 being the only ones that we have found suitable for comparison with cur own case. By referring to Table 1, in which the experiments of these several authors are collected, 5 it will be seen that in both forms of leukemia there is invariably a marked rise in the basal metabolism expressed in terms of body surface area. This is found in both types about equally, the average increase over the normal in eight cases of lymphatic leukemia being 52 per cent.,