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1.
Drug Healthc Patient Saf ; 15: 25-38, 2023.
Article in English | MEDLINE | ID: mdl-36742440

ABSTRACT

Purpose: The aim of this study was to characterize the frequency of adverse effects where delta-8 tetrahydrocannabinol (D8-THC) was identified as a possible suspect drug in the FDA Adverse Event Reporting System (FAERS) database. Methods: A case-series design was used. Results: A total of 183 cases listed D8-THC as a suspect drug in FAERS as of June 30, 2021. The most common events included dyspnea, respiratory disorder, and seizure. The reporting odds ratios were consistently and significantly greater than 2, a 2-fold increase from 2019 to 2021, indicating a potential safety signal. Conclusion: The first report of D8-THC, in the FAERS database, as a suspect drug appears to be in 2011. Overall, there are 183 total cases listing D8-THC as a suspect drug in the FAERS database as of June 30, 2021. Of the 183 cases, most were respiratory in nature.

3.
J Assist Reprod Genet ; 31(7): 857-63, 2014 Jul.
Article in English | MEDLINE | ID: mdl-24793009

ABSTRACT

BACKGROUND: Polycystic ovary syndrome (PCOS) is a condition with central feature of hyperandrogensism that affects 5-12 % of women worldwide. P450sec the cholesterol side chain cleavage enzyme encoded by CYP11A1 gene is instrumental in the synthesis of sex hormones. A promoter pentanucleotide repeat (tttta)(n) polymorphism of this gene is reported to be associated with several hormone related diseases including PCOS. Here we aimed to examine the involvement of CYP11A1 polymorphism with PCOS susceptibility in a case-control study conducted among South Indian women. METHODS: A total of 542 subjects comprised of 267 PCOS patients and 275 controls were recruited. DNA was extracted from blood and CYP11A1 (tttta)(n) polymorphism was genotyped by PCR-PAGE. RESULTS: Fifteen different alleles ranging between 2-16 repeats were identified in the studied group and the most frequent allele observed in controls was of 8 repeats. The presence of >8 repeat allele was common in patients (64 % vs. 38 %) and showed a three-fold risk for PCOS susceptibility than controls (OR = 2.93; p < 0.05). PCOS women with higher BMI were markedly elevated in early quartile (p < 0.05). CONCLUSION: CYP11A1 (tttta)(n) repeat polymorphism appeared to be a potential molecular marker for PCOS risk in our population. Gene-gene and gene-environmental interactions with respect to obesity may play a role in the early onset of this multifactorial condition. This is the first report from South India; however, replicative studies considering other probable causative factors for PCOS risk are warranted.


Subject(s)
Cholesterol Side-Chain Cleavage Enzyme/genetics , Genetic Predisposition to Disease , Microsatellite Repeats/genetics , Polycystic Ovary Syndrome/genetics , Adult , Alleles , Female , Genetic Association Studies , Genotype , Humans , India , Polymorphism, Genetic
4.
Pak J Biol Sci ; 17(4): 574-7, 2014 Apr.
Article in English | MEDLINE | ID: mdl-25911850

ABSTRACT

Polycystic Ovary Syndrome (PCOS) is a multifactorial reproductive healthcare problem affecting 4-12% of women and a leading cause of female infertility worldwide. The potential genetic contributors of PCOS are unclear. However, over the past decade emerging evidence has shown that increased Oxidative Stress (OS) and decreased antioxidant status were often linked with PCOS. The present case-control study was aimed to assess the reactive oxygen species induced OS in women from South India. A total of 164 individuals comprising of 89 patients and 75 controls were enrolled in the present study. For all the subjects, the frequency of micronucleated cells (MNC) in epithelial samples and serum Malondialdehyde (MDA) levels were estimated to assess genomic instability and cytotoxicity respectively. A statistically significant difference between the groups were identified with respect to Body Mass Index, Waist to Hip Ratio, luteinizing hormone and prolactin levels (< 0.05), however the mean follicle stimulating hormone was not different between the groups (p = 0.055). The frequency of MN cells (5.89 ± 4.86 vs. 2.24 ± 2.01) and mean serum MDA (360.84 ± 87.08 vs. 301.70 ± 82.82) levels were considerably higher in patients than controls (p = < 0.0001), furthermore, a positive correlation was observed between MNC and MDA levels in patients (r = 0.349, p = 0.0008) and not in controls (r = 0.104, p = 0.37), suggest high OS in PCOS women. Therefore, MN assay and serum MDA levels may serve together or individually as biomarkers of OS in PCOS women.


Subject(s)
Malondialdehyde/blood , Micronuclei, Chromosome-Defective , Micronucleus Tests , Mouth Mucosa/pathology , Oxidative Stress , Polycystic Ovary Syndrome/diagnosis , Adult , Biomarkers/blood , Case-Control Studies , Female , Humans , India , Polycystic Ovary Syndrome/blood , Polycystic Ovary Syndrome/pathology , Predictive Value of Tests , Prognosis , Young Adult
5.
J Biol Chem ; 289(9): 5828-45, 2014 Feb 28.
Article in English | MEDLINE | ID: mdl-24366865

ABSTRACT

The cannabinoid 1 (CB1) allosteric modulator, 5-chloro-3-ethyl-1H-indole-2-carboxylic acid [2-(4-piperidin-1-yl-phenyl)-ethyl]-amide) (ORG27569), has the paradoxical effect of increasing the equilibrium binding of [(3)H](-)-3-[2-hydroxyl-4-(1,1-dimethylheptyl)phenyl]-4-[3-hydroxylpropyl]cyclohexan-1-ol (CP55,940, an orthosteric agonist) while at the same time decreasing its efficacy (in G protein-mediated signaling). ORG27569 also decreases basal signaling, acting as an inverse agonist for the G protein-mediated signaling pathway. In ligand displacement assays, ORG27569 can displace the CB1 antagonist/inverse agonist, N-(piperidiny-1-yl)-5-(4-chlorophenyl)-1-(2,4-dichlorophenyl)-4-methyl-1H-pyrazole-3-carboxamide(SR141716A). The goal of this work was to identify the binding site of ORG27569 at CB1. To this end, we used computation, synthesis, mutation, and functional studies to identify the ORG27569-binding site in the CB1 TMH3-6-7 region. This site is consistent with the results of K3.28(192)A, F3.36(200)A, W5.43(279)A, W6.48(356)A, and F3.25(189)A mutation studies, which revealed the ORG27569-binding site overlaps with our previously determined binding site of SR141716A but extends extracellularly. Additionally, we identified a key electrostatic interaction between the ORG27569 piperidine ring nitrogen and K3.28(192) that is important for ORG27569 to act as an inverse agonist. At this allosteric site, ORG27569 promotes an intermediate conformation of the CB1 receptor, explaining ORG27569's ability to increase equilibrium binding of CP55,940. This site also explains ORG27569's ability to antagonize the efficacy of CP55,940 in three complementary ways. 1) ORG27569 sterically blocks movements of the second extracellular loop that have been linked to receptor activation. 2) ORG27569 sterically blocks a key electrostatic interaction between the third extracellular loop residue Lys-373 and D2.63(176). 3) ORG27569 packs against TMH6, sterically hindering movements of this helix that have been shown to be important for receptor activation.


Subject(s)
Cannabinoid Receptor Antagonists/pharmacology , Indoles/pharmacology , Molecular Dynamics Simulation , Piperidines/pharmacology , Receptor, Cannabinoid, CB1/agonists , Receptor, Cannabinoid, CB1/antagonists & inhibitors , Signal Transduction/drug effects , Allosteric Regulation/drug effects , Allosteric Regulation/genetics , Binding Sites , Cannabinoid Receptor Antagonists/chemistry , HEK293 Cells , Humans , Indoles/chemistry , Piperidines/chemistry , Protein Binding , Pyrazoles , Receptor, Cannabinoid, CB1/metabolism , Rimonabant , Signal Transduction/genetics
6.
Scand J Immunol ; 77(2): 104-8, 2013 Feb.
Article in English | MEDLINE | ID: mdl-22809231

ABSTRACT

Pre-eclampsia (PE) is a multifactorial pregnancy-specific vascular disorder characterized by hypertension and proteinuria and affects around 3-8% of pregnancies worldwide. Defective placentation during the early stage of pregnancy most likely in combination with maternal and environmental factors could lead to systemic inflammation, endothelial dysfunction and the manifestation of the clinical symptoms. Inadequate number of regulatory T cells (Tregs) or their functional deficiency is linked with infertility, miscarriage and PE. It is well identified that forkhead box P3 (Foxp3) gene is a master control gene for the development and function of Tregs that play an important role in the maintenance of self-tolerance and mediate maternal tolerance to the foetus. The main objective of this study was to assess the maternal susceptibility to PE with respect to a deletion mutation in exon-2 and -3279 C > A polymorphism (rs3761548) in the promoter region within the Foxp3 gene in a total of 282 PE patients and 215 normal pregnant women. The results showed that exon-2 deletion mutation is present in 1.06% of patients and none in the controls, indicating that it was not a common gene polymorphism associated with PE. With respect to rs3761548, the C allele frequency was observed to be higher in patients than in controls (49% versus 27%; OR = 2.81, P < 0.01). In conclusion, our results are suggestive of A allele to be protective against PE and C allele as predisposing in a dose-dependent manner in our population.


Subject(s)
Forkhead Transcription Factors/genetics , Genetic Predisposition to Disease , Pre-Eclampsia/genetics , Adult , Alleles , Exons , Female , Gene Frequency , Genotype , Humans , India , Mutation , Polymorphism, Single Nucleotide , Pregnancy , Promoter Regions, Genetic
7.
Hum Exp Toxicol ; 31(7): 741-7, 2012 Jul.
Article in English | MEDLINE | ID: mdl-21558303

ABSTRACT

BACKGROUND: Pesticides play an important role in controlling the pests on agricultural crops and thereby to increase the yield of agricultural produce. Farmers occupationally exposed to pesticides during spraying activities are more prone to genotoxicity than unexposed. AIM: To assess the genotoxicity in farmers, engaged in spraying complex mixture of pesticides in the cultivation of cotton crops. MATERIAL AND METHODS: A total number of 152 male subjects were selected randomly from Guntur district of Andhra Pradesh (AP), South India. The demographic particulars viz., personal habits, duration of exposure to pesticides, types of pesticides used were collected from the study subjects using an interview schedule. Among them 76 subjects were farmers and the remaining individuals served as unexposed or controls. Blood samples from these subjects were collected for assessing the genetic damage by chromosomal aberrations (CAs) test and micronucleus test (MNT). RESULTS: The results of the study indicated that CA was significantly higher with 2.8% in farmers who were exposed to pesticides when compared to unexposed (0.72%). However, there was a minor difference in MN with 0.13% and 0.12% between exposed and unexposed which was not statistically significant (p < 0.05). CONCLUSION: A correlation between CA frequency and exposure to benzene hexachloride (BHC) pesticide residue was observed.


Subject(s)
Chromosome Aberrations/chemically induced , Hydrocarbons, Chlorinated/toxicity , Occupational Exposure/adverse effects , Organophosphorus Compounds/toxicity , Pesticides/toxicity , Adult , Agriculture , Environmental Monitoring , Humans , Hydrocarbons, Chlorinated/blood , India , Male , Micronucleus Tests , Middle Aged , Occupational Exposure/analysis , Organophosphorus Compounds/blood , Pesticides/blood
8.
J Postgrad Med ; 57(4): 314-20, 2011.
Article in English | MEDLINE | ID: mdl-22120861

ABSTRACT

Glomerular podocytes are highly specialized cells with a complex cytoarchitecture. Their most prominent features are interdigitated foot processes with filtration slits in between. These are bridged by the slit diaphragm, which plays a major role in establishing the selective permeability of the glomerular filtration barrier. We searched Medline and Pubmed using the combination of keywords "NPHS2", "podocin", "steroid-resistant nephrotic syndrome," and "genetics" to identify studies describing an association between NPHS2 gene and renal disease. The highly dynamic foot processes contain an actin-based contractile apparatus comparable to that of smooth muscle cells. Mutations affecting several podocyte proteins lead to rearrangement of the cytoskeleton, disruption of the filtration barrier, and subsequent renal disease. The fact that the dynamic regulation of the podocyte cytoskeleton is vital to kidney function has led to podocytes emerging as an excellent model system for studying actin cytoskeleton dynamics in a physiological context. Injury to podocytes leads to proteinuria, a hallmark of most glomerular diseases. Recent studies have led to a considerable increase in our understanding of podocyte biology including composition and arrangement of the cytoskeleton involved in the control of ultrafiltration. Moreover, disturbances of podocyte architecture resulting in the retraction of foot processes and proteinuria appear to be a common theme in the progression of an acquired glomerular disease. In hereditary nephrotic syndromes identified over the last few years, all mutated gene products were localized in podocytes. This review integrates our recent physiological and molecular understanding of the role of podocytes during the maintenance and failure of the glomerular filtration barrier.


Subject(s)
Intracellular Signaling Peptides and Proteins/genetics , Kidney Glomerulus/physiology , Membrane Proteins/genetics , Nephrotic Syndrome/genetics , Podocytes/physiology , Humans , Kidney Glomerulus/pathology , Mutation , Nephrotic Syndrome/pathology , Podocytes/ultrastructure
9.
J Thromb Thrombolysis ; 32(3): 343-55, 2011 Oct.
Article in English | MEDLINE | ID: mdl-21786025

ABSTRACT

Atherosclerosis will lead to stenosis/occlusion in the lumen of various arteries of living body. This can lead various conditions including myocardial infarction, cerebral infarction/aneurysm and peripheral artery disease. Ang II is believed to be an important regulatory peptide involved in maintaining cardiovascular homeostasis and pathogenesis of various cardiovascular diseases. Matrix metalloproteinase's (MMPs), adhesion molecules and plasminogen systems are involved in the inflammatory reaction of various blood vessels as well as pathogenesis of cerebro vasuclar disease in apo E(-/-) mice during angiotensin II injection. The present study analyses the role of ang II in development of cerebral aneurysm and also evaluated the mRNA levels of MMPs, adhesion molecules, plasminogen systems and peroxisome proliferators-associated receptors in the brain of apo E(-/-) mouse during the progression of cerebral aneurysm and ischemic conditions. Also, this study evaluates the role of dietary ß carotene on cerebrovascular disease. Serum total cholesterol (TC), Low density lipoprotein (LDL) and triglyceride (TG) levels were significantly increased in angiotensin II treated animals and further ß carotene supplementation reduces TC but does not affect the triglyceride and LDL levels. Circulating levels of macrophages were significantly increased in angiotensin treated animals and further beta carotene supplementation significantly reduced the circulating macrophages. Cerebro meningeous aneurysm, subarachnoid haemorrhage, multiple foci of infarction, necrosis and infiltration of inflammatory cells were observed in the cerebral hemispheres of ang II treated animals, however, infarction size were reduced and no aneurysm, inflammatory foci was observed in ß carotene treated animals. Real time analysis showed down regulation of mRNA levels of MMP 2, uPA, PAI, PPAR-A, MCSF1 and up regulation of tPA and MCP-1 in the brain during the progression of cerebral aneurysm and ß carotene supplementation to bring to normal expression levels of all the candidate genes for cerebrovascular diseases. Based on above results, Ang II may induced cerebral aneurysm, ischemia/infarction on brain through RAS system by down regulating the mRNA levels of MMP 2, uPA, PAI, PPAR-A, MCSF1 and up regulating tPA and MCP-1 and ß carotene attenuates the disease condition and bring down to normal expression levels of above genes.


Subject(s)
Apolipoproteins E , Brain/metabolism , Dietary Supplements , Gene Expression Regulation/drug effects , Intracranial Aneurysm/metabolism , Nerve Tissue Proteins/biosynthesis , Subarachnoid Hemorrhage/metabolism , Vitamins/pharmacology , beta Carotene/pharmacology , Angiotensin II/adverse effects , Angiotensin II/pharmacology , Animals , Intracranial Aneurysm/chemically induced , Intracranial Aneurysm/genetics , Lipids/blood , Macrophages/metabolism , Mice , Mice, Knockout , Nerve Tissue Proteins/genetics , Subarachnoid Hemorrhage/chemically induced , Subarachnoid Hemorrhage/genetics , Vasoconstrictor Agents/adverse effects , Vasoconstrictor Agents/pharmacology
10.
J Thromb Thrombolysis ; 30(2): 154-63, 2010 Aug.
Article in English | MEDLINE | ID: mdl-20177736

ABSTRACT

We studied and compared the efficiency of induction aneurysm in apo E mice by using high fat diet and Ang II. Aneurysm induced in 6 week old male apo E -/- mice by subcutaneous release of Ang II injection for 45 days. Also, aneurysm was induced in three month old male apo E by administration of high fat diet for a period of three months. No difference in body weight in Ang II treated mice. But, increase in body weight and mean arterial blood pressure observed in high fat diet group animals. Highly significant increase in total cholesterol, TG, LDL and significant decrease in HDL level were observed in Ang II treated animals. Significant increase in total cholesterol, but no changes in TG, LDL, HDL levels were observed in high fat diet group. Higher percentage of circulating monocytes was observed in ang II treated group but more number of circulating lymphocytes were observed in high fat diet group in FACS analysis. In histopathology, intimal layer of abdominal aorta was completely replaced by chronic inflammatory cells particularly macrophages (80%) which appeared as foam cells and lymphocytes (20%) in ang II treated animals. Degradation of elastin, infiltration of lymphocytes, chondrocytes and cellular migration towards media were observed in the abdominal aorta of high fat diet group. Real time analysis and immunofluorescence assay supports over expression of Vcam 1 Icam1, MCP 1and MMP2 genes were observed in Ang II treated animals. In immunofluorescence assay, over expression of Mac 3 protein specific for macrophages was observed in abdominal aorta of ang II treated animals, but over expression of CD45.1 & 45.2 proteins specific to lymphocytes were observed in high fat diet group. Based on our observations, Ang II induced aortic aneurysm by recruiting/ proliferating circulating monocytes by up regulating Icam-1, Vcam -1 and MCP-1. Also, ang II involved in degradation of elastin in the abdominal aorta by up regulation of MMP2 to promote agranulocytes migration in the intimal layers. Epithelial cell hyperplasia with accumulation of fatty fluids (cyst) was observed in seminal vesicle and ventral prostate of high fat treated animals. Fatty degeneration, germ cell apoptosis and infiltration giant cells were observed in the testes of high fat diet group. As per available literature these observations were not reported with high fat diet treatments with apo E models. High fat diet induced aneurysm prominently in abdominal, thoracic aorta and extensive plaque formation was observed in femoral and renal arteries. Administration of high fat diet containing cholesterol induced aneurysm in apo E mice model also efficient method to rule out the pathogenesis of aortic aneurysm when compared with angiotensin.


Subject(s)
Aortic Aneurysm, Abdominal/etiology , Aortic Aneurysm, Thoracic/etiology , Apolipoproteins E/deficiency , Cell Movement , Cell Proliferation , Cholesterol, Dietary , Granulocytes/immunology , Hypercholesterolemia/complications , Angiotensin II , Animals , Aorta/immunology , Aorta/pathology , Aortic Aneurysm, Abdominal/chemically induced , Aortic Aneurysm, Abdominal/genetics , Aortic Aneurysm, Abdominal/immunology , Aortic Aneurysm, Abdominal/pathology , Aortic Aneurysm, Thoracic/chemically induced , Aortic Aneurysm, Thoracic/genetics , Aortic Aneurysm, Thoracic/immunology , Aortic Aneurysm, Thoracic/pathology , Apolipoproteins E/genetics , Biomarkers/blood , Blood Pressure , Chemokine CCL2/genetics , Cholesterol, Dietary/blood , Disease Models, Animal , Flow Cytometry , Fluorescent Antibody Technique , Gene Expression Regulation , Granulocytes/pathology , Hypercholesterolemia/genetics , Hypercholesterolemia/immunology , Intercellular Adhesion Molecule-1/genetics , Male , Matrix Metalloproteinase 2/genetics , Mice , Mice, Inbred C57BL , Mice, Knockout , Time Factors , Vascular Cell Adhesion Molecule-1/genetics , Weight Gain
11.
Mol Cancer Ther ; 9(1): 180-9, 2010 Jan.
Article in English | MEDLINE | ID: mdl-20053780

ABSTRACT

The cannabinoid 1 (CB(1)) and cannabinoid 2 (CB(2)) receptor agonist Delta(9)-tetrahydrocannabinol (THC) has been shown to be a broad-range inhibitor of cancer in culture and in vivo, and is currently being used in a clinical trial for the treatment of glioblastoma. It has been suggested that other plant-derived cannabinoids, which do not interact efficiently with CB(1) and CB(2) receptors, can modulate the actions of Delta(9)-THC. There are conflicting reports, however, as to what extent other cannabinoids can modulate Delta(9)-THC activity, and most importantly, it is not clear whether other cannabinoid compounds can either potentiate or inhibit the actions of Delta(9)-THC. We therefore tested cannabidiol, the second most abundant plant-derived cannabinoid, in combination with Delta(9)-THC. In the U251 and SF126 glioblastoma cell lines, Delta(9)-THC and cannabidiol acted synergistically to inhibit cell proliferation. The treatment of glioblastoma cells with both compounds led to significant modulations of the cell cycle and induction of reactive oxygen species and apoptosis as well as specific modulations of extracellular signal-regulated kinase and caspase activities. These specific changes were not observed with either compound individually, indicating that the signal transduction pathways affected by the combination treatment were unique. Our results suggest that the addition of cannabidiol to Delta(9)-THC may improve the overall effectiveness of Delta(9)-THC in the treatment of glioblastoma in cancer patients.


Subject(s)
Cannabidiol/pharmacology , Dronabinol/pharmacology , Glioblastoma/pathology , Apoptosis/drug effects , Basic Helix-Loop-Helix Transcription Factors/metabolism , Caspases/metabolism , Cell Cycle/drug effects , Cell Line, Tumor , Cell Proliferation/drug effects , Cell Survival/drug effects , Drug Screening Assays, Antitumor , Drug Synergism , Glioblastoma/enzymology , Humans , Mitogen-Activated Protein Kinases/metabolism , Neoplasm Invasiveness , Neoplasm Proteins/metabolism , Reactive Oxygen Species/metabolism , Receptor, Cannabinoid, CB2/metabolism
12.
Cancer Biomark ; 3(2): 73-8, 2007.
Article in English | MEDLINE | ID: mdl-17522428

ABSTRACT

Endometriosis, uterine fibroids and breast cancer are female health disorders associated with a great deal of morbidity. Since all these disorders are hormone responsive, our present study has been carried out to identify the association of 306bp Alu insertion polymorphism in intron 7 of progesterone receptor gene (PROGINS). DNA was isolated from the blood samples of 445 Asian Indian women, which included 100 endometriosis, 80 fibroids and 157 cases of breast cancer along with 108 age matched normal healthy women as controls. PROGINS polymorphism was assessed by PCR followed by agarose gel electrophoresis. Results showed that T2 allele frequency is 5%, 10% and 14.6% in endometriosis, uterine fibroids and breast cancer, as compared to 5.5% in controls. This indicates that PROGINS can be considered as a predisposing risk marker for breast cancer but not for endometriosis and uterine fibroids.


Subject(s)
Breast Neoplasms/genetics , Endometriosis/genetics , Genetic Predisposition to Disease , Leiomyoma/genetics , Polymorphism, Genetic , Receptors, Progesterone/genetics , Female , Humans , Polymerase Chain Reaction , Risk Factors
13.
Int J Biomed Comput ; 36(1-2): 163-5, 1994 Jun.
Article in English | MEDLINE | ID: mdl-7927856

ABSTRACT

The pharmacokinetics of vancomycin were studied in 10 neutropenic patients (4 male, 6 female) using the USC*PACK Clinical Programs. The experimental data was determined after the first administration of 1000 mg injected as a 1-h infusion. Eight blood samples were collected between 15 min and 11 h after the end of the infusion. Plasma vancomycin concentrations were measured by immunoassay procedure. Creatinine clearance and urine flow were also measured. Pharmacokinetic parameters were computed using a two-compartment model: Vc = 0.270665 +/- 0.161033 (l.kg-1); Kcp = 0.732927 +/- 0.464449 (h-1); Ks = 0.004952 +/- 0.00272 (min.ml-1.h-1); Kpc = 0.470243 +/- 0.194677 (h-1); Ki = 0.011675 +/- 0.004086 (h-1); Ke = 0.644415 +/- 0.239376 (h-1). When we compared this population to the general population of the program, Ke was increased. Elimination constant Ke was not correlated to either creatinine clearance or urine flow. Evaluation of the predictive performance of the Bayesian PC Program for adaptive control of vancomycin therapy in neutropenic patients is the next step of this study.


Subject(s)
Neutropenia/complications , Software , Vancomycin/pharmacokinetics , Adolescent , Adult , Bayes Theorem , Creatinine/blood , Drug Therapy, Computer-Assisted , Female , Gram-Positive Bacterial Infections/drug therapy , Humans , Infusions, Intravenous , Kidney/metabolism , Kidney/physiology , Male , Middle Aged , Neutropenia/metabolism , Urodynamics , Vancomycin/administration & dosage , Vancomycin/blood
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