ABSTRACT
The complex relationship between microbiota, human physiology, and environmental perturbations has become a major research focus, particularly with the arrival of culture-free and high-throughput approaches for studying the microbiome. Early enthusiasm has come from results that are largely correlative, but the correlative phase of microbiome research has assisted in defining the key questions of how these microbiota interact with their host. An emerging repertoire for engineering the microbiome places current research on a more experimentally grounded footing. We present a detailed look at the interplay between microbiota and host and how these interactions can be exploited. A particular emphasis is placed on unstable microbial communities, or dysbiosis, and strategies to reestablish stability in these microbial ecosystems. These include manipulation of intermicrobial communication, development of designer probiotics, fecal microbiota transplantation, and synthetic biology.
Subject(s)
Genetic Engineering , Microbiota , Animals , Bioethics , Humans , Models, Biological , Social Control, FormalABSTRACT
BACKGROUND: Our objective was to evaluate the effect of intensive care treatment on the protein binding of sufentanil and hydromorphone in cardiac surgery patients during postoperative analgesia using a target-controlled infusion (TCI) and patient-controlled analgesia (PCA). METHODS: Fifty adult patients were enrolled in this prospective randomized study; of which, 49 completed the study (age range 40-81 yr). Sufentanil was administered as an analgesic intraoperatively, and hydromorphone was dosed after operation with TCI and PCA until 8 a.m. on the first postoperative day. Arterial plasma samples were collected for drug and protein concentration measurements up to 24 h after cardiac surgery. Corresponding patient data were collected from the electronic patient data system. After explorative data analysis with principal component analysis, multivariate regression analysis and non-linear mixed effects modelling was used to study the effect of treatment on protein binding. RESULTS: Data of 35 patients were analysed. The median protein binding of sufentanil and hydromorphone was 88.4% (IQ range 85.7-90.5%) and 11.6% (IQ range 9.5-14.3%), respectively. Free fraction of sufentanil increased towards the end of the study period, whereas hydromorphone free fraction remained nearly constant. The total sufentanil concentration and volume balance were identified as significant covariates for the protein binding of sufentanil. For the protein binding of hydromorphone, no significant covariate effects were found. CONCLUSIONS: Sufentanil protein binding was significantly dependent on changes in the total drug concentration and volume balance addressing the importance of adequate dosing and fluid-guided therapy. Hydromorphone protein binding was nearly constant throughout the study period. CLINICAL TRIAL REGISTRATION: EudraCT 2011-003648-31 and ClinicalTrials.gov: NCT01490268.
Subject(s)
Analgesics, Opioid/metabolism , Analgesics, Opioid/therapeutic use , Cardiac Surgical Procedures/methods , Critical Care , Hydromorphone/metabolism , Hydromorphone/therapeutic use , Pain, Postoperative/drug therapy , Sufentanil/metabolism , Sufentanil/therapeutic use , Adult , Aged , Algorithms , Analgesia, Patient-Controlled , Analgesics, Opioid/administration & dosage , Dose-Response Relationship, Drug , Female , Humans , Hydromorphone/administration & dosage , Male , Middle Aged , Nonlinear Dynamics , Prospective Studies , Protein Binding , Regression Analysis , Sufentanil/administration & dosage , ThoracotomyABSTRACT
This study investigated differences in the scores on perceived Distress and Bulimia among college women with varying scores on the Behavioral Self-report of Femininity. Distress was assessed using The Psychological Distress Inventory and Bulimia was measured using the Bulimia Cognitive Distortions Scale. Women who reported low numbers of stereotypic feminine behaviors scored lower on the Bulimia Cognitive Distortions Scale than women reporting moderate to high numbers of stereotypic feminine behaviors. Distress scores were not significantly different between women scoring high and low on Bulimic Cognitive Distortions, and Bulimic Cognitive Distortion scores did not vary as a function of scores on Distress and Femininity. A multiple regression indicated that one factor of the Behavioral Self-report of Femininity, Social Connectedness, made a significant contribution to the prediction of Bulimia scores.
