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No regional difference in cisatracurium dose-response and time-course-of-action between patients in China and Bosnia.
Dahaba, AA, Suljevic, I, Bornemann, H, Wu, XM, Metzler, H
British journal of anaesthesia. 2011;(3):331-5
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Abstract
BACKGROUND Variability in drug response could result from a variety of genetic and environmental factors that are often hard to define or quantify. A number of studies demonstrated regional geographic variations in potency of neuromuscular blocking agents (NMBAs). The aim of our study was to compare dose-response and time-course-of-action of cisatracurium besylate, an NMBA eliminated via the Hoffman degradation, in two countries with different life habits, diet, and ambient conditions; being Han Chinese in China and Caucasians in Bosnia. METHODS Neuromuscular block of cisatracurium 20 µg kg(-1), followed by four incremental 10 µg kg(-1) doses, and the remainder of 100 µg kg(-1) was evaluated using the Relaxometer mechanomyograph (Groningen University, Groningen, The Netherlands). Dose-response curves were created using log-dose-probit-response transformation. RESULTS There were no significant differences in cisatracurium mean (95% confidence intervals) ED(50), ED(90), and ED(95) (effective doses for 50%, 90%, and 95% first twitch depression) in Caucasian [39.1 (35.7-42.3), 50.6 (45.5-54.3), and 54.4 (49.8-58.9) µg kg(-1)] compared with Chinese patients [39.2 (35.1-43.1), 52.4 (47.9-56.8), and 56.9 (52.8-61.9) µg kg(-1)], respectively. There were no significant differences in mean (sd) Dur(25) and Dur(0.9) (time until 25% first twitch and 0.9 train-of-four ratio recoveries) in Caucasian [47.1 (6.4) and 77.5 (9.1) min)] compared with Chinese patients [(45.9 (4.7) and 72.3 (9.1) min)], respectively. CONCLUSIONS Cisatracurium dose-response relationship and time-course-of-action were not influenced by geographic location. Thus, cisatracurium would not require dose adjustments between patients living in the two geographic locations.
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Heritability of blood pressure responses to dietary sodium and potassium intake in a Chinese population.
Gu, D, Rice, T, Wang, S, Yang, W, Gu, C, Chen, CS, Hixson, JE, Jaquish, CE, Yao, ZJ, Liu, DP, et al
Hypertension (Dallas, Tex. : 1979). 2007;(1):116-22
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Abstract
The heritability of blood pressure responses to dietary intervention has not been well studied. We examined the heritability of blood pressure responses to dietary sodium and potassium intake in a family feeding study among 1906 study participants living in rural North China. The dietary intervention included a 7-day low-sodium feeding (51.3 mmol per day), a 7-day high-sodium feeding (307.8 mmol per day), and a 7-day high-sodium plus potassium supplementation (60 mmol per day). Blood pressure was measured 9 times during the 3-day baseline period preceding the intervention and also during the last 3 days of each intervention phase using a random-zero sphygmomanometer. Heritability was computed using maximum likelihood methods under a variance components model as implemented in the computer program SOLAR. The heritabilities of baseline blood pressure were 0.31 for systolic, 0.32 for diastolic, and 0.34 for mean arterial pressure. The heritabilities increased significantly under dietary intervention and were 0.49, 0.49, and 0.51 during low sodium; 0.47, 0.49, and 0.51 during high sodium; and 0.51, 0.52, and 0.53 during potassium supplementation for systolic, diastolic, and mean arterial pressure, respectively. The heritabilities for percentage of blood pressure responses to low sodium were 0.20, 0.21, and 0.23; to high-sodium were 0.22, 0.33, and 0.33; and to potassium supplementation were 0.24, 0.21, and 0.25 for systolic, diastolic, and mean arterial pressure, respectively. Our study indicated that the heritabilities of blood pressure under controlled dietary sodium and potassium intake were significantly higher than those under a usual diet. In addition, the heritabilities of blood pressure responses to dietary sodium and potassium intake were moderate in this study population.
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Evidence-based nursing: effects of a structured nursing program for the health promotion of Korean women with Hwa-Byung.
Choi, YJ, Lee, KJ
Archives of psychiatric nursing. 2007;(1):12-6
Abstract
The objectives of this study were to develop a culturally tailored nursing program for patients with Hwa-Byung (HB) and to test the effects of the nursing intervention. The structured nursing intervention program was based on a transcultural theoretical framework in which patients with HB received therapies consisting of music therapy, drama, and group therapy. Hwa-Byung is a culture-bound syndrome, literally translated as anger syndrome, attributed to the suppression of anger. Individuals experience a decrease in quality of life as a result of insufficient treatment. Current health care programs do not meet the needs of these individuals, who still need nursing interventions. A culturally tailored therapy is effective and appropriate for patients with illnesses related to their cultural background. Evidence-based nursing is a crucial approach in verifying the effects of nursing care and in enhancing the body of knowledge on nursing science. A nonequivalent, nonsynchronized, and controlled study design was applied to experimental and control groups of an even number of women. The nursing program was generally effective in the mental health condition test; the mental health condition of the experimental group was significantly more improved as compared with that of the control group. The program was particularly effective in the categories of somatization, depression, psychoticism, and hostility. The data indicate that the mental health of patients with HB could be improved with the use of nursing intervention programs. Nurses need to understand the cultural background of patients and provide culture-sensitive interventions for effective patient-oriented care.