These data suggest that decreases in plasma free-VEGF levels are greater after treatment with aflibercept or bevacizumab compared with ranibizumab at 4 weeks. At 52 and 104 weeks, a greater decrease was observed in bevacizumab versus ranibizumab. Results from 2 subgroups of participants who did not receive injections within at least 1 month and 2 months before collection suggest similar changes in VEGF levels after stopping injections. It is unknown whether VEGF levels return to normal as the drug is cleared from the system or whether the presence of the drug affects the assay's ability to accurately measure free VEGF. No significant associations between VEGF concentration and systemic factors were noted.
This study compares two methods of selecting inspiratory time (Ti) during mechanical ventilation. One selects a standard Ti producing a brief inspiratory pressure plateau (P). The other uses simultaneous pressure, flow and tidal volume (VT) waveforms, generated by a computer-assisted lung mechanics analyzer, to reduce Ti to the point where Vt ceases to accumulate and flow returns to zero. This method does not produce a pressure plateau (NP). Following saline lung washout, ten intubated, paralyzed surfactant-depleted cats were ventilated with pressure-preset infant ventilators at constant measured VT and rates. Five animals were initially ventilated with P (Ti = 0.98 +/- 0.02 s) and five with NP (Ti = 0.77 +/- 0.10 s). Ti was then varied to produce P or NP by using a four-period crossover design. All other ventilator variables remained constant. Intravascular pressures, thermodilution cardiac outputs, arterial and mixed venous blood gases and oxygen saturations, airway pressures, Ti, VT, and gas flows were measured; respiratory system mechanics, alveolar-arterial oxygen gradients, and intrapulmonary shunts were determined for each study period. When P and NP states were compared, only mean airway pressures differed (10.1 vs. 8.9 cmH2O; P less than 0.001). Blood gas values, intravascular pressures, cardiac output, and respiratory system mechanics were all similar. Under the conditions of this study, there was no advantage to prolonging Ti beyond the point where VT ceased to accumulate.
BACKGROUND-Although several macrolide antibiotics are proarrhythmic and associated with an increased risk of sudden cardiac death, azithromycin is thought to have minimal cardiotoxicity. However, published reports of arrhythmias suggest that azithromycin may increase the risk of cardiovascular death.
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