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1.
Dr. Ingrida S. Sketris Pharm.D. M.P.A. Ms. Linda Onorato B.Sc. Pharm. Dr. Randall W. Yatscoff Ph.D. Dr. Morris Givner Ph.D. Dr. David Nicol M.D. Dr. Isaac Abraham Ph.D. 《Pharmacotherapy》1993,13(6):658-660
A 25–year-old woman was admitted to the hospital because of rising trough cyclosporine concentrations thought to be due to self-administration of 4 times the normal dosage of the drug for 8 days. Her symptoms included colicky central abdominal pains and urinary retention; her serum creatinine concentrations were elevated. Whole blood cyclosporine and metabolite concentrations were measured by high-performance liquid chromatography and monoclonal radioimmunoassays. The highest reported trough cyclosporine concentration was 5877 ng/ml, and AM1 (M17) concentration was 3425 ng/ml. A cyclosporine half-life of 91 hours was calculated. Nine days after the agent was discontinued the patient's serum creatinine concentration had returned to normal and her symptoms resolved. Due to the availability of three sizes of cyclosporine capsules, and the need for frequent dosage changes, continued vigilance is necessary to ensure that patients understand their drug regimen. 相似文献
2.
Hillary Bracken Rasha Dabash George Tsertsvadze Svetlana Posohova Milind Shah Selma Hajri Shuchita Mundle Hela Chelli Dhouha Zeramdini Tamar Tsereteli Ingrida Platais Beverly Winikoff 《Contraception》2014
Objective
To test the effectiveness and acceptability of an outpatient medical abortion protocol with 200 mg mifepristone and 400 mcg sublingual misoprostol at 64–70 days' last menstrual period (LMP) and compare it to the already known efficacy of the 57–63 days' LMP gestational age range.Study Design
We conducted a prospective, comparative open-label trial in six hospitals and clinics in Ukraine, Georgia, India and Tunisia. We enrolled 714 reproductive age women with pregnancies 57 to 70 days who presented requesting abortion. Medical abortions were managed with the current service delivery protocol (200 mg oral mifepristone followed in 24–48 h by 400 mcg sublingual misoprostol). Data on safety, efficacy and acceptability were collected. The main outcome measure was complete abortion without surgical intervention at any point.Results
A total of 703 cases were analyzable for efficacy. Success rates did not differ significantly in the two groups [57–63-day group: 94·8%; 64–70-day group: 91.9%; Relative Risk (RR): 0.79 (0.61–1.04)]. Ongoing pregnancy rates also did not differ significantly (57–63 days: 1.8%; 64–70 days: 2.2%; RR: 1.10 (0.65–1.87)].Conclusion
A medical abortion regimen of 200 mg mifepristone followed in 24–48 h by 400 mcg sublingual misoprostol is effective through 70 days' gestation and may be offered within existing outpatient abortion services.Implications
A regimen of 200 mg mifepristone followed in 24–48 h by 400 mcg sublingual misoprostol is effective up to 70 days' LMP. The findings have important implications for expanding access to outpatient medical abortion services in settings where the cost of misoprostol is of concern or a two-pill misoprostol regimen is the standard of care. 相似文献3.
Ingrida Janulevičienė Ieva Sliesoraitytė Brent Siesky Alon Harris 《Acta ophthalmologica. Supplement》2008,86(5):552-557
Purpose: Current evidence indicates that alteration in ocular blood flow may be relevant in open‐angle glaucoma (OAG) patients independent of intraocular pressure (IOP). Presently, the lack of an adequate methodology capable of assessing all vascular beds limits the clinical role of blood flow parameters in glaucoma management. We aimed to compare differences in retinal nerve fibre layer (RNFL) thickness and retrobulbar haemodynamics between OAG patients and healthy age‐matched control subjects. Methods: Sixty eyes of 30 OAG patients and 30 healthy age‐matched controls were enrolled into the prospective, randomized study. Retinal nerve fibre layer thickness was analysed by scanning laser polarimetry (SLP). Standard SLP parameters were determined, including: average temporal, superior, nasal, inferior thickness (TSNIT); superior and inferior averages; TSNIT standard deviation (TSNIT‐SD), and nerve fibre indicator (NFI). Retrobulbar haemodynamics were assessed using colour Doppler imaging (CDI). Peak systolic velocity (PSV), end‐diastolic velocity (EDV), pulsatility index (PI) and resistivity index (RI) in the ophthalmic artery (OA), central retinal artery (CRA) and short posterior ciliary artery (SPCA) were evaluated. Results: The RNFL in OAG patients was statistically significantly thinner compared with that in age‐matched controls: the NFI was 24.9 ± 10.24 in OAG patients and 16.13 ± 7.95 in healthy controls (p < 0.05). Statistically significant differences were observed: CRA PSV was 20.54 ± 7.84 cm/second in OAG subjects and 16.5 ± 6.19 cm/second in healthy controls (p = 0.0038); OA EDV was 8.99 ± 4.71 cm/second in OAG subjects and 5.93 ± 3.23 cm/second in healthy controls (p = 0.0048). Correlation analysis of NFI was in positive association with CRA EDV (r = 0.395; p < 0.05) and CRA PI (r = 0.403; p < 0.05) in OAG subjects, but no statistically significant association was seen in healthy controls. Conclusions: Statistically significant thinning of the RNFL in association with reduced retrobulbar blood flow velocities was observed in OAG patients. Combining ocular structural alterations with ocular circulation assessment may increase our ability to elucidate potential IOP‐independent glaucomatous risk factors. 相似文献
4.
Tara Shochet Monica Dragoman Jennifer Blum Dina Abbas Karmen Louie Ingrida Platais Tamar Tsereteli Beverly Winikoff 《Contraception》2019,99(5):288-292
ObjectivesCurrent service delivery models for second-trimester medical abortion typically include routine inpatient admission and overnight stays. To assess the feasibility of a day-service model, we evaluated outpatient administration of abortion medications and analyzed the proportion of clients who could avoid an overnight stay. We also examined additional key elements of medical abortion care to evaluate the practicality of this model.Study designWe pooled data from six clinical studies of second-trimester medical abortion conducted by Gynuity over the past 10 years. We include 868 individuals receiving mifepristone–misoprostol abortion between 13 and 22 weeks’ gestation.ResultsAt 8 h post misoprostol initiation, 309/521 (59.3%) participants at 13-18 weeks' gestation had a successful abortion; by 10 h, 382/521 (73.3%) were successful. Taking the mifepristone at home lowered neither the efficacy of the method nor satisfaction with the experience. Nonphysician providers played a significant role in the provision of care. Needed interventions were relatively rare; serious complications were very rare.ConclusionsOur findings support the provision of second-trimester medical abortion in a day-clinic setting, especially at ≤18 weeks' gestation. Such a model could increase access to quality care in many settings.ImplicationsSecond-trimester medical abortion can safely and effectively be offered as a day service. Nonphysician providers are well suited to provide the majority of care. Developing guidelines for a 1-day model could increase access to quality care in many settings worldwide. 相似文献
5.
Ingrida S. Sketris Pharm.D. MPA Matthew R. Wright Ph.D. Michael L. West M.D. FRCPC 《Pharmacotherapy》1996,16(2):301-305
Clarithromycin is a macrolide antibiotic similar in structure to erythromycin, but suggested to have fewer drug interactions. Although a pharmacokinetic interaction between clarithromycin and cyclosporine was recently reported, its magnitude and mechanism have not been explored. A 43-year-old renal transplant recipient receiving cyclosporine was treated with clarithromycin because of pneumonia. A cyclosporine pharmacokinetic study was performed 8 days after the initiation of the clarithromycin and 14 days after stopping the drug. Clarithromycin coadministration caused an approximately 2-fold increase in the area under the whole blood concentration versus time curve of cyclosporine. The oral clearance of cyclosporine was halved by clarithromycin, but the terminal elimination rate constant decreased only 15% and mean residence time 20%. These observations suggest that clarithromycin inhibits not only the hepatic metabolism but also the intestinal metabolism of cyclosporine. Caution is advised when administering the two drugs concurrently, and additional studies are necessary to elucidate the mechanism of this interaction. 相似文献
6.
Vidzis A Cema I Krasta I Brinkmane A Kalnins I 《Stomatologija / issued by public institution "Odontologijos studija" ... [et al.]》2011,13(2):68-72
INTRODUCTION. Latvian government Health care financing regulations do not envisage free dental care in nursing homes. Consequently, in this situation arises need to carry out comparative evaluation of oral health status and quantity indicators of dental prosthodontics among retirement-age population in Latvia. The aim of the study was to estimate oral health and dental prosthodontics indicators among retirement-age population in Latvia. PATIENTS AND METHODS. We examinated 465 retirement-age inhabitants in Latvia. We assessed dental status, quantity and quality of the existing complete dental prostheses. We also evaluated the DMF-T index. RESULTS. Oral health indicators among Latvian retirement-age population are better than those for nursing homes residents in the same age group. Complete dental prostheses used by nursing homes residents do not meet denture's quality criteria. Retirement-age patients have oral hygiene problems. CONCLUSIONS. DMF-T index among Latvian retirement-age population is lower than among residents of nursing homes. The major component of DMF-T index is the number of lost teeth. The assessment of dental prostheses among residents of nursing homes showed unsatisfactory results. Retirement-age population in Latvia needs treatment of oral mucosal diseases, improvement of oral hygienic measures and increase of amount of dental prosthodontics. 相似文献
7.
8.
Objective To explore the swallowing-enhancing and taste-masking effects of MedCoat, a new disposable device used to apply a coating
to tablets just before oral administration. Setting Kaunas Medical University Hospital in Lithuania. Method The study was performed as a randomized cross-over study. In total 41 subjects (20 male and 21 female) were enrolled in the
study. Subjects were healthy volunteers who at least sometimes experience difficulties swallowing tablets. Subjects were asked
to swallow placebo tablets uncoated and coated with MedCoat in a randomized order, and indicate their preferences. Subjects
were also asked to evaluate the taste-masking properties of MedCoat. Results Of the 41 subjects, 40 (97.6%) found it less difficult to swallow non-flavoured placebo tablets coated with MedCoat compared
to identical uncoated tablets. Forty subjects (97.6%) found it less difficult to swallow divided non-flavoured placebo tablets
coated with MedCoat compared to identical uncoated divided tablets. All 41 subjects (100.0%) found it less difficult to swallow
bitter flavoured placebo tablets coated with MedCoat compared to identical uncoated tablets. All 41 (100.0%) of the subjects
stated that MedCoat completely masked the bitter taste of a bitter flavoured tablet. Conclusion The study showed that MedCoat made tablets easier to swallow for people with difficulties swallowing tablets and that it
masked the taste of bitter tasting tablets. MedCoat could therefore be a valuable tool to aid the oral taking of tablets for
patients who have difficulties swallowing tablets. 相似文献
9.
Serum antiphospholipid antibody level and ocular haemodynamics in eyes with pseudoexfoliation syndrome 下载免费PDF全文
10.
Elizabeth G. Raymond Holly A. Anger Erica Chong Sue Haskell Melissa Grant Christy Boraas Kristina Tocce Joey Banks Bliss Kaneshiro Maureen K. Baldwin Leah Coplon Paula Bednarek Tara Shochet Ingrida Platais 《Contraception》2021,103(6):400-403
ObjectiveTo examine the proportion of high-sensitivity urine pregnancy test (HSPT) results that were positive by time after successful medication abortion.Study designWe used data from an ongoing study that provides mifepristone and misoprostol for medication abortion by direct-to-patient telemedicine and mail. Providers evaluated abortion outcomes by patient interview and clinical tests per clinical judgment and participant preference. We identified all participants enrolled July 2016 to September, 2020 who had an HSPT result and no indication of viable pregnancy after treatment. We used logistic regression to examine the association between the timing of the initial post-treatment HSPT, gestational age, and the proportion of HSPTs that gave a positive result.ResultsOf the 472 participants in our analysis, 88 (19%) had positive initial HSPTs. The proportions that were positive at ≤20 days, 21 to 27 days, 28 to 34 days, and ≥35 days after mifepristone ingestion was 14 of 29 (48%), 15 of 58 (26%), 49 of 258 (19%), and 10 of 127 (8%), respectively (p < 0.001). Gestational age at mifepristone ingestion was not significantly related to positive HSPT results (p = 0.28). Multivariable logistic regression confirmed both findings and did not identify a statistically significant interaction between these variables. In the 67 participants who relied solely on further HSPTs to confirm abortion outcome, the median interval between the initial positive test and first negative test was 14 days.ConclusionsThe proportion of participants with positive HSPTs declined with time after successful medication abortion. However, nearly one-fifth of participants with complete abortion had positive tests 4 weeks after treatment.ImplicationsHSPTs provide an inexpensive, convenient option for confirming success of medication abortion at home. However, a substantial minority of patients without ongoing pregnancy have positive HSPT results. Development of a symptom-based strategy for medication abortion outcome assessment without any confirmatory tests should be a priority. 相似文献