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Alternate-day dosing of aspirin in atrial fibrillation: A critical evaluation

AMERICAN HEART JOURNAL 1999年第1期138卷 13-13页

作者： Howes, CJ Ezekowitz, MD Yale Univ Sch Med Sect Cardiovasc Med New Haven CT 06520 USA

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Changes in serum chitotriosidase activity with cessation of replacement enzyme (cerebrosidase) administration in Gaucher disease

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CLINICAL BIOCHEMISTRY 2000年第2期33卷 147-149页

作者： Czartoryska, B Tylki-Szymanska, A Lugowska, A Inst Psychiat & Neurol Dept Genet PL-02957 Warsaw Poland Childrens Mem Hlth Inst Dept Metab Dis Warsaw Poland

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Melatonin for the treatment of handicapped children with severe sleep disorders

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PEDIATRIC NEUROLOGY 2000年第3期23卷 229-232页

作者： Jan, MMS King Abdulaziz Univ Hosp Dept Pediat Div Neurol Jeddah 21452 Saudi Arabia Coll Med & Allied Hlth Sci Jeddah Saudi Arabia

Sleep disorders are common in children with mental retardation and neurologic disorders. Melatonin, a recently developed natural compound, has been used successfully in sleep disorders. I report my experience with melatonin in an open, prospective trial to treat circadian rhythm sleep disorder in handicapped children. The sleep disorder had been present for at least 6 months and had not responded to at least one hypnotic drug. The therapeutic response was recorded according to the average number of hours asleep per 24 hours, average number of awakening per night, average number of nights with delayed sleep onset, and average number of nights with early morning arousals. Ten consecutive children (four males, six females;age range = 1-11 years, mean 5.4) were included. Nine children had documented mental retardation that was severe in six (67%). Most had epilepsy and visual impairment (70%). All children were monitored for 4-12 months (mean 7.5 months) after the initiation of 3-mg bedtime melatonin. Most (80%) had a dramatic response to melatonin. No side effects were reported. Melatonin is a well-tolerated, safe, relatively inexpensive, and effective drug, with minimal side effects, for the treatment of severe circadian rhythm sleep disorder in handicapped children. Wider use of this drug is recommended. (C) 2000 by Elsevier Science Inc. All rights reserved.

关键词：昼夜节律/药物作用残疾儿童用药计划表褪黑激素/投药和剂量精神发育迟滞/药物疗法精神发育迟滞/病因学前瞻性研究睡眠障碍昼夜节律性/药物疗法睡眠障碍昼夜节律性/病因学觉醒状态/药物作用儿童儿童学龄前女(雌)性人类婴儿男(雄)性

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Weekly carboplatin as a strategy to prevent severe treatment-related emesis

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GYNECOLOGIC ONCOLOGY 2000年第2期78卷 265-265页

作者： Markman, M Kulp, B Peterson, G Kennedy, A Cleveland Clin Taussig Canc Ctr Cleveland OH 44195 USA

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Scleromyxedema: Response to high-dose intravenous immunoglobulin (hdIVIg)

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JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY 2000年第2期43卷 403-408页

作者： Lister, RK Jolles, S Whittaker, S Black, C Forgacs, I Cramp, M Potter, M Rustin, MHA Royal Free Hosp Dept Dermatol London NW3 2QG England Royal Free Hosp Dept Rheumatol London NW3 2QG England Royal Free Hosp Dept Haematol London NW3 2QG England Natl Inst Med Res Div Cellular Immunol London NW7 1AA England Univ London Kings Coll Dept Med London WC2R 2LS England

We report 2 patients with scleromyxedema, both associated with IgG-lambda paraproteinemia, who were treated with high-dose intravenous immunoglobulin (hdIVIg) 2 g/kg per month. The response to treatment was assessed using an objective skin scoring system initially established for patients with scleroderma. This system grades the overall severity of the induration and the reduction in mobility of the skin. Both patients initially had a dramatic response to treatment which was sustained in one patient. The first patient, a 30-year-old black man, showed a reduction in skin scores from 36/60 to 11/60 over a 3-month period, during which time he had 3 infusions of hdIVIg. After an unplanned 2-month break from treatment, severe neuromuscular complications developed. These improved initially with more frequent infusions of hdIVIg but oral corticosteroids were required to treat worsening myopathy. Unfortunately the initial response to hdIVIg has not been sustained and his skin scores at 1 year returned to baseline. The second patient, a 60-year-old white man, showed a similarly dramatic reduction in skin scores from 36/60 to 15/60 over a 3-month period after having received only 2 infusions of hdIVIg. There has been sustained improvement after 10 months of therapy and the interval between hdIVIg infusions has been increased to 10 weeks without deterioration. HdIVIg may be an effective treatment for some patients with scleromyxedema, a rare condition with few effective treatments and a poor prognosis.

关键词：剂量效应关系药物用药计划表免疫法被动免疫球蛋白λ链/血液硬化萎缩苔癣/诊断硬化萎缩苔癣/免疫学硬化萎缩苔癣/病理学硬化萎缩苔癣/治疗副蛋白血症/诊断副蛋白血症/免疫学副蛋白血症/病理学副蛋白血症/治疗硬皮病局部性/诊断硬皮病局部性/免疫学硬皮病局部性/病理学硬皮病局部性/治疗皮肤/病理学治疗结果成年人人类男(雄)性中年人

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Effects of different insulin infusion rates on heart rate variability in lean and obese subjects

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METABOLISM-CLINICAL AND EXPERIMENTAL 1999年第6期48卷 755-762页

作者： Paolisso, G Manzella, D Tagliamonte, MR Rizzo, MR Gambardella, A Varricchio, M II Univ Naples Dept Geriatr Med & Metab Dis I-80138 Naples Italy

The low-frequency to high-frequency ratio (LF/HF ratio) is an index of cardiac sympathovagal balance. We hypothesized that insulin might also stimulate the LF/HF ratio. Thus, 15 lean and 15 obese subjects were studied. Each subject underwent sequential hyperinsulinemic clamps (insulin infusion rate 0.50, 1, and 2 mU/kg . min) while the heart rate was recorded by the Holter technique continuously. Indirect calorimetry allowed determination of the respiratory quotient (Rq) and substrate oxidation. The leg blood flow (LBF), leg vascular resistance (LVR), and plasma norepinephrine concentration were also measured. In seven lean subjects, hyperinsulinemic clamps were repeated along with propranolol infusion (0.1 mg . kg(-1) as an intravenous bolus dose followed by continuous intravenous infusion of 0.5 mg . kg(-1). min(-1) throughout the study). Lean subjects had better insulin action than obese subjects. Insulin infusion was associated with an increase of the Delta LF/HF ratio in both lean (P < .001 for time-dependent changes) and obese (P < .02 for time-dependent changes) subjects;however, the extent of insulin-mediated stimulation of the LF/HF ratio was greater in lean versus obese subjects. Insulin infusion did not significantly affect HF values in both groups. Independently of gender, body fat, changes in the plasma norepinephrine concentration, LBF, and LVR, the Delta LF/HF ratio at the end of the fastest insulin infusion (0.8 +/- 0.2 v 0.3 +/- 0.2, P < .04) was still greater in lean versus obese subjects. The Delta LF/HF ratio was also more stimulated during insulin versus insulin + propranolol infusion in lean subjects. In conclusion, insulin stimulates the LF/HF ratio in both lean and obese subjects and thus produces a shift in the cardiac autonomic nervous system activity toward sympathetic predominance. Copyright (C) 1999 by W.B. Saunders Company.

关键词：肾上腺素能β受体拮抗剂/药理学血糖/代谢血压/药物作用人体质量指数量热法间接剂量效应关系药物用药计划表心电描记术便携式葡萄糖钳制技术心率/药物作用降血糖药/投药和剂量降血糖药/血液输注静脉内胰岛素/投药和剂量胰岛素/血液去甲肾上腺素/血液肥胖症/血液肥胖症/病理生理学普萘洛尔/药理学时间因素成年人女(雌)性人类男(雄)性

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SINGLE-DOSE BLOCK-REPLACE REGIMES IN TREATMENT OF HYPERTHYROIDISM

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AMERICAN HEART JOURNAL 1975年第2期90卷 273-273页

作者： WISE, PH MARION, M PAIN, RW ROY ADELAIDE HOSP ENDOCRINE UNITN TERRACEADELAIDE 5000S AUSTRALIAAUSTRALIA ROY ADELAIDE HOSP INST MED & VET SCIDIV NUCL MEDADELAIDE 5000S AUSTRALIAAUSTRALIA ROY ADELAIDE HOSP INST MED & VET SCIDIV CLIN CHEMADELAIDE 5000S AUSTRALIAAUSTRALIA

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Depomedroxyprogesterone-induced hypoestrogenism and changes in vaginal flora and epithelium

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OBSTETRICS AND GYNECOLOGY 2000年第3期96卷 431-439页

作者： Miller, L Patton, DT Meier, A Thwin, SS Hooton, TM Eschenbach, DA Univ Washington Dept Obstet & Gynecol Div Infect Dis Seattle WA 98195 USA Univ Washington Dept Med Div Infect Dis Seattle WA 98195 USA

Objective: To identify the effects of depomedroxyprogesterone acetate (DMPA) on vaginal microbial flora and epithelium. Methods: Women who desired DMPA for contraception were evaluated before and at 3 and 6 months after initiation of 150-mg DMPA injections every 3 months. At each visit, we assessed genital symptoms, vaginal signs, vaginal microflora, and histopathology by vaginal biopsies. Results: Among 38 women observed for 6 months, there was significant reduction in mean serum estradiol level (99.9 +/- 9.3 pg/mL to 26.6 +/- 1.6 pg/mL, P < .001). The number of subjects with any Lactobacillus did not change, but the number with hydrogen peroxide (H2O2)-positive Lactobacillus decreased from 20% before to 12% after 6 months of DMPA (P = .005). The log concentration in colony-forming units per milliliter of vaginal fluid of H2O2-positive Lactobacillus decreased in a linear manner from 4.0 +/- 0.6 at baseline to 2.5 +/- 0.6 after 6 months of DMPA use (P = .006). The mean number of cell layers in the epithelium was reduced slightly from 28.1 +/- 0.7 to 25.9 +/- 0.9 (P = .05), epithelial thickness decreased from 1.02 +/- 0.04 mm to 0.89 +/- 0.05 mm (P = .005), and the glycogen-positive thickness decreased from 0.81 +/- 0.04 mm at baseline to 0.66 +/- 0.05 after 6 months of DMPA use (P = .005). Conclusion: Depomedroxyprogesterone acetate produced a systemic hypoestrogenic state associated with decreased H2O2-positive Lactobacillus colonization and slight thinning of the glycogen vaginal epithelial layer. Such changes possibly compromise the vaginal barrier to infection. (Obstet Gynecol 2000;96:431-9. (C) 2000 by The American College of Obstetricians and Gynecologists.).

关键词：集落计数微生物避孕药女用/投药和剂量避孕药女用/副作用用药计划表上皮/药物作用上皮/微生物学上皮/病理学雌激素类/缺乏随访研究注射肌肉内乳杆菌属/药物作用醋酸甲羟孕酮/投药和剂量醋酸甲羟孕酮/副作用阴道/药物作用阴道/微生物学阴道/病理学青少年成年人女(雌)性人类

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Vaginal clindamycin and oral metronidazole for bacterial vaginosis: A randomized trial

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OBSTETRICS AND GYNECOLOGY 2000年第2期96卷 256-260页

作者： Paavonen, J Mangioni, C Martin, MA Wajszczuk, CP Univ Helsinki Dept Obstet & Gynecol FIN-00290 Helsinki Finland Osped San Gerardo Clin Ostetr & Ginecol Milan Italy Pharmacia & Upjohn Inc Kalamazoo MI 49001 USA

Objective: To compare the efficacy and safety of clindamycin vaginal ovules with oral metronidazole for treatment of bacterial vaginosis. Methods: Women with bacterial vaginosis received either 100-mg ovules of clindamycin (intravaginally for 3 consecutive days) plus placebo capsules (orally twice daily for 7 days) or metronidazole 500 mg (two 250-mg capsules orally twice daily for 7 days) plus placebo ovules (intravaginally for 3 consecutive days). The sample was determined prospectively to provide a probability of .84 of correctly concluding that the rate of success for clindamycin is not more than 15% less than the expected 75% success rate for metronidazole. Clinical outcome was determined on the basis of vaginal fluid amine odor and clue cells. Results: Of the 399 patients enrolled, 233 could be evaluated for efficacy. Of those, 77 (68.1%) of 113 patients were cured with clindamycin, compared with 80 (66.7%) of 120 who were cured with metronidazole (95% confidence interval -10.6%, 13.4%;P = .810). Treatment-related adverse events were reported more frequently in the metronidazole treatment group. Systemic symptoms, such as nausea and taste perversion, accounted for most of the difference between groups. Conclusion: A a-day regimen of clindamycin, given as intravaginal ovules, was as effective as and better tolerated than a 7-day regimen of oral metronidazole 500 mg, given twice daily, for treatment of bacterial vaginosis. ((C) 2000 by The American College of Obstetricians and Gynecologists.).

关键词：投药阴道内投药口服抗菌药/投药和剂量抗菌药/治疗应用抗感染药/投药和剂量抗感染药/治疗应用克林霉素/投药和剂量克林霉素/治疗应用双盲法用药计划表药物疗法联合欧洲甲硝唑/投药和剂量甲硝唑/治疗应用阴道病细菌性/药物疗法青少年成年人女(雌)性人类中年人

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Changes in fat cell size and in vitro lipolytic activity of abdominal and gluteal adipocytes after a one-year cross-sex hormone administration in transsexuals

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METABOLISM-CLINICAL AND EXPERIMENTAL 1999年第11期48卷 1371-1377页

作者： Elbers, JMH de Jong, S Teerlink, T Asscheman, H Seidell, JC Gooren, LJG Free Univ Amsterdam Hosp Dept Endocrinol & Androl Res Inst Endocrinol Reproduct & Metab NL-1007 MB Amsterdam Netherlands Free Univ Amsterdam Hosp Dept Clin Chem Res Inst Endocrinol Reproduct & Metab NL-1007 MB Amsterdam Netherlands

We prospectively studied the effects of cross-sex hormone administration on fat cell size and in vitro lipolytic activity in subcutaneous abdominal and gluteal fat biopsies obtained from 19 male-to-female (M-F) transsexuals and 17 female-to-male (F-M) transsexuals. The amount of subcutaneous fat at the abdominal and gluteal levels was quantified with the use of magnetic resonance imaging (MRI). Before cross-sex hormone administration. M-F transsexuals had less subcutaneous fat with smaller fat cells compared with F-M transsexuals, with a higher baseline in vitro lipolytic activity expressed as glycerol release per milligram of triglyceride (TG) in the abdominal region (P < .05). Before cross-sex hormone treatment, no differences in lipolytic activity stimulated with arterenol (ART), isoproterenol (ISO), or ISO + insulin (INS) were observed between groups or regions. After a 1-year treatment with estrogens and antiandrogens in M-F transsexuals, subcutaneous fat areas on MRI and fat cell size were increased (P < .001) and reductions were observed in the basal lipolytic activity of gluteal and abdominal fat biopsies (P < .05). Following administration of testosterone to F-M transsexuals, subcutaneous fat and fat cell size at the gluteal and abdominal depots were decreased (P < .01) and basal lipolysis was increased significantly at the abdominal level (P < .05) but not at the gluteal level. In both M-F and F-M transsexuals, no effect of sex hormone administration was observed on stimulated lipolytic activities;In conclusion, regional sex differences in the amount of subcutaneous fat, adipocyte size, and in vitro basal lipolytic activity were demonstrated that could be largely reversed by cross-sex hormone treatment in adult subjects, providing evidence for their dependence on the sex steroid milieu. Copyright (C) 1999 by W.B. Saunders Company.

关键词：腹部脂细胞/代谢臀用药计划表雌二醇同源物/投药和剂量雌二醇同源物/药理学炔雌醇/投药和剂量炔雌醇/药理学性腺甾类激素/投药和剂量性腺甾类激素/药理学脂类代谢磁共振成像前瞻性研究睾酮/投药和剂量睾酮/药理学易性转化癖/代谢成年人女(雌)性人类男(雄)性

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