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Intravenous therapy  

PubMed Central

Intravenous administration of fluids, drugs, and nutrition is very common in hospitals. Although insertion of peripheral and central cannulae and subsequent intravenous therapy are usually well tolerated, complications that prolong hospitalisation, and in some cases cause death, can arise on occasions. Additionally, many cannulae are inserted unnecessarily. This article seeks to review this area and to outline good medical practice.

Waitt, C; Waitt, P; Pirmohamed, M



Early intervention of intravenous KB220IV--neuroadaptagen amino-acid therapy (NAAT) improves behavioral outcomes in a residential addiction treatment program: a pilot study.  


Substance use disorders (SUD) are inheritable and the culprit is hypodopaminergic function regulated by reward genes. We evaluated a natural dopaminergic agonist; KB220 intravenous (IV) and oral variants, to improve dopaminergic function in SUD. Our pilot experiment found a significant reduction of chronic symptoms, measured by the Chronic Abstinence Symptom Severity (CASS) Scale. The combined group (IV and oral) did significantly better than the oral-only group over the first week and 30-day follow-up period. Next, the combination was given to 129 subjects and three factors; Emotion, Somatic, and Impaired Cognition, with eigenvalues greater than one were extracted for baseline CASS-Revised (CASS-R) variables. Paired sample t-tests for pre and post-treatment scales showed significant declines (p = .00001) from pre- to post-treatment: t = 19.1 for Emotion, t = 16.1 for Somatic, and t = 14.9 for Impaired Cognition. In a two-year follow-up of 23 subjects who underwent KB220IV therapy (at least five IV treatments over seven days) plus orals for 30+ days: 21 (91%) were sober at six months, 19 (82%) having no relapse; 19 (82%) were sober at one year, 18 (78%) having no relapse; and 21 (91%) were sober two-years post-treatment, 16(70%) having no relapse. We await additional research and advise caution in interpreting these encouraging results. PMID:23457891

Miller, Merlene; Chen, Amanda L C; Stokes, Stan D; Silverman, Susan; Bowirrat, Abdalla; Manka, Matthew; Manka, Debra; Miller, David K; Perrine, Kenneth; Chen, Thomas J H; Bailey, John A; Downs, William; Waite, Roger L; Madigan, Margaret A; Braverman, Eric R; Damle, Uma; Kerner, Mallory; Giordano, John; Morse, Siobhan; Oscar-Berman, Marlene; Barh, Debmalya; Blum, Kenneth


Health Instruction Packages: Venipuncture and Intravenous Therapy.  

ERIC Educational Resources Information Center

|Text, illustrations, and exercises are utilized in these five learning modules to instruct nursing students in techniques for initiating intravenous (I.V.) therapy. The first module, "Selection of a Venipuncture Site: Arm" by P. Allen Gray, Jr., describes the utilization of a tourniquet in locating filled veins in the arm. The second module,…

Gray, P. Allen, Jr.; And Others


[Intravenous and subcutaneous immunoglobulin therapy].  


Patients with agammaglobulinaemia and hypogammaglobulinaemia require immunoglobulin G (IgG) replacement therapy to prevent serious infections. Since the 1950s, therapy with human immune globulin products has been the standard of treatment. Currently, the most common routes of administration of IgG replacement therapy are intravenous (IVIG) or subcutaneous (SCIG). The home therapy may improve the quality of life in patients who require lifelong IgG replacement. The -anti-IgA antibody test identifies the patients with the risk of anaphylactoid reactions in IVIG replacement. The SCIG delivery may be used in patients with anti-IgA antibodies and previous systemic reactions to IVIG. PMID:23964967

Vojt?ch, Thon



SBA - Botulism Immune Globulin Intravenous (Human) (BIG-IV ...  

Center for Biologics Evaluation and Research (CBER)

Text Version... Page 9. California Department of Health Services Botulism Immune Globulin Intravenous (Human) (BIG-IV) ... Length of stay in the intensive care unit ... More results from


Home intravenous therapy: Accessibility for Canadian children and youth  

PubMed Central

The administration of intravenous (IV) therapy at home is an alternative to hospitalization for treatment of infection and a number of other conditions, and has been demonstrated to be effective and safe, to reduce cost and to improve quality of life. While home IV therapy has many advantages for children, it is not uniformly available and access may be limited by age, geographical location and ability to pay. Physicians caring for children need to be aware of the indications for home IV therapy, its requirements and limitations, as well as whether this option is available for children in their care. Where access is limited, physicians should advocate for home IV therapy for children when it is medically indicated.

Moore, DL; Bortolussi, R



Intravenous Fluid Therapy Course for the Licensed Practical Nurse. Instructor Guide.  

ERIC Educational Resources Information Center

|This curriculum guide provides materials for a 10-unit intravenous (IV) therapy course for licensed practical nurses. Units contain from one to nine lessons. The first unit provides an introduction and orientation to the course. Subsequent units concern documentation, anatomy and physiology as applied to IV therapy, fundamental aspects of fluid…

Missouri Univ., Columbia. Instructional Materials Lab.


Intravenous immunoglobulin therapy in rheumatic diseases  

Microsoft Academic Search

Prepared from the collective plasma of several thousand people, therapeutic intravenous immunoglobulin (IVIg) consists mostly of human polyspecific IgG. In addition to its use in primary and secondary immune deficiencies, IVIg is used in the treatment of several rheumatic conditions, including Kawasaki disease, dermatomyositis and antineutrophil cytoplasmic antibody (ANCA)-positive vasculitis. In these diseases, IVIg therapy generally involves the use of

Jagadeesh Bayry; Vir Singh Negi; Srini V. Kaveri



Efficacy and Safety of Intravenous Iron Therapy for HCV-Positive Haemodialysis Patients  

Microsoft Academic Search

Background: Iron supplementation is the cornerstone of anaemia management in haemodialysis (HD) patients. However, efficacy and safety of intravenous (IV) iron therapy in hepatitis C virus (HCV)-positive HD patients is yet to be elucidated. Methods: Sixty-six maintenance HD patients with suboptimal response to recombinant human erythropoietin (rh-EPO) were administered IV iron. Each patient received 100 mg\\/session IV iron sucrose for

Serkan Kahraman; Rahmi Yilmaz; Gultekin Genctoy; Mustafa Arici; Bulent Altun; Yunus Erdem; Unal Yasavul; Cetin Turgan



Prolonging the life of a patient's IV: an integrative review of intravenous securement devices.  


In this integrative review, current research on the effectiveness of intravenous (IV) securement devices is described and practical implications for evidence-based practice in IV care are provided. PMID:23243786

Alekseyev, Sonya; Byrne, Melissa; Carpenter, Austin; Franker, Charlie; Kidd, Chelsea; Hulton, Linda


Incremental Cost Analysis of Ambulatory Clinic and Home-Based Intravenous Therapy for Patients with Multiple Myeloma  

Microsoft Academic Search

Background: Patients with multiple myeloma and other forms of cancer receiving pamidronate via intravenous (IV) infusion at the Hamilton Regional Cancer Centre in Hamilton, Ontario, Canada face 2 treatment options: they can have their entire treatment completed at the clinic using traditional IV therapy (e.g. IV bag and pole) or they can have the treatment initiated at the clinic and

Peter C. Coyte; Mark J. Dobrow; Larry Broadfield



Sodium ferric gluconate complex in sucrose: Safer intravenous iron therapy than iron dextrans  

Microsoft Academic Search

Use of recombinant human erythropoietin in patients with end-stage renal disease has highlighted iron deficiency as the major cause of resistant anemia. The current mainstay of intravenous (IV) iron replacement therapy, iron dextran, has been shown in prior studies to have a risk of serious life-threatening anaphylaxis of just under 1 per 100 patients exposed. The current study assessed the

Gerald Faich; Jur Strobos



Stability of benzylpenicillin during continuous home intravenous therapy  

Microsoft Academic Search

Objectives: The aim of this study was to investigate the temperature profile of home intravenous (iv) anti- biotic reservoirs and the stability of 16 megaunits of benzylpenicillin sodium in 120 mL of sodium chloride 0.9% at constant and variable temperatures. Methods: A Tinytag computerized thermometer recorded temperatures every minute in the home iv anti- biotic reservoir pouches of nine patients

Jane W. A. Vella-Brincat; Evan J. Begg; Kate Gallagher; Carl M. J. Kirkpatrick; Mei Zhang; Chris Frampton; Stephen T. Chambers



Clinical competency assessment in intravenous therapy and vascular access: part 2.  


This article explores and critically evaluates clinical practice competencies as a form of assessment within post-registration nurse education, specifically relating to competence assessment of intravenous (IV) therapy. In the first article in this two-part series, 'Competency assessment in intravenous therapy and vascular access: part 1' (BJN, 22(16)), an in-depth literature review was carried out and applied to current competency assessment design. Clinical staff opinion was sought to evaluate users' opinions of this assessment method against recommended literature. The aim of both articles is to describe critically and analyse existing practice using this form of assessment, and relate other forms of assessment to IV therapy and vascular access clinical competence. A small-scale study was performed to evaluate whether clinical competency assessment is the most appropriate form of assessment of IV therapy and vascular access skills. A questionnaire was designed to assess nurse opinion in relation to advantages (positives) and disadvantages (negatives) of clinical practice competency assessment; 35 randomly selected post-registered nurses were included in the sample. Findings illustrated that clinical competency assessment is the most appropriate form for the assessment of clinical skills in IV therapy. However, recommendations were made for the possible use of Objective Structured Clinical Examination (OSCE) assessment. Furthermore, this report recommends the assessment of theory and knowledge through written exams or multiple-choice questions (MCQs) as an addition to clinical practice competence assessment for IV therapy. PMID:24067310

Louise Hulse, Anna



Intravenous Immunoglobulin Therapy for Stevens-Johnson Syndrome  

Microsoft Academic Search

Stevens-Johnson syndrome (SJS) is an acute mucocutaneous disorder that can be associated with considerable morbidity. Several previous reports, all involving either adults with acquired immunodeficiency syndrome or children , suggest that intravenous immunoglobulin may be an effective treatment for SJS. We report a case of SJS in an immunocompetent adult whose condition improved dramatically after therapy with intravenous immunoglobulin.




Immune Globulin Intravenous (Human) Gammar®-P I.V  

Microsoft Academic Search

3% Albumin (Human), 5% sucrose, and 0.5% sodium chloride. The pH of the solution has been adjusted to 6.8 ± 0.4 with citric acid and\\/or sodium carbonate. Gammar ® -P I.V. contains no preservative. This product is intended for intra- venous administration. The heat treatment step employed in the manufacture of Gammar ® -P I.V., pasteurization at 60°C for 10


Intravenous immunoglobulin therapy of lupus pneumonitis.  


Acute lupus pneumonitis in an 11-year-old girl with lupus nephritis is reported. Chest radiograph and arterial blood gas parameters were suggestive of Acute Respiratory Distress Syndrome (ARDS). Definitive pulmonary infection was excluded by investigations and poor clinical response to antibiotics. The respiratory worsening warranted ventilatory support with very high pressures. A trial of intravenous immunoglobulin was given following which there was improvement in the ventilatory requirements by 36 hours. The child was successfully weaned off ventilator and discharged from ICU by day 7. The role of intravenous immunoglobulin during acute life threatening pulmonary emergencies in a case of SLE prompted this clinical brief. PMID:18057686

Chetan, G; Mahadevan, S; Sulanthung, Kikon; Narayanan, P



Intravenous nutrient therapy: the "Myers' cocktail".  


Building on the work of the late John Myers, MD, the author has used an intravenous vitamin-and-mineral formula for the treatment of a wide range of clinical conditions. The modified "Myers' cocktail," which consists of magnesium, calcium, B vitamins, and vitamin C, has been found to be effective against acute asthma attacks, migraines, fatigue (including chronic fatigue syndrome), fibromyalgia, acute muscle spasm, upper respiratory tract infections, chronic sinusitis, seasonal allergic rhinitis, cardiovascular disease, and other disorders. This paper presents a rationale for the therapeutic use of intravenous nutrients, reviews the relevant published clinical research, describes the author's clinical experiences, and discusses potential side effects and precautions. PMID:12410623

Gaby, Alan R



Providing IV therapy education to community nurses.  


The delivery of intravenous therapy (IVT) in the community has expanded considerably in the UK in the last 20 years. Although some primary care trusts are more actively engaged in providing intravenous services than others, whatever the degree of engagement, staff require knowledge and skills to practice safely. An education provider was commissioned by a group of trusts in West London to deliver education on the principles of IVT. Feedback suggested that this enabled nurses to challenge current intravenous practice in their areas and improve service delivery for the benefit of their patients. This article presents the basis of the curriculum delivered and experience of providing education in IVT to community nurses in West London. PMID:17167356

Depledge, Jane; Gracie, Fiona



Oral versus intravenous rehydration therapy in severe gastroenteritis  

Microsoft Academic Search

A controlled, randomised trial comparing the results of oral rehydration therapy with those of intravenous fluid treatment in 470 children with severe gastroenteritis was undertaken. The oral rehydration therapy was divided into two phases--a rehydration phase that used high sodium isotonic fluid at 40 ml\\/kg per hour and a maintenance phase using low sodium isotonic fluid (sodium 40, potassium 30,

J Sharifi; F Ghavami; Z Nowrouzi; B Fouladvand; M Malek; M Rezaeian; M Emami



Intravenous Versus Oral Outpatient Antibiotic Therapy for Pediatric Acute Osteomyelitis  

PubMed Central

The optimal route (oral versus intravenous) of antibiotic administration for pediatric acute osteomyelitis is not well established. Seventy-eight children from our university hospital and 17 children at our county hospital were treated for acute osteomyelitis. The rates of intravenous antibiotics upon discharge were 95% versus 65% (P=0.002), respectively. The recurrence rate and line complication rates were 10% and 24% at the university hospital, compared to 0% (P=0.34) and 6% (P=0.29) at the county hospital. Based on this data, a prospective comparison between intravenous and early oral antibiotic therapy for pediatric acute osteomyelitis is recommended.

Liu, Raymond W.; Abaza, Hadeel; Mehta, Priyesh; Bauer, Jennifer; Cooperman, Daniel R.; Gilmore, Allison



Intravenously administered vitamin C as cancer therapy: three cases  

PubMed Central

Early clinical studies showed that high-dose vitamin C, given by intravenous and oral routes, may improve symptoms and prolong life in patients with terminal cancer. Double-blind placebo-controlled studies of oral vitamin C therapy showed no benefit. Recent evidence shows that oral administration of the maximum tolerated dose of vitamin C (18 g/d) produces peak plasma concentrations of only 220 ?mol/L, whereas intravenous administration of the same dose produces plasma concentrations about 25-fold higher. Larger doses (50–100 g) given intravenously may result in plasma concentrations of about 14 000 ?mol/L. At concentrations above 1000 ?mol/L, vitamin C is toxic to some cancer cells but not to normal cells in vitro. We found 3 well-documented cases of advanced cancers, confirmed by histopathologic review, where patients had unexpectedly long survival times after receiving high-dose intravenous vitamin C therapy. We examined clinical details of each case in accordance with National Cancer Institute (NCI) Best Case Series guidelines. Tumour pathology was verified by pathologists at the NCI who were unaware of diagnosis or treatment. In light of recent clinical pharmacokinetic findings and in vitro evidence of anti-tumour mechanisms, these case reports indicate that the role of high-dose intravenous vitamin C therapy in cancer treatment should be reassessed.

Padayatty, Sebastian J.; Riordan, Hugh D.; Hewitt, Stephen M.; Katz, Arie; Hoffer, L. John; Levine, Mark



Social Work in a Home Intravenous Antibiotic Therapy Program  

Microsoft Academic Search

Home intravenous antibiotic therapy (HIVAT) grew out of one hospital's experience with home parenteral nutrition. Because of the current accelerated pace of discharge planning, the social worker plays a major role in choosing appropriate candidates for this program and in helping them solve practical and affective problems. Patients report a high degree of satisfaction with this homecare plan. Benefits such

John W. Sharp



Stage IV-S neuroblastoma. Results with definitive therapy  

SciTech Connect

The results of management of 14 patients with Stage IV-S neuroblastoma are reported. The treatment policy, although not consistent over this time span, in general used a combination of radiotherapy and chemotherapy or infrequently one modality alone. Twelve of 14 (86%) survived more than 6 years. One patient, with a solitary mediastinal primary tumor, died of rapidly progressive disease at three months. The other death occurred in a 4.5-year-old presenting with hepatomegaly at diagnosis followed by skeletal dissemination 2.5 years later. Thirteen of the patients were younger than 1 year of age. Of the 11 patients that received radiotherapy, 4 experienced mild asymptomatic scoliosis or kyphoscoliosis at 3 to 12 years after initial therapy. A review of the literature indicates that spontaneous regression in this tumor is very frequent; therefore, it is recommended that for the common presentation of massive hepatomegaly in an infant, close observation is warranted, unless life threatening complications occur. However, initial therapeutic intervention may be indicated in those patients with life threatening presentations. This data did not substantiate the necessity for complete surgical excision of the primary tumor, as has been suggested by others.

Stokes, S.H.; Thomas, P.R.; Perez, C.A.; Vietti, T.J.



Is Bridging with Intravenous Thrombolysis of Any Benefit in Endovascular Therapy for Acute Ischemic Stroke?  


OBJECTIVE: Large vessel occlusions with heavy clot burden are less likely to improve with intravenous (IV) thrombolysis alone. The purpose of this study was to show whether a combination of IV thrombolysis and endovascular therapy was superior to endovascular treatment alone. METHODS: Data for 104 patients with acute large artery occlusion treated between 2005 and 2010 were reviewed. Forty-two received endovascular therapy in combination with IV thrombolysis (bridging group), and 62 received endovascular therapy only. Clinical outcome, mortality rate, and symptomatic intracranial hemorrhage (sICH) rate were compared between the two groups. RESULTS: The two groups had similar demographic and vascular risk factor distribution, as well as National Institutes of Health Stroke Scale score on admission (mean ± SD: 14.8 ± 4.7 and 16.0 ± 5.3; P = 0.23). No difference was found in Thrombolysis in Myocardial Infarction recanalization rates (score of 2 or 3) after combined or endovascular therapy alone (83.33% and 79.03%; P = 0.585). Favorable outcome, defined as a modified Rankin Scale score of <2 at 90 days, also did not differ between the bridging group and the endovascular-only group (37.5% and 32.76%; P = 0.643). There was no difference in mortality rate (22.5% and 31.03%; P = 0.5618) and sICH rate (11.9% and 9.68%; P = 0.734). A significant difference was found in mean time from symptom onset to treatment in the bridging group and the endovascular-only group (227 ± 88 min vs. 125 ± 40 min; P < 0.0001). CONCLUSION: Combining IV thrombolysis with endovascular therapy resulted in similar outcome, revascularization, sICH, and mortality rates compared with endovascular therapy alone. Prospective clinical studies comparing both treatment strategies in acute ischemic stroke are warranted. PMID:23376392

Kass-Hout, Tareq; Kass-Hout, Omar; Mokin, Maxim; Thesier, Danielle M; Yashar, Parham; Orion, David; Jahshan, Shady; Hopkins, L Nelson; Siddiqui, Adnan H; Snyder, Kenneth V; Levy, Elad I



Intravenous mesenchymal stem cell therapy for traumatic brain injury  

PubMed Central

Object Cell therapy has shown preclinical promise in the treatment of many diseases, and its application is being translated to the clinical arena. Intravenous mesenchymal stem cell (MSC) therapy has been shown to improve functional recovery after traumatic brain injury (TBI). Herein, the authors report on their attempts to reproduce such observations, including detailed characterizations of the MSC population, non–bromodeoxyuridine-based cell labeling, macroscopic and microscopic cell tracking, quantification of cells traversing the pulmonary microvasculature, and well-validated measurement of motor and cognitive function recovery. Methods Rat MSCs were isolated, expanded in vitro, immunophenotyped, and labeled. Four million MSCs were intravenously infused into Sprague-Dawley rats 24 hours after receiving a moderate, unilateral controlled cortical impact TBI. Infrared macroscopic cell tracking was used to identify cell distribution. Immunohistochemical analysis of brain and lung tissues 48 hours and 2 weeks postinfusion revealed transplanted cells in these locations, and these cells were quantified. Intraarterial blood sampling and flow cytometry were used to quantify the number of transplanted cells reaching the arterial circulation. Motor and cognitive behavioral testing was performed to evaluate functional recovery. Results At 48 hours post-MSC infusion, the majority of cells were localized to the lungs. Between 1.5 and 3.7% of the infused cells were estimated to traverse the lungs and reach the arterial circulation, 0.295% reached the carotid artery, and a very small percentage reached the cerebral parenchyma (0.0005%) and remained there. Almost no cells were identified in the brain tissue at 2 weeks postinfusion. No motor or cognitive functional improvements in recovery were identified. Conclusions The intravenous infusion of MSCs appeared neither to result in significant acute or prolonged cerebral engraftment of cells nor to modify the recovery of motor or cognitive function. Less than 4% of the infused cells were likely to traverse the pulmonary microvasculature and reach the arterial circulation, a phenomenon termed the “pulmonary first-pass effect,” which may limit the efficacy of this therapeutic approach. The data in this study contradict the findings of previous reports and highlight the potential shortcomings of acute, single-dose, intravenous MSC therapy for TBI.

Harting, Matthew T.; Jimenez, Fernando; Xue, Hasan; Fischer, Uwe M.; Baumgartner, James; Dash, Pramod K.; Cox, Charles S.



Infection control in IV therapy: a review of the chain of infection.  


The aim of this article is to review the principles of infection control relating to intravenous (IV) therapy. IV therapy and peripheral IV cannulation are common procedures. Zingg and Pittet (2009) noted that as many as 80% of hospitalized patients will have a cannula in situ, and Hart (2008) suggested that patients who require IV therapy are often seriously ill and immunocompromised, thus are more susceptible to infection. The Department of Health (DH) (2007a) estimated that 6000 patients acquire a catheter-related bloodstream infection every year in the UK. Robust standards of practice are therefore paramount to ensure safe and competent practice, both in peripheral IV cannulation and IV care. Using the chain of infection as a framework to review practice will enable practitioners to ensure thorough standards of practice, and the Royal College of Nursing (RCN) (2005) stated that only trained and competent staff using strict aseptic techniques should be involved in IV or cannulae care. Furthermore, the Code (Nursing and Midwifery Council (NMC), (2008) stipulates all practitioners must deliver care based on the best available evidence and/or best practice, and that knowledge and skills for safe and effective practice must be kept up-to-date throughout each health professional's working life. PMID:21042241

Lavery, Irene


Familial Occurrence of Pulmonary Embolism after Intravenous, Adipose Tissue-Derived Stem Cell Therapy  

PubMed Central

The therapeutic potential of human multipotent mesenchymal stromal cells, especially human adipose tissue-derived stem cells (hASC), is promising. However, there are concerns about the safety of infusion of hASC in human. Recently, we have experienced pulmonary embolism and infarct among family members who have taken multiple infusions of intravenous autologous hASC therapy. A 41-year-old man presented with chest pain for one month. Chest CT showed multiple pulmonary artery embolism and infarct at right lung. Serum D-dimer was 0.8 µg/mL (normal; 0-0.5 µg/mL). He had received intravenous autologous adipose tissue-derived stem cell therapy for cervical herniated intervertebral disc three times (one, two, and three months prior to the visit). His parents also received the same therapy five times and their chest CT also showed multiple pulmonary embolism. These cases represent artificial pulmonary embolisms and infarct after IV injection of hASC. Follow-up chest CT showed spontaneous resolution of lesions in all three patients.

Jung, Jae Woo; Kwon, Minsuk; Choi, Jae Chol; Shin, Jong Wook; Park, In Won; Choi, Byoung Whui



Hypotension with intravenous immunoglobulin therapy: importance of pH and dimer formation  

Microsoft Academic Search

Therapy with intravenous immunoglobulin preparations has been used effectively in a wide range of conditions. Although generally well tolerated, intravenous immunoglobulin preparations may be associated with transient hypotension in some patients. This study examined the role of different immunoglobulin G fractions in the development of intravenous immunoglobulin-induced hypotension in an anaesthetized rat model and assessed the effects of a new

Monika Kroez; Ernst-Jürgen Kanzy; Peter Gronski; Gerhard Dickneite



The fate of intravenously administered tetrahydrobiopterin and its implications for heterologous gene therapy of phenylketonuria  

PubMed Central

Tetrahydrobiopterin (BH4) is a required cofactor for the enzymatic activity of phenylalanine hydroxylase (PAH) and is synthesized de novo from GTP in several tissues. Heterologous expression of PAH in tissues other than liver is a potential novel therapy for human phenylketonuria that is completely dependent upon BH4 supply in the PAH-expressing tissue. Previous experiments with liver PAH-deficient transgenic mice that expressed PAH in skeletal muscle demonstrated transient correction of hyperphenylalaninemia only with hourly parenteral BH4 administration. In this report, the fate of intravenously administered BH4 is examined. The conclusions are that (1) BH4 administered intravenously is rapidly taken up by liver and kidney, and (2) uptake of BH4 into muscle is relatively low. The levels of BH4 achieved in skeletal muscle following IV injection are only 10% of the amount expected were BH4 freely and equally distributed across all tissues. The half-life of BH4 in muscle is approximately 30 min, necessitating repeated injections to maintain muscle BH4 content sufficient to support phenylalanine hydroxylation. The efficacy of heterologous muscle-directed gene therapy for the treatment of PKU will likely be limited by the BH4 supply in PAH-expressing muscle.

Harding, Cary O.; Neff, Mark; Wild, Krzysztof; Jones, Kelly; Elzaouk, Lina; Thony, Beat; Milstien, Sheldon



Intravenous immunoglobulin g therapy in fetal and neonatal alloimmune thrombocytopenia.  


Neonatal alloimmune thrombocytopenia (NAIT) is a rare disorder in the neonatal period, occurring in 1 in 2000 to 5000 births. The clinical syndrome of NAIT can be varied, but the resulting thrombocytopenia can be very severe and can result in serious haemorrhage in the fetus and neonate. At least 5 human platelet antigen systems have been described, and all have been implicated in cases of NAIT. Approximately 50% of platelet antigen-incompatible firstborn infants will be affected. The risk of recurrence in subsequent pregnancies is high, estimated at >75%, with the disease being either equally or more severe than in the first infant. Mortality in NAIT is estimated to be 10%, and is usually associated with intracranial haemorrhage. The incidence of intracranial haemorrhage is estimated to be approximately 14%, with approximately 25% occurring antenatally. In an effort to prevent these severe complications, therapy is usually instituted in infants with severe thrombocytopenia from NAIT. Treatment strategies have included appropriate, compatible platelet transfusion, corticosteroid use and exchange transfusion. However, success in treating immune-mediated thrombocytopenia with intravenous immunoglobulins (IVIg) has prompted the use of this therapy in fetuses and infants with NAIT. IVIg has demonstrated efficacy in both of these clinical situations. The literature concerning the use of IVIg, both ante- and post-natally, is reviewed, and treatment strategies for infants and fetuses affected by NAIT are discussed. PMID:18020518

Dunsmore, K P



The effect of intravenous nitroglycerin therapy on infarct size in patients with acute myocardial infarction.  


The authors investigated the influence of glyceryl-trinitrate (NTG) given intravenously to the reduction of infarction size in 95 patients (71 men and 24 women) aged 36 to 75, with acute myocardial infarction (AIM) admitted to the Intensive Care Unit within six hours of the onset of pain. Infarction mass was calculated by mathematical model from the serial changes of CK and CK MB serum activities during 72 hours and expressed in CK and CK MB gEq. CK and CK MB were determined every four hours. The patients were divided into four groups according to the therapy they were receiving: I--NTG i.v. (n = 29); II SK + NTG i.v. (n = 29); III SK i.v. (n = 17) and IV ISDN per os (n = 20). Each group was divided into subgroups regarding the time interval from the onset of pain to the beginning of the therapy (within three hours and after three hours). Application of NTG i.v. in the early phase of AIM, 0-3 hours from the onset of pain, led to the significant reduction of infarction mass CK gEq and CK MB gEq (0-3 hours; middle rank = 11.35; 3-6 hours: middle rank = 17.7) (P < 0.05) and 0-3 hours: middle rank = 10.31; 3-6 hours: middle rank = 18.81 (P < 0.01). It was established that the "timing" factor was very important in the preservation of myocardial mass in AIM. It affirms the efficacy of NTG i.v., i.e., its direct effects on the coronary arteries and systemic effects that cause salvation of the myocardium. The influence of NTG iv to myocardial infarction size CK gEq did not depend on ECG localization. But it influenced the ECG localization when the infarction size was calculated from CK MB isoenzyme and expressed in CK MB gEq. Infarction mass CK MB gEq was statistically significantly smaller in the inferior than in the anterior localization (P < 0.05). PMID:7633178

Raos, V; Jeren-Struji?, B; Ljuti?, D; Horvatin-Godler, S; Straus, B



Use of continuous ambulatory infusions of concentrated subcutaneous (SQ) hydromorphone versus intravenous (IV) morphine: Cost implications for palliative care  

Microsoft Academic Search

Health care practitioners are increasingly under pressure to curtail spending while trying to deliver excellent patient care. These issues are also affecting palliative care, particularly now that palliative care programs are expanding. A comparison of cost-effectiveness and feasibility of using continuous subcutaneous (SQ) ambulatory infusion of hydromorphone versus intravenous (IV) ambulatory morphine is illustrated in this study. With the high

Jeffrey Fudin; Howard S. Smith; Charlotte S. Toledo-Binette; Ellen Kenney; Andrew B. C. Yu; Ronald Boutin



Long-term effects of intravenous iloprost in patients with idiopathic pulmonary arterial hypertension deteriorating on non-parenteral therapy  

PubMed Central

Background The majority of patients with idiopathic pulmonary arterial hypertension (IPAH) in functional classes II and III are currently being treated with non-parenteral therapies, including endothelin receptor antagonists (ERA), phosphodiesterase (PDE)-5 inhibitors, inhaled iloprost or combinations of these substances. If these treatments fail, current guidelines recommend the addition of parenteral prostanoid therapy. There is, however, limited evidence for the efficacy of parenteral prostanoids when added to combinations of non-parenteral therapies. Methods In this retrospective, multicentre study we collected data from consecutive IPAH patients receiving intravenous iloprost in addition to optimized non-parenteral therapy between Jan 2002 and Dec 2009. Analyses included 6 min walk distance (6MWD), functional class, need for transplantation, and survival. Results During the observation period, 50 patients were treated with intravenous iloprost in addition to non-parenteral therapy; 44% of the patients were on dual combination therapy and 52% on triple combination. Three months after initiation of iloprost, functional class had improved in 24% of the patients and the median 6MWD had increased from 289 m to 298 m (n.s.). During the observation period, 22 patients (44%) died and 14 (28%) underwent lung transplantation. The probabilities of LuTx-free survival at 1, 3 and 5 years following iloprost initiation were 38%, 17% and 17%, respectively. A 6MWD < 300 m and persistent functional class IV at 3 months after initiation of intravenous iloprost were predictors of an adverse outcome. Conclusion In essence, late initiation of intravenous iloprost in IPAH patients who previously failed to respond to non-parenteral therapies appears to be of limited efficacy in the majority patients. Alternative therapeutic options are currently not available, underlying the need for the development of new drugs.



Predictors of nonresponse to intravenous immunoglobulin therapy in Kawasaki disease  

PubMed Central

Purpose It has been reported that 10% to 20% of children with Kawasaki disease (KD) will not respond to intravenous immunoglobulin (IVIG) treatment. In this study, we aimed to identify useful predictors of therapeutic failure in children with KD. Methods We examined 309 children diagnosed with KD at the Kyungpook National University Hospital and the Inje University Busan Paik Hospital between January 2005 and June 2011. We retrospectively reviewed their medical records and analyzed multiple parameters in responders and nonresponders to IVIG. Results Among the 309 children, 30 (9.7%) did not respond to IVIG. They had significantly higher proportion of neutrophils, and higher levels of aspartate aminotransferase, alanine aminotransferase (ALT), total bilirubin, and N-terminal fragment of B-type natriuretic peptide than did responders. IVIG-nonresponders had a significantly longer duration of hospitalization, and more frequently experienced coronary artery lesion, and sterile pyuria. No differences in the duration of fever at initial treatment or, clinical features were noted. Conclusion Two independent predictors (ALT?84 IU/L, total bilirubin?0.9 mg/dL) for nonresponse were confirmed through multivariate logistic regression analysis. Thus elevated ALT and total bilirubin levels might be useful in predicting nonresponse to IVIG therapy in children with KD.

Park, Hyo Min; Hyun, Myung Chul; Lee, Sang Bum



Intravenous ascorbic acid as an adjuvant therapy for recombinant erythropoietin in hemodialysis patients with hyperferritinemia  

Microsoft Academic Search

Intravenous ascorbic acid as an adjuvant therapy for recombinant erythropoietin in hemodialysis patients with hyperferritinemia.BackgroundInadequate iron mobilization and defective iron utilization may cause recombinant erythropoietin (rEPO) hyporesponsiveness in hemodialysis (HD) patients with iron overload. We have demonstrated that intravenous ascorbic acid (IVAA), but not intravenous iron medication, can effectively circumvent the functional iron-deficient erythropoiesis associated with iron overload in HD

Der-Cherng Tarng; Yau-Huei Wei; Tung-Po Huang; Benjamin I. T. Kuo; Wu-Chang Yang



Impact of a dedicated intravenous therapy team on nosocomial bloodstream infection rates  

Microsoft Academic Search

Background: Meticulous care of intravenous catheters could be expected to minimize associated nosocomial bloodstream infections, but care is often suboptimal.Methods: To examine the ostensible benefits of a professional, dedicated intravenous therapy team, we compared the secular trends in nosocomial bloodstream infections before and after such a team was established.Results: After the introduction of the team at the Veterans Administration Medical

Patricia A. Meier; Mary Fredrickson; Michael Catney; Mary D. Nettleman



Intravenous iron therapy: how far have we come?  

PubMed Central

Oral iron supplementation is usually the first choice for the treatment of iron deficiency anemia (IDA) because of its effectiveness and low cost. But unfortunately in many iron deficient conditions, oral iron is a less than the ideal treatment mainly because of adverse events related to the gastrointestinal tract as well as the long course required to treat anemia and replenish body iron stores. The first iron product for intravenous use was high-molecular-weight iron dextran. However, dextran-containing intravenous iron preparations are associated with an elevated risk of anaphylactic reactions, which made physicians reluctant to prescribe intravenous iron in the treatment of iron deficiency anemia for many years. In 1999 and 2001, two new intravenous iron preparations (ferric gluconate and iron sucrose) were introduced into the market as safer alternatives to iron dextran. Over the last five years, three new intravenous iron dextran-free preparations have been developed and have better safety profiles than the more traditional intravenous compounds, as none require test doses and all these products are promising in respect to a more rapid replacement of body iron stores (15-60 minutes/infusion) as they can be given at higher doses (from 500 mg to more than 1000 mg/infusion). The purpose of this review is to discuss some pertinent issues in relation to the history, pharmacology, administration, efficacy, safety profile and toxicity of intravenous iron for the treatment of iron deficiency anemia.

Cancado, Rodolfo Delfini; Munoz, Manuel



Intravenous Therapy in Burn Patients: Suppurative Thrombophlebitis and Other Life-Threatening Complications.  

National Technical Information Service (NTIS)

Intravenous therapy, although essential to the resuscitation of the extensively burned patient, has been associated with complications in 10% of burn patients treated in the years 1967 and 1968. Suppurative phlebitis, noted in 4% of burn patients treated ...

B. A. Pruitt J. M. Stein F. D. Foley J. Moncrief J. A. O'Neill



Suppurative Thrombophlebitis, a Lethal Complication of Intravenous Therapy.  

National Technical Information Service (NTIS)

Suppurative thrombophlebitis is a serious complication of the use of indwelling polyethylene catheters for the prolonged administration of intravenous fluids. It is a common and yet occult cause of death in burned patients. Most patients are asymptomatic....

J. A. O'Neill B. A. Pruitt F. D. Foley J. A. Moncrief



Effective intravenous cyclosporin therapy in a patient with severe Crohn's disease on parenteral nutrition.  

PubMed Central

We report a patient with severe Crohn's disease and the short bowel syndrome on parenteral feeding who was not responding to conventional therapy and underwent treatment with cyclosporin (CyA) given initially intravenously and subsequently orally in each of two courses. Plasma drug concentrations were largely kept within the therapeutic range but wide variability was observed on oral therapy. Improvement both clinically and by objective assessment, was observed on intravenous CyA therapy, but was not sustained when the drug was given orally for several months. None of the side effects observed resisted treatment or was severe enough to warrant discontinuation of therapy. These findings suggest that there may be a place for intravenous CyA therapy in patients with severe Crohn's disease who do not respond to conventional therapy or to oral treatment with CyA.

Allam, B F; Tillman, J E; Thomson, T J; Crossling, F T; Gilbert, L M



Early Neurological Deterioration following Intravenous Recombinant Tissue Plasminogen Activator Therapy in Patients with Acute Lacunar Stroke  

Microsoft Academic Search

Background: The aim of this study was to examine the rate of early neurological deterioration (END) and favorable outcomes after acute lacunar stroke following the use of intravenous recombinant tissue plasminogen activator (IV rtPA). Methods: A total of 76 acute lacunar stroke patients (<12 h from symptom onset) were enrolled during a 1-year period (n = 76). Comparisons were made

Yang-Ha Hwang; Jong-Geun Seo; Ho-Won Lee; Sung-Pa Park; Chung-Kyu Suh



Intravenous Immunoglobulin as Adjunctive Therapy for Juvenile Spasms  

Microsoft Academic Search

Intravenous immunoglobulin has been reported to be an effective treatment for infantile spasms. Juvenile spasms are electrically and clinically similar to infantile spasms but occur in a later age group. We retrospectively reviewed the charts of five children (aged 4.5—11.5 years) at our institution. Their primary seizure type was juvenile spasms and they were treated with a single inpatient course

Ulrike Bingel; Joseph D. Pinter; Márcio Sotero de Menezes; Jong M. Rho



Intravenous Ulinastatin Therapy for Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis in Pediatric Patients  

Microsoft Academic Search

Background: More effective therapy is needed for the treatment of Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). The clinical efficacy of intravenous ulinastatin therapy was investigated in 3 Japanese pediatric patients with SJS or TEN. Methods: Ulinastatin was given to 1 pediatric SJS patient and 2 pediatric TEN patients within 7 days (patient 1; SJS), 6 days (patient 2;

Yasuji Inamo; Takahiro Okubo; Mika Wada; Sachiko Fuchigami; Kouji Hashimoto; Tatsuo Fuchigami; Shigeru Takahashi; Shigemasa Sawada; Kensuke Harada



Early and prolonged intravenous immunoglobulin replacement therapy in childhood agammaglobulinemia: A retrospective survey of 31 patients  

Microsoft Academic Search

Objective: To evaluate the outcome of children who received prolonged intravenous immunoglobulin (IVIg) replacement therapy early in life for X-linked agammaglobulinemia (XLA). Study design: We performed a retrospective study of the clinical features and outcome of patients with genetic and\\/or immunologic results consistent with XLA. Patients receiving IVIg replacement therapy within 3 months of the diagnosis and for at least

Pierre Quartier; Marianne Debré; Jacques De Blic; Rodolphe de Sauverzac; Natacha Sayegh; Nada Jabado; Elie Haddad; Stéphane Blanche; Jean-Laurent Casanova; C. I. Edvard Smith; Françoise Le Deist; Geneviève de Saint Basile; Alain Fischer



Efficacy and adverse effects of intravenous lignocaine therapy in fibromyalgia syndrome  

PubMed Central

Background To investigate the effects of intravenous lignocaine infusions (IV lignocaine) in fibromyalgia. Methods Prospective study of the adverse effects of IV lignocaine in 106 patients with fibromyalgia; retrospective questionnaire study of the efficacy of IV lignocaine in 50 patients with fibromyalgia. Results Prospective study: Two major (pulmonary oedema and supraventricular tachycardia) and 42 minor side-effects were reported. None had long-term sequelae. The commonest was hypotension (17 cases). Retrospective study: Pain and a range of psychosocial measures (on single 11-point scales) improved significantly after treatment. There was no effect of the treatment on work status. The average duration of pain relief after the 6-day course of treatment was 11.5 ± 6.5 weeks. Conclusions Intravenous lignocaine appears to be both safe and of benefit in improving pain and quality of life for patients with fibromyalgia. This needs to be confirmed in prospective randomised controlled trials.

Raphael, JH; Southall, JL; Treharne, GJ; Kitas, GD



High-dose intravenous immunoglobulin therapy in juvenile myasthenia gravis  

Microsoft Academic Search

Autoimmune neurologic disease management has been significantly modified by the use of high-dose intravenous immunoglobulin (HDIVIG) during the past 15 years. Venous access, readily available IgG (until recently), and the relative lack of serious identifiable complications have prompted its use in myasthenia gravis. In adults, its effectiveness has been inconsistent, with variable acetylcholine receptor (AChR) antibody responses. Ten children were

Duygu Selcen; Edward R Dabrowski; Anne M Michon; Michael A Nigro



Bedside Coagulometry During Intravenous Heparin Therapy after Coronary Angioplasty  

Microsoft Academic Search

In order to assess the applicability of a bedside coagulometer for measurement of b-APTT, serial blood samples were obtained from 20 patients receiving intravenous heparin treatment following PTCA, and from 5 healthy volunteers. B-APTT was analysed bedside on the Hemochron® coagulometer; p-APTT and p-heparin, measured as?factor anti-Xa activity, were analysed ex-vivo in the laboratory. B-APTT values, determined by the Hemochron

Anne Pauline Schroeder; Lars Lyhne Knudsen; Steen E. Husted; Jørgen Ingerslev



PAC March 2013 - Nexium and Nexium IV Safety Review  

Center for Biologics Evaluation and Research (CBER)

Text Version... As soon as oral therapy is possible or appropriate, intravenous therapy with NEXIUM IV for Injection should be discontinued and the therapy should ... More results from


Propylene glycol-induced side effects during intravenous nitroglycerin therapy  

Microsoft Academic Search

Propylene glycol, an alcohol frequently used as a solvent in medical preparations, is considered non-toxic. We found that this solvent, used in a commercially available IV nitroglycerin solution, may cause hyperosmolality, hemolysis and lactic acidosis. The influence of kidney function as the main determinant in causing accumulation of this solvent and consequently hyperosmolality is emphasized. A review of the literature

H. E. Demey; R. A. Daelemans; G. A. Verpooten; M. E. Broe; Ch. M. Campenhout; F. V. Lakiere; P. J. Schepens; L. L. Bossaert



Endovascular Therapy after Intravenous t-PA versus t-PA Alone for Stroke  

PubMed Central

BACKGROUND Endovascular therapy is increasingly used after the administration of intravenous tissue plasminogen activator (t-PA) for patients with moderate-to-severe acute ischemic stroke, but whether a combined approach is more effective than intravenous t-PA alone is uncertain. METHODS We randomly assigned eligible patients who had received intravenous t-PA within 3 hours after symptom onset to receive additional endovascular therapy or intravenous t-PA alone, in a 2:1 ratio. The primary outcome measure was a modified Rankin scale score of 2 or less (indicating functional independence) at 90 days (scores range from 0 to 6, with higher scores indicating greater disability). RESULTS The study was stopped early because of futility after 656 participants had undergone randomization (434 patients to endovascular therapy and 222 to intravenous t-PA alone). The proportion of participants with a modified Rankin score of 2 or less at 90 days did not differ significantly according to treatment (40.8% with endovascular therapy and 38.7% with intravenous t-PA; absolute adjusted difference, 1.5 percentage points; 95% confidence interval [CI], ?6.1 to 9.1, with adjustment for the National Institutes of Health Stroke Scale [NIHSS] score [8–19, indicating moderately severe stroke, or ?20, indicating severe stroke]), nor were there significant differences for the predefined subgroups of patients with an NIHSS score of 20 or higher (6.8 percentage points; 95% CI, ?4.4 to 18.1) and those with a score of 19 or lower (?1.0 percentage point; 95% CI, ?10.8 to 8.8). Findings in the endovascular-therapy and intravenous t-PA groups were similar for mortality at 90 days (19.1% and 21.6%, respectively; P = 0.52) and the proportion of patients with symptomatic intracerebral hemorrhage within 30 hours after initiation of t-PA (6.2% and 5.9%, respectively; P = 0.83). CONCLUSIONS The trial showed similar safety outcomes and no significant difference in functional independence with endovascular therapy after intravenous t-PA, as compared with intravenous t-PA alone. (Funded by the National Institutes of Health and others; number, NCT00359424.)

Broderick, Joseph P.; Palesch, Yuko Y.; Demchuk, Andrew M.; Yeatts, Sharon D.; Khatri, Pooja; Hill, Michael D.; Jauch, Edward C.; Jovin, Tudor G.; Yan, Bernard; Silver, Frank L.; von Kummer, Rudiger; Molina, Carlos A.; Demaerschalk, Bart M.; Budzik, Ronald; Clark, Wayne M.; Zaidat, Osama O.; Malisch, Tim W.; Goyal, Mayank; Schonewille, Wouter J.; Mazighi, Mikael; Engelter, Stefan T.; Anderson, Craig; Spilker, Judith; Carrozzella, Janice; Ryckborst, Karla J.; Janis, L. Scott; Martin, Renee H.; Foster, Lydia D.; Tomsick, Thomas A.



Absence of Toxicity of Chronic Weekly Intravenous Gene Therapy with Pegylated Immunoliposomes  

Microsoft Academic Search

Purpose. Plasmid DNA-based gene therapy involves episomal gene expression and must be given on a chronic basis. Therefore, the purpose of the present study was to examine for toxic side effects of the chronic weekly intravenous administration of plasmid DNA delivered with a nonviral gene transfer method using pegylated immunoliposomes (PIL).

Yu-feng Zhang; Ruben J. Boado; William M. Pardridge



Side Effects of Combined Therapy of Methylprednisolone and Intravenous Immunoglobulin in Guillain-Barré Syndrome  

Microsoft Academic Search

Side effects were compared in 9 patients with Guillain-Barré syndrome treated with standard intravenous immunoglobulin (IVIg) only and in 9 treated with combined methylprednisolone and IVIg therapy. Headache occurred in 2 in both groups, indicative that pre-infusion with steroids does not prevent headache. Transient liver function disturbances were present in 2 patients of the former group and in 6 of

M. Odaka; M. Tatsumoto; E. Hoshiyama; K. Hirata; N. Yuki



The utility of zinc protoporphyrin for predicting the need for intravenous iron therapy in hemodialysis patients  

Microsoft Academic Search

The optimal method for diagnosing iron deficiency in end-stage renal disease is an area of controversy. This study compared the use of zinc protoporphyrin (ZPP) with the use of conventional tests for determination of iron deficiency when evaluating the need for intravenous iron therapy in hemodialysis patients maintained on erythropoietin (EPO). A baseline survey was performed in all hemodialysis patients

Steven Fishbane; Robert I. Lynn



Cardiac transplant outcome of patients supported on left ventricular assist device vs intravenous inotropic therapy  

Microsoft Academic Search

BackgroundAlthough the left ventricular assist device (LVAD) has been increasingly used as a bridge to transplant, its effect on post-transplant outcome is uncertain. We, therefore, designed this study using the Cardiac Transplant Research Database to compare patients supported on an LVAD before transplant with those treated with intravenous inotropic medical therapy.

Brian E Jaski; Joseph C Kim; David C Naftel; John Jarcho; Maria Rosa Costanzo; Howard J Eisen; James K Kirklin; Robert C Bourge



Intravenous immunoglobulins in immunodeficiencies: more than mere replacement therapy.  


Intravenous immunoglobulin (IVIG) is a therapeutic compound prepared from pools of plasma obtained from several thousand healthy blood donors. For more than 20 years, IVIG has been used in the treatment of a wide range of primary and secondary immunodeficiencies. IVIG now represents a standard therapeutic option for most antibody deficiencies. Routinely, IVIG is used in patients with X-linked agammaglobulinaemia (XLA), common variable immunodeficiency (CVID), X-linked hyper-IgM, severe combined immunodeficiency, Wiskott-Aldrich syndrome, and selective IgG class deficiency. In addition, IVIG is used extensively in the treatment of a wide variety of autoimmune disorders. IVIG is administered at distinct doses in the two clinical settings: whereas immunodeficient patients are treated with replacement levels of IVIG, patients with autoimmune and inflammatory diseases are administered with very high doses of IVIG. Several lines of experimental evidence gathered in the recent years suggest that the therapeutic beneficial effect of IVIG in immunodeficiencies reflects an active role for IVIG, rather than a mere passive transfer of antibodies. PMID:21466545

Kaveri, S V; Maddur, M S; Hegde, P; Lacroix-Desmazes, S; Bayry, J



Intravitreal vancomycin and amikacin versus intravenous imipenem in the treatment of experimental Staphylococcus aureus endophthalmitis  

Microsoft Academic Search

Background: Controversy still surrounds the intravenous (IV) treatment of endophthalmitis. The purpose of this study was to compare IV and intraocular (IO) treatment in experimental Staphylococcus aureus endophthalmitis: intravitreal injection of vancomycin and amikacin (VA\\/AN) in comparison with IV imipenem (IPM) and a combination of IV and IO (IV+IO) therapy. Methods: The right eyes of 27 rabbits were injected with

Michael Engelbert; Herminia Miño de Kaspar; Martin Thiel; Thomas Grasbon; Christopher N. Ta; Markus Schulze-Schwering; Volker Klauss; Anselm Kampik



Aggressive Blood Pressure--Lowering Treatment Before Intravenous Tissue Plasminogen Activator Therapy in Acute Ischemic Stroke  

PubMed Central

Background Patients with acute ischemic stroke (AIS) commonly have elevated blood pressure (BP). Guidelines have recommended against treatment with intravenous tissue plasminogen activator (tPA) when aggressive measures such as continuous infusion with nicardipine hydrochloride are required to maintain BP lower than 185/110 mm Hg. We evaluated the effect of elevated BP and its management on clinical outcomes after tPA therapy in AIS. Objectives To evaluate safety and outcome in patients with AIS who require treatment to lower BP before tPA therapy and to compare safety and outcome in patients who received aggressive treatment with nicardipine with those who received labetalol hydrochloride before tPA. Design Retrospective review of medical records for all patients who received intravenous tPA within 3 hours of AIS onset. Setting Emergency department. Patients One hundred seventy-eight patients with AIS treated with tPA. Main Outcome Measures Occurrence of symptomatic intracerebral hemorrhage and neurologic deterioration. Results Fifty patients required BP lowering before tPA therapy. Twenty-four of these patients (48%) received nicardipine either after labetalol or as first-line therapy. Patients requiring antihypertensive agents had higher baseline blood glucose concentrations, incidence of hypertension, and National Institutes of Health Stroke Scale scores. The rate of adverse events and of modified Rankin score at discharge were not significantly different in patients without BP-lowering treatment compared with patients given either labetalol or nicardipine before intravenous tPA therapy. Conclusions Blood pressure lowering before intravenous tPA therapy, even using aggressive measures, may not be associated with a higher rate of hemorrhage or poor outcome. Data suggest that patients with AIS requiring aggressive treatment to lower BP should not be excluded from receiving tPA therapy. A prospective study is needed to support these conclusions.

Martin-Schild, Sheryl; Hallevi, Hen; Albright, Karen C.; Khaja, Aslam M.; Barreto, Andrew D.; Gonzales, Nicole R.; Grotta, James C.; Savitz, Sean I.



Developing a strategic approach for IV therapy in the community.  


The development of home intravenous therapy (IVT) services is of benefit to patients and organizations, particularly as it can facilitate early discharge from hospital or avoid hospital admission. However in providing an IVT education/refresher programme to local primary care trusts, we have found that not all of them, by their own admission, could engage in the expansion of IVT services as they did not have measures in place to support robust service delivery. Building on the authors' recent experience of assisting staff, via an education/refresher programme, to update their services, this article offers direction to other PCTs who may be struggling to update their services in times of reform and unprecedented change within the health service. PMID:17170645

Depledge, Jane; Gracie, Fiona



Intravenous iron sucrose: Establishing a safe dose  

Microsoft Academic Search

It is now recognized that the majority of patients on epoetin therapy require intravenous (IV) iron supplementation to maximize the response to treatment. Of the IV iron preparations available, iron sucrose has proved its efficacy and safety; however, there are no guidelines or systematic studies examining the optimum safe dosage regimen for this compound. The aim of the present study

Georgina Chandler; Jatinder Harchowal; Iain C. Macdougall



Gene Expression Changes Associated with Resistance to Intravenous Corticosteroid Therapy in Children with Severe Ulcerative Colitis  

PubMed Central

Background and Aims Microarray analysis of RNA expression allows gross examination of pathways operative in inflammation. We aimed to determine whether genes expressed in whole blood early following initiation of intravenous corticosteroid treatment can be associated with response. Methods From a prospectively accrued cohort of 128 pediatric patients hospitalized for intravenous corticosteroid treatment of severe UC, we selected for analysis 20 corticosteroid responsive (hospital discharge or PUCAI ?45 by day 5) and 20 corticosteroid resistant patients (need for second line medical therapy or colectomy, or PUCAI >45 by day 5). Total RNA was extracted from blood samples collected on day 3 of intravenous corticosteroid therapy. The eluted transcriptomes were quantified on Affymetrix Human Gene 1.0 ST arrays. The data was analysed by the local-pooled error method for discovery of differential gene expression and false discovery rate correction was applied to adjust for multiple comparisons. Results A total of 41 genes differentially expressed between responders and non-responders were detected with statistical significance. Two of these genes, CEACAM1 and MMP8, possibly inhibited by methylprednisolone through IL8, were both found to be over-expressed in non-responsive patients. ABCC4 (MRP4) as a member of the multi-drug resistance superfamily was a novel candidate gene for corticosteroid resistance. The expression pattern of a cluster of 10 genes selected from the 41 significant hits were able to classify the patients with 80% sensitivity and 80% specificity. Conclusions Elevated expression of several genes involved in inflammatory pathways was associated with resistance to intravenous corticosteroid therapy early in the course of treatment. Gene expression profiles may be useful to classify resistance to intravenous corticosteroids in children with severe UC and assist with clinical management decisions.

Hyams, Jeffrey; Mack, David; Leleiko, Neal; Crandall, Wallace; Markowitz, James; Otley, Anthony R.; Xu, Wei; Hu, Pingzhao; Griffiths, Anne M.; Silverberg, Mark S.



Intravenous alpha-1-antitrypsin replacement therapy: Case report after one year of treatment  

Microsoft Academic Search

Alpha-1-antitrypsin deficiency is an autosomaliy inherited disease in which individuals homozygous for the disorder are prone\\u000a to develop severe emphysema. We report the case of a 43 yr old man with severe deficiency and advanced emphysema and the first\\u000a experience in Ireland with intravenous alpha-l-antitrypsin replacement. After I yr of replacement therapy we report our experience\\u000a with dosage and frequency

A. C. Ward; B. A. Keogh



Neonatal autoimmune thrombocytopenia: role of high-dose intravenous immunoglobulin G therapy  

Microsoft Academic Search

High-dose intravenous immunoglobulin G (IVIgG) therapy results in a rapid reversal of thrombocytopenia in over 80% of children with acute immune thrombocytopenic purpura (ITP). Comparable results were observed in eleven infants with an analogous condition, neonatal autoimmune thrombocytopenia (NATP), who received IVIgG (2 g\\/kg body weight) administered alone (n=6) or in combination with steroids (n=5). The median platelet count pre-IVIgG

Victor Blanchette; Maureen Andrew; Max Perlman; Emily Ling; Ami Ballin



Randomized Controlled Trial of Sequential Intravenous (i.v.) and Oral Moxifloxacin Compared with Sequential i.v. and Oral Co-Amoxiclav with or without Clarithromycin in Patients with Community-Acquired Pneumonia Requiring Initial Parenteral Treatment  

Microsoft Academic Search

The objective of the present trial was to compare the efficacy, safety, and tolerability of moxifloxacin (400 mg) given intravenously (i.v.) once daily followed by oral moxifloxacin (400 mg) for 7 to 14 days with the efficacy, safety, and tolerability of co-amoxiclav (1.2 g) administered by i.v. infusion three times a day followed by oral co-amoxiclav (625 mg) three times

R. Finch; D. Schurmann; O. Collins; R. Kubin; J. McGivern; H. Bobbaers; J. L. Izquierdo; P. Nikolaides; F. Ogundare; R. Raz; P. Zuck; G. Hoeffken



Intravenous iron sucrose therapy for moderate to severe anaemia in pregnancy.  


Background & objectives: Iron deficiency anaemia (IDA) is the most common nutritional deficiency in pregnancy. Prophylactic oral iron is recommended during pregnancy to meet the increased requirement. In India, women become pregnant with low baseline haemoglobin level resulting in high incidence of moderate to severe anaemia in pregnancy where oral iron therapy cannot meet the requirement. Pregnant women with moderate anaemia are to be treated with parentral iron therapy. This study was undertaken to evaluate the response and effect of intravenous iron sucrose complex (ISC) given to pregnant women with IDA. Methods: A prospective study was conducted (June 2009 to June 2011) in the department of Obstetrics & Gynecology, All India Institute of Medical Sciences, New Delhi. One hundred pregnant women with haemoglobin between 5-9 g% with diagnosed iron deficiency attending antenatal clinic were given intravenous iron sucrose complex in a dose of 200 mg twice weekly schedule after calculating the dose requirement. Results: The mean haemoglobin raised from 7.63 ± 0.61 to 11.20 ± 0.73 g% (P<0.001) after eight wk of therapy. There was significant rise in serum ferritin levels (from 11.2 ± 4.7 to 69 ± 23.1 ?g/l) (P<0.001). Reticulocyte count increased significantly after two wk of starting therapy (from 1.5 ± 0.6 to 4.6±0.8%).Other parameters including serum iron levels and red cell indices were also improved significantly. Only one woman was lost to follow up. No major side effects or anaphylactic reactions were noted during study period. Interpretation & conclusions: Parentral iron therapy was effective in increasing haemoglobin, serum ferritin and other haematological parameters in pregnant women with moderate anaemia. Intravenous iron sucrose can be used in hospital settings and tertiary urban hospitals where it can replace intramuscular therapy due to injection related side effects. Further, long-term comparative studies are required to recommend its use at peripheral level. PMID:24056559

Kriplani, Alka; Mahey, Reeta; Dash, Biswa Bhusan; Kulshreshta, Vidushi; Agarwal, Nutan; Bhatla, Neerja



Intravenous iron sucrose therapy for moderate to severe anaemia in pregnancy  

PubMed Central

Background & objectives: Iron deficiency anaemia (IDA) is the most common nutritional deficiency in pregnancy. Prophylactic oral iron is recommended during pregnancy to meet the increased requirement. In India, women become pregnant with low baseline haemoglobin level resulting in high incidence of moderate to severe anaemia in pregnancy where oral iron therapy cannot meet the requirement. Pregnant women with moderate anaemia are to be treated with parentral iron therapy. This study was undertaken to evaluate the response and effect of intravenous iron sucrose complex (ISC) given to pregnant women with IDA. Methods: A prospective study was conducted (June 2009 to June 2011) in the department of Obstetrics & Gynecology, All India Institute of Medical Sciences, New Delhi. One hundred pregnant women with haemoglobin between 5-9 g% with diagnosed iron deficiency attending antenatal clinic were given intravenous iron sucrose complex in a dose of 200 mg twice weekly schedule after calculating the dose requirement. Results: The mean haemoglobin raised from 7.63 ± 0.61 to 11.20 ± 0.73 g% (P<0.001) after eight wk of therapy. There was significant rise in serum ferritin levels (from 11.2 ± 4.7 to 69 ± 23.1 ?g/l) (P<0.001). Reticulocyte count increased significantly after two wk of starting therapy (from 1.5 ± 0.6 to 4.6±0.8%). Other parameters including serum iron levels and red cell indices were also improved significantly. Only one woman was lost to follow up. No major side effects or anaphylactic reactions were noted during study period. Interpretation & conclusions: Parentral iron therapy was effective in increasing haemoglobin, serum ferritin and other haematological parameters in pregnant women with moderate anaemia. Intravenous iron sucrose can be used in hospital settings and tertiary urban hospitals where it can replace intramuscular therapy due to injection related side effects. Further, long-term comparative studies are required to recommend its use at peripheral level.

Kriplani, Alka; Mahey, Reeta; Dash, Biswa Bhusan; Kulshreshta, Vidushi; Agarwal, Nutan; Bhatla, Neerja



Randomised phase III study of intravenous vinorelbine plus hormone therapy versus hormone therapy alone in hormone-refractory prostate cancer  

Microsoft Academic Search

Background: Vinorelbine (VRL) has been shown to be active in hormone-refractory prostate cancer (HRPC) in phase II studies, alone or in combination. Its moderate toxicity profile is well tolerated in elderly patients. Patients and methods: Patients with metastatic prostate cancer, progressive after primary hormonal therapy, were randomised to receive intravenous VRL 30 mg\\/m2 on days 1 and 8 every 3

R. P. Abratt; D. Brune; M.-A. Dimopoulos; J. Kliment; J. Breza; F. P. Selvaggi; P. Beuzeboc; T. Demkow; S. Oudard



Intravenous nutrient therapy eliminated androgen deprivation therapy-induced hot flashes in two men with prostate cancer.  


Androgen deprivation therapy (ADT) is commonly used for the treatment of prostate cancer. For many undergoing ADT, hot flashes can affect and significantly reduce quality of life. Traditional medications for hot flashes are limited by both clinical effectiveness and side effects. In two case reports, ADT-induced hot flashes quickly resolved after a short course of a specific intravenous combination of vitamins and minerals. This therapeutic approach may have potential for the treatment of ADT-induced hot flashes. PMID:17022923

Massey, Patrick



Intravenous immunoglobulin therapy: how does IgG modulate the immune system?  


Intravenous immunoglobulin (IVIG) preparations comprise pooled IgG antibodies from the serum of thousands of donors and were initially used as an IgG replacement therapy in immunocompromised patients. Since the discovery, more than 30 years ago, that IVIG therapy can ameliorate immune thrombocytopenia, the use of IVIG preparations has been extended to a wide range of autoimmune and inflammatory diseases. Despite the broad efficacy of IVIG therapy, its modes of action remain unclear. In this Review, we cover the recent insights into the molecular and cellular pathways that are involved in IVIG-mediated immunosuppression, with a particular focus on IVIG as a therapy for IgG-dependent autoimmune diseases. PMID:23411799

Schwab, Inessa; Nimmerjahn, Falk



Effect of intravenous nitroglycerin on lipid peroxidation after thrombolytic therapy for acute myocardial infarction.  


Free oxygen radicals are produced after coronary artery occlusion and reperfusion. Polyunsaturated fatty acids are oxidized by free radicals to lipid peroxides. Measurements of plasma malondialdehyde (MDA) formed by the breakdown of lipid peroxides are often used as markers of lipid peroxidation. The effect of intravenous nitroglycerin on plasma MDA levels was studied in 43 patients who received thrombolytic therapy for acute myocardial infarction. Plasma MDA levels in patients were elevated on admission to the hospital compared with healthy controls, and normalized within 48 hours. A greater increase in plasma MDA concentrations after thrombolysis was found in patients with noninvasive signs of reperfusion than in patients judged to have a persistent occlusion. In the 23 patients receiving immediate intravenous nitroglycerin infusion, plasma MDA levels did not change from baseline to 90 minutes (0.92+/-0.22 and 0.92+/-0.23 micromol/L, p=0.99), whereas a significant increase was found in the 20 control patients who did not receive nitroglycerin (from 0.83+/-0.22 to 1.01+/-0.30 micromol/L, p=0.0004) (p=0.036 for the difference between groups). Successful reperfusion after thrombolytic therapy entails increased lipid peroxidation. Intravenous nitroglycerin reduces lipid peroxidation during myocardial ischemia and reperfusion. PMID:9874048

Ohlin, H; Pavlidis, N; Ohlin, A K



Perioperative intravenous iron: an upfront therapy for treating anaemia and reducing transfusion requirements.  


Perioperative anaemia, with iron deficiency being its leading cause, is a frequent condition among surgical patients, and has been linked to increased postoperative morbidity and mortality, and decreased quality of life. Postoperative anaemia is even more frequent and is mainly caused by perioperative blood loss, aggravated by inflammation-induced blunting of erythropoiesis. Allogenic transfusion is commonly used for treating acute perioperative anaemia, but it also increases the rate of morbidity and mortality in surgical and critically ill patients. Thus, overall concerns about adverse effects of both preoperative anaemia and allogeneic transfusion have prompted the review of transfusion practice and the search for safer and more biologically rational treatment options. In this paper, the role of intravenous iron therapy (mostly with iron sucrose and ferric carboxymaltose), as a safe and efficacious tool for treating anaemia and reducing transfusion requirements in surgical patients, as well as in other medical areas, has been reviewed. From the analysis of published data and despite the lack of high quality evidence in some areas, it seems fair to conclude that perioperative intravenous iron administration, with or without erythropoiesis stimulating agents, is safe, results in lower transfusion requirements and hastens recovery from postoperative anaemia. In addition, some studies have reported decreased rates of postoperative infection and mortality, and shorter length of hospital stay in surgical patients receiving intravenous iron. PMID:23588429

Muñoz, M; Gómez-Ramírez, S; Martín-Montañez, E; Pavía, J; Cuenca, J; García-Erce, J A


Pathotropic nanoparticles for cancer gene therapy Rexin-G IV: three-year clinical experience.  


Metastatic cancer is a life-threatening illness with a predictably fatal outcome, thereby representing a major unmet medical need. In 2003, Rexin-G became the world's first targeted injectable vector approved for clinical trials in the treatment of intractable metastatic disease. Uniquely suited, by design, to function within the context of the human circulatory system, Rexin-G is a pathotropic (disease-seeking) gene delivery system bearing a designer killer gene; in essence, a targeted nanoparticle that seeks out and selectively accumulates in metastatic sites upon intravenous infusion. The targeted delivery of the cytocidal gene to primary tumors and metastatic foci, in effective local concentrations, compels both cancer cells and tumor-associated neovasculature to self-destruct, without causing untoward collateral damage to non-target organs. In this study: i) we report the results of three distinctive clinical studies which demonstrate the initial proofs of concept, safety, and efficacy of Rexin-G when used as a single agent for advanced or metastatic cancer, ii) we introduce the quantitative foundations of an innovative personalized treatment regimen, designated the 'Calculus of Parity', based on a patient's calculated tumor burden, iii) we propose a refinement of surrogate end-points commonly used for defining success in cancer therapy, and iv) we map out a strategic plan for the accelerated approval of Rexin-G based on the oncologic Threshold of Credibility paradigm being developed by the Food and Drug Administration. PMID:17016635

Gordon, Erlinda M; Lopez, Francisco F; Cornelio, Gerardo H; Lorenzo, Conrado C; Levy, John P; Reed, Rebecca A; Liu, Liqiong; Bruckner, Howard W; Hall, Frederick L



Imaging-based treatment selection for intravenous and intra-arterial stroke therapies: a comprehensive review  

PubMed Central

Reperfusion therapy is the only approved treatment for acute ischemic stroke. The current approach to patient selection is primarily based on the time from stroke symptom onset. However, this algorithm sharply restricts the eligible patient population, and neglects large variations in collateral circulation that ultimately determine the therapeutic time window in individual patients. Time alone is unlikely to remain the dominant parameter. Alternative approaches to patient selection involve advanced neuroimaging methods including MRI diffusion-weighted imaging, magnetic resonance and computed tomography perfusion imaging and noninvasive angiography that provide potentially valuable information regarding the state of the brain parenchyma and the neurovasculature. These techniques have now been used extensively, and there is emerging evidence on how specific imaging data may result in improved clinical outcomes. This article will review the major studies that have investigated the role of imaging in patient selection for both intravenous and intra-arterial therapies.

Yoo, Albert J; Pulli, Benjamin; Gonzalez, R Gilberto



Chryseomonas luteola bloodstream infection in a pediatric patient with pulmonary arterial hypertension receiving intravenous treprostinil therapy.  


Treprostinil is a prostacyclin analogue approved for the treatment of pulmonary arterial hypertension (PAH). It is commonly administered through a central venous catheter (CVC). Treprostinil is associated with the incidence of Gram-negative bacterial bloodstream infections (BSI), a susceptibility that has been associated with a diluent used for treprostinil. We report the case of a 14-year-old boy with idiopathic PAH on continuous intravenous treprostinil therapy who presented with fever and fatigue. A blood culture drawn from his CVC was positive for the rare Gram-negative organism Chryseomonas luteola. The patient made a complete recovery with antibacterial treatment. This is the only documented case of a C. luteola BSI in a PAH patient receiving continuous intravenous treprostinil. We recommend maintaining a high index of suspicion for both common and rare Gram-negative pathogens and the early administration of appropriate antibiotic therapy in this population. The use of an alternate diluent solution, such as Sterile Diluent for Flolan, further decreases the infection risk. PMID:23329255

Wen, A Y; Weiss, I K; Kelly, R B



Autologous intravenous bone marrow mononuclear cell therapy for patients with subacute ischaemic stroke: A pilot study  

PubMed Central

Background & objectives: Bone marrow mononuclear cell therapy has emerged as one of the option for the treatment of Stroke. Several preclinical studies have shown that the treatment with mononuclear cell (MNCs) can reduce the infarct size and improve the functional outcome. We evaluated the feasibility, safety and clinical outcome of administering bone marrow mononuclear cell (MNCs) intravenously to patients with subacute ischaemic stroke. Methods: In a non-randomized phase-I clinical study, 11 consecutive, eligible and consenting patients, aged 30-70 yr with ischaemic stroke involving anterior circulation within 7 to 30 days of onset of stroke were included. Bone marrow was aspirated from iliac crest and the harvested mononuclear cells were infused into antecubital vein. Outcomes measured for safety included immediate reactions after cell infusion and evidence of tumour formation at one year in whole body PET scan. Patients were followed at week 1, 4-6, 24 and 52 to determine clinical progress using National Institute of Health Stroke Scale (NIHSS), Barthel Index (BI), modified Rankin Scale (mRS), MRI, EEG and PET. Feasibility outcomes included target-dose feasibility. Favourable clinical outcome was defined as mRS score of 2 or less or BI score of 75 to 100 at six months after stem cell therapy. Results: Between September 2006 and April 2007, 11 patients were infused with bone-marrow mononuclear cells (mean 80 million with CD-34+ mean 0.92 million). Protocol was target-dose feasible in 9 patients (82%). FDG-PET scan at 24 and 52 wk in nine patients did not reveal evidence of tumour formation. Seven patients had favourable clinical outcome. Interpretation & conclusions: Intravenous bone marrow mononuclear cell therapy appears feasible and safe in patients with subacute ischaemic stroke. Further, a randomized controlled trial to examine its efficacy is being conducted.

Prasad, Kameshwar; Mohanty, Sujata; Bhatia, Rohit; Srivastava, M.V.P.; Garg, Ajay; Srivastava, Achal; Goyal, Vinay; Tripathi, Manjari; Kumar, Amit; Bal, Chandrashekar; Vij, Aarti; Mishra, Nalini Kant



Iron Deficiency Anaemia in Pregnancy and Postpartum: Pathophysiology and Effect of Oral versus Intravenous Iron Therapy  

PubMed Central

Nutritional iron-deficiency anaemia (IDA) is the most common disorder in the world, affecting more than two billion people. The World Health Organization's global database on anaemia has estimated a prevalence of 14% based on a regression-based analysis. Recent data show that the prevalence of IDA in pregnant women in industrialized countries is 17.4% while the incidence of IDA in developing countries increases significantly up to 56%. Although oral iron supplementation is widely used for the treatment of IDA, not all patients respond adequately to oral iron therapy. This is due to several factors including the side effects of oral iron which lead to poor compliance and lack of efficacy. The side effects, predominantly gastrointestinal discomfort, occur in a large cohort of patients taking oral iron preparations. Previously, the use of intravenous iron had been associated with undesirable and sometimes serious side effects and therefore was underutilised. However, in recent years, new type II and III iron complexes have been developed, which offer better compliance and toleration as well as high efficacy with a good safety profile. In summary, intravenous iron can be used safely for a rapid repletion of iron stores and correction of anaemia during and after pregnancy.

Khalafallah, Alhossain A.; Dennis, Amanda E.



Diltiazem poisoning treated with hyperinsulinemic euglycemia therapy and intravenous lipid emulsion.  


Intravenous lipid emulsion (ILE) has been proposed as a rescue therapy for severe local anesthetic drugs toxicity, but experience is limited with other lipophilic drugs. An 18-year-old healthy woman was admitted 8 h after the voluntary ingestion of sustained-release diltiazem (3600 mg), with severe hypotension refractory to fluid therapy, calcium salts, and high-dose norepinephrine (6.66 ?g/kg/min). Hyperinsulinemic euglycemia therapy was initiated and shortly after was followed by a protocol of ILE (intralipid 20%, 1.5 ml/kg as bolus, followed by 0.25 ml/kg over 1h). The main finding attributed to ILE was an apparent rapid decrease in insulin resistance, despite a prolonged serum diltiazem elimination half-life. Diltiazem is a lipophilic cardiotoxic drug, which could be sequestered in an expanded plasma lipid phase. The mechanism of action of ILE is not known, including its role in insulin resistance and myocardial metabolism in calcium-channel blocker poisoning. PMID:21088599

Montiel, Virginie; Gougnard, Thierry; Hantson, Philippe



Barriers to an early switch from intravenous to oral antibiotic therapy in hospitalised patients with CAP.  


Do physicians apply an early-switch strategy (from intravenous to oral antibiotics) in clinically stable patients hospitalised with community-acquired pneumonia (CAP)? If not, why not? In a multicentre prospective cohort study, adult patients admitted for i.v. CAP treatment were included. On day 3 of antibiotic treatment, clinical stability was assessed and treating resident physicians were interviewed on their switch strategies. Additionally, treating physicians were interviewed to evaluate their knowledge of and adherence to guideline advice. 149 (92%) out of 162 patients were included and 97 (91%) out of 107 physicians were interviewed. A switch to oral antibiotics was possible in 68 (46%) out of 149 patients on day 3 of treatment but not performed in 27 (40%) out of 68. Patient factors delaying the switch were high CURB-65 (confusion of new onset, urea >7 mmol · L(-1), respiratory rate of ? 30 breaths · min(-1), blood pressure <90 mmHg or diastolic blood pressure ? 60 mmHg, and age ? 65 yrs) score (on admission) (p=0.04) and oxygen treatment (p=0.04), high temperature (p=0.00) and high respiration rate (p=0.04) (day 3). Physicians' barriers to an early switch in clinically stable patients included misconceptions (26 (55%) out of 47), practical considerations (13 (28%) out of 47) and organisational factors (eight (17%) out of 47). Strikingly, 91 (94%) out of 97 interviewed physicians were not aware of guideline advice. The switch from i.v. to oral antibiotics is often unnecessarily delayed in patients hospitalised with CAP due to different types of barriers. PMID:22653769

Engel, Madelon F; Postma, Douwe F; Hulscher, Marlies E J L; Teding van Berkhout, Ferdinand; Emmelot-Vonk, Marielle H; Sankatsing, Sanjay; Gaillard, Carlo A J M; Bruns, Anke H W; Hoepelman, Andy I M; Oosterheert, Jan Jelrik



Intravenous immunoglobulin as immuno-modifying treatment  

Microsoft Academic Search

\\u000a Although developed for the treatment of humoral immunodeficiency, pooled normal human immunoglobulin suitable for intravenous\\u000a use (IgIV) has a wide range of immunoregulatory properties and has, since the early 1980s, excited interest as a therapy for\\u000a autoimmune disease. Attention has focused on the mechanisms of the therapeutic effects of IgIV and the contribution an understanding\\u000a of these mechanisms has made

David Jayne


Intravenous methylprednisolone in idiopathic childhood nephrotic syndrome  

Microsoft Academic Search

The aim of our study was to determine the clinical course of children with idiopathic childhood nephrotic syndrome (ICNS)\\u000a who received intravenous methylprednisolone (ivMP) following failure to achieve remission with standard oral prednisolone\\u000a therapy. This study was designed as a retrospective case record review from 1993 to 2007. Sixteen children received ivMP over\\u000a the 15-year study period, of whom ten

Mohan Shenoy; Nicholas D. Plant; Malcolm A. Lewis; Mark G. Bradbury; Rachel Lennon; Nicholas J. A. Webb



Scedosporium apiospermum Soft Tissue Infection Successfully Treated with Voriconazole: Potential Pitfalls in the Transition from Intravenous to Oral Therapy  

Microsoft Academic Search

An immunocompromised patient with an invasive soft tissue infection due to Scedosporium apiospermum was successfully treated with voriconazole and surgical debridement. After transition from intravenous to oral therapy, successive adjustments of the oral dose were required to achieve complete resolution. For soft tissue infections due to molds characterized by thin, septate hyphae branching at acute angles, voriconazole should be considered

Joanna M. Schaenman; Daniel B. DiGiulio; Laurence F. Mirels; Nancy M. McClenny; Gerald J. Berry; Annette W. Fothergill; Michael G. Rinaldi; Jose G. Montoya



Photothermal cancer therapy using intravenously injected near-infrared-absorbing nanoparticles  

NASA Astrophysics Data System (ADS)

This report focuses on the treatment parameters leading to successful nanoshell-assisted photo-thermal therapy (NAPT). NAPT takes advantage of the strong near infrared (NIR) absorption of gold-silica nanoshells, a new class of nanoparticles with tunable optical absorptivities that are capable of passive extravasation from the abnormal tumor vasculature due to their nanoscale size. Under controlled conditions nanoshells accumulate in tumors with superior efficiency compared to surrounding tissues. For this treatment: (1) tumors were inoculated in immune-competent mice by subcutaneous injection, (2) polyethylene glycol coated nanoshells (?150 nm diameter) with peak optical absorption in the NIR were intravenously injected and allowed to circulate for 6 - 48 hours, and (3) tumors were then extracorporeally illuminated with a collimated diode laser (808 nm, 2-6 W/cm2, 2-4 min). Nanoshell accumulations were quantitatively assessed in tumors and surrounding tissues using neutron activation analysis for gold. In order to assess temperature elevation, laser therapies were monitored in real-time using a mid-infrared thermal sensor. NAPT resulted in complete tumor regression in >90% of the subjects. This simple, non-invasive procedure shows great promise as a technique for selective photo-thermal tumor treatment.

O'Neal, D. P.; Hirsch, Leon R.; Halas, Naomi J.; Payne, J. D.; West, Jennifer L.



Idiotype-Specific Intravenous Immunoglobulin (IVIG) for Therapy of Autoimmune Diseases.  


Intravenous immunoglobulin (IVIG) is used successfully for therapy of inflammatory and autoimmune diseases, especially in cases of conventional therapy resistance. Within the broad spectrum of immunomodulatory activities of IVIG in vitro and in vivo, the anti-idiotypic activity, neutralizing the autoimmune disease related idiotypes, is one of the main mechanism. We and others have proven that from the IVIG composition, diverse fractions of autoimmune disease specific IVIG can be affinity purified (sIVIG). This sIVIG was shown to be more efficient than the whole compound of IVIG in experimental animal models of autoimmune diseases.The affinity purification of disease sIVIG encompasses three stages. The first stage is to construct an autoantigen column for affinity purification of the autoantibodies. In the second stage the purified autoantibodies are used to construct a new column composed of the autoantibodies. The later is utilized for affinity purification of anti-autoantibodies (anti- idiotypes) IVIG defined as autoimmune disease specific IVIG- sIVIG. PMID:24037850

Blank, Miri; Bashi, Tomer; Shoenfeld, Yehuda



[Dose and time dependence of hemodynamic tolerance development during intravenous nitrate therapy in acute myocardial infarct].  


Intravenous nitroglycerin therapy during acute myocardial infarction has beneficial effects on infarct size, infarct complications, and mortality. Numerous dosage formulas for the continuous administration of nitrates are currently used, although several studies have demonstrated the rapid development of tolerance during long-term treatment in patients with ischemic heart disease. The dose and dosage of a continuous nitrate application in the clinical setting of acute myocardial infarction has thus yet to be resolved. This study investigated the hemodynamic effects of a 60-h, low- (33 micrograms/min) vs high- (133 micrograms/min) dose intravenous nitroglycerin (NTG) infusion in 16 patients with uncomplicated acute myocardial infarction. In group I (33 micrograms/min NTG; n = 8) the initial nitrate effect on the pulmonary capillary pressure (PCP-control: 14 +/- 1.5; 4 h: 7 +/- 0.9; 60 h: 7 +/- 0.8; mean +/- SEM; all values in mm Hg) and mean pulmonary artery pressure (PAPM-control: 23 +/- 2.3; 4 h: 15 +/- 1.3; 60 h: 14 +/- 1.3) remained unchanged for 60 h. In group II (133 micrograms/min NTG; n = 8) an almost complete loss of the initial effect on PCP (control: 15 +/- 1.6; 4 h: 5 +/- 1.4; 60 h: 12 +/- 1.3) and PAPM (control: 25 +/- 2.0; 4 h: 14 +/- 1.8; 60 h: 20 +/- 1.3) was observed. In contrast to high-dose application the low-dose NTG-infusion induced comparable acute hemodynamic effects that were not attenuated by tolerance development. PMID:1907422

Meissner, A; Schulte, H M; Herrmann, G; Walek, T; Höfig, M; Simon, R



Ampicillin, Gentamicin and Teicoplanin as Antimicrobial Therapy for Recurrent Streptococcus agalactiae and Enterococcus faecalis Endocarditis in an Intravenous Drug Abuser with HIV Infection  

Microsoft Academic Search

Infective endocarditis associated with human immunodeficiency virus (HIV) infection occurs almost exclusively in intravenous (i.v.) drug users and usually involves the tricuspid valve, with an increased mortality rate among patients with a severe degree of immunosuppression. The first reported case of recurrent tricuspid endocarditis sustained by Streptococcus agalactiae and Enterococcus faecalis in an i.v. drug addict during HIV infection is

Leonardo Calza; Roberto Manfredi; Ginevra Marinacci; Lorenza Fortunato; Francesco Chiodo



Tolerance with low dose intravenous nitroglycerin therapy in acute myocardial infarction.  


The question of vascular tolerance was examined in 154 patients with acute myocardial infarction (64 anterior, 90 inferior) who were treated with prolonged low dose intravenous nitroglycerin in a recent randomized placebo-controlled study. The dose of nitroglycerin was carefully titrated to decrease mean blood pressure by 10% in normotensive patients and 30% in hypertensive (blood pressure greater than 140/90 mm Hg) patients, but not less than 80 mm Hg. Tolerance was defined as the need to increase the dose to maintain this hemodynamic effect. It was labelled "true" if chest pain was absent and "apparent" if chest pain was present. Group analysis of dose, pain scores, hemodynamic, 2-dimensional echocardiographic and clinical parameters monitored serially before and after therapy indicated benefit with nitroglycerin over placebo despite equalizing of blood pressures after 10 hours. Reversal of blood pressures and volumes after discontinuing nitroglycerin suggested lack of significant tolerance. However, detailed individual analysis suggested significant hemodynamic tolerance in 37 patients (24%), both in the true tolerance (12%) and apparent tolerance (12%) subgroups. Tolerance appeared early, requiring the dose to be increased by 30 +/- 39 micrograms/min within 11 +/- 9 hours. The dose was greater (p less than 0.001) in the tolerance than in the no tolerance subgroup, both before (60 vs 27 micrograms/min) and after (90 vs 38 micrograms/min) 10 hours. Tolerance blunted the beneficial effect on infarct size, but positive effects on function, topography and complications persisted. PMID:2506751

Jugdutt, B I; Warnica, J W



Intravenous tPA Therapy Does Not Worsen Acute Intracerebral Hemorrhage in Mice  

PubMed Central

Tissue plasminogen activator (tPA) is the only FDA-approved treatment for reperfusing ischemic strokes. But widespread use of tPA is still limited by fears of inadvertently administering tPA in patients with intracerebral hemorrhage (ICH). Surprisingly, however, the assumption that tPA will worsen ICH has never been biologically tested. Here, we assessed the effects of tPA in two models of ICH. In a mouse model of collagenase-induced ICH, hemorrhage volumes and neurological deficits after 24 hrs were similar in saline controls and tPA-treated mice, whereas heparin-treated mice had 3-fold larger hematomas. In a model of laser-induced vessel rupture, tPA also did not worsen hemorrhage volumes, while heparin did. tPA is known to worsen neurovascular injury by amplifying matrix metalloproteinases during cerebral ischemia. In contrast, tPA did not upregulate matrix metalloproteinases in our mouse ICH models. In summary, our experimental data do not support the assumption that intravenous tPA has a deleterious effect in acute ICH. However, due to potential species differences and the inability of models to fully capture the dynamics of human ICH, caution is warranted when considering the implications of these findings for human therapy.

Foerch, Christian; Rosidi, Nathanael L.; Schlunk, Frieder; Lauer, Arne; Cianchetti, Flor A.; Mandeville, Emiri; Arai, Ken; Yigitkanli, Kazim; Fan, Xiang; Wang, Xiaoying; van Leyen, Klaus; Steinmetz, Helmuth; Schaffer, Chris B.; Lo, Eng H.



Postoperative High-Dose Intravenous Iron Sucrose with Low Dose Erythropoietin Therapy after Total Hip Replacement  

PubMed Central

Erythropoietin combined with parenteral iron sucrose therapy is an alternative to blood transfusion in anemic patients. It was shown to be effective in surgical patients in several previous studies when used in conjunction with other methods. However, there are no guidelines about safety limits in dosage amounts or intervals. In this study, we report a case of significant postoperative hemorrhage managed with high dose parenteral iron sucrose, low dose erythropoietin, vitamin B12, vitamin C, and folic acid. An 80-year-old female patient presented for severe anemia after a total hip arthroplasty and refused an allogenic blood transfusion as treatment. The preoperative hemoglobin of 12.2 g/dL decreased to 5.3 g/dL postoperatively. She received the aforementioned combination of iron sucrose, erythropoietin, and vitamins. A total of 1,500 mg of intravenous iron sucrose was given postoperatively for 6 consecutive days. Erythropoietin was also administered at 2,000 IU every other day for a total of 12,000 IU. The patient was discharged in good condition on the twelfth postoperative day with a hemoglobin of 8.5 g/dL. Her hemoglobin was at 11.2 g/dL on the twentieth postoperative day.

Kim, Sungmin; Lee, Soo Chan; Lim, Hongsub



[Dilution volume of intravenous drugs in patients under fluid restriction therapy].  


INTRODUCTION, A fluid and electrolyte balance is essential for human health. There are some situations in which fluid imbalance occurs, causing fluid overload and consequent associated problems. Patients with these problems, may benefit from the administration of parenteral drugs in the smallest possible volume. Patients in critical condition typically require a large number of drugs intravenously, and high doses of these diluted in large quantities of serum. Therefore, it seems useful to seek an optimization strategy of parenteral drug admi - nistration. Objective: To review and collect data on minimum dilution volumes. Besides administration s routes, recons - titution, compatible diluents, infusion times. Methods: The study included those drug substances frequently used in critically ill patients. A search through multiple sources of information has been made: technical data for Propietary medicinal products, Handbook on Injectable Drugs, Trissel L., American Society Healh-System Pharmacists, 15thEd., 2009, Thomson Micromedex® Healthcare Series, or by phone calls to the manufacturers of the product. Results: Results are shown in a table. 65 drugs were revised. Conclusions: It is considered useful the collection of these data to optimize parenteral administration in critically ill patients, or in those who require restrictive fluid therapy, because information has been collected from different sources, not always found it in the technical data of the drugs. PMID:23461447

Proy Vega, B



The INIS Study. International Neonatal Immunotherapy Study: non-specific intravenous immunoglobulin therapy for suspected or proven neonatal sepsis: an international, placebo controlled, multicentre randomised trial  

Microsoft Academic Search

BACKGROUND: Sepsis is an important cause of neonatal death and perinatal brain damage, particularly in preterm infants. While effective antibiotic treatment is essential treatment for sepsis, resistance to antibiotics is increasing. Adjuvant therapies, such as intravenous immunoglobulin, therefore offer an important additional strategy. Three Cochrane systematic reviews of randomised controlled trials in nearly 6,000 patients suggest that non-specific, polyclonal intravenous



Seizures and stupor during intravenous mannose therapy in a patient with CDG syndrome type 1b (MPI-CDG).  


MPI-CDG (formally called CDG 1b), caused by phosphomannose isomerase (MPI) deficiency, leads to hypoglycaemia, protein losing enteropathy, hepatopathy, and thrombotic events, whereas neurologic development remains unaffected. Dietary supplementation of mannose can reverse clinical symptoms by entering the N-glycosylation pathway downstream of MPI. When oral intake of mannose in patients with MPI-CDG is not possible, e.g. due to surgery, mannose has to be given intravenously. We report a patient with MPI-CDG on intravenous mannose therapy that showed severe depression of consciousness and seizures without apparent cause. EEG and cranial MRI findings were compatible with metabolic coma whereas extended laboratory examinations including repeated blood glucose measurements were normal. Importantly, an intravenous bolus of glucose immediately led to clinical recovery and EEG improvement. Mannose did not interfere with glucose measurement in our assay. We suggest that in patients with MPI-CDG, intravenous mannose infusion can lead to intracellular ATP deprivation due to several mechanisms: (1) in MPI deficiency, mannose 6-P cannot be isomerised to fructose 6-P and therefore is unavailable for glycolysis; (2) animal data has shown that accumulating intracellular mannose 6-P inhibits glycolysis; and (3) elevated intracellular mannose 6-P may induce an ATP wasting cycle of dephosphorylation and rephosphorylation ("honey bee effect"). The mannose-induced metabolic inhibition may be overcome by high-dose glucose treatment. We caution that, in patients with MPI-CDG, life-threatening central nervous system disturbances may occur with intravenous mannose treatment. These may be due to intracellular energy failure. Clinical symptoms of energy deficiency should be treated early and aggressively with intravenous glucose regardless of blood glucose levels. PMID:21240668

Schroeder, A Sebastian; Kappler, Matthias; Bonfert, Michaela; Borggraefe, Ingo; Schoen, Carola; Reiter, Karl



Intravenous Micronutrient Therapy (Myers' Cocktail) for Fibromyalgia: A Placebo-Controlled Pilot Study  

PubMed Central

Abstract Objectives Intravenous micronutrient therapy (IVMT), and specifically the Myers' Cocktail, is a popular approach for treating fibromyalgia syndrome (FMS) among complementary and alternative medicine practitioners, but its efficacy is uncertain. This trial assessed the feasibility, safety, and provided insights into the efficacy of this therapy. Design This was a randomized, double-blind, placebo-controlled pilot study. Locations The study locations were an academic research center, teaching hospital, and affiliated Integrative Medicine Center in Derby, CT. Subjects The subjects were 34 adults with American College of Rheumatology (ACR)-defined FMS. Intervention Subjects were randomly assigned either to treatment (weekly infusions of IVMT) or to placebo (weekly infusions of lactated Ringer's solution) for 8 weeks. Outcome measures Primary outcome was change in the Tender Point Index, assessed 8 and 12 weeks after initiation. Secondary measures included a Visual Analog Scale to assess global pain, and validated measures of physical function (Fibromyalgia Impact Questionnaire), mood (Beck Depression Index), and quality of life (Health Status Questionnaire 2.0). Results Clinically significant improvements were noted (of a magnitude similar to other effective interventions). However, in part because of the high placebo response and the small sample size, no statistically significant differences were seen between groups, in any outcome measure, at 8 and 16 weeks. Statistically significant within-group differences were seen in both the intervention and placebo groups, demonstrating a treatment effect for both IVMT and placebo. At 8 weeks, the IVMT group experienced significantly improved tender points, pain, depression, and quality of life directly following treatment (all p???0.02), while the placebo group experienced significantly improved tender points only (p???0.05). The treatment effects of IVMT persisted at 4 weeks postintervention for tender points, pain, and quality of life, while placebo effects persisted only for tender points. A single minor adverse event was noted in one subject in the intervention group. Conclusions This first controlled pilot study established the safety and feasibility of treating FMS with IVMT. Most subjects experienced relief as compared to baseline, but no statistically significant differences were seen between IVMT and placebo. The efficacy of IVMT for fibromyalgia, relative to placebo, is as yet uncertain.

Ali, Ather; Njike, Valentine Yanchou; Northrup, Veronika; Sabina, Alyse B.; Williams, Anna-Leila; Liberti, Lauren S.; Perlman, Adam I.; Adelson, Harry



Treatment of Anemia in Heart Failure: Potential Risks and Benefits of Intravenous Iron Therapy in Cardiovascular Disease  

PubMed Central

Iron-deficiency anemia is common is patients with heart failure (HF), but the optimum diagnostic tests to detect iron deficiency and the treatment options to replete iron have not been fully characterized. Recent studies in patients with HF indicate that intravenous iron can rapidly replenish iron stores in patients having iron-deficiency anemia, with resultant increased hemoglobin levels and improved functional capacity. Preliminary data from a sub-group analysis also suggests that supplemental intravenous iron therapy can improve functional capacity even in those subjects without anemia. The mechanisms responsible for this observation are not fully characterized, but may be related to beneficial effects of iron supplementation on mitochondrial respiration in skeletal muscle. The long-term safety of using intravenous iron supplementation in HF populations is not known. Iron is a known pro-oxidant factor that can inhibit nitric oxide signaling and irreversibly injury cells. Increased iron stores are associated with vascular endothelial dysfunction and increased risk of coronary heart disease events. Additional clinical trials are needed to more fully characterize the therapeutic potential and safety of intravenous iron in HF patients.

Jelani, Qurat-ul-ain; Katz, Stuart D.



The Role of Outpatient Intravenous Diuretic Therapy in a Transitional Care Program for Patients With Heart Failure: A Case Series  

PubMed Central

We present a case series of seven patients with an established diagnosis of heart failure enrolled in a transitional care program that were treated with intravenous diuretic therapy in the outpatient setting. The patients presented in this cases series were treated due to the development of decompensated heart failure within 30 days of their discharge from our hospital. All seven patients stated that they would have originally presented to the emergency department for their symptoms, but consented to alternative treatment by a transitional care physician, or transitionalist. These patients with decompensated heart failure (four male and three female) with a median age of 55 years (24 - 84 years) were evaluated and treated from November 2011 to March 2012. Of the seven patients, four presented with decompensated systolic heart failure (three with diastolic). All seven patients were treated with an intravenous diuretic for hypervolemia in our outpatient infusion room. All of the patients experienced relief of their dyspnea the day of diuretic administration or the following day. No adverse effects or emergency department transfers occurred as a result of outpatient intravenous diuretic therapy. Through the use of outpatient intravenous diuretic therapy, we have avoided the need for emergency department visits and potential hospitalization in select patients with decompensated heart failure. Based on our preliminary findings, the clinical efficacy of this approach to the treatment of heart failure decompensation is not only due to the pharmacologic effectiveness of intravenous diuretics, but also due to the bidirectional open line of communication that exists between transitionalist and patients in the program. The direct telephone access that patients have to the transitionalist allows for close post-hospitalization monitoring and facilitates timely evaluation and treatment when acute issues arise. The added benefit of our particular transitional care program is that we have an alternate venue in the hospital where our transitional care patients can be treated for heart failure decompensation (our outpatient infusion room), thus, enabling us to avoid emergency department transfers and possible hospital admissions. Further investigation of this therapy in a non-emergency department setting is warranted as our experience with this treatment modality is limited to the case series presented.

Lazkani, Mohamad; Ota, Ken S.



Randomised, double blind, placebo controlled trial of intravenous antioxidant (n-acetylcysteine, selenium, vitamin C) therapy in severe acute pancreatitis  

PubMed Central

Background Based on equivocal clinical data, intravenous antioxidant therapy has been used for the treatment of severe acute pancreatitis. To date there is no randomised comparison of this therapy in severe acute pancreatitis. Methods We conducted a randomised, double blind, placebo controlled trial of intravenous antioxidant (n?acetylcysteine, selenium, vitamin C) therapy in patients with predicted severe acute pancreatitis. Forty?three patients were enrolled from three hospitals in the Manchester (UK) area over the period June 2001 to November 2004. Randomisation stratified for APACHE?II score and hospital site, and delivered groups that were similar at baseline. Results Relative serum levels of antioxidants rose while markers of oxidative stress fell in the active treatment group during the course of the trial. However, at 7 days, there was no statistically significant difference in the primary end point, organ dysfunction (antioxidant vs placebo: 32% vs 17%, p?=?0.33) or any secondary end point of organ dysfunction or patient outcome. Conclusions This study provides no evidence to justify continued use of n?acetylcysteine, selenium, vitamin C based antioxidant therapy in severe acute pancreatitis. In the context of any future trial design, careful consideration must be given to the risks raised by the greater trend towards adverse outcome in patients in the treatment arm of this study.

Siriwardena, Ajith K; Mason, James M; Balachandra, Srinivasan; Bagul, Anil; Galloway, Simon; Formela, Laura; Hardman, Jonathan G; Jamdar, Saurabh



Oral versus intravenous proton pump inhibitors in preventing re-bleeding for patients with peptic ulcer bleeding after successful endoscopic therapy  

PubMed Central

Background High dose intravenous proton pump inhibitor after endoscopic therapy for peptic ulcer bleeding has been recommended as adjuvant therapy. Whether oral proton pump inhibitor can replace intravenous proton pump inhibitor in this setting is unknown. This study aims to compare the clinical efficacy of oral and intravenous proton pump inhibitor after endoscopic therapy. Methods Patients with high-risk bleeding peptic ulcers after successful endoscopic therapy were randomly assigned as oral lansoprazole or intravenous esomeprazole group. Primary outcome of the study was re-bleeding rate within 14?days. Secondary outcome included hospital stay, volume of blood transfusion, surgical intervention and mortality within 1?month. Results From April 2010 to Feb 2011, 100 patients were enrolled in this study. The re-bleeding rates were 4% (2/50) in the intravenous group and 4% (2/50) in the oral group. There was no difference between the two groups with regards to the hospital stay, volume of blood transfusion, surgery or mortality rate. The mean duration of hospital stay was 1.8?days in the oral lansoprazole group and 3.9?days in the intravenous esomeprazole group (p?>?0.01). Conclusion Patients receiving oral proton pump inhibitor have a shorter hospital stay. There is no evidence of a difference in clinical outcomes between oral and intravenous PPI treatment. However, the study was not powered to prove equivalence or non-inferiority. Future studies are still needed. Trial registration NCT01123031



Intravenous ascorbic acid: protocol for its application and use.  


High dose intravenous(i.v.) ascorbic acid (AA) has been used as therapy for infectious disease from bacterial and viral origin and adjuvant therapy for cancer. In this publication we describe a clinical protocol that has been developed over the past twenty years utilizing high dose i.v. AA as therapy for cancer. This includes principles of treatment, rationale, baseline workup, infusion protocol, precautions and side effects. PMID:14619456

Riordan, Hugh D; Hunninghake, Ronald B; Riordan, Neil H; Jackson, James J; Meng, Xiaolong; Taylor, Paul; Casciari, Joseph J; González, Michael J; Miranda-Massari, Jorge R; Mora, Edna M; Rosario, Norberto; Rivera, Alfredo



Intravenous immunoglobulin therapy in the treatment of patients with pemphigus vulgaris unresponsive to conventional immunosuppressive treatment  

Microsoft Academic Search

Background: Severe pemphigus vulgaris (PV) is conventionally treated with high-dose oral prednisone, usually in combination with an immunosuppressive agent (ISA). Some patients experience significant side effects, which are sometimes fatal, from prolonged immunosuppression. Objective: Intravenous immunoglobulin (IVIg) was administered to 21 patients with severe cutaneous and mucosal PV who had not responded to the prolonged use of oral prednisone and

A. Razzaque Ahmed



Aggressive Management of Shunt Infection: Combined Intravenous and Intraventricular Antibiotic Therapy for Twelve or Less Days  

Microsoft Academic Search

Objective: This report is limited to patients with a single cerebrospinal fluid (CSF) shunt infected by a single organism, and compares two treatment protocols. Methods: In the initial protocol (1975–1991), patients underwent removal of the shunt system and received intravenous and intraventricular antibiotics. Intraventricular antibiotics were administered twice daily to those with external ventricular drainage. When CSF was cultured 48

Hector E. James; John S. Bradley



Failure of serum ferritin levels to predict bone-marrow iron content after intravenous iron-dextran therapy.  


The relation between serum ferritin levels and stainable-iron deposits in the liver, spleen, and bone marrow was investigated in 36 patients with chronic renal failure who died after being on haemodialysis for 1-103 months. Elemental iron (mean, 5450 mg) had been given intravenously as iron dextran to patients in a long-term subgroup, who had been on dialysis for more than 3 months. The results of semiquantitative histochemical assessment of tissue iron in slides obtained at necropsy (scale 0 to 4+) were confirmed by chemical analyses of tissue iron. Serum ferritin levels correlated well with the degree of hepatosplenic siderosis but did not always correlate with bone-marrow iron stores in these patients. Serum ferritin concentrations were raised in 10 marrow-iron-depleted subjects (mean, 1336 ng/dl). The paradoxical association of hepatosplenic siderosis with marrow iron depletion was observed in most of the patients on dialysis for less than 40 months. The histochemical data show that the bulk of intravenously injected iron dextran is taken up by the liver and spleen; that the hepatosplenic stores fail to be mobilised to the bone marrow; and that intravenous iron-dextran therapy, by-passing the intestinal mechanism for the regulation of iron absorption, carries a high risk of long-term hepatosplenic siderosis. PMID:6121967

Ali, M; Rigolosi, R; Fayemi, A O; Braun, E V; Frascino, J; Singer, R



Intravenous Iron Sucrose in Chinese Hemodialysis Patients with Renal Anemia  

Microsoft Academic Search

Background\\/Aims: Renal anemia is one of the commonest complications of chronic renal failure. Iron deficiency is the most common factor which affects the efficacy of recombinant human erythropoietin (EPO) therapy. Intravenous (i.v.) iron preparations are commonly used in Western countries, but iron sucrose is seldom used in Chinese patients on maintenance hemodialysis. The aim of the present study was to

Han Li; Shi-xiang Wang



Nitrate therapy for left ventricular failure complicating acute myocardial infarction: a haemodynamic comparison of intravenous, buccal, and transdermal delivery systems.  


The haemodynamic effects of three different methods of nitrate administration [intravenous (i.v.) isosorbide dinitrate (ISDN) and buccal and transdermal nitroglycerin (NTG)] were evaluated in 36 patients with acute left ventricular failure due to a recent myocardial infarction. Similar reductions in pulmonary artery occluded pressure (p less than 0.01) followed all three regimens without change in heart rate and cardiac and stroke volume indices. Significant reductions in systemic arterial pressure and vascular resistance followed both ISDN and buccal NTG but not transdermal NTG. A disadvantage of the buccal NTG delivery was an abrupt and, on occasion, inappropriate reduction in blood pressure. The more gradual and controlled reduction of systemic blood pressure with substantial falls in pulmonary artery occluded pressure following ISDN infusion suggest that in the context of myocardial infarction this method of nitrate delivery may have safety advantages; however, when invasive haemodynamic monitoring facilities are not available, transdermal delivery may offer a practical alternative. PMID:2481190

Verma, S P; Silke, B; Reynolds, G W; Richmond, A; Taylor, S H



Randomised controlled trial comparing oral and intravenous rehydration therapy in children with diarrhoea  

Microsoft Academic Search

OBJECTIVE--To determine the effectiveness of oral rehydration in children with moderate dehydration caused by gastroenteritis, and to compare the complications of oral and intravenous treatment. DESIGN--Randomised controlled trial. SETTING--Emergency department and infectious diseases ward in a large urban teaching hospital. PATIENTS--111 children aged 3-36 months who had been previously healthy, had had diarrhoea for seven days or less, had clinical

A Mackenzie; G Barnes



Intravenous bisphosphonate therapy and atrial fibrillation/flutter risk in cancer patients: a nationwide cohort study  

PubMed Central

Background: There is conflicting evidence regarding bisphosphonates and atrial fibrillation (AF) risk in osteoporosis patients. However, bisphosphonates are used in much higher doses in treatment of bone metastasis and hypercalcemia, but little is known about the AF risk in cancer patients. Methods: We conducted a nationwide population-based cohort study using Danish databases. All cancer patients exposed to intravenous bisphosphonates during 2000–2008 were matched with two non-exposed cancer patients by cancer type, distant metastasis presence at diagnosis, age, and gender. We used Cox proportional hazard regression to estimate hazards ratios (HRs) of AF/flutter adjusting for important confounding factors. Results: Of the 3981 cancer patients exposed to intravenous bisphosponates, 128 (3.2%) developed AF/flutter. This condition occurred in 192 (2.4%) of the 7906 non-exposed cancer patients, corresponding to an adjusted HR of 1.7 (95% CI: 1.2–2.4). Conclusion: Intravenous bisphosphonates may increase AF/flutter risk in cancer patients.

Erichsen, R; Christiansen, C F; Fr?slev, T; Jacobsen, J; S?rensen, H T



Chronic intravenous aminobisphosphonate therapy increases high-density lipoprotein cholesterol and decreases low-density lipoprotein cholesterol.  


Nowadays, bisphosphonates are considered the drugs of choice for the treatment of several bone disorders. Their exact mechanism of action is not clear but recently it has been reported that the aminobisphosphonates inhibit cholesterol biosynthesis and that this might be relevant for their actions on bone osteoclasts. The study includes 87 postmenopausal women with moderate to severe osteoporosis. The patients were randomly assigned to intravenous (iv) infusion of 50 mg of the aminobisphosphonate Neridronate dissolved in 100 ml of saline solution every 2 months for a year (44 patients). The remaining 43 served as controls. At the time of each infusion blood samples were obtained for the evaluation of total cholesterol, triglycerides, high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C), apolipoprotein A-I (Apo A-I), apolipoprotein B (Apo B), and total and bone alkaline phosphatase (AP). Free deoxypyridinoline (f-DPD) was measured in fasting urine specimens. In the control group no significant changes were observed throughout the study period for any of the biochemical variables. In the Neridronate-treated patients both bone AP and f-DPD excretion fell significantly by 15-20%. In these patients serum total cholesterol and serum triglycerides showed marginal decreases, which were occasionally significant. LDL-C and Apo B fell by 5-6% and these changes were statistically significant at most time points. Apo A-I and HDL-C rose progressively with time. At the 12th month, HDL-C rose 17-18% (p < 0.0001) above the baseline values. Similar findings were obtained in four postmenopausal women given high iv doses of Pamidronate or Alendronate. In conclusion aminobisphophonates, at least when given iv, induce remarkable and unexpected effects on lipid metabolism with a final profile that might be clinically relevant. PMID:10750576

Adami, S; Braga, V; Guidi, G; Gatti, D; Gerardi, D; Fracassi, E



Effect of Aggressively Driven Intravenous Iron Therapy on Infectious Complications in End-Stage Renal Disease Patients on Maintenance Hemodialysis.  


For treating end-stage renal disease-associated anemia, various strategies to achieve optimal hemoglobin levels with lower erythropoiesis stimulating agent doses are being tried. One of these involves the use of a high dose [transferrin saturation (TSAT) >30%] of intravenous (IV) iron supplementation. However, due to in vitro effects of iron on stimulating bacterial growth, there are concerns of increased risk of infection. The safety of higher iron targets with respect to infectious complications (bacteremias, pneumonias, soft tissue infections, and osteomyelitis) is unknown. This was a retrospective study of patients on maintenance hemodialysis from a single, urban dialysis center to assess the long-term impact of the higher cumulative use of IV iron, on the incidence of clinically important infections. Our iron protocol was modified in June 2010 to aim for TSAT >30% unless serum ferritin levels were >1200 ng/mL. Data from only those patients who had been on dialysis for the whole duration between June 2009 and May 2011 were included. A total of 140 patients with end-stage renal disease on hemodialysis patients were found to be eligible for the study. There was a statistically significant increase in the mean TSAT and mean serum ferritin with the new anemia management protocol with a significant decrease in the mean erythropoiesis stimulating agent dose requirement. There was no statistically significant increase in the incidence of infectious complications. Although in vitro effects of iron are known to stimulate bacterial growth, a higher IV dose of iron may not increase the risk of infection in such patients. PMID:22832501

Bansal, Anip; Sandhu, Gagangeet; Gupta, Isha; Kalahalli, Shriharsha; Nayak, Rushi; Zouain, Eduardo; Chitale, Rohit A; Meisels, Ira; Chan, Germaine



Phase I study of cancer therapy with recombinant interleukin-2 administered by intravenous bolus injection  

Microsoft Academic Search

Sixty-six patients with disseminated malignancy were treated with recombinant interleukin-2 (IL-2) on a three times a week (M, W, F) IV-bolus injection schedule. Doses ranged from 0.001 to 14.0 × 106 units\\/M2 body surface area. Consecutive groups of 3-5 patients were placed on each dose level and were maintained on that level except for dosage de-escalation for toxicity. Toxicity to

Evan M. Hersh; J. Lee Murray; Waun Ki Hong; Michael G. Rosenblum; James M. Reuben; Robert Weilbaecher; Amar N. Sarwal; Edward C. Bradley; Michael Konrad; Frank C. Arnett



Patients' Assessment of the Convenience of Fentanyl HCl Iontophoretic Transdermal System (ITS) Versus Morphine Intravenous Patient-Controlled Analgesia (IV PCA) in the Management of Postoperative Pain After Major Surgery  

Microsoft Academic Search

The patient-controlled fentanyl HCl iontophoretic transdermal system (ITS) is a compact, self-contained, needle-free system that has been approved for acute postoperative pain management in hospitalized adults. The objective of the present analysis was to evaluate patients' assessment of fentanyl ITS and morphine intravenous patient-controlled analgesia (IV PCA) convenience on 7 different subscales, using a validated patient ease of care (EOC)

Peg Pennington; Stephanie Caminiti; Jeff R. Schein; David J. Hewitt; Winnie W. Nelson



Desensitization Therapy with Intravenous Gammaglobulin (IVIG): Applications in Solid Organ Transplantation  

PubMed Central

Intravenous immunoglobulin products (IVIG) are derived from pooled human plasma and have been used for the treatment of primary immunodeficiency disorders for more than 24 years. Shortly after their introduction, IVIG products were found to be effective in the treatment of autoimmune and inflammatory disorders. Over the past 2 decades, the list of diseases where IVIG has a demonstrable beneficial effect has grown rapidly. These include inflammatory diseases such as Kawasaki disease, Guillain-Barre syndrome, myasthenia gravis, dermatomyositis and demyelinating polyneuropathy. Recently, we have described a beneficial effect on the reduction of anti-HLA antibodies with subsequent improvement in rates of transplantation for highly human leukocyte antigen (HLA) sensitized patients as well as a potent anti-inflammatory effect that is beneficial in the treatment of antibody-mediated rejection (AMR). These advancements have enabled transplantation of patients previously considered untransplantable and in concert with new diagnostic techniques has resulted in new approaches to management of AMR.

Jordan, Stanley C; Vo, Ashley; Tyan, Dolly; Toyota, Mieko



Photoacoustic imaging of intravenously injected photosensitizer in rat burn models for efficient antibacterial photodynamic therapy  

NASA Astrophysics Data System (ADS)

For efficient photodynamic treatment of wound infection, a photosensitizer must be distributed in the whole infected tissue region. To ensure this, depth profiling of a photosensitizer is necessary in vivo. In this study, we applied photoacoustic (PA) imaging to visualize the depth profile of an intravenously injected photosensitizer in rat burn models. In burned tissue, pharmacokinetics is complicated; vascular occlusion takes place in the injured tissue, while vascular permeability increases due to thermal invasion. In this study, we first used Evans Blue (EB) as a test drug to examine the feasibility of photosensitizer dosimetry based on PA imaging. On the basis of the results, an actual photosensitizer, talaporfin sodium was used. An EB solution was intravenously injected into a rat deep dermal burn model. PA imaging was performed on the wound with 532 nm and 610 nm nanosecond light pulses for visualizing vasculatures (blood) and EB, respectively. Two hours after injection, the distribution of EB-originated signal spatially coincided well with that of blood-originated signal measured after injury, indicating that EB molecules leaked out from the blood vessels due to increased permeability. Afterwards, the distribution of EB signal was broadened in the depth direction due to diffusion. At 12 hours after injection, clear EB signals were observed even in the zone of stasis, demonstrating that the leaked EB molecules were delivered to the injured tissue layer. The level and time course of talaporfin sodium-originated signals were different compared with those of EB-originated signals, showing animal-dependent and/or drug-dependent permeabilization and diffusion in the tissue. Thus, photosensitizer dosimetry should be needed before every treatment to achieve desirable outcome of photodynamic treatment, for which PA imaging can be concluded to be valid and useful.

Tsunoi, Yasuyuki; Sato, Shunichi; Ashida, Hiroshi; Terakawa, Mitsuhiro



Comparison of cost of immune globulin intravenous therapy to conventional immunosuppressive therapy in treating patients with autoimmune mucocutaneous blistering diseases  

Microsoft Academic Search

Autoimmune mucocutaneous blistering diseases (AMBD) are a group of potentially fatal diseases that affect the skin and mucous membranes. AMBD have different target antigens as well as variable clinical presentation, course, and prognosis.The mainstay of conventional immunosuppressive therapy (CIST) for AMBD is long-term high-dose systemic corticosteroids and immunosuppressive agents. Such therapy has proven effective in many patients; however, in some

Yassine J. Daoud; Ketan G. Amin



A double-blind, placebo-controlled trial of intravenous iron dextran therapy in patients with ESRD and restless legs syndrome  

Microsoft Academic Search

Background: Restless legs syndrome (RLS) is a common disorder in patients with end-stage renal disease (ESRD) that causes motor agitation and insomnia. Because RLS has been associated with iron deficiency, we sought to investigate the effects of intravenous (IV) iron dextran on symptoms of RLS in a double-blind placebo-controlled trial. Methods: Patients determined to have RLS by International RLS Study

James A. Sloand; Mark A. Shelly; Andrew Feigin; Paul Bernstein; Rebeca D. Monk



Treating stage IV pressure ulcers with negative pressure therapy: a case report.  


Decubitus ulcers remain a significant healthcare concern today, especially in the elderly and immobile population. Following the observation of three Stage IV decubitus ulcers refractory to standard medical and surgical therapy for 10 months, a new vacuum-assisted closure device (V.A.C.) was initiated to speed wound healing. The V.A.C. was initiated in August 1996. The three Stage IV ulcers were located on the patient's right ischium, left ischium, and sacrum. On initiation, they measured 7 1/2 cm x 2 1/2 cm x 2 1/2 cm, 8 cm x 3 1/2 cm x 2 1/2 cm, and 3 1/2 cm x 2 cm x 2 cm respectively. The treatment consisted of insertion of sterile sponge into the wound bed connected to the negative pressure device by suction hose. The device operated at a negative pressure of 125 mm Hg with a 5-minute-on 2-minute-off-cycle. Dressing changes were performed every 48 hours during the treatment period. Successful closure of the sacral ulcer occurred in October 1996. The ischial ulcers were small enough to be taken off V.A.C. therapy in early November 1996. While we are encouraged by the results of this study, further additional clinical studies are warranted. PMID:10347508

Baynham, S A; Kohlman, P; Katner, H P



Use of Physostigmine by the Intravenous, Intramuscular, and Oral Routes in the Therapy of Anticholinergic Drug Intoxication.  

National Technical Information Service (NTIS)

Physostigmine was administered by three routes (intravenous, intramuscular, and oral) to treat intoxication by anticholinergic compounds in man. The drug by all routes of administration is effective. There are several reasons why the intravenous route of ...

F. R. Sidell



Intratympanic dexamethasone with hyaluronic acid in the treatment of idiopathic sudden sensorineural hearing loss after failure of intravenous steroid and vasoactive therapy  

Microsoft Academic Search

The purpose of this prospective study was to test whether intratympanic application of dexamethasone\\/hyaluronic acid improves hearing outcome in patients with pantonal idiopathic sudden sensorineural hearing loss (ISSHL), in patients with sudden deafness or sudden profound SHL and in patients with predominant high-frequency ISSHL who are refractory to intravenous steroid and vasoactive therapy. The study took place in an academic

Haralampos Gouveris; Oksana Selivanova; Wolf Mann



Intravenous rt-PA Fibrinolytic Therapy in Acute Carotid Territory Ischemic Stroke with Severe Neurologic Deficits : The Implication of Arterial Recanalization for Stroke Outcome  

Microsoft Academic Search

Background : Our previous pilot study demonstrated that intravenous recombinant tissue plasminogen activator(rt- PA) fibrinolytic therapy was effective in treatment of effects of acute ischemic stroke within 3 hours of onset. We stud - ied whether rt-PA was effective and safe in patients with acute carotid artery territory ischemic stroke with severe neu - rologic deficits (National Institute of Health

Dae Il Chang; Sung Sang Yoon; Won Chul Shin; Kyung Cheon Chung


Pharmacoeconomics of therapy for Guillain-Barré syndrome: plasma exchange and intravenous immunoglobulin.  


Guillain-Barré syndrome (GBS) is an acute neuropathy and a clinical syndrome that includes a number of pathological and electrophysiological subtypes. Intravenous immunoglobulin (IVIG) and plasma exchange (PE) are both equally efficacious for the treatment of GBS; however, the cost of IVIG may be lower for both the patient and the healthcare system. To compare the pharmacoeconomics of PE and IVIG in GBS, a retrospective study was done from 1999 to 2004, which included a total of 24 patients with GBS who were admitted to Taipei Veterans General Hospital. This showed that except for the costs of the drugs used in IVIG, treatment of GBS with IVIG was more cost-effective (p=0.057) than that with PE in total length of hospitalization and the cost of procedures and hospitalization. The study also showed that the total costs were higher for patients on ventilators than those not requiring ventilators (p=0.008, t-test) and the length of hospitalization showed a very strong linear relationship to total costs (Pearson correlation coefficient=0.907). The regression analysis showed that each additional day of hospitalization increased the hospitalization costs by an average of 5599 New Taiwan Dollars (NT) (US$1.00=NT$33.50 in 2005). PMID:17532498

Tsai, Ching-Piao; Wang, Kai-Chen; Liu, Chih-Yang; Sheng, Wen-Yung; Lee, Tzu-Chi



Complete FcRn dependence for intravenous Ig therapy in autoimmune skin blistering diseases  

PubMed Central

Numerous mechanisms of action have been proposed for intravenous Ig (IVIG). In this study, we used IgG passive transfer murine models of bullous pemphigoid (BP), pemphigus foliaceus (PF), and pemphigus vulgaris (PV) to test the hypothesis that the effect of IVIG in autoantibody-mediated cutaneous bullous diseases is to accelerate the degradation of pathogenic IgG by saturation of the MHC-like Fc receptor neonatal Fc receptor (FcRn). BP, PF, and PV are organ-specific antibody-mediated diseases in which autoantibodies target the hemidesmosomal antigen BP180 and desmosomal antigens Dsg1 and Dsg3, respectively. Antibodies against BP180, Dsg1, and Dsg3, when injected into neonatal mice, induce the BP, PF, and PV disease phenotypes, respectively. We found that FcRn-deficient mice were resistant to experimental BP, PF, and PV. Circulating levels of pathogenic IgG in FcRn-deficient mice were significantly reduced compared with those in WT mice. Administration of high-dose human IgG (HDIG) to WT mice also drastically reduced circulating pathogenic IgG levels and prevented blistering. In FcRn-deficient mice, no additional protective effect with HDIG was realized. These data demonstrate that the therapeutic efficacy of HDIG treatment in the pemphigus and pemphigoid models is dependent on FcRn. Thus, FcRn is a promising therapeutic target for treating such IgG-mediated autoimmune diseases.

Li, Ning; Zhao, Minglang; Hilario-Vargas, Julio; Prisayanh, Phillip; Warren, Simon; Diaz, Luis A.; Roopenian, Derry C.; Liu, Zhi



Calcium Kinetics in Children with Osteogenesis Imperfecta Type III and IV: Pre and Post-Growth Hormone Therapy  

Microsoft Academic Search

.   Children with osteogenesis imperfecta (OI) type III and type IV were studied using a 42Ca stable isotope technique. Serum dilution kinetics of 42Ca were studied pre- and post-growth hormone (GH) treatment in 9 OI III (age range 5–9 years) and 8 OI IV patients (age range\\u000a 5–12 years). Each subject was studied twice: at baseline and following GH therapy

N. E. Vieira; R. E. Goans; G. H. Weiss; E. Hopkins; J. C. Marini; A. L. Yergey



Monoclonal antibody and intravenous immunoglobulin therapy for rheumatic diseases: rationale and mechanisms of action  

Microsoft Academic Search

Advances in our understanding of the pathogenesis of rheumatic diseases such as rheumatoid arthritis and systemic lupus erythematosus have led to the emergence of immunoglobulin-based therapy as a major therapeutic force. Numerous monoclonal antibodies that target proinflammatory cytokines or their receptors (e.g. infliximab, adalimumab, tocilizumab, belimumab, HuMax-IL-15), and cell-surface or co-stimulatory molecules (e.g. rituximab) are either in clinical development or

Sébastien Lacroix-Desmazes; Michel D Kazatchkine; Jagadeesh Bayry; Srini V Kaveri



Do glutathione-S-transferase polymorphisms influence response to intravenous cyclophosphamide therapy in idiopathic nephrotic syndrome?  

Microsoft Academic Search

The response to cyclophosphamide (CP) is variable and difficult to predict in children with idiopathic nephrotic syndrome\\u000a (INS). The polymorphic expression of glutathione-S-transferase (GST) may affect the remission rate after CP therapy. In this\\u000a study, we evaluated the correlation of GST polymorphism and response to CP in INS. We studied GST polymorphism in 74 children\\u000a with steroid-sensitive (44) and steroid-resistant

Sheetal V. Sharda; Sanjeev Gulati; Gaurav Tripathi; Tabrez Jafar; Alok Kumar; Raj Kumar Sharma; Suraksha Agrawal



Developing an interactive intravenous education and training program.  


Intravenous therapy knowledge, skills, and attitudes of nurses within a healthcare organization vary greatly. Primary nursing education programs, responsibility for i.v. therapy in previous jobs, patient populations, types of therapies provided, and clinical setting are just a few of the factors contributing to these variations. However, administrators usually expect all nurses to function in all areas of clinical practice. The gap between actual and expected knowledge and skills can be extremely wide, especially in i.v. therapy. Interactive multimedia i.v. education products provide a way to narrow that gap in a quick and cost-effective manner when appropriate planning processes are used to incorporate them into an educational program. PMID:10418412

Hadaway, L C


A prospective randomised trial comparing nasogastric with intravenous hydration in children with bronchiolitis (protocol) The comparative rehydration in bronchiolitis study (CRIB)  

Microsoft Academic Search

BACKGROUND: Bronchiolitis is the most common reason for admission of infants to hospital in developed countries. Fluid replacement therapy is required in about 30% of children admitted with bronchiolitis. There are currently two techniques of fluid replacement therapy that are used with the same frequency-intravenous (IV) or nasogastric (NG). The evidence to determine the optimum route of hydration therapy for

Ed Oakley; Franz E Babl; Jason Acworth; Meredith Borland; David Kreiser; Jocelyn Neutze; Theane Theophilos; Susan Donath; Mike South; Andrew Davidson



[Intravenous therapy with methylprednisolone and cyclophosphamide in vasculitis of peripheral nervous system. Evaluation of 8 patients].  


The peripheral nervous system is frequently involved in systemic vasculitis and it may be helpful in the disease diagnosis. We report on eight patients: seven women and one man; five white, two black and one yellow; age mean 55.9 years; four had polyarteritis nodosa, one had systemic lupus erythematosus, one had isolated peripheral nerve vasculitis and one had livedoid vasculitis. All of them received endovenous therapy with "pulse" of methylprednisolone (1 g/day/3 days) and cyclophosphamide (1 g/1 day). Five patients improved, two remained unchanged and one died. The neurological improvement occurred after the third or fourth pulse and in the patients who have had a shorter time of disease. PMID:9698740

Lino, A M; Hirata, M T; Baêta, A M; Tsanaclis, A M; Scaff, M; Marchiori, P E



Patients' assessment of the convenience of fentanyl HCl iontophoretic transdermal system (ITS) versus morphine intravenous patient-controlled analgesia (IV PCA) in the management of postoperative pain after major surgery.  


The patient-controlled fentanyl HCl iontophoretic transdermal system (ITS) is a compact, self-contained, needle-free system that has been approved for acute postoperative pain management in hospitalized adults. The objective of the present analysis was to evaluate patients' assessment of fentanyl ITS and morphine intravenous patient-controlled analgesia (IV PCA) convenience on 7 different subscales, using a validated patient ease of care (EOC) questionnaire in 2 prospective, open-label, randomized, phase IIIb clinical trials. Patients received fentanyl ITS or morphine IV PCA (N = 1,305) for up to 72 h after total hip replacement surgery (THR study) or abdominal or pelvic surgery (APS study). For the majority of items on the patient EOC questionnaire, trends suggest that greater percentages of patients reported the most positive response for fentanyl ITS than they did for morphine IV PCA in both studies; differences were particularly noteworthy for items on the Movement subscale. In the THR study, more patients in the fentanyl ITS group were responders compared with those in the morphine IV PCA group for the subscales Confidence with Device, Pain Control, Knowledge/Understanding, and Satisfaction. In the APS study, responder rates for these subscales did not differ between treatment groups. These findings indicate that patients assessed the EOC associated with fentanyl ITS higher compared with morphine IV PCA for the management of acute postoperative pain and suggest that fentanyl ITS has the potential to improve acute postoperative pain care for patients and nurses. PMID:19706349

Pennington, Peg; Caminiti, Stephanie; Schein, Jeff R; Hewitt, David J; Nelson, Winnie W



Modulation of Total Body Irradiation Induced Life Shortening by Systemic Intravenous MnSOD-Plasmid Liposome Gene Therapy  

PubMed Central

To determine whether systemic administration of MnSOD-PL protected mice from the acute hematopoietic syndrome as well as delayed death following total body irradiation (TBI), C57BL/6J mice received intravenously 100?l liposomes containing 100?g of human MnSOD-transgene plasmid 24 hours prior to 9.5 Gy or 1.0 Gy. The dose of 9.5 Gy was lethal to 42% of irradiated control female and 74% of irradiated control male mice respectively at 30 days with bone marrow hypocellularity consistent with the hematopoietic syndrome. A statistically significant increase in survival was detected in MnSOD-PL treated compared to 9.5 Gy irradiated control female mice out to 400 days, and in male mice out to 340 days. The incidence of tumors was similar between surviving groups. Between 350 to 600 days, outcome was similar for both MnSOD-PL treated and control irradiated groups consistent with aging with no difference in gross or microscopic pathologic evidence of tumors. Male and female mice receiving 1.0 Gy TBI showed irradiation induced life shortening after 120 days that was decreased by MnSOD-PL administration, and was associated with no increase in rate of tumor associated death. Therefore, systemic MnSOD-PL radioprotective gene therapy is not associated with a detectably higher incidence of late carcinogenesis.

Epperly, Michael W.; Smith, Tracy; Wang, Hong; Schlesselman, James; Franicola, Darcy; Greenberger, Joel S.



[Multimodal treatment for acute antibody-mediated renal transplant rejection: successful rescue therapy with combined plasmapheresis, photopheresis and intravenous immunoglobulin].  


The fundamental role of antibodies in the development of acute graft rejection has been established recently. Antibody-mediated acute rejection may develop at any time during the post-transplant period. Several therapeutic approaches have been proposed in the last decades. However, there is no standardized therapy. The aim of this study is to report the Sapienza University experience of combined plasma treatment and high-dose intravenous immunoglobulin ± extracorporeal photopheresis. From January 2006 to September 2009, 6 patients were treated at Sapienza University. In 5 cases (83%) complete regression of the acute rejection was observed, followed by stable renal function (median creatinine value at 1-year follow-up: 1.5 mg/dL). No adverse events were reported. Our approach seems to give good results in terms of graft survival and procedure safety. Further studies on a larger number of patients will be needed to confirm the validity of these findings. Moreover, comparison between our protocol and other treatments is necessary. PMID:22388827

Lai, Quirino; Pretagostini, Renzo; Gozzer, Maria; Cinti, Paola; Meo, Donatella; Vita, Fabiana; Bafti, Manas Shafii; Poli, Luca; Novelli, Gilnardo; Rossi, Massimo; Girelli, Gabriella; Berloco, Pasquale B


Efficacy of intravenous delta-aminolaevulinic acid photodynamic therapy on rabbit papillomas.  

PubMed Central

Endogenously induced protoporphyrin IX (PPIX), a metabolite of delta-aminolaevulinic acid (ALA), has been evaluated as a photosensitising agent for destruction of papillomas in cottontail rabbit papillomavirus-infected Dutch belted and New Zealand rabbits. Three factors were evaluated: (1) relative retention ratio of drug in normal tissue, papilloma and plasma over time; (2) tissue tolerance to treatment factors; and (3) efficacy of treatment protocol. Three drug doses of ALA were examined: 50, 100 and 200 mg kg-1. Actual PPIX concentrations in tissue and plasma were determined spectrophotofluorometrically. The optimal treatment time occurred 3-6 h post ALA injection. The highest PPIX concentration ratio between papilloma and normal skin was 6:1. Different light doses were investigated, using an injection to exposure interval of 3 h and an irradiance of 100 mW cm-2 at a wavelength of 630 nm. Efficacy without risk of significant damage to normal skin was obtained using 100-200 mg kg-1 ALA and 40-60 J cm-2. A long-term (3 months) cure rate of 82% was obtained with a single treatment, provided that papilloma depth did not exceed 8 mm, volume was not more than 1000 mm3 and the plasma concentration of PPIX immediately before exposure was above 500 micrograms ml-1. The short time between injection and treatment and high efficacy, together with PPIX disappearance from plasma and tissue within 24 h, make injected ALA a highly attractive drug for photodynamic therapy.

Lofgren, L. A.; Ronn, A. M.; Nouri, M.; Lee, C. J.; Yoo, D.; Steinberg, B. M.



Interim evaluation of two cooperative studies assessing the effects of intravenous immunoglobulin (i.v. IgG) on childhood idiopathic thrombocytopenic purpura (ITP)  

Microsoft Academic Search

Since in a pilot study i.v. IgG was shown to induce a rapid rise of thrombocytes in children with ITP two prospective multicenter ITP studies were started: one comparing i.v. IgG with oral corticosteroids in previously untreated acute ITP, the other investigating the response to i.v. IgG in pretreated acute or chronic ITP in childhood. In this report preliminary results

P. Imbach; G. Gaedicke; P. Joller



Post-marketing observational study on 5% intravenous immunoglobulin therapy in patients with secondary immunodeficiency and recurrent serious bacterial infections.  


Secondary hypogammaglobulinemia is one of the factors responsible for the increased susceptibility to infection in patients with chronic lymphocytic leukemia (CLL). This study assessed the therapeutic results, concomitant medication and tolerance of administering 5% intravenous immunoglobulin, secondary immunodeficiency and recurrent serious bacterial infections. A single center, post-marketing, observational clinical study was performed on 10 patients with a variety of hematological malignancies (CLL, follicular non-Hodgkin lymphoma, IgM-secreting immunocytoma, IgA plasmacytoma and myelodysplastic syndrome/non-Hodgkin lymphoma) who had been infused with IVIG from June 1994 to May 2009. The clinical benefit of IVIG was assessed by comparing the incidence of bacterial infections before and after starting this therapy. Plasma immunoglobulin concentrations and relevant hematological variables were recorded. For safety assessment, adverse events were monitored. The standard IVIG dosage was approximately 0.35?g/kg body weight every 3-4 weeks. Most patients had normal IgG trough values of?>600?mg/dL during the IVIG treatment period. The rate of bacterial infections was reduced from 2.4 per patient in the 3 months before IVIG to 0.7 (0-1.5) per patient per year during IVIG treatment. All patients received concomitant medication, mainly anticancer and anti-anemia therapy (100%). No serious adverse events related to IVIG were observed. The frequency of at least one minor adverse reaction was 1.44% (8/556 infusions). In conclusion, the investigated IVIG preparation was well tolerated and clinically beneficial in reducing the long term rate of serious bacterial infections in patients receiving concomitant treatment for malignant diseases. PMID:23607863

Günther, Georg; Dreger, Bettina



Plasma nitrate plus nitrite changes during continuous intravenous infusion interleukin 2  

Microsoft Academic Search

Nitric oxide (NO), a biologically active mediator generated in many cell types by the enzyme NO synthase, may play an important role in cardiovascular toxicity that is frequently observed in cancer patients during intravenous (i.v.) interleukin 2 (IL-2) therapy. The induction of NO synthase and the production of NO seem to be involved in the pathogenesis of the vascular leakage

G Citterio; F Pellegatta; GD Lucca; G Fragasso; U Scaglietti; D Pini; C Fortis; M Tresoldi; C Rugarli



Intravenous Iron Versus Oral Iron in the Treatment of Postpartum Iron Deficiency Anemia  

Microsoft Academic Search

Background: Postpartum anemia can develop after delivery because of unforeseen medical problems during and after delivery which could complicate a mother’s ability to properly care for her newborn child. The current treatment for postpartum anemia is oral iron supplementation but this treatment has been associated with several gastrointestinal side effects. Alternative treatments include blood transfusions and intravenous (IV) iron therapy.

Meghan Crowley



INCB024360 and Vaccine Therapy in Treating Patients With Stage III-IV Melanoma

Mucosal Melanoma; Recurrent Intraocular Melanoma; Recurrent Melanoma; Stage IIIA Intraocular Melanoma; Stage IIIA Melanoma; Stage IIIB Intraocular Melanoma; Stage IIIB Melanoma; Stage IIIC Intraocular Melanoma; Stage IIIC Melanoma; Stage IV Intraocular Melanoma; Stage IV Melanoma



Evaluation of the efficacy and safety of intravenous ciprofloxacin versus meropenem in the treatment of postoperative infection.  


Therapeutic options for postoperative infection in gastrointestinal surgery are limited. To identify new treatment alternatives, the Japan Society for Surgical Infection conducted a multicenter prospective, randomized, controlled clinical trial comparing the efficacy of intravenous ciprofloxacin (CIP IV) and intravenous meropenem (MEM IV). Between July 2005 and May 2008, the trial recruited patients who developed postoperative infection or had suspected infectious systemic inflammatory response syndrome after elective clean-contaminated gastrointestinal surgery. All patients had received prophylactic postoperative antibiotic treatment. Patients received either intravenous CIP IV 300 mg b.i.d. or MEM IV 500 mg b.i.d. A total of 205 patients from 31 institutions were enrolled. Of these, 101 were randomized to CIP IV and 104 to MEM IV. There were 100 and 102 in the intent-to-treat (ITT)/safety population and 75 and 77 in the per-protocol (PP) population. There was no significant difference between CIP IV and MEM IV in terms of clinical efficacy, bacteriological efficacy, incidence of adverse drug reactions, duration of antimicrobial treatment, or relapse/reactivation. Overall clinical success PP population) was high in both treatment groups: 85.3% (64/75) for CIP IV and 89.6% (69/77) for MEM IV, although the non-inferiority of CIP IV was not demonstrated (difference -4.3%, 95% CI -14.8, 6.2). In patients who had undergone upper gastrointestinal surgery, success was 88.5% (23/26) for CIP IV and 85.2% (23/27) for MEM IV. Intravenous ciprofloxacin is as effective as intravenous meropenem in the empiric therapy of postoperative infection after gastrointestinal surgery. PMID:22009525

Kusachi, Shinya; Sumiyama, Yoshinobu; Takahashi, Yoshiki; Kato, Komei; Mashita, Keiji; Takeyama, Hiromitsu; Oda, Shigeto; Kobayashi, Shinichi



Use of Intravenous Amiodarone for Postoperative Junctional Ectopic Tachycardia in Children  

Microsoft Academic Search

To assess the efficacy and safety of intravenous (IV) amiodarone for the treatment of postoperative junctional ectopic tachycardia (JET) in children, we retrospectively reviewed 11 patients treated with IV amiodarone for JET between 1\\/92 and 2\\/00. Data included heart rate and hemodynamics pre- and post-amiodarone, drug dosage, duration of therapy, and effect. Success was defined as reversion to sinus rhythm

W. P. Laird; C. S. Snyder; N. J. Kertesz; R. A. Friedman; D. Miller; A. L. Fenrich



Circulatory kinetics of intravenously injected {sup 238}Pu(IV) citrate and {sup 14}C-CaNa{sub 3}-DTPA in mice: Comparison with rat, dog, and Reference Man  

SciTech Connect

New ligands for in vivo chelation of Pu(IV) are being synthesized and evaluated in mice for efficacy and toxicity. Biokinetic studies of the new ligands, CaNa{sub 3}-DTPA, and Pu(IV) are major components of those investigations. Young adult female mice were injected intravenously (iv) with {sup 3}H-inulin, {sup 14}C-CaNa{sub 3}-DTPA, or {sup 238}Pu(IV) citrate to provide base- line data for plasma clearance, tissue uptake, and excretion rates and to determine the dilution volume (VOD) and renal clearance rate (RC) of filterable substances. Published plasma clearance data in Reference Man, dog, and rat were collected. Based on combined data for {sup 3}H-inulin and {sup 14}C-CaNa{sub 3}-DTPA, VOD = 17% of body weight and RC = 18 mL kg{sup -1} min{sup -1} for mice. Retention of {sup 14}C-CaNa{sub 3}-DTPA in the four species is proportional to body weight and inversely proportional to RC: Integrals of the retention of {sup 14}C-CaNa{sub 3}-DTPA from R(t) = 1.0 to R(t) = 0.05 are 108, 43, 28, and 10 DF min, respectively, for Reference Man, dog, rat, and mouse. Clearances of iv-injected Pu(IV) citrate from plasma are in the same order: The plasma curve integrals from injection to 1440 min are 840, 640, 280, and 67 DF min, respectively, for Reference Man, dog, rat, and mouse. In mice, a large fraction of newly injected Pu(IV) is rapidly transferred to the interstitial water of bulk soft tissue (excluding liver and kidneys), from which it is cleared at the same rate as from the plasma. Rapid plasma clearance, escape into interstitial water (22%ID at 20 min), significant early urinary excretion (8%ID in 12 h), and prompt deposition in liver and skeleton (complete in 12 h) are evidence of inefficient binding to plasma protein of newly injected Pu(IV) in mice. Slow plasma clearance, little early urinary excretion, and delayed deposition in liver and skeleton reflect more efficient binding of newly injected Pu(IV) in Reference Man and dog. 39 refs., 6 figs., 3 tabs.

Durbin, P.W.; Kullgren, B.; Schmidt, C.T. [Lawrence Berkeley National Lab., CA (United States)



Accumulation of the solvent vehicle sulphobutylether beta cyclodextrin sodium in critically ill patients treated with intravenous voriconazole under renal replacement therapy  

PubMed Central

Background Voriconazole was introduced for the treatment of life-threatening fungal infections. The intravenous form includes the solvent vehicle sulphobutylether beta cyclodextrin sodium which shows an impaired clearance under intermittent dialysis therapy. This investigation aimed to determine first clinical data on sulphobutylether beta cyclodextrin sodium blood levels to verify the risk for accumulation. Methods In four patients suffering from renal insufficiency and intermittent dialysis therapy who needed a treatment with intravenous voriconazole as a reserve antifungal at the intensive care unit of the Mainz University Hospital the trough levels of voriconazole and sulphobutylether beta cyclodextrin sodium were measured. Results A 75-year-old woman showed a maximal sulphobutylether beta cyclodextrin sodium plasma level of 145 ?g/ml in the initial phase. After a few days renal function recovered and the plasma levels came down to less than 20 ?g/ml. In contrast to this patient with a recovery of renal function the remaining three patients showed renal failure during the complete period of intravenous treatment with voriconazole. In these patients an accumulation of sulphobutylether beta cyclodextrin sodium plasma levels was determined with a maximum of 523 ?g/ml in a 18-year-old man, 409 ?g/ml in a 57-year-old man, and 581 ?g/ml in a 47-year-old man. Conclusion The present data indicate an accumulation of sulphobutylether beta cyclodextrin sodium in patients treated with intravenous voriconazole and dialysis therapy. Fortunately, no toxic effects were observed, although the accumulated dose values were lower but comparable with those used in previous toxicity studies with animals.

von Mach, Marc A; Burhenne, Jurgen; Weilemann, Ludwig S



Safety and Usefulness of Intravenous Iron Sucrose in the Management of Preoperative Anemia in Patients with Menorrhagia: A Phase IV, Open-Label, Prospective, Randomized Study  

Microsoft Academic Search

Background: The aim of this study was to compare the efficacy, safety and achievement of the target hemoglobin level (Hb ?10 g\\/dl) in patients with preoperative anemia due to menorrhagia who received intravenous iron sucrose compared with oral iron protein succinylate for anemia management. Methods: Seventy-six patients with Hb levels <9.0 g\\/dl who were scheduled to undergo surgical treatment were

Yun Hwan Kim; Hyun Hoon Chung; Soon-Beom Kang; Seung Cheol Kim; Young Tae Kim



Studies on haemolymph nodes. IV. Comparison of the route of entry of carbon particles into parathymic nodes after intravenous and intraperitoneal injection.  

PubMed Central

Haemolymph nodes are found in certain mammals including man. In the rat they are located near the kidneys, spleen and thymus. A distinctive feature is that their sinuses contain numerous erythrocytes. For renal and splenic haemolymph nodes, the erythrocytes appear to be extrinsic in origin, entering the node via its afferent lymphatics (Hogg et al. 1982; Abbas et al. 1983). In the present study we investigated the drainage of carbon particles injected intraperitoneally or intravenously into the parathymic haemolymph nodes. Carbon particles injected intraperitoneally reached the nodes rapidly, within minutes and in large quantities, via the afferent lymphatics draining principally from the diaphragmatic peritoneum. Carbon particles injected intravenously entered the nodes much more slowly, reaching a maximum after 5-7 d, and in much smaller amounts, although the pattern of distribution was similar, spreading from the subcapsular sinus into the intermediate and medullary sinuses. No carbon particles were found crossing the walls of high endothelial venules. Carbon particles injected intravenously reach the parathymic nodes from peripheral lymph via the afferent lymphatics. Whilst accepting that there are significant biological differences between carbon particles and erythrocytes it seem possible that erythrocytes, like injected carbon particles, may enter the nodes by a similar route. Images Fig. 1 Fig. 2 Fig. 3 Fig. 4 Figs 5,6 Fig. 7 Figs 8,9

Abu-Hijleh, M F; Scothorne, R J



Bevacizumab and Intravenous or Intraperitoneal Chemotherapy in Treating Patients With Stage II, Stage III, or Stage IV Ovarian Epithelial Cancer, Fallopian Tube Cancer, or Primary Peritoneal Cancer

Brenner Tumor; Ovarian Clear Cell Cystadenocarcinoma; Ovarian Endometrioid Adenocarcinoma; Ovarian Mixed Epithelial Carcinoma; Ovarian Mucinous Cystadenocarcinoma; Ovarian Serous Cystadenocarcinoma; Ovarian Undifferentiated Adenocarcinoma; Stage IIA Fallopian Tube Cancer; Stage IIA Ovarian Epithelial Cancer; Stage IIA Primary Peritoneal Cavity Cancer; Stage IIB Fallopian Tube Cancer; Stage IIB Ovarian Epithelial Cancer; Stage IIB Primary Peritoneal Cavity Cancer; Stage IIC Fallopian Tube Cancer; Stage IIC Ovarian Epithelial Cancer; Stage IIC Primary Peritoneal Cavity Cancer; Stage IIIA Fallopian Tube Cancer; Stage IIIA Ovarian Epithelial Cancer; Stage IIIA Primary Peritoneal Cavity Cancer; Stage IIIB Fallopian Tube Cancer; Stage IIIB Ovarian Epithelial Cancer; Stage IIIB Primary Peritoneal Cavity Cancer; Stage IIIC Fallopian Tube Cancer; Stage IIIC Ovarian Epithelial Cancer; Stage IIIC Primary Peritoneal Cavity Cancer; Stage IV Fallopian Tube Cancer; Stage IV Ovarian Epithelial Cancer; Stage IV Primary Peritoneal Cavity Cancer



Use of intravenous immune globulin in addition to antiviral therapy in the treatment of CMV gastrointestinal disease in allogeneic bone marrow transplant patients: a report from the European Group for Blood and Marrow Transplantation (EBMT)  

Microsoft Academic Search

The best treatment of CMV gastrointestinal disease has been controversial, with some centers adding intravenous (i.v.) Ig to antiviral chemotherapy. The aim of this retrospective survey was to compare the outcome of antiviral chemotherapy with or without i.v. Ig. A questionnaire was sent to centers belonging to the EBMT. Thirty-three patients with CMV gastrointestinal disease were reported, 22 patients were

P Ljungman; C Cordonnier; H Einsele; C Bender-Götze; A Bosi; A Dekker; R De la Camara; J Gmür; AC Newland; HG Prentice; AJ Robinson; M Rovira; W Rösler; D Veil



Intravenous Chemotherapy or Oral Chemotherapy in Treating Patients With Previously Untreated Stage III-IV HIV-Associated Non-Hodgkin Lymphoma

AIDS-related Diffuse Large Cell Lymphoma; AIDS-related Diffuse Mixed Cell Lymphoma; AIDS-related Diffuse Small Cleaved Cell Lymphoma; AIDS-related Immunoblastic Large Cell Lymphoma; AIDS-related Lymphoblastic Lymphoma; AIDS-related Peripheral/Systemic Lymphoma; AIDS-related Small Noncleaved Cell Lymphoma; Stage III AIDS-related Lymphoma; Stage IV AIDS-related Lymphoma



An intravenous (i.v.) route-compatible formulation of FL118, a survivin, Mcl-1, XIAP, and cIAP2 selective inhibitor, improves FL118 antitumor efficacy and therapeutic index (TI)  

PubMed Central

We recently reported a novel anticancer small molecule, designated FL118, which was discovered via high throughput screening (HTS), and followed by hit-lead in vitro and in vivo analysis. FL118 selectively inhibits the expression of four major cancer survival-associated gene products (survivin, Mcl-1, XIAP, and cIAP2) and shows promising antitumor activity in animal models of human cancers when administered using a weekly x 4 schedule (Ling et al., PLOS ONE. 2012, 7: e45571). Here, we compared the antitumor efficacy and therapeutic index (TI) of FL118 in a newly developed Tween 80-free formulation that can be delivered intravenously (i.v.) and intraperitoneally (i.p.) against the previous Tween 80-containing formulation that can only be delivered via an i.p. route. We found that the maximum tolerated dose (MTD) for FL118 in the i.v. formulation increases 3-7 fold in comparison with the MTD of FL118 in the i.p. formulation. FL118 in the i.v. recipe was able to eliminate human tumor xenografts in all three major schedules tested (daily x 5, q2 x 5 and weekly x 5). In contrast, FL118 was able to eliminate human tumor xenografts in the i.p. formulation only with the weekly x 4 schedule previously reported. The TI of FL118 in the i.v. formulation reached 5-6 in the most effective schedule, while the TI of FL118 in the i.p. formulation was only 1.3 - 2. These findings overcome several clinical challenges including FL118 formulation to realize clinically compatible drug administration routes, and expanding effective treatment schedules. The striking improvement of the TI makes FL118 a much safer drug for further development toward clinical trials.

Ling, Xiang; Li, Fengzhi



Intravenous immunoglobulin (i.v. IgG) for previously treated acute or for chronic idiopathic thrombocytopenic purpura (ITP) in childhood: a prospective multicenter study  

Microsoft Academic Search

In a prospective multicenter study 42 thrombocytopenic (9 platelets\\/l) children with chronic idiopathic thrombocytopenic purpura (ITP) or with acute ITP, dependent on or refractory to corticosteroids, were given 0.4 g i.v. IgG\\/kg body weight\\/day on 5 consecutive days and thereafter once a week if the platelet count fell to 9\\/l or if the patient bled. After the initial 5 days

B. Imholz; P. Imbach; C. Baumgartner; W. Berchtold; G. Gaedicke; E. Gugler; A. Hirt; W. Hitzig; C. Mueller-Eckhardt; H. P. Wagner



Intravenous immunoglobulin-induced lichenoid dermatitis: a unique adverse reaction.  


Intravenous immunoglobulin (IVIG) therapy has been used to treat various diseases. Generalized allergic reactions (types I, II, and III) to IVIG are uncommon and are usually related to the rate of infusion. Cutaneous reactions have been anecdotally described. Herein we describe a 73-year-old man with Sjögren's syndrome who had development of a lichenoid cutaneous eruption after administration of IVIG therapy. CD3 immunostaining demonstrated the overwhelming presence of T lymphocytes within a lesional skin biopsy specimen, and thus we present an alternative cell-mediated immune mechanism (type IV) by which allergic reactions to IVIG may occur. PMID:9413297

Yockey, S M; Ahmed, I



Cost Effectiveness of Personalized Therapy for First-Line Treatment of Stage IV and Recurrent Incurable Adenocarcinoma of the Lung  

PubMed Central

Purpose: Patients with epidermal growth factor receptor (EGFR) mutation–positive stage IV adenocarcinoma have improved survival with tyrosine kinase inhibitor (TKI) treatments, but the cost effectiveness of personalized first-line therapy using EGFR mutation testing is unknown. Methods: We created a decision analytic model comparing the costs and effects of platinum combination chemotherapy with personalized therapy in which patients with EGFR mutation–positive tumors were treated with erlotinib. We used two testing strategies: testing only those with tissue available and performing a repeat biopsy if tissue was not available versus three nontargeted chemotherapy regimens (ie, carboplatin and paclitaxel; carboplatin and pemetrexed; and carboplatin, pemetrexed, and bevacizumab). Results: Compared with a carboplatin plus paclitaxel regimen, targeted therapy based on testing available tissue yielded an incremental cost-effectiveness ratio (ICER) of $110,644 per quality-adjusted life year (QALY), and the rebiopsy strategy yielded an ICER of $122,219 per QALY. Probabilistic sensitivity analysis revealed substantial uncertainty around these point estimates. With a willingness to pay of $100,000 per QALY, the testing strategy was cost effective 58% of the time, and the rebiopsy strategy was cost effective 54% of the time. Personalized therapy with an EGFR TKI was more favorable when the nontargeted chemotherapy regimen was more expensive. Compared with carboplatin, pemetrexed, and bevacizumab, ICERs were $25,547 per QALY for the testing strategy and $44,036 per QALY for the rebiopsy strategy. Conclusion: Although specific clinical circumstances should guide therapy, our cost-effectiveness analysis supports the strategy of testing for EGFR mutations in patients with stage IV or recurrent adenocarcinoma of the lung, rebiopsying patients if insufficient tissue is available for testing, and treating patients with EGFR mutations with erlotinib as first-line therapy.

Handorf, Elizabeth A.; McElligott, Sean; Vachani, Anil; Langer, Corey J.; Bristol Demeter, Mirar; Armstrong, Katrina; Asch, David A.



Chronic baclofen therapy improves the blunted growth hormone response to intravenous arginine in subjects with spinal cord injury.  


Human GH (hGH) secretion is stimulated by vigorous physical activity, whereas immobilization reduces its release. In paralyzed subjects with spinal cord injury (SCI), it has recently been shown that the release of hGH to provocative stimulation and plasma insulin-like growth factor-I (IGF-I) levels are reduced. The acute administration of baclofen, a gamma-aminobutyric acid derivative, has been shown to stimulate hGH release. The present study investigated the effect of chronic administration of baclofen on the provocative testing of hGH secretion and plasma IGF-I levels. Sixteen subjects with SCI were studied; eight subjects were treated (40-80 mg/day; > 6 months) with baclofen (Bac+), and eight were not (Bac-). Additionally, 8 non-SCI subjects were studied as controls. The groups were matched for gender and age. The subjects were not receiving any medications known to influence hGH secretion. After an overnight fast, arginine hydrochloride (30 g/subject) was infused iv over 30 min, with blood drawn for hormone determinations at baseline and 30, 60, 90, and 120 min. In the Bac- group compared with the Bac+ group, the arginine-stimulated mean plasma hGH levels at 30 and 60 min (P < 0.05) and peak and sum plasma hGH levels (P < 0.01) were reduced. There were no significant differences in the plasma hGH response between the Bac+ group and the control group. Plasma IGF-I levels may reflect the integrated tissue response to hGH. A significant inverse relationship was present between age and plasma IGF-I levels for the control and Bac+ groups, but not for the Bac- group. The mean plasma IGF-I level was significantly reduced in the Bac- compared with the Bac+ group. No significant differences in mean plasma IGF-I levels were noted between the Bac+ and control groups. SCI is associated with body composition changes and metabolic alterations that may be exacerbated by reduced activity of the hGH-IGF-I axis. Oral chronic baclofen therapy appears to reverse the deleterious effects of paralysis and immobilization on hGH physiology. PMID:8175969

Bauman, W A; Spungen, A M; Zhong, Y G; Tsitouras, P D



Crystalline-Like Keratopathy after Intravenous Immunoglobulin Therapy with Incomplete Kawasaki Disease: Case Report and Literature Review  

PubMed Central

A 7-year-old girl had presented with high body temperature and joint pain which continued for 3 days. Because of the prolonged history of unexplained fever, rash, bilateral nonpurulent conjunctival injection, oropharyngeal erythema, strawberry tongue, and extreme of age, incomplete Kawasaki disease was considered and started on an intravenous immunoglobulin infusion. Six days after this treatment, patient was referred to eye clinic with decreased vision and photophobia. Visual acuity was reduced to 20/40 in both eyes. Slit-lamp examination revealed bilateral diffuse corneal punctate epitheliopathy and anterior stromal haze. Corneal epitheliopathy seemed like crystal deposits. One day after presentation, mild anterior uveitis was added to clinical picture. All ocular findings disappeared in one week with topical steroid and unpreserved artificial tear drops. We present a case who was diagnosed as incomplete Kawasaki disease along with bilateral diffuse crystalline-like keratopathy. We supposed that unusual ocular presentation may be associated with intravenous immunoglobulin treatment.

Kocabas, Emine; Taylan Sekeroglu, Hande; Ozgur, Ozlem; Yagmur, Meltem; Ersoz, T. Reha



Crystalline-like keratopathy after intravenous immunoglobulin therapy with incomplete kawasaki disease: case report and literature review.  


A 7-year-old girl had presented with high body temperature and joint pain which continued for 3 days. Because of the prolonged history of unexplained fever, rash, bilateral nonpurulent conjunctival injection, oropharyngeal erythema, strawberry tongue, and extreme of age, incomplete Kawasaki disease was considered and started on an intravenous immunoglobulin infusion. Six days after this treatment, patient was referred to eye clinic with decreased vision and photophobia. Visual acuity was reduced to 20/40 in both eyes. Slit-lamp examination revealed bilateral diffuse corneal punctate epitheliopathy and anterior stromal haze. Corneal epitheliopathy seemed like crystal deposits. One day after presentation, mild anterior uveitis was added to clinical picture. All ocular findings disappeared in one week with topical steroid and unpreserved artificial tear drops. We present a case who was diagnosed as incomplete Kawasaki disease along with bilateral diffuse crystalline-like keratopathy. We supposed that unusual ocular presentation may be associated with intravenous immunoglobulin treatment. PMID:23607016

Erdem, Elif; Kocabas, Emine; Taylan Sekeroglu, Hande; Ozgür, Ozlem; Yagmur, Meltem; Ersoz, T Reha



Speed of Intracranial Clot Lysis With Intravenous Tissue Plasminogen Activator Therapy Sonographic Classification and Short-Term Improvement  

Microsoft Academic Search

Background—Arterial recanalization precedes clinical improvement or may lead to hemorrhage or reperfusion injury. Speed of clot lysis was not previously measured in human stroke. Methods and Results—Transcranial Doppler (TCD) and the National Institutes of Health Stroke Scale (NIHSS) were used to monitor consecutive patients receiving intravenous tissue plasminogen activator (tPA), before tPA bolus and at 24 hours. Patients with complete

Andrei V. Alexandrov; W. Scott Burgin; Andrew M. Demchuk; Ashraf El-Mitwalli; James C. Grotta


Final Report for Intravenous Fluid Generation (IVGEN) Spaceflight Experiment.  

National Technical Information Service (NTIS)

NASA designed and operated the Intravenous Fluid Generation (IVGEN) experiment onboard the International Space Station (ISS), Increment 23/24, during May 2010. This hardware was a demonstration experiment to generate intravenous (IV) fluid from ISS Water ...

D. F. Brown D. V. W. Griffin J. B. McQuillen J. T. Zoldak T. L. McKay



Bleomycin, vinorelbine and trofosfamide in relapsed stage IV cutaneous malignant melanoma patients  

Microsoft Academic Search

Purpose  To evaluate the efficacy of bleomycin, vinorelbine, and trofosfamide (BVT) in 28 patients with pretreated relapsed AJCC stage\\u000a IV cutaneous malignant melanoma.\\u000a \\u000a \\u000a \\u000a Methods  Patients in relapse after first- or second-line therapy received 8 mg\\/m2 intravenous (i.v.) bleomycin, 25 mg\\/m2 i.v. vinorelbine, on days 1 and 6, each, and oral (p.o.) trofosfamide 60 mg\\/m2\\/day, days 1–7. BVT therapy was repeated every 5 weeks until progression

Jens Atzpodien; Lars Morawek; Michael Fluck; Martina Reitz



Economics of home intravenous services.  


Home care has become a more attractive option as economic constraints are placed on the total healthcare system. Over the past 25 years, home intravenous service programmes have developed simultaneously with the development of more reliable means of providing intravenous therapy in the home. Reports have been published on a variety of home intravenous programmes including antibiotic therapy, parenteral nutrition support, chemotherapy, blood product administration and pain control. This review examines the economics of home intravenous programmes, including such direct cost items as drugs, medical supplies and equipment, personnel, hospital room, inventory control, and carrying inventory. Indirect costs, assessed as loss of wages, are also analysed. Cost savings have been reported ranging from 18 to 75% for intravenous antibiotic programmes and 60 to 76% for parenteral nutrition programmes. Earlier reports concentrated on analysis of savings derived from comparison of direct costs only, but recent studies have explored a more comprehensive fiscal analysis. PMID:10146945

Thickson, N D



Intravenous multipotent adult progenitor cell therapy for traumatic brain injury: Preserving the blood brain barrier via an interaction with splenocytes  

PubMed Central

Recent investigation has shown an interaction between transplanted progenitor cells and resident splenocytes leading to modulation of the immunologic response in neurological injury. We hypothesize that the intravenous injection of multipotent adult progenitor cells (MAPC) confers neurovascular protection after traumatic brain injury through an interaction with resident splenocytes, subsequently leading to preservation of the blood brain barrier. Four groups of rats underwent controlled cortical impact injury (3 groups) or sham injury (1 group). MAPC were injected via the tail vein at two doses (2*106 MAPC/kg or 10*106 MAPC/kg) 2 and 24 hours after injury. Blood brain barrier permeability was assessed by measuring Evans blue dye extravasation (n=6/group). Additionally, splenic mass was measured (n=12/group) followed by splenocyte characterization (n=9/group) including: cell cycle analysis (n=6/group), apoptosis index (n=6/group), cell proliferation (n=6/group), and inflammatory cytokine measurements (n=6/group). Vascular architecture was determined by immunohistochemistry (n=3/group). Traumatic brain injury results in a decrease in splenic mass and increased blood brain barrier permeability. Intravenous infusion of MAPC preserved splenic mass and returned blood brain barrier permeability towards control sham injured levels. Splenocyte characterization indicated an increase in the number and proliferative rate of CD4+ T cells as well as an increase in IL-4 and IL-10 production in stimulated splenocytes isolated from the MAPC treatment groups. Immunohistochemistry demonstrated stabilization of the vascular architecture in the peri-lesion area Traumatic brain injury causes a reduction in splenic mass that correlates with an increase in circulating immune cells leading to increased blood brain barrier permeability. The intravenous injection of MAPC preserves splenic mass and the integrity of the blood brain barrier. Furthermore, the co-localization of transplanted MAPC and resident CD4+ splenocytes is associated with a global increase in IL-4 and IL-10 production and stabilization of the cerebral microvasculature tight junction proteins.

Walker, Peter A.; Shah, Shinil K.; Jimenez, Fernando; Gerber, Michael H.; Xue, Hasen; Cutrone, Rochelle; Hamilton, Jason A.; Mays, Robert W.; Deans, Robert; Pati, Shibani; Dash, Pramod K; Cox, Charles S.



Update of a comparative analysis of cost minimization following the introduction of newly available intravenous iron therapies in hospital practice  

PubMed Central

Background The clinical need to be able to administer high doses of intravenous iron conveniently as a rapid infusion has been addressed by the recent introduction of ferric carboxymaltose and subsequently iron isomaltoside 1000. Neither requires a test dose. The maximum dose of ferric carboxymaltose is 1000 mg. The maximum dose of iron isomaltoside 1000 is based on 20 mg/kg body weight without a specified ceiling dose, thereby increasing the scope of being able to achieve total iron repletion with a single infusion. This ability to give high doses of iron is important in the context of managing iron deficiency anemia, which is associated with a number of clinical conditions where demands for iron are high. It is also an important component of the strategy as an alternative to blood transfusion. Affordability is a key issue for health services. Recent price changes affecting iron sucrose and ferric carboxymaltose, plus modifications to the manufacturers’ prescribing information, have provoked this update. Methods This study is a comparative analysis of the costs of acquiring and administering the newly available intravenous iron formulations against standard treatments in the hospital setting. The costs include the medication, nursing costs, equipment, and patient transportation. Three dosage levels (600 mg, 1000 mg, and 1600 mg) are considered. Results and conclusion The traditional standard treatments, blood and iron sucrose, cost more than the alternative intravenous iron preparations across the dose spectrum and sensitivities. Low molecular weight iron dextran is the least expensive option at the 1600 mg dose level but has the caveat of a prolonged administration time and requirement for a test dose. At 600 mg and 1000 mg dose levels, both iron isomaltoside 1000 and ferric carboxymaltose are more economical than low molecular weight iron dextran. Iron isomaltoside 1000 is less expensive than ferric carboxymaltose at all dose levels. Newly available iron preparations appear to be clinically promising, cost effective, and practical alternatives to current standards of iron repletion.

Bhandari, Sunil



Alpha 1-antitrypsin deficiency and the impact of nursing interventions and treatment with intravenous therapy. An overview.  


The primary function of alpha1-antitrypsin is to protect the alveoli in the lung from harmful destruction from proteolytic enzymes, which prevent optimal elastic recoil of the lungs and destroy the lungs. Insufficient serum levels of alpha1-antitrypsin eventually lead to early onset of emphysema in the third, fourth, or fifth decade of life. Treatment of alpha1-antitrypsin deficiency by intravenous administration of an enzyme inhibitor known as alpha1-proteinase inhibitor, a human-derived blood product, can be administered to help replace the enzymes required to maintain lung function. Early detection, nursing intervention, and clinical management slow the progression of this hereditary disease. PMID:10776189

Scharnweber, K


Neutralization of Measles Virus Infectivity and Antibody-Dependent Cell-Mediated Cytotoxicity Activity against an Epstein-Barr Virus-Infected Cell Line by Intravenous Administration of Immunoglobulin G  

Microsoft Academic Search

Patients with antibody deficiency disorders are highly susceptible to microbial infections. Intravenous (i.v.) immunoglobulin concentrates were originally developed as replacement therapy for such patients. The present study assesses the measles virus neutralizing antibody titers and the antibody-dependent cell-mediated cyto- toxicity (ADCC) capacities against Epstein-Barr virus (EBV)-infected cells of immunoglobulin G (IgG) prep- arations produced for i.v. use (i.v. IgG). The

MariCarmen Colomar; Irene Puga; Maite Lopez; Marta Massot; Juan I. Jorquera; Manuel Reina; Senen Vilaro; Enric Espel



Primary angioplasty versus intravenous thrombolytic therapy for acute myocardial infarction: a quantitative review of 23 randomised trials  

Microsoft Academic Search

Summary Background Many trials have been done to compare primary percutaneous transluminal coronary angioplasty (PTCA) with thrombolytic therapy for acute ST-segment elevation myocardial infarction (AMI). Our aim was to look at the combined results of these trials and to ascertain which reperfusion therapy is most effective. Methods We did a search of published work and identified 23 trials, which together

Ellen C Keeley; Judith A Boura; Cindy L Grines



Ehlers-Danlos syndrome type IV: diagnosis and therapy of associated bowel perforation.  


Ehlers-Danlos syndrome type IV is a heritable disease of type III collagen metabolism. This diagnosis is suspected in a patient with a combination of clinical manifestations and family history, but it is confirmed only by culture of the patient's skin fibroblasts and demonstration of a defect in type III collagen metabolism. The disease may rarely present with spontaneous colonic perforation, a complication traditionally treated by primary closure of the perforated segment and creation of an end colostomy. Attempts at bowel reanastomosis have often resulted in repeated colon perforations. We present the first patient with Ehlers-Danlos type IV syndrome to develop a colon perforation proximal to an end colostomy, and discuss the surgical strategy to prevent recurrences of this and other postoperative complications associated with the syndrome. PMID:1998319

Stillman, A E; Painter, R; Hollister, D W



Hypothyroid dogs treated with intravenous levothyroxine.  


The purpose of this retrospective study was to report clinical and clinicopathologic findings, response to treatment, and outcome of hypothyroid dogs treated with levothyroxine intravenously (IV). Seven levothyroxine IV treated hypothyroid dogs and 799 other hypothyroid dogs examined during the same period were included. Rottweiler dogs were overrepresented in the group of levothyroxine IV-treated hypothyroid dogs compared with other hypothyroid dogs (P < .0001). Common physical examination abnormalities were obese or overweight body condition (5 dogs), mental dullness (5 dogs), and nonpitting edema (4 dogs). Anemia (4 dogs) and hypercholesterolemia (5) were common, although 1 dog had neither. Concurrent disease (most commonly infection) was observed in 5 dogs. Glucocorticoids and nonsteroidal antiinflammatory drugs had been administered to 2 dogs before examination. Surgery was performed in 2 dogs before treatment with levothyroxine IV. Four of the 7 dogs received 4-5 microg/kg of levothyroxine IV. Subjective improvement in mentation or ambulation (6 of 7 dogs) and systolic hypotension (2 of 2 dogs) occurred within 30 hours of levothyroxine IV administration. Six of the 7 dogs responded well to therapy and were discharged from the hospital. It was concluded that physical examination and clinicopathologic findings of dogs with a hypothyroid crisis are nonspecific, although Rottweiler dogs may be at increased risk. Concurrent disorder, such as infection, concurrent administration of thyroid hormone-altering medication, and surgery, may be associated with development of a hypothyroid crisis. Resolution of abnormal mentation, ambulation, and systolic hypotension should be expected within 30 hours. Prognosis is good in most treated dogs. PMID:16496920

Pullen, William H; Hess, Rebecka S


Effect of intravenous gammaglobulin therapy in IgG2 deficient and IgG2 sufficient children with recurrent infections and poor response to immunization with Hemophilus influenzae type b capsular polysaccharide antigen.  


Nine children with recurrent sinopulmonary infections and normal IgG levels failed to improve after a 12-month period of prophylactic antibiotic therapy with trimethoprim-sulfamethoxazole. Five of these children had selective deficiency of IgG2 subclass, while the other four did not, but all nine children had a poor response to immunization with Hemophilus influenzae type b (Hib) capsular polysaccharide. Following the institution of intravenous immunoglobulin (IVIG) therapy, there was a significant decrease in the episodes of sinusitis and otitis media in all patients. Intravenous immunoglobulin therapy resulted in a significant increase in total serum IgG, IgG2, and IgG anti-Hib antibody levels. Discontinuation of IVIG therapy was followed by the return of recurrent infections. This preliminary study demonstrates that IVIG replacement therapy in children with recurrent infections and selective antibody deficiency is associated with a significant reduction in the frequency of sinopulmonary infections. PMID:2297141

Silk, H J; Ambrosino, D; Geha, R S



Comparison of intravenous and oral antibiotic therapy in the treatment of fractures caused by low-velocity gunshots. A prospective, randomized study of infection rates.  


One hundred and ninety consecutive patients (222 fractures) who had an extra-articular fracture of a long bone as a result of a low-velocity gunshot were randomized into two groups on the basis of the method of administration of antibiotics. Group 1 consisted of 101 patients (120 fractures) who were managed with intravenous administration of cephapirin sodium and gentamicin for three days. Group 2 comprised eighty-nine patients (102 fractures) who were managed with oral administration of ciprofloxacin for three days. The two groups were comparable in terms of the age of the patient, the locations of the fractures, and the time from the injury to the commencement of antibiotic therapy. Injuries that needed operative débridement or fixation were excluded. All patients were followed until the fracture had healed. Two infections developed in two of the ninety-nine patients (118 fractures) who completed the study in Group 1, and two infections developed in two of the eighty-seven patients (100 fractures) who completed the study in Group 2. With the numbers available, there was no significant difference in the rates of infection (2 per cent for both) between the two groups. All four fractures that were complicated by infection were located in the distal half of the tibia. We concluded that oral and intravenous administration of antibiotics were equally effective for prophylaxis against infection after an extra-articular fracture from a low-velocity gunshot. PMID:8753708

Knapp, T P; Patzakis, M J; Lee, J; Seipel, P R; Abdollahi, K; Reisch, R B



Intravenous Leiomyomatosis  

PubMed Central

Leiomyomas are benign tumors arising from smooth muscle of the uterus. Intravenous leiomyomatosis is characterized by intraluminal growth of benign smooth muscle into either venous or lymphatic vessels outside the limits of myoma. It commonly extends into the pelvic veins and manifests as worm-like protrusions of tumor emanating from veins at the parametrial margins of hysterectomy specimen. The tumor can cause life-threatening symptoms if it involves inferior vena cava or right atrium. We report a case of intravenous leiomyomatosis of the uterus managed at our institution.

Mariyappa, Narayanaswamy; Manikyam, Uday Kumar; Krishnamurthy, Dinesh; Preeti, K; Agarwal, Yamini; Prakar, U



Practical Considerations in Administering Intravenous  

Microsoft Academic Search

Novel biopharmaceutical agents that require intravenous (IV) administra- tion are currently in development or available for the treatment of many neurological conditions, including multiple sclerosis (MS). The use of these medications has the potential to change the course of disease man- agement. Hence, neurology nurses and other caregivers may be called upon to to administer a higher num- ber of

Janice L. Hinkle; Medications Lynn Hadaway


Early embolic events complicating intravenous thrombolysis for acute ischemic stroke.  


Intravenous recombinant tissue plasminogen activator (IV rt-PA) is the only established thrombolytic therapy for acute ischemic stroke. However, secondary embolism after IV rt-PA for acute ischemic stroke is recognized as an uncommon complication, and the pathophysiology is unclear. We describe a 72-year-old man with acute infarction in the territory of left anterior cerebral artery who developed new infarction in the territory of right middle cerebral artery and acute peripheral arterial occlusion after IV rt-PA therapy. It suggested a central embolic source. Because the patient has paroxysmal atrial fibrillation (Af), the possible embolic sources may come from fragmentation of pre-existing intra-atrial clot. Although Af and the presence of cardiac thrombus are not contraindication for IV rt-PA in acute ischemic stroke, our case and review suggested that the administration of IV rt-PA to patients with known Af and intracardiac thrombus could represent a particular risk situation and should be carefully evaluated. PMID:22205004

Chou, Ping Song; Lin, Chien Hung; Chao, Hai Lun; Chao, A Ching



Molecular Aspects of Bladder Cancer IV: Gene Therapy of Bladder Cancer  

Microsoft Academic Search

Cancer gene therapy is the applied consequence of the intense research on cell function during the last decades. With the discovery of genes, the genetic code and gene functions many diseases, like bladder cancer, were linked to dysfunction of the cell’s genetic material. Soon the wish for a direct treatment of the underlying cause of such genetically based diseases, a

Peter Ardelt; Andreas Böhle



Calcium kinetics in children with osteogenesis imperfecta type III and IV: pre- and post-growth hormone therapy.  


Children with osteogenesis imperfecta (OI) type III and type IV were studied using a (42)Ca stable isotope technique. Serum dilution kinetics of (42)Ca were studied pre- and post-growth hormone (GH) treatment in 9 OI III (age range 5-9 years) and 8 OI IV patients (age range 5-12 years). Each subject was studied twice: at baseline and following GH therapy (range 1-1.5 years). Isotopic enrichments of (42)Ca were followed over 7 days using thermal ionization mass spectrometry. A binding site model, which describes reversible and irreversible binding of calcium (Ca) ions to postulated short- and long-term binding sites in bone, was used to analyze the kinetic data. In type III patients, GH treatment (1) increased the fraction of short-term binding sites, theta (0.777 +/- 0.112 versus 0.877 +/- 0.05, respectively; P = 0.034); (2) increased the apparent half-life of a Ca ion attached to the long-term binding site by 76% (P = 0. 009); (3) although not statistically significant (P = 0.098), a trend toward an increased growth rate was observed with increasing change in theta (Deltatheta); (4) patients experienced a 75% increase in growth rate during the first 6 months of treatment. In type IV patients, GH treatment increased the apparent half-life of a Ca ion attached to the long-term binding site by 83% (P = 0.048), however, no trend toward an increased growth rate was observed with increasing Deltatheta in these patients. These significant changes in Ca binding to bone may influence growth in type III patients. PMID:10920211

Vieira, N E; Goans, R E; Weiss, G H; Hopkins, E; Marini, J C; Yergey, A L



A randomized double-blind trial of intravenous trimetazidine as adjunctive therapy to primary angioplasty for acute myocardial infarction  

Microsoft Academic Search

Background: Despite high patency rates, primary angioplasty for myocardial infarction does not necessarily result in optimal myocardial reperfusion and limitation of infarct size. Experimentally, trimetazidine limits infarct size, decreases platelet aggregation, and reduces leukocyte influx into the infarct zone. To assess trimetazidine as adjunctive therapy to primary angioplasty for acute myocardial infarction a prospective, double-blind, placebo-controlled pilot trial was performed.

Ph. Gabriel Steg; Gilles Grollier; Pierre Gallay; Marie-Claude Morice; Gaëtan J. Karrillon; Hakim Benamer; Christian Kempf; Thierry Laperche; Pierre Arnaud; Philippe Sellier; Christian Bourguignon; Catherine Harpey



Initial fetal platelet counts predict the response to intravenous gammaglobulin therapy in fetuses that are affected by PLA1 incompatibility  

Microsoft Academic Search

Objective: Fetal alloimmune thrombocytopenia is the result of maternal fetal platelet antigen incompatibility; intracranial hemorrhage is its most serious complication. Our previous studies have demonstrated an inability to accurately predict fetal platelet counts in this disorder. The goal of the present investigation was to identify factors that would predict the response of the fetal platelet count to therapy so that

Sreedhar Gaddipati; Richard L. Berkowitz; A. Arda Lembet; Robert Lapinski; Janice G. McFarland; James B. Bussel



Systematic review: intravenous Ibuprofen in preterm newborns.  


Ibuprofen, a nonsteroidal antiinflammatory drug, widely used as antipyretic, antiinflammatory, and analgesic agent and for therapy of arthritis, exerts a dose-dependent constriction of the ductus arteriosus in newborn lambs. Two intravenous preparations, namely ibuprofen lysine and ibuprofen-THAM, have been studied in preterm newborns with patent ductus arteriosus. Clinical trials have compared IV ibuprofen to placebo, or to indomethacin. Pharmacodynamic effects of this drug before and after its administration have also been evaluated. Compared with placebo, IV ibuprofen effectively closed PDA with minimal effect on renal function. One study using intravenous ibuprofen-THAM showed decreased renal function and increased risk of NEC and PPHN. Compared with indomethacin, IV ibuprofen lysine exerted similar efficacy (75% to 93% closure). However, indomethacin increased abnormal renal function and decreased mesenteric and cerebral blood flow and bio-energetics. Two clinical trials showed that ibuprofen did not reduce the incidence of intraventricular hemorrhage compared with placebo. The drug has prolonged elimination (plasma half-life = ca 23 hours), suggesting that once daily dosing is appropriate. Dose finding studies indicate that a starting dose of 10 mg/kg followed by 5 mg/kg/d for 2 more days provides optimal efficacy with the least adverse effects. Neonatal data on ibuprofen and indomethacin indicate that, on the first day of life when IVH prevention is desired, indomethacin and not ibuprofen should be used since ibuprofen has no effect on IVH risk. On or after the second day of postnatal life, when early or therapeutic PDA closure is needed, ibuprofen and not indomethacin is probably the first choice due to its better adverse event profile. PMID:16813969

Aranda, J V; Thomas, Ronald



Adherence to and Gastrointestinal Tolerability of Monthly Oral or Quarterly Intravenous Ibandronate Therapy in Women with Previous Intolerance to Oral Bisphosphonates: A 12Month, Open-Label, Prospective Evaluation  

Microsoft Academic Search

Background: Gastrointestinal (GI) symptoms and high dosing frequency have been cited as reasons for inadequate adherence to daily or weekly oral bisphosphonate therapy. Inadequate adherence may lead to poor therapeutic outcomes.Objective: The PRIOR study evaluated adherence to and GI tolerability of monthly therapy with oral and quarterly intravenous ibandronate in postmenopausal women with osteoporosis or osteopenia.Methods: This 12-month, multicenter, prospective,

E. Michael Lewiecki; Ann M. Babbitt; Veronica K. Piziak; Zafer E. Ozturk; Henry G. Bone



Intracoronary thallium-201 scintigraphy after thrombolytic therapy for acute myocardial infarction compared with 10 and 100 day intravenous thallium-201 scintigraphy  

SciTech Connect

Thallium-201 imaging has been utilized to estimate myocardial salvage after thrombolytic therapy for acute myocardial infarction. However, results from recent animal studies have suggested that as a result of reactive hyperemia and delayed necrosis, thallium-201 imaging may overestimate myocardial salvage. To determine whether early overestimation of salvage occurs in humans, intracoronary thallium-201 scans 1 hour after thrombolytic therapy were compared with intravenous thallium-201 scans obtained approximately 10 and 100 days after myocardial infarction in 29 patients. In 10 patients with angiographic evidence of coronary reperfusion, immediate improvement in thallium defects and no interim clinical events, there was no change in imaging in the follow-up studies. Of nine patients with coronary reperfusion but no initial improvement of perfusion defects, none showed worsening of defects in the follow-up images. Six of these patients demonstrated subsequent improvement at either 10 or 100 days after infarction. Seven of 10 patients with neither early evidence of reperfusion nor improvement in perfusion defects had improvement of infarct-related perfusion defects, and none showed worsening. In conclusion, serial scanning at 10 and 100 days after infarction in patients with no subsequent clinical events showed no worsening of the perfusion image compared with images obtained in acute studies. Therefore, there is no evidence that thallium-201 imaging performed early in patients with acute myocardial infarction overestimates improvement.

Heller, G.V.; Parker, J.A.; Silverman, K.J.; Royal, H.D.; Kolodny, G.M.; Paulin, S.; Braunwald, E.; Markis, J.E.



[Method for determining the amount of blood loss using the storage iron decrease rate as obtained from serum ferritin after intravenous iron therapy].  


This is to introduce a new method for determining the amount of blood loss by measuring the storage iron decrease rate (SID), as obtained by following serum ferritin after intravenous iron therapy in a patient with iron deficiency anemia due to intestinal blood loss. The patient was followed from the day S, when iron therapy started, to the day E, when serum ferritin decreased to 12 microg/l, indicating the exhaustion of the iron stores. The SID was calculated from the formula: SID=(T-R)/D, where, T mg = total amount of injected iron, R mg = the difference in the iron in the hemoglobin (deltaHb) between day S and E, and D = days from S to E. The SID was thought to be iron loss only, as the contribution of iron absorption and iron loss to the SID, with the exception of bleeding, was believed to be negligible and as the serum ferritin decrease curve was exponentially linear. Using the formula, V = iron loss/iron in mean Hb, the amount of blood loss: V=29 ml/day was obtained. This method can also be used for the quantitation of blood loss in other patients with chronic blood loss, because the SID could also be determined in 12 cases of post-treatment iron deficiency anemia with chronic blood loss. PMID:15609683

Saito, Hiroshi; Maeda, Hideaki



Antipseudomonal therapy in cystic fibrosis: Aztreonam and amikacin versus ceftazidime and amikacin administered intravenously followed by oral ciprofloxacin  

Microsoft Academic Search

In order to determine the optimal antipseudomonal therapy in patients with cystic fibrosis aztreonam plus amikacin was compared to ceftazidime plus amikacin, and these two-week hospital regimens were followed by oral ciprofloxacin given for four weeks. Fifty-six cases of acute pulmonary exacerbation of the disease in 42 patients associated with isolation ofPseudomonas aeruginosa from the sputum were randomly treated with

U. B. Schaad; J. Wedgwood-Krucko; K. Guenin; U. Buehlmann; R. Kraemer



Intravenous Vitamin D Therapy Reduces PTH(1–84)\\/Large C Fragments Ratio in Chronic Hemodialysis Patients  

Microsoft Academic Search

Background: Renal osteodystrophy is one of the major complications in patients with chronic renal failure. Large C-PTH fragments are secreted from the parathyroid glands and exert antagonistic actions against PTH-(1–84). The PTH-(1–84)\\/large C-PTH fragments ratio reflects both biosynthesis and processing of PTH; however the alteration of the ratio under vitamin D therapy has not been investigated. Methods: Seventeen hemodialysis patients

Takashi Kihara; Haruo Ichikawa; Hisanori Morimoto; Ai Yano; Shigeru Akagi; Kazushi Nakao; Hiroko Kohmoto; Jun Wada; Isao Kumagai; Hirofumi Makino



Early intervention in acute myocardial infarction: significance for myocardial salvage of immediate intravenous streptokinase therapy followed by coronary angioplasty  

SciTech Connect

Sixteen patients with acute myocardial infarction underwent treatment with streptokinase up to 3 hours after the onset of chest pain. Nine patients (group I) received streptokinase within 1 hour of the onset of pain, and seven patients (group II) received it within 2 to 3 hours. All underwent multigated radionuclide ventriculography after streptokinase therapy and 1 week later. Percutaneous transluminal coronary angioplasty of the infarct artery was performed within 24 hours in all patients. An effort-limited treadmill stress test was performed before discharge. There was no mortality or serious complication. Mean peak total creatine kinase was 521 +/- 289 mU/ml in group I, and 1,614 +/- 709 mU/ml in group II (p less than 0.05). The mean initial left ventricular ejection fraction was 47 +/- 11% in group I and 37 +/- 10% in group II. After early angioplasty (within 24 hours) and at 1 week recovery, left ventricular ejection fraction increased to 53 +/- 9% in group I (p less than 0.05) and to 40 +/- 7% in group II (p = NS). Seven of the nine patients in group I had normal radionuclide ventriculograms at discharge compared with none of the seven patients in group II. Thrombolytic therapy administered less than 1 hour after the onset of symptoms of acute myocardial infarction followed by angioplasty of the infarct artery results in preservation of left ventricular function, whereas therapy given after 2 hours has only a limited effect.

Miller, H.I.; Almagor, Y.; Keren, G.; Chernilas, J.; Roth, A.; Eschar, Y.; Shapira, I.; Shargorodsky, B.; Berenfeld, D.; Laniado, S.



A double-blinded randomised controlled study of the value of sequential intravenous and oral magnesium therapy in patients with chronic low back pain with a neuropathic component.  


Persistent mechanical irritation of the nerve root sets up a series of events mediating sensitisation of the dorsal roots and dorsal horns in the spinal cord. Current evidence supports the role of magnesium in blocking central sensitisation through its effect on N-methyl-d-aspartate receptors. We studied the role of sequential intravenous and oral magnesium infusion in patients with chronic low back pain with a neuropathic component. We recruited a cohort of 80 patients with chronic low back pain with a Leeds Assessment of Neuropathic Signs and Symptoms pain scale score ? 12, who were receiving a physical therapy programme. All patients were treated with anticonvulsants, antidepressants and simple analgesics; in addition 40 patients received placebo for 6 weeks (control group), while the other 40 patients received an intravenous magnesium infusion for 2 weeks followed by oral magnesium capsules for another 4 weeks (magnesium group). Patients were asked to rate their pain using a numerical rating scale. Lumbar spine range of motion was also determined using a long-arm goniometer. In the magnesium group, the patients' numerical rating scales revealed a significant reduction in pain intensity. The mean (SD) pre-treatment value was 7.5 (2.2) compared with 4.7 (1.8) at 6 months (p = 0.034). The reduction in pain intensity was accompanied by significant improvement in lumbar spine range of motion during the follow-up period. The mean (SD) values of flexion, extension and lateral flexion movements before treatment and at 6-month follow up were 22.2 (8.4) vs 34.7 (11.5) (p = 0.018), 11.8 (3.4) vs 16.9 (3.5) (p = 0.039), 11.4 (3.6) vs 17.2 (4.4) (p = 0.035), respectively. Our findings show that a 2-week intravenous magnesium infusion followed by 4 weeks of oral magnesium supplementation can reduce pain intensity and improve lumbar spine mobility during a 6-month period in patients with refractory chronic low back pain with a neuropathic component. PMID:23384256

Yousef, A A; Al-deeb, A E



[Character of changes in the rheological parameters of blood in patients with heart failure III-IV FC treated by the combination therapy with plasmapheresis].  


The purpose of the investigation is to estimate the blood rheological parameters in patients with heart failure III-IV FC treated by the combination therapy (plasmapheresis with the standard therapy). There were 96 patients under the investigations, 69 men and 27 women. Age ranged from 55 to 75 years. All patients were divided into two groups: the 1st group--29 patients (20 men and 9 women) treated by standard therapy (ACE inhibitors, diuretics, digoxin and etc.), the 2nd group included 67 patients (49 men and 18 women), which received the combination therapy with plasmapheresis (2-4 times). The investigations of the blood rheological parameters in patients with heart failure III-IV FC treated by the standard therapy and by the combination therapy show the benefit of the combined one. It was proved by the statistically significant decrease of prothrombin time, fibrinogen, antithrombin III and haematocrit indicator in patients with heart failure treated with the combined therapy (in comparison with patients treated with standard therapy). Patients treated with the combined therapy demonstrated low blood viscosity levels -BV20, BV200 and high erythrocyte deformability index. PMID:23787503



Epidermal growth factor receptor targeted therapy in stages III and IV head and neck cancer  

PubMed Central

Question What are the benefits associated with the use of anti–epidermal growth factor receptor (anti-egfr) therapies in squamous cell carcinoma of the head and neck (hnscc)? Anti-egfr therapies of interest included cetuximab, gefitinib, lapatinib, zalutumumab, erlotinib, and panitumumab. Perspectives Head-and-neck cancer includes malignant tumours arising from a variety of sites in the upper aerodigestive tract. The most common histologic type is squamous cell carcinoma, and most common sites are the oral cavity, the oropharynx, the hypopharynx, and the larynx. Worldwide, hnscc is the sixth most common neoplasm, and despite advances in therapy, long-term survival in hnscc patients is poor. Primary surgery followed by chemoradiation, or primary chemoradiation, are the standard treatment options for patients with locally advanced (stages iii–ivb) hnscc; however, meta-analytic data indicate that the benefit of concurrent platinum-based chemotherapy disappears in patients over the age of 70 years. Cetuximab is a monoclonal antibody approved for use in combination with radiation in the treatment of patients with untreated locally advanced hnscc and as monotherapy for patients with recurrent or metastatic (stage ivc) hnscc who have progressed on platinum-based therapy. Given the interest in anti-egfr agents in advanced hnscc, the Head and Neck Cancer Disease Site Group (dsg) of Cancer Care Ontario’s Program in Evidence-Based Care (pebc) chose to systematically review the literature pertaining to this topic so as to develop evidence-based recommendations for treatment. Outcomes Outcomes of interest included overall and progression-free survival, quality of life, tumour response rate and duration, and the toxicity associated with the use of anti-egfr therapies. Methodology The medline, embase, and Cochrane Library databases, the American Society of Clinical Oncology online conference proceedings, the Canadian Medical Association InfoBase, and the National Guidelines Clearinghouse were systematically searched to locate primary articles and practice guidelines. The reference lists from relevant review articles were searched for additional trials. All evidence was reviewed, and that evidence informed the development of the clinical practice guideline. The resulting recommendations were approved by the Report Approval Panel of the pebc, and by the Head and Neck Cancer dsg. An external review by Ontario practitioners completed the final phase of the review process. Feedback from all parties was incorporated to create the final practice guideline. Results The electronic search identified seventy-four references that were reviewed for inclusion. Only four phase iii trials met the inclusion criteria for the present guideline. No practice guidelines, systematic reviews, or meta-analyses were found during the course of the literature search. The randomized controlled trials (rcts) involved three distinct patient populations: those with locally advanced hnscc being treated for cure, those with incurable advanced recurrent or metastatic hnscc being treated with first-line platinum-based chemotherapy, and those with incurable advanced recurrent or metastatic hnscc who had disease progression despite, or who were unsuitable for, first-line platinum-based chemotherapy. Practice Guideline These recommendations apply to adult patients with locally advanced (nonmetastatic stages iii–ivb) or recurrent or metastatic (stage ivc) hnscc. Platinum-based chemoradiation remains the current standard of care for treatment of locally advanced hnscc. In patients with locally advanced hnscc who are medically unsuitable for concurrent platinumbased chemotherapy or who are over the age of 70 years (because concurrent chemotherapy does not appear to improve overall survival in this patient population), the addition of cetuximab to radical radiotherapy should be considered to improve overall survival, progression-free survival, and time to local recurrence. Cetuximab in combination with platinum-based combination chemotherapy is super

Cripps, C.; Winquist, E.; Devries, M.C.; Stys-Norman, D.; Gilbert, R.



Erlotinib Hydrochloride and Radiation Therapy in Stage III-IV Squamous Cell Cancer of the Head and Neck

Stage III Squamous Cell Carcinoma of the Hypopharynx; Stage III Squamous Cell Carcinoma of the Larynx; Stage III Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage III Squamous Cell Carcinoma of the Oropharynx; Stage III Verrucous Carcinoma of the Larynx; Stage III Verrucous Carcinoma of the Oral Cavity; Stage IV Squamous Cell Carcinoma of the Hypopharynx; Stage IV Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage IV Squamous Cell Carcinoma of the Nasopharynx; Stage IV Squamous Cell Carcinoma of the Oropharynx; Stage IV Verrucous Carcinoma of the Larynx; Stage IV Verrucous Carcinoma of the Oral Cavity



Empiric antimicrobial therapy of febrile neutropenic patients undergoing haematopoietic stem cell transplantation  

Microsoft Academic Search

This study was conducted to assess the efficacy and toxicity of intravenous (i.v.) ceftazidime and ciprofloxacin in neutropenic febrile patients undergoing high dose myeloablative therapy and hematopoietic stem cell transplantation (HSCT). All patients undergoing HSCT for leukaemia, lymphoma, multiple myeloma and solid tumours received open-label ceftazidime 2 g i.v. every 8 h and ciprofloxacin 400 mg i.v. every 12 h

Bassema A Antabli; Peter Bross; Robert S Siegel; Connie D Small; Imad A Tabbara



A pilot randomised controlled trial of negative pressure wound therapy to treat grade III/IV pressure ulcers [ISRCTN69032034  

PubMed Central

Background Negative pressure wound therapy (NPWT) is widely promoted as a treatment for full thickness wounds; however, there is a lack of high-quality research evidence regarding its clinical and cost effectiveness. A trial of NPWT for the treatment of grade III/IV pressure ulcers would be worthwhile but premature without assessing whether such a trial is feasible. The aim of this pilot randomised controlled trial was to assess the feasibility of conducting a future full trial of NPWT for the treatment of grade III and IV pressure ulcers and to pilot all aspects of the trial. Methods This was a two-centre (acute and community), pilot randomised controlled trial. Eligible participants were randomised to receive either NPWT or standard care (SC) (spun hydrocolloid, alginate or foam dressings). Outcome measures were time to healing of the reference pressure ulcer, recruitment rates, frequency of treatment visits, resources used and duration of follow-up. Results Three hundred and twelve patients were screened for eligibility into this trial over a 12-month recruitment period and 12/312 participants (3.8%) were randomised: 6 to NPWT and 6 to SC. Only one reference pressure ulcer healed (NPWT group) during follow-up (time to healing 79?days). The mean number of treatment visits per week was 3.1 (NPWT) and 5.7 (SC); 6/6 NPWT and 1/6 SC participants withdrew from their allocated trial treatment. The mean duration of follow-up was 3.8 (NPWT) and 5.0 (SC) months. Conclusions This pilot trial yielded vital information for the planning of a future full study including projected recruitment rate, required duration of follow-up and extent of research nurse support required. Data were also used to inform the cost-effectiveness and value of information analyses, which were conducted alongside the pilot trial. Trial registration Current Controlled Trials ISRCTN69032034.



Intravenous nitroglycerin for acute myocardial infarction.  


Intravenous nitroglycerin (IV TNG) has been increasingly used in the setting of acute myocardial infarction. The seven randomized trials comparing IV TNG with placebo, and one trial comparing IV isosorbide dinitrate with furosemide, were reviewed for evidence of beneficial clinical effects. IV TNG in low dosage is safe in the setting of acute myocardial infarction and modestly effective in relieving chest pain. Favorable hemodynamic effects are most pronounced in patients with congestive heart failure. Limited evidence suggests that IV TNG, particularly when administered early, reduces both infarct size and mortality when given prophylactically. PMID:1804825

Borzak, S



Streptokinase Promotes Development of Dipeptidyl Peptidase IV (CD26) Autoantibodies after Fibrinolytic Therapy in Myocardial Infarction Patients  

Microsoft Academic Search

Dipeptidyl peptidase IV (DPP IV) (CD26) plays a critical role in the modulation and expression of auto- immune and inflammatory diseases. We recently reported that sera from patients with rheumatoid arthritis and systemic lupus erythematosus contained low levels of DPP IV and high titers of anti-DPP IV autoanti- bodies of the immunoglobulin A (IgA) and IgG classes and found a

Miguel Cuchacovich; Hector Gatica; Paula Vial; Jorge Yovanovich; Salvatore V. Pizzo; Mario Gonzalez-Gronow



Incorrect Prescription of Intravenous Paracetamol in a Pediatric Patient  

PubMed Central

Intravenous (IV) paracetamol is widely used for the treatment of pain and fever, when there is a clinical indication for an IV route. A 16-month-old girl weighing 12 kg had undergone anterior open reduction for developmental dysplasia of the hip. Twenty-four hours after the operation, IV paracetamol (Perfalgan® 10 mg/ml) infusion was started for the postoperative pain management. After 12 hours’ infusion, she has developed nausea, vomiting and agitation. The liver function tests were found to be more than 10-fold elevated on the laboratory results. When the medication order was checked, it was shown that she had been administered paracetamol 5 times at a dose of 42 mg/kg (total: 2.5 g/30 hours or 168 mg/kg/24 hours). The patient was started on N-acetyl cysteine (NAC) therapy immediately. She was asymptomatic at the 36th hour of the NAC treatment and the liver function tests completely recovered over 15 days. Since the errors in the calculation of the dosage of IV paracetamol may lead to serious complications or even death, physicians should be careful not to miscalculate when preferring the IV form of the drug.

Orun, E; Polat, A; Andan, H; Cizmeci, N; Tufan, N



A retrospective evaluation of the efficacy of intravenous bumetanide and comparison of potency with furosemide  

PubMed Central

Background The potency of intravenous bumetanide to furosemide using a ratio of 1:40 has been suggested; however, there are little data supporting this ratio. Recent drug shortages required the use of bumetanide in a large patient population, enabling further characterization of the efficacy of IV bumetanide. Objective The primary objective of this study was to estimate a dose-response effect of IV bumetanide on urine output (UOP) in all patients that received 48 hours of therapy as well as in a subgroup of patients with heart failure (HF). This subgroup was used to compare the potency of bumetanide with furosemide. A secondary safety objective described electrolyte replacement required during therapy. Methods This was a single-center retrospective study examining the dose-response effect of IV bumetanide in patients receiving at least 48 hours of intermittent (iIV) or continuous (cIV) dosing, measured by UOP per mg of drug received (mL/mg). The potency of IV bumetanide was compared with furosemide in a subset of patients with HF using pre-existing data. The safety of IV bumetanide was analyzed by quantifying electrolyte replacement received during the study period. Results The primary outcome was higher in the iIV group (n=93) at 1273 ± 844 mL/mg compared with the cIV group (n=16) at 749 ± 370 mL/mg (P=0.002). Among patients with HF who received furosemide (iIV n=30, cIV n=26) or bumetanide (iIV n=30, cIV n=3), a potency ratio of 41:1 was found for the iIV group and 34:1 for all patients with HF. There was no significant difference in electrolyte replacement between groups. Conclusions A greater response was seen with intermittent bumetanide compared with continuous infusion bumetanide. This study supports the 40:1 dose equivalence ratio (furosemide:bumetanide) in patients with HF receiving at least 48 hours of intravenous intermittent bumetanide.

Nappi, Jean M.


Intravenous genetic mesothelin vaccine based on human adenovirus 40 inhibits growth and metastasis of pancreatic cancer.  


High pancreatic cancer mortality and poor prognosis are caused by the difficulty for early diagnosis and extremely low rates of resection because of metastasis. Mesothelin overexpression in pancreatic cancer is a remarkable biomarker for tumor progression, especially for invasion and metastasis. Here, we generated a novel replication-defective recombinant adenovirus 40 (rAd40), whose gene delivery properties are totally different from a conventional rAd5. In this study, we have identified intravenous administration with rAd40 expressing mouse mesothelin (Msln) as an effective prophylactic cancer vaccine against metastatic lesions of pancreatic cancer in mice. Intravenous administration of rAd40 (rAd40 i.v.) achieved transgene delivery in wider range of organs compared to rAd5 i.v., while rAd5 was distributed mainly to the liver, spleen, and lungs. Additionally, rAd40 i.v. showed less transduction of the liver or inflammatory responses, resulted in reduced liver toxicity compared to rAd5 i.v. Also, more robust systemic antigen-specific immune responses were stimulated by rAd40 i.v. Pretreatment with a single ovalbumin-expressing rAd40 i.v. prevented tumor growth in mouse subcutaneous models of ovalbumin-expressing pancreatic cancer. When used with Msln-expressing rAd40 i.v., Msln protein expression and metastases were suppressed in a syngeneic orthotopic mouse model of pancreatic cancer, corresponding to the detection of Msln- and tumor-specific cytotoxic T lymphocyte (CTL). Our novel methods generated antitumor effects against antigen-expressing tumors through antigen- and tumor-specific CTL-mediated immunity. Thus, our results indicate that a rAd40-based intravenous vaccine provides a new strategy for the effective control of metastatic pancreatic cancer and novel therapy against other cancers and infectious diseases. PMID:23233329

Yamasaki, Satoshi; Miura, Yoshiaki; Davydova, Julia; Vickers, Selwyn M; Yamamoto, Masato



A randomized, multicenter trial of weight-adjusted intravenous heparin dose titration and point-of-care coagulation monitoring in hospitalized patients with active thromboembolic disease. Antithrombotic Therapy Consortium Investigators  

Microsoft Academic Search

BACKGROUND: Therapy with intravenous unfractionated heparin improves clinical outcome in patients with active thromboembolic disease, but achieving and maintaining a therapeutic level of anticoagulation remains a major challenge for clinicians.\\u000aMETHODS: A total of 113 patients requiring heparin for at least 48 hours were randomly assigned at 7 medical centers to either weight-adjusted or non-weight-adjusted dose titration. They were separately

Richard C. Becker; Steven P. Ball; Paul Eisenberg; Steven Borzak; A. Christian Held; Frederick A. Spencer; Stephen J. Voyce; Robert Jesse; Robert C. Hendel; Yunsheng Ma; Thomas G. Hurley; James R. Hebert



Markers of increased risk of intracerebral hemorrhage after intravenous recombinant tissue plasminogen activator therapy for acute ischemic stroke in clinical practice: the multicenter rt-PA acute stroke survey  

Microsoft Academic Search

Background—Intravenous recombinant tissue plasminogen activator (rtPA) is an effective therapy for acute ischemic stroke, but it is associated with risk of intracerebral hemorrhage (ICH). Our aim was to identify, in a large cohort of patients, readily available baseline factors that are associated with thrombolysis-related ICH. Methods and Results—In a multicenter retrospective and prospective investigation of individual data from 1205 patients

David Tanne; Scott E. Kasner; Andrew M. Demchuk



Mycobacterium abscessus Bacteremia After Receipt of Intravenous Infusate of Cytokine-Induced Killer Cell Therapy for Body Beautification and Health Boosting.  


Background.?We report the first series of Mycobacterium abscessus bacteremia after cytokine-induced killer cell therapy for body beautification and health boosting. Methods.?The clinical manifestations, laboratory and radiological investigations, cytokine/chemokine profiles, and outcomes were described and analyzed. Results.?Four patients were admitted, and 3 patients had septic shock. Chest radiographs showed pulmonary infiltrates in all patients. Three patients developed peripheral gangrene, and 1 patient required lower limb and finger amputations. Patient 1 also developed disseminated infection including meningitis and urinary tract infection. Postmortem examination of patient 1 showed focal areas of pulmonary hemorrhage and diffuse alveolar damage, splenic infarct, adrenal necrosis, and hemorrhage, and acid-fast bacilli (AFB) were seen in the lung, liver, kidney, and adrenal gland. Patient 2 developed inguinal granulomatous lymphadenitis about 40 days after onset of lower limb gangrene. Wedge-shaped pulmonary infarcts were found in patient 3, and retinitis and subcutaneous lesions developed in patient 4. Patients in septic shock had dysregulated cytokine/chemokine profiles. Patient 4 with relatively milder presentation had increasing levels of interleukin 17 and cytokines in the interferon-?/interleukin 12 pathway. All survivors required prolonged intravenous antibiotics. Blood cultures grew M. abscessus for all patients, and admission peripheral blood smear revealed AFB for 3 patients. Mycobacterium abscessus was also isolated from respiratory specimens (2 patients), urine (1 patient), and cerebrospinal fluid (1 patient). Time to initial blood culture positivity (patients 1, 2, and 3: ?52 hours; patient 4: 83 hours) appeared to correlate with disease severity. Conclusions.?Empirical coverage for rapidly growing mycobacteria should be considered in patients with sepsis following cosmetic procedures. PMID:23825355

Liu, Raymond; To, Kelvin K W; Teng, Jade L L; Choi, Garnet K Y; Mok, Ka-Yi; Law, Kin-Ip; Tso, Eugene Y K; Fung, Kitty S C; Wu, Tak-Chiu; Wu, Alan K L; Fung, Shing-Hoi; Wong, Sally C Y; Trendell-Smith, Nigel J; Yuen, Kwok-Yung



Contraceptive Behavior Among Intravenous Drug Users at Risk for AIDS  

Microsoft Academic Search

In both Europe and the United States, intravenous (IV) drug use has become the primary source for perinatal transmission of the acquired immunodeficiency syndrome (AIDS), yet there have been few studies of the contraceptive behavior of IV drug users, We examined factors associated with practicing contraception among 319 street-recruited IV drug users in New York City Slightly over half of

Anthony C. Kouzi; Don C. Des Jarlais; Susan Tross; Abu Abdul-Quader; Samuel R. Friedman



The dipeptidyl peptidase IV inhibitor NVP-DPP728 reduces plasma glucagon concentration in cats.  


Glucagon-like peptide-1 (GLP-1) analogues and inhibitors of its degrading enzyme, dipeptidyl peptidase IV (DPPIV), are interesting therapy options in human diabetics because they increase insulin secretion and reduce postprandial glucagon secretion. Given the similar pathophysiology of human type 2 and feline diabetes mellitus, this study investigated whether the DPPIV inhibitor NVP-DPP728 reduces plasma glucagon levels in cats. Intravenous glucose tolerance tests (ivGTT; 0.5 g/kg glucose after 12 h fasting) and a meal response test (test meal of 50% of average daily food intake, offered after 24 h fasting) were performed in healthy experimental cats. NVP-DPP728 (0.5-2.5 mg/kg i.v. or s.c.) significantly reduced glucagon output in all tests and increased insulin output in the ivGTT. Follow-up studies will investigate the potential usefulness as therapy in diabetic cats. PMID:19128990

Furrer, Daniela; Kaufmann, Karin; Tschuor, Flurin; Reusch, Claudia E; Lutz, Thomas A



Intravenous iron in inflammatory bowel disease  

PubMed Central

The prevalence of anemia across studies on patients with inflammatory bowel disease (IBD) is high (30%). Both iron deficiency (ID) and anemia of chronic disease contribute most to the development of anemia in IBD. The prevalence of ID is even higher (45%). Anemia and ID negatively impact the patient’s quality of life. Therefore, together with an adequate control of disease activity, iron replacement therapy should start as soon as anemia or ID is detected to attain a normal hemoglobin (Hb) and iron status. Many patients will respond to oral iron, but compliance may be poor, whereas intravenous (IV) compounds are safe, provide a faster Hb increase and iron store repletion, and presents a lower rate of treatment discontinuation. Absolute indications for IV iron treatment should include severe anemia, intolerance or inappropriate response to oral iron, severe intestinal disease activity, or use of an erythropoietic stimulating agent. Four different products are principally used in clinical practice, which differ in their pharmacokinetic properties and safety profiles: iron gluconate and iron sucrose (lower single doses), and iron dextran and ferric carboxymaltose (higher single doses). After the initial resolution of anemia and the repletion of iron stores, the patient’s hematological and iron parameters should be carefully and periodically monitored, and maintenance iron treatment should be provided as required. New IV preparations that allow for giving 1000-1500 mg in a single session, thus facilitating patient management, provide an excellent tool to prevent or treat anemia and ID in this patient population, which in turn avoids allogeneic blood transfusion and improves their quality of life.

Munoz, Manuel; Gomez-Ramirez, Susana; Garcia-Erce, Jose Antonio



Phase I Study of Intravenous Triapine (IND # 68338) in Combination With Pelvic Radiation Therapy With or Without Weekly Intravenous Cisplatin Chemotherapy for Locally Advanced Cervical, Vaginal, or Pelvic Gynecologic Malignancies

Recurrent Cervical Cancer; Recurrent Ovarian Epithelial Cancer; Recurrent Vaginal Cancer; Recurrent Vulvar Cancer; Stage III Vaginal Cancer; Stage IIIA Cervical Cancer; Stage IIIA Ovarian Epithelial Cancer; Stage IIIA Vulvar Cancer; Stage IIIB Cervical Cancer; Stage IIIB Ovarian Epithelial Cancer; Stage IIIB Vulvar Cancer; Stage IIIC Ovarian Epithelial Cancer; Stage IIIC Vulvar Cancer; Stage IV Ovarian Epithelial Cancer; Stage IVA Cervical Cancer; Stage IVA Vaginal Cancer; Stage IVB Cervical Cancer; Stage IVB Vaginal Cancer



A Phase I study of weekly intravenous oxaliplatin in combination with oral daily capecitabine and radiation therapy in the neoadjuvant treatment of rectal adenocarcinoma  

SciTech Connect

Purpose: We conducted a Phase I study to determine the maximum tolerated dose (MTD) of neoadjuvant capecitabine, oxaliplatin, and radiation therapy (RT) in Stage II to III rectal adenocarcinoma. Methods and Materials: Capecitabine was given orally twice daily Monday through Friday concurrently with RT. Oxaliplatin was given i.v. once weekly x 5 (for 5 weeks) starting the first day of RT. RT was given daily except on weekends and holidays at 1.8 Gy per fraction x 28. Escalation for capecitabine or oxaliplatin was to occur in cohorts of three patients until the maximum tolerated dose (MTD) was defined. Endorectal tumor biopsy samples were obtained before and on Day 3 of treatment to explore the effects of treatment on thymidine phosphorylase, thymidylate synthase, dihydropyrimidine dehydrogenase, DNA repair, and apoptosis. Results: Twelve patients were enrolled on this study. Two of 6 patients at dose level (DL) 1 (capecitabine 825 mg/m{sup 2} orally (p.o.) given twice daily (b.i.d.); oxaliplatin 50 mg/m{sup 2}/week) had a dose-limiting diarrhea. One of 6 patients at DL (-)1 (capecitabine 725 mg/m{sup 2} p.o., b.i.d.; oxaliplatin 50 mg/m{sup 2}/week) experienced-dose-limiting diarrhea. Three of 11 patients who underwent resection had a complete pathologic response. No remarkable variations in rectal tumor biologic endpoints were noted on Day 3 of treatment in comparison to baseline. However, a higher apotosis index was observed at baseline and on Day 3 in complete pathologic responders (no statistical analysis performed). Conclusions: Capecitabine 725 mg/m{sup 2} p.o., twice daily in combination with oxaliplatin 50 mg/m{sup 2}/week and RT 50.4 Gy in 28 fractions is the recommended dose for future studies.

Fakih, Marwan G. [Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (United States) and Department of Pharmacology and Experimental Therapeutics, Roswell Park Cancer Institute, Buffalo, NY (United States)]. E-mail:; Rajput, Ashwani [Department of Surgical Oncology, Roswell Park Cancer Institute, Buffalo, NY (United States); Department of Pharmacology and Experimental Therapeutics, Roswell Park Cancer Institute, Buffalo, NY (United States); Yang, Gary Y. [Department of Radiation Oncology, Roswell Park Cancer Institute, Buffalo, NY (United States); Pendyala, Lakshmi [Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (United States); Toth, Karoly [Department of Pharmacology and Experimental Therapeutics, Roswell Park Cancer Institute, Buffalo, NY (United States); Smith, Judy L. [Department of Surgical Oncology, Roswell Park Cancer Institute, Buffalo, NY (United States); Lawrence, David D. [Department of Biostatistics, Roswell Park Cancer Institute, Buffalo, NY (United States); Rustum, Youcef M. [Department of Pharmacology and Experimental Therapeutics, Roswell Park Cancer Institute, Buffalo, NY (United States)



Adherence of radiopharmaceuticals and labeled cells to intravenous tubing  

SciTech Connect

A survey of 67 nuclear medicine departments revealed no agreement on which radiolabeled agents could be injected through intravenous lines (IVs) and which required direct venipuncture. Labeled cells and several common radiopharmaceuticals were tested for adherence to intravenous tubing. Residual activity remaining in the tubing after an adequate flush was less than 1% of the injected dose in each case. Administration of radiolabeled agents through existing IVs is an acceptable alternative to direct venipuncture in many cases.

Segall, G.M.; Gurevich, N.; McDougall, I.R.



Effects of Prolonged Intravenous of Flunixin Meglumine in Healthy Dogs  

Microsoft Academic Search

Erdogan H. M., V. Gunes, H. I. Gokce, M. Uzun, M. Citil, N. Yuksek: Effects of Prolonged Intravenous of Flunixin Meglumine in Healthy Dogs. Acta Vet. Brno 2003, 72: 71-78. This study was designed to evaluate possible side effects on liver and kidney functions and haematological indices, associated with long-term intravenous (IV) administration of flunixin meglumine in healthy dogs. For



Intravenous iron for the treatment of predialysis anemia  

Microsoft Academic Search

Intravenous iron for the treatment of predialysis anemia. This article, based on our own studies and those of others, presents evidence to show that the anemia of chronic renal failure in the predialysis period is, to a significant extent, caused by iron deficiency and can be improved in most cases by the administration of intravenous (i.v.) but not oral iron.




Remote Ischemic Perconditioning is Effective Alone and in Combination with Intravenous Tissue Plasminogen Activator in Murine Model of Embolic Stroke  

PubMed Central

Background and Purpose Remote ischemic conditioning is cardioprotective in myocardial infarction and neuroprotective in mechanical occlusion models of stroke. However, there is no report on its therapeutic potential in a physiologically relevant embolic stroke model (eMCAO) in combination with intravenous (IV) tissue plasminogen activator (tPA). Methods We tested remote ischemic perconditioning therapy (RIPerC) at 2 hours after eMCAO in the mouse with and without IV tPA at 4 hours. We assessed cerebral blood flow (CBF) up to 6 hours, neurologic deficits, injury size and phosphorylation of Akt (Serine473; p-Akt) as a pro-survival signal in the ischemic hemisphere at 48 hours post stroke. Results RIPerC therapy alone improved the CBF and neurologic outcomes. tPA alone at 4 hours did not significantly improve the neurologic outcome even after successful thrombolysis. Individual treatments with RIPerC and IV tPA reduced the infarct size (25.7% and 23.8%, respectively). Combination therapy of RIPerC and tPA resulted in additive effects in further improving the neurologic outcome, and reducing the infarct size (50%). All the therapeutic treatments upregulated p-Akt in the ischemic hemisphere. Conclusions RIPerC is effective alone after eMCAO and has additive effects in combination with IV tPA. RIPerC may be a simple, safe and inexpensive combination therapy with IV tPA.

Hoda, Md Nasrul; Siddiqui, Shahneela; Herberg, Samuel; Periyasamy-Thandavan, Sudharsan; Bhatia, Kanchan; Johnson, Maribeth H; Hafez, Sherif S; Hill, William D; Ergul, Adviye; Fagan, Susan C; Hess, David C



Usefulness of high-dose intravenous human immunoglobulins treatment for refractory recurrent pericarditis.  


The management of refractory recurrent pericarditis is challenging. Previous clinical reports have noted a beneficial effect of high-dose intravenous human immunoglobulins (IvIgs) in isolated and systemic inflammatory disease-related forms. In this article, we analyzed retrospectively our clinical experience with IvIg therapy in a series of clinical cases of pericarditis refractory to conventional treatment. We retrospectively analyzed 9 patients (1994 to 2010) with refractory recurrent pericarditis, who received high-dose IvIg as a part of their medical treatment. Nonsteroidal anti-inflammatory drugs (NSAIDs), steroids, or colchicine treatment was not discontinued during IvIg treatment. No patients had a history of autoimmune or connective tissue diseases. During an average period of 11 months from the first recurrence, patients had experienced a mean of 5 relapses before the first IvIg treatment. In 4 cases, patients showed complete clinical remission with no further relapse after the first IvIg cycle. Two patients experienced a single minor relapse, responsive to short-term nonsteroidal anti-inflammatory drugs. In 2 patients, we performed a second cycle of IvIg after a recurrence of pericarditis, with subsequent complete remission. One patient did not respond to 3 cycles of IvIg and subsequently underwent pericardial window and long-term immunosuppressive treatment. No major adverse effect was observed in consequence of IvIg administration in all the cases. In conclusion, although IvIg mode of action is still poorly understood in this setting, this treatment can be considered as an option in patients with recurrent pericarditis refractory to conventional medical treatment and, in our small series, has proved to be effective in 8 of 9 cases. PMID:23972350

Moretti, Michele; Buiatti, Alessandra; Merlo, Marco; Massa, Laura; Fabris, Enrico; Pinamonti, Bruno; Sinagra, Gianfranco



Intravenous dexamethasone to prevent the recurrence of benign headache after discharge from the emergency department: a randomized, double-blind, placebo-controlled clinical trial  

Microsoft Academic Search

Objective: To evaluate whether the addition of intravenous (IV) dexamethasone to standard emergency department (ED) benign headache therapy would reduce the incidence of headache recurrence at 48-72 hours. Methods: This randomized, double-blind, placebo-controlled clinical trial of adult patients pre- senting with the chief complaint of headache was conducted in the ED of 2 academic, urban Level 1 hospitals. Headache evaluation

Eric Y. Baden; Curtis J. Hunter



Is there a role for adjuvant therapy in patients being treated with epoetin?  

Microsoft Academic Search

form of adjuvant therapy; intravenous (i.v.) iron is cytokines; iron; vitamins required by the majority of haemodialysis patients receiving epoetin. Measurement of hypochromic red blood cells is the most direct way of assessing iron supply to the bone marrow. During the correction Introduction phase, a dose of i.v. iron equivalent to 50 mg\\/day is recommended, with the total dose not

W. H. Horl


Treatment of Pemphigus Vulgaris with Rituximab and Intravenous Immune Globulin  

Microsoft Academic Search

Background Pemphigus vulgaris is a potentially fatal autoimmune mucocutaneous blistering dis- ease. Conventional therapy consists of high-dose corticosteroids, immunosuppressive agents, and intravenous immune globulin. Methods We studied patients with refractory pemphigus vulgaris involving 30% or more of their body-surface area, three or more mucosal sites, or both who had inadequate responses to conventional therapy and intravenous immune globulin. We treated

A. Razzaque Ahmed; Zachary Spigelman; Lisa A. Cavacini; Marshall R. Posner



The B Cell Superantigen-like Interaction of Intravenous Immunoglobin (IVIG) with Fab Fragments of V H 3-23 and 3-30\\/3-30.5 Germline Gene Origin Cloned from a Patient with Kawasaki Disease Is Enhanced after IVIG Therapy  

Microsoft Academic Search

The etiology of Kawasaki disease (KD) is still unknown. Therefore, the diagnosis relies on clinical criteria only. Although a specific therapy for KD is not available, coronary complications can be significantly reduced with the help of intravenous immunoglobulin (IVIG) therapy. It is not clear how IVIG interacts with the immune system. Previously, we selected a large number of IgG and

Stephan Leucht; Martina M. Uttenreuther-Fischer; Gerhard Gaedicke; Peter Fischer



Home intravenous antibiotics in a tertiary care hospital in Saudi Arabia  

PubMed Central

BACKGROUND AND OBJECTIVE: Home intravenous (IV) antibiotic programs are becoming increasingly popular worldwide because of their efficacy and safety. However, in Saudi Arabia these programs have not yet become an integrated part of the health care system. We present our experience with a home IV antibiotic program, as one of the major health care providers in Saudi Arabia. DESIGN AND SETTING: Retrospective chart review of patients enrolled in the King Abdulaziz Medical City Home Health Care IV Antibiotic Program from 1 May 2005 (the start of the program) until 30 December 2007. METHODS: In addition to demographic characteristics, we collected data on the site of infection, the clinical diagnosis, the isolated microorganisms, and the type of antibiotics given. Outcome measures evaluated included the relapse rate, failure rate, the safety of the program, and readmission rates. RESULTS: Of the 155 patients enrolled, 152 patients completed the program. Those who completed the program had a mean (SD) age of 52.8 (23.9) years. The mean (SD) duration of the IV antibiotic treatment was 20.6 (17) days. Three patients refused to complete the intended duration of therapy. Peripherally inserted central catheter (PICC) lines were utilized in 130 patients (86%). One-hundred and thirty-one patients completed the intended duration of therapy, although the therapy was changed from the initial plan for 21 (13.8%) patients. Readmission to the hospital during therapy was required for 13 patients (8.5%). Osteomyelitis was the most frequently encountered diagnosis (65 patients, 42.8%), followed by urinary tract infection (36 patients, 23.7%). CONCLUSIONS: The home health care-based IV antibiotic program was an effective and safe alternative for in-patient management of patients with non-life-threatening infections, and was associated with a very low complication rate. Home IV antibiotic programs should be used more frequently as part of the health care system in Saudi Arabia.

Baharoon, Salim; Almodaimeg, Hind; Al Watban, Haifa; Al Jahdali, Hamdan; Alenazi, Thamer; Al Sayyari, Abdullah; Al Dawood, Abdulaziz; Al-Sultan, Mohammed; Al Safi, Eiman



Effect of intravenous infusion of propantheline bromide on gastric secretion.  


The effect of 2 hours' intravenous infusion (7.5 mg/h) of propantheline bromide (Ercotina, Erco Läkemedel AB) on basal or pentagastrin-stimulated gastric secretion was studied in 7 healthy subjects and in 11 patients with acute duodenal ulcer. A moderate to marked decrease in acid secretion rate and acid output was found both in subjects and patients during the infusion period. The acidity decreased in most of the subjects but did not change much in the patients. Two other dose rates (3.75 and 15 mg/h) were studied in a few subjects and patients. The lowest dose rate gave as good an inhibition of the gastric secretion as the higher ones. No troublesome side effects were noticed. It was concluded that a dose rate of around 5-10 mg/h may be suitable for prolonged i.v. infusion, for example as trial therapy in patients with upper gastro-intestinal bleeding. PMID:1145899

Furberg, B; Krause, U; Rimsten, A



Holistic Medicine IV: Principles of Existential Holistic Group Therapy and the Holistic Process of Healing in a Group Setting  

Microsoft Academic Search

In existential holistic group therapy, the whole person heals in accordance with the holistic process theory and the life mission theory. Existential group psychotherapy addresses the emotional aspect of the human mind related to death, freedom, isolation, and meaninglessness, while existential holistic group therapy addresses the state of the person's wholeness. This includes the body, the person's philosophy of life,

Soren Ventegodt; Niels Jorgen Andersen; Joav Merrick



Cefodizime in serum and skin blister fluid after single intravenous and intramuscular doses in healthy volunteers.  

PubMed Central

In gonorrhea therapy, cephalosporins are conventionally administered by intramuscular (i.m.) injection, which rather frequently leads to local side effects. To investigate whether the well-tolerated intravenous (i.v.) injection of cephalosporins may be of comparable gonocidal effect, levels of cefodizime, a new broad-spectrum cephalosporin, in serum and tissue fluid (suction blister and cantharides blister fluid) were determined in six healthy men. Single doses of 1 g of cefodizime were injected i.v. and i.m. according to a randomized crossover design. On i.m. injection the drug was completely bioavailable, and the peak concentration in serum was 75 +/- 8 micrograms/ml. The terminal half-life of serum levels was 2.4 h. Cefodizime concentrations in the blister fluids increased for 1.5 to 3 h after the i.v. dose and for at least 3 h on i.m. administration. The concentrations of non-protein-bound cefodizime in blister fluid already exceeded the MIC for 90% of Neisseria gonorrhoeae strains 10 min after i.v. injection and 20 to 30 min after the i.m. dose. At 6 h after each dose, active concentrations were still present in serum. The results suggest that cefodizime administered i.v. and i.m. has equivalent high cure rates in uncomplicated gonorrhea. This hypothesis should be tested further by a controlled clinical trial. If equivalent, i.v. administration excels because it is better tolerated locally.

Korting, H C; Schafer-Korting, M; Maass, L; Klesel, N; Mutschler, E



Treatment of acute pandysautonomia with intravenous immunoglobulin.  

PubMed Central

Acute pandysautonomia has been suggested to be an uncommon variant of Guillain-Barre syndrome. Acute pandysautonomia does not seem to have been treated with intravenous immunoglobulin or other therapies proved efficacious in Guillain-Barre syndrome. A patient is reported with severe acute pandysautonomia who responded dramatically to intravenous immunoglobulin. The findings are consistent with a dysimmune pathogenesis for this syndrome and suggest a possible treatment for future cases.

Mericle, R A; Triggs, W J



Evaluation of the Intravenous Stat Constant Pressure Infuser.  

National Technical Information Service (NTIS)

The I.V. Stat Constant Pressure Infuser is a self-contained, portable intravenous (I.V.) pump that generates a constant, safe pressure on flexible infusion bags to assure a steady flow. The source of its energy is a unique, constant force spring that cont...

R. U. Navalta



Intravenous versus subcutaneous dosing of Epoetin alfa in hemodialysis patients  

Microsoft Academic Search

Hemodialysis patients were studied to determine whether the dose of recombinant human erythropoietin (Epoetin alfa; Amgen Inc, Thousand Oaks, CA) required to maintain a therapeutic hematocrit level changed when the route of administration was switched from intravenously (IV) three times per week to subcutaneously (SC) three times per week. Thirteen to 16 weeks after patients were changed from IV three

Emil P. Paganini; Joseph W. Eschbach; J. Michael Lazarus; John C. Van Stone; Luis F. Gimenez; Stanley E. Graber; Joan C. Egrie; Douglas M. Okamoto; David A. Goodkin



Development of a novel systemic gene delivery system for cancer therapy with a tumor-specific cleavable PEG-lipid  

Microsoft Academic Search

For successful cancer gene therapy via intravenous (i.v.) administration, it is essential to optimize the stability of carriers in the systemic circulation and the cellular association after the accumulation of the carrier in tumor tissue. However, a dilemma exists regarding the use of poly(ethylene glycol) (PEG), which is useful for conferring stability in the systemic circulation, but is undesirable for

H Hatakeyama; H Akita; K Kogure; M Oishi; Y Nagasaki; Y Kihira; M Ueno; H Kobayashi; H Kikuchi; H Harashima



[A case of stage IV b pancreatic cancer in which a catheter-related infection caused by epidural/subcutaneous reservoir therapy affected palliative home-based care].  


We report the case of a patient with a stage IV b pancreatic cancer in which epidural/subcutaneous reservoir therapy was effective for pain control. However, a catheter-related infection caused by methicillin-resistant Staphylococcus aureus (MRSA)was occurred. In recent years, the number of cancer patients desiring palliative home-based care in Japan has increased. Epidural/subcutaneous reservoir therapy is often offered to relieve refractory pain, and to reduce the side effects of systemic administration of opioids, such as drowsiness, in homecare patients. We believe that this patient may have been able to continue home-based care if the catheter-related infection did not occur, because a significant improvement was calculated in the pain level by the numerical rating scale(NRS)observed. It is important to establish and share common strict guidelines between hospital doctors and general practitioners for the management of the subcutaneous catheter and reservoir therapy in order to prevent catheter-related infections over a long period. PMID:23268902

Kinoshita, Shoji; Inoue, Daisuke; Sakuyama, Toshikazu; Yoshizawa, Akitaka; Nagasaki, Eijiroh; Arakawa, Yasuhiro; Uwagawa, Tadashi; Kobayashi, Kazuma; Kobayashi, Tadashi; Saitoh, Nobuhiro; Aiba, Keisuke



Intravenous 1?, 25[OH]2 vitamin D3 (calcitriol) pulse therapy for bone lesions in a murine model of chronic cadmium toxicosis  

PubMed Central

The aim of the present study was to clarify the therapeutic effects of 1?, 25[OH]2 vitamin D3 (calcitriol) pulse injection on bone lesions induced in a rat model of chronic cadmium toxicosis. Ovariectomized (OVX) and control-operated (sham-OVX) rats were given repeated intravenous injections of 0.5 mg/kg/day CdCl2 for 70 weeks. The rats were then treated intravenously with 0.02 ?g/kg/day calcitriol 3 days per week for 8 weeks. CdCl2 treatment induced increases in osteoid volumes of the femur cortex and trabecula. This change was accompanied by an increase in the volume of iron deposition at the mineralization front of the trabeculae and a reduction in mineral density. Abnormalities of bone metabolic parameters, which were increases in the blood calcium, inorganic phosphorous, bone-specific alkaline phosphatase, parathyroid hormone (PTH) and osteocalcin levels, and in the urine deoxypyridinoline (D-PYR) level, were also induced. Calcitriol treatment increased the blood calcium and inorganic phosphorous levels, and reduced the blood PTH level. Decreases in blood tartrate-resistant acid phosphatase and urine d-PYR levels were also induced indicating that bone resorption was suppressed. The findings indicated that the increased osteoid volume of the cortex and Fe-deposition volume of the trabecula were improved. These effects or improvements were observed in the sham-OVX rats but not in the OVX rats.

Kurata, Yoshimasa; Katsuta, Osamu; Hiratsuka, Hideaki; Tsuchitani, Minoru; Umemura, Takashi



Efficacy and safety of Hizentra(®) in patients with primary immunodeficiency after a dose-equivalent switch from intravenous or subcutaneous replacement therapy.  


A prospective, open-label, multicenter, single-arm, Phase III study evaluated the efficacy and safety of Hizentra(®), a 20% human IgG for subcutaneous administration, in 51 primary immunodeficiency patients over 40 weeks. Patients previously on intravenous or subcutaneous IgG were switched to weekly subcutaneous infusions of Hizentra(®) at doses equivalent to their previous treatment. IgG levels achieved with Hizentra(®) were similar to pre-study levels with subcutaneous, and higher by 17.7% than pre-study levels with intravenous IgG. No serious bacterial infections were reported in the efficacy period. The rate of all infections was 5.18/year/patient, the rates of days missed from work/school, and days spent in hospital were 8.00/year/patient and 3.48/year/patient, respectively. Local reactions (rate 0.060/infusion) were mostly mild (87.3%). No serious, Hizentra(®)-related adverse events were reported. Individual median infusion durations ranged between 1.14 and 1.27 h. Hizentra(®) maintained or improved serum IgG levels without dose increases and effectively protected patients against infections. PMID:21705277

Jolles, S; Bernatowska, E; de Gracia, J; Borte, M; Cristea, V; Peter, H H; Belohradsky, B H; Wahn, V; Neufang-Hüber, J; Zenker, O; Grimbacher, B



Medicolegal Considerations with Intravenous Tissue Plasminogen Activator in Stroke: A Systematic Review  

PubMed Central

Background. Intravenous tPA (tissue plasminogen activator) therapy remains underutilized in patients with Acute Ischemic Stroke (AIS). Anecdotal data indicates that physicians are increasingly liable for administering and for failure to administer tPA. Methods. An extensive search of Medline, Embase, Westlaw, LexisNexis Legal, and Google Scholar databases was performed. Case studies that involved malpractice litigation in ischemic stroke and thrombolytic therapy were analyzed systematically. Results. We identified 789 ischemic stroke litigation cases, of which 46 cases were related to intravenous tPA and stroke litigation. Case descriptions of 40 cases were available. Data for verdicts were available for 38 patients. The most frequent plaintiff claim was related to failure to administer intravenous tPA (38, 95%). Only 2 (5.0%) claim involved complications of treatment with tPA. Hospitals were defendants in majority of the 36 cases. Physicians were involved in 33 cases. While ED physicians were involved in 25 (60.52%) cases, neurologists were involved in 8 (20.0%) cases. There were 26 (65%) defendant-favored and 12 (30%) plaintiff-favored verdicts. Conclusion. Physicians and hospitals are at an increased risk of litigation in patients with AIS when in IV-tPA is being considered for treatment. While majority of the cases litigated were cases where tPA was not administered, only about 1 in 20 cases was litigated when complications occurred.

Bhatt, Archit; Safdar, Adnan; Majid, Arshad; Kassab, Mounzer



Prediction of clinical outcome with baseline and 24-hour perfusion CT in acute middle cerebral artery territory ischemic stroke treated with intravenous recanalization therapy  

Microsoft Academic Search

Introduction  We sought to determine whether Alberta Stroke Program Early CT Scores (ASPECTS) derived from baseline noncontrast CT (NCCT)\\u000a and perfusion CT (CTP) imaging maps can predict clinical outcome after recanalization therapy in acute ischemic stroke of\\u000a the middle cerebral artery (MCA) territory and whether changes in the ASPECTS from baseline to 24 h after recanalization therapy\\u000a can help predict clinical outcome.

Ji-Yong Lee; Seo Hyun Kim; Myeong Sub Lee; Sang Hyun Park; Sung Soo Lee



Therapeutic Targets and Drugs IV: Telomerase-Specific Gene and Vector-Based Therapies for Human Cancer  

Microsoft Academic Search

\\u000a Recent advances in genetic engineering technology have opened a new avenue of gene-and vector-based therapies for human cancer.\\u000a For targeting cancer cells, there is a need for tissue- or cell-specific promoters that can express in diverse tumor types\\u000a but are silent in normal cells. Genetic approaches fostered remarkable insights into the molecular basis of neoplasm, and\\u000a a number of oncotropic

Toshiyoshi Fujiwara; Yasuo Urata; Noriaki Tanaka


Tolerability of intensified intravenous interferon alfa-2b versus the ECOG 1684 schedule as adjuvant therapy for stage III melanoma: a randomized phase III Italian Melanoma Inter-group trial (IMI - Mel.A.) [ISRCTN75125874  

PubMed Central

Background High-dose interferon alfa-2b (IFNalfa-2b), according to the ECOG 1684 schedule, is the only approved adjuvant treatment for stage III melanoma patients by the FDA and EMEA. However, the risk/benefit profile has been questioned limiting its world-wide use. In the late nineties, the Italian Melanoma Inter-group started a spontaneous randomized clinical trial (RCT) to verify if a more intense, but shorter than the ECOG 1684 regimen, could improve survival without increasing the toxicity profile. The safety analysis in the first 169 patients who completed the treatment is here described. Methods Stage III melanoma patients were randomized to receive IFNalfa-2b 20 MU/m2/d intravenously (IV) 5 days/week × 4 weeks, repeated for three times on weeks 9 to 12, 17 to 20, 25 to 28 (Dose-Dense/Dose-Intense, DD/DI, arm), or IFNalfa-2b 20 MU/m2/d IV 5 days/week × 4 weeks followed by 10 MU/m2 subcutaneously (SC) three times per week × 48 weeks (High Dose Interferon, HDI, arm). Toxicity was recorded and graded, according to the WHO criteria, as the worst grade that occurred during each cycle. Results The most common toxicities in both arms were flu-like and gastrointestinal symptoms, leukopenia, liver and neuro-psichiatric morbidities; with regard to severe toxicity, only leukopenia was statistically more frequent in DD/DI arm than in HDI arm (24% vs 9%) (p = 0.0074), yet, this did not cause an increase in the infection risk. Discontinuation of treatment, due to toxicity, was observed in 13 and 17% of the patients in the DD/DI and HDI arm, respectively. The median actual dose intensity delivered in the DD/DI arm (36.4 MU/m2/week) was statistically higher than that delivered in the HDI arm (30.7 MU/m2/week) (p = 0.003). Conclusion Four cycles of intravenous high-dose IFNalfa-2b can be safely delivered with an increase in the median dose intensity. Efficacy results from this trial are eagerly awaited.

Chiarion-Sileni, Vanna; Del Bianco, Paola; Romanini, Antonella; Guida, Michele; Paccagnella, Adriano; Dalla Palma, Maurizio; Naglieri, Emanuele; Ridolfi, Ruggero; Silvestri, Barbara; Michiara, Maria; De Salvo, Gian Luca



Pharmacokinetic targeting of intravenous busulfan reduces conditioning regimen related toxicity following allogeneic hematopoietic cell transplantation for acute myelogenous leukemia.  


Optimal conditioning therapy for hematopoietic cell transplantation (HCT) in acute myelogenous leukemia (AML) remains undefined. We retrospectively compared outcomes of a consecutive series of 51 AML patients treated with oral busulfan (1 mg/kg every 6 hours for 4 days) and cyclophosphamide (60 mg/kg IV × 2 days) - (Bu/Cy) with 100 consecutive AML patients treated with pharmacokinetic targeted IV busulfan (AUC < 6000 ?M/L*min per day × 4 days) and fludarabine (40 mg/m2 × 4 days) - (t-IV Bu/Flu). The Bu/Cy and t-IV Bu/Flu groups significantly differed according to donor relation, stem cell source, aGVHD prophylaxis, remission status, primary vs. secondary disease, median age, and % blasts prior to HCT (p < 0.01 for each). Conditioning with t-IV Bu/Flu reduced early toxicity including idiopathic pneumonia syndrome (IPS) and hepatic veno-occlusive disease (VOD). Additionally, the trajectory of early NRM (100 day: 16% vs. 3%, and1 year: 25% vs. 15% for Bu/Cy and t-IV Bu/Flu, respectively) favored t-IV Bu/Flu. Grade II-IV aGVHD (48% vs. 82%, p < 0.0001), as well as moderate/severe cGVHD (7% vs. 40%, p < 0.0001) differed between the Bu/Cy and t-IV Bu/Flu groups, due to the predominance of peripheral blood stem cells in the t-IV Bu/Flu group. Pharmacokinetic targeting of intravenous busulfan in combination with fludarabine is associated with reduced conditioning regimen related toxicity compared to oral busulfan and cyclophosphamide. However, multivariable analysis did not demonstrate significant differences in overall survival (p = 0.78) or non-relapse mortality (p = 0.6) according to conditioning regimen delivered. PMID:20925957

Pidala, Joseph; Kim, Jongphil; Anasetti, Claudio; Kharfan-Dabaja, Mohamed A; Nishihori, Taiga; Field, Teresa; Perkins, Janelle; Perez, Lia; Fernandez, Hugo F



Microwave heating of intravenous fluids.  


Microwave heating of intravenous (IV) fluids is a viable alternative to heating by conventional means, such as by blood warmer(s) or an on-site warming oven, for administration to hypothermic patients and trauma victims. Three 1-l bags each of lactated Ringer's solution, normal saline solution, 1/2 normal saline solution, and 5% dextrose in water were packaged in parenteral containers and heated in a microwave oven from room temperature (21 degrees C) to 40-42 degrees C in 3 minutes. Little difference between temperatures of the four solutions was detected at each of five intervals up to two hours after heating for 3 minutes. Samples were taken before and after heating to assess any potential alterations in sodium, potassium, chloride, calcium, glucose, and lactate levels; differences were within the range of variation of the methods used. Though the plasticizer in the polyvinyl chloride containers is stable to microwave heating, data on other components is incomplete. PMID:4005001

Anshus, J S; Endahl, G L; Mottley, J L



Intravenous Injection of Oxygen (Survey of Literature).  

National Technical Information Service (NTIS)

It appears to be that the consignment of intravenous oxygen therapy to oblivion as a useless and dangerous method is incorrect. A penetrating study of the mode of action of i.v.-injected oxygen, a determination of doses and indications for its use, and th...

Y. G. Antonov V. L. Kassil



Intravenous ?-globulin treatment in a patient with subacute sclerosing panencephalitis  

Microsoft Academic Search

A 10-year-old boy with subacute sclerosing panencephalitis was treated with intravenous ?-globulin and inosiplex and followed for 18 months. Clinical improvement, demonstrated by decreasing scores on the Neurologic Disability Index, was observed. There were no side effects. We recommend intravenous immune globulin as an alternative therapy in the treatment of subacute sclerosing panencephalitis.

Y. K. Yavuz Gürer; ?enay Kükner; Bige Sarica



Colistin therapy for microbiologically documented multidrug-resistant Gram-negative bacterial infections: a retrospective cohort study of 258 patients  

Microsoft Academic Search

It is unclear whether the effectiveness of polymyxins depends on the site of infection, the responsible pathogen, dosage, and monotherapy vs. combination therapy. We investigated colistin therapy in a large, retrospective, single-centre, cohort study. Primary analysis outcomes were infection outcome, survival and nephrotoxicity. Over a 7-year period (October 2000 to October 2007), 258 patients received intravenous (i.v.) colistin for at

Matthew E. Falagas; Petros I. Rafailidis; Elda Ioannidou; Vangelis G. Alexiou; Dimitrios K. Matthaiou; Drosos E. Karageorgopoulos; Anastasios Kapaskelis; Dimitra Nikita; Argyris Michalopoulos



696. Comparative study of lentiviral vector-mediated gene therapy in neonatal and young-adult MPS I mice by a single intravenous injection  

Microsoft Academic Search

Mucopolysaccharidosis type I (MPS I) is lysosomal storage disorder caused by deficiency of the enzyme, alpha-L-iduronidase (IDUA). We investigated gene therapy for MPS I by using a recombinant lentiviral (HIV-based) vector (pSMPU-MCU3-huID-IRES-eGFP) that contains the normal human IDUA cDNA as well as the enhanced green fluorescence protein (eGFP) reporter gene. We have demonstrated significant levels of IDUA gene expression by

Hiroshi Kobayashi; Denise Petersen; Denise Carbonaro; Dianne Skelton; Shundi Ge; Carolyn Luzko; Paula Cannon; Maya Otto Dussel; Michael Rosol; Rex Moats; Hiroyuki Shimada; Donald B. Kohn



Tumor tropism of intravenously injected human-induced pluripotent stem cell-derived neural stem cells and their gene therapy application in a metastatic breast cancer model.  


Human pluripotent stem cells can serve as an accessible and reliable source for the generation of functional human cells for medical therapies. In this study, we used a conventional lentiviral transduction method to derive human-induced pluripotent stem (iPS) cells from primary human fibroblasts and then generated neural stem cells (NSCs) from the iPS cells. Using a dual-color whole-body imaging technology, we demonstrated that after tail vein injection, these human NSCs displayed a robust migratory capacity outside the central nervous system in both immunodeficient and immunocompetent mice and homed in on established orthotopic 4T1 mouse mammary tumors. To investigate whether the iPS cell-derived NSCs can be used as a cellular delivery vehicle for cancer gene therapy, the cells were transduced with a baculoviral vector containing the herpes simplex virus thymidine kinase suicide gene and injected through tail vein into 4T1 tumor-bearing mice. The transduced NSCs were effective in inhibiting the growth of the orthotopic 4T1 breast tumor and the metastatic spread of the cancer cells in the presence of ganciclovir, leading to prolonged survival of the tumor-bearing mice. The use of iPS cell-derived NSCs for cancer gene therapy bypasses the sensitive ethical issue surrounding the use of cells derived from human fetal tissues or human embryonic stem cells. This approach may also help to overcome problems associated with allogeneic transplantation of other types of human NSCs. PMID:22311724

Yang, Jing; Lam, Dang Hoang; Goh, Sally Sallee; Lee, Esther Xingwei; Zhao, Ying; Tay, Felix Chang; Chen, Can; Du, Shouhui; Balasundaram, Ghayathri; Shahbazi, Mohammad; Tham, Chee Kian; Ng, Wai Hoe; Toh, Han Chong; Wang, Shu



The maternal immune response to fetal platelet GPIb? causes frequent miscarriage in mice that can be prevented by intravenous IgG and anti-FcRn therapies  

PubMed Central

Fetal and neonatal immune thrombocytopenia (FNIT) is a severe bleeding disorder caused by maternal antibody–mediated destruction of fetal/neonatal platelets. It is the most common cause of severe thrombocytopenia in neonates, but the frequency of FNIT-related miscarriage is unknown, and the mechanism(s) underlying fetal mortality have not been explored. Furthermore, although platelet ?IIb?3 integrin and GPIb? are the major antibody targets in immune thrombocytopenia, the reported incidence of anti-GPIb?–mediated FNIT is rare. Here, we developed mouse models of FNIT mediated by antibodies specific for GPIb? and ?3 integrin and compared their pathogenesis. We found, unexpectedly, that miscarriage occurred in the majority of pregnancies in our model of anti-GPIb?–mediated FNIT, which was far more frequent than in anti-?3–mediated FNIT. Dams with anti-GPIb? antibodies exhibited extensive fibrin deposition and apoptosis/necrosis in their placentas, which severely impaired placental function. Furthermore, anti-GPIb? (but not anti-?3) antiserum activated platelets and enhanced fibrin formation in vitro and thrombus formation in vivo. Importantly, treatment with either intravenous IgG or a monoclonal antibody specific for the neonatal Fc receptor efficiently prevented anti-GPIb?–mediated FNIT. Thus, the maternal immune response to fetal GPIb? causes what we believe to be a previously unidentified, nonclassical FNIT (i.e., spontaneous miscarriage but not neonatal bleeding) in mice. These results suggest that a similar pathology may have masked the severity and frequency of human anti-GPIb?–mediated FNIT, but also point to possible therapeutic interventions.

Li, Conglei; Piran, Siavash; Chen, Pingguo; Lang, Sean; Zarpellon, Alessandro; Jin, Joseph W.; Zhu, Guangheng; Reheman, Adili; van der Wal, Dianne E.; Simpson, Elisa K.; Ni, Ran; Gross, Peter L.; Ware, Jerry; Ruggeri, Zaverio M.; Freedman, John; Ni, Heyu



[The application of UHF therapy for the prevention of complications of specific antiblastoma therapy in the patients presenting with III-IV stage lung cancer].  


One of the complications of specific antiblastoma therapy in the patients presenting with malignant neoplasms is the suppressed functional activity of blood neutrophil granulocytes. The results of clinical and experimental investigations suggest the enhanced enzymatic activity of neutrophils and lymphocytes under effect of ultrahigh-frequency electromagnetic radiation (UHF EMR). Our study has demonstrated that UHF EMR with a frequency selected on an individual basis in the range from 59 to 63 GHz exerts the protective action on the function and metabolism of blood neutrophils exposed to the damaging action of gamma-radiation in the patients presenting with lung cancer. Moreover, it allows the severity of local and systemic complications of specific antiblastoma chemo- and radiotherapy in these patients to be reduced. PMID:23718077

Kolmatsu?, N B; Levitski?, E F; Golosova, O E; Pyzhova, I B


Peripheral intravenous cannulation.  


The placement of intravenous cannulas can be a difficult task, especially when treating a hypovolaemic or critically ill patient. Often the physician is faced with the problem of being unable to locate a suitable vein or, even more frustrating, finding a vein but not being able to insert the cannula. The author summarises the general principles of peripheral intravenous cannulation and presents some practical tips. PMID:1953471

Cleary, M



Gefitinib and Radiation Therapy With or Without Cisplatin in Treating Patients With Stage III or Stage IV Head and Neck Cancer

Stage III Squamous Cell Carcinoma of the Hypopharynx; Stage III Squamous Cell Carcinoma of the Larynx; Stage III Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage III Squamous Cell Carcinoma of the Oropharynx; Stage IV Squamous Cell Carcinoma of the Hypopharynx; Stage IV Squamous Cell Carcinoma of the Larynx; Stage IV Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage IV Squamous Cell Carcinoma of the Oropharynx



The use of intravenous palivizumab for treatment of persistent RSV infection in children with leukemia.  


Palivizumab is a humanized monoclonal antibody used to decrease the threat of respiratory syncytial virus (RSV) infection among children at high risk. There are no standard guidelines due to conflicting data on palivizumab's use in the treatment of RSV lower respiratory tract infections. Intravenous (IV) palivizumab was shown to be well tolerated and associated with decreased mortality in high-risk children who have RSV disease. However, it did not prevent lower respiratory tract infections and did not affect the survival rate of allogeneic stem cell transplant recipients who had RSV infection. We present 2 children with acute lymphocytic leukemia (ALL) and persistent RSV infection while receiving chemotherapy. Patient A is a 4-year-old male with Down syndrome, ALL, and persistent RSV infection for at least 3 months. Patient B is a 3-year-old female with pre-B cell ALL whose chemotherapy intensification phase was delayed due to a month-long RSV infection. RSV infections were determined by using real-time polymerase chain reaction assays from nasopharyngeal swabs before IV palivizumab therapy; patient A was positive for RSV at 36 cycles and patient B was positive for RSV at 29 cycles. RSV infection was cleared in both patients within 72 hours after receiving IV palivizumab (patient A: 16 mg/kg; patient B: 15 mg/kg). IV palivizumab may be a treatment option for persistent RSV infection among immunocompromised patients. PMID:23147965

Santos, Roberto P; Chao, Jeffery; Nepo, Anne G; Butt, Shafiq; Stellrecht, Kathleen A; Pearce, Jennifer M; Lepow, Martha L



Post-transplant gastric antral vascular ectasia after intra-venous busulfan regimen.  


Gastric antral vascular ectasia (GAVE) is an angiodysplastic disorder that causes gastric bleeding. GAVE can develop as a complication of hematopoietic stem cell transplantation (HSCT-GAVE), and it has been suggested that it may be associated with oral administration of busulfan. We report two cases of HSCT-GAVE after a conditioning regimen containing intra-venous busulfan (ivBu), not oral busulfan. The first case, a 42-year-old woman with blastic plasmacytoid dendritic cell neoplasm, underwent second allogeneic HSCT with conditioning regimen consisting of cyclophosphamide (120 mg/kg) and ivBu (12.8 mg/kg). HSCT-GAVE developed on day 84 post-transplant, and argon plasma coagulation (APC) was performed successfully. The second case, a 60-year-old woman with acute myelogenous leukemia, underwent allogeneic HSCT with the conditioning regimen consisting of ivBu (12.8 mg/kg) and fludarabine (150 mg/kg). She developed melena and was diagnosed with GAVE by endoscopy on day 145 post-transplant. Although complete hemostasis was not achieved despite four administrations of APCs, the melena spontaneously terminated on day 235 post-transplant. To our knowledge, this is the first report describing HSCT-GAVE after ivBU-based HSCT. Although there is no established therapy for HSCT-GAVE, APC may be an option for HSCT-GAVE. PMID:23632949

Fukuda, Kuniyoshi; Kurita, Naoki; Sakamoto, Tatsuhiro; Nishikii, Hidekazu; Okoshi, Yasushi; Sugano, Masato; Chiba, Shigeru



Effective intravenous immunoglobulin therapy for Churg-Strauss syndrome (allergic granulomatous angiitis) complicated by neuropathy of the eighth cranial nerve: a case report  

PubMed Central

Introduction We report the case of a patient with Churg-Strauss syndrome with eighth cranial nerve palsy. Vestibulocochlear nerve palsy is extremely rare in Churg-Strauss syndrome. To the best of our knowledge, only one case of complicated neuropathy of the eighth cranial nerve has been described in a previous report presenting an aggregate calculation, but no differentiation between polyarteritis nodosa and Churg-Strauss syndrome was made. High-dose immunoglobulin was administered to our patient, and her neuropathy of the eighth cranial nerve showed improvement. Case presentation At the age of 46, a Japanese woman developed Churg-Strauss syndrome that later became stable with low-dose prednisolone treatment. At the age of 52, she developed sudden difficulty of hearing in her left ear, persistent severe rotary vertigo, and mononeuritis multiplex. At admission, bilateral perceptive deafness of about 80dB and eosinophilia of 4123/?L in peripheral blood were found. A diagnosis of cranial neuropathy of the eighth cranial nerve associated with exacerbated Churg-Strauss syndrome was made. Although high doses of steroid therapy alleviated the inflammatory symptoms and markers, the vertigo and bilateral hearing loss remained. Addition of a high-dose immunoglobulin finally resulted in marked alleviation of the symptoms associated with neuropathy of the eighth cranial nerve. Conclusions A high dose of immunoglobulin therapy shows favorable effects in neuropathy of the eighth cranial nerve, but no reports regarding its efficacy in cranial neuropathy have been published.



Bilateral atypical insufficiency fractures of the proximal tibia and a unilateral distal femoral fracture associated with long-term intravenous bisphosphonate therapy: a case report  

PubMed Central

Introduction Atypical insufficiency fractures of the femur in patients on long-term bisphosphonate therapy have been well described in recent literature. The majority of cases are associated with minimal or no trauma and occur in the subtrochanteric or diaphyseal region. Case presentation We describe the case of a 76-year-old British Caucasian woman who presented initially to an emergency department and then to her primary care physician with a long-standing history of bilateral knee pain after minor trauma. Plain radiographs showed subtle linear areas of sclerosis bilaterally in her proximal tibiae. Magnetic resonance imaging confirmed the presence of insufficiency fractures in these areas along with her left distal femur. There are very few reports of atypical insufficiency fractures involving the tibia in patients on long-term bisphosphonate therapy and this appears to be the only documented bilateral case involving the metaphyseal regions of the proximal tibia and distal femur. Conclusion In addition to existing literature describing atypical fractures in the proximal femur and femoral shaft, there is a need for increased awareness that these fractures can also occur in other weight-bearing areas of the skeleton. All clinicians involved in the care of patients taking long-term bisphosphonates need to be aware of the growing association between new onset lower limb pain and atypical insufficiency fractures.



Cisplatin and Radiation Therapy With or Without Erlotinib Hydrochloride in Treating Patients With Stage III or Stage IV Head and Neck Cancer

Stage III Squamous Cell Carcinoma of the Hypopharynx; Stage III Squamous Cell Carcinoma of the Larynx; Stage III Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage III Squamous Cell Carcinoma of the Nasopharynx; Stage III Squamous Cell Carcinoma of the Oropharynx; Stage IV Squamous Cell Carcinoma of the Hypopharynx; Stage IV Squamous Cell Carcinoma of the Larynx; Stage IV Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage IV Squamous Cell Carcinoma of the Nasopharynx; Stage IV Squamous Cell Carcinoma of the Oropharynx



Bloodstream Infections in Patients With Pulmonary Arterial Hypertension Treated With Intravenous Prostanoids: Insights From the REVEAL REGISTRY®  

PubMed Central

Objective To evaluate the rate of and potential risk factors for bloodstream infections (BSIs) using data from the REVEAL (Registry to Evaluate Early and Long-term Pulmonary Arterial Hypertension [PAH] Disease Management) REGISTRY®, which provides current information about patients with PAH. Patients and Methods Patients were enrolled from March 30, 2006, through December 8, 2009, and data on reported BSIs were collected through the third quarter of 2010. Bloodstream infection rates were calculated per 1000 patient-days of risk. Results Of 3518 patients enrolled, 1146 patients received intravenous (IV) prostanoid therapy for more than 1 day (no BSI, n=1023; ?1 BSI, n=123; total BSI episodes, n=166). Bloodstream infections rates were significantly increased in patients receiving IV treprostinil vs IV epoprostenol (0.36 vs 0.12 per 1000 treatment days; P<.001), primarily due to gram-negative organisms (0.20 vs 0.03 per 1000 treatment days; P<.001). Multivariate analysis adjusting for age, causes of PAH, and year of BSI found that treatment with IV treprostinil was associated with a 3.08-fold increase (95% confidence interval, 2.05-4.62; P<.001) in BSIs of any type and a 6.86-fold increase (95% confidence interval, 3.60-13.07; P<.001) in gram-negative BSIs compared with treatment with IV epoprostenol. Conclusion Compared with IV epoprostenol therapy, treatment with IV treprostinil is associated with a significantly higher rate of gram-negative BSIs; observed differences in BSI rate did not seem to be due to any other analyzed factors. Trial Registration Identifier: NCT00370214

Kitterman, Natalie; Poms, Abby; Miller, Dave P.; Lombardi, Sandra; Farber, Harrison W.; Barst, Robyn J.



Heparin Vs. Saline and Patency of 24 Gauge IV Catheters.  

National Technical Information Service (NTIS)

Maintaining patency of small-bore intravenous (IV) catheters in infants is problematic. Traditionally, heparin has been used in flush solutions due to its anticoagulant properties. There is conflict in the existing literature, however, regarding the effic...

L. A. Kyle



Performing peripheral intravenous cannulation.  


Nurses need to be aware of their level of accountability when performing i.v. cannulation. Nurse cannulation should be incorporated into practice as part of holistic patient care. When introducing nurse cannulation into a department, a commitment is required from the individual nurse and the organisation. i.v. cannulation is a skilled technique, best performed as a staged process. PMID:9393049

Jackson, A



Effects of Intravenous Injection of Adipose-Derived Stem Cells in a Rat Model of Radiation Therapy-Induced Erectile Dysfunction  

PubMed Central

Introduction Radiation therapy (RT) for prostate cancer is frequently associated with post-treatment erectile dysfunction (ED). Aim To investigate whether injection of adipose-derived stem cells (ADSCs) can ameliorate RT-associated ED. Methods Thirty male rats were divided into 3 groups. The Control+PBS group received tail-vein injection of phosphate-buffered saline (PBS). The Radiation+PBS group received radiation over the prostate and tail-vein injection of PBS. The Radiation+ADSC group received radiation over the prostate and tail-vein injection of ADSCs, which were labeled with 5-ethynyl-2-deoxyuridine (EdU). Seventeen weeks later erectile function was evaluated by intracavernous pressure (ICP) in response to electrostimulation of cavernous nerves (CN). Penile tissue and major pelvic ganglia (MPG) were examined by immunofluorescence (IF) and EdU staining. Main Outcome Measures Erectile function was measured by ICP. Protein expression was examined by IF, followed by image analysis and quantification. Results Radiation over the prostate caused a significant decrease in erectile function and in the expression of neuronal nitric oxide synthase (nNOS) in penis and MPG. Cavernous smooth muscle (CSM) but not endothelial content was also reduced. Injection of ADSCs significantly restored erectile function, nNOS expression, and CSM content in the irradiated rats. EdU-positive cells were visible in MPG. Conclusions Radiation appears to cause ED via CN injury. ADSC injection can restore erectile function via CN regeneration.

Qiu, Xuefeng; Villalta, Jacqueline; Ferretti, Ludovic; Fandel, Thomas M; Albersen, Maarten; Lin, Guiting; Dai, Yutian; Lue, Tom F.; Lin, Ching-Shwun



Effect of intravenous vitamin C on cytokine activation and oxidative stress in end-stage renal disease patients receiving intravenous iron sucrose.  


Reticuloendothelial blockade in hemodialysis patients prevents optimal intravenous (IV) iron utilization. Vitamin C has emerged as a potential therapy to improve anemia treatment by enhancing iron mobilization. However, Vitamin C can act as a pro-oxidant in the presence of iron. This was a prospective, open-label, crossover study. Thirteen patients with end-stage renal disease on hemodialysis and four healthy controls were assigned to receive 100 mg of IV iron sucrose (IS) or 100 mg of IV IS co-administered with 300 mg of IV Vitamin C (IS + C) in random sequence. Serum samples for IL-1, IL-6, TNF-? and IL-10 and non-transferrin bound iron were obtained at baseline, 45 min and 105 min post study medication administration. Peripheral blood mononuclear cells were isolated at the same time points and stained with fluorescent probes to identify intracellular reactive oxygen species and mitochondrial membrane potential (??m) by flow cytometry. Lipid peroxidation was assessed by plasma F2-isoprosatane concentration. Both IS and IS + C were associated with increased plasma F2-isoprostanes concentrations post-infusion. Maximal plasma F2-isoprostane concentrations after IS + C were significantly elevated from baseline (234 ± 0.04 vs. 0.198 ± 0.028 ng/mL, p = 0.02). After IS + C, IL-1, IL-6, IL-10, and TNF-alpha were significantly elevated compared to baseline. After IS alone only IL-6 was noted to be elevated. Intracellular production of H(2)O(2) and loss of mitochondrial membrane potential (??m) was observed after IS while IS + C was associated with increased O (2) (·-) production. Both IS and IS + C induced serum cytokine activation accompanied by lipid peroxidation, however, IS + C induced higher plasma concentrations of F2-isoprostanes, IL-1, IL-10, and TNF-? post-infusion. Long-term safety studies of IV iron co-administered with Vitamin C are warranted. PMID:22706571

Conner, Todd A; McQuade, Charles; Olp, Jonathan; Pai, Amy Barton



Experience With Intravenous Ribavirin in the Treatment of Hemorrhagic Fever With Renal Syndrome in Korea.  

National Technical Information Service (NTIS)

Results of a clinical study using intravenous (IV) ribavirin for treating Department of Defense personnel with hemorrhagic fever with renal syndrome (HFRS) acquired in Korea from 1987 to 2005 were reviewed to determine the clinical course of HFRS treated ...

J. M. Rusnak K. N. Chung P. H. Gibbs T. T. Kim W. R. Byrne



Physician-Delivered Injection Therapies for Mechanical Neck Disorders: A Systematic Review Update (Non-Oral, Non-Intravenous Pharmacological Interventions for Neck Pain)  

PubMed Central

Background: Controversy persists regarding medicinal injections for mechanical neck disorders (MNDs). Objectives: To determine the effectiveness of physician-delivered injections on pain, function/disability, quality of life, global perceived effect and patient satisfaction for adults with MNDs. Search Methods: We updated our previous searches of CENTRAL, MEDLINE and EMBASE from December 2006 through to March 2012. Selection Criteria: We included randomized controlled trials of adults with neck disorders treated by physician-delivered injection therapies. Data Collection and Analysis: Two authors independently selected articles, abstracted data and assessed methodological quality. When clinical heterogeneity was absent, we combined studies using random-effects models. Results: We included 12 trials (667 participants). No high or moderate quality studies were found with evidence of benefit over control. Moderate quality evidence suggests little or no difference in pain or function/disability between nerve block injection of steroid and bupivacaine vs bupivacaine alone at short, intermediate and long-term for chronic neck pain. We found limited very low quality evidence of an effect on pain with intramuscular lidocaine vs control for chronic myofascial neck pain. Two low quality studies showed an effect on pain with anaesthetic nerve block vs saline immediately post treatment and in the short-term. All other studies were of low or very low quality with no evidence of benefit over controls. Authors' Conclusions: Current evidence does not confirm the effectiveness of IM-lidocaine injection for chronic mechanical neck pain nor anaesthetic nerve block for cervicogenic headache. There is moderate evidence of no benefit for steroid blocks vs controls for mechanical neck pain.

Gross, Anita R.; Peloso, Paul M.; Galway, Erin; Navasero, Neenah; Essen, Karis Van; Graham, Nadine; Goldsmith, Charlie H; Gzeer, Wisam; Shi, Qiyun; Haines, Ted and COG



A randomized, controlled trial of a clinical pharmacist intervention in microdiscectomy surgery - Low dose intravenous ketamine as an adjunct to standard therapy  

PubMed Central

Aim The hypothesis that postoperative pain would be reduced by using 1 ?g/kg/min of ketamine, both intra- and post-operatively, for lumbar microdiscectomy surgery was assessed by measuring morphine consumption. Patient side effects were reported. Methods Forty-five patients undergoing microdiscectomy surgery were randomized under double-blind conditions into three groups: Group1 (G1) received normal saline, Group 2 (G2) ketamine (1 ?g/kg/min) intra-operatively and Group 3 (G3) ketamine (1 ?g/kg/min) both intra- and post-operatively. Morphine consumption, pain scores, nausea and vomiting, CNS disorders were recorded for 24 h post surgery. This study was conducted by applying the concept of a clinical pharmacist intervention. Results The time for the first analgesia demand dose was significantly shorter (P < 0.05) in G117 ± 1.7 min than for G2 and G3. In G3 morphine consumption 6, 12, and 24 h after surgery was 3 ± 2.26, 9.2 ± 2.11 and 26.9 ± 2.71 mg. Total morphine consumption was significantly lower for G3 than for G1 or G2 (P < 0.05). The visual analog scale score (VAS) values were significantly lower in G3 (P < 0.05) than for the other groups during the first 24 h. The rate of nausea and vomiting was significantly higher in G1 vs G3 (P < 0.05). No difference in drug induced CNS disturbances was observed among the groups. Conclusions Using 1 ?g/kg/min of ketamine hydrochloride intra- and post-operatively for microdiscectomy surgery could be an adjunct therapy to reduce postoperative morphine consumption minimizing its side effects. Collaborative clinical pharmacy practice on the basis of pharmacology had an effective role in improving the general outcome of microdiscectomy surgery.

Hadi, Bushra A.; Daas, Rafat; Zelko, Romana



AIDS health education for intravenous drug users.  


Intravenous (IV) drug users are the second largest risk group for AIDS and the main source of infection for heterosexual partner and pediatric AIDS cases. IV drug users have an addiction and a subculture that make risk reduction difficult; for example, to refuse to share needles can endanger personal relationships, and carrying clean works (rather than renting them in a shooting gallery) risks arrest. In New York City, at least, knowledge about AIDS transmission is widespread among IV drug users, and most drug injectors report having changed their drug use practices to reduce their risks. The main functions of health education in areas where IV drug users have this level of knowledge are to disseminate news of new discoveries; reach those drug users who have not yet learned AIDS basics; reinforce what is already known; and provide information about new programs to help drug users deal with AIDS-related problems. To encourage behavior change requires going beyond simple education, however; it entails trying to change IV drug user subculture. Drug user groups in the Netherlands and in New York City are attempting to do this from within the subculture. Outside intervention requires repeated messages from multiple sources; face-to-face, interactive communication; and perhaps the use of ex-addicts as health educators. PMID:3781862

Friedman, S R; Des Jarlais, D C; Sotheran, J L



Hypotensive effects of intravenously administered uridine and cytidine in conscious rats: Involvement of adenosine receptors  

Microsoft Academic Search

In the present study, we investigated the cardiovascular effects of intravenously injected uridine or cytidine, and the role of adenosine receptors in mediating these effects, in conscious normotensive rats. Intravenous (i.v.) administration of uridine (124, 250, 500 mg\\/kg) dose-dependently decreased arterial pressure and heart rate. Cytidine (124, 250, 500 mg\\/kg; i.v.) produced slight dose-related hypotension without changing heart rate. Plasma uridine and

M. Sertac Yilmaz; Cenk Coskun; Oner Suzer; Murat Yalcin; Duygu Mutlu; Vahide Savci



The treatment of restless legs syndrome with intravenous iron dextran  

Microsoft Academic Search

Background and purpose: To evaluate the safety and efficacy of a single 1000 mg iron infusion in treating Restless Legs Syndrome (RLS).Patients and methods: A single 1000 mg intravenous (IV) [Am J Med Sci 31 (1999) 213] infusion of iron dextran was evaluated in an open-label study. Primary outcomes of efficacy were symptom severity assessed by global rating scale and

Christopher J Earley; Debbie Heckler; Richard P Allen



The vascular response observation by the monitoring of the photosensitizer, oxygen, and blood flow during the high intensity pulsed excitation photodynamic therapy 1h after water-soluble photosensitizer intravenous injection  

NASA Astrophysics Data System (ADS)

We investigated the correlation between the therapeutic effect by early irradiation Photodynamic Therapy (PDT) and vascular response. The early irradiation PDT has been proposed by our group. This PDT protocol is that pulse laser irradiates to tumors 1 h after intravenous injection of water-soluble photosensitizer. The intact layer appeared over the well treated layer, when the early irradiation PDT was performed at rat prostate subcutaneous tumors with high intensity pulse laser (over 1 MW/cm2 in peak intensity) and Talaporfin sodium. In order to clarify the phenomenon mechanism, we monitored blood volume, surface temperature, photosensitizer amount, and oxygen saturation during the PDT. The rat prostate subcutaneous tumor was irradiated with excimer dye laser light at 1 h after the intravenous injection. The photosensitizer dose wa 2.0 mg/kg, and the pulse energy density was 2.5 mJ/cm2 (low intensity) or 10 mJ/cm2 (high intensity). Under the low intensity pulsed PDT, the fluorescence amount was decreasing gently during the irradiation, and the blood volume and oxygen saturation started decreasing just after the irradiation. Under the hgh intensity pulsed PDT, the fluorescence amount was decreaased rapidly for 20 s after the irradiation started. The blood volume and oxygen saturation were temporally decreased during the irradiation, and recovered at 48 hrs after the irradiation. According to these results, under the low intensity pulsed PDT, the blood vessel located near the surface started closing just after the irradiation. On the other hand, under the high intensity pulsed PDT the blood vessel was closing for 20 s after the irradiation started, moreover, the blood flow recovered at 48 hrs after the irradiation. We concluded that the vascular response depended on the pulse energy density, and then the therapeutic effect was attributed to the difference of the vascular response. In other words, the surface intact layer could be considered to be induced the temporal drug and oxygen depletion effect associated with the temporal vascular shutdown.

Hakomori, S.; Matsuo, H.; Arai, T.



Total intravenous anaesthesia for caesarean section in a patient with Marfan's syndrome  

Microsoft Academic Search

The case is described of a pregnant patient with Marfan's syndrome scheduled at 39 weeks' gestation for elective caesarean section carried out for the first time by total intravenous anaesthesia (TIVA) with continuous intravenous (i.v.) infusion of propofol. The diagnosis was based on a positive family history, classic phenotype, scoliosis, arachnodactyly, high narrow palate, hyperextensible joints, ectopia lentis and mitral

J. E. Llopis; R. Garcia-Aguado; C. Sifre; M. Tommasi Rosso; M. Vivó; J. Martin-Jurado; F. Grau



Illicit intravenous use of methylphenidate (ritalin) tablets: A review of four cases  

Microsoft Academic Search

Intravenous injection of crushed Ritalin (methylphenidate 10 mg) tablets has emerged as a current medical concern in New Zealand. We report the clinical features of four cases of methylphenidate toxicity arising from intravenous (IV) injection of crushed Ritalin tablets, and highlight concerns regarding this form of drug abuse. Two patients required intensive care management and one died approximately 10 hours

John Fountain; P FAWCETT



Lack of a hypotensive effect with rapid administration of a new aqueous formulation of intravenous amiodarone  

Microsoft Academic Search

Hypotension is the most frequent adverse event reported with intravenous amiodarone. Hypotension has been attributed to the vasoactive solvents of the standard formulation (Cordarone IV) and is not dose related, but related to the rate of infusion. Drug labeling calls for intravenous amiodarone to be administered over 10 minutes. A new aqueous formulation of amiodarone (Amio-Aqueous) does not contain vasoactive

John C. Somberg; Sandor Timar; Steven J. Bailin; Ferenc Lakatos; Charles I. Haffajee; Jeno Tarjan; Walter P. Paladino; Istvan Sarosi; Nicholas Z. Kerin; Jozsef Borbola; Duane E. Bridges; Janos Molnar



Utilization Patterns of IV Iron and Erythropoiesis Stimulating Agents in Anemic Chronic Kidney Disease Patients: A Multihospital Study.  


Intravenous (IV) iron and Erythropoiesis Stimulating Agents (ESAs) are recommended for anemia management in chronic kidney disease (CKD). This retrospective cohort study analyzed utilization patterns of IV iron and ESA in patients over 18 years of age admitted to University Health System Hospitals with a primary or secondary diagnosis of CKD between January 1, 2006 to December 31, 2008. A clustered binomial logistic regression using the GEE methodology was used to identify predictors of IV iron utilization. Only 8% (n = 6678) of CKD patients on ESA therapy received IV iron supplementation in university hospitals. Those receiving iron used significantly less amounts of ESAs. Patient demographics (age, race, primary payer), patient clinical conditions (admission status, severity of illness, dialysis status), and physician specialty were identified as predictors of IV iron use in CKD patients. Use of IV iron with ESAs was low despite recommendations from consensus guidelines. The low treatment rate of IV iron represents a gap in treatment practices and signals an opportunity for healthcare improvement in CKD anemic patients. PMID:22577528

Joshi, Avani D; Holdford, David A; Brophy, Donald F; Harpe, Spencer E; Mays, Darcy; Gehr, Todd W B



Conversion Efficacy and Safety of Intravenous Ibutilide Compared With Intravenous Procainamide in Patients With Atrial Flutter or Fibrillation  

Microsoft Academic Search

Objectives. This multicenter study compared the efficacy and safety of ibutilide versus procainamide for conversion of recent- onset atrial flutter or fibrillation. Background. Ibutilide fumarate is an intravenous (IV) class III antiarrhythmic agent that has been shown to be significantly more effective than placebo in the pharmacologic conversion of atrial flutter and fibrillation to sinus rhythm. Procainamide is com- monly



Intravenous digital subtraction angiography in the investigation of intracranial disease  

SciTech Connect

Eighty-six patients who presented with a variety of intracranial lesions were examined with intravenous digital subtraction angiogrphy (IV-DSA). A grading system was used to evaluate the ability IV-DSA to answer specific diagnostic questions regarding intracranial tumors, vasospasm following subarachnoid hemorrhage, lesions of the sella, dural sinus occlusion, and post-therapeutic embolization. Eighty-four percent of the examinations provided clinically useful information. In 15% of the cases limited but useful information was obtained; only 1% of the examinations provided no useful information. We conclude that IV-DSA can routinely provide useful information in the evaluation of the variety of intracranial lesions described above.

DeFilipp, G.J.; Pinto, R.S.; Lin, J.P.; Kricheff, I.I.



A case of septicaemic anthrax in an intravenous drug user  

PubMed Central

Background In 2000, Ringertz et al described the first case of systemic anthrax caused by injecting heroin contaminated with anthrax. In 2008, there were 574 drug related deaths in Scotland, of which 336 were associated with heroin and or morphine. We report a rare case of septicaemic anthrax caused by injecting heroin contaminated with anthrax in Scotland. Case Presentation A 32 year old intravenous drug user (IVDU), presented with a 12 hour history of increasing purulent discharge from a chronic sinus in his left groin. He had a tachycardia, pyrexia, leukocytosis and an elevated C-reactive protein (CRP). He was treated with Vancomycin, Clindamycin, Ciprofloxacin, Gentamicin and Metronidazole. Blood cultures grew Bacillus anthracis within 24 hours of presentation. He had a computed tomography (CT) scan and magnetic resonance imagining (MRI) of his abdomen, pelvis and thighs performed. These showed inflammatory change relating to the iliopsoas and an area of necrosis in the adductor magnus. He underwent an exploration of his left thigh. This revealed chronically indurated subcutaneous tissues with no evidence of a collection or necrotic muscle. Treatment with Vancomycin, Ciprofloxacin and Clindamycin continued for 14 days. Negative Pressure Wound Therapy (NPWT) device was applied utilising the Venturi™ wound sealing kit. Following 4 weeks of treatment, the wound dimensions had reduced by 77%. Conclusions Although systemic anthrax infection is rare, it should be considered when faced with severe cutaneous infection in IVDU patients. This case shows that patients with significant bacteraemia may present with no signs of haemodynamic compromise. Prompt recognition and treatment with high dose IV antimicrobial therapy increases the likelihood of survival. The use of simple wound therapy adjuncts such as NPWT can give excellent wound healing results.



Esophagoscopy in Evaluating Treatment in Patients With Stage I-IV Head and Neck Cancer Who Are Undergoing Radiation Therapy and/or Chemotherapy

Stage I Adenoid Cystic Carcinoma of the Oral Cavity; Stage I Mucoepidermoid Carcinoma of the Oral Cavity; Stage I Squamous Cell Carcinoma of the Hypopharynx; Stage I Squamous Cell Carcinoma of the Larynx; Stage I Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage I Verrucous Carcinoma of the Larynx; Stage I Verrucous Carcinoma of the Oral Cavity; Stage II Adenoid Cystic Carcinoma of the Oral Cavity; Stage II Mucoepidermoid Carcinoma of the Oral Cavity; Stage II Squamous Cell Carcinoma of the Hypopharynx; Stage II Squamous Cell Carcinoma of the Larynx; Stage II Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage II Verrucous Carcinoma of the Larynx; Stage II Verrucous Carcinoma of the Oral Cavity; Stage III Adenoid Cystic Carcinoma of the Oral Cavity; Stage III Mucoepidermoid Carcinoma of the Oral Cavity; Stage III Squamous Cell Carcinoma of the Hypopharynx; Stage III Squamous Cell Carcinoma of the Larynx; Stage III Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage III Verrucous Carcinoma of the Larynx; Stage III Verrucous Carcinoma of the Oral Cavity; Stage IV Adenoid Cystic Carcinoma of the Oral Cavity; Stage IV Mucoepidermoid Carcinoma of the Oral Cavity; Stage IV Squamous Cell Carcinoma of the Hypopharynx; Stage IV Squamous Cell Carcinoma of the Larynx; Stage IV Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage IV Verrucous Carcinoma of the Larynx; Stage IV Verrucous Carcinoma of the Oral Cavity



A randomized controlled trial of isotonic versus hypotonic maintenance intravenous fluids in hospitalized children  

PubMed Central

Background Isotonic saline has been proposed as a safer alternative to traditional hypotonic solutions for intravenous (IV) maintenance fluids to prevent hyponatremia. However, the optimal tonicity of maintenance intravenous fluids in hospitalized children has not been determined. The objective of this study was to estimate and compare the rates of change in serum sodium ([Na]) for patients administered either hypotonic or isotonic IV fluids for maintenance needs. Methods This was a masked controlled trial. Randomization was stratified by admission type: medical patients and post-operative surgical patients, aged 3 months to 18 years, who required IV fluids for at least 8 hours. Patients were randomized to receive either 0.45% or 0.9% saline in 5.0% dextrose. Treating physicians used the study fluid for maintenance; infusion rate and the use of additional fluids were left to their discretion. Results Sixteen children were randomized to 0.9% saline and 21 to 0.45% saline. Baseline characteristics, duration (average of 12 hours) and rate of study fluid infusion, and the volume of additional isotonic fluids given were similar for the two groups. [Na] increased significantly in the 0.9% group (+0.20 mmol/L/h [IQR +0.03, +0.4]; P = 0.02) and increased, but not significantly, in the 0.45% group (+0.08 mmol/L/h [IQR -0.15, +0.16]; P = 0.07). The rate of change and absolute change in serum [Na] did not differ significantly between groups. Conclusions When administered at the appropriate maintenance rate and accompanied by adequate volume expansion with isotonic fluids, 0.45% saline did not result in a drop in serum sodium during the first 12 hours of fluid therapy in children without severe baseline hyponatremia. Confirmation in a larger study is strongly recommended. Clinical Trial Registration Number NCT00457873 (



Immune Globulin Intravenous (Human), Gammar-P IV  

Center for Biologics Evaluation and Research (CBER)

... example, it is more effective than pasteurization in the inactivation of hepatitis C and related model viruses and it is more robust than heat treatment. ... More results from


Response of livedoid vasculitis to intravenous immunoglobulin.  


Livedoid vasculitis is a chronic condition characterized by recurrent painful ulceration of the lower limbs, which heals to leave atrophie blanche surrounded by hyperpigmentation and telangiectasia. We report two patients with livedoid vasculitis who, after failure of conventional therapies, responded to intravenous immunoglobulin (IVIg). There was healing of areas of active ulceration and improvement of erythema, swelling and pain. IVIg has been used successfully to treat a variety of vasculitic disorders and appears to be well tolerated. We suggest that this treatment is offered to patients who have livedoid vasculitis that is unresponsive to other therapies. PMID:12100203

Ravat, F E; Evans, A V; Russell-Jones, R



Welding IV.  

ERIC Educational Resources Information Center

|Instructional objectives and performance requirements are outlined in this course guide for Welding IV, a competency-based course in advanced arc welding offered at the Community College of Allegheny County to provide students with proficiency in: (1) single vee groove welding using code specifications established by the American Welding Society…

Allegheny County Community Coll., Pittsburgh, PA.


Low doses of intravenous epinephrine for refractory sustained monomorphic ventricular tachycardia  

PubMed Central

We report three cases of sustained monomorphic ventricular tachycardia (VT) in the setting of coronary artery disease, resistant to beta-blockers in two patients and to amiodarone in all, successfully terminated by low doses of intravenous (IV) epinephrine. VT was the first manifestation of coronary artery disease in one patient, whereas the other two patients had a previous history of myocardial infarction and were recipients of an implantable cardioverter-defibrillator (ICD). One of these two patients experienced an arrhythmic storm. All had hemodynamic instability at the time of epinephrine administration. A single slow administration of IV epinephrine (0.5 to 1 mg administered over 30 to 60 s) restored sinus rhythm after 30-90 s with only minor side effects. In the ICD patient with recurrent VT and several cardioversions due to transformation of VT to ventricular fibrillation, epinephrine injection led to the avoidance of further shocks. Although potentially harmful, low doses of IV epinephrine used alone or in combination with beta-blocker treatment and electrical cardioversion may be an alternative effective therapy for sustained monomorphic VT refractory to amiodarone. The role of epinephrine in the termination of VT should be studied further, especially in patients pre-treated with amiodarone in combination with beta-blockers.

Bonny, Aime; De Sisti, Antonio; Marquez, Manlio F; Megbemado, Richard; Hidden-Lucet, Francoise; Fontaine, Guy



[Treatment of myasthenia gravis with intravenous immunoglobulin G (IVIG)].  


In the two past years 25 patients with generalized myasthenia gravis (MG) were treated with high-dose intravenous immunoglobulin G (IVIG) at the Institute of Neurology in Belgrade. The patients were affected with severe forms of MG (IIB, III and IV according to Osserman's classification) refractory to all previous treatment. All patients received IVIG, 250-350 mg/kg during five consecutive days. An immediate positive effect was mild and recorded 12-15 days later in only 37.5% patients. On the contrary, 92% patients showed delayed improvement which was effective for over six months. Distribution and severety of the disease decreased as expressed by reduced Besinger mean clinical score from 12.3 to 5.7 after six months. Immunologic parameters before and after IVIG treatment did not differ significantly. An increase of IgG was observed in 88% of patients. IVIG side effects were infrequent, usually mild, and qualitatively different from those induced by other therapies (azathioprine, corticosteroids). The authors emphasize the beneficial delayed effect of IVIG on the course of MG which resulted in significant reduction of the dose of additional immunosuppressive agents. The absance of immediate therapeutic effect of IVIG does not justify this mode of treatment in acute deterioration and crisis of MG. PMID:17974459

Lavrni?, D B; Stojanovi?, V; Marinkovi?, Z; Pavlovi?, S; Vidakovi?, A; Apostolski, S


Intravenous fentanyl kinetics  

Microsoft Academic Search

Fentanyl is considered to be a short-acting narcotic analgesic but prolonged and recurrent ventilatory depression has been reported. We examined fentanyl kinetics and excretion in 7 healthy male subjects who were given a 3.2- or 6.4-?g\\/kg dose of 3H-fentanyi intravenously. Arterial blood and urine samples were analyzed for unchanged fentanyl and total radioactivity. Fentanyl concentrations fell rapidly and 98.6% of

Deborah A McClain; Carl C Hug



Treatment of adenoviral pneumonitis with intravenous ribavirin and immunoglobulin.  

PubMed Central

A 67 year old woman developed a severe adenoviral pneumonitis whilst receiving immunosuppressive therapy. She showed clinical and radiological evidence of a response to treatment with nebulised and intravenous ribavirin and intravenous pooled normal human immunoglobulin. To our knowledge this is the first time that such a therapeutic approach has been used in the treatment of a condition which normally carries a very high mortality. Images

Sabroe, I; McHale, J; Tait, D R; Lynn, W A; Ward, K N; Shaunak, S



Intravenous dexamethasone pretreatment reduces remifentanil induced cough  

PubMed Central

Background Remifentanil infusion is commonly used for general anesthesia but reflex cough can occur after an intravenous (IV) infusion. This study was designed to examine the effect of IV-dexamethasone on remifentanil-induced cough (RIC). Methods One hundred thirty patients scheduled for elective surgery were randomly assigned into two groups that received by either 2 ml of IV 0.9% saline (Group C, n = 68) or 10 mg of dexamethasone (Group D, n = 62) 5 min before administration of remifentanil at a target effect-site concentration of 5 ng/ml. The incidence and severity of coughs of each patient were recorded. Results The overall incidence of cough was 6.5% (4/62 patients) in Group D and 26.5% (18/68 patients) in the Group C (P = 0.002). The severity of cough observed was significantly different by dexamethasone pretreatment (P = 0.02) but there were no significant hemodynamic changes. Conclusions Pretreatment with dexamethasone after IV administration was effective in suppressing the reflex cough induced by remifentanil infusion.

Yu, Mi-Suk; Kim, Hye Young



A phase II study of single-agent gefitinib as first-line therapy in patients with stage IV non-small-cell lung cancer  

Microsoft Academic Search

The aim of this study was to evaluate the efficacy and tolerability of gefitinib (‘IRESSA’) in Japanese patients with previously untreated stage IV non-small-cell lung cancer (NSCLC). This was a multi-institutional phase II study. Thirty-four patients with previously untreated stage IV NSCLC were enrolled between May 2003 and September 2004. Gefitinib was administered orally 250 mg once a day and

R Suzuki; Y Hasegawa; K Baba; H Saka; H Saito; H Taniguchi; M Yamamoto; S Matsumoto; K Kato; T Oishi; K Imaizumi; K Shimokata



Multiple Intravenous Infusions Phase 1b  

PubMed Central

Background Minimal research has been conducted into the potential patient safety issues related to administering multiple intravenous (IV) infusions to a single patient. Previous research has highlighted that there are a number of related safety risks. In Phase 1a of this study, an analysis of 2 national incident-reporting databases (Institute for Safe Medical Practices Canada and United States Food and Drug Administration MAUDE) found that a high percentage of incidents associated with the administration of multiple IV infusions resulted in patient harm. Objectives The primary objectives of Phase 1b of this study were to identify safety issues with the potential to cause patient harm stemming from the administration of multiple IV infusions; and to identify how nurses are being educated on key principles required to safely administer multiple IV infusions. Data Sources and Review Methods A field study was conducted at 12 hospital clinical units (sites) across Ontario, and telephone interviews were conducted with program coordinators or instructors from both the Ontario baccalaureate nursing degree programs and the Ontario postgraduate Critical Care Nursing Certificate programs. Data were analyzed using Rasmussen’s 1997 Risk Management Framework and a Health Care Failure Modes and Effects Analysis. Results Twenty-two primary patient safety issues were identified with the potential to directly cause patient harm. Seventeen of these (critical issues) were categorized into 6 themes. A cause-consequence tree was established to outline all possible contributing factors for each critical issue. Clinical recommendations were identified for immediate distribution to, and implementation by, Ontario hospitals. Future investigation efforts were planned for Phase 2 of the study. Limitations This exploratory field study identifies the potential for errors, but does not describe the direct observation of such errors, except in a few cases where errors were observed. Not all issues are known in advance, and the frequency of errors is too low to be observed in the time allotted and with the limited sample of observations. Conclusions The administration of multiple IV infusions to a single patient is a complex task with many potential associated patient safety risks. Improvements to infusion and infusion-related technology, education standards, clinical best practice guidelines, hospital policies, and unit work practices are required to reduce the risk potential. This report makes several recommendations to Ontario hospitals so that they can develop an awareness of the issues highlighted in this report and minimize some of the risks. Further investigation of mitigating strategies is required and will be undertaken in Phase 2 of this research. Plain Language Summary Patients, particularly in critical care environments, often require multiple intravenous (IV) medications via large volumetric or syringe infusion pumps. The infusion of multiple IV medications is not without risk; unintended errors during these complex procedures have resulted in patient harm. However, the range of associated risks and the factors contributing to these risks are not well understood. Health Quality Ontario’s Ontario Health Technology Advisory Committee commissioned the Health Technology Safety Research Team at the University Health Network to conduct a multi-phase study to identify and mitigate the risks associated with multiple IV infusions. Some of the questions addressed by the team were as follows: What is needed to reduce the risk of errors for individuals who are receiving a lot of medications? What strategies work best? The initial report, Multiple Intravenous Infusions Phase 1a: Situation Scan Summary Report, summarizes the interim findings based on a literature review, an incident database review, and a technology scan. The Health Technology Safety Research Team worked in close collaboration with the Institute for Safe Medication Practices Canada on an exploratory study to understand the risks associated with multiple IV infusions and th

Cassano-Piche, A; Fan, M; Sabovitch, S; Masino, C; Easty, AC



Early intravenous beta-blockers in patients with acute coronary syndrome-A meta-analysis of randomized trials.  


BACKGROUND: Intravenous (IV) beta-blockade is currently a Class IIa recommendation in early management of patients with acute coronary syndromes (ACS) without obvious contraindications. METHODS: We searched the PubMed, EMBASE and the Cochrane Register for Controlled Clinical Trials for randomized clinical trials from 1965 through December, 2011, comparing intravenous beta-blockers administered within 12hours of presentation of ACS with standard medical therapy and/or placebo. The primary outcome assessed was the risk of short-term (in-hospital mortality-with maximum follow up duration of 90days) all-cause mortality in the intervention group versus the comparator group. The secondary outcomes assessed were ventricular tachyarrhythmias, myocardial reinfarction, cardiogenic shock, and stroke. Pooled treatment effects were estimated using relative risk with Mantel-Haenszel risk ratio, using a random-effects model. RESULTS: Sixteen studies enrolling 73,396 participants met the inclusion ? exclusion criteria. In- hospital mortality was reduced 8% with intravenous beta-blockers, RR=0.92 (95% CI, 0.86-1.00; p=0.04) when compared with controls. Moreover, intravenous beta-blockade reduced the risk of ventricular tachyarrhythmias (RR=0.61; 95 % CI 0.47-0.79; p=0.0003) and myocardial reinfarction (RR=0.73, 95 % CI 0.59-0.91; p=0.004) without increase in the risk of cardiogenic shock, (RR=1.02; 95% CI 0.77-1.35; p=0.91) or stroke (RR=0.58; 95 % CI 0.17-1.98; p=0.38). CONCLUSIONS: Intravenous beta-blockers early in the course of appropriate patients with ACS appears to be associated with significant reduction in the risk of short-term cardiovascular outcomes, including a reduction in the risk of all-cause mortality. PMID:23168009

Chatterjee, Saurav; Chaudhuri, Debanik; Vedanthan, Rajesh; Fuster, Valentin; Ibanez, Borja; Bangalore, Sripal; Mukherjee, Debabrata



Three Monthly Intravenous Injections of Ibandronate in the Treatment of Postmenopausal Osteoporosis  

Microsoft Academic Search

PURPOSE: Oral treatment of osteoporosis with bisphosphonates relies on compliance, the absorption being low and suppressed by simultaneous food intake. Intravenous (IV) treatment with an aminobisphosphonate, pamidronate (once every 3 months) was effective, but required infusions. Ibandronate, a new very potent aminobisphosphonate, can be administered safely as an IV bolus injection, and therefore offers an interesting alternative suitable for outpatient

D Thiébaud; P Burckhardt; H Kriegbaum; H Huss; H Mulder; J. R Juttmann; K. H Schöter



The Rate and Costs Attributable to Intravenous Patient-Controlled Analgesia Errors  

Microsoft Academic Search

Purpose: To estimate the rates and costs of intravenous patient-controlled analgesia (IV PCA) errors from the hos- pital or integrated health system perspective. Methods: This study used a cost-accounting methodology to estimate the costs attributable to IV PCA errors in the United States. Data for the study were obtained from the MEDMARX and Manufacturer and User Facility Device Experience (MAUDE)

Brian Meissner; Winnie Nelson; Vanja Sikirica; Josh Gagne; Jeff Schein



Risk perception, risk taking and risk management among intravenous drug users: Implications for AIDS prevention  

Microsoft Academic Search

The risks associated with AIDS transmission among intravenous drug users overlap with a constellation of other risk events common in the use of IV drugs. This paper explores the subcultural definition, meaning and use of risk from the experience of the active user. In assessing the extent and nature of risk among IV drug users, street-based ethnographic research was conducted

Margaret M. Connors



Pediatric Procedural Sedation with Ketamine: Time to Discharge after Intramuscular versus Intravenous Administration  

Microsoft Academic Search

Objectives: Ketamine is an attractive agent for pediatric procedural sedation. There are limited data on time to discharge comparing intramuscular (IM) vs. intravenous (IV) ketamine. The authors set out to determine whether IM or IV ketamine leads to quicker discharge from the emergency department (ED) and how side effect profiles compare. Methods: All patients who had received ketamine IM or

Preeti Ramaswamy; Franz E. Babl; Conor Deasy; Lisa N. Sharwood



Intravenous Drug Injection Habits: Drug Users’ Self-Reports versus Researchers’ Perception  

Microsoft Academic Search

The present study was designed to obtain human data on the speed of intravenous (i.v.) injection of cocaine, heroin, and morphine as well as on the rate of onset of their subjective effects and their duration in order to improve the accuracy of animal and human experimental models of i.v. drug abuse. To that end, a questionnaire was submitted both

Gerald Zernig; Salvatore Giacomuzzi; Yvonne Riemer; Gudrun Wakonigg; Katja Sturm; Alois Saria



Sirolimus and Vaccine Therapy in Treating Patients With Stage II-IV Ovarian Epithelial, Fallopian Tube, or Primary Peritoneal Cavity Cancer

Recurrent Fallopian Tube Cancer; Recurrent Ovarian Epithelial Cancer; Recurrent Primary Peritoneal Cavity Cancer; Stage IIA Fallopian Tube Cancer; Stage IIA Ovarian Epithelial Cancer; Stage IIA Primary Peritoneal Cavity Cancer; Stage IIB Fallopian Tube Cancer; Stage IIB Ovarian Epithelial Cancer; Stage IIB Primary Peritoneal Cavity Cancer; Stage IIC Fallopian Tube Cancer; Stage IIC Ovarian Epithelial Cancer; Stage IIC Primary Peritoneal Cavity Cancer; Stage IIIA Fallopian Tube Cancer; Stage IIIA Ovarian Epithelial Cancer; Stage IIIA Primary Peritoneal Cavity Cancer; Stage IIIB Fallopian Tube Cancer; Stage IIIB Ovarian Epithelial Cancer; Stage IIIB Primary Peritoneal Cavity Cancer; Stage IIIC Fallopian Tube Cancer; Stage IIIC Ovarian Epithelial Cancer; Stage IIIC Primary Peritoneal Cavity Cancer; Stage IV Fallopian Tube Cancer; Stage IV Ovarian Epithelial Cancer; Stage IV Primary Peritoneal Cavity Cancer



Causes of intravenous medication errors—observation of nurses in a German hospital  

Microsoft Academic Search

AimErrors in the preparation and administration of intravenous (IV) drugs are frequent events. Human error theory has recently been applied to understand the causes of IV drug errors in an ethnographic study in the United Kingdom. We used this approach to explore causes of IV drug errors by nursing staff in a German hospital.MethodsA trained and experienced observer accompanied nurses

Katja Taxis; Nick Barber



Use of Intravenous Proton-Pump Inhibitors in a Teaching Hospital Practice  

Microsoft Academic Search

Objective To evaluate intravenous proton-pump inhibitor (IV PPI) prescribing in a single academic teaching hospital. Methods A retrospective pilot study of 107 patients in a single United States military teaching hospital was conducted over a 1-month\\u000a period. Clinical data were collected and analyzed for demographic features, prior medication use, admission hemoglobin level,\\u000a service prescribing the IV PPI, indication for IV

Jacob G. Hoover; Annabel L. Schumaker; Kevin J. Franklin



Intravenous treatment of experimental Staphylococcus aureus endophthalmitis: imipenem versus the combination of ceftazidime and amikacin  

Microsoft Academic Search

Background: To compare the efficacy of intravenous (IV) imipenem (IPM) and a combination of IV ceftazidime (CAZ) and amikacin (AN) in the treatment of Staphylococcus aureus endophthalmitis in a rabbit model. Methods: Right eyes of 60 albino rabbits were injected with 1000 colony-forming units of S. aureus intravitreally. After 24 h, treatment with either IV IPM (37.5 mg\\/kg) every 8 h ( n=18)

Michael Engelbert; Herminia Miño de Kaspar; Martina Mette; Martin Thiel; Christopher N. Ta; Thomas Grasbon; Markus Schulze-Schwering; Volker Klauss; Anselm Kampik



Intravenous Morphine for Breakthrough (Episodic) Pain in an Acute Palliative Care Unit: A Confirmatory Study  

Microsoft Academic Search

The aim of this prospective cohort study was to confirm the safety of intravenous morphine (IV-M) used in doses proportional to the basal opioid regimen for the management of breakthrough pain and to record the nurse compliance on regularly recording data regarding breakthrough pain treated by IV-M. Over a one-year period, 99 patients received IV-M for breakthrough pain during 116

Sebastiano Mercadante; Giuseppe Intravaia; Patrizia Villari; Patrizia Ferrera; Salvatore Riina; Salvatore Mangione



Reducing hospital-acquired infection by quantitative risk modeling of intravenous bag preparation.  


Vascular access of patients by peripheral and central venous catheters for the delivery of sterile or aseptically manufactured parenterals is commonly regarded as one of the major causes of blood stream infections. Rigorous evaluation and management of the risks of microbial infection originating from the administration of aseptically manufactured therapies remain imperative to reduce patient infection risks. Healthcare clinicians are continually faced with choosing intravenous (IV) parenteral administration strategies to minimize patient blood stream infection risk. Data facilitating such decisions are often difficult to obtain. Analysis and interpretation of the available, reported hospital infection rate data to evaluate medical device- and therapy-associated infection rates are constrained by the variability and uncertainty associated with each individual administration scenario. Moreover, clinical trials quantifying infection risk are constrained by their practicality, cost, and the control of the exacting requisite trial criteria. Furthermore, it is ethically inappropriate to systematically conduct clinical evaluations incorporating conditions that do not favor the best possible patient outcomes. Quantitative risk modeling (QRM) is a unique tool offering an alternative and affective means of assessing design and clinical use in the context of the clinical environment on medical device and combinatorial therapy infection rates. Here, we report the generation of QRMs and the evaluation of manual admixing IV bags for use in IV administration sets upon patient infection rates. The manual admixing of IV bags was assessed for the opportunity and risk of microbial ingress accessing across the sterile barrier during clinical preparation and contaminating the IV solution. The risk of microbial contamination was evaluated under (a) ISO 5 compounding conditions adopting ideal aseptic technique (in compliance with USP ?797?) and (b) realistic worst-case point-of-care conditions (typically found in hospital wards). These choices of conditions encompass the complete spectrum of clinical environments encountered in the hospital. The evaluation estimated contamination rates ranged from <2.2 ppm (2.2 contaminated units in every million uses) to 2.9% (29 contaminated units in every 1000 uses), contingent upon the clinical environment. QRM permits the swift probabilistic evaluation of contamination rates providing the healthcare professional with data to make an informed choice of medical devices and a preparation strategy in their precise clinical context, reducing hospital acquired infections for optimal clinical patient outcomes. PMID:21502008

Tidswell, Edward C; Rockwell, Jim; Wright, Marc-Oliver


Immune Globulin Intravenous (IGIV) Indications  

Center for Biologics Evaluation and Research (CBER)

... Immune Globulins. -. Immune Globulin Intravenous (IGIV) Indications. ... B-cell Chronic Lymphocytic Leukemia; Immune Thrombocytopenic Purpura; ... More results from


Pharmacokinetics of felodipine after intravenous and chronic oral administration in patients with congestive heart failure.  

PubMed Central

1. In a randomized, parallel, double-blind study felodipine was administered to 11 and placebo to 12 patients with congestive heart failure. The kinetics of felodipine were studied after acute intravenous administration and after chronic oral treatment for 8 weeks. The relationship between cardiac output and pharmacokinetics was analyzed. The pharmacokinetic data were compared with data from young healthy individuals and hypertensive patients. 2. After oral therapy, significant correlations were found between cardiac output and AUC and systemic bioavailability (F). Furthermore, cardiac output before therapy was also significantly correlated with absorption characteristics. No relationship could be demonstrated between cardiac output and i.v. pharmacokinetics. A comparison of patients with heart failure and young healthy individuals revealed that the AUC was three times higher in heart failure patient, while Vss and the ratio of the AUC of the pyridine metabolite to that of felodipine were similar. Oral clearance was reduced by 50% and the terminal half-life was concomitantly increased. Pharmacokinetic data for felodipine are similar in patients with heart failure to published data from elderly hypertensive patients. 3. An increase in liver blood flow during chronic oral therapy, induced by felodipine itself, appears to explain an increase in bioavailability and thus to higher plasma drug concentrations. Thus, it is advisable to start felodipine treatment at a low dosage in patients with congestive heart failure.

Dunselman, P H; Edgar, B; Scaf, A H; Kuntze, C E; Wesseling, H



Bolus i.v. nitroglycerin treatment of ischemic chest pain in the ED.  


A prospective case series was conducted to demonstrate the safety and efficacy of intravenous nitroglycerin (i.v. NTG) boluses in the treatment of ischemic chest pain (CP) in the emergency department (ED). Patients with CP symptomatic after sublingual nitroglycerin (SL NTG) therapy with a systolic blood pressure (SBP) greater than 95 mmHg were included. Patients were treated with i.v. NTG boluses of 0.05 mg to 0.4 mg during a 1- to 2-minute period per a protocol based on the patient's prebolus SBP. This was followed by a maintenance infusion. Additional NTG boluses were repeated every 5 minutes as needed. The end point of treatment was the resolution of chest discomfort, thrombolysis, or a SBP less than 95 mmHg. There were 16 cases of CP. All 16 patients treated, ie, 5 with acute myocardial infarction and 11 with unstable angina showed significant decrease in chest discomfort after 1 to 2 boluses. Two of five with acute myocardial infarction and 9 of 11 patients with unstable angina had complete relief of chest pain after 1 to 4 boluses. There were no episodes of hypotension (SBP < 90 mmHg) in any of the 16 cases. The judicious use of i.v. NTG boluses administered during a 1- to 2-minute period, in the ED, appears safe and efficacious in patients with CP unresponsive to SL NTG therapy. PMID:8179732

Nashed, A H; Allegra, J R; Larsen, S; Horowitz, M



Secondary erythromelalgia successfully treated with intravenous immunoglobulin.  


Erythromelalgia is a rare condition characterized by episodic painful erythema and warmth often affecting, but not limited to, the distal extremities. This condition is notoriously difficult to treat. We report a young female patient with seronegative polyarthritis who presented with a 6-year history of recurrent bouts of painful erythema and swelling often triggered by minor trauma. An extensive evaluation was unremarkable. Several medical therapies provided limited and inconsistent relief of her symptoms over many years. Treatment with intravenous immunoglobulin significantly decreased the frequency and severity of her symptoms. PMID:22156790

Moody, Shadé; Pacheco, Susan; Butler, Ian J; Koenig, Mary Kay



Pharmacokinetics of Intravenously Administered Azithromycin in Pediatric Patients  

Microsoft Academic Search

Background: The objective of this study was to characterize the pharmacokinetics and tolerance of a single intravenous (IV) azithro- mycin dose in children. Methods: Subjects were stratified into 4 age groups: 0.5-2 years; 2-6 years; 6-12 years; and 12-16 years. Each subject received a single 10 mg\\/kg dose (500 mg maximum) infused in 1 hour. Serial venous blood samples were

Richard F. Jacobs; Holly D. Maples; Jacob V. Aranda; Gabriela M. Espinoza; Charles Knirsch; Richa Chandra; Jeannine M. Fisher; Gregory L. Kearns



Topical amethocaine (Ametop™) is superior to EMLA for intravenous cannulation  

Microsoft Academic Search

Purpose  A eutectic mixture of local anesthetics (EMLA) is commonly used to provide topical anesthesia for intravenous (iv) cannulation.\\u000a One of its side effects is vasoconstriction, which may render cannulation more difficult. A gel formulation of amethocaine\\u000a (Ametop™) is now commercially available. The aim of this study was to compare EMLA and Ametop™ with regard to the degree of\\u000a topical anesthesia

John Browne; Imad Awad; Robert Plant; John McAdoo; George Shorten



Haemodynamic response to intravenous vasopressin and nitroglycerin in portal hypertension  

Microsoft Academic Search

We have evaluated the haemodynamic effects of intravenous (iv) nitroglycerin (NG) and vasopressin (VP) alone and in combination, in 12 patients with cirrhosis and recent variceal haemorrhage (two to seven days). Nitroglycerin infusion alone (200 micrograms\\/min) produced a significant fall in portal pressure (WHVP-FHVP) (from 16.4 (0.6) to 13.3 (1.2) mmHg; p less than .001) associated with hypotension (mean arterial

D Westaby; A Gimson; P C Hayes; R Williams



Cyto- and genotoxicity of a vanadyl(IV) complex with oxodiacetate in human colon adenocarcinoma (Caco-2) cells: potential use in cancer therapy  

Microsoft Academic Search

The complex of vanadyl(IV) cation with oxodiacetate, VO(oda) caused an inhibitory effect on the proliferation of the human\\u000a colon adenocarcinoma cell line Caco-2 in the range of 25–100 ?M (P < 0.001). This inhibition was partially reversed by scavengers of free radicals. The difference in cell proliferation in\\u000a the presence and the absence of scavengers was statistically significant in the range of 50–100 ?M

Ana L. Di Virgilio; Josefina Rivadeneira; Cecilia I. Muglia; Miguel A. Reigosa; Nataliya Butenko; Isabel Cavaco; Susana B. Etcheverry


Intravenous lipid emulsion - rescued at LAST.  


The accidental overdose of local anaesthetics may prove fatal. The commonly used amide local anaesthetics have varying adverse effects on the myocardium and beyond a certain dose all are capable of causing death. Local anaesthetics are the most frequently used drugs in dentistry and although uncommon, local anaesthetic systemic toxicity (LAST) accounts for a high proportion of mortalities in the dental office, with local anaesthetic-induced cardiac arrest particularly resistant to standard resuscitation methods. Over the last decade there has been convincing evidence of using intravenous lipid emulsions as a rescue in local anaesthetic - cardiotoxicity and anaesthetic organisations over the globe have developed guidelines on the use of this drug. Despite this, however, awareness among practitioners appears to be lacking. All who use local anaesthetics in their practice should have an appreciation of patients at high risk of toxicity, early symptoms and signs of toxicity, preventative measures when using these drugs and the initial management of systemic toxicity with intravenous lipid emulsion. In this review we intend to discuss the pharmacology and pathophysiology of local anaesthetic toxicity, and the rationale for intravenous lipid emulsion therapy. PMID:22402543

Ciechanowicz, S J; Patil, V K



COSMOS - a study comparing peripheral intravenous systems.  


In many areas of the world, safety peripheral intravenous systems have come into widespread use. The Madrid region was the first in Spain to adopt such an approach. These systems, though initially introduced to protect users from sharps injuries, have now evolved to include patient protection features as well. Patient protection, simply stated, means closing the system to pathogen entry. The authors' purpose was to investigate, in a prospective and randomized study, the clinical performance of a closed safe intravenous system versus an open system (COSMOS - Compact Closed System versus Mounted Open System). COSMOS is designed to provide definitive answers, from a nursing perspective, to many topics related to peripheral venous catheterization, which have important implications in intravenous therapy and which have not been validated scientifically. Furthermore, it forms pioneering research in that it is the first clinical trial on medical devices in a legislated environment carried out entirely by nurses and whose promoter and principal investigator is a nurse. The objectives of COSMOS are to compare the effectiveness (as defined by time of survival without complications) and rates of catheter-related complications, such as phlebitis, pain, extravasation, blockage and catheter-related infections. It also looks at rates of catheter colonization, the ease of handling of both systems and overall costs. This article outlines the authors' approach, both in preparing hospital units for such an evaluation as well as in the choice of parameters and their method of study. Further articles will detail the results and findings of the study. PMID:19633594

López, Juan Luis González; Del Palacio, Encarnación Ferenández; Marti, Carmen Benedicto; Corral, Javier Olivares; Portal, Pilar Herrera; Vilela, Ana Arribi


Bacterial colonization and phlebitis-associated risk with transparent polyurethane film for peripheral intravenous site dressings.  


Previous studies of various brands of polyurethane dressings have noted differences in the rates of catheter colonization. We compared Bioclusive transparent polyurethane (TP) dressing with a cotton gauze (CG) dressing on peripheral intravenous (IV) access sites for the incidence of phlebitis, catheter tip colonization, skin colonization, and catheter-related bacteremia. The study, involving 598 ward patients, was case controlled, prospective, and randomized for a period of 4 months. Each patient was entered into the study only once, and all dressings were applied by a member of the IV therapy team. No significant difference was seen for phlebitis rate (TP: 9.8% vs. CG: 7.6%) or catheter tip colonization, defined as greater than 15 colony forming units (CFU) (5.7% vs. 4.4%) by a semiquantitative technique. Cultures of specimens from the skin and catheter tips of the majority of patients (91%) showed no growth. An association was found between those patients with greater than 15 CFU isolated from catheter tips and those with phlebitis (p = 0.022). No documented catheter-related bacteremia occurred in either study group. PMID:3408013

Hoffmann, K K; Western, S A; Kaiser, D L; Wenzel, R P; Groschel, D H



Acute renal failure due to high-grade obstruction following therapy with epsilon-aminocaproic acid.  


An 18-year-old man with mild factor VIII deficiency developed hematuria and, subsequently, acute renal failure due to high-grade urinary obstruction by clots during therapy with cryoprecipitate, epsilon-aminocaproic acid, and acetazolamide administered for ocular trauma. Discontinuation of therapy with the latter two agents and induction of a brisk diuresis with intravenous (IV) fluid therapy resulted in return of renal function concomitant with spontaneous clot passage. A review of previous literature suggests that hemophiliacs may be more susceptible than nonhemophiliacs to high-grade urinary obstruction due to clot formation when epsilon-aminocaproic acid is administered during episodes of hematuria. Acute flank pain, fever, and delayed dense nephrograms on IV pyelogram are characteristic of the syndrome and distinguish it from other forms of acute renal failure associated with epsilon-aminocaproic acid. PMID:3812474

Pitts, T O; Spero, J A; Bontempo, F A; Greenberg, A



Differences in gross target volumes on contrast vs. noncontrast CT scans utilized for conformal radiation therapy treatment planning for prostate carcinoma  

Microsoft Academic Search

Purpose: To compare the gross target volumes (GTVs) (prostate and seminal vesicles) defined on noncontrast and contrast-enhanced computed tomography (CT) images used for three-dimensional conformal treatment planning (3DCRT).Methods and Materials: From 1993 to 1996, 39 patients referred for radiation therapy for adenocarcinoma of the prostate underwent pretreatment pelvic CT scanning with and without intravenous (IV) contrast for treatment planning purposes.

Su-Min Zhou; Gunilla C. Bentel; Catherine G. Lee; Mitchell S. Anscher



Morphological and biochemical changes after intravenous injection of gold nanoparticles  

NASA Astrophysics Data System (ADS)

Advances in nanotechnology applications in medicine, including enhanced cancer therapy cause necessity investigation of nanoparticles toxicity. Herein, we report results encompassing the histological examination of tissues and biochemical tests of blood plasma after intravenous injection of gold nanoparticles. Besides of this, we analyzed passive accumulation of nanoshells in the tumor.

Terentyuk, G. S.; Maslyakova, G. N.; Suleymanova, L. V.; Borodulin, V. B.; Dudakova, Yu. S.; Khlebtsov, N. G.; Khlebtsov, B. N.; Akchurin, G. G.; Maksimova, I. L.; Tuchin, V. V.



Stroke Therapy Academic Industry Roundtable (STAIR) Recommendations For Extended Window Acute Stroke Therapy Trials  

PubMed Central

The Stroke Therapy Academic Industry Roundtable (STAIR) meetings focus on helping to advance the development of acute stroke therapies. Further extending the time window for acute stroke therapies is an important endeavor for increasing the number of stroke patients who might benefit from treatment. The STAIR group recommends that future extended time window trials initially should focus on selected patient groups most likely to respond to investigational therapies and that penumbral imaging is one tool that may identify such patients. The control group in these trials should receive best locally available medical care; if regulatory approval for intravenous (i.v.) tPA is extended to 4.5 hours, then tPA will become the most appropriate comparator in trials conducted within this time window. In future well-designed extended window clinical trials randomization is appropriate and should not be precluded by using unproven treatment with intra-arterial (i.a.) thrombolysis or mechanical devices. For proof of concept, extended time window, phase II trials of i.v. thrombolysis or mechanical devices in which early recanalization/reperfusion is the primary endpoint, rescue therapy/bailout treatment with i.a. thrombolysis or devices may be acceptable. Statistical considerations and definitions of successful recanalization/reperfusion are suggested for these trials.

Saver, Jeffrey L.; Albers, Gregory W.; Dunn, Billy; Johnston, Karen C.; Fisher, Marc



Blockade of nucleus accumbens opiate receptors attenuates intravenous heroin reward in the rat  

Microsoft Academic Search

A quaternary derivative of naloxone, methyl naloxonium chloride (MN), was administered intracerebrally to rats trained to self-administer heroin intravenously. Increases in intravenous (IV) heroin self-administration rates were found following injections of low doses of MN into the nucleus accumbens (N.Acc), but not following injections of low doses of MN into the ventral tegmental area (VTA). These results were interpreted to

Franco J. Vaccarino; Floyd E. Bloom; George F. Koob




PubMed Central

Background Measures of a therapy’s effect size are important guides to clinicians, patients, and policy-makers on treatment decisions in clinical practice. The ECASS 3 trial demonstrated a statistically significant benefit of intravenous TPA for acute cerebral ischemia in the 3–4.5 hour window, but an effect size estimate incorporating benefit and harm across all levels of poststroke disability has not previously been derived. Methods Joint outcome table specification was employed to derive number needed to treat to benefit (NNTB) and number needed to treat to harm (NNTH) values summarizing treatment impact over the entire outcome range on the modified Rankin Scale of global disability, including both expert-dependent and expert-independent (algorithmic and repeated random sampling) array generation. Results For the full 7-category mRS, algorithmic analysis demonstrated that the NNTB for 1 additional patient to have a better outcome by 1 or more grades than with placebo must lie between 4.0 – 13.0. In bootstrap simulations, the mean NNTB was 7.1. Expert joint outcome table analyses indicated that the NNTB for improved final outcome was 6.1 (95%CI 5.6–6.7) and the NNTH 37.5 (95%CI 34.6–40.5). Benefit per hundred patients treated was 16.3 and harm per hundred 2.7. The likelihood of help to harm (LHH) ratio was 6.0. Conclusions Treatment with TPA in the 3–4.5 hour window confers benefit on about half as many patients as treatment under 3 hours, with no increase in the conferral of harm. About one in six patients has a better and one in thirty-five a worse outcome as a result of therapy.

Saver, Jeffrey L.; Gornbein, Jeffrey; Grotta, James; Liebeskind, David; Lutsep, Helmi; Schwamm, Lee; Scott, Phillip; Starkman, Sidney



Epileptic Seizure Following IV Tramadol in a Patient with Mental Retardation and Cerebellar Ataxia  

Microsoft Academic Search

ObjectiveTo present a case of an epileptic seizure related to intravenous (IV) tramadol for pain control following a total abdominal hysterectomy operation on a patient with mental retardation and cerebellar ataxia.

Hale Yarkan Uysal; Ba?nu Bilimgut; Bayazit Dikmen; Nurten Inan; Gülay Ülger; Solmaz Eruyar



Rapid IV Versus Oral Rehydration: Responses to Subsequent Exercise Heat Stress.  

National Technical Information Service (NTIS)

This study sought to determine the effect of rapid intravenous (IV) versus oral (ORAL) rehydration immediately after dehydration, on cardiovascular, thermoregulatory, and perceptual responses during subsequent exercise in the heat.

J. W. Castellani K. M. O'Moore N. V. Mahood R. W. Kenefick



Cost Implications of Administering Intravenous Proton Pump Inhibitors to All Patients Presenting to the Emergency Department with Peptic Ulcer Bleeding  

Microsoft Academic Search

ObjectivesAdministering proton pump inhibitors (PPI) intravenously (iv) after endoscopic treatment of bleeding peptic ulcers reduces the incidence of rebleeding, the need for operative procedures, and hospitalizations. We assessed the cost implications of iv PPI initiated in all patients presenting to the emergency department (ED) with signs of upper gastrointestinal (UGI) bleeding.

Yves M. Gagnon; Adrian R. Levy; Mohamad A. Eloubeidi; Miguel R. Arguedas; Kevin P. Rioux; Robert A. Enns



A comparison of continuous epidural infusion and intermittent intravenous bolus doses of morphine in children undergoing selective dorsal rhizotomy  

Microsoft Academic Search

Background and Objectives. Selective dorsal rhizotomy (SDR) is associated with moderate to severe postoperative pain. Although the efficacy of epidural analgesia in this population has been demonstrated, it has not been compared with conventional intravenous (i.v.) analgesia. This prospective study compared the effects of epidural and i.v. morphine regarding postoperative analgesia, side effects, and outcomes in children following SDR. Methods.

Shobha Malviya; Uma A. Pandit; Sandra Merkel; Terri Voepel-Lewis; Laura Zang; Monica Siewert; Alan R. Tait; Karin Muraszko



High-dose intravenous immunoglobulin infusion in polyarteritis nodosa  

Microsoft Academic Search

We describe a 58-year-old Japanese female who developed polyarteritis nodosa (PN). Her skin disease and systemic symptoms\\u000a were resistant to dapsone (1.5 mg kg?1 day?1), high-dose oral prednisone (1 mg kg?1 day?1) and azathioprine (2 mg kg?1 day?1), and intravenous cyclophosphamide pulse therapy (10 mg kg?1 day?1). She was ultimately treated with infusion of high-dose intravenous immunoglobulin (IVIG) at a dose of 0.1 g kg?1

Yoshihide Asano; Hironobu Ihn; Takeo Maekawa; Takafumi Kadono; Kunihiko Tamaki



A tool to measure the attributes of receiving IV therapy in a home versus hospital setting: the Multiple Sclerosis Relapse Management Scale (MSRMS)  

PubMed Central

Background Intravenous steroids are routinely used to treat disabling relapses in multiple sclerosis (MS). Theoretically, the infusion could take place at home, rather than in hospital. Findings from other patient populations suggest that patients may find the experiences of home relapse management more desirable. However, formal comparison of these two settings, from the patients' point of view, was prevented by the lack of a clinical scale. We report the development of a rating scale to measure patient's experiences of relapse management that allowed this question to be answered confidently. Methods Scale development had three stages. First, in-depth interviews of 21 MS patients generated a conceptual model and pool of potential scale items. Second, these items were administered to 160 people with relapsing-remitting MS. Standard psychometric techniques were used to develop a scale. Third, the psychometric properties of the scale were evaluated in a randomised controlled trial of 138 patients whose relapses were managed either at home or hospital. Results A preliminary conceptual model with eight dimensions, and a pool of 154 items was generated. From this we developed the MS Relapse Management Scale (MSRMS), a 42-item with four subscales: access to care (6 items), coordination of care (11 items), information (7 items), interpersonal care (18 items). The MSRMS subscales satisfied most psychometric criteria but had notable floor effects. Conclusions The MSRMS is a reliable and valid measure of patients' experiences of MS relapse management. The high floor effects suggest most respondents had positive care experiences. Results demonstrate that patients' experiences of relapse management can be measured, and that the MSRMS is a powerful tool for determining which services to develop, support and ultimately commission.



Weekly low-dose treatment with intravenous iron sucrose maintains iron status and decreases epoetin requirement in iron-replete haemodialysis patients  

Microsoft Academic Search

Background. Haemodialysis patients need sustained treatment with intravenous iron because iron defi- ciency limits the efficacy of recombinant human epoetin therapy in these patients. However, the optimal intravenous iron maintenance dose has not been established yet. Methods. We performed a prospective multicentre clinical trial in iron-replete haemodialysis patients to evaluate the efficacy of weekly low-dose (50 mg) intravenous iron sucrose

Daniela Schiesser; Isabelle Binet; Dimitrios Tsinalis; Michael Dickenmann; Markus Schmidli; Patrice M. Ambuhl; Rudolf P. Wuthrich


Intravenous urocortin II decreases blood pressure through CRF 2 receptor in rats  

Microsoft Academic Search

Urocortin II (Ucn II) is a new member of the corticotropin-releasing factor (CRF) family that binds selectively to the CRF subtype 2 receptor (CRF2). CRF or urocortin injected intravenously (iv) induced hypotension. We investigated the influence of iv human Ucn II (hUcn II) on basal mean blood pressure (MAP) and on the sympathetic mediated hypertensive response to TRH analog, RX-77368

Chih-Yen Chen; Ming-Luen Doong; Jean E Rivier; Yvette Taché



Preferences of Patients with Advanced Colorectal Cancer for Treatment with Oral or Intravenous Chemotherapy  

Microsoft Academic Search

Background: In recent years, patient-reported outcomes such as health-related quality of life have become important areas of clinician focus in general cancer management. Patients' preferences for, and\\/or satisfaction with, oral versus intravenous (IV) chemotherapy schedules may have a major impact on such outcomes. Objective: To evaluate preferences for oral or IV chemotherapy in patients with advanced colorectal cancer. Methods: A

Candida M. Mastroianni; Caterina Viscomi; Silvia Ceniti; Rosanna De Simone; Aldo Filice; Gennaro Gadaleta Caldarola; Stefania Infusino; Caterina Manfredi; Antonio Rea; Claudia Sandomenico; Salvatore Turano; Francesco Serrano; Giovanni Condemi; Carla Cortese; Tullia Prantera; Salvatore Palazzo



The comparative effects of single intravenous doses of cimetidine, ranitidine, famotidine, and omeprazole on intragastric PH  

Microsoft Academic Search

Twelve healthy subject participated in this randomized, double-masked, four-way crossover study to determine treatment schedules for intravenous (IV) administration of various gastric antisecretory drugs. Intragastric pH was monitored continuously for 14 hours after a single IV injection of cimetidine 300 mg, ranitidine 50 mg, famotidine 20 mg, or omeprazole 40 mg, each administered during one of four succcessive treatment periods

Olivier Chassany; Jean Francois Bergmann; Guy Simoneau; Lisa Elouaer-Blanc; Jean Marc Segrestaa; Charles Caulin



Combined Intravenous and Intra-Arterial Recombinant Tissue Plasminogen Activator in Acute Ischemic Stroke  

Microsoft Academic Search

Background and Purpose—A retrospective analysis was performed on 20 consecutive patients who presented with severe acute ischemic stroke and were evaluated for a combined intravenous (IV) and local intra-arterial (IA) recombinant tissue plasminogen activator (rtPA) thrombolytic approach within 3 hours of onset. Methods—Twenty consecutive patients with carotid artery distribution strokes were evaluated and treated using a combined IV and IA

Robert Ernst; Arthur Pancioli; Thomas Tomsick; Brett Kissela; Daniel Woo; Daniel Kanter; Edward Jauch; Janice Carrozzella; Judith Spilker; Joseph Broderick


Influence of timing on the analgesic effect of intravenous ketorolac after orthopedic surgery  

Microsoft Academic Search

This study evaluated the pre-emptive analgesic effect of intravenous (i.v.) ketorolac (KET) for total hip replacement (THR). Sixty patients who underwent surgery for THR under general anesthesia were randomly allocated to 3 groups. Two i.v. injections were administered: one before induction and one after surgery. The patients were studied prospectively in a double-blind manner. The control group (CONT; n =

D. Fletcher; P. Zetlaoui; S. Monin; M. Bombart; K. Samii



Ronidazole pharmacokinetics after intravenous and oral immediate-release capsule administration in healthy cats  

Microsoft Academic Search

Ronidazole (RDZ) is an effective treatment for feline Tritrichomonas foetus infection, but has produced neurotoxicity in some cats. An understanding of the disposition of RDZ in cats is needed in order to make precise dosing recommendations. Single-dose pharmacokinetics of intravenous (IV) RDZ and immediate-release RDZ capsules were evaluated. A single dose of IV RDZ (mean 9.2 mg\\/kg) and a 95

Dana N. LeVine; Mark G. Papich; Jody L. Gookin; Gigi S. Davidson; Jennifer L. Davis; Rebecca B. Hayes



CGP 55398, a liposomal Ge(IV) phthalocyanine bearing two axially ligated cholesterol moieties: a new potential agent for photodynamic therapy of tumours.  

PubMed Central

Ge(IV) phthalocyanine (GePc) with two axially ligated cholesterol moieties was prepared by chemical synthesis and incorporated in a monomeric state into small unilamellar liposomes (CGP 55398). Upon photoexcitation with light wavelengths around its intense absorption peak at 680 nm, GePc shows an efficient photosensitising activity towards biological substrates through a mechanism which largely involves the intermediacy of singlet oxygen. GePc injected systemically into mice bearing an intramuscularly implanted MS-2 fibrosarcoma is quantitatively transferred to serum lipoproteins and localises in the tumour tissue with good efficiency: at 24 h post injection the GePc content in the tumour is 0.74 and 1.87 micrograms per g of tissue with a tumour/peritumoral ratio of 4.35 and 5.67 for injected doses of 0.76 and 1.52 mg kg-1 respectively. At this time the red-light irradiation of the GePc-loaded fibrosarcoma causes a fast and massive tumour necrosis involving both malignant cells and blood vessels. Images Figure 8 Figure 9 Figure 10 Figure 11 Figure 12

Segalla, A.; Milanesi, C.; Jori, G.; Capraro, H. G.; Isele, U.; Schieweck, K.



Improved tumor imaging and therapy via i.v. IgG-mediated time-sequential modulation of neonatal Fc receptor  

PubMed Central

The long plasma half-life of IgG, while allowing for enhanced tumor uptake of tumor-targeted IgG conjugates, also results in increased background activity and normal-tissue toxicity. Therefore, successful therapeutic uses of conjugated antibodies have been limited to the highly sensitive and readily accessible hematopoietic tumors. We report a therapeutic strategy to beneficially alter the pharmacokinetics of IgG antibodies via pharmacological inhibition of the neonatal Fc receptor (FcRn) using high-dose IgG therapy. IgG-treated mice displayed enhanced blood and whole-body clearance of radioactivity, resulting in better tumor-to-blood image contrast and protection of normal tissue from radiation. Tumor uptake and the resultant therapeutic response was unaltered. Furthermore, we demonstrated the use of this approach for imaging of tumors in humans and discuss its potential applications in cancer imaging and therapy. The ability to reduce the serum persistence of conjugated IgG antibodies after their infusion can enhance their therapeutic index, resulting in improved therapeutic and diagnostic efficacy.

Singh Jaggi, Jaspreet; Carrasquillo, Jorge A.; Seshan, Surya V.; Zanzonico, Pat; Henke, Erik; Nagel, Andrew; Schwartz, Jazmin; Beattie, Brad; Kappel, Barry J.; Chattopadhyay, Debjit; Xiao, Jing; Sgouros, George; Larson, Steven M.; Scheinberg, David A.



Improved tumor imaging and therapy via i.v. IgG-mediated time-sequential modulation of neonatal Fc receptor.  


The long plasma half-life of IgG, while allowing for enhanced tumor uptake of tumor-targeted IgG conjugates, also results in increased background activity and normal-tissue toxicity. Therefore, successful therapeutic uses of conjugated antibodies have been limited to the highly sensitive and readily accessible hematopoietic tumors. We report a therapeutic strategy to beneficially alter the pharmacokinetics of IgG antibodies via pharmacological inhibition of the neonatal Fc receptor (FcRn) using high-dose IgG therapy. IgG-treated mice displayed enhanced blood and whole-body clearance of radioactivity, resulting in better tumor-to-blood image contrast and protection of normal tissue from radiation. Tumor uptake and the resultant therapeutic response was unaltered. Furthermore, we demonstrated the use of this approach for imaging of tumors in humans and discuss its potential applications in cancer imaging and therapy. The ability to reduce the serum persistence of conjugated IgG antibodies after their infusion can enhance their therapeutic index, resulting in improved therapeutic and diagnostic efficacy. PMID:17717602

Jaggi, Jaspreet Singh; Carrasquillo, Jorge A; Seshan, Surya V; Zanzonico, Pat; Henke, Erik; Nagel, Andrew; Schwartz, Jazmin; Beattie, Brad; Kappel, Barry J; Chattopadhyay, Debjit; Xiao, Jing; Sgouros, George; Larson, Steven M; Scheinberg, David A



Human immunodeficiency virus seropositivity in intravenous drug users in Ohio.  


A seroprevalence survey of 508 intravenous (IV) drug users enrolled in methadone treatment programs in Ohio for evidence of infection with the human immunodeficiency virus (HIV) demonstrated a positivity prevalence of 1.4%. This seropositivity prevalence is low compared with 10% to 72% positive from surveys conducted in the IV drug-using populations of New York, New Jersey, Detroit and San Francisco. Although needle sharing was common (71% since 1983), the number of sharing partners was usually limited and regular. A potential for cross-infection from urban centers with higher seropositivity prevalence was indicated by patterns of travel and needle sharing while traveling to higher risk metropolitan centers such as New York. Hispanics appeared to be at greater risk for HIV infection (OR 17.7, 95% CI 2.4-133.0), as were male IV drug users with gay/bisexual lifestyles (OR 14.1, 95% CI 1.3-153.0). HIV positive individuals were identified in Cleveland (1.6%), Dayton (3.1%), and Columbus (0.8%), but not in the four other Ohio metropolitan areas participating in the survey. Study participants indicated that knowledge of AIDS had changed their IV drug-using habits with 60% reporting that fear of AIDS had caused them to give up IV drugs or needle sharing. Sampling from methadone clinics may underestimate the HIV seropositivity in Ohio's IV drug-using community; however, it appears that relatively few IV drug users in Ohio are currently infected with HIV. The low prevalence of HIV infection in the Ohio IV drug-using community provides the opportunity to intervene in limiting the spread of the virus by educating individuals to reduce or eliminate risk factors for the transmission of the disease. PMID:2927870

Seligman, P J; Campbell, R J; Keeler, G P; Halpin, T J



Intravenous Tissue Plasminogen Activator and Stroke in the Elderly  

PubMed Central

Objective Since publication in 1995 of the National Institute of Neurological Disorders and Stroke (NINDS) trial of intravenous tissue plasminogen activator (IV tPA) for acute ischemic stroke, the benefit and frequency of use of IV tPA in the elderly have remained uncertain. Methods We obtained data from the NINDS trial to summarize outcomes for randomized subjects older than 80 years. We used data from the Cardiovascular Health Study, a cohort study of 5,888 elderly participants from four US communities followed longitudinally for stroke since 1989, to estimate the use of and hospital outcome after IV tPA in older adults following publication of the trial in 1995. Results In the NINDS trial, 44 subjects older than 80 years were randomized, and their three-month functional outcomes were not significantly improved with IV tPA. Four of 25 randomized to IV tPA experienced symptomatic intracranial hemorrhages within 36 hours of treatment. Compared with younger patients, older patients were 2.87 times more likely to experience a symptomatic intracranial hemorrhage within 36 hours of IV tPA (95% confidence interval (CI) 1.04, 7.93). Of 227 CHS participants hospitalized for ischemic stroke between 1995 and 2002, seven, whose mean was age 84, were treated with IV tPA (3.1%; 95% CI 1.2, 6.2). Two had symptomatic intracranial hemorrhages, three failed to improve, and two of the seven had good outcomes. Conclusions These data highlight the need to clarify the risk-benefit profile of IV tPA in ischemic stroke victims who are older than 80 years.

Longstreth, WT; Katz, Ronit; Tirschwell, David L.; Cushman, Mary; Psaty, Bruce M.



A comparison of intravenous and subcutaneous hydration in elderly acute stroke patients.  

PubMed Central

The aim of this study was to compare the effectiveness of subcutaneous and intravenous fluid therapy in hydrating, elderly acute stroke patients. Thirty-four such patients, needing parenteral fluids because of impaired consciousness or dysphagia, were randomly allocated to receive either subcutaneous or intravenous fluids (2 litres of dextrose-saline/24 hours). Serum osmolality was measured before starting fluid therapy (Day 1) and on Days 2 and 3. An analysis of covariance of the osmolalities showed no statistical difference between the two groups (P = 0.12). The total cost of cannulae used over the 3 days for the subcutaneous route was approximately a third of that for the intravenous route. Complication rates were similar for the two groups. The results suggest that subcutaneous fluid therapy is an effective alternative to the intravenous route.

Challiner, Y. C.; Jarrett, D.; Hayward, M. J.; al-Jubouri, M. A.; Julious, S. A.



A pilot intravenous cannulation team: an Irish perspective.  


Peripheral intravenous cannulation (PIVC) is a potentially painful and distressing procedure for patients, and is traditionally carried out by medical personnel. A university hospital in Ireland was chosen to initiate a pilot intravenous (IV) cannulation team, to ascertain whether this procedure could be performed effectively by a team of nurses. The team was introduced to support the implementation of the European working time directive (EWTD). A team of four registered general nurses, led by a senior phlebotomist, provided PIVC. Request books were placed on each ward and data was recorded before and after each insertion. A constantly increasing percentage of first-time cannulation success is displayed from the first five months of the study. In-depth analysis on an orthopaedic ward reveal a preference for distal site insertion and routine change at 72 hours. IV teams performing IV cannulation can effectively reduce insertion rate attempts, and potentially offer a solution to the manpower issues arising as a result of implementation of the EWTD. PMID:20622770

Carr, Peter J; Glynn, Ronan W; Dineen, Brendan; Kropmans, Thomas Jb


In-use contamination of intravenous infusion fluid.  


During the 1970 to 1971 nationwide epidemic of septicemias caused by Enterobacter cloacae and Enterobacter agglomerans traced to intrinsic contamination of Abbott intravenous infusion products, 94 infusion systems manufactured by Baxter Laboratories were studied microbiologically and epidemiologically during hospital use. Intravenous fluid from 10 systems (11%) contained microorganisms, usually Staphylococcus or Bacillus species; one infusion was heavily contaminated with Klebsiella pneumoniae. No national epidemic organisms, E. cloacae or E. agglomerans (formerly Erwinia), were recovered, suggesting that during this period frequent contamination with these organisms was unique to Abbott's infusion products. Contamination in this study appeared to be extrinsic in origin (introduced during clinical use) and related to the duration of continuous intravenous therapy. Nine of 61 systems (15%) that had been used longer than 48 h were contaminated, whereas only 1 of 33 used less than 48 h (3%) contained microorganisms. This study and the recent national outbreak indicate that contamination of infusion fluid, both from intrinsic and extrinsic sources, must be recognized as an additional risk of intravenous therapy; however, a once-daily replacement of the delivery apparatus can significantly diminish this hazard. PMID:4613269

Maki, D G; Anderson, R L; Shulman, J A



Comparison of Intravenous Iron Sucrose to Oral Iron in the Treatment of Anemic Patients with Chronic Kidney Disease Not on Dialysis  

Microsoft Academic Search

Background: Few studies compare oral to intravenous (IV) iron for managing anemia in patients with chronic kidney disease (CKD) not on dialysis. Methods: We enrolled 96 CKD anemic patients on erythropoietin in a randomized, open-label, multicenter, controlled study. Patients received 29 days of oral FeSO4 (325 mg t.i.d.) or intravenous (IV) iron sucrose (5 doses of 200 mg weekly). Assessments

Chaim Charytan; Wajeh Qunibi; George R. Bailie



Low dose intravenous minocycline is neuroprotective after middle cerebral artery occlusion-reperfusion in rats  

Microsoft Academic Search

BACKGROUND: Minocycline, a semi-synthetic tetracycline antibiotic, is an effective neuroprotective agent in animal models of cerebral ischemia when given in high doses intraperitoneally. The aim of this study was to determine if minocycline was effective at reducing infarct size in a Temporary Middle Cerebral Artery Occlusion model (TMCAO) when given at lower intravenous (IV) doses that correspond to human clinical

Lin Xu; Susan C Fagan; Jennifer L Waller; David Edwards; Cesar V Borlongan; Jianqing Zheng; William D Hill; Giora Feuerstein; David C Hess



Intravenous catheter training system: Computer-based education versus traditional learning methods  

Microsoft Academic Search

BackgroundVirtual reality simulators allow trainees to practice techniques without consequences, reduce potential risk associated with training, minimize animal use, and help to develop standards and optimize procedures. Current intravenous (IV) catheter placement training methods utilize plastic arms, however, the lack of variability can diminish the educational stimulus for the student. This study compares the effectiveness of an interactive, multimedia, virtual

Scott A Engum; Pamela Jeffries; Lisa Fisher




Microsoft Academic Search

? ? ? ? ? Objective: Sufficient iron substitution leads to a de- crease in the required recombinant human erythropoietin (rHuEPO) dose and\\/or an increased hematocrit in dialy- sis patients. Intravenous (IV) application of larger doses of iron sucrose may be associated with hyperferritinemia, appearance of catalytically free iron, and impaired phago- cyte function. Therefore, we investigated the effectiveness of

Elisabeth Dittrich; Martin Schillinger; Gere Sunder-Plassmann; Walter H. Hörl; Andreas Vychytil


Intravenous fluid restriction after major abdominal surgery: a randomized blinded clinical trial  

Microsoft Academic Search

BACKGROUND: Intravenous (IV) fluid administration is an essential part of postoperative care. Some studies suggest that a restricted post-operative fluid regime reduces complications and postoperative hospital stay after surgery. We investigated the effects of postoperative fluid restriction in surgical patients undergoing major abdominal surgery. METHODS: In a blinded randomized trial, 62 patients (ASA I-III) undergoing elective major abdominal surgical procedures

Hester Vermeulen; Jan Hofland; Dink A Legemate; Dirk T Ubbink



Analgesia after thoracotomy: epidural fentanyl\\/bupivacaine compared with intercostal nerve block plus intravenous morphine  

Microsoft Academic Search

Objectives: Intercostal nerve blockade plus intravenous (IV) patient-controlled analgesia (PCA) could be an easier and safer alternative to epidural analgesia for postthoracotomy pain, but information about the efficacy of this technique is scarce. The objective of this randomized study was to compare the quality of analgesia and lung function in 2 groups of patients undergoing pulmonary surgery through a posterolateral

Mario Concha; Jorge Dagnino; Mario Cariaga; Jorge Aguilera; Rodrigo Aparicio; Mario Guerrero



Tissue disposition of azithromycin after intravenous and intramuscular administration to rabbits  

Microsoft Academic Search

Tissue disposition of azithromycin after intravenous (IV) or intramuscular (IM) injection at a single dose rate of 10mg\\/kg bodyweight were investigated in rabbits using a modified agar diffusion bioassay for determining tissue concentrations. The pharmacokinetic behaviour of azithromycin was characterized by low and sustained plasma concentrations but high and persistent tissue concentrations. Kinetic parameters indicated a high retention of the

Carlos M. Cárceles; Emilio Fernández-Varón; Pedro Mar?´n; Elisa Escudero



Use of infrared thermometry to measure lavage and intravenous fluid temperature  

Microsoft Academic Search

A study was conducted to determine the accuracy of tympanic thermometers for measuring the temperature of warmed fluids in fluid bags and in tubing at the delivery site (ie, beside the intravenous [IV] catheter). One-liter 0.9% saline bags were warmed in a microwave oven. A thermocouple electronic temperature probe was then used to measure the reference temperature. The probe was

Robert O Wright; Gregory D Jay; Bruce M Becker; James G Linakis



Emergency Department Use of Intravenous Procainamide for Patients with Acute Atrial Fibrillation or Flutter  

Microsoft Academic Search

Objectives: Acute atrial fibrillation and flutter are very common arrhythmias seen in emergency depart- ment (ED) patients, but there is no consensus for their optimal management. The objective of this study was to examine the efficacy and safety of intravenous (IV) procainamide for acute atrial fibrillation or flutter. Methods: This health records review included a consecutive cohort of ED patients

Ian G. Stiell; Catherine M. Clement; Cheryl Symington; Jeffrey J. Perry; Christian Vaillancourt; George A. Wells



Aerobic bacterial culture of used intravenous fluid bags intended for use as urine collection reservoirs.  


Numerous studies have shown a relationship between indwelling urinary catheters and bacterial urinary tract infection. Some veterinary hospitals utilize stored, used intravenous (IV) fluid bags as part of the urine collection system. The authors cultured 95 such bags to see if they were potential sources of bacterial contamination. Forty-two unused IV bags were emptied of their contents for use as controls. Results indicated no aerobic bacterial growth in either group. The authors conclude that properly stored, used IV bags are unlikely sources of aerobic bacterial contamination when used in a urine collection system. PMID:18175792

Barrett, Masuma; Campbell, Vicki L


Adverse effects of treatment with intravenous immunoglobulins for neurological diseases  

Microsoft Academic Search

\\u000a Abstract\\u000a   Therapy with intravenous immunoglobulins (IVIg) is considered to be a safe treatment for a number of immune-mediated neurological\\u000a diseases. Published data about prevalence of adverse effects range from 11 to 81%. The purpose of our study was to preserve\\u000a a representative view on adverse effects by analysis of a large cohort of patients treated by IVIg. A recent prospective

Matthias Wittstock; Uwe K. Zettl



Prototype Space Flight Intravenous Injection System.  

National Technical Information Service (NTIS)

Medical emergencies, especially those resulting from accidents, frequently require the administration of intravenous fluids to replace lost body liquids. The development of a prototype space flight intravenous injection system is presented. The definition...

G. V. Colombo



[The clinical effect of intravenous regional sympathectomy with guanethidine in the management of sympathetically maintained pain].  


We treated 25 patients suffering from sympathetically maintained pain with intravenous regional sympathectomy with guanethidine. Of these patients, 18 had reflex sympathetic dystrophy; 5 had causalgia; and 2 had shoulder hand syndrome. The visual analog scale before IRS therapy was 6.1 +/- 0.3, and after therapy, it was 2.3 +/- 0.4. The mean rate of improvement was 54.2% in reflex sympathetic dystrophy and 81.0% in causalgia. The therapy was particularly effective in patients with shoulder hand syndrome. These results suggest that intravenous regional sympathectomy with guanethidine could be effective for sympathetically maintained pain. PMID:1279232

Onaka, M; Morimoto, M; Morimoto, E; Kurioka, M; Otada, H; Hyodo, M



Potential toxicity from nickel contamination of intravenous fluids  

SciTech Connect

Numerous investigations of nickel contamination of intravenous fluids are reviewed. The specific toxic effects of Ni/sup 2 +/ are cardiac toxicity, oxytocic action on the uterus, and allergic reactions. As a result of these studies, it is recommended that the maximum permissible level of nickel be set at 5 for common i.v. solutions, and 10 for solutions that contain albumin or amino acids which avidly bind Ni/sup 2 +/. It is also recommended that the maximum permissible amount of nickel administered to infants, growing children, and adults as a contaminant in i.v. fluids should not exceed 0.5

Sunderman, W.F. Jr.



Analysis of current data on the use of intravenous immunoglobulins in management of pemphigus vulgaris  

Microsoft Academic Search

Background: Systemic corticosteroids, with or without the addition of immunosuppressive adjuvant agents, are frequently used in treating patients with pemphigus vulgaris (PV). The severe, catastrophic, and potentially fatal side effects of these agents highlight the need for the development of safe alternatives for PV therapy. Intravenous immunoglobulin (IVIG) therapy has recently been reported to be effective in the treatment of

Leela Engineer; Kailash C. Bhol; A. Razzaque Ahmed



Complications of cyclosporin therapy  

Microsoft Academic Search

Cyclosporin (CsA) therapy has improved the outcome of allotransplants. Because of a relatively selective action on T lymphocytes, CsA therapy causes fewer immunosuppressive complications of infection or malignancy compared to previous chemical agents, which were relatively nonspecific in their spectrum of action on lymphoid versus nonlymphoid cells. Gastrointestinal complaints after oral administration and vasomotor reactions after intravenous administration represent pharmacologic

Barry D. Kahan; Stuart M. Flechner; Marc I. Lorber; Chris Jensen; Debbie Golden; Charles T. Van Buren



Safety and efficacy of intravenous tigecycline in treatment of community-acquired pneumonia: results from a double-blind randomized phase 3 comparison study with levofloxacin.  


Tigecycline exhibits potent in vitro activity against many community-acquired pneumonia (CAP) pathogens, including antibiotic-resistant ones. Its spectrum of activity and ability to penetrate lung tissue suggest it may be effective for hospitalized CAP patients. Hospitalized CAP patients (n=418) were randomized to receive intravenous (i.v.) tigecycline or levofloxacin. Patients could be switched to oral levofloxacin after receiving 6 or more doses of i.v. study medication. Therapy duration was 7 to 14 days. Coprimary efficacy end points were clinical responses in the clinically evaluable (CE: tigecycline, n=138; levofloxacin, n=156) and clinical modified intent-to-treat (c-mITT: tigecycline, n=191; levofloxacin, n=203) populations at test-of-cure (TOC). Safety was assessed in the mITT population (tigecycline, n=208; levofloxacin, n=210). Cure rates in tigecycline and levofloxacin groups were comparable in CE (90.6% versus 87.2%, respectively) and c-mITT (78% versus 77.8%, respectively) populations at TOC. Nausea and vomiting occurred in significantly more tigecycline-treated patients; elevated alanine aminotransferase and aspartate aminotransferase levels were reported in significantly more levofloxacin-treated patients. There were no significant differences in hospital length of stay, median duration of i.v. or oral antibiotic treatments, hospital readmissions, or number of patients switched to oral levofloxacin. Tigecycline was safe, effective, and noninferior to levofloxacin in hospitalized patients with CAP. PMID:18990531

Bergallo, Carlos; Jasovich, Abel; Teglia, Osvaldo; Oliva, Maria Eugenia; Lentnek, Arnold; de Wouters, Luisa; Zlocowski, Juan Carlos; Dukart, Gary; Cooper, Angel; Mallick, Rajiv



Intravenous magnetic nanoparticle cancer hyperthermia.  


Magnetic nanoparticles heated by an alternating magnetic field could be used to treat cancers, either alone or in combination with radiotherapy or chemotherapy. However, direct intratumoral injections suffer from tumor incongruence and invasiveness, typically leaving undertreated regions, which lead to cancer regrowth. Intravenous injection more faithfully loads tumors, but, so far, it has been difficult achieving the necessary concentration in tumors before systemic toxicity occurs. Here, we describe use of a magnetic nanoparticle that, with a well-tolerated intravenous dose, achieved a tumor concentration of 1.9 mg Fe/g tumor in a subcutaneous squamous cell carcinoma mouse model, with a tumor to non-tumor ratio > 16. With an applied field of 38 kA/m at 980 kHz, tumors could be heated to 60°C in 2 minutes, durably ablating them with millimeter (mm) precision, leaving surrounding tissue intact. PMID:23901270

Huang, Hui S; Hainfield, James F



Intravenous pamidronate in juvenile osteoporosis  

PubMed Central

AIMS—To investigate the use of the aminobisphosphonate, disodium pamidronate, in children with vertebral osteoporosis.?METHODS—Five children (aged 10-15 years) with vertebral osteoporosis who developed compression fractures in the thoracic and/or lumbar spine as a consequence of five different conditions, received treatment with intravenous disodium pamidronate in doses ranging from 0.5 to 12 mg/kg/y.?RESULTS—Each child had rapid pain relief following the first treatment, followed by large increments in lumbar spine bone density over one year; the change in bone density standard deviation score ranged from 0.5 to 2.5 with percentage increments of 26% to 54%.?CONCLUSION—Intravenous pamidronate appears to be a useful therapeutic option in childhood osteoporosis, but its use in children must still be regarded as experimental and therefore closely monitored.??

Shaw, N; Boivin, C; Crabtree, N



Intravenous bisphosphonates for postmenopausal osteoporosis.  


Numerous clinical studies have shown bisphoshonates (BPs) to be useful and cost-effective options for the fractures prevention and postmenopausal bone loss. The use of oral bisphoshonates is an established option for managment of osteoporosis in postmenopausal women, but many of them complaint from gastrointestinal side effect or frequently dosed oral regimens. To improve upon the suboptimal therapeutic compliance in postmenopausal women, newer, longer-acting intravenous formulations of BPs has been approved for intermittent administration in postmenopausal women. These preparations would become an option for patients who can not tolerate oral BPs or it was ineffective in increasing their bone density.This article proposed to review effectiveness and tolerability of intravenous BPs in postmenopausal women with osteoporosis. PMID:21526078

Mottaghi, Peyman



Intravenous bisphosphonates for postmenopausal osteoporosis  

PubMed Central

Numerous clinical studies have shown bisphoshonates (BPs) to be useful and cost-effective options for the fractures prevention and postmenopausal bone loss. The use of oral bisphoshonates is an established option for managment of osteoporosis in postmenopausal women, but many of them complaint from gastrointestinal side effect or frequently dosed oral regimens. To improve upon the suboptimal therapeutic compliance in postmenopausal women, newer, longer-acting intravenous formulations of BPs has been approved for intermittent administration in postmenopausal women. These preparations would become an option for patients who can not tolerate oral BPs or it was ineffective in increasing their bone density. This article proposed to review effectiveness and tolerability of intravenous BPs in postmenopausal women with osteoporosis.

Mottaghi, Peyman



Intravenous Regional Anesthesia with Meperidine  

Microsoft Academic Search

Forty-five ASA physical status I volunteers, divided in three groups of 15 each, received intravenous regional anesthesia (IVRA) of the upper limb with 40 mL meper- idine 0.25%, lidocaine 0.5%, or 0.9% sodium chloride (isolated ischemia) by random allocation. Using a dou- ble-blind method, the onset and recovery of sensory block was tested at six sites of the forearm and

Iurie Acalovschi; Tudor Cristea



Intravenous levetiracetam in critically ill children with status epilepticus or acute repetitive seizures  

PubMed Central

Objective Intravenous (IV) levetiracetam (LEV) is approved for use in patients older than 16 years and may be useful in critically ill children, although there is little data available regarding pharmacokinetics. We aim to investigate the safety, an appropriate dosing, and efficacy of IV LEV in critically ill children. Design We describe a cohort of critically ill children who received IV LEV for status epilepticus, including refractory or nonconvulsive status, or acute repetitive seizures. Results There were no acute adverse effects noted. Children had temporary cessation of ongoing refractory status epilepticus, termination of ongoing nonconvulsive status epilepticus, cessation of acute repetitive seizures, or reduction in epileptiform discharges with clinical correlate. Conclusions IV LEV was effective in terminating status epilepticus or acute repetitive seizures and well tolerated in critically ill children. Further study is needed to elucidate the role of IV LEV in critically ill children.

Abend, Nicholas S.; Monk, Heather M.; Licht, Daniel J.; Dlugos, Dennis J.



Reduced intravenous toxicity of amiodarone nanosuspension in mice and rats.  


The toxicity of amiodarone Lek formulation (test formulation) was investigated after a single intravenous (i.v.) administration to mice and rats. When compared to the reference item, Cordarone (Cordarone(®); Wyeth Pharmaceuticals Inc., Collegeville, Pennsylvania, USA), median lethal dose (LD(50)) after i.v. administration in female mice was 294.0?mg/kg body weight (b.w.) for the test formulation and 227.5?mg/kg b.w. for Cordarone. In female rats after i.v. administration, the LD(50) value was 269.9?mg/kg b.w. for the test formulation and 192.4?mg/kg b.w. for Cordarone. By altering the particle size of amiodarone in the Lek formulation, we were able to improve the solubility of amiodarone, thereby decreasing the number and quantity of excipients needed for preparation of the i.v. formulation and, consequently, reduced the acute toxic effects observed in the present study. PMID:22950665

Barle, Ester Lovšin; Cerne, Manica; Peternel, Luka; Homar, Miha



Phase I Trial of Polifeprosan 20 With Carmustine Implant Plus Continuous Infusion of Intravenous O6-Benzylguanine in Adults With Recurrent Malignant Glioma: New Approaches to Brain Tumor Therapy CNS Consortium Trial  

PubMed Central

Purpose This phase I trial was designed to (1) establish the dose of O6-benzylguanine (O6-BG) administered intravenously as a continuous infusion that suppresses O6-alkylguanine-DNA alkyltransferase (AGT) levels in brain tumors, (2) evaluate the safety of extending continuous-infusion O6-BG at the optimal dose with intracranially implanted carmustine wafers, and (3) measure the pharmacokinetics of O6-BG and its metabolite. Patients and Methods The first patient cohort (group A) received 120 mg/m2 of O6-BG over 1 hour followed by a continuous infusion for 2 days at escalating doses presurgery. Tumor samples were evaluated for AGT levels. The continuous-infusion dose that resulted in undetectable AGT levels in 11 or more of 14 patients was used in the second patient cohort. Group B received the optimal dose of O6-BG for 2, 4, 7, or 14 days after surgical implantation of the carmustine wafers. The study end point was dose-limiting toxicity (DLT). Results Thirty-eight patients were accrued. In group A, 12 of 13 patients had AGT activity levels of less than 10 fmol/mg protein with a continuous-infusion O6-BG dose of 30 mg/m2/d. Group B patients were enrolled onto 2-, 4-, 7-, and 14-day continuous-infusion cohorts. One DLT of grade 3 elevation in ALT was seen. Other non-DLTs included ataxia and headache. For up to 14 days, steady-state levels of O6-BG were 0.1 to 0.4 ?mol/L, and levels for O6-benzyl-8-oxoguanine were 0.7 to 1.3 ?mol/L. Conclusion Systemically administered O6-BG can be coadministered with intracranially implanted carmustine wafers, without added toxicity. Future trials are required to determine if the inhibition of tumor AGT levels results in increased efficacy.

Weingart, Jon; Grossman, Stuart A.; Carson, Kathryn A.; Fisher, Joy D.; Delaney, Shannon M.; Rosenblum, Mark L.; Olivi, Alessandro; Judy, Kevin; Tatter, Stephen B.; Dolan, M. Eileen



Fatal Multiple Systemic Emboli after Intravenous Thrombolysis for Cardioembolic Stroke.  


Our objective is to present a case of fatal multiple systemic emboli after intravenous thrombolysis for cardioembolic stroke. A 64-year-old woman with atrial fibrillation was admitted for evaluation of sudden consciousness disturbance, right hemiplegia, and aphasia. Diffusion-weighted imaging showed no early ischemic changes of the brain, and magnetic resonance angiography (MRA) showed occlusion of the left middle cerebral artery (MCA). One hour after initiation of 0.6 mg/kg of intravenous alteplase, the MCA was partially recanalized. Her symptoms disappeared the following day. We began intravenous heparin for secondary prevention of cardioembolic stroke. However, on the third day (52 hours after thrombolysis), she suddenly developed a coma and left hemiplegia. MRA showed acute occlusion of the right internal carotid artery (ICA). She developed acute kidney injury and sudden shock and then died of fatal cardiorespiratory arrest on the fourth day. Autopsy revealed occlusion of the mitral valve orifice by a spherical fresh red thrombus that led from the left atrial appendage. Acute embolic infarcts were identified in the spleen and right kidney, the latter secondary to occlusion of the right renal artery with fresh red thrombus. Intravenous thrombolysis and subsequent anticoagulation therapy may destabilize pre-existing intracardiac thrombus, potentially leading to recurrent stroke, multiple systemic embolisms, and the fatal "hole-in-one" effect. PMID:23545321

Tanaka, Koji; Ohara, Tomoyuki; Ishigami, Akiko; Ikeda, Yoshihiko; Matsushige, Toshinori; Satow, Tetsu; Ishibashi-Ueda, Hatsue; Iihara, Koji; Toyoda, Kazunori



Methods for intravenous self administration in a mouse model.  


Animal models have been developed to study the reinforcing effects of drugs, including the intravenous self-administration (IVSA) paradigm. The advantages of using an IVSA paradigm to study the reinforcing properties of drugs of abuse such as cocaine include the fact that the drug is self-administered instead of experimenter-administered, the schedule of reinforcement can be altered, and accurate measurement of the quantities of drug consumed as well as the timing and pattern of IV injections can be obtained. Furthermore, the intravenous route of administration avoids potential confounds related to first pass metabolism or taste, and produces rapid increases in blood and brain drug levels. As outlined in this video, intravenous self-administration can be obtained without prior food restriction or prior drug training following careful catheter placement during surgery and meticulous daily catheter flushing and maintenance. Experimental procedures outlined in this paper include a description of animal housing and acclimation methods, operant training using sweetened milk solutions, and catheter implantation surgery. PMID:23242006

Kmiotek, Elizabeth K; Baimel, Corey; Gill, Kathryn J



Minimum intravenous infectious dose of ovine progressive pneumonia virus (OPPV).  


The minimum intravenous infectious dose for ovine progressive pneumonia virus (OPPV) WLC1 was determined using twenty-four 6month-old lambs. Twelve groups of two 6month-old lambs were inoculated intravenously (i.v.) with tissue culture fluid containing ovine progressive pneumonia virus (OPPV) WLC1 titers ranging from 10(7.6) TCID(50)/lamb down to 10(-3.4) TCID(50)/lamb and were monitored for seroconversion using the OPPV agar gel immunodiffusion assay (AGID). Fifteen of the 16 lambs given equal or greater than 10(0.6) TCID(50) seroconverted, and virus could be isolated from peripheral blood leukocytes in 13 out of the 15 of these lambs. None of the eight lambs receiving less than 10(0.6) TCID(50) seroconverted during the 12months. The results of this study indicated that 10(0.6) or 4 TCID(50)/lamb given i.v. was capable of establishing infection. PMID:19246063

Herrmann-Hoesing, Lynn M; Lehmkuhl, Howard D; Cutlip, Randall C



Efficacy and safety of intravenous voriconazole and intravenous itraconazole for antifungal prophylaxis in patients with acute myelogenous leukemia or high-risk myelodysplastic syndrome  

Microsoft Academic Search

Purpose  To compare the efficacy and safety of voriconazole with itraconazole as prophylaxis in leukemia patients.\\u000a \\u000a \\u000a \\u000a Methods  Open-label, randomized study. Patients with acute myelogenous leukemia or high-risk myelodysplastic syndrome undergoing induction\\u000a chemotherapy or first salvage were eligible. Patients received voriconazole (400 mg intravenous (IV) every 12 h for two doses,\\u000a followed by 300 mg BID) or itraconazole (200 mg IV twice daily for 2 days, followed by

Gloria N. Mattiuzzi; Jorge Cortes; Gladys Alvarado; Srdan Verstovsek; Charles Koller; Sherry Pierce; Deborah Blamble; Stefan Faderl; Lianchun Xiao; Mike Hernandez; Hagop Kantarjian



Reduced use of erythropoiesis-stimulating agents and intravenous iron with ferric citrate: a managed care cost-offset model  

PubMed Central

Background Ferric citrate (FC) is a phosphate binder in development for the treatment of hyperphosphatemia in patients with end-stage renal disease (ESRD). In clinical trials, FC improved patient serum phosphorus levels and increased serum ferritin and percent transferrin saturation. Because nephrologists respond to increases in these iron measures by reducing intravenous (IV) iron and erythropoiesis-stimulating agent (ESA) doses, the decreased use of iron and ESA associated with FC may reduce costs. Objectives To develop a cost-offset model from a managed care perspective estimating the cost savings associated with FC use. Methods We created a cost-offset model from the managed care payer perspective that compared the treatment costs of ESRD for patients given FC. The model considered the number of dialysis sessions per month; number of ESRD patients enrolled in the health plan; cost of ESAs, iron, and dialysis sessions; and the proportion of patients on phosphate binder therapy. The model assumed equivalent efficacy and cost neutrality between FC and other phosphate binders. Monte Carlo simulations were conducted by varying model inputs. Results When FC was compared to other phosphate binders, the monthly cost of ESA and IV iron per 500 patients with ESRD (85% treated with phosphate binders) was reduced by 8.15% and 33.2%, respectively. When incorporated into the total cost of dialysis for patients with ESRD (dialysis, ESA, and IV iron), the decrease in the monthly cost of dialysis care was US$80,214 per 500 ESRD patients. Monte Carlo simulations suggest that a plan serving 500 dialysis patients could save between US$626,000 and US$1,106,000 annually with the use of FC. Conclusion The use of FC in ESRD patients with hyperphosphatemia may help reduce treatment costs.

Mutell, Richard; Rubin, Jaime L; Bond, T Christopher; Mayne, Tracy



Intravenous anaesthesia in goats: a review.  


Intravenous anaesthesia is gradually becoming popular in veterinary practice. Traditionally, general anaesthesia is induced with intravenous drugs and then maintained with inhalation agents. Inhalation anaesthetic agents cause more significant dose-dependent cardiorespiratory depression than intravenous anaesthetic drugs, creating a need to use less of the inhalation anaesthetic agents for maintenance of general anaesthesia by supplementing with intravenous anaesthesia drugs. Better still, if anaesthesia is maintained completely with intravenous anaesthetic drugs, autonomic functions remain more stable intra-operatively. Patient recovery from anaesthesia is smoother and there is less pollution of the working environment than happens with inhalation anaesthetic agents. Recently, a number of drugs with profiles (pharmacokinetic and pharmacodynamic) suitable for prolonged intravenous anaesthesia have been studied, mostly in humans and, to a certain extent, in dogs and horses. There is currently very little scientific information on total intravenous anaesthesia in goats, although, in the past few years, some scholarly scientific articles on drugs suitable for partial intravenous anaesthesia in goats have been published. This review article explored the information available on drugs that have been assessed for partial intravenous anaesthesia in goats, with the aim of promoting incorporation of these drugs into total intravenous anaesthesia protocols in clinical practice. That way, balanced anaesthesia, a technique in which drugs are included in anaesthetic protocols for specific desired effects (hypnosis, analgesia, muscle relaxation, autonomic stabilisation) may be utilised in improving the welfare of goats undergoing general anaesthesia. PMID:23718851

Dzikiti, T Brighton



Gestation Time-Dependent Pharmacokinetics of Intravenous (+)-Methamphetamine in Rats  

PubMed Central

We tested the hypothesis that differences in (+)-methamphetamine (METH) disposition during late rat pregnancy could lead to increased vulnerability to acute METH effects. The disposition of a single 1 mg/kg i.v. METH dose was studied during early (gestation day 7, GD7) and late (GD21) gestation. Results showed gestation time-dependent pharmacokinetics, characterized by a significantly higher area under the METH serum concentration versus time curve and a lower clearance on GD21 (p < 0.05; total, renal, and nonrenal clearance). The terminal elimination half-life (t1/2?z) of METH and (+)-amphetamine (AMP; a pharmacologically active metabolite of METH) were not different on GD7, but by GD21, AMP t1/2?z was 37% longer than METH t1/2?z (p < 0.05). To identify the mechanism for AMP metabolite changes, intravenous AMP pharmacokinetics on GD21 were compared with AMP metabolite pharmacokinetics after intravenous METH. The intravenous AMP t1/2?z was significantly shorter than metabolite AMP t1/2?z (p < 0.05), which suggested AMP metabolite formation (not elimination) was the rate-limiting process. To understand the medical consequence of METH use during late-stage pregnancy, timed-pregnant rats received an intravenous dose of saline or METH (1, 3, or 5.6 mg/kg) on GD21, 0 to 2 days antepartum. Although one rat died and another had stillbirths at term after the 5.6-mg/kg dose, the pharmacokinetic values for all of the other animals were not significantly different. In conclusion, late-gestational clearance reductions lengthen METH exposure time, possibly increasing susceptibility to adverse effects, including death.

White, Sarah; Laurenzana, Elizabeth; Hendrickson, Howard; Gentry, W. Brooks



Efficacy and safety of intravenous iron sucrose in treating adults with iron deficiency anemia  

PubMed Central

Background Iron deficiency is the most common disorder in the world, affecting approximately 25% of the world`s population and the most common cause of anemia. Objective To evaluate the efficacy and safety of intravenous iron sucrose (IS) in the treatment of adults with iron deficiency anemia Methods Eighty-six adult patients with iron deficiency anemia, who had intolerance or showed no effect with oral iron therapy, received a weekly dose of 200 mg of intravenous iron sucrose until the hemoglobin level was corrected or until receiving the total dose of intravenous iron calculated for each patient Results The mean hemoglobin and serum ferritin levels were 8.54 g/dL and 7.63 ng/mL (pre-treatment) and 12.1 g/dL and 99.0 ng/mL (post-treatment) (p-value < 0.0001), respectively. The average increases in hemoglobin levels were 3.29 g/dL for women and 4.58 g/dL for men; 94% of male and 84% of female patients responded (hemoglobin increased by at least 2 g/dL) to intravenous iron therapy. Correction of anemia was obtained in 47 of 69 (68.1%) female patients and in 12 of 17 male (70.6%) patients. A total of 515 intravenous infusions of iron sucrose were administered and iron sucrose was generally well tolerated with no moderate or serious adverse drug reactions recorded by the investigators. Conclusions Our data confirm that the use of intravenous iron sucrose is a safe and effective option in the treatment of adult patients with iron deficiency anemia who lack satisfactory response to oral iron therapy. Intravenous iron sucrose is well tolerated and with a clinically manageable safety profile when using appropriate dosing and monitoring. The availability of intravenous iron sucrose would potentially improve compliance and thereby reduce morbidities from iron deficiency.

Cancado, Rodolfo Delfini; de Figueiredo, Pedro Otavio Novis; Olivato, Maria Cristina Albe; Chiattone, Carlos Sergio



Pharmacokinetics and pharmacodynamics of once-daily administration of intravenous tobramycin in adult patients with cystic fibrosis hospitalized for an acute pulmonary exacerbation.  


The serum pharmacokinetic profile of intravenous (i.v.) tobramycin administration was characterized for a sample of nine adult patients with cystic fibrosis (CF) who were hospitalized for an acute pulmonary exacerbation. Current recommended i.v. tobramycin dosing protocols are predicted through modeling and simulation to be suboptimal. Empirical tobramycin regimens of ?15 mg/kg of body weight administered i.v. once daily should be evaluated for adult patients with CF to optimize outcomes. PMID:23896470

Butterfield, Jill M; Lodise, Thomas P; Beegle, Scott; Rosen, Jonathan; Farkas, Joshua; Pai, Manjunath P



Evaluation of safety and pharmacokinetics of administering intravenous busulfan in a twice-daily or daily schedule to patients with advanced hematologic malignant disease undergoing stem cell transplantation  

Microsoft Academic Search

Intravenous busulfan (i.v. BU) has demonstrated safety when administered at 0.8 mg\\/kg per dose i.v. every 6 hours x 16 doses. We evaluated the safety and pharmacokinetics (PK) of giving the same total daily i.v. BU dose (3.2 mg\\/kg) either divided as a twice-daily infusion or as a single infusion to patients undergoing hematopoietic stem cell transplantation (HSCT). Twelve patients

Hugo F Fernandez; Hai T Tran; Federico Albrecht; Shari Lennon; Humberto Caldera; Mark S Goodman



Early Recanalization After Intravenous Administration of Recombinant Tissue Plasminogen Activator as Assessed by Pre and Post-Thrombolytic Angiography in Acute Ischemic Stroke Patients  

Microsoft Academic Search

Background and Purpose—Recanalization rates after the intravenous (IV) recombinant tissue plasminogen activator (rt-PA) treatment have been poorly studied in acute stroke. Methods—CT angiography was performed before IV rt-PA in all patients and digital subtraction angiography was undertaken for intra-arterial thrombolysis in cases of no improvement after rt-PA infusion. Results—Forty-five patients were treated with IV rt-PA. Initial CT angiography showed relevant

Kyung-Yul Lee; Sang Won Han; Seo Hyun Kim; Hyo Seok Nam; Sung Whan Ahn; Dong Joon Kim; Sang Hyun Seo; Dong Ik Kim; Ji Hoe Heo



Is Intra-Arterial Thrombolysis Safe After Full-Dose Intravenous Recombinant Tissue Plasminogen Activator for Acute Ischemic Stroke?  

Microsoft Academic Search

Background and Purpose—The optimal approach for acute ischemic stroke patients who do not respond to intravenous recombinant tissue plasminogen activator (IV rt-PA) is uncertain. This study evaluated the safety and response to intra-arterial thrombolytics (IATs) in patients unresponsive to full-dose IV rt-PA. Methods—A case series from a prospectively collected database on consecutive acute ischemic stroke patients treated with IATs after

Hashem M. Shaltoni; Karen C. Albright; Nicole R. Gonzales; Raymond U. Weir; Aslam M. Khaja; Rebecca M. Sugg; Morgan S. Campbell; Edwin D. Cacayorin; James C. Grotta; Elizabeth A. Noser



Clinical Efficacy of Intravenous followed by Oral Azithromycin Monotherapy in Hospitalized Patients with Community-Acquired Pneumonia  

Microsoft Academic Search

The purpose of this study was to evaluate intravenous (i.v.) azithromycin followed by oral azithromycin as a monotherapeutic regimen for community-acquired pneumonia (CAP). Two trials of i.v. azithromycin used as initial monotherapy in hospitalized CAP patients are summarized. Clinical efficacy is reported from an open-label randomized trial of azithromycin compared to cefuroxime with or without erythromycin. Bacteri- ologic and clinical




Do two intravenous iron sucrose preparations have the same efficacy?  

PubMed Central

Background. Intravenous (i.v.) iron sucrose similar (ISS) preparations are available but clinical comparisons with the originator iron sucrose (IS) are lacking. Methods. The impact of switching from IS to ISS on anaemia and iron parameters was assessed in a sequential observational study comparing two periods of 27 weeks each in 75 stable haemodialysis (HD) patients receiving i.v. iron weekly and an i.v. erythropoiesis-stimulating agent (ESA) once every 2 weeks. Patients received IS in the first period (P1) and ISS in the second period (P2). Results. Mean haemoglobin value was 11.78 ± 0.99 g/dL during P1 and 11.48 ± 0.98 g/dL during P2 (P = 0.01). Mean serum ferritin was similar for both treatment periods (P1, 534 ± 328 ?g/L; P2, 495 ± 280 ?g/L, P = 0.25) but mean TSAT during P1 (49.3 ± 10.9%) was significantly higher than during P2 (24.5 ± 9.4%, P <0.0001). The mean dose of i.v. iron per patient per week was 45.58 ± 32.55 mg in P1 and 61.36 ± 30.98 mg in P2 (+34.6%), while the mean ESA dose was 0.58 ± 0.52 and 0.66 ± 0.64 ?g/kg/week, respectively (+13.8%). Total mean anaemia drug costs increased in P2 by 11.9% compared to P1. Conclusions. The switch from the originator IS to an ISS preparation led to destabilization of a well-controlled population of HD patients and incurred an increase in total anaemia drug costs. Prospective comparative clinical studies are required to prove that ISS are as efficacious and safe as the originator i.v. IS.

Kadri, Ahmed; Leonard, Emmanuelle; Dansaert, Aurelie; Lafuma, Antoine



Quarterly intravenous injection of ibandronate to treat osteoporosis in postmenopausal women  

PubMed Central

Osteoporosis is a chronic condition that generally requires long-term therapy for fracture risk reduction to become apparent. Although the bisphosphonates have made a major contribution to how clinicians manage osteoporosis, compliance with therapy has generally been less in the real-world setting than seen in clinical trials. Less-frequently administered dosage regimens or nonoral routes may enhance compliance and so maximize the therapeutic benefit of bisphosphonates. Ibandronate is a nitrogen-containing bisphosphonate, whose high potency allows it to be administered orally or intravenously with extended dosing intervals. This paper will review the role of intravenous ibandronate in the treatment of postmenopausal osteoporosis.

Sambrook, Philip



The outcome of proliferative lupus nephritis with pulse cyclophosphamide therapy  

PubMed Central

Proliferative lupus nephritis deserves aggressive therapy and cyclophosphamide plays a pivotal role. Thirty nine patients with proliferative lupus nephritis (Class III-7 patients and Class IV- 32 patients) with a median follow up of 38 months were considered for this observational study. All the patients received induction therapy with intravenous methylprednisolone. Cyclophosphamide was given intravenously initially in monthly pulses for six months and later quarterly pulses until remission was achieved or until the target dose (200 mg/kg) was reached. The treatment with intravenous methylprednisolone was repeated in the event of a nephritic flare. Later the corticosteroid was reduced to a minimum effective dose and cyclophosphamide was changed to either azathioprine or mycophenolate mofetil. At the time of the last follow up, 82.05% of the patients were in remission (complete remission 51.28% and partial remission 30.77%). The median interval to achieve remission in responders was 15 months. Early diagnosis (P=0.04), a higher creatinine clearance at presentation (P=0.02), and concurrent use of an ACEI or an ARB (P=007) significantly favored attaining remission. Five patients experienced a doubling of serum creatinine and one of them became dialysis dependent. Risk of doubling of serum creatinine correlated with a low Ccr (P=0.03) at presentation, occurrence of renal flares (P=0.034) and failure to achieve remission (P=0.0001). The parameters like serum creatinine, serum C3, serum C4, activity and chronicity indices on renal biopsy, hypertension were not statistically significant. Therapy with cyclophosphamide, if initiated early, helps in inducing remission and hence can retard the progression to CKD.

Annavarajula, S. K.; Murty, K. V. D.; Prayaga, A.; Das, U.; Desai, M.; Narain, C. A.



The outcome of proliferative lupus nephritis with pulse cyclophosphamide therapy.  


Proliferative lupus nephritis deserves aggressive therapy and cyclophosphamide plays a pivotal role. Thirty nine patients with proliferative lupus nephritis (Class III-7 patients and Class IV- 32 patients) with a median follow up of 38 months were considered for this observational study. All the patients received induction therapy with intravenous methylprednisolone. Cyclophosphamide was given intravenously initially in monthly pulses for six months and later quarterly pulses until remission was achieved or until the target dose (200 mg/kg) was reached. The treatment with intravenous methylprednisolone was repeated in the event of a nephritic flare. Later the corticosteroid was reduced to a minimum effective dose and cyclophosphamide was changed to either azathioprine or mycophenolate mofetil. At the time of the last follow up, 82.05% of the patients were in remission (complete remission 51.28% and partial remission 30.77%). The median interval to achieve remission in responders was 15 months. Early diagnosis (P=0.04), a higher creatinine clearance at presentation (P=0.02), and concurrent use of an ACEI or an ARB (P=007) significantly favored attaining remission. Five patients experienced a doubling of serum creatinine and one of them became dialysis dependent. Risk of doubling of serum creatinine correlated with a low Ccr (P=0.03) at presentation, occurrence of renal flares (P=0.034) and failure to achieve remission (P=0.0001). The parameters like serum creatinine, serum C3, serum C4, activity and chronicity indices on renal biopsy, hypertension were not statistically significant. Therapy with cyclophosphamide, if initiated early, helps in inducing remission and hence can retard the progression to CKD. PMID:21886974

Annavarajula, S K; Murty, K V D; Prayaga, A; Das, U; Desai, M; Narain, C A



Intravenous saline injection as an interoceptive signal in rats  

PubMed Central

Rationale Addictive drugs are commonly delivered in the organism by means of intravenous (iv) injections. Since saline mimics the blood environment by basic ionic properties and pH, it is generally assumed that it should not have any physiological effects, serving as a control for the effects induced by drugs. Objective To examine central, behavioral and physiological effects of stress- and cue-free iv saline injection in freely moving rats. Methods We examined how typical, low-volume and slow-speed saline injections affects cortical EEG and neck EMG, locomotor activity as well as central and peripheral temperatures. Results Saline injection made during slow-wave synchronized activity induces rapid, transient EEG desynchronization, manifesting as a drop of EEG total power, decrease in alpha activity, and increases in beta and gamma activities. Saline injection did not affect locomotor activity as well as brain and body temperatures, but induced a transient increase in neck EMG activity and rapid, brief drop in skin temperature, suggesting peripheral vasoconstriction. These responses were virtually fully absent when saline injection was made during naturally occurring desynchronized EEG activity during behavioral activity. Conclusions Since iv injection is able to produce a peripheral sensory signal that is transmitted rapidly to the CNS and followed by a more prolonged effect of the injected drug on brain cells, with repeated drug administrations the injection itself could play a role of drug-related sensory cue, thus inducing conditioned physiological responses and altering the effects of injected drugs.

Kiyatkin, Eugene A.; Lenoir, Magalie



Pharmacokinetics and efficacy of intravenous and extradural tramadol in dogs.  


Tramadol is a synthetic opioid agonist used extensively in human and, to a lesser extent, veterinary medicine throughout the world. The clinical efficacy and pharmacokinetic profile of intravenous (i.v.) and extradural (e.d.) tramadol (2 mg/kg) and its o-desmethyl metabolite were studied in dogs undergoing tibial plateau levelling osteotomy (TPLO). Intra-operative cardiorespiratory variables were monitored and post-operative pain was assessed using the short form of the Glasgow Composite Pain Scale. A rapid (<5 min) and effective production of o-desmethyl tramadol was recorded. The pharmacokinetic profile was similar for tramadol and its metabolite irrespective of the route of administration. E.d. tramadol provided sufficient intra- and post-operative analgesia without significant clinical side-effects, but the post-operative analgesia was comparable to that following i.v. administration and the e.d. route could therefore not be considered a practical alternative to the i.v. route. PMID:19138866

Vettorato, Enzo; Zonca, Annalisa; Isola, Maurizio; Villa, Roberto; Gallo, Martina; Ravasio, Giuliano; Beccaglia, Michela; Montesissa, Clara; Cagnardi, Petra



Determinants of receiving intravenous sedation in a sample of dentally-fearful patients in the USA  

PubMed Central

Dental fear may be the most common reason for referral for intravenous sedation. Intravenous sedation offers many patients an opportunity to obtain needed dental care. However, intravenous sedation also has costs and may not help patients overcome their fear. Given a sample of 518 dentally-fearful patients in the USA presenting for dental care, this study examined the variables which predicted receiving intravenous sedation or not. About one-fifth of the patients received intravenous sedation, while the others received only cognitive behavioural therapy. Having more carious teeth, higher dental fear, more negative beliefs about dentists, lifetime diagnoses of panic disorder and/or generalized anxiety disorder, fewer existing coping skills, and a lower desire to cope with the dental situation were each predictive of having intravenous sedation. When the variables were considered simultaneously, only lower desire to cope contributed uniquely to the prediction. In a setting where psychological treatment for dental fear is available, patients’ desire to cope with their fear was the most important factor in determining whether they received intravenous sedation or not.

Coolidge, Trilby; Irwin, Scott P.; Leyster, Kimberly A.; Milgrom, Peter



Atovaquone Maintenance Therapy Prevents Reactivation of Toxoplasmic Encephalitis in a Murine Model of Reactivated Toxoplasmosis  

PubMed Central

Acute therapy with pyrimethamine plus sulfadiazine is the treatment of choice for reactivated toxoplasmic encephalitis (TE). Acute therapy is followed by lifelong maintenance therapy (secondary prophylaxis) with the same drugs at lower dosages. The use of pyrimethamine plus sulfadiazine is hampered by severe side effects including allergic reactions and hematotoxicity. Alternative treatment regimens with pyrimethamine plus clindamycin or other antiparasitic drugs are less efficacious. Atovaquone nanosuspensions show excellent therapeutic effects for “acute” intravenous (i.v.) treatment of reactivated TE in a murine model. In the present study, the therapeutic efficacy of atovaquone for oral “maintenance” therapy was investigated. Mice with a targeted mutation in the interferon regulatory factor 8 gene were latently infected with Toxoplasma gondii, developed reactivated TE, and received acute i.v. therapy with atovaquone nanosuspensions. Mice were then treated orally with atovaquone suspension or other antiparasitic drugs to prevent relapse of TE. Maintenance therapy with atovaquone at daily doses of 50 or 100 mg/kg (body weight) protected mice against reactivated TE and death. This maintenance treatment was superior to standard therapy with pyrimethamine plus sulfadiazine. The latter combination was superior to the combination of pyrimethamine plus clindamycin. Inflammatory changes in the brain parenchyma and meninges, as well as parasite numbers, in the brains of mice confirmed the therapeutic efficacy of atovaquone for maintenance therapy. Atovaquone was detectable in sera, brains, livers, and lungs of infected mice by high-performance liquid chromatography and/or mass spectrometry. In conclusion, atovaquone appears to be superior to the standard maintenance therapy regimens in a murine model of reactivated TE. The therapeutic efficacy of atovaquone for maintenance therapy against TE should be further investigated in clinical trials.

Dunay, Ildiko R.; Heimesaat, Markus M.; Bushrab, Faris Nadiem; Muller, Rainer H.; Stocker, Hartmut; Arasteh, Keikawus; Kurowski, Michael; Fitzner, Rudolf; Borner, Klaus; Liesenfeld, Oliver



Fentanyl HCl iontophoretic transdermal system versus intravenous morphine pump after gynecologic surgery  

Microsoft Academic Search

Objective  To compare the efficacy and safety of fentanyl iontophoretic transdermal system (ITS) with morphine intravenous patient-controlled\\u000a analgesia (IV PCA) for pain management following gynecologic surgery.\\u000a \\u000a \\u000a \\u000a Method  A subgroup (n = 275) of gynecologic surgery patients from a randomized study (N = 636) of patients treated with fentanyl ITS or morphine IV PCA was analyzed. The main efficacy endpoint was the patient\\u000a global assessment (PGA) of

Shireen Ahmad; David J. Hewitt; C. V. Damaraju



Lack of Hydroxylated Fullerene Toxicity after Intravenous Administration to Female Sprague-Dawley Rats  

PubMed Central

Hydroxylated fullerenes (C60OHx) or fullerols are water-soluble carbon nanoparticles that have been explored for potential therapeutic applications. This study assessed acute in vivo tolerance in 8 week old female Sprague Dawley rats to intravenous administration (IV) of 10 mg/kg of well-characterized C60(OH)30. Complete histopathology and clinical chemistries were assessed at 8, 24, and 48 hr after dosing. Minor histopathology changes were seen, primarily in one animal. No clinically significant chemistry changes were observed after treatment. These experiments suggest that this fullerol was well tolerated after IV administration to rats.

Monteiro-Riviere, Nancy A.; Linder, Keith E.; Inman, Alfred O.; Saathoff, John G.; Xia, Xin-Rui; Riviere, Jim E.



Randomized comparison of intra-arterial and intravenous thrombolysis in a canine model of acute basilar artery thrombosis  

Microsoft Academic Search

We compared the rates of recanalization cerebral infarct and hemorrhage between intra-arterial (IA) reteplase and intravenous (IV) alteplase thrombolysis in a canine model of basilar artery thrombosis. Thrombosis was induced by injecting a clot in the basilar artery of 13 anesthetized dogs via superselective catheterization. The animals were randomized in a blinded fashion, 2 h after clot injection and verification of arterial

A. I. Qureshi; A. S. Boulos; R. A. Hanel; M. F. K. Suri; A. M. Yahia; R. A. Alberico; L. N. Hopkins



Intravenous iron supplementation for the treatment of the anemia of moderate to severe chronic renal failure patients not receiving dialysis  

Microsoft Academic Search

Iron deficiency may develop in hemodialysis patients, especially when erythropoietin is given. The role of iron deficiency in the anemia of predialysis chronic renal failure (CRF), however, is much less clear. We have intravenously (IV) administered iron as ferric saccharate in a total dose of 200 mg elemental iron monthly for 5 months to 33 CRF patients who remained anemic

Donald S. Silverberg; Adrian Iaina; Gary Peer; Eliezer Kaplan; Bat Ami Levi; Naama Frank; Shoshana Steinbruch; Miriam Blum



Transmucosal fentanyl vs intravenous morphine in doses proportional to basal opioid regimen for episodic-breakthrough pain  

Microsoft Academic Search

The use of supplemental doses of opioids is commonly suggested to manage breakthrough pain. A comparative study of intravenous morphine (IV-MO) and oral transmucosal fentanyl citrate (OTFC) given in doses proportional to the basal opioid regimen was performed in 25 cancer patients receiving stable opioid doses. For each episode, when it occurred and 15 and 30 min after the treatment,

S Mercadante; P Villari; P Ferrera; A Casuccio; S Mangione; G Intravaia



Safety and effectiveness of intravenous morphine for episodic (breakthrough) pain using a fixed ratio with the oral daily morphine dose  

Microsoft Academic Search

Breakthrough pain is normally severe in intensity and has a rapid onset. The availability of supplemental doses of opioids (rescue medication) in addition to the continuous analgesic medication is the main treatment suggested to manage these pain flares. The intravenous (IV) route may provide analgesia fast enough, but has never been assessed in clinical studies. The aim of this open-label

Sebastiano Mercadante; Patrizia Villari; Patrizia Ferrera; Mauro Bianchi; Alessandra Casuccio



Intravenous amiodarone for the prevention of atrial fibrillation after open heart surgery: the amiodarone reduction in coronary heart (ARCH) trial  

Microsoft Academic Search

OBJECTIVESThis study was designed to test whether intravenous (IV) amiodarone would prevent atrial fibrillation and decrease hospital stay after open heart surgery.BACKGROUNDAtrial fibrillation commonly occurs after open heart procedures and is thought to be a significant determinant for prolongation of hospitalization. Oral amiodarone given preoperatively appears to reduce the incidence of atrial fibrillation. This study was designed to test whether

Thomas Guarnieri; Shellee Nolan; Sidney O Gottlieb; Audrey Dudek; David R Lowry



Intravenous Ethanol Infusions Can Mimic the Time Course of Breath Alcohol Concentrations Following Oral Alcohol Administration in Healthy Volunteers  

Microsoft Academic Search

Background: Our previous studies have used intravenous (IV) clamping methods to demon- strate that family history positive (FHP) subjects exhibit a greater initial response to alcohol than family history negative (FHN) subjects. These results differ from other studies of family history of alcoholism (FHA) influences, most of which have used an oral alcohol challenge, suggesting that the route of administration

Vijay A. Ramchandani; Martin Plawecki; Ting-Kai Li; Sean O’Connor



[The rational immunotherapy with intravenous immunoglobulin in neurologic diseases].  


Intravenous immunoglobulins (IVIG) have been used mainly as a supplement therapy in hypogammglobulinemia patients. IVIG have been proved effective in treating TTP and recently they have been used in treating many autoimmune and inflammatory diseases. In neurologic diseases IVIG have immunomodulating features dependent on IgG Fc-fragment. Which diseases benefit from the use of IVIG was the find from controlled clinical trials in accordance with Evidence Based Medicine. IVIG have been proved effective in Guillaine-Barre syndrom, chronic inflammatory demyelinating polyradiculoneuropathy, miastenia, dermathomyositis and sclerosis multiple. The recommendations include the frequency of IVIG administering its dosage and duration of treatment. PMID:21751554

Korsak, Jolanta



Body distribution in mice of intravenously injected camptothecin solid lipid nanoparticles and targeting effect on brain  

Microsoft Academic Search

The objective of the present study was to investigate the specific drug targeting of anticarcinogenic drugs, such as camptothecin (CA), after intravenous (i.v.) injection by incorporation into solid lipid nanoparticles (SLN). A CA loaded SLN suspension consisted of 0.1% (w\\/w) camptothecin, 2.0% (w\\/w) stearic acid, 1.5% (w\\/w) soybean lecithin and 0.5% (w\\/w) polyoxyethylene–polyoxypropylene copolymer (Poloxamer 188) was prepared by high

Shi Cheng Yang; Li Fang Lu; Ying Cai; Jia Bi Zhu; Bing Wen Liang; Chang Zheng Yang



Elimination of intravenously injected endothelin-1 from the circulation of the rat  

Microsoft Academic Search

The rate of elimination and the fate of endothelin-1 (ET-1) from the circulating blood was studied in urethane-anesthetized rats by intravenous injection of (125I)-labeled ET-1. The vasoconstrictor activities of the iodinated ET-1 were confirmed to be similar to those of native ET-1. Following i.v. bolus injection of 30 pmol\\/kg of (125I)-ET-1 into the femoral vein, the total radioactivity of the

Reiko Shiba; Masashi Yanagisawa; Takashi Miyauchi; Yukio Ishii; Sadao Kimura; Yasuo Uchiyama; Tomoh Masaki; Katsutoshi Goto



Biological Behavior of Dextran-Iron Oxide Magnetic Fluid Injected Intravenously in Rats  

Microsoft Academic Search

Dextran-magnetic iron oxide complex (CMDM) consisting of carboxymethyl dextran and a magnetite core has been synthesized. The physical and biological properties were compared with those of the conventional dextran-magnetite complex (ATDM). The CMDM exhibits a super-paramagnetic property, has high stability and low toxicity. The uptake and metabolic behavior of CMDM in live rats after intravenous (iv) administration were studied using

Masakatsu Hasegawa; Takamasa Hanaichi; Hirokazu Shoji; Takeshi Kawaguchi; Shigeo Maruno



Elderly Patients on Chronic Hemodialysis with Hyperparathyroidism: Increase of Hemoglobin Level after Intravenous Calcitriol  

Microsoft Academic Search

In patients on chronic hemodialysis (CHD), hyperparathyroidism (HPTH) is associated with anemia and resistance to erythropoietin\\u000a (EPO). In the last few years, calcitriol intravenously (IV) has been used with success in the treatment of the HPTH, secondary\\u000a to chronic renal failure. However, the effects of calcitriol on the hematological parameters of these patients have never\\u000a been well evaluated. This study

Pedro L. Neves; Julio Triviño; Francisco Casaubon; Viriato Santos; Patricia Mendes; Paulo Romão; Isilda Bexiga; Idalécio Bernardo



Painless intravenous catheterization by intradermal jet injection of lidocaine: a randomized trial  

Microsoft Academic Search

Study Objective: To compare efficacy and cost of lidocaine cutaneous anesthesia by two jet injectors to routine needle infiltration for pain relief of intravenous (IV) catheterization, hypothesizing that jet injection of lidocaine is less painful than its needle infiltration.Design: Randomized, prospective, controlled trial.Setting: University hospital outpatient surgical unit.Participants: 75 surgical patients ASA I and II.Interventions: Three groups of 25 patients

Elemer K Zsigmond; Patrick Darby; Heidi M Koenig; Eric F Goll



Disposition kinetics of enrofloxacin and ciprofloxacin following intravenous administration of enrofloxacin in goats  

Microsoft Academic Search

Pharmacokinetic properties of the antimicrobial fluoroquinolone, enrofloxacin, were studied in female goats. Enrofloxacin was given to goats in a single dose of 2.5mgkg?1 body weight by intravenous (i.v.) route. Blood samples were collected via jugular venipuncture into heparinized tubes at predetermined times after drug administration. Plasma concentrations of enrofloxacin and its active metabolite ciprofloxacin were simultaneously determined by reversed-phase high

G. S. Rao; S. Ramesh; A. H. Ahmad; H. C. Tripathi; L. D. Sharma; J. K. Malik



Embolized Crospovidone (poly[N-vinyl-2-pyrrolidone]) in the Lungs of Intravenous Drug Users  

Microsoft Academic Search

Crospovidone is an insoluble polymer of N-vinyl-2-pyrrolidone that is used as a disintegrant in pharmaceutical tablets. It can potentially embolize to the lung when aqueous tablet suspensions are injected intravenously. In this report, we identified embolized crospovidone in autopsy-derived lung tissue from three adult IV drug users, 1 man and 2 women, whose ages respectively were 27, 38, and 40

Santhi Ganesan; Joseph Felo; Mario Saldana; Victor F. Kalasinsky; Michael R. Lewin-Smith; Joseph F. Tomashefski



Oral and intravenous caffeine for treatment of children with post-sedation paradoxical hyperactivity  

Microsoft Academic Search

BackgroundParadoxical hyperactivity (PH) is a known complication of sedation in children, especially with barbiturates such as pentobarbital. The accompanying inconsolable irritability and agitation, similar to behaviors reported in children with attention deficit hyperactivity disorder (ADHD), is uncomfortable for the child and anxiety-provoking for parents and health-care workers. Our objective was to describe our experience with oral (PO) and intravenous (IV)

Joan T. Rubin; Richard B. Towbin; MaryBeth Bartko; Kevin M. Baskin; Anne Marie Cahill; Robin D. Kaye



Pharmacokinetics and Safety of Voriconazole following Intravenous to Oral-Dose Escalation Regimens  

Microsoft Academic Search

In this study, the safety, tolerability, and pharmacokinetics of intravenous (i.v.)- to oral-dose regimens of voriconazole were evaluated with a group of 42 healthy men, 41 of whom completed the study. Two cohorts of subjects participated in the study. Cohort 1 (n 28) took part in two study periods, each consisting of 14 days separated by a minimum 7-day washout.

L. Purkins; N. Wood; P. Ghahramani; K. Greenhalgh; M. J. Allen; D. Kleinermans



Ineffectiveness of on-site intravenous lines: is prehospital time the culprit?  


The purpose of the present study was to test the association between on-site intravenous fluid replacement and mortality in patients with severe trauma. The effect of prehospital time on this association was also evaluated. The design was that of an observational quasi-experimental study comparing 217 patients who had on-site intravenous fluid replacement (IV group) with an equal number of matched patients for whom this intervention was not performed (no-IV group). The patients were individually matched on their Prehospital Index obtained at the scene and were included in the study if they had an on-site Prehospital Index score > 3 and were transported alive to the hospital. The outcome measure of interest was mortality because of injury. The patients in the IV group had a significantly lower mean age (37 vs. 45 years; p < 0.001) and higher incidence of injuries to the head or neck (46 vs. 32%; p = 0.004), chest (34 vs. 17%; p < 0.001), and abdomen (28 vs. 12%; p < 0.001). The IV group also had a higher proportion of patients injured by motor vehicle crashes (41 vs. 27%; p = 0.003), firearms (9 vs. 2%; p = 0.001), and stabbing (20 vs. 9%; p = 0.001). The rate of extremity injuries (38 vs. 59%; p < 0.001) and falls (12 vs. 40%; p < 0.001) was lower for the IV group. In addition, the mean Injury Severity Score was significantly higher for the IV group (15 vs. 9; p < 0.001). The mortality rates for the IV and no-IV groups were 23 and 6% (p < 0.001). Logistic regression analysis showed that after adjusting for patient age, gender, Injury Severity Score, mechanism of injury, and prehospital time, the use of on-site intravenous fluid replacement was associated with a significant increase in the risk of mortality (adjusted odds ratio = 2.3; 95% confidence interval = 1.02-5.28; p = 0.04). To further evaluate the effect of prehospital time on the association between on-site IV use and mortality, the analysis was repeated separately for the following time strata: 0 to 30 minutes, 31 to 60 minutes, and >60 minutes. The adjusted odds ratios (95% confidence interval) for these strata were 1.05 (0.08-14.53; p = 0.97), 3.38 (0.84-13.62; p = 0.08), and 8.40 (1.27-54.69; p = 0.03). These results show that for prehospital times of less than 30 minutes, the use of on-site intravenous fluid replacement provides no benefit, and that for longer times, this intervention is associated with significant increases in the risk of mortality. The results of this observational study have shown that the use of on-site intravenous fluid replacement is associated with an increase in mortality risk and that this association is exacerbated by, but is not solely the result of, increased prehospital times. Our findings are consistent with the hypothesis that early intravenous fluid replacement is harmful because it disrupts the normal physiologic response to severe bleeding. Although this evidence is against the implementation of on-site intravenous fluid replacement for severely injured patients, further studies including randomized controlled trials are required to provide a definitive answer to this question. PMID:9356056

Sampalis, J S; Tamim, H; Denis, R; Boukas, S; Ruest, S A; Nikolis, A; Lavoie, A; Fleiszer, D; Brown, R; Mulder, D; Williams, J I



High-Dose Intravenous Corticosteroids for Ocular Inflammatory Diseases  

PubMed Central

Purpose To evaluate the effectiveness and risk of complications of high-dose intravenous pulsed corticosteroids for non-infectious ocular inflammatory diseases. Methods Retrospective cohort study. One hundred four eyes of seventy patients who received high-dose intravenous corticosteroids for treatment of active ocular inflammation were identified from five centers. The main outcome measures were control of inflammation and occurrence of ocular or systemic complications within one month after treatment. Results Within ?1 month of starting treatment, 57% of eyes achieved complete control of inflammation (95% confidence interval (CI): 33-83%), improving to 82% when near-complete control was included (95% CI: 61-96%). Most eyes (85%; 95% CI: 70-95%) gained clinically significant improvement in anterior chamber inflammation. One patient developed a colon perforation during treatment. No other major complications were recorded. Conclusions Treatment of ocular inflammation with high-dose intravenous corticosteroids resulted in substantial clinical improvement for most cases within one month. Complications of therapy were infrequent.

Charkoudian, Leon D.; Ying, Gui-shuang; Pujari, Siddharth S.; Gangaputra, Sapna; Thorne, Jennifer E.; Foster, C. Stephen; Jabs, Douglas A.; Levy-Clarke, Grace A.; Nussenblatt, Robert B.; Rosenbaum, James T.; Suhler, Eric B.; Kempen, John H.



Titan IV Requirements.  

National Technical Information Service (NTIS)

The objective of the audit was to evaluate the requirements for Titan IV launch vehicles to support classified and unclassified systems. The audit determined whether requisite system specifications and needs were efficiently and effectively incorporated i...

W. F. Thomas C. M. Santoni L. G. O'Daniel P. B. Shepphard R. Bertocchi



Titan IV Program.  

National Technical Information Service (NTIS)

The Titan IV is an unmanned, expendable launch vehicle that complements the space shuttle and ensures access to space for national security payloads. The target and ceiling prices for the single ceiling fixed-price- incentive contract for development, pro...



PDUFA IV Update Topics  

Center for Drug Evaluation (CDER)

Text VersionPage 1. PDUFA IV Update Gary M Gensinger Deputy Director, Office of Business Process Support Center for Drug Evaluation and Research Topics ... More results from


ODID IV Simulation Report.  

National Technical Information Service (NTIS)

The Operational Display and Input Development (ODID) IV simulation evaluated the Human Machine Interface (HMI) aspects of an advanced stripless air traffic control (ATC) system. An extensive simulation environment including approach control, lower and upp...

R. V. Graham D. Young I. Pichancourt A. Marsden A. Irkiz



Paragraph IV Patent Certifications  

Center for Drug Evaluation (CDER)

... Paragraph IV Patent Certifications. As of October 21, 2013. The PDF contains a list of drug products for which an Abbreviated ... More results from


Peripheral intravenous cannulation in nursing: performance predictors.  


This study examined the impact of nurses' education and experience and the characteristics of their patients on their performance of peripheral intravenous cannulation. A researcher-developed peripheral intravenous cannulation assessment tool was used to assess nurses' behavior during cannulation. Results from a hierarchical multiple regression indicated that patient demographic variables did not significantly predict overall ratings of peripheral intravenous cannulation performance. Nurses' education and experience significantly predicted overall ratings of peripheral intravenous cannulation. Educational preparation at a postgraduate level was a significant positive predictor, and the years of experience in general nursing were a significant negative predictor of overall ratings of peripheral intravenous cannulation. The results from the current study highlight the importance of applied education, such as that indicated by a graduate degree, in providing and maintaining advanced clinical skills for specialty practice. PMID:12023658

Ung, Lerma; Cook, Sara; Edwards, Ben; Hocking, Lynda; Osmond, Felicity; Buttergieg, Heather


Mucopolysaccharidosis IV (Morquio Syndrome)  

Microsoft Academic Search

Morquio syndrome (mucopolysaccharidosis IV: MPS IV) is an autosomal recessive disease classified in the group of mucopolysaccharide\\u000a storage diseases. Two forms are recognized, type A and type B. MPS IVA is characterized by the absence of the enzyme N-acetylgalactosamine\\u000a 6-sulfate sulfatase (GALNS). MPS IVB results from deficiency of the enzyme ?-galactosidase. Both types excrete keratan sulfate\\u000a (KS) in urine. In

Shunji Tomatsu; Adriana M. Montaño; Tatsuo Nishioka; Tadao Orii


Basilar Artery Thrombosis in a Child Treated With Intravenous Tissue Plasminogen Activator and Endovascular Mechanical Thrombectomy.  


Basilar artery occlusion in children is rare. It has a high mortality and morbidity if recanalization is not achieved before extensive brainstem infarction has occurred. An 11-year-old boy presented with a clinical and radiological "top-of-the-basilar" syndrome. Intravenous tissue plasminogen activator was administered, and the patient was immediately referred to the regional stroke center. Subsequent mechanical thrombectomy using a Solitaire stent (Solitaire FR stent; ev3, Irvine, CA, USA) resulted in clot removal and recanalization of the basilar artery 4 hours after stroke onset. The patient made a full clinical recovery. To the authors' knowledge this is the first report on basilar artery occlusion in a child treated with "bridging" therapy, the combination of intravenous thrombolysis and endovascular thrombectomy. If the diagnosis can be made within the time window for intravenous thrombolysis (4.5 hours), the present case suggests that bridging therapy in pediatric basilar artery occlusion can be safe and effective. PMID:23034976

Fink, Jakob; Sonnenborg, Laura; Larsen, Line Lunde; Born, Alfred Peter; Holtmannspötter, Markus; Kondziella, Daniel



Diagnosing DSM-IV--Part I: DSM-IV and the concept of disorder.  


In this first article in a two-article series, I diagnose' a problem with DSM-IV, specifically, the overinclusiveness of its diagnostic criteria. Using the harmful dysfunction analysis of the concept of disorder (Wakefield, 1992a, American Psychologist, 47, 373-388) as a framework, I argue that DSM-IV criteria for many diagnostic categories fail to satisfy the analysis' dysfunction' requirement, that is, the criteria do not distinguish harmful conditions due to internal dysfunctions from harmful conditions that are nondisordered 'problems in living'. The overinclusiveness problem, I suggest, can be partly dealt with by giving up purely symptomatic criteria and contextualizing diagnosis to take into account the relationship between triggering causes and resulting symptoms. In Part II (Wakefield, 1997, Behaviour Research and Therapy, 35, 651-665, I examine Eysenck's (1986, Contemporary directions in psychopathology: Toward the DSM-IV) proposal for a dimensional diagnostic system to supplant DSM-IV. PMID:9193127

Wakefield, J C



Low-dose anti-CD20 veltuzumab given intravenously or subcutaneously is active in relapsed immune thrombocytopenia: a phase I study.  


Low doses of the humanized anti-CD20 monoclonal antibody, veltuzumab, were evaluated in 41 patients with immune thrombocytopenia (ITP), including 9 with ITP ?1 year duration previously treated with steroids and/or immunoglobulins, and 32 with ITP >1 year and additional prior therapies. They received two doses of 80-320 mg veltuzumab 2 weeks apart, initially by intravenous (IV) infusion (N = 7), or later by subcutaneous (SC) injections (N = 34), with only one Grade 3 infusion reaction and no other safety issues. Thirty-eight response-assessable patients had 21 (55%) objective responses (platelet count ?30 × 10(9) /l and ?2 × baseline), including 11 (29%) complete responses (CRs) (platelet count ?100 × 10(9) /l). Responses (including CRs) occurred with both IV and SC administration, at all veltuzumab dose levels, and regardless of ITP duration. Responders with ITP ?1 year had a longer median time to relapse (14·4 months) than those with ITP >1 year (5·8 months). Three patients have maintained a response for up to 4·3 years. SC injections resulted in delayed and lower peak serum levels of veltuzumab, but B-cell depletion occurred after first administration even at the lowest doses. Eight patients, including 6 responders, developed anti-veltuzumab antibodies following treatment (human anti-veltuzumab antibody, 19·5%). Low-dose SC veltuzumab appears convenient, well-tolerated, and with promising clinical activity in relapsed ITP.( identifier: NCT00547066.). PMID:23829485

Liebman, Howard A; Saleh, Mansoor N; Bussel, James B; Negrea, Ovidiu George; Horne, Heather; Wegener, William A; Goldenberg, David M



Effectiveness of Virtual Reality for Pediatric Pain Distraction during IV Placement  

Microsoft Academic Search

The objective of this study was to test the efficacy and suitability of virtual reality (VR) as a pain distraction for pediatric intravenous (IV) placement. Twenty children (12 boys, 8 girls) requiring IV placement for a magnetic resonance imaging\\/computed tomography (MRI\\/CT) scan were randomly assigned to two conditions: (1) VR distraction using Street Luge (5DT), presented via a head-mounted display,

Jeffrey I. Gold; Seok Hyeon Kim; Alexis J. Kant; Michael H. Joseph; Albert \\ Rizzo



Safety, tolerability, and pharmacokinetics of oral and intravenous administration of GSK1322322, a peptide deformylase inhibitor.  


GSK1322322 is the first in a new class of antibiotics that targets peptide deformylase (PDF), an essential bacterial enzyme required for protein maturation. This randomized, double-blind, placebo-controlled, eight-cohort phase I trial enrolled 62 healthy volunteers to assess safety, tolerability, and pharmacokinetic profiles of GSK1322322. GSK1322322 was administered as a single oral or intravenous (IV) dose, escalating from 500 to 3,000?mg or repeat IV doses escalating from 500 to 1,500?mg twice daily. Upon repeat IV administration, GSK1322322 exhibits linear pharmacokinetics over time upon repeat doses as shown by time-invariant pharmacokinetics. A dose-proportional increase in area under concentration-time curve was observed after single or repeat IV dosing, whereas clearance at steady state remained generally unchanged across doses. There was minimal accumulation of GSK1322322 after repeat IV twice-daily administration. After oral tablet doses of GSK1322322 1,000 and 1,500?mg, absolute bioavailability was 69% and 56%, respectively. GSK1322322 administration at single and repeat IV doses and at supratherapeutic single IV doses of 2,000 and 3,000?mg was associated with mild-to-moderate drug-related adverse events. On the basis of the pharmacokinetics and tolerability demonstrated in this study, GSK1322322 has the potential to become the first-in-class PDF inhibitor for clinical use. PMID:23907665

Naderer, Odin J; Jones, Lori S; Zhu, John; Kurtinecz, Milena; Dumont, Etienne



Site of Arterial Occlusion Identified by Transcranial Doppler Predicts the Response to Intravenous Thrombolysis for Stroke  

Microsoft Academic Search

Background and Purpose—The objective of this study was to examine clinical outcomes and recanalization rates in a multicenter cohort of stroke patients receiving intravenous tissue plasminogen activator by site of occlusion localized with bedside transcranial Doppler. Angiographic studies with intraarterial thrombolysis suggest more proximal occlusions carry greater thrombus burden and benefit less from local therapy. Methods—Using validated transcranial Doppler criteria

Maher Saqqur; Ken Uchino; Andrew M. Demchuk; Carlos A. Molina; Zsolt Garami; Sergio Calleja; Naveed Akhtar; Finton O. Orouk; Abdul Salam; Ashfaq Shuaib; Andrei V. Alexandrov



Potential Uses of Intravenous Proton Pump Inhibitors to Control Gastric Acid Secretion  

Microsoft Academic Search

Proton pump inhibitors are the most effective agents for suppressing gastric acidity and are the preferred therapy for many acid-related conditions. While proton pump inhibitors have been accessible in intravenous formulations in several European countries, they have been available only as oral drugs in the United States. In the near future, the proton pump inhibitor pantoprazole is likely to become

David C. Metz



Successful treatment of permethrin toxicosis in two cats with an intravenous lipid administration.  


The present work describes successful treatment of permethrin toxicosis in two cats with a novel therapy of intravenous lipid administration. Two cats presented in lateral recumbency and with generalized tremor after they had been incidentally treated with permethrin for flea control by their owners. Initial therapy consisted of diazepam, propofol, bathing, and intravenous fluids. After an initial bolus of 2mg/kg BW pentobarbital a pentobarbital continuous rate infusion (CRI) was started. Both cats received an emulsion of 20% soybean oil and 80% olive oil, commonly used as fat component of total parenteral nutrition in humans, later in the course of therapy. A bolus of 2 ml/kg BW of the emulsion followed by a CRI of 4 ml/kg BW/h for 4 hours was administered via a jugular catheter as reported previously. One cat received two cycles of therapy with intravenous lipid whereas the other cat needed just one application. Both cats recovered completely without requiring any further treatment. In conclusion, administration of intravenous lipids for permethrin toxicosis in cats is a novel treatment approach which seems to be highly effective in shortening the recovery time for permethrin toxicosis and possibly other fat-soluble toxins. PMID:22526817

Brückner, M; Schwedes, C S



Oral ferrous fumarate or intravenous iron sucrose for patients with inflammatory bowel disease  

Microsoft Academic Search

Objective. Iron therapy may reinforce intestinal inflammation by catalysing production of reactive oxygen species. The effects of oral ferrous fumarate and intravenous iron sucrose on clinical disease activity and plasma redox status were investigated in patients with inflammatory bowel disease (IBD). Material and methods. Nineteen patients with iron deficiency anaemia and Crohn's disease (11) or ulcerative colitis (8) were included

Kari Erichsen; Rune J. Ulvik; Gunnar Nysaeter; Jack Johansen; Jens Ostborg; Arnold Berstad; Rolf K. Berge; Trygve Hausken



Intravenous calcium chloride in the conversion of paroxysmal supraventricular tachycardia to normal sinus rhythm  

Microsoft Academic Search

This brief report describes several cases of paroxysmal supraventricular tachycardia that converted promptly to normal sinus rhythm within 1 to 2 minutes of receiving intravenous calcium salts as pretreatment in anticipation of verapamil therapy. A review of calcium's hemodynamic and dromotropic effects suggests that this probably was due to electrophysiological effects rather than mere coincidence. Calcium raises blood pressure, which

John F O'Brien; Glenn P Tremml; Jay L Falk



Intravenous immunoglobulin treatment of multiple sclerosis and its animal model, experimental autoimmune encephalomyelitis  

Microsoft Academic Search

Intravenous immunoglobulin (IVIG) is an established treatment of immune-mediated demyelinating neuropathy. Since IVIG possesses multiple immunomodulatory and anti-inflammatory properties, IVIG therapy may represent a way of interfering with the disease process in multiple sclerosis (MS). In the MS animal model experimental autoimmune encephalomyelitis (EAE), infusions of IVIG significantly reduced disease symptoms as well as the underlying CNS pathology. IVIG was

Signe Humle Jorgensen; Per Soelberg Sorensen



Echoplanar diffusion-weighted MRI with intravenous gadolinium-DTPA.  


It is occasionally necessary to repeat diffusion weighted imaging (DWI) after giving intravenous contrast medium (CM). However, the effects of CM on DWI and apparent diffusion coefficients (ADC) have not been fully examined. The aim of this prospective study was to investigate whether there are any diagnostically significant differences between echo-planar imaging (EPI)-DWI before and after intravenous CM. EPI-DWI was acquired twice in 203 consecutive patients before and after i.v. CM. Three blinded readers rated the diagnostic image quality. Quantitative ADC calculations were performed before and after CM in all 72 patients with lesions sufficiently large for quantification, and in 72 normal brain regions. Of the 203 patients, 127 had abnormalities on MRI, including ischaemic stroke (52), bleeding (nine), brain tumour with disturbed blood-brain barrier (BBB) (18) and other lesions (48). There were no significant signal differences on isotropic DWI before and after CM, even in lesions with definite disturbance of the BBB. No statistically significant difference between ADC of lesions and contralateral normal brain was observed. PMID:12923668

Fitzek, C; Mentzel, H J; Fitzek, S; Sauner, D; Kaiser, W A; Reichenbach, J R



Vitamin C: Intravenous Use by Complementary and Alternative Medicine Practitioners and Adverse Effects  

PubMed Central

Background Anecdotal information and case reports suggest that intravenously administered vitamin C is used by Complementary and Alternate Medicine (CAM) practitioners. The scale of such use in the U.S. and associated side effects are unknown. Methods and Findings We surveyed attendees at annual CAM Conferences in 2006 and 2008, and determined sales of intravenous vitamin C by major U.S. manufacturers/distributors. We also queried practitioners for side effects, compiled published cases, and analyzed FDA's Adverse Events Database. Of 199 survey respondents (out of 550), 172 practitioners administered IV vitamin C to 11,233 patients in 2006 and 8876 patients in 2008. Average dose was 28 grams every 4 days, with 22 total treatments per patient. Estimated yearly doses used (as 25g/50ml vials) were 318,539 in 2006 and 354,647 in 2008. Manufacturers' yearly sales were 750,000 and 855,000 vials, respectively. Common reasons for treatment included infection, cancer, and fatigue. Of 9,328 patients for whom data is available, 101 had side effects, mostly minor, including lethargy/fatigue in 59 patients, change in mental status in 21 patients and vein irritation/phlebitis in 6 patients. Publications documented serious adverse events, including 2 deaths in patients known to be at risk for IV vitamin C. Due to confounding causes, the FDA Adverse Events Database was uninformative. Total numbers of patients treated in the US with high dose vitamin C cannot be accurately estimated from this study. Conclusions High dose IV vitamin C is in unexpectedly wide use by CAM practitioners. Other than the known complications of IV vitamin C in those with renal impairment or glucose 6 phosphate dehydrogenase deficiency, high dose intravenous vitamin C appears to be remarkably safe. Physicians should inquire about IV vitamin C use in patients with cancer, chronic, untreatable, or intractable conditions and be observant of unexpected harm, drug interactions, or benefit.

Chen, Qi; Espey, Michael Graham; Drisko, Jeanne; Levine, Mark



Efficacy and safety of intravenously administered iron sucrose with and without adjuvant recombinant human erythropoietin for the treatment of resistant iron-deficiency anemia during pregnancy  

Microsoft Academic Search

Objective: This study was undertaken to determine the efficacy and safety of intravenously administered iron sucrose with versus without adjuvant recombinant human erythropoietin in the treatment of gestational iron-deficiency anemia resistant to therapy with orally administered iron alone. Study Design: Forty patients with gestational iron-deficiency anemia were randomly assigned to receive intravenously iron sucrose plus recombinant human erythropoietin or iron

Christian Breymann; Eva Visca; Renate Huch; Albert Huch



Pharmacokinetics of Intravenous Acyclovir, Zidovudine, and Acyclovir-Zidovudine in Pregnant Rats  

Microsoft Academic Search

The pharmacokinetics and placental transfer of acyclovir and zidovudine monotherapies and acyclovir- zidovudine combination therapy were compared in the pregnant rat. Timed-pregnancy Sprague-Dawley rats were used for the study. Doses of 60 mg of each drug\\/kg of body weight in monotherapy and in combination therapy were given by intravenous bolus, and samples of maternal plasma, amniotic fluid, fetal tissue, and

Stacy D. Brown; Michael G. Bartlett; Catherine A. White



Warming Intravenous Fluids for Improved Patient Comfort in the Emergency Department: A Pilot Crossover Randomized Controlled Trial  

PubMed Central

Introduction: The purpose of this study was to test if intravenous (IV) fluids warmed to body temperature are associated with greater patient comfort than room temperature IV fluids in adult emergency department (ED) patients. Methods: This was a pilot double-blind, crossover, randomized controlled trial. Enrolled subjects sequentially received boluses of body temperature (36°C) and room temperature (22 °C) IV fluid, with the order of boluses randomized. Each subject’s level of discomfort was assessed prior to and after each bolus, using a 10 cm visual analog scale (Discomfort VAS), with higher scores indicating greater discomfort. We calculated the change in Discomfort VAS score associated with body temperature IV fluid (?VASbody) and room temperature IV fluid (?VASroom) by subtracting the score reported before the bolus from the score reported after that bolus. We compared changes in Discomfort VAS score with body temperature and room temperature IV fluid using the Wilcoxon matched-pairs signed-rank test. Results: Twenty-seven subjects were included. Treatment with body temperature IV fluid was associated with a significant decrease in discomfort (median ?VASbody: ?0.7 cm; interquartile range (IQR): ?4.5 cm to +0.4 cm) compared to room temperature IV fluid (median ?VASroom: +1.2 cm; interquartile range: ?0.1 cm to + 3.6 cm) (P = 0.001). Conclusion: In this small trial of adult ED patients, infusing IV fluids warmed to body temperature was associated with improved comfort compared to standard, room temperature IV fluids.

Self, Wesley H.; White, Steven J.; McNaughton, Candace D.; Storrow, Alan B.; Slovis, Corey M.; Collins, Sean P.



Ustur whole body case 0269: demonstrating effectiveness of i.v. CA-DTPA for Pu.  


This whole body donation case (USTUR Registrant) involved a single acute inhalation of an acidic Pu(NO3)4 solution in the form of an aerosol 'mist'. Chelation treatment with intravenously (i.v.) Ca-EDTA was initiated on the day of the intake, and continued intermittently over 6 months. After 2.5 y with no further treatment, a course of i.v. Ca-DTPA was administered. A total of 400 measurements of 239+240Pu excreted in urine were recorded; starting on the first day (both before and during the initial Ca-EDTA chelation) and continuing for 37 y. This sampling included all intervals of chelation. In addition, 91 measurements of 239+240Pu-in-feces were recorded over this whole period. The Registrant died about 38 y after the intake, at age 79 y, with extensive carcinomatosis secondary to adenocarcinoma of the prostate gland. At autopsy, all major soft tissue organs were harvested for radiochemical analyses of their 238Pu, 239+240Pu and 241Am content. Also, all types of bone (comprising about half the skeleton) were harvested for radiochemical analyses, as well as samples of skin, subcutaneous fat and muscle. This comprehensive data set has been applied to derive 'chelation-enhanced' transfer rates in the ICRP Publication 67 plutonium biokinetic model, representing the behaviour of blood-borne and tissue-incorporated plutonium during intervals of therapy. The resulting model of the separate effects of i.v. Ca-EDTA and Ca-DTPA chelation shows that the therapy administered in this case succeeded in reducing substantially the long-term burden of plutonium in all body organs, except for the lungs. The calculated reductions in organ content at the time of death are approximately 40% for the liver, 60% for other soft tissues (muscle, skin, glands, etc.), 50% for the kidneys and 50% for the skeleton. Essentially, all of the substantial reduction in skeletal burden occurred in trabecular bone. This modelling exercise demonstrated that 3-y-delayed Ca-DTPA therapy was as effective as promptly administered Ca-EDTA. PMID:18227077

James, A C; Sasser, L B; Stuit, D B; Glover, S E; Carbaugh, E H



Ultrasound-Guided Peripheral Intravenous Access in the Emergency Department: Patient-Centered Survey  

PubMed Central

Introduction To assess characteristics, satisfaction, and disposition of emergency department (ED) patients who successfully received ultrasound (US)-guided peripheral intravenous (IV) access. Methods This is a prospective observational study among ED patients who successfully received US-guided peripheral IV access by ED technicians. Nineteen ED technicians were taught to use US guidance to obtain IV access. Training sessions consisted of didactic instruction and hands-on practice. The US guidance for IV access was limited to patients with difficult access. After successfully receiving an US-guided peripheral IV, patients were approached by research assistants who administered a 10-question survey. Disposition information was collected after the conclusion of the ED visit by accessing patients' electronic medical record. Results In total, 146 surveys were completed in patients successfully receiving US-guided IVs. Patients reported an average satisfaction with the procedure of 9.2 of 10. Forty-two percent of patients had a body mass index (BMI) of greater than 30, and 17.8% had a BMI of more than 35. Sixty-two percent reported a history of central venous catheter placement. This patient population averaged 3 ED visits per year in the past year. Fifty-three percent of the patients were admitted. Conclusion Patients requiring US-guided IVs in our ED are discharged home at the conclusion of their ED visit about half of the time. These patients reported high rates of both difficult IV access and central venous catheter placement in the past. Patient satisfaction with US-guided IVs was very high. These data support the continued use of US-guided peripheral IVs in this patient population.

Schoenfeld, Elizabeth; Shokoohi, Hamid; Boniface, Keith



Intravenous zoledronic acid for the treatment of osteoporosis.  


Osteoporosis is a preventable disease characterized by loss of bone mineral density, progression to diminished skeletal integrity, extensive bone fragility, and an increased risk of fracture. Morbidity and mortality from osteoporosis are significant, and the public health costs are substantial. Although safe and effective therapy is available, the disease remains underdiagnosed and undertreated. Oral bisphosphonates such as alendronate, risedronate, and ibandronate are the current first-line therapy; however, adherence to treatment is suboptimal, largely because the treatment regimen is difficult to follow. The bisphosphonate zoledronic acid (zoledronate), 5 mg, is administered as an annual 15-minute intravenous infusion for the treatment of postmenopausal osteoporosis, assuring treatment compliance and persistence over the 12-month dosing interval. The drug is safe and generally well tolerated, and provides sustained anti-fracture efficacy at all relevant skeletal sites. Zoledronic acid has the potential to improve clinical outcomes by reducing the risk of fracture in patients with osteoporosis. PMID:18430396

Lewiecki, E Michael



Treatment of toxic epidermal necrolysis with intravenous immunoglobulin.  


Toxic epidermal necrolysis (TEN) is a rare severe reaction of the skin resulting in full thickness damage to the epidermis. The condition has significant morbidity as a result of dehydration, protein loss, thermoregulatory difficulties, and renal, lung, liver and heart failure. The mortality rate approaches 30%, most commonly from bacterial sepsis. Management of this condition is cessation of the suspected causative agent and supportive care on a burns or intensive care unit. There have been recent reports of treatment using intravenous immunoglobulin (IVIG) therapy, though its efficacy is yet to be established. It has been proposed that IVIG inhibits the Fas-FasL mediated apoptosis of keratinocytes affected by TEN. We describe a case of extensive drug-induced TEN in a 33-year-old woman who showed rapid improvement with IVIG therapy at a dose of 0.75 g/kg/day given for four consecutive days. PMID:14529073

Sidwell, R U; Swift, S; Yan, C L; Porter, W; Thompson, E M; Clark, J A; Bunker, C B



Randomized Clinical Trial of Intravenous Valproate (Orifil) and Dexamethasone in Patients with Migraine Disorder  

PubMed Central

Background: Intravenous Valproate (IVVP) has been used in the treatment of migraine in some studies; however, it is far better known in the management of status epilepticus. Methods: Consecutive patients with migraine in our Headache Clinic were enrolled in this prospective, randomized clinical trial in 2011. The patients were randomized into two therapeutic groups, one receiving 900 mg IVVP (Orifil) and the other 16 mg IV Dexamethasone (IVDEX) diluted in 150 CC normal saline and infused for 10 minutes. Worst severity of pain before treatment and least severity at 3 hours after the infusion using a 0-10 point numeric rating scale were recorded. An interview with the patient was performed 72 hours after treatment to detect a possible relapse of headache. Results: Thirty-one migraine status patients, comprising 28 women and 3 men at a mean±SD age of 33.355±12.373 SD, were investigated. Differences in the therapeutic effects of IVVP (Orifil) and IVDEX on pain score were not significant between the two groups (t=0.933, df=29; P=0.358). Relapse of headache occurred in 68.42% of the IVVP (Orifil) group and 66.67% of the IVDEX group. Distribution of relapse was not significantly different between the two therapeutic groups of patients (P=0.870). Conclusion: IVVP (Orifil) was similar in efficacy to IVDEX as abortive therapy in patients with migraine status. IVVP (Orifil) appears to offer a safe and well-tolerated abortive treatment. Trial Registration Number: IRCT13891146234N2

Foroughipour, Mohsen; Ghandehari, Kavian; Khazaei, Mojtaba; Ahmadi, Fahimeh; Shariatinezhad, Keyvan; Ghandehari, Kosar



Hypotensive effects of intravenously administered uridine and cytidine in conscious rats: involvement of adenosine receptors.  


In the present study, we investigated the cardiovascular effects of intravenously injected uridine or cytidine, and the role of adenosine receptors in mediating these effects, in conscious normotensive rats. Intravenous (i.v.) administration of uridine (124, 250, 500 mg/kg) dose-dependently decreased arterial pressure and heart rate. Cytidine (124, 250, 500 mg/kg; i.v.) produced slight dose-related hypotension without changing heart rate. Plasma uridine and cytidine concentrations increased time- and dose-dependently while plasma adenosine levels did not change after injection of the respective nucleosides. Pretreatment with intravenous caffeine (20 mg/kg), 8-phenyltheophylline (8-PT) (1 mg/kg), nonselective adenosine receptor antagonists, or 8-p-sulfophenyltheophylline (8-SPT) (20 mg/kg), a nonselective adenosine receptor antagonist which does not cross the blood-brain barrier, abolished the cardiovascular effects of uridine (250 mg/kg; i.v.) or cytidine (250 mg/kg; i.v.). Intracerebroventricular (i.c.v.) caffeine (200 microg) or 8-SPT (50 microg) pretreatment did not change the magnitude of the cardiovascular responses induced by nucleosides. Intravenous 8-cyclopenthyl-1,3-dipropylxanthine (DPCPX) (5 mg/kg), a selective adenosine A(1) receptor antagonist, greatly attenuated the cardiovascular responses to uridine and cytidine. Pretreatment with 3,7,-dimethyl-1-propargylxanthine (DMPX) (2 mg/kg), an adenosine A(1)/A(2) receptor antagonist, attenuated hypotension induced by uridine and blocked the arterial pressure decrease in response to cytidine. Uridine-induced bradycardia was blocked by DMPX. 4-(2-[7-amino-2-(2-furyl[1,2,4]-triazolo[2,3-a[1,3,5]triazin-5-yl-aminoethyl)phenol (ZM241385) (1 mg/kg; i.v.), a selective adenosine A(2A) receptor antagonist, pretreatment produced an only very small blockade in the first minute of the hypotensive effects of uridine without affecting the bradycardia. ZM241385 pretreatment completely blocked cytidine's hypotensive effect. In Langendorff-perfused rat heart preparation, uridine (10(-3) M), but not cytidine, decreased the heart rate. Our results show that intravenously injected uridine or cytidine is able to decrease arterial pressure by activating peripheral adenosine receptors. The data also implicates that the mainly adenosine A(1) receptor activation is involved in the uridine-induced cardiovascular effects, while both adenosine A(1) and A(2A) receptor activations mediate the cytidine's effects. PMID:18313046

Yilmaz, M Sertac; Coskun, Cenk; Suzer, Oner; Yalcin, Murat; Mutlu, Duygu; Savci, Vahide



Community-acquired bacteremias from tunneled central intravenous lines: results from studies of a single vendor.  


Tunneled central intravenous catheters are a common method for rendering prolonged outpatient intravenous therapy. Their safety, however, has not been well studied. We conducted a retrospective evaluation of bacteremias associated with tunneled central intravenous catheters managed by a single home health care vendor during a 1-year period. All catheters were inserted in the operating room under sterile conditions. To calculate total line days, the dates of catheter insertion and removal were obtained from either the hospital operating room or the home health care agency. Catheter care was conducted according to written protocols. Total line days were calculated. Community-acquired bacteremia (defined as bacteremia occurring more than 6 days after the patients' discharge from the hospital) was determined from records available in the infection control department. Sixty-eight patients received intravenous therapy from the vendor during the 1-year study period. Total line days were 5548 (median 52 days/patient). Eleven episodes of bacteremia occurred in five patients, providing an incidence density rate of 2.0 infections/1000 catheter days. The most frequent bacteria encountered were Staphylococcus epidermidis (five), Klebsiella pneumoniae (two), and Acinetobacter calcoaceticus var anitratus (two). Median time to bacteremia was 103 days. Two patients, both younger than 4 years, accounted for seven of the infections; both had short-bowel syndrome. On the basis of historical comparisons, outpatient intravenous therapy appears to be associated with a lower risk of bacteremia than in-hospital therapy. These data can provide quality improvement information and may be a means for comparing home infusion therapy vendors. PMID:7943925

Brown, R B; Cipriani, D; Schulte, M; Corl, A; Pieczarka, R



Chromium(IV) siloxide.  


The reaction of Na(OSi(t)Bu(2)Me) with CrCl(3) yields solid [Cr(OSi(t)Bu(2)Me)(3)](n) (1), which can be crystallized in the presence of excess Na(OSi(t)Bu(2)Me) to yield [Na(THF)][Cr(OSi(t)Bu(2)Me)(4)] (2). This complex is oxidized to yield Cr(OSi(t)Bu(2)Me)(4) (3), a crystalline chromium(IV) siloxide complex that is air- and moisture-stable. Electronic spectroscopic analysis of the absorption spectrum of 3 indicates a particularly weak ligand field (?(T) = 7940 cm(-1)) and covalent Cr-O bonding. 3 provides the first structural and spectroscopic characterization of a homoleptic chromium(IV) siloxide complex and provides a benchmark for tetrahedral chromium(IV) ions residing in solid oxide lattices. PMID:23339466

Marshak, Michael P; Nocera, Daniel G



Pharmacokinetics of intravenous dynorphin A(1–13) in opioid-naive and opioid-treated human volunteers  

Microsoft Academic Search

Background: Dynorphin A(1–13) is a fragment of the endogenous opioid neuropeptide dynorphin A. Previous research suggested that intravenously administered dynorphin A(1–13) has the ability to modulate morphine-induced analgesia. We designed this study to characterize the disposition of intravenous dynorphin immunoreactivity in humans and to determine whether concomitant long-term opioid therapy influenced the pharmacokinetics or side-effects profile of dynorphin A(1–13).Methods: The

Pedro L. Gambús; Thomas W. Schnider; Charles F. Minto; Elizabeth J. Youngs; Valerie Billard; William G. Brose; Günther Hochhaus; Steven L. Shafer



Evolution of iv iron compounds over the last century.  


Administration of intravenous (IV) iron has become pivotal in the management of anaemia in patients with chronic kidney disease (CKD). Since parenteral iron was first introduced for human use in the 1930s, things have come a long way. Seventy years ago, iron was toxic, administered as an iron oxyhydroxide complex. This problem was circumvented with the introduction of compounds containing iron in a core surrounded by a carbohydrate shell. The carbohydrate shell consists of molecules such as dextran, sucrose, dextrin or gluconate. The first dextran-containing IV iron preparations carried a small risk of anaphylaxis, but the more recently introduced low molecular weight iron dextran preparation has significantly less risk of this. Iron reactions occur with all IV iron preparations, but are generally not thought to be immune based. Recently, newer IV iron preparations have appeared in the market, including Ferumoxytol (Feraheme) and ferric carboxymaltose (Ferinject). These latest IV iron preparations do not contain a requirement for a test dose, and a much higher dose of iron can be delivered as a single administration. Thus, giving supplemental iron to man has come a long way since 1930s; we are now in an era when we are able to administer higher doses of iron with acceptable safety and without significant adverse effects. However, the long-term safety of the newer IV iron preparations is not yet established. PMID:19891680

Macdougall, Iain C



Urgent – Drug Recall - BIVIGAM Immune Globulin Intravenous ...  

Center for Biologics Evaluation and Research (CBER)

... Urgent – Drug Recall - BIVIGAM Immune Globulin Intravenous (Human), 10% Liquid, 100 mL sterile vial. DATE RECALL INITIATED: April 2, 2013. ... More results from


Development of a Novel Intravenous Membrane Oxygenator.  

National Technical Information Service (NTIS)

The Intravenous Membrane Oxygenator (IMO) at the University of Pittsburgh is intended to provide temporary and portable respiratory support to military personnel and civilians whose lungs are acutely impaired. The current IMO device consists of several hu...

B. G. Hattler W. J. Federspiel L. W. Wallace J. L. Williams



CSL Behring Immune Globulin Intravenous (Human), 10% ...  

Center for Biologics Evaluation and Research (CBER)

Text Version... Draft Labeling Text Privigen® ... CSL Behring Immune Globulin Intravenous (Human), 10% Liquid, Privigen® Draft Labeling Text ... More results from


Solubility of Injectable Valium in Intravenous Solutions.  

National Technical Information Service (NTIS)

A study of the solubility of Valium in commonly used intravenous solutions showed Valium to be equally insoluble in 5% dextrose in saline, normal saline, and Ringer's lactate. However, the precipitate which was formed became completely resuspended when mi...

M. F. Grower E. A. Russell L. Getter



Dear Manufacturer: Immune Globulin Intravenous (Human) ...  

Center for Biologics Evaluation and Research (CBER)

... Thomas MJ, Misbah SA, Chapel HM, Jones M, Elrington G, Newsom-Davis J. Hemolysis after high-dose intravenous Ig. Blood 1993;15:3789. ... More results from


Importance of nondrug costs of intravenous antibiotic therapy  

Microsoft Academic Search

INTRODUCTION: Costs are one of the factors determining physicians' choice of medication to treat patients in specific situations. However, usually only the drug acquisition costs are taken into account, whereas other factors such as the use of disposable materials, the drug preparation time and the staff workload are insufficiently taken into consideration. We therefore decided to assess true overall costs

Arthur RH van Zanten; Peter M Engelfriet; Karin van Dillen; Miriam van Veen; Mark JC Nuijten; Kees H Polderman



Oxidative effect of several intravenous iron complexes in the rat.  


The objective of this study was to compare the oxidative stress induced in rat internal organs by the administration of the following clinically used intravenous (IV) iron (Fe) containing compounds: iron sucrose (IS), iron dextran (ID), ferric carboxymaltose and ferumoxytol. Groups of six adult rats received 1 mg/kg of each compound weekly for 5 doses. Seven days following the last dose, animals were euthanized and tissue samples of heart, lung, liver, and kidney were obtained, washed in warmed saline and frozen under liquid nitrogen and stored at -80 °C for analysis for nitrotyrosine (NT) and dinitro phenyl (DNP) as markers of oxidative stress. All tissues showed a similar pattern of oxidative stress. All Fe products stimulated an increase in the tissue concentration of both NT and DNP. In general, DNP was stimulated significantly less than NT except for IS. DNP was stimulated to an equal degree except for ID where NT was significantly higher than the NT concentrations in all other Fe compounds. ID produced over 10-fold the concentration of NT than any other Fe. IV Fe compounds present a risk of oxidative stress to a variety of internal organs. However, we found that IS was the least damaging and ID was the worst. PMID:23681275

Bailie, George R; Schuler, Catherine; Leggett, Robert E; Li, Hsin; Li, Hsin-Dat; Patadia, Hiten; Levin, Robert



Pharmacokinetics of intravenous and intramuscular parecoxib in healthy Beagles.  


Parecoxib is an inactive pro-drug that is rapidly converted to valdecoxib, a selective cyclooxygenase (COX)-2 inhibitor registered for the management of post-operative pain in humans. Recent studies have suggested that parecoxib has excellent clinical efficacy and safety in veterinary species. The aim of the current study was to assess the pharmacokinetics of parecoxib and valdecoxib after intravenous (i.v.) and intramuscular (i.m.) administration. Seven healthy male Beagle dogs received 2.5 mg/kg parecoxib by either the i.v. or i.m. route in a cross-over design, with the alternative route of administration used 1 week later. The plasma concentrations of both analytes were detected according to a previously validated method using high performance liquid chromatography with fluorescence detection (HPLC-FL). No adverse effects were observed in any animal during the study. For both routes of administration, parecoxib was rapidly and almost completely converted to valdecoxib. The parecoxib/valdecoxib area under the curve (AUC) ratio for both routes of administration was 1.4. The half-life of valdecoxib was about 2 h, which was shorter than reported for humans, although the plasma concentrations following both routes of administration were likely to be effective for analgesia. The absolute bioavailability of parecoxib was 66%. The pharmacokinetic features of parecoxib make it suitable for treatment of acute pain in the canine species. PMID:22130459

Giorgi, M; Saccomanni, G; Del Carlo, S; Manera, C; Lavy, E



Back to basics: iatrogenic intravenous cannula embolus.  


We present a case of distal venous embolisation of a peripheral intravenous cannula tip that had lost its structural integrity through repeated failed attempts of insertion of the same cannula, contrary to protocols for intravenous access. Radiological imaging confirmed the presence of a foreign body in the middle finger and the patient was brought to theatre. A 2.2cm long catheter tube was removed via a venotomy from the dorsal digital vein. PMID:24112480

Khadim, M F; Leonard, D; Moorehead, R A; Hill, C



Chronopharmacology of intravenous and oral modified release verapamil  

PubMed Central

Aims Using a stable isotope technique which allows simultaneous and differential measuring of orally and intravenously administered drugs we compared the pharmacokinetics and pharmacodynamics of unlabelled modified release verapamil p.o. (steady state) and deuterated verapamil i.v. (single dose) following morning and evening administration. Methods Twelve female and 12 male healthy volunteers were studied in a randomized, crossover design. During the last day of each treatment period (day 6 and day 10) pharmacokinetics and pharmacodynamics (PR interval) of verapamil were assessed; 1 h before ingestion of a new R/S-verapamil 240 mg modified release formulation (08.00 h vs 20.00 h) a single dose of 10 mg d7-R/S-verapamil was administered intravenously. Serum levels of unlabelled and labelled R/S-verapamil were measured by gas chromatography/mass spectrometry. In selected samples of serum which were chosen at tmin,po and tmax,po the enantiomers were separated by chiral high-performance liquid chromatography in order to calculate R- to S-verapamil serum concentration ratios. Results We observed no significant differences in pharmacokinetics (AUCpo, Cmax, tmax, CLo, F and R/S enantiomer ratio) between morning and evening treatment with modified release verapamil and there was no influence of time of dosing on mean prolongation of PR interval. AUCiv, CL, Vss and d7-R/d7-S enantiomer ratio following verapamil i.v. did not show circadian variation. t1/2 was slightly but statistically significantly increased after the morning infusion. PR-prolongation was significantly greater after verapamil i.v. in the morning than in the evening. The 90% confidence intervals of the differences between morning and evening administration in AUCpo, Cmax and AUCiv were within the equivalence range of 0.8–1.25. Conclusions Time of dosing has no significant influence on pharmacokinetics and pharmacodynamics of this new modified release formulation of verapamil. Circadian variation in presystemic metabolism of verapamil was not observed.

Dilger, Karin; Eckhardt, Klaus; Hofmann, Ute; Kucher, Klaus; Mikus, Gerd; Eichelbaum, Michel



The PLATO IV Architecture.  

ERIC Educational Resources Information Center

|The PLATO IV computer-based instructional system consists of a large scale centrally located CDC 6400 computer and a large number of remote student terminals. This is a brief and general description of the proposed input/output hardware necessary to interface the student terminals with the computer's central processing unit (CPU) using available…

Stifle, Jack


PLATO IV Accountancy Index.  

ERIC Educational Resources Information Center

|The catalog was compiled to assist instructors in planning community college and university curricula using the 48 computer-assisted accountancy lessons available on PLATO IV (Programmed Logic for Automatic Teaching Operation) for first semester accounting courses. It contains information on lesson access, lists of acceptable abbreviations for…

Pondy, Dorothy, Comp.


Division Iv: Stars  

NASA Astrophysics Data System (ADS)

During the General Assembly in Rio de Janeiro the Division IV meeting, and the meetings of the participating working groups and commissions, were held on thursday 6th (session 1 and 2) and friday 7th (sessions 1, 2, 3, 4).

Spite, Monique; Corbally, Christopher; Dravins, Dainis; Allen, Christine; d'Antona, Francesca; Giridhar, Sunetra; Landstreet, John; Parthasarathy, Mudumba