It would exclude biologics, infused drugs, injected drugs, inhaled drugs for surgery and certain parenteral drugs.
|
|
The case is Eli Lilly and Co v Teva Parenteral Medicines Inc et al, U.S. Federal Circuit Court of Appeals, No. 2015-2067.
|
|
And in many cases, this malnutrition goes undiagnosed; according to the American Society for Parenteral and Enteral Nutrition (ASPEN), every minute, 10 hospitalized patients with malnutrition go undiagnosed.
|
|
Dr. Dudrick was the first president and founder of the American Society for Parenteral and Enteral Nutrition, and was instrumental in the founding of the Oley Foundation, a support group for TPN patients.
|
|
According to the medical records, all the children were being fed by parenteral nutrition, in which fluids containing all necessary nutrients are given intravenously by the NICU, and only one child was using a ventilator, the National Forensic Service said.
|
|
By the late 250s, experimenting first on beagle puppies, Dr. Dudrick developed a treatment called total parenteral nutrition, or TPN, which bypasses the intestinal tract when a patient cannot receive food or fluids by mouth and instead injects nutrients — liquid carbohydrates, electrolytes, fats, minerals, proteins and vitamins — directly into the circulatory system through a vein.
|
|
Journal of Parenteral and Enteral Nutrition. Vol. 26. Iss. 4. p. 219–225. It was officially incorporated on November 30, 1976."American Society for Parenteral and Enteral Nutrition". Corporation File Detail.
|
|
An alternative parenteral regimen is ampicillin/sulbactam plus doxycycline. Erythromycin-based medications can also be used. A single study suggests superiority of azithromycin over doxycycline. Another alternative is to use a parenteral regimen with ceftriaxone or cefoxitin plus doxycycline.
|
|
These diseases cause chylothorax by obstructing or destroying the thoracic duct. Also, parenteral nutrition has been a possible cause; a quick dose of total parenteral nutrition can overwhelm the thoracic duct, causing the chyle to leak into the surrounding pleural space.
|
|
Therefore n-3-rich fat may alter the course of parenteral nutrition associated liver disease.
|
|
Soybean oil is indicated for parenteral nutrition as a source of calories and essential fatty acids.
|
|
Parenteral Iron is increasingly used in these cases to improve patient outcomes and void blood usage.
|
|
High-dose parenteral polyestradiol phosphate therapy has been found to increase SHBG levels by about 1.5-fold.
|
|
Parenteral nutrition (PN) is the feeding of nutritional products to a person intravenously, bypassing the usual process of eating and digestion. The products are made by pharmaceutical compounding companies . The person receives a nutritional formulae that contain nutrients including glucose, salts, amino acids, lipids and added vitamins and dietary minerals . It is called total parenteral nutrition (TPN) or total nutrient admixture (TNA) when no significant nutrition is obtained by other routes, and partial parenteral nutrition (PPN) when nutrition is also partially enteric.
|
|
Last Updated: February 15, 2006. Retrieved on September 19, 2007."Skeletal Muscle Relaxant (Oral Route, Parenteral Route)." Mayo Clinic.
|
|
Due to the frequent intolerance of oral iron and the slow improvement, parenteral iron is recommended in many indications.
|
|
These additional components in parenteral nutritions, however were subject to stability checks, since they greatly affect the stability of lipid emulsions that serve as the base for these formulations. Studies have shown differences in physical and chemical stabilities of these total parenteral nutrition solutions, which greatly influences pharmaceutical manufacturing of these admixtures.
|
|
The newborn children of mothers who received parenteral magnesium sulfate during labor may exhibit toxicity with normal serum magnesium levels.
|
|
Both natural or bioidentical estrogens and synthetic estrogens have been used and both oral and parenteral routes may be used.
|
|
Hypersensitivity is a rarely described but significant complication of parenteral nutrition therapy. First reported in 1965, the incidence of these reactions is speculated to be around one in 1.5 million patients who are provided parenteral nutrition. There is a wide range in how and when these reactions manifest. Cutaneous manifestations are the most common presentation.
|
|
The Journal of Parenteral and Enteral Nutrition is a peer-reviewed medical journal that publishes papers in the field of nutrition and dietetics. The editor-in-chief is Kelly A. Tappenden. It was established in 1977 and is currently published by SAGE Publications on in association with the American Society for Parenteral and Enteral Nutrition.
|
|
Only a limited number of emulsifiers are commonly regarded as safe to use for parenteral administration, of which the most important is lecithin. Lecithin can be biodegraded and metabolized, since it is an integral part of biological membranes, making it virtually non-toxic. Other emulsifiers can only be excreted via the kidneys, creating a toxic load. The emulsifier of choice for most fat emulsions used for parenteral nutrition is a highly purified egg lecithin,Lecithin - An Emulsifier for Parenteral Use: TORVS Research Team due to its low toxicity and complete integration with cell membranes.
|
|
Considering the diversity of possible causes and several surprising symptomatologic presentations, and because there is low assumed risk of toxicity of thiamine, because the therapeutic response is often dramatic from the first day, some qualified authors indicate parenteral thiamine if WE is suspected, both as a resource for diagnosis and treatment. The diagnosis is highly supported by the response to parenteral thiamine, but is not sufficient to be excluded by the lack of it.Thomson, Cook et al. 2008 Parenteral thiamine administration is associated with a very small risk of anaphylaxis.
|
|
Jonathan Evans Rhoads (May 9, 1907 – January 2, 2002) was a surgeon, responsible for the development of total parenteral nutrition (TPN).
|
|
Other anticoagulants cannot be taken by mouth. These parenteral (non-oral) medicines include low-molecular-weight heparin, fondaparinux, and unfractionated heparin. Some oral medicines are sufficient when taken alone, while others require the use of an additional parenteral blood thinner. Rivaroxaban and apixaban are the typical first-line medicines, and they are sufficient when taken orally.
|
|
They are also being replaced by parenteral forms of estradiol like polyestradiol phosphate and transdermal estradiol in the treatment of prostate cancer.
|
|
Most women with mild to moderate anemia, however, resolve the anemia sufficiently rapidly with oral iron alone and do not need parenteral iron.
|
|
Iron polymaltose must not be administered at the same time as parenteral iron preparations. No interactions with other medications or foods are known.
|
|
Clinical experience guides decisions regarding transition from parenteral to oral therapy, which usually can be initiated within 24–48 hours of clinical improvement.
|
|
As such, although rectal administration is a parenteral route, it may still be subject to some first-pass metabolism similarly to oral progesterone.
|
|
Many glass tubing can be used right away for example for pneumatic conveying systems, lighting, photobioreactors or as an architectural item. However, modifying of glass tubing is quite common and indespendsable for applications like laboratory glass, pharma packaging Swift, R., et al., Glass Containers for Parenteral Products, in Pharmaceutical Dosage Forms: Parenteral Medications, S. Nema and J.D. Ludwig, Editors. 2019., and diode encapsulants.
|
|
Paradoxically, total parenteral nutrition may produce hypouricemia followed shortly by acute gout, a condition normally associated with hyperuricemia. The reasons for this are unclear.
|
|
The claimed symptoms of chromium deficiency caused by long-term total parenteral nutrition are severely impaired glucose tolerance, weight loss, peripheral neuropathy and confusion.
|
|
Polysorbates are widely used in cosmetics, food products and oral, parenteral, and topical pharmaceutical formulations and are generally regarded as nontoxic and nonirritant materials.
|
|
We treated her with the decompression of the small intestine via enterostomy for stasis and total parenteral nutrition for stasis-related malabsorption and malnutrition.
|
|
All of the patients involved were receiving total parenteral nutrition at the time, and this is being investigated as a possible source of the outbreak.
|
|
Other guidelines advise oral iron as first line with parenteral iron reserved for those that fail to adequately respond as oral iron is considerably cheaper. All agree that severe anemia (hemoglobin under 10g/dL) should be treated with parenteral iron. Blood transfusion should be reserved for those who are cardiovascularly unstable, due to its relatively poor safety profile, lack of long term efficacy, and cost.
|
|
Clinical dietitians work in hospitals, outpatient clinics, nursing care facilities and other health care facilities to provide nutrition therapy to patients with a variety of health conditions, and provide dietary consultations to patients and their families. They confer with other health care professionals to review patients' medical charts and develop individual plans to meet nutritional requirements. Some clinical dietitians will also create or deliver outpatient or public education programs in health and nutrition. Clinical dietitians may provide specialized services in areas of nourishment and diets, tube feedings (called enteral nutrition), and intravenous feedings (called parenteral nutrition) such as total parenteral nutrition (TPN) or peripheral parenteral nutrition (PPN).
|
|
Prognosis is poor; many patients die before the age of 5 (mainly from infections or cirrhosis), although most patients nowadays survive with intravenous feeding (parenteral nutrition).
|
|
Later research work included contributions on oral, parenteral, buccal, and vaginal drug delivery systems and mechanisms, with a strong emphasis on bioadhesion as a control phenomenon.
|
|
Further research is needed to find out if parenteral nutrition is of benefit to people with an inoperable blockage of the bowel caused by advanced cancer.
|
|
Parenteral (intravenous) administration of glucagon is a common human medical intervention in diabetic emergencies when sugar cannot be given orally. It can also be administered intramuscularly.
|
|
It is be called peripheral parenteral nutrition (PPN) when administered through vein access in a limb rather than through a central vein as central venous nutrition (CVN).
|
|
Octreotide is useful in overdose management of sulfonylurea type hypoglycemic medications, when recurrent or refractory to parenteral dextrose. Mechanism of action is the suppression of insulin secretion.
|
|
The incidence of relapse after oral refeeding may be reduced by post-pyloric enteral rather than parenteral feeding prior to oral refeeding. IMRIE scoring is also useful.
|
|
Among the routes of administration, the preferred means of nutrition is, if possible, oral administration. Alternatives include enteral administration (in nasogastric feeding) and intravenous (in parenteral nutrition).
|
|
MCTs are an ingredient in some specialised parenteral nutritional emulsions in some countries. Studies have also shown promising results for epilepsy through the use of ketogenic dieting.
|
|
The differences can be attributed to the lack of the first-pass effect with parenteral administration as well as structural and pharmacological differences between estradiol and ethinylestradiol.
|
|
There is no cure for short bowel syndrome except transplant. In newborn infants, the 4-year survival rate on parenteral nutrition is approximately 70%. In newborn infants with less than 10% of expected intestinal length, 5 year survival is approximately 20%. (mean follow-up time was 5.1 years) Some studies suggest that much of the mortality is due to a complication of the total parenteral nutrition (TPN), especially chronic liver disease.
|
|
For adults, intravenous (IV) or intramuscular (IM) artesunate is recommended. Quinine is an acceptable alternative if parenteral artesunate is not available. For children, especially in the malaria-endemic areas of Africa, artesunate IV or IM, quinine (IV infusion or divided IM injection), and artemether IM are recommended. Parenteral antimalarials should be administered for a minimum of 24 hours, irrespective of the patient's ability to tolerate oral medication earlier.
|
|
Another use for intravenous injections includes for the administration of nutrition to people who cannot get nutrition through the digestive tract. This is termed parenteral nutrition and may provide all or only part of a person's nutritional requirements. Parenteral nutrition may be pre-mixed or customized for a person's specific needs. Intravenous injections may also be used for recreational drugs when a rapid onset of effects is desired.
|
|
One advantage small molecule drugs (SMDs) have over "large molecule" biologics is that many small molecules can be taken orally whereas biologics generally require injection or another parenteral administration.
|
|
Zinc deficiency can be classified as acute, as may occur during prolonged inappropriate zinc-free total parenteral nutrition; or chronic, as may occur in dietary deficiency or inadequate absorption.
|
|
Erythropoietin and iron therapy can be considered in cases of anemia. Accordingly, patients should be screened for anemia at least 30 days prior to an elective surgical procedure. Although either oral or parenteral iron could be given, increasingly clinicians are giving parenteral iron to ensure that the haemoglobin is increased the maximal amount before the elective surgery is undertaken. During surgery, techniques are utilized to reduce or eliminate exposure to allogeneic blood.
|
|
Rivaroxaban is taken once daily, and apixaban is taken twice daily. Warfarin, dabigatran, and edoxaban require the use of a parenteral anticoagulant to initiate oral anticoagulant therapy. When warfarin is initiated for VTE treatment, a 5-day minimum of a parenteral anticoagulant together with warfarin is given, which is followed by warfarin only therapy. Warfarin is taken to maintain an international normalized ratio (INR) of 2.0–3.0, with 2.5 as the target.
|
|
Distribution services include a computerized system to provide centralized, traditional drug distribution to the acute care and long term care areas; total parenteral nutrition, chemotherapy and a full CIVA service.
|
|
In the case of long-term total parenteral nutrition induced fatty liver disease, choline has been shown to alleviate symptoms. This may be due to a deficiency in the methionine cycle.
|
|
Rouxiella chamberiensis is a member of the family Yersiniaceae. It is implicated in the deaths of three infants in France, and was found to be a contaminant of parenteral nutrition bags.
|
|
Henri Joyeux was born in Montpellier, where he studied medicine. He got his PhD from the University of Montpellier in 1972 with a thesis on artificial gut with total parenteral nutrition.
|
|
185 (pg. 1657-9)McClain DJ, Harrison S, Yeager CL, et al. Immunologic responses to vaccinia vaccines administered by different parenteral routes, J Infect Dis, 1997, vol. 175 (pg. 756-63).
|
|
If eating and drinking is not possible, as is often the case when recovering from surgery, alternatives are enteral nutrition and parenteral nutrition.Heisler, Jennifer. "Surgery." About.com. N.p., May–June 2010. Web.
|
|
The safety profile of parenteral estradiol esters like PEP is greatly improved relative to synthetic oral estrogens like ethinylestradiol and diethylstilbestrol. PEP was discovered around 1953 and was introduced for medical use in the United States in 1957. Along with estradiol undecylate and estradiol valerate, it has been frequently used in the United States and Europe as a parenteral form of estrogen to treat men with prostate cancer. However, it is no longer available in the United States.
|
|
Cephalothin, a first generation cephalosporin for parenteral use was the first cephalosporin to become available for patients in the US in 1964. It was chosen for clinical trials from series of 7-ACA derivatives prepared at Eli Lilly. The second cephalosporin for parenteral use became available little later and was marketed in the US under the name Cephaloridine. The clinical successes of these two cephalosporins urged researchers to improve the pharmacological properties and develop more agents.
|
|
Research suggests that in children and young people undergoing cancer treatment, parenteral nutrition may help with this leading to weight gain and increased calorie and protein intake, when compared to enteral nutrition.
|
|
False positive Aspergillus Galactomannan test have been found in patients on intravenous treatment with some antibiotics or fluids containing gluconate or citric acid such as some transfusion platelets, parenteral nutrition or PlasmaLyte.
|
|
Contraindications for parenteral or oral administration include benign prostatic hyperplasia, peptic ulcer, pyloric and duodenal stenosis, uncontrolled glaucoma, pregnancy and breast-feeding. It is not intended for the management of acute bronchospasm.
|
|
An alternative parenteral regimen is ampicillin/sulbactam plus doxycycline. Once infection has been eliminated, surgery may be successful in opening the lumen of the fallopian tubes to allow a successful pregnancy and birth.
|
|
Oral testosterone and oral testosterone undecanoate are not hepatotoxic, unlike orally administered 17α-alkylated anabolic steroids such as methyltestosterone and fluoxymesterone but similarly to parenteral routes and forms of bioidentical testosterone like injections.
|
|
Factory Unit-2. Now the company has extended their manufacturing facility is located 48 miles from Dhaka in Gazipur with the factory (Unit 2), where they produce Ophthalmic & Injectable drugs such as Solution, Suspension & Ointment, Nasal Preparation, Large Volume Parenteral (LVP), Small Volume Parenteral (SVP), Dry Vial, Pre- filled Syringe Injection in key therapeutic segments. This is one and only dedicated steroid & Non-steroid pharmaceuticals facilities in Bangladesh. Total site is 29,792 square metres and building foot print is 14,444 square metres.
|
|
Calea UK is a supplier of parenteral nutrition based in Runcorn, part of Fresenius Kabi. In July 2019 the Medicines and Healthcare products Regulatory Agency imposed restrictions on the company following an inspection which it said had revealed contamination risks and that its production processes did not meet required standards. The resulting disruption of supplies to patients who rely on total parenteral nutrition was declared a national emergency by NHS England. Intravenous feed bags were imported from Norway and Germany for 511 patients.
|
|
She is a member of the National Rifle Association, the Kiwanis service club, the American Society for Quality, and the Parenteral Drug Association. Parks is married and has one daughter. She is a Baptist.
|
|
Initially reported as high as 62.5% with most deaths in the first year, more recent reports have estimated mortality of around 30%, which is similar to other disorders which are dependent on parenteral nutrition.
|
|
Baxter Healthcare Proprietary Limited (Baxter), was the Australian subsidiary of the multinational health care company Baxter International. Baxter manufactured intravenous (IV) and peritoneal dialysis (PD) fluids at various plants in Australia.. Because of the cost of importing sterile IV fluids and the absence of a rival domestic producer, Baxter was a monopoly supplier of sterile IV fluids in the Australian market. Its monopoly covered large volume parenteral fluids, irrigating solutions and parenteral nutrition fluids. However, Baxter faced competition in the market for peritoneal dialysis fluids (PD fluids).
|
|
In contrast to oral administration, parenteral progesterone, such as with vaginal administration, avoids the first-pass effect, and is not associated with supraphysiological levels of neurosteroid metabolites, nor with spikes or marked fluctuations in neurosteroid levels. Parenteral routes can be used instead of oral administration to avoid adverse effects related to neurosteroid fluctuations if they prove to be problematic. Lower doses of oral progesterone (e.g., 100 mg/day) are also associated with relatively reduced formation of neurosteroid metabolites, and may similarly help to alleviate such side effects.
|
|
Chrysiasis is a dermatological condition induced by the parenteral administration of gold salts, usually for the treatment of rheumatoid arthritis.James, William; Berger, Timothy; Elston, Dirk (2005). Andrews' Diseases of the Skin: Clinical Dermatology. (10th ed.). Saunders. .
|
|
Solid lipid nanoparticles possess a solid lipid core matrix that can solubilize lipophilic molecules. The lipid core is stabilized by surfactants (emulsifiers). The emulsifier used depends on administration routes and is more limited for parenteral administrations.
|
|
It can be associated with the gene APOE. It can also be acquired. Sea-blue histiocyte syndrome is seen in patients receiving fat emulsion as a part of long-term parenteral nutrition (TPN) for intestinal failure.
|
|
Long-term survival with Berdon syndrome usually requires parenteral nutrition and urinary catheterisation or diversion. Most long-term survivors also have ileostomies. A multivisceral transplant (stomach, pancreas, small bowel, liver and large intestine) has also been successful.
|
|
Moreover, GLP2 prevents intestinal hypoplasia resulting from total parenteral nutrition. GLP2R, a G protein-coupled receptor superfamily member is expressed in the gut and closely related to the glucagon receptor (GCGR) and the receptor for GLP1 (GLP1R).
|
|
Artesunate is safe for use in children. Artesunate + sulfadoxine/pyrimethamine should be avoided in the newborns due to sulfadoxine/pyrmethamine effects on bilirubin. Parenteral artesunate dosing for treatment of severe malaria in children less than 20 kg should be higher than that of adults in order to increase exposure. When artesunate cannot be given orally or intramuscularly due to an individual's weakness or inability to swallow, rectal administration may be given as pre-referral treatment as long as parenteral administration is initiated after transfer to a more advanced facility.
|
|
Iron therapy (intravenously or intramuscular) is given when therapy by mouth has failed (not tolerated), oral absorption is seriously compromised (by illnesses, or when the person cannot swallow), benefit from oral therapy cannot be expected, or fast improvement is required (for example, prior to elective surgery). Parenteral therapy is more expensive than oral iron preparations and is not suitable during the first trimester of pregnancy. There are cases where parenteral iron is preferable over oral iron. These are cases where oral iron is not tolerated, where the haemoglobin needs to be increased quickly (e.g.
|
|
The elbow and ankle are the most commonly affected joints, followed by the hip and knee. Some physical weakness may result from malnutrition during critical illness. Though nutrition may be provided by tube-feeding or parenteral nutrition, the initiation of parenteral nutrition may be delayed, and interruptions in feeding often occur due to gastrointestinal intolerance or the performance of procedures that require an empty stomach. In people who experience acute respiratory distress syndrome and are treated with mechanical ventilation, lung function is often compromised for months to years.
|
|
Enteral administration involves the esophagus, stomach, and small and large intestines (i.e., the gastrointestinal tract). Methods of administration include oral, sublingual (dissolving the drug under the tongue), and rectal. Parenteral administration is via a peripheral or central vein.
|
|
In patients suffering from malnutrition or malabsorption, intravenous ascorbic acid can be used to treat deficiency. For people who are receiving all of their nutrient requirements via total parenteral nutrition there are vitamin products that include ascorbic acid.
|
|
Microcrystalline EB/P4 in aqueous suspension was developed and marketed under the brand name Sistocyclin several years later. EB/P4 was eventually superseded by longer- acting parenteral estrogen–progestogen combinations as well as by oral estrogen–progestogen combinations.
|
|
Similar results were reported by Neef and co-workers using rats. Metabolism and excretion: Parenteral administration of radio-labeled tetramethylammonium iodide to rats resulted in almost the whole dose being excreted in urine, without any evidence of metabolic transformation.
|
|
Fish oil, sold under the brand name Omegaven, is a fatty acid emulsion. It is used for total parenteral nutrition (feeding directly into a venous catheter), e.g. in short bowel syndrome. It is rich in omega-3 fatty acids.
|
|
Treatment focuses on addressing the underlying cause of symptoms. Treatment of gastritis that leads to pernicious anemia consists of parenteral vitamin B-12 injection. Associated immune-mediated conditions (e.g., insulin-dependent diabetes mellitus, autoimmune thyroiditis) should also be treated.
|
|
Piroxicam is one of the few NSAIDs that can be given parenteral routes. It was patented in 1968 by Pfizer and approved for medical use in 1979. It became generic in 1992, and is marketed worldwide under many brandnames.
|
|
Raspaud, et al., « Evidence of oxidative burst in patients on chronic haemodialysis by alcane measurements », Frontiers of reactive oxygen species in biology and medicine, 1994, p. 457-458 medical device, enteral and parenteral nutrition.M.Salgueiron et al., « Zinc and diabetes Mellitus.
|
|
The compound also occurs as a major and important metabolite of estradiol and estrone. E1S is most commonly taken by mouth, but in the form of Premarin can also be taken by parenteral routes such as transdermal, vaginal, and injection.
|
|
Common support drugs of antacids are either H2 receptor antagonists, and/or a proton pump inhibitor. Sucralfate was used as an option. Parenteral nutrition greatly increased chance of recovery. An esophagectomy can be issued if the disorder is severe enough.
|
|
The European Society for Clinical Nutrition and Metabolism (ESPEN) is an organization in the field of parenteral and enteral nutrition and promotes basic and clinical research, basic and advanced education, organization of consensus statements about clinical care and care quality control. In 1979 an informal meeting laid the foundations of ESPEN, deciding to create a multidisciplinary society devoted to the study of metabolic problems associated with acute diseases and their nutritional implications and management. ESPEN was formally established in 1980 as the European Society for Parenteral and Enteral Nutrition. It later changed its name to the European Society for Clinical Nutrition and Metabolism.
|
|
No specific treatment or cure exists. Affected children usually need total parenteral nutrition through a central venous catheter. Further worsening of liver damage should however be avoided if possible. Diarrhea will likely continue even though food stops passing through the gastrointestinal system.
|
|
The Journal of Parenteral and Enteral Nutrition is abstracted and indexed in Scopus and the Social Sciences Citation Index. According to the Journal Citation Reports, its 2014 impact factor is 3.151, ranking it 23 out of 77 journals in the category ‘Nutrition & Dietetics’.
|
|
1990 phosphorus (dicalcium phosphate) and in some cases taurine, especially suitable when there cardiocirculatory impairment. Patient-guided nutrition is suggested. In patients with Wernicke- Korsakoff syndrome, even higher doses of parenteral thiamine are recommended. Concurrent toxic effects of alcohol should also be considered.
|
|
Molybdenum deficiency refers to the clinical consequences of inadequate supplies of molybdenum in the diet. The amount of molybdenum required is relatively small, and molybdenum deficiency usually does not occur in natural settings. However, it can occur in individuals receiving parenteral nutrition.
|
|
Phase II hepatic metabolism renders the metabolites water-soluble, which are excreted by the kidneys. Thus, reduced doses may be used in renal and hepatic impairment. Its volume of distribution is around 306 l after oral administration and 203 l after parenteral administration.
|
|
Outpatient parenteral antibiotic therapy is used to administer non-oral antibiotics (usually intravenously) without a need for ongoing hospitalisation. OPAT is particularly useful in people who are not severely unwell but do require a prolonged course of treatment that cannot be given in oral form.
|
|
The estrogenic potency of oral ethinylestradiol is approximately 30-fold higher than that of parenteral EBB. In accordance, 50 μg/day oral ethinylestradiol has been reported to be about 3 times stronger in estrogenic effect than once-a-month injections of 10 mg EBB.
|
|
Horses are withheld feed when colic signs are referable to gastrointestinal disease. In long-standing cases, parenteral nutrition may be instituted. Once clinical signs improve, the horse will slowly be re-fed (introduced back to its normal diet), while being carefully monitored for pain.
|
|
Either parenteral or normal feeding can be used to support the stressed metabolism of the sick horse. Finally, the use of probiotics is considered beneficial in the restoration of the normal intestinal flora. The probiotics most often used for this purpose contain Lactobacillus and Bifidobacterium.
|
|
Exercise augments the acute anabolic effects of intradialytic parenteral nutrition in chronic hemodialysis patients. Am J Physiol Endocrinol Metab, 286(4), E589-97, 2004 can mitigate the defects in protein metabolism. Later papers assessed the effectiveness of oral nutritional supplementation, alone or with resistance exercise.
|
|
Salmon calcitonin is rapidly absorbed and eliminated. Peak plasma concentrations are attained within the first hour of administration. Animal studies have shown that calcitonin is primarily metabolised via proteolysis in the kidney following parenteral administration. The metabolites lack the specific biological activity of calcitonin.
|
|
The first line of treatment are corticosteroids and other medicines used to suppress the immune system such as tacrolimus and sirolimus. An intravenous nutrition such as total parenteral nutrition and/or a special diet may be necessary. Hematopoietic stem cell transplantation may be curative.
|
|
The commercial SABAs, salbutamol and terbutaline are resistant to COMT but are slowly metabolised by MAO, while the LABAs are resistant to both COMT and MAO. Also, the long duration of action for salmeterol is related to increased lipophilicity of the molecules, allowing it to remain for a longer time in the lungs. β2-agonists are mainly eliminated by the renal process after parenteral administration, while after oral administration a more pronounced metabolic clearance (high first pass effect) is responsible for a low bioavailability. The elimination after inhalation has not been studied but the profile is likely somewhere between what we see after parenteral and oral administration.
|
|
High parenteral doses of vitamin B6 are also used to treat isoniazid overdose with no adverse effects found, although a preservative in parenteral vitamin B6 may cause transient worsening of metabolic acidosis. High doses of vitamin B6 are also used to treat gyromitra mushroom (false morel) poisoning, hydrazine exposure and homocystinuria Doses of 50 mg to 100 mg per day may also be used to treat pyridoxine deficient seizures and where patients are taking medications that reduce vitamin B6. Daily doses of 10 mg to 50 mg are recommended for patients undergoing hemodialysis. High doses of vitamin B6 may be effective at suppressing lactation.
|
|
Effector and memory lymphocytes in turn preferentially home back to the tissue where they were first activated, in this case the secondary lymph nodes. This is the reason why parenteral immunization with non-replicating antigens is generally considered ineffective in eliciting a mucosal immune response. Another possible explanation for an increased level of anti-aberrant-lactobacillus sIgA in vaginal secretions involves natural priming by mucosal infection at this site. Similarly to how subcutaneously administered killed whole-cell cholera vaccines reportedly only provoke substantial mucosal secretory antibody response in cholera‐endemic countries, vaginal priming with aberrant lactobacilli may be necessary for the generation of mucosal IgA-secreting plasma cells following parenteral vaccination.
|
|
These findings suggest that parenteral forms of estradiol may have similar effectiveness and safety relative to androgen deprivation therapy (ADT) in the treatment of prostate cancer. In addition, estrogens may have significant advantages relative to ADT in terms of bone loss and fractures, hot flashes, sexual function, and quality of life, as well as considerable cost savings with parenteral forms of estradiol compared to analogue therapy. On the other hand, breast tenderness and gynecomastia occur at very high rates with estrogens, whereas incidences are low with castration and CAB. However, gynecomastia with estrogens is generally only mild-to- moderate in severity and is usually only modestly discomforting.
|
|
These bags are only a temporary expedient because they do not provide vital nutrients and electrolytes, such as potassium. Dozens of patients were admitted to hospital as a result. The actions of the regulator were denounced as reprehensible by clinical members of the British Association for Parenteral and Enteral Nutrition who said there wasn’t any apparent forward planning or mitigation plan around what would happen when they were closed down. Calea said it “was directed by the MHRA to make an immediate change to the process by which we add trace elements and vitamins to our parenteral nutrition bags and we complied with the instruction.
|
|
As of a 2018 review evidence of overtreatment overmedicalization, and overdiagnosis in Pediatrics have been use of commercial rehydration solution, antidepressants, and parenteral nutrition; overmedicalization with planned early deliveries, immobilization of ankle injuries, use of hydrolyzed infant formula; and overdiagnosis of hypoxemia among children recovering from bronchiolitis.
|
|
A 1997 review (Suarez- Almazor ME et al.) reports that treatment with intramuscular gold (parenteral gold) reduces disease activity and joint inflammation. Gold salts taken by mouth are less effective than by injection. Three to six months are often required before gold treatment noticeably improves symptoms.
|
|
Masculinizing hormone therapy usually includes testosterone to produce masculinization and suppress the production of estrogen. Treatment options include oral, parenteral, subcutaneous implant, and transdermal (patches, gels). Dosing is patient-specific and is discussed with the physician. The most commonly prescribed methods are intramuscular and subcutaneous injections.
|
|
There is a relationship between the subcutaneous dose of calcitonin and peak plasma concentrations. Following parenteral administration of 100 IU calcitonin, peak plasma concentration lies between about 200 and 400 pg/ml. Higher blood levels may be associated with increased incidence of nausea, vomiting, and secretory diarrhea.
|
|
Another route of administration is chosen for systemic treatment, e.g., parenteral (often intravenously) or by inhalation. They are also used externally as a cream or drops to treat otitis externa (swimmers ear), and as a component of triple antibiotic ointment to treat and prevent skin infections.
|
|
The use of zinc sulfate supplements together with oral rehydration therapy decreases the number of bowel movements and the time until the diarrhea stops. Its use in this situation is recommended by the World Health Organization. Zinc sulfate is also an important part of parenteral nutrition.
|
|
Biliary sludge has been associated with pregnancy, rapid weight loss, total parenteral nutrition, drugs such as ceftriaxone and octreotide, solid organ transplantation, and gastric surgery. In many of these conditions, it is thought that the impairment in the contractility of the gallbladder leads to the formation of the sludge.
|
|
The racemic mixture of 5-formyltetrahydrofolate (leucovorin) is generally available; the active S-isomer, levoleucovorin, may be obtained as well. Parenteral administration is the optimal treatment if that is possible. Folic acid should not be used for the treatment of HFM. Folic acid is not a physiological folate.
|
|
Therapy with hyperbaric oxygen (HBO) may also be useful. The main goal of antimicrobials is in restricting the local and systemic spread of the microorganisms. The available parenteral antimicrobials for most infections are metronidazole, clindamycin, chloramphenicol, cefoxitin, a penicillin (i.e. ticarcillin, ampicillin, piperacillin) and a beta-lactamase inhibitor (i.e.
|
|
BFS is used for the filling of vials for parenteral preparations and infusions, eye drops, and inhalation products. Generally the plastic containers are made up of polyethylene and polypropylene. Polypropylene is more commonly used to form containers which are further sterilised by autoclaving as polypropylene has greater thermostability.
|
|
The inclusion of sulbactam extends ampicillin's spectrum of action to beta-lactamase producing strains of bacteria. Oral sulbactam with parenteral form provides a regimen of continuous sulbactam therapy throughout the treatment, resulting in better clinical results. It was patented in 1979 and approved for medical use in 1987.
|
|
It does not bind to sex hormone-binding globulin. Segesterone, the deacetylated form of SGA, is a metabolite of the medication. The biological half-life of parenteral SGA has been reported to be 24 to 72 hours. One study specifically reported a biological half-life of 26.8 hours.
|
|
The potent immunomodulatory activities of BiP/GRP78 have also been demonstrated in animal models of autoimmune disease including collagen- induced arthritis, a murine disease that resembles human rheumatoid arthritis. Prophylactic or therapeutic parenteral delivery of BiP has been shown to ameliorate clinical and histological signs of inflammatory arthritis.
|
|
The Parenteral Drug Association (PDA) is an international non-profit industry trade group for pharmaceutical and biopharmaceutical manufacturers headquartered in Bethesda, MD, USA, with offices in Berlin, Germany, and Singapore. The Parenteral Drug Association (PDA) is the leading global provider of science, technology, regulatory information, and education for the bio/pharmaceutical community. For nearly 75 years, since its founding as a non-profit in 1946, PDA has been committed to developing scientifically sound, practical technical information and resources to advance science and regulation through the expertise of our more than 10,500 members worldwide. PDA is a truly global organization, with membership nearly equally divided between those working in the U.S. and in other regions around the world.
|
|
Nutrition in Clinical Practice is a peer-reviewed medical journal that covers research in the field of nutrition. The journal's editor-in-chief is Jeanette M. Hasse. It was established in 1986 and is currently published by SAGE Publications in association with the American Society for Parenteral and Enteral Nutrition.
|
|
Alkalinizing agents are drugs used to manage disorders associated with low pH. For example, they may be used to treat acidosis due to kidney failure. Used for oral or parenteral therapy, sodium bicarbonate is the commonly preferred alkalinizing agent. Others include potassium citrate, calcium carbonate, sodium lactate and calcium acetate.
|
|
When listeric meningitis occurs, the overall mortality may reach 70%, from sepsis 50%, and from perinatal/neonatal infections greater than 80%. In infections during pregnancy, the mother usually survives. Reports of successful treatment with parenteral penicillin or ampicillin exist. Trimethoprim-sulfamethoxazole has been shown effective in patients allergic to penicillin.
|
|
This route includes medications that are either swallowed, absorbed through the mucosa of the oral cavity, or inserted rectally. The parenteral route involves the administration of sedative drugs other than absorption across enteric membranes (outside of the alimentary canal). These methods include intravenous, inhalation, intramuscular, and submucosal administration, among others.
|
|
No specific treatment for the canine distemper is known. As with measles, the treatment is symptomatic and supportive. Care is geared towards treating fluid/electrolyte imbalances, neurological symptoms, and preventing any secondary bacterial infections. Examples include administering fluids, electrolyte solutions, analgesics, anticonvulsants, broad-spectrum antibiotics, antipyretics, parenteral nutrition, and nursing care.
|
|
The American Society for Parenteral and Enteral Nutrition (ASPEN) is a US..-based professional organization. Its members include dieticians, nurses, pharmacists, physicians and scientists who are involved in providing clinical nutrition to patients.Mirtallo, J. "A.S.P.E.N. A quarter century of commonality of purpose: Presidential perspectives and insights". Clinical Congress Syllabus. 2001.
|
|
He also dealt with the therapy of micronutrient deficiency, mainly vitamin C at intensive care patients.Biesalski HK. Parenteral ascorbic acid as a key for regulating microcirculation in critically ill. Crit Care Med. 2008 Aug;36(8):2466-8 A further experimental field is nutritargeting, which was described by him first.
|
|
Most emetic patients recover within 6 to 24 hours, but in some cases, the toxin can be fatal via fulminant hepatic failure. In 2014, 23 newborns in the UK receiving total parenteral nutrition contaminated with B. cereus developed septicaemia, with three of the infants later dying as a result of infection.
|
|
An injection of estradiol undecylate has a duration of about 1 to 4 months. Estradiol undecylate was first described in 1953 and was introduced for medical use by 1956. It has been used in Europe as a parenteral estrogen to treat prostate cancer in men, although not as often as polyestradiol phosphate.
|
|
The great majority of trichinosis infections have either minor or no symptoms and no complications. The two main phases for the infection are enteral (affecting the intestines) and parenteral (outside the intestines). The symptoms vary depending on the phase, species of Trichinella, quantity of encysted larvae ingested, age, sex, and host immunity.
|
|
Generally, in the UK oral preparations are trialled before using parenteral delivery.Goddard AF, James MW, McIntyre AS and Scott BB (May 2005). Guidelines for the management of iron deficiency anaemia . British Society of Gastroenterology unless there is the requirement for a rapid response, previous intolerance to oral iron or likely failure to respond.
|
|
Virosomes deliver antigens and therapeutic agents to their targeted cells. Virosomes can act as immunopotentiating agents and as agents of targeted drug delivery. Virosomes as immunopotentiating agents activate cell mediated and humoral immune responses. Virosomes are suspended in saline buffers and are administered through respiratory, parenteral, intravenous, oral, intramuscular, and topical routes.
|
|
Lornoxicam, also known as chlortenoxicam, is a nonsteroidal anti-inflammatory drug (NSAID) of the oxicam class with analgesic (pain relieving), anti- inflammatory and antipyretic (fever reducing) properties. It is available in oral and parenteral formulations. It was patented in 1977 and approved for medical use in 1997. Brand names include Xefo among others.
|
|
According to the Dietary Reference Intake review, neither plasma nor urine concentrations can serve as useful clinical indicators of chromium status. Before chromium became a standard ingredient in total parenteral nutrition (TPN), people getting TPN as their sole source of nutrition developed symptoms that were reversed within two week after chromium was added.
|
|
Overeating can be a symptom of binge eating disorder or bulimia nervosa. Compulsive over eaters depend on food to comfort themselves when they are stressed, suffering bouts of depression, and have feelings of helplessness. In a broader sense, hyperalimentation includes excessive food administration through other means than eating, e.g. through parenteral nutrition.
|
|
Cefotiam is a parenteral second-generation cephalosporin antibiotic. It has broad-spectrum activity against Gram-positive and Gram-negative bacteria. As a beta-lactam, its bactericidal activity results from the inhibition of cell wall synthesis via affinity for penicillin-binding proteins. It was patented in 1973 and approved for medical use in 1981.
|
|
Therefore, the treatment could be repeated after a period of 2–6 weeks. Of late such a need does not arise, as drug combinations are commonly used. When parenteral emetine is combined with oral chloroquine or two courses of emetine are given, the relapse rate can be brought down to 1 percent.
|
|
Vitamin C aids in the body's ability to absorb iron, so taking oral iron supplements with orange juice is of benefit. In the anemia of chronic kidney disease, recombinant erythropoietin or epoetin alfa is recommended to stimulate RBC production, and if iron deficiency and inflammation are also present, concurrent parenteral iron is also recommended.
|
|
In the case of non-thrombotic occlusion (e.g. formation of precipitates), dilute acid can be used to restore patency to the catheter. A solution of 0.1N hydrochloric acid is commonly used. Infusates that contain a significant amount of lipids such as total parenteral nutrition (TPN) or propofol are also prone to occlusion over time.
|
|
Ceftizoxime is a third-generation cephalosporin available for parenteral administration. Unlike other third-generation cephalosporins, the whole C-3 side chain in ceftizoxime has been removed to prevent deactivation by hydrolytic enzymes. It rather resembles cefotaxime in its properties, but is not subject to metabolism. It was removed from the US Market in 2007.
|
|
Descriptions of human molybdenum deficiency are few. A patient receiving prolonged parenteral nutrition acquired a syndrome described as ‘acquired molybdenum deficiency.’ This syndrome, exacerbated by methionine administration, was characterized by high blood methionine, low blood uric acid, and low urinary uric acid and sulfate concentrations. The patient suffered mental disturbances that progressed to a coma.
|
|
Horses that are not eating well may also require parenteral nutrition. Horses usually require 3–6 days of treatment before clinical signs improve. Due to the risk of endotoxemia, laminitis is a potential complication for horses suffering from colitis, and may become the primary cause for euthanasia. Horses are also at increased risk of thrombophlebitis.
|
|
The differential diagnoses are extensive and include: Alagille syndrome, alpha-1-antitrypsin deficiency, Byler disease (progressive familial intrahepatic cholestasis), Caroli disease, choledochal cyst, cholestasis, congenital cytomegalovirus disease, congenital herpes simplex virus infection, congenital rubella, congenital syphilis, congenital toxoplasmosis, cystic fibrosis, galactosemia, idiopathic neonatal hepatitis, lipid storage disorders, neonatal hemochromatosis, and total parenteral nutrition-associated cholestasis.
|
|
SGA has no antiglucocorticoid activity in animals either. The ovulation-inhibiting dosage of parenteral SGA has been reported to be 0.15 mg per day, while the endometrial transformation dosage has been reported to be 0.6 mg per cycle. SGA has antigonadotropic effects and functional antiestrogenic effects via its progestogenic activity similarly to other progestogens.
|
|
No specific treatments are available for THES. The goal is to maximise weight gain and reduce infection rates. Most children require parenteral nutrition (PN) which can be combined with oral feeding, most commonly a semi-elemental diet which allows patients to become independent of PN over time. Nutrition and growth should be closely monitored.
|
|
Restlessness, apprehension, and anxiety were reported effects after the use of various beta-agonists, particularly after oral or parenteral treatment. In pilot clinical trials with ractopamine, four patients showed little evidence for central nervous system stimulation. Whether long-term treatment with these drugs results in the development of tolerance to these adverse effects is unclear.
|
|
Oral formulations are available in Europe, Andriol®, but are not available in the U.S. due to their pharmacokinetic properties. Estrogen and anti-androgen therapy are typically used for feminizing treatments. Estrogen is available in oral, parenteral, and transdermal formulations. Often, estrogen alone is insufficient for androgen suppression, and appropriate therapy will call for additional anti-androgen medications.
|
|
Prescription parenteral nutrition formulation. Regardless of the underlying condition, the loss of intestinal function does not necessarily necessitate a transplant. Several conditions, such as necrotizing enterocolitis or volvulus, may be adequately resolved by other surgical and nonsurgical treatments, especially if SBS never develops. An individual can obtain nutrients intravenously through PN, bypassing food consumption entirely and its subsequent digestion.
|
|
In the geriatric population, it is indicated if oral or enteral nutrition is impossible for 3 days or when oral or nutrition is likely insufficient for more than 7 to 10 days. While there are no complications of parenteral nutrition specific to the geriatric population, complications are more prevalent in this population due to increased comorbidities.
|
|
A common practice is to offer a transfusion to symptomatic women with a hemoglobin value less than 7 g/dL. In most cases of uterine atony-related postpartum hemorrhage, the amount of iron lost is not fully replaced by the transfused blood. Oral iron should thus be also considered. Parenteral iron therapy is an option as it accelerated recovery.
|
|
Up to a certain point, the gut can adapt to partial resections that result in short bowel syndrome. Still, parenteral substitution of water, minerals and vitamins (depending on which part of the gut has been removed) is often necessary. Teduglutide may reduce or shorten the necessity of such infusions by improving the intestinal mucosa and possibly by other mechanisms.
|
|
Treatment may include a specific diet, medications, or surgery. The diet may include slightly salty and slightly sweet liquids, vitamin and mineral supplements, small frequent meals, and the avoidance of high fat food. Occasionally nutrients need to be given through an intravenous line, known as parenteral nutrition. Medications used may include antibiotics, antacids, loperamide, teduglutide, and growth hormone.
|
|
Low- molecular-weight heparin is usually given by subcutaneous injections with a needle under the skin of these colored areas Acutely ill hospitalized patients are suggested to receive a parenteral anticoagulant, although the potential net benefit is uncertain. Critically ill hospitalized patients are recommended to either receive unfractionated heparin or low-molecular weight heparin instead of foregoing these medicines.
|
|
Common examples include oral and intravenous administration. Routes can also be classified based on where the target of action is. Action may be topical (local), enteral (system-wide effect, but delivered through the gastrointestinal tract), or parenteral (systemic action, but delivered by routes other than the GI tract). Route of administration and dosage form are aspects of drug delivery.
|
|
They have also been used in total parenteral nutrition (TPN) . Hickman lines may remain in place for extended periods and are used when long-term intravenous access is required. Long-term venous catheters became available in 1968, and the design was improved by Dr. John W. Broviac (b. 1942), a nephrologist based in East Lansing, Michigan, in 1973.
|
|
Lipid-containing foods undergo digestion within the body and are broken into fatty acids and glycerol, which are the final degradation products of fats and lipids. Lipids, especially phospholipids, are also used in various pharmaceutical products, either as co- solubilisers (e.g., in parenteral infusions) or else as drug carrier components (e.g., in a liposome or transfersome).
|
|
However, is estimated that about 20% of an administered dose does still eventually pass through the liver. Hence, these preparations are not completely liver-neutral. Nonetheless, they have dramatically reduced hepatic effects relative to oral ethinylestradiol. In addition, parenteral estradiol in general has about 4- or 5-fold reduced potency in the liver than oral estradiol.
|
|
Recommended academics: József Knoll, Kálmán Magyar, Emil Pásztor Gaszner Péter akadémiai címre történő ajánlása. Akadémiai Értesítő-Magyar Tudomány. Az MTA folyóirata. 2003/12. sz. Melléklet.Részletek: “After his neuropathological work, he developed a procedure for uncomplicated atropine coma. He found that occasionally a hundred times the “usual” toxic dose could be given as a single parenteral dose.
|
|
However, a role for PCFT in heme and iron homeostasis is excluded by the observation that humans or mice with loss-of-function PCFT mutations are not iron or heme deficient and the anemia, and all other systemic consequences of the loss of this transporter, are completely corrected with high-dose oral, or low-dose, parenteral folate.
|
|
Systemic administration is a route of administration of medication, nutrition or other substance into the circulatory system so that the entire body is affected. Administration can take place via enteral administration (absorption of the drug through the gastrointestinal tract) or parenteral administration (generally injection, infusion, or implantation). Contrast with topical administration where the effect is generally local.
|
|
Controversy arose in the early 1990s regarding routine supplementation, when two studies suggested a relationship between parenteral administration of vitamin K and childhood cancer. However, both studies have been discredited on the basis of poor methodology and small sample sizes, and a review of the evidence published in 2000 by Ross and Davies found no link between the two.
|
|
Anaesthetized patient in postoperative recovery. Hospitals strive for pain-free awakening from anaesthesia. Although not a direct result of general anaesthesia, postoperative pain is managed in the anaesthesia recovery unit with regional analgesia or oral, transdermal, or parenteral medication. Patients may be given opioids, as well as other medications like non steroidal anti-inflammatory drugs and acetaminophen.
|
|
In accordance, another study found no change in levels of coagulation factor VII, a protein of particular importance in the cardiovascular side effects of estrogens, with 240 mg/month intramuscular polyestradiol phosphate. In spite of the markedly reduced impact of parenteral estradiol on the liver compared to other estrogens however, high dosages of parenteral estradiol, producing high levels of circulating estradiol, can still result in important and undesirable changes in liver protein synthesis as with other estrogens. A high dosage of 320 mg/month polyestradiol phosphate has been found to result in significantly increased cardiovascular morbidity (due to non-fatal ischemic heart events and heart decompensation) in men with prostate cancer in two large studies, though cardiovascular mortality was notably not increased. In addition to the liver, ethinylestradiol shows disproportionate estrogenic effects in the uterus.
|
|
The medication is also available in combination with other medications, such as hydrochlorothiazide (brand name Aldactazide, others). Spironolactone has poor water solubility, and for this reason, only oral and topical formulations have been developed; other routes of administration such as intravenous injection are not used. The only antimineralocorticoid that is available as a solution for parenteral use is the related medication potassium canrenoate.
|
|
The production of pancreatic enzymes is suppressed by restricting the patient's oral intake of food patient in conjunction with the use of long- acting somatostatin analogues. The patient's nutrition is maintained by total parenteral nutrition. This treatment is continued for 2–3 weeks, and the patient is observed for improvement. If no improvement is seen, the patient may receive endoscopic or surgical treatment.
|
|
The acute uveitis phase of VKH is usually responsive to high- dose oral corticosteroids; parenteral administration is usually not required. However, ocular complications may require a subtenon or intravitreous injection of corticosteroids or bevacizumab. In refractory situations, other immunosuppressives such as cyclosporine, or tacrolimus, antimetabolites (azathioprine, mycophenolate mofetil or methotrexate), or biological agents such as intravenous immunoglobulins (IVIG) or infliximab may be needed.
|
|
In advanced cancer patients, the use of PN should be discussed in context of the risks and benefits, such as if the approximate survival rate is longer than 3 months and if PN would be expected to greatly improve the patients' quality of life. It is uncertain whether home parenteral nutrition improves survival or quality of life in people with malignant bowel obstruction.
|
|
Ewing's s other clinical interests were in head and neck cancer, parenteral nutrition and peripheral vascular disease. He also introduced the practice of using sheepskins under the patient to reduce the incidence of pressure sores. He was active in promoting seatbelt legislation. The wearing of seatbelts in cars was made compulsory in the State of Victoria in 1970, a world first.
|
|
Benzalkonium chloride is a frequently used preservative in eye drops; typical concentrations range from 0.004% to 0.01%. Stronger concentrations can be caustic and cause irreversible damage to the corneal endothelium. Avoiding the use of benzalkonium chloride solutions while contact lenses are in place is discussed in the literature.M Akers, "Consideration in selecting antimicrobial preservative agents for parenteral product development", Pharmaceutical Technology, May, p.
|
|
Protocols for different forms of primary immunodeficiency vary significantly. The aim of treatments implemented by specialist centers is usually to reduce the risk of complications. One method of treatment is by parenteral administration of gamma globulins, either monthly intravenously, subcutaneously, or more recently, by weekly self- administered hypodermoclysis. In either case, mild allergic reactions are common, and are usually manageable with oral diphenhydramine.
|
|
A medical professional demonstrates how to offer oral medication to a dummy. A medical professional injects medication into a gastric tube. Administering medication rectally Enteral administration is food or drug administration via the human gastrointestinal tract. This contrasts with parenteral nutrition or drug administration (Greek para, "besides" + enteros), which occurs from routes outside the GI tract, such as intravenous routes.
|
|
Use of a non-absorbent patch during surgery can lead to wound sepsis post-surgery. Herniation from the patch is also a possibility. Intestinal dysfunction for a few weeks after the surgery is common, therefore parenteral feeding is continued post-surgery, however prolonged use of this may lead to hepatomegaly and cholestasis. If intestinal dysfunction persists it can lead to intestinal necrosis.
|
|
Holt began his research career as a medical student. At Johns Hopkins, he studied calcium metabolism and its association with rickets. His main field of research was pediatric nutrition. His research into fat absorption in premature babies led to the development of a popular infant formula, while his studies on the nutritional requirements of infants provided data for parenteral nutrition regimes.
|
|
Enteral feeding with a protein hydrolysate or amino acid based formulas worsen the diarrhoea and the children rapidly fail to thrive and develop protein energy malnutrition. In the majority of cases the severity of the malabsorption and diarrhoea make them dependent on daily long term total parenteral nutrition. Hepatic fibrosis and cirrhosis are known complications. Bowel transplantation may be an option.
|
|
Conducts two programs: Doctor of Pharmacy (PharmD) entry-to- practice degree program and Master in Clinical Pharmacy (MCP) degree program that offers several areas of specialization including cardiology, infectious diseases, parenteral nutrition, and others. Both programs are accredited by Commission for Academic Accreditation, Ministry of Education, UAE and the PharmD program is under certification by Accreditation Council for Pharmacy Education, USA.
|
|
These are also called injectable formulations and are used with intravenous, subcutaneous, intramuscular, and intra-articular administration. The drug is stored in liquid or if unstable, lyophilized form. Many parenteral formulations are unstable at higher temperatures and require storage at refrigerated or sometimes frozen conditions. The logistics process of delivering these drugs to the patient is called the cold chain.
|
|
The cold chain can interfere with delivery of drugs, especially vaccines, to communities where electricity is unpredictable or nonexistent. NGOs like the Gates Foundation are actively working to find solutions. These may include lyophilized formulations which are easier to stabilize at room temperature. Most protein formulations are parenteral due to the fragile nature of the molecule which would be destroyed by enteric administration.
|
|
Treating sexual partners for possible STIs can help in treatment and prevention. For women with PID of mild to moderate severity, parenteral and oral therapies appear to be effective. It does not matter to their short- or long-term outcome whether antibiotics are administered to them as inpatients or outpatients. Typical regimens include cefoxitin or cefotetan plus doxycycline, and clindamycin plus gentamicin.
|
|
Ampicillin is well-absorbed from the GI tract (though food reduces its absorption), and reaches peak concentrations in one to two hours. The bioavailability is around 62% for parenteral routes. Unlike other penicillins, which usually have bind 60–90% to plasma proteins, ampicillin binds to only 15–20%. Ampicillin is distributed through most tissues, though it is concentrated in the liver and kidneys.
|
|
In addition to its action and use as an anesthetic, etomidate has also been found to directly inhibit the enzymatic biosynthesis of steroid hormones, including corticosteroids in the adrenal gland. As the only adrenal steroidogenesis inhibitor available for intravenous or parenteral administration, it is useful in situations in which rapid control of hypercortisolism is necessary or in which oral administration is unfeasible.
|
|
Refeeding syndrome is caused by a shift in fluid and electrolytes in a malnourished person as they receive artificial refeeding. It is potentially fatal, and can occur whether receiving enteral or parenteral nutrition. The most serious and common electrolyte abnormality is hypophosphatemia, although sodium abnormalities are common as well. It can also cause changes in glucose, protein, and fat metabolism.
|
|
Larger hospitals may use automated transport systems to aid in the efficient distribution of medications. Hospital pharmacists and trained pharmacy technicians compound sterile products for patients such as total parenteral nutrition (TPN) and other medications given intravenously such as neonatal antibiotics and chemotherapy. Some hospital pharmacies may outsource high-risk preparations and some other compounding functions to companies that specialize in compounding.
|
|
Some subjective improvement may appear right away, but this is usually due to the overall benefits of alcohol detoxification. If alcohol consumption continues, vitamin supplementation alone is not enough to improve the symptoms of most individuals. Nutritional therapy with parenteral multivitamins is beneficial to implement until the person can maintain adequate nutritional intake. Treatments also include vitamin supplementation (especially thiamine).
|
|
The risk increases following resection of the small bowel. Such individuals may require oral supplements to increase their caloric intake, or in severe cases, total parenteral nutrition (TPN). Most people with moderate or severe Crohn's disease are referred to a dietitian for assistance in nutrition. The major significant complications of Crohn's disease include bowel obstruction, abscesses, free perforation, and hemorrhage, which in rare cases may be fatal.
|
|
Therefore, fructose-1-phosphate accumulates with the corresponding reduction of intracellular Pi available for phosphorylation reactions in the cell. This is why fructose is contraindicated for total parenteral nutrition (TPN) solutions and is never given intravenously as a source of carbohydrate. It has been suggested that excessive dietary intake of fructose may also result in reduced phosphorylation potential. However, this is still a contentious issue.
|
|
Anti-miR therapeutics inhibit specific microRNA targets. Animal models showed that modulating microRNAs through anti-miRs effectively regulates biological processes and provides therapeutic benefit to cardiac dysfunction, cancer and hepatitis C virus infection. Administration of anti-miR oligonucleotides is possible through local or parenteral injection. The company's lead drug candidate, RG-012, is intended as a treatment for alport syndrome in phase 2 clinical trials.
|
|
Vitamins may be added to a bulk premixed nutrient immediately before administration, since the additional vitamins can promote spoilage of stored product. Vitamins can be added in two doses, one fat-soluble, the other water-soluble. There are also single-dose preparations with both fat- and water-soluble vitamins such as Cernevit. Minerals and trace elements for parenteral nutrition are available in prepared mixtures, such as Addaven.
|
|
Following the accident, Abigail was hospitalized and received a rare triple organ transplant to replace her small intestine, liver, and pancreas, all of which were damaged in the accident. She was unable to eat or drink, and she required total parenteral nutrition. Abigail died nine months after the accident because of a transplant-related cancer. She was six years old at the time of her death.
|
|
To increase their effectiveness, vaccines should be administered as soon as possible after a dog enters a high-risk area, such as a shelter. 10 to 14 days are required for partial immunity to develop. Administration of B. bronchiseptica and canine parainfluenza vaccines may then be continued routinely, especially during outbreaks of kennel cough. There are several methods of administration, including parenteral and intranasal.
|
|
Intravenous sugar solution, also known as dextrose solution, is a mixture of dextrose (glucose) and water. It is used to treat low blood sugar or water loss without electrolyte loss. Water loss without electrolyte loss may occur in fever, hyperthyroidism, high blood calcium, or diabetes insipidus. It is also used in the treatment of high blood potassium, diabetic ketoacidosis, and as part of parenteral nutrition.
|
|
Immediately following the surgery, the patient is placed in an intensive care unit for monitoring, normally for a period of a few days. The patient is put on a ventilator to assist breathing. Nutritional needs are generally met via total parenteral nutrition, although in some cases a nasogastric tube is sufficient for feeding. Chest tubes are put in so that excess fluids may be removed.
|
|
For severe malaria, parenteral artesunate was superior to quinine in both children and adults. In another systematic review, artemisinin derivatives (artemether and arteether) were as efficacious as quinine in the treatment of cerebral malaria in children. Treatment of severe malaria involves supportive measures that are best done in a critical care unit. This includes the management of high fevers and the seizures that may result from it.
|
|
British Journal of Anaesthesia 2015; Mar;114(3):423–9 Further, Kranke´s group conducted numerous systematic reviews on interventions in conjunction with the perioperative period,P. Kranke, L. H. Eberhart, N. Roewer, M. R. Tramèr. Single-dose parenteral pharmacological interventions for the prevention of postoperative shivering – A quantitative systematic review of randomized controlled trials. Anesthesia and Analgesia 2004; 99: 718–727 amongst other, various antiemetics.
|
|
Hypouricemia is common in vegetarians due to the low purine content of most vegetarian diets. Vegetarian diet has been found to result in mean serum uric acid values as low as 239 µmol/L (2.7 mg/dL). While a vegetarian diet is typically seen as beneficial with respect to conditions such as gout, care should be taken to avoid associated health conditions. Transient hypouricemia sometimes is produced by total parenteral nutrition.
|
|
Glutamine is safe in adults and in preterm infants. Although glutamine is metabolized to glutamate and ammonia, both of which have neurological effects, their concentrations are not increased much, and no adverse neurological effects were detected. The observed safe level for supplemental L-glutamine in normal healthy adults is 14 g/day. Adverse effects of glutamine have been prescribed for people receiving home parenteral nutrition and those with liver-function abnormalities.
|
|
Congress meetings are held every year in a different European city and gather over 3,000 participants from 82 different countries.MCI (January 2010). "Book of Congress statistics" A bimonthly journal named Clinical Nutrition, which goes along with Clinical Nutrition Supplements and an electronic journal e-SPEN are the society's official publications, published by Elsevier. European Parenteral and Enteral National Societies support ESPEN in the form of block members, e.g.
|
|
Gallbladder sludge disappears after four weeks of normal oral diet. Administration of exogenous cholecystokinin (CCK) or stimulation of endogenous CCK by periodic pulse of large amounts of amino acids has been shown to help prevent sludge formation. These therapies are not routinely recommended. Such complications are suggested to be the main reason for mortality in people requiring long-term total parenteral nutrition, such as in short bowel syndrome.
|
|
Because HFM is a rare disorder, there are no studies that define its optimal treatment. Correction of the systemic folate deficiency, with the normalization of folate blood levels, is easily achieved with high doses of oral folates or much smaller doses of parenteral folate. This will rapidly correct the anemia, immune deficiency and GI signs. The challenge is to achieve adequate treatment of the neurological component of HFM.
|
|
Another form of endocarditis is healthcare-associated endocarditis when the infecting organism is believed to be transmitted in a health care setting like hospital, dialysis unit or a residential nursing home. Nosocomial endocarditis is a form of healthcare associated endocarditis in which the infective organism is acquired during a stay in a hospital and it is usually secondary to presence of intravenous catheters, total parenteral nutrition lines, pacemakers, etc.
|
|
In various other animal species, sperm can be introduced into the female's reproductive tract by various means. For example, in some species of hemiptera sperm can be introduced violently by traumatic insemination, parenteral injection through the body wall. In some species of animals, sperm finds its way through the body wall when the spermatophore is left in contact with the female's skin, such as in the onychophora (velvet worms).
|
|
Although there are clinical situations where transfusion with red blood cells is the only clinically appropriate option, clinicians look at whether alternatives are feasible. This can be due to several reasons, such as patient safety, economic burden or scarcity of blood. Guidelines recommend blood transfusions should be reserved for patients with or at risk of cardiovascular instability due to the degree of their anaemia. In these cases parenteral iron is recommended.
|
|
London: The Company Book Club. The colonial authorities also gave many vaccinations against smallpox, and injections, of which many would be made without sterilising the equipment between uses (unsafe or unsterile injections). Chitnis et al. proposed that both these parenteral risks and the prostitution associated with forced labor camps could have caused serial transmission (or serial passage) of SIV between humans (see discussion of this in the next section).
|
|
Solid lipid nanoparticles have recently materialized as a novel approach to oral and parenteral drug delivery systems. SLNs combine the advantages of lipid emulsion and polymeric nanoparticle systems while overcoming the temporal and in vivo stability issues that troubles the conventional as well as polymeric nanoparticles drug delivery approaches (Mehnert et al., 2001). It has been proposed that SLNs combine numerous advantages over the other colloidal carriers i.e.
|
|
Typical PICC line: Note the manual clamp at top. A peripherally inserted central catheter (PICC or PIC line), less commonly called a percutaneous indwelling central catheter, is a form of intravenous access that can be used for a prolonged period of time (e.g., for long chemotherapy regimens, extended antibiotic therapy, or total parenteral nutrition) or for administration of substances that should not be done peripherally (e.g., antihypotensive agents a.k.a. pressors).
|
|
Antibiotics may be administered to prevent infection if there is a delay in treatment, if the wound is deep, or if there is a large amount of foreign material in the wound. Pain may be treated with local anesthetic in and around the wound, a regional nerve blockade, or parenteral opiates such as intramuscular pethidine. Local anesthetic may bring almost instant relief for several hours. Vinegar and papain are ineffective.
|
|
Women not responding to IV rehydration and medication may require nutritional support. Patients might receive parenteral nutrition (intravenous feeding via a PICC line) or enteral nutrition (via a nasogastric tube or a nasojejunal tube). There is only limited evidence from trials to support the use of vitamin B6 to improve outcome. An oversupply of nutrition (hyperalimentation) may be necessary in certain cases to help maintain volume requirements and allow weight gain.
|
|
Venous access is any method used to access the bloodstream through the veins, either to administer intravenous therapy (e.g. medication, fluid), parenteral nutrition, to obtain blood for analysis, or to provide an access point for blood-based treatments such as dialysis or apheresis. Access is most commonly achieved via the Seldinger technique, and guidance tools such as ultrasound and fluoroscopy can also be used to assist with visualizing access placement.
|
|
They may be administered orally or, in some cases, through long-acting (depot) injections administered in the dorsgluteal, ventrogluteal or deltoid muscle. Short-acting parenteral formulations also exist, which are generally reserved for emergencies or when oral administration is otherwise impossible. The oral formulations include immediate release, extended release, and orally disintegrating products (which are not sublingual, and can help ensure that medications are swallowed instead of "cheeked"). Sublingual products (e.g.
|
|
Autoimmune enteropathy (AIE) is a rare disorder of the immune system condition that affects infants, young children and (rarely) adults causing severe diarrhea, vomiting, and other morbidities of the digestive tract. AIE causes malabsorption of food, vitamins, and minerals often necessitating replacement fluids and total parenteral nutrition. Some disorders, such as IPEX Syndrome, include autoimmune enteropathy as well as autoimmune "pathies" of the skin, thyroid, other glands, or kidneys.
|
|
Levels of hemoglobin are lower in the third trimesters. According to the United Nations (UN) estimates, approximately half of pregnant individuals suffer from anemia worldwide. Anemia prevalences during pregnancy differed from 18% in developed countries to 75% in South Asia. Treatment varies due to the severity of the anaemia, and can be used by increasing iron containing foods, oral iron tablets or by the use of parenteral iron.
|
|
The virus spreads by the fecal–oral route, and infections often occur in conditions of poor sanitation and overcrowding. Hepatitis A can be transmitted by the parenteral route, but very rarely by blood and blood products. Food-borne outbreaks are common, and ingestion of shellfish cultivated in polluted water is associated with a high risk of infection. About 40% of all acute viral hepatitis is caused by HAV.
|
|
In cases which do not require parenteral nutrition an elemental diet and supplemental feeding is required. The majority of SKIV2L pathogenic variant harbouring patients are small at birth (<10th centile) and remain growth restricted despite increased nutrition. Hair abnormalities are seen in >90% of patients and are described as woolly, brittle hair that is easily removed. Facial dysmorphisms are found in most patients and become more apparent with age.
|
|
The insulin present in the brain acts on the central nervous system by crossing the blood-brain barrier and affecting the sympathetic nervous system. Thereby, helping to initiate a response to hypoglycemia through the sympathoadrenal system. Individuals with hypoglycemia should self- monitor their blood glucose level and can take glucose in the forms of tablets or foods high in glucose. Parenteral therapy may be necessary for severe hypoglycemia.
|
|
Amoxicillin/clavulanic acid is the International Nonproprietary Name (INN) and co-amoxiclav is the British Approved Name (BAN). Many branded products indicate their strengths as the quantity of amoxicillin. Augmentin 250, for example, contains 250 mg of amoxicillin and 125 mg of clavulanic acid. An intravenous preparation has been available in the UK since 1985, but no parenteral preparation is available in the US; the nearest equivalent is ampicillin/sulbactam.
|
|
One study established that dialysis changes protein metabolism in such a way as to stimulate protein degradation in muscle and other tissues.Ikizler, TA, Pupim, LB, Brouillette, JR, Levenhagen, DK, Farmer, K, Hakim, RM, Flakoll, PJ. Hemodialysis stimulates muscle and whole body protein loss and alters substrate oxidation. Am J Physiol Endocrinol Metab, 282(1), E107-16, 2002 Work by Ikizler's team showed that dialysis-stimulated proteolysis is partly induced by inflammation;Caglar, K, Peng, Y, Pupim, LB, Flakoll, PJ, Levenhagen, D, Hakim, RM, Ikizler, TA. Inflammatory signals associated with hemodialysis. Kidney Int, 62(4), 1408-16, 2002 and that parenteral nutrition during dialysis,Pupim, LB, Flakoll, PJ, Brouillette, JR, Levenhagen, DK, Hakim, RM, Ikizler, TA. Intradialytic parenteral nutrition improves protein and energy homeostasis in chronic hemodialysis patients. J Clin Invest, 110(4), 483-92, 2002 as well as exercise during dialysis,Pupim, Lara B, Flakoll, Paul J, Levenhagen, Deanna K, Ikizler, T Alp.
|
|
Although parenteral estradiol has diminished effects on liver protein synthesis and by extension coagulation and cardiovascular risk compared to oral estradiol and non-bioidentical estrogens, a property attributable to its absence of disproportionate effects on the liver, sufficient doses of parenteral estradiol can nonetheless result in high estradiol concentrations in the liver and may increase coagulation and cardiovascular risk similarly. Estradiol valerate at a dose of 10 to 40 mg by intramuscular injection once every 2 weeks in men with prostate cancer has been found to increase markers of coagulation and plasminogen system activation such as levels of thrombin–antithrombin complex and quantitative D-dimers. Administration of daily prophylactic anticoagulation in the form of low molecular-weight heparin was able to successfully return these hemostasis markers to baseline. Doses of estradiol valerate of 10 to 40 mg by intramuscular injection have also been used to limit bleeding in women with hemorrhage due to dysfunctional uterine bleeding, although this is due primarily to stimulation of uterine growth.
|
|
Factors such as hemodynamic stability, severe IUGR, respiratory, abdominal exam, whether feeding cues are present, and stable glucose could all effect the timing of nutrition. Some preterm infants will be NPO (nil per os). If infants are unable to start oral or enteral intake intravenous fluids may begin with amino acids or total parenteral nutrition. According to the American Academy of Pediatrics section on breastfeeding recommendations are all infants should receive human milk.
|
|
The objective for the administration of an erythropoiesis-stimulating agent (ESA) is to maintain hemoglobin at the lowest level that both minimizes transfusions and meets the individual person's needs. They should not be used for mild or moderate anemia. They are not recommended in people with chronic kidney disease unless hemoglobin levels are less than 10 g/dL or they have symptoms of anemia. Their use should be along with parenteral iron.
|
|
Neonatal dietitians provide individualized medical nutrition therapy for critically ill premature newborns. They are considered a part of the Neonatal Intensive Care Unit's medical team. The neonatal dietitian performs clinical assessment of patients, designs nutrition protocols and quality improvement initiatives with the medical team, develops enteral and parenteral regimens, helps establish and promote lactation/breastfeeding guidelines and often oversees the management of infection prevention in the handling, storage, and delivery of nutritional products.
|
|
This effect can be particularly worrisome when multiple doses accumulate over the course of a treatment or when the kidney concentrates urine by increasing tubular reabsorption during sleep. Adequate hydration may help prevent excess nephrotoxicity and subsequent loss of renal function. For these reasons parenteral tobramycin needs to be carefully dosed by body weight, and its serum concentration monitored. Tobramycin is thus said to be a drug with a narrow therapeutic index.
|
|
Palliative surgery may result in short bowel syndrome, enterocutaneous fistula, or re-obstruction; or may not be possible due to the extent of obstruction. Other treatments of complications can include total parenteral nutrition, a low-residue diet, palliative gastrostomy, and adequate pain control. Bowel obstruction can also be treated with octreotide when palliative surgery is not an option. Cancer can also block the ureters, which can be relieved by a nephrostomy or a ureteric stent.
|
|
J Parenteral and Enteral Nutrition (1989) 13: 382-386 The study found that whey protein hydrolysate led to better nitrogen retention and growth than the other proteins studied. However the study's flaw is in the BV method used, as starvation affects how well the body will store incoming protein (as does a very high caloric intake), leading to falsely elevated BV measures.Pellett, PL and Young, VR. Nutritional evaluation of protein foods. United Nations University, 1980.
|
|
See FDA index page for NDA 203565 for updates and further information. Iron Isomaltoside 1000 (Trade name Monofer) is a newer formulation of parenteral iron that has a matrix structure that results in very low levels of free iron and labile iron. It can be given at high doses – 20 mg/kg in a single visit – no upper dose limit. This formulation has the benefit of giving a full iron correction in a single visit.
|
|
Follow-up is needed to ensure compliance and to detect adequate response to therapy. The interval of follow up can widely depend on both the method of administration, and the underlying pathology. For parenteral irons it is recommended that there be a period of 4 weeks before repeating blood test to allow the body to utilise the iron. For oral iron, this can take considerably longer, so waiting three months may be appropriate.
|
|
Chromium(III) picolinate (CrPic3) is a chemical compound sold as a nutritional supplement to treat type 2 diabetes and promote weight loss. This bright-red coordination compound is derived from chromium(III) and picolinic acid. Large quantities of chromium are needed for glucose utilization by insulin in normal health, but deficiency is extremely common and has been observed in people receiving 100% of their nutrient needs intravenously, i.e., total parenteral nutrition diets.
|
|
Steiger's Hyperalimentation Team worked closely to provide supplies at home for their parenteral therapy patients. Satellite offices were subsequently opened in Atlanta, Philadelphia, Houston, Chicago, and Irvine. HHCA changed its name to Caremark in 1985. In 1987, Caremark was acquired by Baxter International. In 1991, when Caremark was Baxter International's home infusion subsidiary, Caremark was accused by the United States government of "paying doctors to steer patients to its intravenous drug service".
|
|
Additional risk factors for developing CIP/CIM include: female gender, high blood sugar (hyperglycemia), low serum albumin, and immobility. A greater severity of illness increases the risk of CIP/CIM. Such risk factors include: multi-organ dysfunction, kidney failure, renal replacement therapy, duration of organ dysfunction, duration of ICU stay, and central neurologic failure. Certain medications are associated with CIP/CIM, such as corticosteroids, neuromuscular blocking agents, vasopressors, catecholamines, and intravenous nutrition (parenteral nutrition).
|
|
Intramuscular injection, often abbreviated IM, is the injection of a substance into a muscle. In medicine, it is one of several methods for parenteral administration of medications. Intramuscular injection may be preferred because muscles have larger and more numerous blood vessels than subcutaneous tissue, leading to faster absorption than subcutaneous or intradermal injections. Medication administered via intramuscular injection also is not subject to the first-pass metabolism effect which affects oral medications.
|
|
He has published on various diseases, including melioidosis, Outpatient Parenteral Antibiotic Therapy (OPAT), Severe Acute Respiratory Disease (SARS), infection control in hospital settings especially as it relates to multi-drug-resistant pathogens and most recently COVID-19. During the 2019-2020 coronavirus pandemic, which began in China, Fisher was part of the World Health Organization’s team that visited China to understand about the virus, and to guide the global response to the pandemic.
|
|
By catalyzing the hydrolysis of hyaluronan, a constituent of the extracellular matrix (ECM), hyaluronidase lowers the viscosity of hyaluronan, thereby increasing tissue permeability. It is, therefore, used in medicine in conjunction with other drugs to speed their dispersion and delivery. Common applications are ophthalmic surgery, in combination with local anesthetics. It also increases the absorption rate of parenteral fluids given by hypodermoclysis, and is an adjunct in subcutaneous urography for improving resorption of radiopaque agents.
|
|
Initially, thrombelastography was simply performed with whole blood without adding reagents (except calcium when citrate anticoagulated blood was used). This provides a global overview about all phases of clot formation, stabilization and degradation. In the case of monocausal haemostasis disorders, the resulting reaction curves may be quite typical; however, under most clinical conditions this approach has severe limitations. In reality various effects overlap, including haemodilution or application of high doses of parenteral anticoagulants.
|
|
Chromium supplementation in general is subject to a certain amount of controversy as it is by no means clear that chromium is an essential element in human biology. Nevertheless, chromium is an ingredient in total parenteral nutrition, along with other trace minerals. It is also in nutritional products for preterm infants. Many chromium-containing products, including chromium chloride, chromium citrate, chromium(III) picolinate, chromium(III) polynicotinate are sold as non-prescription dietary supplements.
|
|
Potassium canrenoate (INN, JAN) or canrenoate potassium (USAN) (brand names Venactone, Soldactone), also known as aldadiene kalium, the potassium salt of canrenoic acid, is an aldosterone antagonist of the spirolactone group. Like spironolactone, it is a prodrug, and is metabolized to active canrenone in the body. Potassium canrenoate is notable in that it is the only clinically used antimineralocorticoid which is available for parenteral administration (specifically intravenous) as opposed to oral administration.
|
|
In China, she taught the methodology of conducting human metabolic studies. Kies recruited several Chinese students to pursue their education in the United States. Kies was a member of the American Institute of Nutrition, the American Dietetic Association, the Institute of Food Technologists, the American Oil Chemists' Society, the American Society for Parenteral and Enteral Nutrition, and the Society for Nutrition Education. She was a certified home economist and a registered dietitian.
|
|
It can occur in patients with severely compromised intestinal function, those undergoing total parenteral nutrition, those who have had gastrointestinal bypass surgery, and also in persons of advanced age (i.e., over 90). People dependent on food grown from selenium-deficient soil may be at risk for deficiency. Increased risk for developing various diseases has also been noted, even when certain individuals lack optimal amounts of selenium, but not enough to be classified as deficient.
|
|
Moderate to severe attacks should be treated first with an oral triptan, a medication that mimics serotonin (an agonist) and causes mild vasoconstriction. If accompanied by nausea and vomiting, parenteral (through a needle in the skin) triptans and antiemetics can be given. Sphenopalatine ganglion block (SPG block, also known nasal ganglion block or pterygopalatine ganglion blocks) can abort and prevent migraines, tension headaches and cluster headaches. It was originally described by American ENT surgeon Greenfield Sluder in 1908.
|
|
Inflamm Bowel Dis Volume 13, Number 12, December 2007 Adequate disease control usually improves anemia of chronic disease, but iron deficiency may require treatment with iron supplements. Guidelines vary as to how iron should be administered. Besides other, problems include a limitation in possible daily resorption and an increased growth of intestinal bacteria. Some advise parenteral iron as first line as it works faster, has fewer gastrointestinal side effects, and is unaffected by inflammation reducing enteral absorption.
|
|
Initial empiric therapy for CSF shunt infection should include broad coverage that includes gram-negative aerobic bacilli including pseudomonas and gram- positive organisms including Staph aureus and coagulase negative staphylococcus, such as a combination of ceftazidime and vancomycin. Some clinicians add either parenteral or intrathecal aminoglycosides to provide enhanced pseudomonas coverage, although the efficacy of this is not clear at this time. Meropenem and aztreonam are additional options that are effective against gram-negative bacterial infections.
|
|
Chromium is an ingredient in total parenteral nutrition (TPN) because deficiency can occur after months of intravenous feeding with chromium-free TPN. For this reason, chromium is added to TPN solutions, along with other trace minerals. It is also in nutritional products for preterm infants. Although the mechanism in biological roles for chromium is unclear, in the United States chromium-containing products are sold as non-prescription dietary supplements in amounts ranging from 50 to 1,000 μg.
|
|
Carpenter told Levenkron that she felt dizzy and that her heart was beating irregularly. Finally, in September 1982, she was admitted to Lenox Hill Hospital in New York, where she was placed on intravenous parenteral nutrition. The procedure was successful, and she gained some weight in a relatively short time, but this put a strain on her heart, which was already weak from years of improper diet. She maintained a relatively stable weight for the rest of her life.
|
|
Here, he built up an active research group in drug delivery systems. Davis took the position of Lord Trent Professor of Pharmacy at the University of Nottingham in 1975, where he ran a large research group, studying novel drug delivery systems. Topics of research have included drug targeting (with particular emphasis on colloidal carriers), transmucosal delivery, oral and parenteral systems for controlled release and product evaluation through gamma scintigraphy. He became an emeritus professor in 2003.
|
|
Hypersensitivity is thought to occur to the individual components of TPN, with the intravenous lipid emulsion being the most frequently implicated component, followed by the multivitamin solution and the amino acid solution. Medications Patients who are receiving intravenous parenteral nutrition may also need to receive intravenous medications as well using the same Y-site. It is important to assess the compatibility of the medications with the nutrition components. Incompatibilities can be observed physically through discoloration, phase separation, or precipitation.
|
|
About 50 percent of them are imported from India. The Pakistan Pharmaceutical Industry meets around 90% of the country's demand of finished dosage forms and 4% of Active ingredients. Specialized finished dosage forms such as soft gelatin capsules, parenteral fat emulsions and Metered-dose inhalers continue to be imported. There are only a few bulk drug Active ingredient producers and Pakistan mainly depends on imports of bulk drugs for its formulation needs resulting in frequent drug shortages.
|
|
A narcotic antagonist such as naloxone is indicated to reverse respiratory depression and other effects of pethidine. Serotonin syndrome has occurred in patients receiving concurrent antidepressant therapy with selective serotonin reuptake inhibitors (SSRIs) or monoamine oxidase inhibitors, or other medication types (see Interactions below). Convulsive seizures sometimes observed in patients receiving parenteral pethidine on a chronic basis have been attributed to accumulation in plasma of the metabolite norpethidine (normeperidine). Fatalities have occurred following either oral or intravenous pethidine overdose.
|
|
Almost exclusively used by anesthesia providers during portions of a case where quick, fast acting (though not long lasting) pain control is needed (i.e. during a nerve block, head pinning etc..) Alfentanil is administered by the parenteral (injected) route for fast onset of effects and precise control of dosage. Alfentanil is a restricted drug which is classified as Schedule II in the US, according to the U.S. DEA website. Alfentanil was discovered at Janssen Pharmaceutica in 1976.
|
|
Kremsner led numerous studies on tropical infectious diseases and is author of more than 600 scientific publications. Since 20 years he is one of the most cited scientists in the field of parasitology and malaria in Europe and worldwide. He has been principal investigator on key studies for the development of atovaquone/proguanil, artesunate/amodiaquine, artesunate/pyronaridine and parenteral artesunate for malaria therapy and prophylaxis. Kremsner and his team developed a simplified method for assessment of severity of malaria.
|
|
Administering a 5% sugar solution peri- and postoperatively usually achieves a good balance between starvation reactions and hyperglycemia caused by sympathetic activation. A 10% solution may be more appropriate when the stress response from the reaction has decreased, after approximately one day after surgery. After more than approximately two days, a more complete regimen of total parenteral nutrition is indicated. In patients with hypernatremia and euvolemia, free water can be replaced using either 5% D/W or 0.45% saline.
|
|
The ideal treatment for anemia of chronic disease is to treat the chronic disease successfully, but this is rarely possible. Parenteral iron is increasingly used for anemia in chronic renal disease and inflammatory bowel disease. Erythropoietin can be helpful, but this is costly and may be dangerous.Anemia of chronic disease at Mount Sinai Hospital Erythropoietin is advised either in conjunction with adequate iron replacement which in practice is intravenous, or when IV iron has proved ineffective.
|
|
When an unconscious person is being fed intravenously (for example, total parenteral nutrition) or via a nasogastric tube, the fluids given must be carefully balanced in composition to match fluids and electrolytes lost. These fluids are typically hypertonic, and so water is often co-administered. If the electrolytes are not monitored (even in an ambulatory patient), either hypernatremia or hyponatremia may result. Some neurological/psychiatric medications (Oxcarbazepine, among others) have been found to cause hyponatremia in some patients.
|
|
The majority of immunocompetent individuals clear GBV-C viraemia, but in some individuals, infection persists for decades. However, the time interval between GBV-C infection and clearance of viraemia (detection of GBV-C RNA in plasma) is not known. About 2% of healthy US blood donors are viraemic with GBV-C, and up to 13% of blood donors have antibodies to E2 protein, indicating possible prior infection. Parenteral, sexual, and vertical transmissions of GBV-C have been documented.
|
|
GBV-C infection has been found worldwide and currently infects around a sixth of the world's population. High prevalence is observed among subjects with the risk of parenteral exposures, including those with exposure to blood and blood products, those on hemodialysis, and intravenous drug users. Sexual contact and vertical transmission may occur. About 10–25% of hepatitis C-infected patients and 14–36% of drug users who are seropositive for HIV-1 show the evidence of GBV-C infection.
|
|
As described above, macrophages play a key role in removing dying or dead cells and cellular debris. Erythrocytes have a lifespan on average of 120 days and so are constantly being destroyed by macrophages in the spleen and liver. Macrophages will also engulf macromolecules, and so play a key role in the pharmacokinetics of parenteral irons. The iron that is released from the haemoglobin is either stored internally in ferritin or is released into the circulation via ferroportin.
|
|
However, oral progesterone has very low bioavailability, and produces relatively weak progestogenic effects even at high doses. In accordance, and in contrast to progestins, oral progesterone has no antigonadotropic effects in men even at high doses. Progesterone can also be taken by various parenteral (non-oral) routes, including sublingually, rectally, and by intramuscular or subcutaneous injection. These routes do not have the bioavailability and efficacy issues of oral progesterone, and accordingly, can produce considerable antigonadotropic and other progestogenic effects.
|
|
Obesity increases the risk of VTE as well. Increased risk of VTE with estrogens is thought to be due to their influence on liver protein synthesis, specifically on the production of coagulation factors. Non- bioidentical estrogens such as conjugated estrogens and especially ethinylestradiol have markedly disproportionate effects on liver protein synthesis relative to estradiol. In addition, oral estradiol has a 4- to 5-fold increased impact on liver protein synthesis than does transdermal estradiol and other parenteral estradiol routes.
|
|
The vancomycin regimen has replaced the traditional use of metronidazole due to its greater efficacy, safety profile, and lower recurrence rates. In patients who cannot tolerate vancomycin, fidaxomicin is an acceptable option with similar efficacy and even lower recurrence rates than vancomycin. In cases of fulminant CDI, adjuvant therapy with parenteral metronizadole plus oral vancomycin or fidaxomicin is suggested. About 20% of patients who successfully complete therapy of primary infection with metronidazole or vancomycin will experience a relapse.
|
|
Some people develop a hypersensitivity to products and foods containing iodine. Applications of tincture of iodine or Betadine can cause rashes, sometimes severe.DermNet New Zealand Trust, Iodine Parenteral use of iodine-based contrast agents (see above) can cause reactions ranging from a mild rash to fatal anaphylaxis. Such reactions have led to the misconception (widely held, even among physicians) that some people are allergic to iodine itself; even allergies to iodine-rich seafood have been so construed.
|
|
These included decreased levels of total cholesterol, triglycerides, and high- density lipoprotein (HDL) cholesterol, and increased levels of low-density lipoprotein (LDL) cholesterol. However, the changes were small in magnitude, and the long-term significance in relation to cardiovascular outcomes is uncertain. The changes were more pronounced with oral testosterone undecanoate than with parenteral routes, such as transdermal testosterone. Testosterone showed no significant effect on depressed mood anxiety, bone mineral density (BMD), or anthropomorphic measures like body weight or body mass index.
|
|
Copper deficiency myelopathy in humans was discovered and first described by Schleper and Stuerenburg in 2001. They described a patient with a history of gastrectomy and partial colonic resection who presented with severe tetraparesis and painful paraesthesias and who was found on imaging to have dorsomedial cervical cord T2 hyperintensity. Upon further analysis, it was found that the patient had decreased levels of serum coeruloplasmin, serum copper, and CSF copper. The patient was treated with parenteral copper and the patient's paraesthesias did resolve.
|
|
A number of persons have developed toxicity due to acute overdosage with nifedipine, either accidentally or intentionally, and via either oral or parenteral administration. The adverse effects include lethargy, bradycardia, marked hypotension and loss of consciousness. The drug may be quantified in blood or plasma to confirm a diagnosis of poisoning, or to assist in a medicolegal investigation following death. Analytical methods usually involve gas or liquid chromatography and specimen concentrations are usually in the 100-1000 μg/L range.
|
|
For patients with central nervous system involvement, parenteral therapy with ceftriaxone 2 g/day for 10–14 days is preferred. All patients treated with antibiotics should be observed during the first 4 hours of treatment for a Jarisch-Herxheimer reaction, which is a worsening of symptoms characterized by rigors, hypotension, and high fever. The reaction occurs in over 50% of cases and may be difficult to distinguish from a febrile crisis. Given appropriate treatment, most patients recover within a few days.
|
|
The oil mentioned in the Ayurvedic texts was determined to be from the tree Hydnocarpus wightiana, known as Tuvakara in Sanskrit and chaulmugra in Hindi and Persian. The first parenteral administration was given by the Egyptian doctor Tortoulis Bey, personal physician to the Sultan Hussein Kamel of Egypt. He had been using subcutaneous injections of creosote for tuberculosis. In 1894 he administered subcutaneous injection of chaulmoogra oil to a 36-year- old Egyptian Copt who had been unable to tolerate oral treatment.
|
|
Total parenteral nutrition increases the risk of acute cholecystitis due to complete disuse of the gastrointestinal tract, which may result in bile stasis in the gallbladder. Other potential hepatobiliary dysfunctions include steatosis, steatohepatitis, cholestasis, and cholelithiasis. Six percent of patients on TPN longer than three weeks and 100% of patients on TPN longer than 13 weeks develop biliary sludge. The formation of sludge is the result of stasis due to lack of enteric stimulation and is not due to changes in bile composition.
|
|
It is essential that the folate dose is sufficiently high to achieve CSF folate levels as close as possible to the normal range for the age of the child. This requires close monitoring of the CSF folate level. The physiological folate is 5-methyltetrahydrofolate but the oral formulation available is insufficient for treatment of this disorder and a parenteral form is not available. The optimal folate at this time is 5-formyltetrahydrofolate which, after administration, is converted to 5-methyltetrahydrofolate.
|
|
Artesunate is preferred over parenteral quinine for severe malaria treatment. Artesunate was shown to prevent more deaths from severe malaria than quinine in two large multicentre randomized controlled trials from Africa and Asia. A subsequent systematic review of seven randomized controlled trials found this improvement in survival rates to be consistent across all trials. Artesunate's efficacy is comparable to that of artemether, another artemisinin derivative, in treating adults for severe malaria caused by Plasmodium falciparum, though artesunate clears more parasites initially.
|
|
Non-operative therapy uses escharotic ointments. This is used for infants with large omphaloceles that have been born prematurely with respiratory insufficiency and associated chromosomal defects, as they would not be able to tolerate surgery. The ointment causes the sac to granulate and epithelialize, which leaves a residual large ventral hernia, which can be repaired later with surgery when the baby is more stable. After surgery, for larger omphaloceles, mechanical ventilation and parenteral nutrition is needed to manage the baby.
|
|
Cladribine is used for as a first and second-line treatment for symptomatic hairy cell leukemia and for B-cell chronic lymphocytic leukemia and is administered by intravenous or subcutaneous infusion. Since 2017, cladribine is approved as an oral formulation (10 mg tablet) for the treatment of RRMS in Europe, UAE, Argentina, Chile, Canada and Australia. Marketing authorization for RRMS and SPMS in the US was obtained in March 2019. Some investigators have used the parenteral formulation orally to treat patients with HCL.
|
|
The advisory caution to use blood transfusion only with more severe anemia is in part due to evidence that outcomes are worsened if larger amounts are given. One may consider transfusion for people with symptoms of cardiovascular disease such as chest pain or shortness of breath. In cases where patients have low levels of hemoglobin due to iron deficiency, but are cardiovascularly stable, parenteral iron is a preferred option based on both efficacy and safety. Other blood products are given where appropriate, e.g.
|
|
These small sponges travel throughout the body until they reach the targeted site where they bind to the surface and perform controlled drug release. Nanosponge technology is widely explored for its use in drug delivery using oral, parenteral, and topical administration techniques.This may include substances such as antineoplastic agents, proteins and peptides, volatile oils, and genetic materials. These small sponges travel throughout the body until they reach the targeted site where they bind to the surface and perform controlled drug release.
|
|
Identical drugs can produce different results depending on the route of administration. For example, some drugs are not significantly absorbed into the bloodstream from the gastrointestinal tract and their action after enteral administration is therefore different from that after parenteral administration. This can be illustrated by the action of naloxone (Narcan), an antagonist of opiates such as morphine. Naloxone counteracts opiate action in the central nervous system when given intravenously and is therefore used in the treatment of opiate overdose.
|
|
They are utilized in both the hospital and community settings. They are commonly used in people receiving total parenteral nutrition (TPN), chemotherapy, or long term medications such as antibiotics. They may also be used to obtain a blood sample if the lumen is of sufficient size (at least 4 French gauge). To help prevent the line from becoming clogged, the line should be regularly flushed with normal saline, and "locked" by filling it with Heparin or normal saline when not in use.
|
|
UBA and Fidelity Banks on Zik Avenue, Awka In recent years, several new businesses have erected new buildings that have largely changed the face of Awka city. The partly state-owned Orient Petroleum Resources Ltd has the headquarters in Awka. The company is poised to set up a refinery at Igbariam to jump-start the exploitation of the huge crude oil deposits in the Anambra River basin. Also Juhel Nigeria has constructed a manufacturing plant for Parenteral drugs in the city.
|
|
Treatment consists primarily of supportive care including providing bowel rest by stopping enteral feeds, gastric decompression with intermittent suction, fluid repletion to correct electrolyte abnormalities and third-space losses, support for blood pressure, parenteral nutrition, and prompt antibiotic therapy. Monitoring is clinical, although serial supine and left lateral decubitus abdominal X-rays should be performed every six hours. As an infant recovers from NEC, feeds are gradually introduced. "Trophic feeds" or low- volume feeds (<20 ml/kg/day) are usually initiated first.
|
|
On chest X-ray and CT, pulmonary aspergillosis classically manifests as a halo sign, and later, an air crescent sign. In hematologic patients with invasive aspergillosis, the galactomannan test can make the diagnosis in a noninvasive way. False-positive Aspergillus galactomannan tests have been found in patients on intravenous treatment with some antibiotics or fluids containing gluconate or citric acid such as some transfusion platelets, parenteral nutrition, or PlasmaLyte. On microscopy, Aspergillus species are reliably demonstrated by silver stains, e.g.
|
|
It is nearly always fatal unless, like short bowel syndrome patients, treated with parenteral nutrition or an intestinal transplant. The patient is often classified as being in "intestinal failure" and treated with the cohort of patients known as "short bowel syndrome" patients. One patient from the UK was documented as achieving nutritional independence at age 3.On 26 June 2009, a six-year-old girl with microvillus inclusion disease became the third person in the UK to die of swine flu.
|
|
Egg lecithin is usually extracted chemically using ethanol, acetone, petroleum ether but not benzene or hexane due to restrictions on residual solvents by the pharmaceutical regulations.ICH Topic Q3C (R4) Impurities: Guideline for Residual Solvents It is an emulsifier, especially for parenteral use since it does not need to be metabolized. In aqueous solution, its phospholipids can form either liposomes, bilayer sheets, micelles, or lamellar structures, depending on hydration and temperature. This results in a type of surfactant that is usually classified as amphipathic.
|
|
Cephalosporins remain the preferred drugs for perioperative prophylaxis due to their low toxicity. Parenteral systemic antibiotics seem to be more appropriate than oral or topical antibiotics because the chosen antibiotics must reach high concentrations at all sites of danger. It is well recognized that broad- spectrum antibiotics are more likely to prevent gram-negative sepsis. New data demonstrate that third generation cephalosporins are more effective than first and second generation cephalosporins if all perioperative infectious complications are taken into consideration.
|
|
4-Amino-2-methyl-1-naphthol HCl salt is a vitamin K and prevents bleeding caused by vitamin K deficiency when given via intravenous or intramuscular injections at doses of about 1–3 mg. HCl salt is water-soluble and its parenteral administration requires no emulsifiers unlike fat-soluble phylloquinone for example, which is often in formulations with lecithin or glycocholic acid. Parenterally given 1 mg/ml aqueous solutions and orally taken 4 mg tablets of the HCl salt have been available commercially.
|
|
In 1978 the Food and Drug Administration required zinc to be in total parenteral nutrition fluids. In the 1990s there was increasing attention on the role of zinc deficiency in childhood morbidity and mortality in developing countries. In 2002 the zinc transporter protein ZIP4 was first identified as the mechanism for absorption of zinc in the gut across the basolateral membrane of the enterocyte. By 2014 over 300 zinc containing enzymes have been identified, as well as over 1000 zinc containing transcription factors.
|
|
FVRCP vaccines have also come under scrutiny of late due to possible risks to long term health. A study at Colorado State University noted an association between vaccination with parenteral (injectable) FVRCP vaccinations and development of antibodies against feline kidney tissue. Antibody development is hypothesized to develop when the immune system reacts to protein contaminants from the cell line used to cultivate vaccinial viruses. The cell line in question, the Crandell-Rees Feline Kidney (CRFK) cell line, was derived from a cat kidney.
|
|
For a modern society, convenient and fast drug administration is the key to a good drug compliance. In 2008 the first direct Xa inhibitor was approved for clinical use. Direct Xa inhibitors are just as efficacious as LMWH and warfarin but they are given orally and don't need as strict monitoring. Other Xa inhibitors advantages are rapid onset/offset, few drug interactions and predictable pharmacokinetics. The rapid onset/offset effect greatly reduces the need for “bridging” with parenteral anticoagulants after surgeries.
|
|
The standard treatment of childhood malnutrition is administered in two phases. Phase one usually deals with children who are severely malnourished and very ill as a result. The therapy used in this phase is F-75, a milk-based liquid food containing modest amounts of energy and protein (75 kcal/100 mL and 0.9 g protein/100 mL) and the administration of parenteral antibiotics. When an improvement in the child's appetite and clinical condition is observed, the child is entered into phase two of the treatment.
|
|
In cases where oral iron has either proven ineffective, would be too slow (for example, pre-operatively) or where absorption is impeded (for example in cases of inflammation), parenteral iron can be used. The body can absorb up to 6 mg iron daily from the gastrointestinal tract. In many cases the patient has a deficit of over 1,000 mg of iron which would require several months to replace. This can be given concurrently with erythropoietin to ensure sufficient iron for increased rates of erythropoiesis.
|
|
Blood pressure, pulse, respiratory rate, and Glasgow Coma Scale are monitored frequently. Once the diagnosis is confirmed, admission to an intensive care unit may be preferable, especially since 15 percent may have further bleeding soon after admission. Nutrition is an early priority, mouth or nasogastric tube feeding being preferable over parenteral routes. In general, pain control is restricted to less-sedating agents such as codeine, as sedation may impact on the mental status and thus interfere with the ability to monitor the level of consciousness.
|
|
Saltman's research focused on the chemistry, biochemistry and nutritional role of trace metals such as iron, copper, zinc and manganese. His approach to nutrition made the point that it is an exact science, and can be accurately measured and tested. He often clearly differentiated between the concept of eating food, about which he noted: "food is not in itself a science, it is a sensual experience required for survival", and nutrition. Nutritional requirements, he maintained, could in theory be provided with total parenteral nutrition.
|
|
There are physical, physiological, or mental differences in the geriatric population that could potentially lead to poor nutrient intake that would require them to have nutrition therapy. Geriatric patients are more inclined to have delayed muscle restoration compared to the younger population. Additionally, older patients are observed to have greater cardiac and renal impairment, insulin resistance, and to have deficiencies in vitamins and crucial elements. Patients that require nutrition therapy but have contraindications for or cannot tolerate enteral nutrition are appropriate candidates for parenteral nutrition.
|
|
Individual nutrient components may be added to more precisely adjust the body contents of it. That individual nutrient may, if possible, be infused individually, or it may be injected into a bag of nutrient solution or intravenous fluids (volume expander solution) that is given to the patient. Administration of individual components may be more hazardous than administration of pre-mixed solutions such as those used in total parenteral nutrition, because the latter are generally already balanced in regard to e.g. osmolarity and ability to infuse peripherally.
|
|
Along with hydroxyprogesterone acetate, OHPC was developed by Karl Junkmann of Schering AG in 1953 and was first reported by him in the medical literature in 1954. It was reportedly first marketed in Japan in 1954 or 1955, and was subsequently introduced as Delalutin in the United States in 1956. Due to its much longer duration than parenteral progesterone, OHPC had largely replaced progesterone in clinical practice by 1975. After decades of use, Squibb, the manufacturer, voluntarily withdrew the Delalutin product in the United States in 1999.
|
|
Medications to relieve nausea and vomiting or to enhance mobility may be helpful, as may cholinesterase inhibitors. Immunotherapy and plasma exchange have also been reportedly effective. Pyridostigmine is a pharmaceutical treatment option for patients with AGID. In severe cases patients with AGID are required to abandon eating foods, requiring them to get nourishment through a process called parenteral nutrition, where the patient is fed via a permanent IV and the liquid nourishment is infused directly in the blood stream, as opposed to a feeding tube.
|
|
A commonly used therapy in recent times has been based on oral, parenteral, topical, or spot topical (as in veterinary flea repellant "drops") administration of avermectins. They show activity against a broad range of nematodes and arthropod parasites of domestic animals at dose rates of 300 μg/kg or less (200 μg/kg ivermectin appearing to be the common interspecies standard, from humans to horses to house pets, unless otherwise indicated). Unlike the macrolide or polyene antibiotics, they lack significant antibacterial or antifungal activities.
|
|
S.) Society and dozens of other national institutions for disability advocacy. From the entertainment community, the book was endorsed by musician George Shearing, and actor Raymond Burr. The foreword was written by singer Mel Tillis. Maloff is also the author of a graduate level textbook entitled Computers in Nutrition that has been referenced in the Journal of Parenteral & Enteral Nutrition, and a seminal article on computer music composition and performance, The Fourth B, published in SIGART, a publication for the Association for Computing Machinery (Issue 54).
|
|
Lipid nanoparticles can be manufactured by high pressure homogenization, a current method used to produce parenteral emulsions. This process can ultimately form a uniform dispersion of small droplets in a fluid substance by subdividing particles until the desired consistency is acquired. This manufacturing process is already scaled and in use in the food industry, which therefore makes it more appealing for researchers and for the drug delivery industry. Liposomes can also be functionalized by attaching various ligands on the surface to enhance brain- targeted delivery.
|
|
Soluble iron salts have a significant risk of adverse effects and can cause toxicity due to damage to cellular macromolecules. Delivering iron parenterally has utilised various different molecules to limit this. This has included dextrans, sucrose, carboxymaltose and more recently Isomaltoside 1000. One formulation of parenteral iron is iron dextran which covers the old high molecular weight (trade name DexFerrum) and the much safer low molecular iron dextrans (tradenames including Cosmofer and Infed). Iron sucrose has an occurrence of allergic reactions of less than 1 in 1000.
|
|
Cholesterol gallstone formation risk factors include age, female sex, family history, race, pregnancy, parity, obesity, hormonal birth control, diabetes mellitus, cirrhosis, prolonged fasting, rapid weight loss, total parenteral nutrition, ileal disease and impaired gallbladder emptying. Patients that have gallstones and biliary colic are at increased risk for complications, including cholecystitis. Complications from gallstone disease is 0.3% per year and therefore prophylactic cholecystectomy are rarely indicated unless part of a special population that includes porcelain gallbladder, individuals eligible for organ transplant, diabetics and those with sickle cell anemia.
|
|
The cardiovascular toxicity of PEP is far less than that of oral synthetic estrogens like diethylstilbestrol and ethinylestradiol, which increase the risk of venous and arterial thromboembolism, consequently increase the risk of transient ischemic attack, cerebrovascular accident (stroke), and myocardial infarction (heart attack), and result in substantial increases in cardiovascular mortality. It is thought that the relatively minimal cardiovascular toxicity of parenteral forms of estradiol, like PEP and high- dose transdermal estradiol patches, is due to their absence of effect on hepatic coagulation factors.
|
|
A peripheral IV placed on the hand. A medical professional performs an intradermal (ID) injection. The term injection encompasses intravenous (IV), intramuscular (IM), subcutaneous (SC) and intradermal (ID) administration. Parenteral administration generally acts more rapidly than topical or enteral administration, with onset of action often occurring in 15–30 seconds for IV, 10–20 minutes for IM and 15–30 minutes for SC. They also have essentially 100% bioavailability and can be used for drugs that are poorly absorbed or ineffective when they are given orally.
|
|
Newborn screening tests are most commonly done from whole blood samples collected on specially designed filter paper, originally designed by Robert Guthrie. The filter paper is often attached to a form containing required information about the infant and parents. This includes date and time of birth, date and time of sample collection, the infant's weight and gestational age. The form will also have information about whether the baby has had a blood transfusion and any additional nutrition the baby may have received (total parenteral nutrition).
|
|
WILCO AG is a company with headquarters in Wohlen (Switzerland), which mainly produces sophisticated equipment for the pharmaceutical industry, as well as for the food, packaging, aerosol, can making and automotive industries. The machines are used for leak testing and inspection of containers, such as medicine bottles, vials, syringes, cartridges, packaging, cans, filters and pouches. The company is the global market leader for leak detection machines and trendsetter for inspection with a new inspection approach. Lee E. Kirsch (Hrsg.); Parenteral Drug Association (Hrsg.): Pharmaceutical container/closure integrity.
|
|
Traditionally, nothing by mouth was considered to be mandatory in all cases, but gentle feeding by enteral feeding tube may help to restore motility by triggering the gut's normal feedback signals, so this is the recommended management initially. When the patient has severe, persistent signs that motility is completely disrupted, nasogastric suction and parenteral nutrition may be required until passage is restored. In such cases, continuing aggressive enteral feeding causes a risk of perforating the gut. Several options are available in the case of paralytic ileus.
|
|
Quinidine is occasionally used as a class I antiarrhythmic agent to prevent ventricular arrhythmias, particularly in Brugada Syndrome, although its safety in this indication is uncertain. It reduces the recurrence of atrial fibrillation after patients undergo cardioversion, but it has proarrhythmic effects and trials suggest that it may lead to an overall increased mortality in these patients. Quinidine is also used to treat short QT syndrome. Eli Lilly has discontinued manufacture of parenteral quinidine gluconate in the US, and its future availability in many countries is uncertain.
|
|
VTE occurs more frequently in the first year of treatment with estrogens. The risk of VTE is higher with oral non-bioidentical estrogens such as ethinylestradiol and conjugated estrogens than with parenteral formulations of estradiol such as injectable, transdermal, implantable, and intranasal. VTE risk also increases with age and in patients who smoke, so many clinicians advise using the safer estrogen formulations in smokers and patients older than 40. In addition, VTE risk is increased by progestins and increases with the dosages of both estrogens and progestins.
|
|
It is hydrolyzed to p-hydroxybenzoic acid and rapidly excreted in urine without accumulating in the body. Acute toxicity studies have shown that methylparaben is practically non-toxic by both oral and parenteral administration in animals. In a population with normal skin, methylparaben is practically non-irritating and non-sensitizing; however, allergic reactions to ingested parabens have been reported. A 2008 study found no competitive binding for human estrogen and androgen receptors for methylparaben, but varying levels of competitive binding were seen with butyl- and isobutyl- paraben.
|
|
Mutations are spread throughout the gene with no identifiable hotspot and generally consist of frameshift, missense and nonsense mutations; a smaller number are splice site mutations. There is no clear genotype/phenotype correlation with overall disease severity, even siblings with the same homozygous mutation display variable phenotypes. Patients have been described globally in Europe, Saudi Arabia, Malaysia, China and Japan. Intractable watery diarrhoea is a near consistent feature in almost all described cases, almost always starting soon after birth and commonly requiring parenteral nutrition.
|
|
It is the antagonist of cholecystokinin and inhibits the pancreatic secretion which is stimulated by cholecystokinin. On fasting, PP seric concentration is 80 pg/ml; after the meal, it rises up from 8 to 10 times more; glucose and fats also induce PP's level increase, but on parenteral introduction of those substances, the level of hormones doesn't change. The administration of atropine, the vagotomy, blocks the PP's after-meal secretion. The excitation of the vagus nerve, the administration of gastrin, secretin or cholecystokinin induce PP secretion.
|
|
Cortisol levels were unchanged in the other groups (e.g., orchiectomy, GnRH agonist therapy, and parenteral estrogen therapy) in this study, but increased by 300 to 400% in the oral and synthetic estrogen groups, likely secondary to increases in hepatic corticosteroid-binding globulin (CBG) production and compensatory upregulation of adrenal corticosteroid synthesis. Changes in levels of weak adrenal androgens are of relevance as these androgens serve as circulating reservoir of precursors that are transformed in tissues into potent androgens like testosterone and dihydrotestosterone and into estrogens.
|
|
Intradialytic parenteral nutrition (IDPN) is a nutritional support therapy (medical nutrition therapy) for people on hemodialysis who have a difficult time maintaining adequate nutrition. It is administered directly into the bloodstream of patients suffering from chronic kidney disease (CKD) in an effort to decrease the associated morbidity and mortality experienced in patients with kidney failure. IDPN contains protein (amino acids), carbohydrates (dextrose), and fats (lipids) in an attempt to meet a patient's weekly nutritional needs. Solutions can be individualized for each patient based on weight, needs, medical history and enteral intake.
|
|
Intestine transplantation (intestinal transplantation, or small bowel transplantation) is the surgical replacement of the small intestine for chronic and acute cases of intestinal failure. While intestinal failure can oftentimes be treated with alternative therapies such as parenteral nutrition (PN), complications such as PN-associated liver disease and short bowel syndrome may make transplantation the only viable option. One of the rarest type of organ transplantation performed, intestine transplantation is becoming increasingly prevalent as a therapeutic option due to improvements in immunosuppressive regimens, surgical technique, PN, and the clinical management of pre and post-transplant patients.
|
|
Patients who are diagnosed with cancer, whether as outpatient undergoing treatment or hospitalized, are at a greater risk of malnutrition and cachexia. Cancer-related malnutrition can be attributed to the decrease in food intake, increase in the need for energy, and the alteration of metabolism. Patients should be assessed early on in their cancer treatment for any nutritional risk, such as by taking routine weights and BMI. Parenteral nutrition is indicated in cancer patients when it is not possible to access the digestive tract or if the tract is ineffective.
|
|
The CSF folate level is usually undetectable at the time of diagnosis. Even when the blood folate level is corrected, or far above normal, the CSF folate level remains low, consistent with impaired transport across the choroid plexus. The normal CSF folate level in children over the first three years of life is in the 75 to 150 nM range. In subjects with HFM it is very difficult indeed, rarely possible, to bring the CSF folate level into the normal range even with substantial doses of parenteral folate (see below).
|
|
Neutrophils, macrophages and dendritic cells produce this lipase, acyloxyacyl hydrolase (AOAH), which inactivates LPS by removing the two secondary acyl chains from lipid A to produce tetraacyl LPS. If they are given LPS parenterally, mice that lack AOAH develop high titers of non- specific antibodies, develop prolonged hepatomegaly, and experience prolonged endotoxin tolerance. LPS inactivation may be required for animals to restore homeostasis after parenteral LPS exposure. Although mice have many other mechanisms for inhibiting LPS signaling, none is able to prevent these changes in animals that lack AOAH.
|
|
Euthanasia can be accomplished either through an oral, intravenous, or intramuscular administration of drugs, or by oxygen deprivation (anoxia), as in some euthanasia machines. In individuals who are incapable of swallowing lethal doses of medication, an intravenous route is preferred. The following is a Dutch protocol for parenteral (intravenous) administration to obtain euthanasia: Intravenous administration is the most reliable and rapid way to accomplish euthanasia. A coma is first induced by intravenous administration of 20 mg/kg sodium thiopental (Nesdonal) in a small volume (10 ml physiological saline).
|
|
Deficiencies of B vitamins, fat-soluble vitamins, essential fatty acids, and key minerals such as magnesium, zinc, and selenium are extremely common and benefit from replacement therapy. Dietary interventions, including certain exclusion diets like the SCD or Specific carbohydrate diet. Anaemia is commonly present in both ulcerative colitis and Crohn's disease. Due to raised levels of inflammatory cytokines which lead to the increased expression of hepcidin, parenteral iron is the preferred treatment option as it bypasses the gastrointestinal system, has lower incidence of adverse events and enables quicker treatment.
|
|
Candicine is a naturally occurring organic compound that is a quaternary ammonium salt with a phenethylamine skeleton. It is the N,N,N-trimethyl derivative of the well-known biogenic amine tyramine, and, being a natural product with a positively charged nitrogen atom in its molecular structure, it is classed as an alkaloid. Although it is found in a variety of plants, including barley, its properties have not been extensively studied with modern techniques. Candicine is toxic after parenteral administration, producing symptoms of neuromuscular blockade; further details are given in the "Pharmacology" section below.
|
|
Jejunostomy is the surgical creation of an opening (stoma) through the skin at the front of the abdomen and the wall of the jejunum (part of the small intestine). It can be performed either endoscopically, or with open surgery. A jejunostomy may be formed following bowel resection in cases where there is a need to bypassing the distal small bowel and/or colon due to a bowel leak or perforation. Depending on the length of jejunum resected or bypassed the patient may have resultant short bowel syndrome and require parenteral nutrition.
|
|
Victims who show signs of anaphylaxis are treated with antihistamines, epinephrines, and parenteral corticosteroids. Epinephrine is the first product for use to treat systemic allergic responses, particularly if a patient is experiencing dyspnoea or hypotension because it is capable of reversing adverse events quickly and is very safe to use. It is recommended that people who have suffered from anaphylaxis carry an epinephrine autoinjector (EpiPen), should dyspnoea or hypotension begin to occur. Whole body extract immunotherapy (WBE) to treat victims of anaphylaxis has been in use since 1973.
|
|
Endocarditis can be caused by C. parapsilosis in patients using prosthetic valves (57.4%), intravenous drug (20%), or having intravenous parenteral nutrition (6.9%), abdominal surgery (6.9%), immunosuppression (6.4%), treatment with broad-spectrum antibiotics (5.6%), and previous valvular disease (4.8%). Although the mortality rate is 41.7% to 61%, the treatment is still unknown. Ocular infection caused by C. parapsilosis has been reported after cataract extraction and with corticosteroid eye drop use. C. parapsilosis infection of the skin and gastrointestinal tract can occur, in which the production of pseudohyphae is associated with the elicitation of an inflammatory response.
|
|
Stevanato Group is an Italian multinational company headquartered in Piombino Dese, Padua – Italy. Founded in 1949, it is committed to creating systems, processes, and services that guarantee the integrity of parenteral medicines. Founded in 1949, it is also active in the glass tube forming technology and inspection systems sector. Profile page of Stevanato Group website The Group is the first worldwide producer of insulin cartridges for diabetes treatment Facts and Figures page of Stevanato Group website and it has the technological leadership in design and production of machinery for glass tubing converting.
|
|
An syringe being prepared for injection of medication. An injection (often referred to as a "shot" in US English, or a "jab" in UK English) is the act of administering a liquid, especially a drug, into a person's body using a needle (usually a hypodermic needle) and a syringe. An injection is considered a form of administering drugs via the parenteral route, which refers to routes of administration which do not involve absorption in the digestive tract. This allows the medication to be absorbed more rapidly and avoid the first pass effect.
|
|
Needle insertion angles for 4 types of injection: intramuscular, subcutaneous, intravenous, and intradermal. Injections are usually classified by the tissue into which the substance is administered, and may be sub- classified based on the site of the body at which they are administered. All injections are considered a type of parenteral administration, which avoid the first pass effect of oral administration. Furthermore, all injections should be considered sterile procedures for which proper aseptic technique should be followed, as they necessarily involve breaking the skin or other outer layer of protection from pathogens and the environment.
|
|
After 48 hours of uncured postpartum endometritis (notably 48 hours of fever that is unaffected by antibiotics), one could diagnose SPT until proven otherwise (with pelvic radiography). Imaging studies can be helpful in patient refractory to broad- spectrum parenteral antibiotics to look for an abscess, retained products, or septic pelvic thrombophlebitis. Septic pelvic thrombophlembitis (SPT) occurs most often in bedridden patients after giving birth, or after having undergone a Caesarean section. The blood often pools in the pelvis as this is the lowest part of the patient while laying in a hospital bed.
|
|
Due to the poor oral activity of oral micronized progesterone, it has relatively weak progestogenic effects. Administration of progesterone in oil solution by intramuscular injection has a duration of about 2 or 3 days, necessitating frequent injections. Transdermal administration of progesterone in the form of creams or gels achieves only very low levels of progesterone and weak progestogenic effects. Due to the poor oral activity of progesterone and its short duration with intramuscular injection, progestins were developed in its place both for oral use and for parenteral administration.
|
|
Estradiol-containing combined birth control pills, like estradiol valerate/dienogest and estradiol/nomegestrol acetate, and high-dose parenteral polyestradiol phosphate therapy have both been found to increase SHBG levels by about 1.5-fold. Hormone therapy with high-dose ethinylestradiol and cyproterone acetate in transgender women has been associated with a 20- to 45-fold higher risk of VTE relative to non-use. The absolute incidence was about 6%. Conversely, the risk of VTE in transgender women is much lower with oral or transdermal estradiol plus high-dose cyproterone acetate.
|
|
Adrenaline may be quantified in blood, plasma or serum as a diagnostic aid, to monitor therapeutic administration, or to identify the causative agent in a potential poisoning victim. Endogenous plasma adrenaline concentrations in resting adults are normally less than 10 ng/L, but may increase by 10-fold during exercise and by 50-fold or more during times of stress. Pheochromocytoma patients often have plasma adrenaline levels of 1000–10,000 ng/L. Parenteral administration of adrenaline to acute-care cardiac patients can produce plasma concentrations of 10,000 to 100,000 ng/L.
|
|
Intraperitoneal injection or IP injection is the injection of a substance into the peritoneum (body cavity). It is more often applied to animals than to humans. In general, it is preferred when large amounts of blood replacement fluids are needed or when low blood pressure or other problems prevent the use of a suitable blood vessel for intravenous injection. In animals, it is used predominantly in veterinary medicine and animal testing for the administration of systemic drugs and fluids because of the ease of administration compared with other parenteral methods.
|
|
Prokinetic drugs such as lidocaine, erythromycin, metoclopramide, and bethanechol are often used to treat the ileus associated with the disease. Horses are withheld food until reflux returns to less than 1–2 L of production every 4 hours, and gut sounds return, often requiring 3–7 days of therapy. Parenteral nutrition is often provided to horses that are withheld feed for greater than 3–4 days. It is suspected to improve healing and shorten the duration of the illness, since horses often become cachexic due to the protein losing enteropathy associated with this disease.
|
|
There are three basic methodologies: gel- clot, turbidimetric, and chromogenic. The primary application for LAL is the testing of parenteral pharmaceuticals and medical devices that contact blood or cerebrospinal fluid. In the United States, the FDA has published a guideline for validation of the LAL test as an endotoxin test for such products. The LAL cascade is also triggered by (1,3)-β-D-glucan, via a different Factor G. Both bacterial endotoxins and (1,3)-β-D-glucan are considered pathogen-associated molecular patterns, or PAMPs, substances which elicit inflammatory responses in mammals.
|
|
Penicillin has been suggested as the drug of choice for the treatment of S. iniae infection in mammals, including humans. In the 1995–1996 cluster of human cases, all clinical isolates were susceptible to penicillin, several cephalosporins, clindamycin, erythromycin, and co-trimoxazole (MICs 0.25 µg/ml); all nine patients were treated with parenteral beta-lactam antibiotics and recovered uneventfully. A study of isolates submitted to the Centers for Disease Control and Prevention between 2000 and 2004 found all to be sensitive to beta- lactams, macrolides, quinolones, and vancomycin.
|
|
Prostaglandins, specifically PGE2 and PGI2, are important in inflammation and have been implicated in promoting apical resorption. This is because neutrophils, which are rich sources of PGE2, are present when the majority of rapid bone loss occurs during the initial stages of apical periodontitis. It has been illustrated clinically that parenteral administration of indomethacin, an inhibitor of cyclooxygenase, can act to suppress resorption of apical hard tissue. The predominant mechanism of bone resorption in a periapical lesion, as in the rest of the body, is the performed by osteoclasts.
|
|
Increases in levels of 11-deoxycorticosterone are markedly higher when progesterone is given orally as opposed to via parenteral routes like vaginal or intramuscular injection. The conversion of progesterone into 11-deoxycorticosterone occurs in the intestines (specifically the duodenum) and in the kidneys. 21-Hydroxylase appears to be absent in the liver, so conversion of progesterone into 11-deoxycorticosterone is thought not to occur in this part of the body. Endogenous progesterone is metabolized approximately 50% into 5α-dihydroprogesterone in the corpus luteum, 35% into 3β-dihydroprogesterone in the liver, and 10% into 20α-dihydroprogesterone.
|
|
The cause of death seemed to be starvation: the condition of Kafka's throat made eating too painful for him, and since parenteral nutrition had not yet been developed, there was no way to feed him. Kafka was editing "A Hunger Artist" on his deathbed, a story whose composition he had begun before his throat closed to the point that he could not take any nourishment. His body was brought back to Prague where he was buried on 11 June 1924, in the New Jewish Cemetery in Prague-Žižkov. Kafka was virtually unknown during his own lifetime, but he did not consider fame important.
|
|
Compared to the United States, which has a greater supply of molybdenum in the soil, people living in those areas have about 16 times greater risk for esophageal squamous cell carcinoma. Molybdenum deficiency has also been reported as a consequence of non-molybdenum supplemented total parenteral nutrition (complete intravenous feeding) for long periods of time. It results in high blood levels of sulfite and urate, in much the same way as molybdenum cofactor deficiency. However (presumably since pure molybdenum deficiency from this cause occurs primarily in adults), the neurological consequences are not as marked as in cases of congenital cofactor deficiency.
|
|
Buprenorphine/naloxone, when taken in excess, can produce dysphoric symptoms for non opioid-dependent/tolerant individuals due to buprenorphine being a partial opioid agonist. The sublingual formulation of the buprenorphine/naloxone combination was designed to reduce abuse potential via the injection route in comparison to buprenorphine alone. If the combination is taken via the sublingual route, as directed, the addition of naloxone does not diminish the effects of buprenorphine. When the combination sublingual tablet is dissolved and injected by opioid-dependent individuals, a withdrawal effect may be triggered due to the high parenteral bioavailability of naloxone.
|
|
Although many of these symptoms can be accounted for on the basis of impairment of neurotransmission in the autonomic nervous system, there also seem to be distinct indications of central affects. In animal studies, parenteral administration of TMA- containing extracts from Neptunea to mice, cats and fish mainly show effects involving skeletal muscles: there are muscular fasciculations, convulsions, loss of balance, motor paralysis and ultimately cessation of respiration. The lethal oral dose of TMA for humans has been estimated at 3–4 mg/kg. The lethal dose for rats was estimated to be ~45–50 mg/kg, p.o.
|
|
The toxicology of MLA has been studied largely in the context of livestock poisoning by wild larkspurs. The seminal work by John Jacyno and Mike Benn at the University of Calgary in Canada showed that MLA was most likely to be the agent responsible for the toxicity of a local larkspur, D. brownii, and provided some preliminary acute toxicity data in several animal species. These LD50s are as follows: mouse, 3–5 mg/kg; frog, 3–4 mg/kg; rabbit, 2–3 mg/kg (after parenteral administration). Cats appeared to have comparable susceptibility to rabbits, whereas dogs were ~ 1.5 x more sensitive.
|
|
In the past, the prophylactic use of dantrolene was recommended for MH-susceptible patients undergoing general anesthesia. However, multiple retrospective studies have demonstrated the safety of trigger-free general anesthesia in these patients in the absence of prophylactic dantrolene administration. The largest of these studies looked at the charts of 2214 patients who underwent general or regional anesthesia for an elective muscle biopsy. About half (1082) of the patients were muscle biopsy positive for MH. Only five of these patients exhibited signs consistent with MH, four of which were treated successfully with parenteral dantrolene, and the remaining one recovered with only symptomatic therapy.
|
|
Anticoagulants and anti-platelet agents are amongst the most commonly used medications. Anti-platelet agents include aspirin, dipyridamole, ticlopidine, clopidogrel, ticagrelor and prasugrel; the parenteral glycoprotein IIb/IIIa inhibitors are used during angioplasty. Of the anticoagulants, warfarin (and related coumarins) and heparin are the most commonly used. Warfarin affects the vitamin K-dependent clotting factors (II, VII, IX, X) and protein C and protein S, whereas heparin and related compounds increase the action of antithrombin on thrombin and factor Xa. A newer class of drugs, the direct thrombin inhibitors, is under development; some members are already in clinical use (such as lepirudin).
|
|
The duration of action is generally long compared to other comparable analgesics and varies from 4 hours to as much as 15 hours. For this reason levorphanol is useful in palliation of chronic pain and similar conditions. Levorphanol has an oral to parenteral effectiveness ratio of 2:1, one of the most favorable of the strong narcotics. Its antagonism of the NMDA receptor, similar to those of the phenylheptylamine open-chain opioids such as methadone or the phenylpiperidine ketobemidone, make levorphanol useful for types of pain that other analgesics may not be as effective against, such as neuropathic pain.
|
|
Additionally, borosilicate tubing is used as the feedstock for the production of parenteral drug packaging, such as vials and pre-filled syringes, as well as ampoules and dental cartridges. The chemical resistance of borosilicate glass minimizes the migration of sodium ions from the glass matrix, thus making it well suited for injectable-drug applications. This type of glass is typically referred to as USP / EP JP Type I. Borosilicate is widely used in implantable medical devices such as prosthetic eyes, artificial hip joints, bone cements, dental composite materials (white fillings)R Wananuruksawong et al 2011 IOP Conf. Ser.: Mater. Sci. Eng.
|
|
Graduate medical education programs are located in Chattanooga, Knoxville, and Nashville; family medicine centers in Jackson, Knoxville, and Memphis; dentistry clinics in Bristol, Jackson, and Union City, as well as public and continuing education programs across the state. The Health Science Center is part of the statewide, multi-campus University of Tennessee system. The University of Tennessee Health Science Center also runs the Plough Center for Sterile Drug Delivery Systems, which celebrated its 53-year anniversary in 2016. The center educates on sterile product preparation, develops a basis for parenteral medications, and provides services to the pharmaceutical industry and individuals.
|
|
In contrast to estradiol and estriol, estrone is not a ligand of the G protein-coupled estrogen receptor (affinity >10,000 nM). Clinical research has confirmed the nature of estrone as a relatively inert precursor of estradiol. With oral administration of estradiol, the ratio of estradiol levels to estrone levels is about 5 times higher on average than under normal physiological circumstances in premenopausal women and with parenteral (non-oral) routes of estradiol. Oral administration of menopausal replacement dosages of estradiol results in low, follicular phase levels of estradiol, whereas estrone levels resemble the high levels seen during the first trimester of pregnancy.
|
|
When combined with antidepressants of the MAOI or SSRI class, very high parenteral doses of 5-HTP can cause acute serotonin syndrome in rats. It is unclear if such findings have clinical relevance, as most drugs will cause serious adverse events or death in rodents at very high doses. In humans 5-HTP has never been clinically associated with serotonin syndrome, although a case report suggests 5-HTP can precipitate mania when added to an MAOI. When combined with carbidopa (as a treatment for symptoms of Parkinson's disease), 5-HTP causes nausea and vomiting; however this can be alleviated via administration of granisetron.
|
|
An extensive study of the toxicology of tetraethylammonium chloride in mice, rats and dogs was published by Gruhzit and co-workers in 1948. These workers reported the following symptoms in mice and rats receiving toxic parenteral doses: tremors, incoordination, flaccid prostration, and death from respiratory failure within 10–30 minutes; dogs exhibited similar symptoms, including incoordination, flaccid prostration, respiratory and cardiac depression, ptosis, mydriasis, erythema, and death from respiratory paralysis and circulatory collapse. After non-lethal doses, symptoms abated within 15–60 minutes. There was little evidence of toxicity from chronic administration of non-lethal doses.
|
|
Iatrogenic theories propose that medical interventions were responsible for HIV origins. By proposing factors that only appeared in Central and West Africa after the late 19th century, they seek to explain why all HIV groups also started after that. The theories centred on the role of parenteral risks, such as unsterile injections, transfusions, or smallpox vaccinations are accepted as plausible by most scientists of the field. Discredited HIV/AIDS origins theories include several iatrogenic theories, such as the polio vaccine hypothesis which argues that the early oral polio vaccines were contaminated with a chimpanzee virus, leading to the Central African outbreak.
|
|
Two options are intravenous iron injections and blood transfusion. Intravenous can be for people who do not tolerate oral iron, who are unlikely to respond to oral iron, or who require iron on a long-term basis. For example, people receiving dialysis treatment who are also getting erythropoietin or another erythropoiesis-stimulating agent are given parenteral iron, which helps the body respond to the erythropoietin agents to produce red blood cells. Intravenous iron can induce an allergic response that can be as serious as anaphylaxis, although different formulations have decreased the likelihood of this adverse effect.
|
|
A panel, including the American Pain Society and American Society of Regional Anesthesia and Pain Medicine, recommends multimodal analgesia, which they define as a combination of pharmacological agents and non-pharmacological techniques to treat postoperative pain. A significant benefit of this technique is that non-opioid analgesics used in combination with opioids can decrease the amount of opioids required and reduce the risk of opioid-related side effects. Medications can be delivered as needed or around-the-clock depending on the patient's needs. For children, intravenous patient-controlled analgesia (IV-PCA) can be used when parenteral administration is preferred.
|
|
Veterinary Nurses are the primary paraveterinary workers in the United Kingdom and work alongside vets. Veterinary Nurses must be registered and follow a strict code of conduct. Veterinary Nurses have a scope of autonomous practice within which they can act for the animals they treat. Under schedule 3 of the Veterinary Surgeons act they can perform many complex procedures include minor surgery, admission of intravenous fluid therapy and parenteral nutrition, performing diagnostic imaging and monitoring anaesthesia. Preventative medicine is also an important part of the veterinary nurse’s role with nurse clinics and consultations becoming increasingly common.
|
|
Annu Rev Med 40: 137–147 () physiology of haemorrhage;Shires GT, Cunningham JN, Backer CR et al.. (1972) Alterations in cellular membrane function during hemorrhagic shock in primates. Ann Surg 176: 288–295 () (full text) responses to endotoxin;Fong YM, Marano MA, Barber A et al.. (1989) Total parenteral nutrition and bowel rest modify the metabolic response to endotoxin in humans. Ann Surg 210: 449–456 () (full text)Fong YM, Marano MA, Moldawer LL et al.. (1990) The acute splanchnic and peripheral tissue metabolic response to endotoxin in humans. J Clin Invest 85: 1896–1904 () (full-text) and the epidemiology of suicide.
|
|
In the 1980s, Jacobson operated a reproductive genetics center in Fairfax County, Virginia. He specialized in treating women who had difficulty getting pregnant, or problems carrying a pregnancy to term. One form of treatment was to inject patients, before and after conception, with the hormone hCG (commonly used as a parenteral fertility medication and a hormone normally released during pregnancy), and patients who had been unable to conceive with other treatments reported success under Jacobson's care. The pregnancies progressed normally through the early stages: standard pregnancy tests were positive and patients' bodies began to undergo the normal changes.
|
|
ADSA Membership is open to all dental professionals who have an interest in sedation and anesthesia. From its inception, Oral and Maxillofacial Surgeons and Dentist Anesthesiologists were encouraged to attain Fellowship status to recognize their high level of training. Since 2001, Diplomates of the National Dental Board of Anesthesiology and the American Board of Anesthesiology have been allowed to obtain ADSA Fellowship without a second examination process. The American Dental Society of Anesthesiology established the College of Sedation in Dentistry in 2001 for General Dentists to attain either Member (Enteral) or Master (Parenteral) status in the College.
|
|
However, it notes that these physiological levels of estradiol are usually unable to suppress testosterone levels into the female range. A 2018 Cochrane review proposal questioned the notion of keeping estradiol levels lower in transgender women, which results in incomplete suppression of testosterone levels and necessitates the addition of antiandrogens. The review proposal noted that high-dose parenteral estradiol is known to be safe. The Endocrine Society itself recommends dosages of injected estradiol esters that result in estradiol levels markedly in excess of the normal female range, for instance 10 mg per week estradiol valerate by intramuscular injection.
|
|
Due to extensive first-pass metabolism with oral progesterone, about 80 to 90% or more of progesterone is rapidly transformed into these metabolites, and massive quantities of these neurosteroids are consequently formed and circulate throughout the body and brain. It is for this reason that commonly reported side effects of oral progesterone include dizziness, drowsiness, sedation, somnolence, and fatigue. Both oral and sufficiently high doses of intramuscular progesterone can produce these sedative effects. However, compared to oral progesterone, the levels of these neurosteroids have been found to be very low with parenteral routes like vaginal and intramuscular progesterone.
|
|
Lethal injection has also been used in cases of euthanasia to facilitate voluntary death in patients with terminal or chronically painful conditions. Euthanasia can be accomplished either through oral, intravenous, or intramuscular administration of drugs. In individuals who are incapable of swallowing lethal doses of medication, an intravenous route is preferred. The following is a Dutch protocol for parenteral (intravenous) administration to obtain euthanasia, with the old protocol listed first and the new protocol listed second: :First a coma is induced by intravenous administration of 1 g sodium thiopental (Nesdonal), if necessary, 1.5–2.0 g of the product in case of strong tolerance to barbiturates.
|
|
He wasthe recipient of numerous grants from the NIH and other government agencies. Blackburn was on the editorial boards of numerous peer- reviewed journals, including the Journal of the American Medical Association (JAMA) New England Journal of Medicine, Annals of Internal Medicine, American Journal of Clinical Nutrition, Journal of Parenteral and Enteral Nutrition, American Journal of Public Health, Journal of the National Cancer Institute, and the International Journal of Obesity. He also serves as a reviewer for JAMA, the New England Journal of Medicine, Diabetes Care, and many other highly esteemed publications. Blackburn was awarded the 1988 Grace Goldsmith Award by the American College of Nutrition.
|
|
Selenium deficiency can occur in patients with severely compromised intestinal function, those undergoing total parenteral nutrition, and in those of advanced age (over 90). Also, people dependent on food grown from selenium-deficient soil are at risk. Although New Zealand has low levels of selenium in its soil, adverse health effects have not been detected. Selenium deficiency as defined by low (<60% of normal) selenoenzyme activity levels in brain and endocrine tissues only occurs when a low selenium status is linked with an additional stress, such as high exposures to mercury or as a result of increased oxidant stress due to vitamin E deficiency.
|
|
Anker has participated in and chaired several consensus meeting and guidelines committees: # Chair, ESPEN Guidelines on Parenteral Nutrition: on cardiology and pneumology. (Anker et al., Clin Nutr 2009) # Co-Chair, Consensus Group “The definition of Cachexia” (Evans et al., Clinical Nutrition 2008) # AHA Consensus Group “State of the science: promoting self-care in persons with heart failure: a scientific statement from the American Heart Association.” (Riegel et al., Circulation 2009) # ADQI 7 Consensus Group “Cardio-Renal Syndromes” (Ronco et al., Eur Heart J 2010) # Co-Chair, Consensus Group “Endpoints for Cachexia Trials & Nutrition for Cachexia and Sarcopenia” (Morley et al., JAMDA 2010) # Nutritional recommendations for the management of sarcopenia. Co-Chair.
|
|
Also known as 'Local Neonatal Units', these can look after babies who need more advanced support such as parenteral nutrition and continuous positive airway pressure (CPAP). Confusingly, they may also look after babies who need short-term intensive care such as mechanical ventilation. Babies who will need longer- term or more elaborate intensive care, for example extremely preterm infants, are usually transferred to a Level 3 unit. Babies in a Level 2 unit may be classified for nursing purposes as 'Special Care', 'High Dependency' (HDU) (in which a nurse will be assigned up to two babies) or 'Intensive care' (where nursing is one-to-one, or sometimes even two-to-one).
|
|
This controversy centers on whether Cr3+ provides any nutritional benefits. Furthermore, this controversy is amplified by the fact that no Cr-containing biomolecules have had their structure characterized, nor has the mode of action been determined. The first experiment that led to the discovery of Cr3+ playing a role in glucose metabolism proposed that the biologically active form of the metal existed in a protein called glucose tolerance factor, however, new evidence suggests that it is simply an artifact obtained from isolation procedures. The only accepted indicator of chromium deficiency is the reversal of symptoms that occurs when chromium(III) supplementation is administered to people on total parenteral nutrition.
|
|
Dobutamine is used to treat acute but potentially reversible heart failure, such as which occurs during cardiac surgery or in cases of septic or cardiogenic shock, on the basis of its positive inotropic action. Dobutamine can be used in cases of congestive heart failure to increase cardiac output. It is indicated when parenteral therapy is necessary for inotropic support in the short-term treatment of patients with cardiac decompensation due to depressed contractility, which could be the result of either organic heart disease or cardiac surgical procedures. It is not useful in ischemic heart disease because it increases heart rate and thus increases myocardial oxygen demand.
|
|
Blood smear of a person with iron-deficiency anemia at 40X enhancement Conventionally, a definitive diagnosis requires a demonstration of depleted body iron stores obtained by bone marrow aspiration, with the marrow stained for iron. However, with the availability of reliable blood tests that can be more readily collected for iron-deficiency anemia diagnosis, a bone marrow aspiration is usually not obtained. Furthermore, a study published April 2009 questions the value of stainable bone marrow iron following parenteral iron therapy. Once iron deficiency anemia is confirmed, gastrointestinal blood loss is presumed to be the cause until proven otherwise since it can be caused by an otherwise asymptomatic colon cancer.
|
|
His early research included work on drug discovery and studies on the use of cephaloridine. Pertaining to trials of what became known as Augmentin, a combination of amoxicillin and clavulanic acid, he later recalled that “getting the right dose of amoxicillin proved important for efficacy and getting the right dose of clavulanic acid was key to tolerability”. In 1977, he published on the efficacies of cephamycins, including their parenteral administration, dosages and penetrations through normal and inflamed blood-brain barrier. He made comparisons of clindamycin with lincomycin against H. influenzae in vitro, and later demonstrated that clindamycin was active against Coxiella burnetti, the cause of Q fever.
|
|
In particular, EES is said to have considerably reduced cardiovascular side effects relative to EE when used as a form of high-dose estrogen therapy in the treatment of prostate cancer. This may in part be related to the greatly reduced oral dosing frequency of EES relative to EE, as parenteral EE, which bypasses the first pass through the liver that occurs with oral EE, has been found to have a 5-fold lower impact on liver protein synthesis by weight than oral EE. Conversely however, studies with EE- containing contraceptive vaginal rings and contraceptive patches have shown similar metabolic effects and VTE risk as combined birth control pills containing EE.
|
|
The goal of medical treatment for SMA syndrome is resolution of underlying conditions and weight gain. Medical treatment may involve nasogastric tube placement for duodenal and gastric decompression, mobilization into the prone or left lateral decubitus position,Dietz UA, Debus ES, Heuko-Valiati L, Valiati W, Friesen A, Fuchs KH, Malafaia O, Thiede A: Aorto-mesenteric artery compression syndrome. Chirurg 2000;71:1345–51 the reversal or removal of the precipitating factor with proper nutrition and replacement of fluid and electrolytes, either by surgically inserted jejunal feeding tube, nasogastric intubation, or peripherally inserted central catheter (PICC line) administering total parenteral nutrition (TPN). Pro-motility agents such as metoclopramide may also be beneficial.
|
|
In the United States, edoxaban is approved for treating deep vein thrombosis and pulmonary embolism following five to ten days of initial therapy with a parenteral anticoagulant. It is also approved for reducing the risk of blood clots in people with nonvalvular atrial fibrillation. In the European Union, edoxaban is approved for preventing blood clots in people with nonvalvular atrial fibrillation who also have at least one risk factor, such as having had a previous stroke, high blood pressure, diabetes mellitus, heart failure or being 75 years old or over. It is also used to treat deep vein thrombosis and pulmonary embolism and to prevent either of these from reoccurring.
|
|
Bliss, the special care baby charity are currently funding research at Liverpool Women's Hospital into parenteral nutrition for premature and sick babies. Other funded research projects at the Trust include; • the LAMB (Liverpool Archive of MRI in Babies) study looks to use MRI scans to understand how nutrition and medicines affect the development of the brain, liver and hips in new born babies. • the TINN (Treat Infections in Neonates) study aims to find more information about the antibiotic ciprofloxacin including safety, most effective dose and other factors that may influence the way babies respond to the drug. This information may help other babies in future.
|
|
A fluid warmer is a medical device used in healthcare facilities for warming fluids, crystalloid, colloid, or blood product, prior to being administered (intravenously or by other parenteral routes) to body temperature levels in order to prevent hypothermia in physically traumatized or surgical patients. Infusion Fluid Warmers are FDA regulated medical devices, product code LGZ. They are unclassified devices with special considerations and require 510(k) clearance to be legally marketed in the United States. There are two primary categories of fluid warmers- those that warm fluids before use, typically warming cabinets, and those that actively warm fluids while being administered, in-line warming.
|
|
This functional iron deficiency will resolve once the source of inflammation is rectified; however, if not resolved, it can progress to anaemia of chronic inflammation. The underlying inflammation can be caused by fever, inflammatory bowel disease, infections, chronic heart failure (CHF), carcinomas, or following surgery. Reflecting this link between iron bioavailability and bacterial growth, the taking of oral iron supplements in excess of 200 mg/day causes a relative overabundance of iron that can alter the types of bacteria that are present within the gut. There have been concerns regarding parenteral iron being administered whilst bacteremia is present, although this has not been borne out in clinical practice.
|
|
A related bundle, the "Sepsis Six", is in widespread use in the United Kingdom; this requires the administration of antibiotics within an hour of recognition, blood cultures, lactate and hemoglobin determination, urine output monitoring, high-flow oxygen, and intravenous fluids. Apart from the timely administration of fluids and antibiotics, the management of sepsis also involves surgical drainage of infected fluid collections and appropriate support for organ dysfunction. This may include hemodialysis in kidney failure, mechanical ventilation in lung dysfunction, transfusion of blood products, and drug and fluid therapy for circulatory failure. Ensuring adequate nutrition—preferably by enteral feeding, but if necessary, by parenteral nutrition—is important during prolonged illness.
|
|
A review of the hormonal regimens of 20 of the centers was published that year. The Harry Benjamin International Gender Dysphoria Association (HBIGDA), now known as the World Professional Association for Transgender Health (WPATH), was formed in 1979, with the first version of the Standards of Care published the same year. The Endocrine Society published guidelines for the hormonal care of transgender people in 2009, with a revised version in 2017. Hormone therapy for transgender women was initially done using high-dose estrogen therapy with parenteral estrogens such as estradiol benzoate, estradiol valerate, and estradiol undecylate and with oral estrogens such as ethinylestradiol, conjugated estrogens, and diethylstilbestrol.
|
|
Conjugated estrogens (Premarin), which are used in menopausal hormone therapy, and ethinylestradiol, which is used in birth control pills, have been used in transgender women in the past, but are no longer recommended and are rarely used today due to their higher risks of blood clots and cardiovascular problems. Estrogens may be administered orally, sublingually, transdermally/topically (via patch or gel), rectally, by intramuscular or subcutaneous injection, or by an implant. Parenteral (non-oral) routes are preferred, owing to a minimal or negligible risk of blood clots and cardiovascular issues. In addition to producing feminization, estrogens have antigonadotropic effects and suppress gonadal sex hormone production.
|
|
Progesterone levels were less than 3 ng/mL for all three doses after 24 hours. The researchers concluded that the 25 and 50 mg doses would be appropriate for twice daily administration while the 100 mg dose would be appropriate for administration three times a day. There is a uterine first-pass effect with vaginal progesterone, such that progesterone levels are far greater in the uterus than in the circulation. Full secretory transformation of the endometrium was produced by vaginal progesterone administration that resulted in circulating progesterone levels of 1 to 3 ng/mL, whereas other parenteral routes (intramuscular and intranasal) were less effective in comparison.
|
|
The gradual loss of blood from the gastrointestinal tract, as well as chronic inflammation, often leads to anemia, and professional guidelines suggest routinely monitoring for anemia with blood tests repeated every three months in active disease and annually in quiescent disease. Adequate disease control usually improves anemia of chronic disease, but iron deficiency anemia should be treated with iron supplements. The form in which treatment is administered depends both on the severity of the anemia and on the guidelines that are followed. Some advise that parenteral iron be used first because people respond to it more quickly, it is associated with fewer gastrointestinal side effects, and it is not associated with compliance issues.
|
|
Although the etiology is unconfirmed, transient hyperammonemia is known to be caused by increased levels of ammonia in the blood stream, as well as a failure of the urea cycle to convert enough of the ammonia into urea. Since transamination of proteins is a leading producer of ammonia, protein restriction may be recommended as a therapy to reduce the symptoms of the episode. THAN can also be treated by avoiding amino acids in TPN or total parenteral nutrition or by giving a high caloric diet to limit catabolism of the tissues and therefore to minimize the breakdown of endogenous protein. The most common treatments are dialysis (both peritoneal and hemodialysis), sodium benzoate, and arginine.
|
|
GH has also been used experimentally in patients with short bowel syndrome to lessen the requirement for intravenous total parenteral nutrition. In 1990, the US Congress passed an omnibus crime bill, the Crime Control Act of 1990, that amended the Federal Food, Drug, and Cosmetic Act, that classified anabolic steroids as controlled substances and added a new section that stated that a person who "knowingly distributes, or possesses with intent to distribute, human growth hormone for any use in humans other than the treatment of a disease or other recognized medical condition, where such use has been authorized by the Secretary of Health and Human Services" has committed a felony.Mannfred A. Hollinger. Introduction to Pharmacology, Third Edition.
|
|
However, this suggestion was apparently based only on work by Solinas et al. who showed that doses of 0.3-5.6 mg/kg, i.p., in rats, dose-dependently antagonized the discriminative-stimulus effects of 3 mg/kg THC. Given that the early Soviet work with "mellictine" indicated that as little as ~0.2-0.3 mg/kg, orally, in man (assuming a weight of 60–70 kg, for the sake of making the dose conversion) could produce symptoms of toxicity, and that oral administration of most drugs typically requires more drug than parenteral administration, it is uncertain if MLA will prove to be a practical treatment for either nicotine or cannabis addiction, based on the effective doses required in the rat experiments.
|
|
A 2007 review of studies found that injected (parenteral) administration of alpha lipoic acid (ALA) was found to reduce the various symptoms of peripheral diabetic neuropathy. While some studies on orally administered ALA had suggested a reduction in both the positive symptoms of diabetic neuropathy (dysesthesia including stabbing and burning pain) as well as neuropathic deficits (paresthesia), the meta-analysis showed "more conflicting data whether it improves sensory symptoms or just neuropathic deficits alone". There is some limited evidence that ALA is also helpful in some other non-diabetic neuropathies. Benfotiamine is an oral prodrug of Vitamin B1 that has several placebo-controlled double-blind trials proving efficacy in treating neuropathy and various other diabetic comorbidities.
|
|
The results of two Phase I clinical studies in healthy human volunteers indicate that subcutaneously injected Ex-Rad is safe and well tolerated, with "no evidence of systemic side effects". A study in mice demonstrated the efficacy of Ex-Rad by increasing the survival rate of mice exposed to typically lethal whole-body irradiation. The study tested oral and parenteral administration of Ex-Rad for both pre- and post-exposure radiomitigation. Research on Ex-Rad has involved collaboration with the Armed Forces Radiobiology Research Institute (AFRRI), the Department of Biochemistry and Molecular & Cellular Biology at Georgetown University, Long Island University's Arnold & Marie Schwartz College of Pharmacy, and the Department of Oncological Sciences at the Mt. Sinai School of Medicine.
|
|
Pregnancy can cause major complications when trying to properly dose the nutrient mixture. Because all of the baby’s nourishment comes from the mother’s blood stream, the doctor must properly calculate the dosage of nutrients to meet both recipients’ needs and have them in usable forms. Incorrect dosage can lead to many adverse, hard-to-guess effects, such as death, and varying degrees of deformation or other developmental problems. It is recommended that parenteral nutrition administration begin after a period of natural nutrition so doctors can properly calculate the nutritional needs of the fetus. Otherwise, it should only be administered by a team of highly skilled doctors who can accurately assess the fetus’ needs.
|
|
When compared to other hospitalized patients, those admitted from long-term acute care (LTAC) facilities have significantly higher incidence of colonization and infection rates. Another 2012 multicenter study found that over 30% of patients with recent exposure to LTAC were colonized or infected with CRE. A person susceptible to CRE transmission is more likely to be female, have a greater number of parenteral nutrition-days (meaning days by which the person received nutrition via the bloodstream), and to have had a significant number of days breathing through a ventilator. Infections with carbapenem-resistant Klebsiella pneumoniae were associated with organ/stem cell transplantation, mechanical ventilation, exposure to antimicrobials, and overall longer length of stay in hospitals.
|
|
The idea of chromium being used for the treatment of type II diabetes was first sparked in the 1970s. A patient receiving total parenteral nutrition (TPN) had developed "severe signs of diabetes", and was administered chromium supplements based on previous studies that proved the effectiveness of this metal in modulating blood glucose levels. The patient was administered chromium for a total of two weeks, and by the end of this time-period, their ability to metabolize glucose had increased significantly; they also now required less insulin ("exogenous insulin requirements decreased from 45 units/day to none"). It was these experiments that were performed in the 1950s and 1970s that paved the foundation for future studies on chromium and diabetes.
|
|
Clometerone () (developmental code name L-38000), or clometherone (), also known as 6α-chloro-16α-methylprogesterone, is a synthetic pregnane steroid and derivative of progesterone which was reported in 1962 and is described as an antiestrogen and antiandrogen but was never marketed. Clometerone has been found to suppress estrone-induced uterine hypertrophy in mice at oral and parenteral doses in which progesterone is inactive (active at 10 µg with clometerone and progesterone inactive at 10–100 µg in the case of both routes). However, its progestogenic potency in the Clauberg assay is considerably less than that of progesterone. As such, the progestogenic effects of clometerone do not seem to parallel its estrogenic effects.
|
|
PEP produces minimal undesirable effects on coagulation factors and is thought to increase the risk of blood clots little or not at all. This is in spite of the fact that estradiol levels can reach high concentrations of as much as 700 pg/mL with high-dose (320 mg/month) PEP therapy. It is also in contrast to oral synthetic estrogens such as diethylstilbestrol and ethinylestradiol, which produce marked increases in coagulation factors and high rates of blood clots at the high doses used to achieve castrate levels of testosterone in prostate cancer. The difference between the two types of therapies is due to the bioidentical and parenteral nature of PEP and its minimal influence on liver protein synthesis.
|
|
This domain consists of molecular regions that make hydrophobic interactions with the FKB domain and triene region from C-1-C-6, methoxy group at C-7, and methyl groups at C-33, C-27 and C-25. All changes of the macrolide ring can have unpredictible effects on binding and therefore, make determination of SAR for rapalogs problematic. Rapamycin contains no functional groups that ionize in the pH range 1-10 and therefore, are rather insoluble in water. Despite its effectiveness in preclinic cancer models, its poor solubility in water, stability, and the long half-life elimination made its parenteral use difficult, but the development of soluble rapamycin analogs vanquished various barriers.
|
|
Team Consulting's work primarily focuses on the design and development of medical devices, helping companies in areas such as drug delivery (respiratory, parenteral, etc.), critical care, surgery, regenerative medicine and stem cell therapies. The company's work means that it contributes to industry and scientific discussion, has filed many patents with clients to advance technology and is a thought-leader in areas such as inhaler technology and drug delivery devices. Team Consulting have won various design and engineering awards for their work with their clients. In 2012, Team Consulting worked with OrganOx, a spin-out company from the University of Oxford to develop a world-first device which keeps a human liver alive outside the body.
|
|
In particular, the oral route is subject to a high first-pass effect, which results in high levels of estradiol and consequent estrogenic effects in the liver and low potency due to first-pass hepatic and intestinal metabolism into metabolites like estrone and estrogen conjugates. Conversely, this is not the case for parenteral (non- oral) routes, which bypass the intestines and liver. Different estradiol routes and dosages can achieve widely varying circulating estradiol levels. For purposes of comparison with normal physiological circumstances, menstrual cycle circulating levels of estradiol in premenopausal women are 40 pg/mL in the early follicular phase, 250 pg/mL at the middle of the cycle, and 100 pg/mL during the mid-luteal phase.
|
|
In contrast to progestogen-only birth control, the addition of progestins to oral estrogen therapy, including in combined birth control pills and menopausal hormone therapy, is associated with a higher risk of VTE than with oral estrogen therapy alone. The risk of VTE is increased by about 2-fold or less with such regimens in menopausal hormone therapy and by 2- to 4-fold with combined birth control pills containing ethinylestradiol, both relative to non-use. In contrast to oral estrogen therapy, parenteral estradiol, such as with transdermal estradiol, is not associated with a higher risk of VTE. This is likely due to its lack of first-pass effect in the liver.
|
|
A G-tube may instead be used for gastric drainage as a longer term solution to the condition where blockage in the proximal small intestine causes bile and acid to accumulate in the stomach, typically leading to periodic vomiting, or if the vagus nerve is damaged. Where such conditions are only short term, as in a hospital setting, a nasal tube connected to suction is usually used. A blockage lower in the intestinal tract may be addressed with a surgical procedure known as a colostomy, and either type of blockage may be corrected with a bowel resection under appropriate circumstances. If such correction is not possible or practical, nutrition may be supplied by parenteral nutrition.
|
|
Additional rotavirus vaccines are under development. These include: a human neonatal P[6]G3 strain, RV3, developed by Ruth Bishop and colleagues in Australia; a human bovine reassortant vaccine developed by Albert Kapikian and presently undergoing development and trials in different countries; and a non-replicating rotavirus vaccine (NRRV) candidate made of the P2-VP8 fusion protein, which is currently undergoing development and trials in South Africa. Rotavirus antigens for parenteral delivery, such as the P2-VP8 candidate, can be expressed as virus-like particles prepared in baculovirus, expressed antigens, DNA vaccines, and killed virus. These novel approaches are being pursued using animal models and, in the case of the NRRV P2-VP8 candidate, clinical trials.
|
|
Biorisk generally refers to the risk associated with biological materials and/or infectious agents, also known as pathogens. The term has been used frequently for various purposes since the early 1990s.Ecotoxicology of Soil Organisms: Conference : Papers By Marianne H. Donker, H. Eijsackers, Fred Heimbach Contributor Marianne H. Donker, H. Eijsackers, Fred Heimbach; CRC Press, 1994Pharmaceutical Dosage Forms: Parenteral Medications By Kenneth E. Avis, Herbert A. Lieberman, Leon Lachman Contributor Kenneth E. Avis; Informa Health Care, 1993 The term is used by regulators, laboratory personnel and industry alike and is used by the World Health Organization (WHO).The World Health Organization, Biorisk Management: Laboratory Biosecurity Guidance September 2006, WHO/CDS/EPR/2006.6 WHO/Europe also provides tools and training courses in biosafety and biosecurity.
|
|
These early observations have been comprehensively extended by USDA researchers, who have estimated the LD50 of MLA to be ~10 mg/kg in sheep, ~ 5 mg/kg in rats, and ~2 mg/kg in cattle. Although most LD50s are usually determined from parenteral administration of the test drug, MLA is also active when taken orally. Signs of toxicity in calves, sheep, rats and mice, at low doses, included agitation, respiratory difficulty, and loss of motor control; symptoms appeared within 2–3 minutes of injection, and disappeared within 10 minutes. Doses large enough to produce collapse also caused an increase in heart and respiration rates, as well as tremor, with significant convulsions evident in mice and rats, but not in cattle or sheep.
|
|
However, estrogens cause feminization and gynecomastia as side effects. Moreover, at a dosage of 3 to 5 mg/day, diethylstilbestrol can increase cardiovascular mortality – particularly in those patients who already have a compromised cardiovascular system. Diethylstilbestrol at 1 to 2 mg/day appears to be safe and effective for CRPC patients who have healthy cardiovascular systems and who concurrently take low-dose aspirin. Although the most commonly employed estrogens, oral and synthetic estrogens such as diethylstilbestrol and ethinylestradiol, increase cardiovascular mortality, certain estrogens, namely bioidentical parenteral estrogens such as polyestradiol phosphate and high-dose transdermal estradiol, do not do so; this is attributed to different degrees of effect of the estrogen classes on liver protein synthesis and by extension coagulation factors.
|
|
Because the length of therapy for anaerobic infections is generally longer than for infections due to aerobic and facultative anaerobic bacteria, oral therapy is often substituted for parenteral treatment. The agents available for oral therapy are limited and include amoxacillin plus clavulanate, clindamycin, chloramphenicol and metronidazole. In 2010 the Surgical Infection Society and Infectious Diseases Society of America updated joint guidelines for the treatment of abdominal infections.Solomkin JS, Mazuski JE, Bradley JS, Rodvold KA, Goldstein EJ, Baron EJ, O'Neill PJ, Chow AW, Dellinger EP, Eachempati SR, Gorbach S, Hilfiker M, May AK, Nathens AB, Sawyer RG, Bartlett JG. Diagnosis and management of complicated intra-abdominal infection in adults and children: guidelines by the Surgical Infection Society and the Infectious Diseases Society of America.
|
|
For example, persistent nausea, especially with vomiting, may make it difficult to use an oral dosage form, and in such a case, it may be necessary to use an alternative route such as inhalational, buccal, sublingual, nasal, suppository or parenteral instead. Additionally, a specific dosage form may be a requirement for certain kinds of drugs, as there may be issues with various factors like chemical stability or pharmacokinetics. As an example, insulin cannot be given orally because upon being administered in this manner, it is extensively metabolized in the gastrointestinal tract (GIT) before reaching the blood stream, and is thereby incapable of sufficiently reaching its therapeutic target destinations. The oral and intravenous doses of a drug such as paracetamol will differ for the same reason.
|
|
Therefore, treatment of chyle fistulae relies upon either decreased production of lymphatic fluid to allow for healing of lymphatic defect(s) or permanent diversion of lymphatic fluid away from lymphatic defect(s). Decreased production of lymphatic fluid may be accomplished by dietary restriction (or complete replacement of oral intake with total parenteral nutrition), as well as by the medications octreotide (a synthetic analogue of the hormone somatostatin) and orlistat (a lipase inhibitor that decreases absorption of dietary fats). Permanent diversion of lymphatic fluid may be accomplished by thoracic duct embolization (a needle- based procedure to occlude the duct by depositing glue/embolic material into it) or by thoracic duct ligation (an open surgical procedure to occlude the duct by suturing tightly around it).
|
|
As a result of this study, HDE for prostate cancer fell out of favor. However, in recent times there has been a resurgence in interest of HDE for prostate cancer with safer, bioidentical and parenteral forms of estrogen that don't share the same risks like polyestradiol phosphate and transdermal estradiol. Modern HDE for prostate cancer has a variety of advantages and benefits over conventional androgen deprivation therapy with castration, including fewer side effects like osteoporosis, hot flashes, and impairment in cognitive, emotional, and sexual domains, potentially superior quality of life, and considerable cost savings. The main drawback of modern HDE for prostate cancer is a high incidence of gynecomastia of about 40 to 77%, although it is generally only mildly or modestly discomforting.
|
|
Jacques Pépin and Annie-Claude Labbé reviewed the colonial health reports of Cameroon and French Equatorial Africa for the period 1921–59, calculating the incidences of the diseases requiring intravenous injections. They concluded that trypanosomiasis, leprosy, yaws, and syphilis were responsible for most intravenous injections. Schistosomiasis, tuberculosis, and vaccinations against smallpox represented lower parenteral risks: schistosomiasis cases were relatively few; tuberculosis patients only became numerous after mid-century; and there were few smallpox vaccinations in the lifetime of each person. The authors suggested that the very high prevalence of the Hepatitis C virus in southern Cameroon and forested areas of French Equatorial Africa (around 40–50%) can be better explained by the unsterile injections used to treat yaws, because this disease was much more prevalent than syphilis, trypanosomiasis, and leprosy in these areas.
|
|
A single administered dose of estradiol is absorbed 15% as estrone, 25% as E1S, 25% as estradiol glucuronide, and 25% as estrone glucuronide. Formation of estrogen glucuronide conjugates is particularly important with oral estradiol as the percentage of estrogen glucuronide conjugates in circulation is much higher with oral ingestion than with parenteral estradiol. Estrone glucuronide can be reconverted back into estradiol, and a large circulating pool of estrogen glucuronide and sulfate conjugates serves as a long-lasting reservoir of estradiol that effectively extends its terminal half-life of oral estradiol. To demonstrate the importance of first-pass metabolism and the estrogen conjugate reservoir in the pharmacokinetics of estradiol, the terminal half-life of oral estradiol is 13 to 20 hours whereas with intravenous injection its terminal half-life is only about 1 to 2 hours.
|
|
Estradiol is used as a form of high-dose estrogen therapy to treat prostate cancer and is similarly effective to other therapies such as androgen deprivation therapy with castration and antiandrogens. It is used in the form of long-lasting injected estradiol prodrugs like polyestradiol phosphate, estradiol valerate, and estradiol undecylate, and has also more recently been assessed in the form of transdermal estradiol patches. Estrogens are effective in the treatment of prostate cancer by suppressing testosterone levels into the castrate range, increasing levels of sex hormone-binding globulin (SHBG) and thereby decreasing the fraction of free testosterone, and possibly also via direct cytotoxic effects on prostate cancer cells. Parenteral estradiol is largely free of the cardiovascular side effects of the high oral dosages of synthetic estrogens like diethylstilbestrol ad ethinylestradiol that were used previously.
|
|
In contrast to oral synthetic estrogens like EE and diethylstilbestrol, high-dosage polyestradiol phosphate and transdermal estradiol have not been found to increase the risk of cardiovascular mortality or thromboembolism in men with prostate cancer. However, significantly increased cardiovascular morbidity has been observed with high-dosage polyestradiol phosphate. In any case, these estrogens are considered to be much safer than oral synthetic estrogens like EE and diethylstilbestrol. In addition, ethinylestradiol sulfonate (EES), an oral but parenteral-like long- lasting prodrug of EE, is used in the treatment of prostate cancer, and is said to have a considerably better profile of cardiovascular safety than EE. Because of its disproportionate effects on liver protein synthesis and associated cardiovascular risks, synthetic estrogens like EE and diethylstilbestrol are no longer used in menopausal hormone therapy.
|
|
Moreover, whereas normal physiological estrone sulfate levels are 10 to 25 times higher than those of estradiol and estrone in premenopausal women, levels of estrone sulfate with oral estradiol are an additional 8 to 20 times higher than normal premenopausal or postmenopausal estrone sulfate levels. One study found that estrone sulfate levels were 200-fold higher than estradiol levels with 2 mg/day oral micronized estradiol or oral estradiol valerate, and estrone sulfate levels can reach up to nearly 1,000-fold higher concentrations than estradiol in some cases. In contrast to oral estradiol, due to the lack of the first pass, an excess in estrone and estrogen conjugate levels does not occur with transdermal estradiol or other parenteral estradiol routes. The transformation of estradiol into estrone and estrogen conjugates is reversible.
|
|
The concept of validation was first proposed by two Food and Drug Administration (FDA) officials, Ted Byers and Bud Loftus, in 1979 in USA, to improve the quality of pharmaceuticals. It was proposed in direct response to several problems in the sterility of large volume parenteral market. The first validation activities were focused on the processes involved in making these products, but quickly spread to associated processes including environmental control, media fill, equipment sanitization and purified water production. The concept of validation was first developed for equipment and processes and derived from the engineering practices used in delivery of large pieces of equipment that would be manufactured, tested, delivered and accepted according to a contractHoffmann, A., Kahny-Simonius, J., Plattner, M., Schmidli-Vckovski, V., & Kronseder, C. (1998), 'Computer system validation: An overview of official requirements and standards', Pharmaceutica Acta Helvetiae, vol.
|
|
Fischer has published over 850 journal articles and edited 21 books including the standard surgical textbook, Mastery of Surgery. He has served on the editorial board for 13 journals including The American Journal of Surgery, Journal of American College of Surgeons, Archives of Surgery, Journal of Surgical Research, and Journal of Parenteral and Enteral Nutrition. In 2008, Dr. Carol Warfield sued Beth Israel Deaconess Medical Center, Paul Levy, the former CEO of Beth Israel Deaconess Medical Center, Harvard Medical Faculty Physicians and Fischer for discrimination and retaliation. The parties resolved their dispute in February 2013 when Beth Israel Deaconess paid Warfield $7 million, clarified its policies and procedures for employees to report discrimination, agreed to sponsor a lecture series on women’s health and women’s achievement in surgery, and named the hospital’s pain clinic in Warfield’s honor.
|
|
They suggested that all these parenteral risks caused not only the massive spread of Hepatitis C but also the spread of other pathogens, and the emergence of HIV-1: "the same procedures could have exponentially amplified HIV-1, from a single hunter/cook occupationally infected with SIVcpz to several thousand patients treated with arsenicals or other drugs, a threshold beyond which sexual transmission could prosper." They do not suggest specifically serial passage as the mechanism of adaptation. According to Pépin's 2011 book, The Origins of AIDS, the virus can be traced to a central African bush hunter in 1921, with colonial medical campaigns using improperly sterilized syringe and needles playing a key role in enabling a future epidemic. Pépin concludes that AIDS spread silently in Africa for decades, fueled by urbanization and prostitution since the initial cross-species infection.
|
|
As a result, studies that have assessed the pharmacokinetics of oral progesterone using IA have reported falsely high progesterone levels and inaccurate dependent pharmacokinetic parameters. Comparative studies using reliable and exact methods such as liquid chromatography–mass spectrometry (LC–MS) and IA in conjunction with adequate CS have found that IA without CS overestimates levels of progesterone by 5- to 8-fold. For this reason, the use of reliable assays is mandatory when studying the pharmacokinetics of oral progesterone, and an awareness of these methodological issues is likewise essential for an accurate understanding of the pharmacokinetics of oral progesterone. Conversely, the same issues are not applicable to parenteral routes of progesterone such as vaginal administration and intramuscular injection, because these routes are not subject to a first pass and relatively low levels of progesterone metabolites are formed.
|
|
Represented in this diverse membership is a growing number of young/early career professionals and students. Recognized for its expertise and authority in the field of parenteral science and technology, PDA is leading the way in promoting the exchange of information on rapidly evolving technology and regulations to ensure high-quality pharmaceutical production. PDA supports its mission to advance pharmaceutical and biopharmaceutical science and regulation so members can better serve patients by: • Providing global forums for the scientific community, regulators, and industry professionals on emerging trends within the industry • Delivering unique, hands-on education and training courses through PDA’s manufacturing training facility • Fostering career-long learning and professional development • Encouraging scientific information sharing among industry peers • Serving as a leading contributor of information and expertise to influence global industry and regulatory solutions. PDA draws its strength from its members, which includes a corps of 2,500 active volunteers.
|
|
18, 2005. Retrieved 29 April 2008 AAS were placed on the list of banned substances of the International Olympic Committee (IOC) in 1976, and a decade later the committee introduced 'out-of-competition' doping tests because many athletes used AAS in their training period rather than during competition. Three major ideas governed modifications of testosterone into a multitude of AAS: Alkylation at C17α position with methyl or ethyl group created POly active compounds because it slows the degradation of the drug by the liver; esterification of testosterone and nortestosterone at the C17β position allows the substance to be administered parenterally and increases the duration of effectiveness because agents soluble in oily liquids may be present in the body for several months; and alterations of the ring structure were applied for both PO and parenteral agents to seeking to obtain different anabolic-to- androgenic effect ratios.
|
|
Inducers of cytochrome P450 enzymes like CYP3A4 such as St. John's wort, phenobarbital, carbamazepine and rifampicin decrease the circulating levels of estradiol by accelerating its metabolism, whereas inhibitors of cytochrome P450 enzymes like CYP3A4 such as erythromycin, cimetidine, clarithromycin, ketoconazole, itraconazole, ritonavir and grapefruit juice may slow its metabolism resulting in increased levels of estradiol in the circulation. There is an interaction between estradiol and alcohol such that alcohol considerably increases circulating levels of estradiol during oral estradiol therapy and also increases estradiol levels in normal premenopausal women and with parenteral estradiol therapy. This appears to be due to a decrease in hepatic 17β-hydroxysteroid dehydrogenase type 2 (17β-HSD2) activity and hence estradiol inactivation into estrone due to an alcohol-mediated increase in the ratio of NADH to NAD in the liver. Spironolactone may reduce the bioavailability of high doses of oral estradiol.
|
|
With oral administration of estradiol, the ratio of estradiol levels to estrone levels is about 5 times higher on average than under normal physiological circumstances in premenopausal women and with parenteral (non-oral) routes of estradiol. Oral administration of menopausal replacement dosages of estradiol results in low, follicular phase levels of estradiol, whereas estrone levels resemble the high levels seen during the first trimester of pregnancy. In spite of markedly elevated levels of estrone with oral estradiol but not with transdermal estradiol, clinical studies have shown that doses of oral and transdermal estradiol achieving similar levels of estradiol possess equivalent and non-significantly different potency in terms of measures including suppression of luteinizing hormone and follicle- stimulating hormone levels, inhibition of bone resorption, and relief of menopausal symptoms such as hot flashes. In addition, estradiol levels were found to correlate with these effects, while estrone levels did not.
|
|
The use of estradiol by the rectal route considerably bypasses the liver and hence the first-pass metabolism that occurs with oral estradiol, similarly to other parenteral routes of estradiol such as vaginal and transdermal administration. Irritation of the intestines does not usually occur with rectal estradiol. The use of estradiol by the rectal route is not well-accepted by all individuals, and due to its inconvenience, it has been said that rectal administration of estradiol has gained no practical clinical importance. Lauritzen (1986) reported that 3 hours after a single rectal dose of 1 mg micronized estradiol, estradiol levels increased by 620 pg/mL and estrone levels increased by 120 pg/mL. Subsequently, Lauritzen (1987, 1990) reported that 0.5 mg/day and 1 mg/day rectal estradiol resulted in respective estradiol levels of 363 pg/mL and 515 pg/mL 6 hours following the last dose.
|
|
Total Parenteral Nutrition or TPN was born. In 1966, he tried TPN on six terminally- ill patients, all of whom recovered and all walked out of the hospital. In 1967, he first used TPN on an infant who could not eat, showing for the first time in history that an infant could grow with all nutrition given by vein. Dr. Dudrick has traveled the world to spread the knowledge of his discovery and along the way has received numerous awards and honors including American Medical Association (AMA) Joseph B. Goldberger Award in Clinical Nutrition, the AMA Brookdale Award in Medicine, the Ladd Medal of the American Academy of Pediatrics, the American College of Nutrition Goldsmith Award, the American College of Surgeons Jacobson Innovation Award, and the American Surgical Association’s Medallion of Scientific Achievement. He was even decorated Knight Hospitalier of the Order of Saint John of Jerusalem and was named a “Legend of Neonatology” by the Neonatology Association.
|
|
Recently, there has been a shift in the management paradigm from TPN (total parenteral nutrition) to early, post-pyloric enteral feeding (in which a feeding tube is endoscopically or radiographically introduced to the third portion of the duodenum). The advantage of enteral feeding is that it is more physiological, prevents gut mucosal atrophy, and is free from the side effects of TPN (such as fungemia). The additional advantages of post-pyloric feeding are the inverse relationship of pancreatic exocrine secretions and distance of nutrient delivery from the pylorus, as well as reduced risk of aspiration. Disadvantages of a naso-enteric feeding tube include increased risk of sinusitis (especially if the tube remains in place greater than two weeks) and a still-present risk of accidentally intubating the trachea even in intubated patients (contrary to popular belief, the endotracheal tube cuff alone is not always sufficient to prevent NG tube entry into the trachea).
|
|
Desbutal is no longer manufactured since withdrawal of its marketing approval by the Food and Drug Administration (FDA) in 1973 as part of a mass recall of all obesity combination drugs containing a CNS stimulant, often with a CNS depressant. The recall also included all existing stocks of parenteral amphetamines based on the FDA's contention that these products have such a great drug abuse potential that they cannot be used safely. Although the Bureau of Narcotics and Dangerous Drugs (BNDD) had already reduced the amphetamine aggregate production quota (APQ) for pharmaceutical manufacturers by approximately 90% throughout the prior two years, these combination drugs had rapidly grown in popularity throughout the two preceding decades. Many pharmaceutical manufacturers were vigorously competing for market shares by continuously developing new combinations and dosage formulations, and at the time of the 1973 recall, the estimated annual distribution of these pills was equivalent to 480 million dosage units of Obetrol 10mg tablets.
|
|
In addition to their antigonadotropic effects, estrogens at high concentrations can significantly decrease androgen production by the adrenal glands. A study found that treatment with a high dosage of ethinylestradiol (100 µg/day) reduced circulating adrenal androgen levels by 27 to 48% in transgender women. Another study found similar effects in men with prostate cancer, with levels of the adrenal androgens dehydroepiandrosterone (DHEA), dehydroepiandrosterone sulfate (DHEA-S), and androstenedione (A4) all decreasing significantly more with high-dose estrogen therapy (oral ethinylestradiol plus intramuscular polyestradiol phosphate) than with orchiectomy (by 33–39% and 10–26%, respectively). However, a study found that these effects occurred with high- dose oral and synthetic estrogens such as ethinylestradiol and estramustine phosphate but not with the parenteral estrogen polyestradiol phosphate, suggesting that decreases in adrenal androgen levels are secondary to changes in liver protein synthesis rather than due to a direct action in the adrenal cortex, and that such changes will only occur in the context of strong hepatic impact.
|
|
Young’s named lectureships included the Vickers Lecture of the British Neonatal Health Science Center, San Antonio, 1986; the American Society for Nutritional Sciences McCollum Award Lecture, 1987; Burns Lecture, Royal College of Physicians and Surgeons, Scotland, 1990; Brackenridge Lecture, University of Texas Health Science Center, San Antonio, 1996; Bruce and Virginia Street Lecture in Preventive Nutrition, University of North Texas, Fort Worth, 1996; Ninth Annual Malcolm Trout Lecture, Michigan State University, 1997; Rudolf Schonheimer Centenary Lecture, Nutrition Society of U.K.,1998; first David Murdock Lecture in Nutrition, Mayo Clinic, Rochester, 1998; Jonathan Roads Lecture, American Society for Parenteral and Enteral Nutrition. 1999; Hans Fischer Lecture, Rutgers University, New Brunswick, 1999; and W. O. Atwater Lecture and Award, USDA Agricultural Research Service, 2001. Editorial boards on which he served included the American Journal of Clinical Nutrition, 1976–1978; Nutrition Research, 1980–1984; Advances in Nutrition Research, 1976–2004; Pediatric Gastroenterology and Nutrition, 1981–1985; Age, 1977–1982; Growth, 1986–1990; Journal of the Nutrition Society of Nigeria, 1990–1994; and Nutrition Today, 1997-2004.
|
|
The hypodermic needle and syringe in its current form was invented by the French scientist Charles Pravaz in 1851, and became especially known during the wars of that and the subsequent decade. However, the first well-known attempt to inject drugs into the body was a 1667 attempt to inject a solution of opium into a dog, and some had suspected that parenteral administration of drugs may work better based on the practise of rubbing opium and other drugs into sores or cuts on the skin for the purpose of causing systemic absorption and the beginnings of scientific understanding of the functioning of the lungs. During most of the 1850s, the previously-held belief that opiate dependence and addiction (often called "the opium appetite", or, when relevant, the "morphine appetite" or "codeine appetite") was due to the drug's action on the digestive system—just like any hunger or thirst—caused doctors to opt to inject morphine rather than administer it orally, in the hope that addiction would not develop. Certainly, by c.
|
|
Stark Law is a set of United States federal laws that prohibit physician self- referral, specifically a referral by a physician of a Medicare or Medicaid patient to an entity for the provision of designated health services ("DHS") if the physician (or an immediate family member) has a financial relationship with that entity. The term "referral" means "the request by a physician for the item or service" for Medicare Part B services and "the request or establishment of a plan of care by a physician which includes the provision of the designated health service" for all other services. DHS includes "clinical laboratory services"; "physical therapy services"; "occupational therapy services"; "radiology services, including magnetic resonance imaging, computerized axial tomography scans, and ultrasound services"; "radiation therapy services and supplies"; "durable medical equipment and supplies"; "parenteral and enteral nutrients, equipment, and supplies"; "prosthetics, orthotics, and prosthetic devices and supplies"; "home health services"; "outpatient prescription drugs"; "inpatient and outpatient hospital services"; and "outpatient speech-language pathology services." A "financial relationship" includes ownership, investment interest, and compensation arrangements.
|
|
In contrast to progestins, the addition of oral progesterone to either oral or transdermal estrogen therapy is not associated with a higher risk of VTE. However, oral progesterone achieves very low progesterone levels and has relatively weak progestogenic effects, which might be responsible for the absence of increase in VTE risk. Parenteral progesterone, such as vaginal or injectable progesterone, which can achieve luteal-phase levels of progesterone and associated progestogenic effects, has not been characterized in terms of VTE risk. A 2012 meta-analysis estimated that the absolute risk of VTE is 2 per 10,000 women for non-use, 8 per 10,000 women for ethinylestradiol and levonorgestrel-containing birth control pills, and 10 to 15 per 10,000 women for birth control pills containing ethinylestradiol and a newer-generation progestin. For comparison, the absolute risk of VTE is generally estimated as 1 to 5 per 10,000 woman-years for non-use, 5 to 20 per 10,000 woman-years for pregnancy, and 40 to 65 per 10,000 woman-years for the postpartum period.
|
|
Zeisel is the Kenan Distinguished University Professor in the Department of Nutrition in the Gillings School of Global Public Health at the University of North Carolina at Chapel Hill. He is also the Director of the UNC’s Nutrition Research Institute at the newly formed North Carolina Research Campus in Kannapolis, North Carolina and the UNC Nutrition Obesity Research Center. He served as chair of the Department of Nutrition at the University of North Carolina at Chapel Hill from 1990-2005. He is currently a member of the American Society for Nutrition, the American Society for Parenteral and Enteral Nutrition, the American College of Nutrition and the Society for Pediatric Research, among others. He has served on the Annual Review of Nutrition’s editorial committee and continues to serve on the FASEB Journal editorial board. Zeisel is a member of the World Cancer Research Fund’s Expert Panel on “Food, Nutrition and the Prevention of Cancer: a global perspective.” He serves as the principal investigator on multiple federally funded research projects that focus on human requirements for choline and the effects of this nutrient on brain development. He has authored more than 280 scientific publications.
|
|