Selective Streptokinase Fibrinolysis in Femoro-Iliac Arterial Obstruction

1986 ◽  
Vol 27 (3) ◽  
pp. 279-283 ◽  
Author(s):  
K. Sørensen ◽  
V. Hegedüs

Percutaneous transluminal angioplasty of iliac and femoral arteries was in 17 patients combined with selective intra-arterial streptokinase treatment. The patients were divided into two groups, one given low dose long-term therapy and the other high dose short-term therapy. The experiences obtained during an observation period of over one year revealed greater benefit from high dose short-term therapy. It seems that the major cause of complications must be attributed to the development of a high level of streptokinase antibodies during low dose long-term therapy. References

2000 ◽  
Vol 11 (suppl a) ◽  
pp. 6A-10A
Author(s):  
Laurent Delorme ◽  
Charles Frenette ◽  
Isabelle Le Corre ◽  
Julie Duchesne ◽  
Carole Delorme ◽  
...  

From January 1, 1996 to December 31, 1996, 343 patients received outpatient intravenous antibiotic therapy at Charles LeMoyne Hospital, a 436-bed, acute care hospital in Greenfield Park, south of Montréal, Québec. The infectious diseases department saved 2660 bed-days using outpatient therapy. The mean duration of outpatient therapy was 7.76 days; 81.6% of patients were admitted to the program directly from the emergency room, or outpatient hospital clinics or private offices in the community. Hospitalized patients constituted only 18.4% of admissions to the outpatient intravenous antibiotic therapy program. Forty per cent of the surgical/medical staff participated in the program and they were able to generate a significant impact by diverting patients to outpatient therapy. Two types of patients can benefit from an outpatient intravenous antibiotic therapy program. One group of patients needs empirical short term therapy and can be switched to oral sequential therapy after two to five days of outpatient intravenous antibiotic therapy. A second group of patients needs specific long term therapy for the full duration of the antibiotic therapy. Empirical short term therapy can be managed by emergency department or hospital-based primary physicians, or medical/surgical specialists. Specific long term therapy can be managed by microbiology/infectious disease specialists or medical/surgical specialists. Hospitals that want to relieve pressure on emergency rooms and hospital bed demands should create facilities for both types of patients. Cefazolin and gentamicine/tobramycine were the most commonly used antibiotics in empirical short term therapy and in terms of number of patients treated. Ceftriaxone and vancomycin were most commonly used for long term therapy. The Drug acquisition antibiotic cost was $73,117 but constituted only 20% of the total outpatient intravenous antibiotic therapy cost. The per diem ambulatory cost was $140/patient/day.


PEDIATRICS ◽  
1994 ◽  
Vol 94 (5) ◽  
pp. 724-731 ◽  
Author(s):  
Brigitta U. Mueller ◽  
Karina M. Butler ◽  
Vicki L. Stocker ◽  
Frank M. Balis ◽  
Philip A. Pizzo ◽  
...  

Background. Didanosine has demonstrated promising antiviral activity and a tolerable toxicity profile in short term studies. We describe a cohort of HIV-infected children who were treated for a prolonged period of time with didanosine. Methods. Children (6 months to 18 years of age) with symptomatic HIV infection or an absolute CD4 count < 0.5 x 109 cells/L, received oral didanosine at doses between 20 mg/m2 to 180 mg/m2 every 8 hours. Clinical, immunological, and virological parameters were assessed at least every 2 months. The pharmacokinetics of didanosine were evaluated in 85 patients. Results. Previously untreated children (n = 51) and children who had received prior antiretroviral therapy (n = 52) were enrolled in the study (median time on study 22.6 months; range 2 to 48). The long-term administration of didanosine was well tolerated and no new toxicities were observed. The absolute CD4 count increased by ≥ .05 x 109 cells/L in 28 of 87 (32%) of patients after 6 months of therapy. Responses were also sustained in 41% of these children after 3 years of therapy. Children entering the study with a CD4 count >0.1 x 109 cells/L (n = 51) had a marked survival advantage (P = .00002) with an estimated survival probability after 3 years of 80% compared to 39% for children with lower CD4 counts. Although the area under the curve of didanosine increased proportionally with the dose, there was considerable interpatient variability at each dose level. There was no apparent relationship between surrogate markers of clinical outcome and plasma drug concentration. Conclusions. Didanosine was well tolerated with chronic administration, and toxicities were uncommon and usually reversible. In 41% of patients, the CD4 count increased and was maintained at the higher level even after years of treatment.


Blood ◽  
1998 ◽  
Vol 91 (2) ◽  
pp. 727-728 ◽  
Author(s):  
Javier Pinilla ◽  
Manuel Quintana ◽  
Manuel Magallon

1978 ◽  
Vol 12 (4) ◽  
pp. 291-295
Author(s):  
O. T. Stanley

This review attempts to deal with the complex issues involved in the time to heal, with special reference to psychological processes. The questions of convalescence and relapse in organic medicine are explored and extrapolated to psychiatric processes. The concept of a latency period of change in treatment outcome is discussed with reference to both less complicated reactive states as well as highly charged neurotic processes. The problems of recognizing slow but perceptible change and separating it from failure to respond is analysed. The value of long-term psychotherapy is assessed and comparison made with the newer concept of short-term therapy. Crisis therapy and disaster reactions are discussed within the concept of time to heal. Finally the difficult issue of “miraculous cure” with its therapeutic implications is evaluated.


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