Treatment and Prophylaxis of Pityriasis Versicolor with Oral Fluconazole

2003 ◽  
Vol 1 (3) ◽  
pp. 129-132 ◽  
Author(s):  
N. Cassano ◽  
V. D'Argento ◽  
F. Loconsole ◽  
G.A. Vena
Keyword(s):  
Oral Treatment ◽  
Large Body ◽  
Pityriasis Versicolor ◽  
Primary Efficacy ◽  
Once Daily ◽  
Oral Fluconazole ◽  
Surface Areas ◽  
End Of Treatment ◽  
Efficacy Parameter ◽  
Preliminary Study

Treatment with oral antifungals is usually preferred when pityriasis versicolor (PV) affects large body surface areas, especially in chronic or recurrent cases. In this study, we evaluated the effectiveness of fluconazole in the treatment and prophylaxis of patients with chronic or recurrent, mostly extensive, PV. Treatment regimen consisted of fluconazole 100mg once daily for 10 consecutive days; 3–4 weeks after the end of treatment, patients were evaluated for clinical and mycological response (visit T1). Patients with mycological eradication received fluconazole 200mg/day (100mg twice a day) for two consecutive days per month for 5 months. Clinical and mycological evaluations were performed after 2 months (T2) and 5 months (T3) from visit T1. Mycological efficacy was assessed using microscopic examination and represented the primary efficacy parameter; therefore, positive microscopy at any visit was reason for withdrawal from the study. At visit T1 60 subjects were evaluated; most patients (94 %) were clinically cured or improved. Similar clinical response rates were observed at visits T2 and T3. The proportion of patients with eradication of Malassezia was 92 % at T1 visit, 88 % at T2 visit, and 91 % at T3 visit. No relevant adverse events occurred. The results of this open preliminary study suggest that an oral treatment with fluconazole 100mg/day for 10 days is effective in PV. A maintenance monthly treatment with fluconazole 200mg/day for two consecutive days can be very useful to prevent recurrence of PV.

scholarly journals Determination of Posaconazole Levels in Toenails of Adults with Onychomycosis following Oral Treatment with Four Regimens of Posaconazole for 12 or 24 Weeks

2011 ◽  
Vol 55 (9) ◽  
pp. 4424-4426 ◽  
Author(s):  
Gopal Krishna ◽  
Lei Ma ◽  
Monika Martinho ◽  
Pratapa Prasad ◽  
Janice Wahl ◽  
...  
Keyword(s):  
Plasma Concentration ◽  
Concentration Ratio ◽  
Oral Treatment ◽  
Pharmacokinetic Data ◽  
Once Daily ◽  
Parallel Group ◽  
End Of Treatment ◽  
Plasma Concentration Ratio ◽  
Related Increase

ABSTRACTPharmacokinetic data from a randomized, parallel-group, multicenter study are presented. Adults with toenail onychomycosis (n= 146) received posaconazole (100 mg, 200 mg, or 400 mg) once daily (QD) for 24 weeks or 400 mg QD for 12 weeks. The posaconazole concentration in the great toenail exhibited a dose-related increase starting at week 2 for 24 weeks and a mean toenail-to-plasma concentration ratio of approximately 3:1 at the end of treatment for the 400-mg 24-week dose.

scholarly journals Pharmacokinetics and pharmacodynamics of ampreloxetine, a novel, selective norepinephrine reuptake inhibitor, in symptomatic neurogenic orthostatic hypotension

2021 ◽  
Author(s):  
Arthur Lo ◽  
Lucy Norcliffe-Kaufmann ◽  
Ross Vickery ◽  
David Bourdet ◽  
Jitendra Kanodia
Keyword(s):  
Orthostatic Hypotension ◽  
Sympathetic Neurons ◽  
Oral Treatment ◽  
Plasma Concentrations ◽  
Treatment Phase ◽  
Target Population ◽  
Neurogenic Orthostatic Hypotension ◽  
Open Label ◽  
Once Daily ◽  
Norepinephrine Reuptake

Abstract Purpose Ampreloxetine is a novel, selective, long-acting norepinephrine reuptake (NET) inhibitor being investigated as a once-daily oral treatment for symptomatic neurogenic orthostatic hypotension (nOH) in patients with autonomic synucleinopathies. The purpose of this study was to characterize the pharmacokinetic and pharmacodynamic profiles of ampreloxetine in this target population. Methods Patients with nOH were enrolled in a multicenter, phase II clinical trial of ampreloxetine (NCT02705755). They received escalating doses over 5 days in the clinical research unit, followed by 20 weeks of open-label treatment and then a 4-week withdrawal. As neurochemical biomarkers of NET inhibition, we assayed plasma concentrations of norepinephrine (NE) and its main intraneuronal metabolite 3,4-dihydroxyphenylglycol (DHPG) pre- and post-ampreloxetine. Results Thirty-four patients with nOH were enrolled. Plasma ampreloxetine concentrations increased with repeated escalating doses, with peak concentrations observed 6–9 h post-drug administration. The median ampreloxetine dose in the 20-week treatment phase was 10 mg once daily. Plasma ampreloxetine concentrations reached steady state by 2 weeks, with stable plasma levels over 24 h. No influence of age or renal function on ampreloxetine plasma concentrations was observed. On treatment, compared to baseline, plasma NE significantly increased by 71% (p < 0.005), plasma DHPG significantly declined by 22% (p < 0.05), and the NE:DHPG ratio significantly increased (p < 0.001). Conclusions Persistent elevation of plasma NE levels accompanied by reduced DHPG levels after ampreloxetine suggests reduced neuronal reuptake and metabolism of NE in postganglionic efferent sympathetic neurons. The findings are consistent with long-lasting NET inhibition, which may increase vasoconstrictor tone, supporting once-daily ampreloxetine dosing in patients with nOH.

scholarly journals A case of diquat poisoning in pigs

2019 ◽  
Vol 64 (No. 11) ◽  
pp. 505-511
Author(s):  
Z Siroka ◽  
M Svoboda ◽  
Z Svobodova ◽  
I Nagl
Keyword(s):  
Toxic Substance ◽  
Large Body ◽  
Skin Lesions ◽  
Acute Poisoning ◽  
Pathological Examination ◽  
Tissue Destruction ◽  
Large White ◽  
Surface Areas ◽  
Stomach Fundus ◽  
White Foam

Diquat is a bipyridyl compound which belongs to the group of herbicides. Its activity is based on the liberation of the superoxide anion radical and, subsequently, hydrogen peroxide, leading to tissue destruction by oxidative stress. Acute poisoning is associated with high mortality within several hours to a few days. The reported case of poisoning occurred on a commercial farm. The fattening pigs of the Landrace and Large White breeds were affected. The pigs were kept on a deep litter. Reglone (active ingredient diquat dibromide, 200 g/l) was used on the farm fields to desiccate the clover crop. The dry clover straw was harvested and stored for approximately a month and then used as a litter. In total, 50 pigs were affected. The onset of the poisoning was very fast. Within eight hours after the litter administration, 20 animals died. The only clinical sign seen was severe haemorrhagic dermatitis. The pathological examination revealed acute superficial haemorrhagic dermatitis on the belly, the snout and the ears of the affected pigs. Hyperaemia of the tonsils, pharynx and oesophagus was diagnosed, as well as a pronounced hyperaemia of the stomach fundus. In the distal part of the trachea, there was a dense, white foam. The lungs were congested, with focal emphysema. The liver was slightly hyperaemic. The histological examination revealed a massive haemostasis in liver and diffuse acute polymorphonuclear hepatitis. The other organs were without changes. The examination revealed acute poisoning caused by the large body surface areas contacting with a toxic substance. The pigs that survived were immediately removed to a non-contaminated area. The changes on their skin were not so extensive compared to the dead ones. Within 5–7 days after the exposure to diquat, the skin lesions healed.

505 Efficacy of Pitolisant in the Treatment of Cataplexy in Adults With Narcolepsy

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A199-A199
Author(s):  
Craig Davis ◽  
Donna Zarycranski ◽  
Markiyan Doliba ◽  
Jeffrey Dayno ◽  
Jean-Charles Schwartz
Keyword(s):  
Placebo Group ◽  
Washout Period ◽  
Excessive Daytime Sleepiness ◽  
Daytime Sleepiness ◽  
Symptom Burden ◽  
Pooled Analysis ◽  
Once Daily ◽  
High Burden ◽  
Treatment Assessment ◽  
End Of Treatment

Abstract Introduction Pitolisant was initially approved by the FDA in 2019 for the treatment of excessive daytime sleepiness in adult patients with narcolepsy; in 2020, the indication was expanded to include the treatment of cataplexy. Methods Cataplexy data from 7- or 8-week, randomized, placebo-controlled studies (HARMONY-CTP, HARMONY-1) are reviewed and summarized. In HARMONY-CTP, all patients were required to have ≥3 cataplexy attacks per week at baseline; HARMONY-1 enrolled patients with narcolepsy with or without cataplexy. Pitolisant was individually titrated to a maximum potential dose of 35.6 mg/day. The weekly (WRC) or daily (DRC) rate of cataplexy attacks was calculated from patient diaries. Results In HARMONY-CTP (pitolisant, n=54; placebo, n=51), mean baseline WRC was 11.7 in the pitolisant group and 9.6 in the placebo group. In the subset of HARMONY-1 patients with cataplexy (pitolisant, n=17; placebo, n=11), mean baseline DRC was 1.5 and 1.2, respectively. In HARMONY-CTP, least-squares (LS) mean change in WRC was significantly greater for pitolisant versus placebo at Week 2 (-4.1 vs 1.2; P=0.004) and continued through end of treatment (Week 7; -6.5 vs -0.1; P&lt;0.001). In HARMONY-CTP, treatment response was observed in 66.7% of pitolisant-treated versus 25.5% of placebo-treated patients (P&lt;0.001) for WRC reduction ≥50%, and 77.8% versus 33.3% of patients (P&lt;0.001) for WRC reduction ≥25%. In HARMONY-1, LS mean change in DRC was significantly greater for pitolisant versus placebo at Week 5 (-1.04 vs 0.17; P=0.047) and continued through end of treatment (Week 8; -0.96 vs 0.35; P=0.035). In a pooled analysis of patients with high burden of cataplexy (≥15 attacks/week) at baseline (pitolisant, n=20; placebo, n=11), LS mean change in WRC at end-of-treatment assessment was significantly greater for pitolisant (-14.5; baseline, 23.9; final, 9.4) versus placebo (-0.1; baseline, 23.1; final, 23.0; P=0.004). There was no evidence of rebound cataplexy after a 1-week placebo washout period. Conclusion Pitolisant, at once-daily doses of up to 35.6 mg, demonstrated a statistically significant and clinically meaningful reduction in the frequency of cataplexy attacks in adults with narcolepsy, including patients with a high symptom burden. Onset of response was observed within the first few weeks of pitolisant treatment. Support (if any) Bioprojet Pharma and Harmony Biosciences, LLC.

The Relation of Vibrator Surface Area and Static Application Force to the Vibrator-to-Head Coupling

1968 ◽  
Vol 11 (4) ◽  
pp. 805-810 ◽  
Author(s):  
E. R. Nilo
Keyword(s):  
Young Adult ◽  
Surface Area ◽  
Unit Area ◽  
Bone Conduction ◽  
Pressure Force ◽  
Adult Men ◽  
Surface Areas ◽  
History Of ◽  
Preliminary Study ◽  
Bone Conduction Hearing

Twelve young adult men with normal hearing and no history of ear disease took part in our study of the relation of vibrator surface area and static application force to the vibrator-to-head coupling. For vibrator surface areas of 1.125, 2.25, and 4.5 cm 2 coupled to the forehead under static forces of 150, 300, and 600 gm, monaural thresholds of bone-conduction hearing were determined at frequencies 250, 500, 1000, and 2000 Hz. With surface area constant, threshold improvement was frequency dependent. It decreased with increasing frequency until at 2000 Hz it was minimal. In contrast to this, with force constant, the influence of surface area was observed to begin at 2000 Hz. Preliminary study suggests this influence would extend to 4000 Hz. In view of the respective influence of application force and surface area to bone-conduction hearing, equating vibrator-to-head coupling on the basis of pressure (force per unit area), when there are two or more vibrators, may not represent an adequate control.

Oral cobalamin supplementation in cats with hypocobalaminaemia: a retrospective study

2017 ◽  
Vol 19 (12) ◽  
pp. 1302-1306 ◽  
Author(s):  
Linda Toresson ◽  
Joerg M Steiner ◽  
Gunilla Olmedal ◽  
MajBritt Larsen ◽  
Jan S Suchodolski ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Gastrointestinal Disease ◽  
Oral Treatment ◽  
Clinical Signs ◽  
Reference Interval ◽  
Inclusion Criteria ◽  
Promising Alternative ◽  
Once Daily ◽  
Oral Supplementation ◽  
Number Of Patients

Objectives The objective of the study was to evaluate whether oral cobalamin supplementation can restore normocobal-aminaemia in cats with hypocobalaminaemia and clinical signs of gastrointestinal disease. Methods This was a retrospective study based on a computerised database search for client-owned cats treated at Evidensia Specialist Animal Hospital, Helsingborg, Sweden, during the period December 2013 to August 2016. Inclusion criteria were cats with clinical signs of chronic enteropathy, an initial serum cobalamin concentration ⩽250 pmol/l (reference interval 214–738 pmol/l) and oral treatment with cobalamin tablets. Results Twenty-five cats met the inclusion criteria. The cats were treated with 0.25 mg cyanocobalamin tablets once daily. Serum cobalamin concentration was rechecked 27–94 days after continuous oral cobalamin supplementation. All cats had serum cobalamin concentrations above the reference interval after oral cobalamin supplementation. Median (range) serum cobalamin concentration was 128 pmol/l (111–250 pmol/l) prior to treatment and 2701 pmol/l (738–16,359 pmol/l) after supplementation. This difference was statistically significant ( P <0.0001). Conclusions and relevance Our results suggest that oral cobalamin supplementation is effective in increasing serum cobalamin to supranormal concentrations in cats with hypocobalaminaemia. Thus, oral cobalamin supplementation is a promising alternative to parenteral administration. Prospective comparative studies in cats being treated with parenteral vs oral cobalamin supplementation in a larger number of patients are warranted before oral supplementation can be recommended for routine use.

scholarly journals Pharmacokinetics, Safety, and Clinical Outcomes of Omadacycline in Women with Cystitis: Results from a Phase 1b Study

2019 ◽  
Vol 63 (5) ◽  
Author(s):  
J. Scott Overcash ◽  
Pouru Bhiwandi ◽  
Lynne Garrity-Ryan ◽  
Judith Steenbergen ◽  
Stephen Bai ◽  
...  
Keyword(s):  
Clinical Success ◽  
Open Label ◽  
Once Daily ◽  
Open Label Study ◽  
End Of Treatment ◽  
Urine Concentrations ◽  
Phase 1B ◽  
Blood And Urine Samples ◽  
Group 3 ◽  
Group 2

ABSTRACT Omadacycline, an aminomethylcycline antibiotic, is approved as once-daily intravenous (i.v.) and oral (p.o.) monotherapy for acute bacterial skin and skin structure infections and for community-acquired bacterial pneumonia, and it is under development for treatment of urinary tract infection (UTI). This is a phase 1b, randomized, open-label study of omadacycline in women with cystitis (defined as UTI symptoms and a positive urine leukocyte esterase test). Patients received omadacycline for 5 days (group 1: 200 mg intravenously on day 1, then 300 mg orally every 24 h [q24h]; group 2: 300 mg orally every 12 h [q12h] on day 1, then 300 mg orally q24h; group 3: 450 mg orally q12h on day 1, then 450 mg orally q24h). Blood and urine samples were collected over 5 days. Investigator-assessed clinical response was determined at end of treatment (EOT; day 6) and posttreatment evaluation (PTE; 5 to 9 days after last dosing). A total of 31 women were treated. At steady state (day 5), the range of mean omadacycline urine concentrations over 24 h across the groups was 17.94 to 48.12 μg/ml. The most common treatment-emergent adverse events were gastrointestinal (including nausea [60% to 73%] and vomiting [20% to 40%]) and were generally mild and transient. Investigator-determined clinical success was observed in 94% and 84% of patients at EOT and PTE, respectively, with similar results across groups. A favorable microbiological response at PTE was observed in 78% of patients who had a baseline pathogen. Omadacycline is partially excreted in urine and appears to be safe and well tolerated. These preliminary results indicate that omadacycline warrants further evaluation in larger controlled UTI studies.

Low-dose oral administration of human interferon alpha can control the development of Theileria parva infection in cattle

Parasitology ◽  
1990 ◽  
Vol 101 (2) ◽  
pp. 201-209 ◽  
Author(s):  
A. S. Young ◽  
A. C. Maritim ◽  
D. P. Kariuki ◽  
D. A. Stagg ◽  
J. M. Wafula ◽  
...  
Keyword(s):  
Interferon Alpha ◽  
Oral Treatment ◽  
Human Interferon ◽  
Theileria Parva ◽  
Once Daily ◽  
Treatment Groups ◽  
Control Calf ◽  
Dose Oral ◽  
Homologous Challenge

Two natural human interferon alpha preparations, (nHuIFN-μ [Cantell]) and (Nhuifn-μ [ISI]), were used for the oral treatment of cattle experimentally infected with Theileria parva parva. In the first experiment, 8 Friesian bulls were inoculated with a 1 in 10 dilution of a sporozoite stabilate of T. p. parva (Marikebuni) stock. Four of the cattle were treated daily with 1 international unit/kg body weight (i.u./kg bwt) of nHuIFN-μ (Cantell) from day –2 to day 8 p.i. None of the 4 calves given IFN developed clinical theileriosis, but 3 of the 4 control calves died of theileriosis while the fourth had a mild infection. Three of 4 treated calves and the 1 surviving control calf developed a detectable antibody response to T. p. parva schizont antigen but, on challenged with a 10-fold higher dose of stabilate, the surviving control animal and only 1 of the 4 treated calves proved to be immune. In a second experiment, 4 groups of 4 calves were inoculated with the same stabilate dilution. Three treatment groups were given either 1 i.u. nHuIFN-μ (Cantell), 1 i.u. nHuIFN-μ (ISI), or 10 i.u. nHuIFN-μ (ISI)/kg bwt from day –2 to day 8 p.i. once daily and the fourth group were controls. Clinical theileriosis occurred in 2 controls, 2 calves given 10 i.u. nHuINF-μ (ISI), 1 calf given 1 i.u. nHuIFN-μ (ISI) and no calves given 1 i.u. nHuIFN-μ (Cantell)/kg bwt. Of these, 2, 1, 0 and 0 cattle died in the respective groups. All the surviving cattle proved to be immune on homologous challenge with 10-fold higher dose of stabilate except the 2 cattle which did not develop high antibody responses. A third experiment using an undiluted challenge of T. p. parva (Muguga) sporozoite stabilate (10α) on 8 steers. Four steers were treated with 1 i.u. nHuIFN-α (Cantell)/kg bwt and 4 were controls. All calves developed acute theileriosis and the experiment was terminated. Cells of the C2 lymphoblastoid cell line, infected with T. p. parva (Muguga) schizonts, were cultured in vitro with various concentrations (0-01-100 i.u./ml) of nHuIFN-a (Cantell). The IFN appeared to have no effect on host cell or parasite developmental variables when compared to untreated control cultures.

Oral direct factor Xa inhibition with edoxaban for thromboprophylaxis after elective total hip replacement

2010 ◽  
Vol 104 (09) ◽  
pp. 642-649 ◽  
Author(s):  
Alexander Cohen ◽  
Bengt Eriksson ◽  
David Puskas ◽  
Minggao Shi ◽  
Tomas Bocanegra ◽  
...  
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Factor Xa ◽  
Primary Efficacy ◽  
Direct Factor ◽  
Bleeding Events ◽  
Once Daily ◽  
Total Hip ◽  
Efficacy Analysis ◽  
Safety Outcome

SummaryEdoxaban is a new oral direct factor Xa inhibitor. The purpose of this study was to evaluate the efficacy and safety of different doses of edoxaban for the prevention of venous thromboembolism (VTE) in patients undergoing elective total hip replacement. A total of 903 patients were randomised to oral edoxaban 15, 30, 60 or 90 mg once daily or subcutaneous dalteparin once daily (initial dose 2,500 IU, subsequent doses 5,000 IU). Both drugs were begun 6–8 hours postoperatively and continued for 7–10 days, when bilateral venography was performed. The primary efficacy endpoint was the incidence of total VTE, which included proximal and/or distal deep-vein thrombosis (DVT) by venography or symptomatic, objectively confirmed DVT or pulmonary embolism during the treatment period. The primary safety outcome was the incidence of the composite of major and clinically relevant non-major bleeding. All venograms and bleeding events were reviewed by a central independent adjudication committee blinded as to treatment allocation. Of the 903 patients randomised, 776 were evaluable for the primary efficacy analysis. The incidences of VTE were 28.2%, 21.2%, 15.2%, and 10.6% in patients receiving edoxaban 15, 30, 60 and 90 mg, respectively, compared with 43.8% in the dalteparin group (p<0.005 ). There was a statistically significant (p<0.001) dose-response for efficacy across the edoxaban dose groups for total VTE and for major VTE. The incidence of clinically relevant bleeding was low and similar across the groups. Oral edoxaban once daily is effective for preventing VTE after total hip replacement.

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