Testosterone Replacement Therapy for Bone Loss Prevention in HIV-Infected Males

2003 ◽  
Vol 37 (4) ◽  
pp. 582-585 ◽  
Author(s):  
Patrick G Clay ◽  
Amy I Lam
Keyword(s):  
Bone Loss ◽  
Hiv Infection ◽  
Data Sources ◽  
Hormone Deficiency ◽  
Testosterone Replacement Therapy ◽  
Data Synthesis ◽  
Medline Search ◽  
Prevention Of Bone Loss ◽  
Endocrine Abnormality ◽  
Hiv Negative

OBJECTIVE: To review the use of testosterone for the prevention of bone loss in men with HIV infection. DATA SOURCES: A MEDLINE search (1966–May 2002) on the use of testosterone in osteoporosis/HIV infection was performed. A reference bibliography search was also completed. DATA SYNTHESIS: Osteopenia/osteoporosis is reported in HIV-infected men due to a myriad of factors. Sex hormone deficiency is a frequent endocrine abnormality in this population. CONCLUSIONS: In HIV-negative men, testosterone may be beneficial for preventing bone loss and hastening the resolution of fractures. Testosterone's role in preventing bone loss in HIV-infected men remains to be defined.

Isoniazid-Associated Psychosis: Case Report and Review of the Literature

1993 ◽  
Vol 27 (2) ◽  
pp. 167-170 ◽  
Author(s):  
Karen A. Pallone ◽  
Morton P. Goldman ◽  
Matthew A. Fuller
Keyword(s):  
Case Report ◽  
English Language ◽  
Case Reports ◽  
Data Extraction ◽  
Data Sources ◽  
Review Of The Literature ◽  
Data Synthesis ◽  
Medline Search ◽  
Study Selection ◽  
Language Literature

Objective To describe a case of isoniazid-associated psychosis and review the incidence of this adverse effect. Data Sources Information about the patient was obtained from the medical chart. A MEDLINE search of the English-language literature published from 1950 to 1992 was conducted and Index Medicus was manually searched for current information. Study Selection All case reports describing isoniazid-associated psychosis were reviewed. Data Extraction Studies were evaluated for the use of isoniazid, symptoms of psychosis, onset of symptoms, and dosage of isoniazid. Data Synthesis The case report is compared with others reported in the literature. The incidence of isoniazid-associated psychosis is rare. Conclusions The mechanism of isoniazid-associated psychosis is uncertain. It appears that isoniazid was associated with the psychosis evident in our patient and in the cases reviewed.

Etiology of Patellar Tendinopathy in Athletes

2005 ◽  
Vol 14 (3) ◽  
pp. 259-272 ◽  
Author(s):  
Sheri A. Hale
Keyword(s):  
Clinical Management ◽  
Data Sources ◽  
Patellar Tendinopathy ◽  
Extrinsic Factors ◽  
Data Synthesis ◽  
Medline Search ◽  
Complex Process ◽  
Study Selection ◽  
Joint Dynamics ◽  
Type Data

Objective:To review the etiology of patellar tendinopathy as it relates to clinical management of chronic patellar-tendon disease in athletes.Data Sources:Information was gathered from a MEDLINE search of literature in English using the key wordspatellar tendinitis, patellar tendonitis, patellar tendinosis, patellar tendinopathy,andjumper’s knee.Study Selection:All relevant peer-reviewed literature in English was reviewed.Data Synthesis:The etiology of patellar tendinopathy is multifactorial, incorporating both intrinsic and extrinsic factors. Age, muscle flexibility, training program, and knee-joint dynamics have all been associated with patellar tendinopathy. The roles of gender, body morphology, and patellar mobility in patellar tendinopathy are unclear.Conclusions:The pathoetiology of patellar tendinopathy is a complex process that results from both an inflammatory response and degenerative changes. There is a tremendous need for research to improve our understanding of the pathoetiology of patellar tendinopathy and its clinical management.

Divalproex Sodium Therapy in Elderly with Dementia-Related Agitation

2002 ◽  
Vol 36 (10) ◽  
pp. 1625-1628 ◽  
Author(s):  
Crystal E Pratt ◽  
Steven M Davis
Keyword(s):  
Clinical Trials ◽  
Elderly Patients ◽  
Statistical Significance ◽  
Data Sources ◽  
Controlled Trials ◽  
Divalproex Sodium ◽  
Data Synthesis ◽  
Medline Search ◽  
Potential Benefits

OBJECTIVE: To review available literature regarding the use of divalproex sodium in the treatment of agitation in elderly patients with dementia. DATA SOURCES: Clinical trials and review articles were identified by MEDLINE search (1966 — March 2002). DATA SYNTHESIS: The literature provides information regarding the potential benefits and tolerability of divalproex sodium in the treatment of dementia-related agitation. This article analyzes 7 studies to better understand the role of divalproex sodium in the treatment of dementia. CONCLUSIONS: Divalproex sodium may offer a slight benefit to elderly patients suffering from dementia-related agitation. Until better-controlled trials demonstrate statistical significance and comparisons with established treatments are performed, practitioners should use divalproex sodium cautiously.

Safety and Efficacy of Influenza Vaccine in Children

2003 ◽  
Vol 37 (11) ◽  
pp. 1712-1715 ◽  
Author(s):  
Leslie GB Goldstein
Keyword(s):  
Influenza Vaccine ◽  
Asthma Exacerbation ◽  
Data Sources ◽  
Influenza Vaccines ◽  
Data Synthesis ◽  
Safety And Efficacy ◽  
Medline Search ◽  
Asthmatic Children ◽  
Search Terms

OBJECTIVE: To describe the safety and efficacy of influenza vaccines in asthmatic children. DATA SOURCES: Literature was identified by a MEDLINE search (2002–March 2003). Key search terms included asthma, exacerbation, children, vaccine, and influenza. DATA SYNTHESIS: Concerns that the influenza vaccine may exacerbate asthma attacks have kept many asthmatic children from receiving this immunization. Researchers have conducted studies to determine the burden of influenza on asthmatic children, the safety of influenza vaccines, and their benefit in the presence of glucocorticoid burst therapy in the same population. CONCLUSIONS: Influenza vaccines tested are safe and efficacious in asthmatic children.

Levodopa Therapy and the Risk of Malignant Melanoma

2000 ◽  
Vol 34 (3) ◽  
pp. 382-385 ◽  
Author(s):  
Jolene F Siple ◽  
Diana C Schneider ◽  
Wendy A Wanlass ◽  
Burton K Rosenblatt
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Malignant Melanoma ◽  
English Language ◽  
Case Reports ◽  
Levodopa Therapy ◽  
Data Sources ◽  
Data Synthesis ◽  
Medline Search ◽  
Search Terms

OBJECTIVE: To evaluate the use of levodopa therapy in patients with Parkinson's disease and malignant melanoma. DATA SOURCES: A MEDLINE search (January 1966–September 1999) of English-language articles was conducted. Key search terms included levodopa, melanoma, and Parkinson's disease; 34 case reports were identified. DATA SYNTHESIS: Carbidopa/levodopa continues to be a mainstay in the treatment of Parkinson's disease. Since the late 1970s, a warning has appeared in the prescribing literature for levodopa regarding the risk of activating malignant melanoma. An evaluation was conducted of the case reports in which a causal relationship between levodopa and melanoma was suggested. CONCLUSIONS: There is an unlikely association between levodopa and induction or exacerbation of malignant melanoma.

Cephalosporin-Associated Hypoprothrombinemia: Case and Review of the Literature

1994 ◽  
Vol 10 (1) ◽  
pp. 5-13
Author(s):  
Christine Stork ◽  
Joseph V. Etzel ◽  
Joseph M. Brocavich ◽  
Susan Forlenza
Keyword(s):  
Adverse Effect ◽  
Data Sources ◽  
Side Chain ◽  
Review Of The Literature ◽  
Clotting Factors ◽  
Data Synthesis ◽  
Medline Search ◽  
Factors Associated ◽  
Study Selection ◽  
Risk Patients

Objective: To present a case of cefotetan-associated hypoprothrombinemia and to review the literature concerning cephalosporin-associated hypoprothrombinemia. Data Sources: Information was collected by conducting a MEDLINE search for cases, clinical trials, reviews, and other articles pertaining to cephalosporin use and the development of hypoprothrombinemia. Study Selection: Studies, cases, and letters were selected if they addressed the development of hypoprothrombinemia in cephalosporin-treated patients. Data Synthesis: A case of hypoprothrombinemia is described in an 82-year-old woman who received cefotetan for the treatment of a urinary tract infection. A review of the literature revealed more than 50 reported cases and multiple clinical studies evaluating this adverse effect. The postulated mechanism behind this occurrence is the inhibition of the synthesis of vitamin K-dependent clotting factors by the N-methyl-thiotetrazole (NMTT) moiety found in certain cephalosporin side chains. Risk factors associated with the development of this adverse effect include advanced age, renal and hepatic impairment, recent surgical procedures, malnutrition, and the use of H2-antagonists. Conclusions: Cephalosporins containing the NMTT side chain are associated with the development of hypoprothrombinemia and possibly bleeding, especially in high-risk patients.

Interactions of Acetaminophen, Opiates, and Their Combinations with Warfarin and other Oral Anticoagulants

1997 ◽  
Vol 13 (2) ◽  
pp. 89-92 ◽  
Author(s):  
Thomas YK Chan
Keyword(s):  
Oral Anticoagulants ◽  
Data Sources ◽  
Bleeding Complications ◽  
Data Synthesis ◽  
Healthy Men ◽  
Medline Search ◽  
Duration Of Therapy ◽  
Study Selection ◽  
Combined Use ◽  
Pertinent Information

Objective: To determine whether acetaminophen, opiates, or acetaminophen–opiate combinations potentiate the effect of warfarin. Data Sources: Previous studies or reports of interactions between warfarin and acetaminophen, opiates, or acetaminophen–opiate combinations (MEDLINE search, January 1976 to January 1996). Study Selection: All articles were included in the review. Pertinent information was selected for discussion. Data Synthesis: Studies of the effects of acetaminophen on anticoagulation with warfarin and other oral anticoagulants have yielded conflicting results. In three placebo-controlled studies of patients or healthy men, acetaminophen 2–4 g/d for 2–3 weeks potentiated the anticoagulant effect of warfarin and other related drugs compared with placebo. Similar findings were seen in one uncontrolled study of patients taking acetaminophen 2.6 g/d for 4 weeks, but not in another in which patients took acetaminophen 3.25 g/d for 14 days. Other studies showed that two doses of acetaminophen 650 mg for 1 day did not influence the prothrombin time. There were six reports of adverse interactions between warfarin and acetaminophen–opiate combinations. Of five patients who were given an acetaminophen–propoxyphene combination, the equivalent daily doses of acetaminophen and propoxyphene were specified for four and ranged from 1.95 to 6.5 g and from 195 to 1,000 mg, respectively. The duration of therapy in the five patients ranged from less than 1 day to 10 days. One of these patients also received ibuprofen. Another patient took an unspecified acetaminophen–codeine product equivalent to acetaminophen 1.56 g/d. The exact mechanism underlying such interactions is not clear. Conclusions: During the combined use of warfarin and acetaminophen (in high daily doses for 2–3 wk) or acetaminophen–propoxyphene combinations, patients should be closely monitored for anticoagulant control and bleeding complications.

Do Ethanol and Metronidazole Interact to Produce a Disulfiram-Like Reaction?

2000 ◽  
Vol 34 (2) ◽  
pp. 255-257 ◽  
Author(s):  
Caroline S Williams ◽  
Kevin R Woodcock
Keyword(s):  
Drug Reaction ◽  
Case Reports ◽  
Convincing Evidence ◽  
Data Sources ◽  
Data Synthesis ◽  
Medline Search

OBJECTIVE: To obtain and evaluate evidence about the supposed disulfiram-like interaction between metronidazole and ethanol. DATA SOURCES: MEDLINE search from January 1964 to June 1999, using the terms metronidazole, ethanol, and drug reaction. DATA SYNTHESIS: The manufacturer's warnings include a disulfiram-like reaction between metronidazole and ethanol. However, review of reports published between 1969 and 1982 produced no convincing evidence that this reaction exists. Six case reports involving eight patients were evaluated. CONCLUSIONS: Four of the eight cases were serious, including one death, but the authors of all the reports presumed the metronidazole–ethanol reaction to be an established pharmacologic fact. None provided evidence that could justify their conclusions.

Effect of Cyclobenzaprine on Tricyclic Antidepressant Assays

2005 ◽  
Vol 39 (7-8) ◽  
pp. 1314-1317 ◽  
Author(s):  
Nicole M Van Hoey
Keyword(s):  
Tricyclic Antidepressants ◽  
Tricyclic Antidepressant ◽  
Ultraviolet Absorption ◽  
Data Sources ◽  
Charge Ratio ◽  
Data Synthesis ◽  
Medline Search ◽  
Search Terms ◽  
History Of ◽  
Unique Mass

OBJECTIVE To evaluate cyclobenzaprine interference on tricyclic antidepressant assays. DATA SOURCES Literature was identified through a MEDLINE search (1966–August 2004) using the search terms cyclobenzaprine, tricyclic antidepressant, toxicology, and assay. DATA SYNTHESIS Cyclobenzaprine is structurally similar to tricyclic antidepressants and is often identified as a tricyclic antidepressant on toxicology assays. Older chromatographic assays demonstrate retention time differences of only seconds and nearly identical color stains between cyclobenzaprine and individual tricyclic antidepressants. In comparison, ultraviolet absorption ratios of 4.18 for amitriptyline and 1.85 for cyclobenzaprine are easily distinguished. Spectroscopy also consistently identifies cyclobenzaprine's unique mass-to-charge ratio peaks of 275 and 215 compared with those of amitriptyline. Available bioanalytic techniques are reviewed for their ability to correctly identify cyclobenzaprine and differentiate the drug from tricyclic antidepressants. CONCLUSIONS When assays are positive for tricyclic antidepressants without a history of their use, an attempt should be made to identify confounders, such as cyclobenzaprine. Newer bioanalytic techniques, such as ultraviolet absorption and mass spectroscopy, accurately identify cyclobenzaprine in such instances.

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