Medicine and Health Sciences Commons^™

Effects Of Metformin On Spontaneous And Clomiphene-Induced Ovulation In The Polycystic Ovary Syndrome, John E. Nestler , M.D., Daniela J. Jakubowicz , M.D., William S. Evans , M.D., Renato Pasquali , M.D.

Obstetrics and Gynecology Publications

ABSTRACT

Background Obese women with the polycystic ovary syndrome are relatively unresponsive to the induction of ovulation by clomiphene. We hypothesized that reducing insulin secretion by administering metformin would increase the ovulatory response to clomiphene.

Methods We performed oral glucose-tolerance tests before and after the administration of 500 mg of metformin or placebo three times daily for 35 days in 61 obese women with the polycystic ovary syndrome. Women who did not ovulate spontaneously were then given 50 mg of clomiphene daily for five days while continuing to take metformin or placebo. Serum progesterone was measured on days 14, 28, …

Atovaquone Compared With Dapsone For The Prevention Of Pneumocystis Carinii Pneumonia In Patients With Hiv Infection Who Cannot Tolerate Trimethoprim, Sulfonamides, Or Both, Wafaa M. El-Sadr , M.D., M.P.H., Robert L. Murphy , M.D., Teresa Mccabe Yurik , M.S., Roberta Luskin-Hawk , M.D., Tony W. Cheung , M.D., Henry H. Balfour , Jr., M.D., Robert Eng , M.D., Thomas M. Hooton , M.D., Thomas M. Kerkering , M.D., Malte Schutz , M.D., Charles Van Der Horst , M.D., Richard Hafner , M.D.

Internal Medicine Publications

BACKGROUND

Although trimethoprim–sulfamethoxazole is the drug of choice for the prevention of Pneumocystis carinii pneumonia, many patients cannot tolerate it and must switch to an alternative agent.

METHODS

We conducted a multicenter, open-label, randomized trial comparing daily atovaquone (1500-mg suspension) with daily dapsone (100 mg) for the prevention of P. carinii pneumonia among patients infected with the human immunodeficiency virus who could not tolerate trimethoprim–sulfamethoxazole. The median follow-up period was 27 months.

RESULTS

Of 1057 patients enrolled, 298 had a history of P. carinii pneumonia.P. cariniipneumonia developed in 122 of 536 patients assigned to atovaquone (15.7 cases per …

Interferon Alfa-2b Alone Or In Combination With Ribavirin As Initial Treatment For Chronic Hepatitis C, John G. Mchutchison , M.D., Stuart C. Gordon , M.D., Eugene R. Schiff , M.D., Mitchell L. Shiffman , M.D., William M. Lee , M.D., Vinod K. Rustgi , M.D., Zachary D. Goodman , M.D., Ph.D., Mei-Hsui Ling , Ph.D., Susannah Cort , M.D., Janice K. Albrecht , Ph.D.

Internal Medicine Publications

BACKGROUND

Only 15 to 20 percent of patients with chronic hepatitis C have a sustained virologic response to interferon therapy. We compared the efficacy and safety of recombinant interferon alfa-2b alone with those of a combination of interferon alfa-2b and ribavirin for the initial treatment of patients with chronic hepatitis C.

METHODS

We randomly assigned 912 patients with chronic hepatitis C to receive standard-dose interferon alfa-2b alone or in combination with ribavirin (1000 or 1200 mg orally per day, depending on body weight) for 24 or 48 weeks. Efficacy was assessed by measurements of serum hepatitis C virus (HCV) RNA …

Quality Of Life And Clinical Outcomes In Elderly Patients Treated With Ventricular Pacing As Compared With Dual-Chamber Pacing, Gervasio A. Lamas , M.D., E. John Orav , Ph.D., Bruce S. Stambler , M.D., Kenneth A. Ellenbogen , M.D., Elena B. Sgarbossa , M.D., Shoei K. Stephen Huang , M.D., Roger A. Marinchak , M.D., N.A. Mark Estes , M.D., Gary F. Mitchell , M.D., Eric H. Lieberman , M.D., Carol M. Mangione , M.D., Lee Goldman , M.D., John J. Griffin, James D. Maloney, Carlos Rizo-Patrón, Ferdinand J. Venditti, Bruce L. Wilkoff

Internal Medicine Publications

ABSTRACT

Background Standard clinical practice permits the use of either single-chamber ventricular pacemakers or dual-chamber pacemakers for most patients who require cardiac pacing. Ventricular pacemakers are less expensive, but dual-chamber pacemakers are believed to be more physiologic. However, it is not known whether either type of pacemaker results in superior clinical outcomes.

Methods The Pacemaker Selection in the Elderly study was a 30-month, single-blind, randomized, controlled comparison of ventricular pacing and dualchamber pacing in 407 patients 65 years of age or older in 29 centers. Patients received a dual-chamber pacemaker that had been randomly programmed to either ventricular pacing or …

Interferon Alfa-2b Alone Or In Combination With Ribavirin For The Treatment Of Relapse Of Chronic Hepatitis C, Gary L. Davis , M.D., Rafael Esteban-Mur , M.D., Vinod Rustgi , M.D., John Hoefs , M.D., Stuart C. Gordon , M.D., Christian Trepo , M.D., Mitchell L. Shiffman , M.D., Stefan Zeuzem , M.D., Antonio Craxi , M.D., Mei-Hsui Ling , Ph.D., Janice Albrecht , Ph.D.

Internal Medicine Publications

BACKGROUND

Interferon alfa is the only effective treatment for patients with chronic hepatitis C. Forty percent of patients have an initial response to this therapy, but most subsequently relapse. We compared the effect of interferon alone with that of interferon plus oral ribavirin for relapses of chronic hepatitis C.

METHODS

We studied 345 patients with chronic hepatitis C who relapsed after interferon treatment. A total of 173 patients were randomly assigned to receive standard-dose recombinant interferon alfa-2b concurrently with ribavirin (1000 to 1200 mg orally per day, depending on body weight) for six months, and 172 patients were assigned to …

A Comparison Of Four Treatments For Generalized Convulsive Status Epilepticus, David M. Treiman , M.D., Patti D. Meyers , M.P.A., Nancy Y. Walton , Ph.D., Joseph F. Collins , Sc.D., Cindy Colling , R.Ph., M.S., A. James Rowan , M.D., Adrian Handforth , M.D., Edward Faught , M.D., Vincent P. Calabrese , M.D., Basim M. Uthman , M.D., R. Eugene Ramsay , M.D., Meenal B. Mamdani , M.D., Pratap Yagnik , M.D., John C. Jones , M.D., Elizabeth Barry , M.D., Jane G. Boggs , M.D., Andres M. Kanner , M.D.

VCU Health Publications

ABSTRACT

Background and Methods Although generalized convulsive status epilepticus is a life-threatening emergency, the best initial drug treatment is uncertain. We conducted a five-year randomized, doubleblind, multicenter trial of four intravenous regimens: diazepam (0.15 mg per kilogram of body weight) followed by phenytoin (18 mg per kilogram), lorazepam (0.1 mg per kilogram), phenobarbital (15 mg per kilogram), and phenytoin (18 mg per kilogram). Patients were classified as having either overt generalized status epilepticus (defined as easily visible generalized convulsions) or subtle status epilepticus (indicated by coma and ictal discharges on the electroencephalogram, with or without subtle convulsive movements such as …

Preventing The Unnecessary Losses Of Alzheimer's Disease, Lin E. Noyes

Case Studies from Age in Action

Educational Objectives

1. To state the importance of early detection and diagnosis of Alzheimer's disease.

2. To describe common concerns of people in the early stages of Alzheimer's disease.

3. To describe interventions to help people who have recently been diagnosed with Alzheimer's disease or other dementias.

Reducing Medication Mismanagement In Adult Care Residences, Mary Ann F. Kirkpatrick

Case Studies from Age in Action

Educational Objectives

1. Describe the prevalence of medication mismanagement in adult care facilities in Virginia.

2. Explain the significance of selected medication management errors.

3. Recommend practices to improve medication management task performance in adult care facilities.

State Regulation Of Assisted Living Facilities, Sonya A. Sterbenz

Case Studies from Age in Action

Educational Objectives

1. To define the role of assisted living facilities in the continuum of long-term care options for older adults.

2. To present the various arguments concerning the regulation of the assisted living industry.

Medications And Falls, Patricia W. Slattum

Case Studies from Age in Action

Educational Objectives:

1. To describe potential causes of falls and ways to prevent them.

2. To illustrate how medications can contribute to an increased risk of falls and recommend strategies for reducing this risk.

A Comparison Of Rectal Diazepam Gel And Placebo For Acute Repetitive Seizures, Fritz E. Dreifuss , M.D., N. Paul Rosman , M.D., James C. Cloyd , Pharm.D., John M. Pellock , M.D., Ruben I. Kuzniecky , M.D., Warren D. Lo , M.D., Fumisuke Matsuo , M.D., Gregory B. Sharp , M.D., Joan A. Conry , M.D., Donna C. Bergen , M.D., Walter E. Bell , Ph.D

Neurology Publications

ABSTRACT

Background Acute repetitive seizures are readily recognizable episodes involving increased seizure frequency. Urgent treatment is often required. Rectal diazepam gel is a promising therapy.

Methods We conducted a randomized, doubleblind, parallel-group, placebo-controlled study of home-based treatment for acute repetitive seizures. Patients were randomly assigned to receive either rectal diazepam gel, at doses ranging from 0.2 to 0.5 mg per kilogram of body weight on the basis of age, or placebo. Children received one dose at the onset of acute repetitive seizures and a second dose four hours later. Adults received three doses — one dose at onset, and two …