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Human immunodeficiency virus (HIV)
Published in Hung N. Winn, Frank A. Chervenak, Roberto Romero, Clinical Maternal-Fetal Medicine Online, 2021
Richard Basilan, William Salzer
Patients already on ARV therapy should be continued on their regimen, with the oral route being preferred whenever possible. Intravenous zidovudine is recommended for all HIV-positive women during labor, even if drug resistance to this drug has been documented. If the patient was taking zidovudine as part of a combination regimen, the other components of her ARV therapy should also be continued. Zidovudine should be given at a dose of 2mg/kg IV over 1 hour, followed by an infusion of 1mg/kg/hour until the time of delivery, and should ideally be started 3 hours prior to surgery in the event of planned caesarian section. This dose is based on the original protocol used in the PACTG 076 (8) published in 1994, which demonstrated a marked reduction in MTCT from 25.5% in the placebo group to 8.3% infants in the zidovudine group. Stavudine (d4T) should be discontinued when administering zidovudine because of antagonism between these two drugs.
Infections
Published in Evelyne Jacqz-Aigrain, Imti Choonara, Paediatric Clinical Pharmacology, 2021
Evelyne Jacqz-Aigrain, Imti Choonara
This dosing schedule is not justifiable in pharmacokinetic terms. It was recently shown that exposure to zidovudine (area under the plasma concentration time curve and maximum plasma concentration) was of the same order of magnitude with dosing schedules of 4 mg/kg BD and 2 mg/kg QDS [7]. However, data on the intracellular pharmacokinetics of zidovudine in neonates using either of the 2 dosing schedules are not available. It may be difficult for parents to administer zidovudine to their infants every 6 hours; administration of zidovudine to neonates in 2 daily doses, as is done in adults, might be preferable. This dosing schedule (4 mg/kg BD) was used in a randomised, placebo-controlled comparative study (the PETRA study) [8]. Similar results were obtained in reducing perinatal HIV-1 transmission in the PETRA treated groups and in the PACTG 076 treated group. However, aspects of treatment, other than the dosing schedule for zidovudine, differed between the PETRA and PACTG 076 trials (eg, duration of treatment, combined treatment with lamivudine), making it impossible to specifically identify the consequences of the change in dosing schedule. From the results currently available, it is not possible to determine whether zidovudine administered BD is as effective as zidovudine administered QDS for preventing HIV transmission from mother to fetus.
Benzydamine
Published in Anton C. de Groot, Monographs in Contact Allergy, 2021
Benzydamine is an indazole non-steroidal anti-inflammatory drug with analgesic, antipyretic, and anti-edema properties. Available as a liquid mouthwash, spray for mouth and throat, topical cream, and vaginal irrigation (formerly also available in tablets, suppositories and intramuscular injections), benzydamine is most frequently employed for the relief of painful inflammatory conditions of the mouth and the musculoskeletal system, respectively. It is also said to promote healing. In pharmaceutical products, benzydamine is employed as benzydamine hydrochloride (CAS number 132-69-4, EC number 205-076-0, molecular formula C19H24ClN3O) (1).
The Association Between Suicide-Related Media Coverage and Suicide: A Cross-Sectional Observational Study
Published in Archives of Suicide Research, 2022
Emma Hofstra, Marjan Bakker, Chiara A. M. Diepstraten, Iman Elfeddali, Mathilde S. Lucas, Chijs van Nieuwenhuizen, Christina M. van der Feltz-Cornelis
RQ4. Corrected for seasonal influences, multiple regression indicated no significant effects on differences in the number of suicides of reporting the method of suicide (t = 0.680; b = 0.561; p = .498; R2=0.017), celebrity-status (t=.085; b=.076; p = .932; R2= .017), gender (t = 0.563; b = 0.847; p =.574; R2=0.017), age (t=.199; b=.160; p = .843; R2= .017), and guideline adherence (t = 1.164; b = 0.306; p=.247; R2=0.017). Substantial evidence for the null hypothesis (no effect) was found in Bayesian correlations (BF01=8.000; BF01=8.403; BF01=8.475; BF01=8.696; BF01=6.135, respectively). The type of media report (suicide-cases, suicide-news, and the remaining category) was also not associated with differences in suicides (F (2, 437)=1.504; p = .223; R2=0.007). The outcomes are presented in Table 3.
Expressions of circadian clock genes represent disease activities of RA patients treated with biological DMARDs
Published in Modern Rheumatology, 2020
Kenta Kaneshiro, Kohsuke Yoshida, Kanta Morii, Yuto Oketani, Koto Uchida, Arisa Yaekura, Ikumi Okumura, Teppei Hashimoto, Yoshiko Kawasaki, Nao Shibanuma, Yoshitada Sakai, Akira Hashiramoto
As shown in Figure 2, the expressions of Per2, Cry1, Cry2, Clock and Rora in RA patients was lower than healthy controls; p < .000001, p < .00001, p = .0745, p < .000001, and p < .000001, respectively. While the expression of E4bp4 in RA patients was higher than healthy controls (p < .001). After treatments, expressions of Per2 were significantly increased in TCZ-treated (p < .05), ABT-treated (p < .01) and overall patients (p < .001), though was not significant in TNFi-treated patients (p = .055). Expression of Cry1 and Cry2 were significantly increased in overall patients (p < .05), though there was no significant difference for individual agents. Expressions of Clock were significantly increased in ABT-treated (p < .01) and overall patients (p < .01), and also they were increased in TNFi-treated and TCZ-treated patients though not statistically significant (p = .064 and .076, respectively). Expressions of Rora were increased in ABT-treated (p < .05) and overall patients (p < .01), and also increased in TNFi-treated and TCZ-treated patients (p = .075 and .098, respectively). Finally, Expressions of E4bp4 were decreased in overall patients (p < .01), though not significant in individual agents.
Shifting to the long view: engagement of pregnant and postpartum women living with HIV in lifelong antiretroviral therapy services
Published in Expert Review of Anti-infective Therapy, 2019
Tamsin K Phillips, Landon Myer
Over the past two decades, there has been a paradigm shift in our approach to PMTCT. Global guidelines on the use of antiretroviral drugs for PMTCT have evolved from the initial ACTG 076 trial of zidovudine in pregnancy in 1994 [5] and the WHO’s first guidelines on single-dose and short-course antiretroviral prophylaxis for PMTCT in 2000 [6], through lifelong ART for those meeting strict disease stage criteria and short-term prophylaxis for those not eligible [7–9], to lifelong ART for all pregnant and breastfeeding women [10] and, since 2016, treatment for all [1]. This change represents an evolution in our understandings of HIV transmission, the role of antiretroviral drugs in HIV treatment and prevention, and the potential for PMTCT services as an entry into lifelong HIV care [11]. The benefits of virologic suppression, as a result of ART initiated in pregnancy and continued for life, extend beyond PMTCT in the current pregnancy to protection against transmission in future pregnancies, horizontal transmission to HIV-negative partners, and to improved maternal health [1]. Lifelong ART ultimately impacts on individual-, family- and population-level health outcomes and therefore it is essential to extend our focus to the long view of sustained engagement in lifelong ART services [12].