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PubMed1995

Safety and efficacy of controlled-release mesalamine for maintenance of remission in ulcerative colitis. Pentasa UC Maintenance Study Group.

This 12-month, double-blind, placebo-controlled study randomized 205 ulcerative colitis patients in remission to placebo or controlled-release mesalamine at 4 g/day for 12 months. Patients were stratified to either pancolitis or left-sided disease, based on previous diagnosis. Maintenance of remission was defined as a sigmoidoscopic index of < 5, less than five stools per day, and the absence of rectal bleeding. A significantly greater number of patients maintained remission on mesalamine 4 g/day than on placebo at each of five study visits, following the first one-month visit (P < 0.05). The estimated 12-month remission rates for the mesalamine group were 64% (38% for placebo, P = 0.0004). Baseline subgroups (disease location, time since last flare of active disease, and previous response to oral/rectal steroids or sulfasalazine) did not influence remission rates. Treatment-related adverse events were rare. Controlled-release mesalamine is a safe and efficacious single agent for maintaining remission of ulcerative colitis.

Adult↗

PubMed2006

Slow tapering from methadone maintenance in a program encouraging indefinite maintenance.

Longitudinal studies have indicated that most opioid agonist-using patients are not able to successfully complete tapering attempts. Little is known, however, about tapering within a treatment environment that is supportive of indefinite agonist treatment and medication tapering. In this study, all records of patients beginning a slow methadone taper were reviewed (N = 30). No patient successfully completed methadone tapering. Four patients (13.3%) successfully switched to buprenorphine/naloxone, one of whom tapered off buprenorphine/naloxone. Three patients (10%) were continuing their taper at the study's end. One patient transferred to another program, one was administratively discharged, and one had his taper stopped for mishandling doses. The remaining patients (n = 20, 66.7%) stopped their tapers for the following reasons: feeling unstable/withdrawal symptoms (n = 4, 13.3%), drug use/positive urinalysis results (n = 12, 40%), psychiatric instability (n = 3, 10%), and pain management (n = 1, 3.3%). Only one patient prematurely left treatment secondary to a failed taper attempt. Patients attempting tapers should be informed about the difficulty involved and be monitored closely for signs of instability. For a few patients, a taper to a lower methadone dose and a switch to buprenorphine/naloxone are obtainable. Program policies that support both tapering attempts and indefinite maintenance are described in this article.

Adult↗

PubMed1994

A randomized clinical trial in bronchogenic small-cell carcinoma evaluating alternating maintenance therapy of vincristine, adriamycin, procarbazine, and etoposide (VAPE) with cyclophosphamide, CCNU, and methotrexate (CCM) versus CCM maintenance alone in complete responders following VAPE induction and late intensification.

Initially, 109 evaluable patients with locally advanced or metastatic small cell lung cancer (SCLC) were treated with vincristine, Adriamycin, procarbazine, and etoposide (VAPE). Partial (PR) or nonresponders (NR) were crossed to CCM (cyclophosphamide, CCNU, and methotrexate) and then to HMiVe (hexamethylmelamine, mitomycin C, vinblastine) sequentially at maximum response. Complete responders (CR) were intensified by 50% with VAPE primarily and randomized to VAPE, alternating with CCM or CCM alone during maintenance. CR patients with limited disease received local thoracic irradiation and prophylactic cranial irradiation (PCI), whereas those with extensive disease received PCI alone. There were 45 patients (41%) who achieved a CR to chemotherapy, and 27 patients were eligible for randomization. Of 12 CR patients randomized to alternating therapy (VAPE/CCM), the median survival was 25.9 months compared to 12.9 months for 15 CR patients randomized to continuous CCM (P = .049). In addition, 35 patients achieved a PR (32%) and 29 were NR (27%). Overall median survivals were significantly different for the CR patients (13.0 months) as compared to PR (7.6 months) and NR patients (6.4 months). Late intensification did not appear to add substantially to survival while contributing to toxicity. In summary, VAPE is a new outpatient regimen for SCLC, which is highly effective as an induction regimen with moderate hematologic toxicity and predominantly gastrointestinal nonhematologic toxicity.

Aged↗

PubMed1980

[Studies on establishment and maintenance of persistent infection with measles virus in NC-37 cell. III. Role of interferon in establishment and maintenance of persistent infection (author's transl)].

Human lymphoblastoid cell, NC-37, persistently infected with measles virus could always produce interferon in culture medium. Persistently infected cells were sensitive to interferon and acquired antiviral state, but normally yielded infectious progeny virus in culture fluid. Sensitivity of measles virus to interferon was studied because measles virus continued to replicate in these persistently infected cell. Attenuated and SSPE viruses which established persistent infection were relatively resistant to antiviral effect of interferon while wild strain had a sensitivity. Interferon produced endogenously in these persistently infected cells did not play an important role in maintenance of persistent infection caused by the suppression of virus replication. As it was found that persistently infected cell treated with interferon as high as 10(4) units/ml was significantly decreased virus yield in parallel with hemadsorption, it is suggested that endogenous measles virus which has been replicate in persistently infected cell might be also sensitive to high titer of interferon. NC-37 cell pretreated with interferon (10(3) units/ml) was infected with wild strain of measles virus. The treated cell led to decrease approximately 30% of virus yield and hemadsorption at the time when maximum yield was obtained in control cell, and that cell death reduced one week, but persistent infection could not be established.

Cells, Cultured↗

PubMed1994

The role of the restorative dentist in the diagnosis and maintenance phases of implant therapy--Part III: The restoration and maintenance of oral health prior to the provision of the implant prosthesis.

Establishing and maintaining the patient's oral health prior to provision of the definitive implant restoration is the responsibility of the restorative dentist and is an important aspect of comprehensive treatment. The additional time and expense required to provide oral hygiene and conventional dental treatment needs to be acknowledged by the implant team and the patient. An anticipated three to five treatment hours are often required to provide maintenance and hygiene care, with additional time needed to provide individualized conventional dental treatment to each patient. The provision of implant therapy is a rewarding experience when all aspects of treatment are properly planned and competently performed. The general practitioner is the logical resource to provide much of the necessary treatment that is directly and indirectly related to the provision of implant restorative dentistry.

Dental Care↗

PubMed1994

Postextraction ridge maintenance using the endosseous ridge maintenance implant (ERMI).

Classically, alveolar bone height in the maxilla and mandible is naturally lost by resorption soon after exodontia; or subsequently by pressure that is exerted on the edentulous ridge by the removable denture. As the alveolar bone is resorbed, the only alternative given to the dental practitioner in the past was to constantly reline the removable prosthesis. With the ERMI, the postextraction edentulous ridge can be sustained; thus reducing the physiological and retentive complications encountered by the patient over time. The intent of this article is to review the physiology of the ERMI in bone, describe in detail the basic placement procedure, as well as discuss the indications and contraindications to the use of the Endosseous Ridge Maintenance Implant System.

Alveolar Bone Loss↗

PubMed1980