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PubMed2005

Cost-utility of 2 maintenance treatments for older adults with depression who responded to a course of electroconvulsive therapy: results from a decision analytic model.

OBJECTIVE: The prevalence of major depressive disorder (MDD) in community-dwelling elderly populations is 1% to 3%. After initial treatment of the acute phase of depression, only about 25% to 30% of elderly patients remain well after 1 to 3 years of follow-up. Previous studies suggested that patients who received maintenance electroconvulsive therapy (MECT) demonstrated lower relapse rates, a better subjective sense of well-being, and lower health care costs at 12-month follow-up. This study provides a cost-utility analysis of 2 maintenance treatments for recurrent depression in elderly patients. METHOD: We used a Markov decision model to compare maintenance pharmacotherapy (MPT) with MECT in a theoretical cohort of elderly individuals with MDD who responded to an initial course of ECT. We estimated total costs and total quality-adjusted life years (QALYs) for each strategy as well as the cost per QALY. RESULTS: The model produced a cost per patient of dollar 436,102 for MPT and dollar 281,356 for MECT. The MPT strategy yielded 7.55 QALYs and the MECT strategy yielded 11.43 QALYs. Therefore, MPT cost dollar 57,762 per QALY and MECT cost dollar 24,616 per QALY. CONCLUSION: Our model suggests that MECT may be more cost-effective than MPT in the maintenance treatment of older adults with depression who have responded to a course of acute ETC.

Aged↗
PubMed2006

[Twice-weekly intermittent chemotherapy during the maintenance phase of the short-course treatment for new patients with pulmonary tuberculosis].

BACKGROUND AND OBJECTIVE: Various types of intermittent chemotherapy regimens have been applied for the treatment of tuberculosis worldwide, but, in Japan, any type of intermittent treatment has not been adopted currently as the standard regimens for the treatment of tuberculosis. Intermittent regimens have a great advantage to facilitate directly observed therapy (DOT). To introduce DOT more extensively in Japan, we conducted the present clinical trial to assess the effectiveness and safety of intermittent chemotherapy. PATIENTS AND METHODS: This is a non-randomized trial to compare twice-weekly intermittent therapy under DOT with daily therapy by self-administration. Newly diagnosed patients with pulmonary tuberculosis who completed the initial intensified phase of 2 months with 4 drugs were enrolled. Supervision of drug administration was carried out by the pharmacists who cooperated to the study (Pharmacy DOT). RESULTS: Total 385 patients were enrolled in this trial, of which 135 patients were treated by twice-weekly intermittent maintenance chemotherapy under the supervision by pharmacists and remaining 250 patients were treated by daily maintenance chemotherapy without supervision (self-administration). Treatment success-rates were 97.6% for intermittent treatment group and 95.6% for daily treatment group. Relapse rates after the completion of the treatment course were 3.73/ 100 person-year and 1.76/100 person-year, respectively. The difference between the two groups was not statistically significant. Adverse events required the modification of treatment schedule occurred only in 0.2% of the intermittently treated patients. CONCLUSIONS: After the successful completion of the initial intensified phase of tuberculosis chemotherapy, twice-weekly intermittent chemotherapy during the maintenance phase under the supervision by pharmacist is as effective and safe as the daily therapy, and is conveniently accepted by the patients. The pharmacy DOT with the intermittent therapy during maintenance phase adopted in this trial, should be widely introduced in Japan.

Adolescent↗
PubMed1991

Maintenance of surgical muscle relaxation by repeat doses of vecuronium and atracurium at three different dose levels.

The time-course of the neuromuscular effects of vecuronium (n = 25) and atracurium (n = 25) has been compared at three different levels of maintenance dose in anaesthetized patients. Following intubation with vecuronium 0.1 mg kg-1 or atracurium 0.5 mg kg-1, surgical muscle relaxation was maintained by using increments of equipotent maintenance doses equivalent to 0.5, 1.0 and 1.5 x ED95 for each drug. Repeat doses were administered each time the twitch height, depressed by the previous dose, returned to 25% of its control value. The apparent increase in the duration of action, i.e. the difference between the duration of the last and the first maintenance dose, did not reach statistical significance and approximated 3 +/- 2, 6 +/- 4, 11 +/- 5 and 3 +/- 2, 8 +/- 13, 5 +/- 7 min following the low, medium and high maintenance doses of vecuronium and atracurium, respectively.

Adolescent↗
PubMed1992

Pyrimethamine alone as maintenance therapy for central nervous system toxoplasmosis in 38 patients with AIDS.

We retrospectively assessed the efficacy of maintenance therapy with pyrimethamine alone in 38 patients with AIDS and central nervous system (CNS) toxoplasmosis. The diagnosis was based on clinical presentation and compatible CT scan abnormalities with subsequent response to therapy. Survival analysis was performed by the product limit method of Kaplan-Meier. Fourteen patients received maintenance therapy with 25 mg pyrimethamine per day (group 1), and 24 patients were treated with 50 mg per day (group 2). The median survival from initiation of maintenance therapy until death or end of the study for the entire study population was 32 weeks. Median survival in group 1 was 28 weeks, as compared with 36 weeks in group 2 (p = 0.34). Relapses occurred in 12 patients, six in group 1 and six in group 2. There was no significant difference in failure-free survival between the two treatment groups (p = 0.09). One patient in group 1 and two patients in group 2 experienced severe toxicity, requiring discontinuation of therapy. All three patients relapsed and died. Two patients in group 2 who stopped treatment on their own initiative also had relapses. Thus, all five patients who discontinued therapy had relapses. Five of 13 patients in group 1 and two of 20 patients in group 2 relapsed during continuous therapy with pyrimethamine (p = 0.13); these seven patients responded to reintroduction of combination therapy (n = 6) or treatment with 50 mg pyrimethamine per day (n = 1). The results of our retrospective analysis suggest that maintenance therapy with oral pyrimethamine, 50 mg per day, in AIDS patients with CNS toxoplasmosis is effective.

Acquired Immunodeficiency Syndrome↗
PubMed1991

[Effectiveness of maintenance treatment with cimetidine in duodenal ulcer. Variations depending on the risk group].

One hundred and twenty-two patients with confirmed duodenal ulcer were treated with cimetidine during 6 or 12 weeks. After gastroscopic confirmation of healing, treatment was suppressed during 3 months. Patients were randomized into two therapeutic regimens: intermittent according to recurrence of symptoms and maintenance with 400 mg cimetidine. In patients considered as having mild disease (healing at 6 weeks without recurrence) fared better with maintenance therapy than with intermittent dosage. All patients with moderate to severe disease on intermittent therapy had a recurrence (criterion: more than 6 weeks for healing the ulcer or recurrence before three months). Those on maintenance therapy had the following results: no recurrences 28%, one recurrence 56% and more than one 16%. Ninety three patients were followed during one entire year. There was also a statistical difference in the number of severe complications among patients on continuous maintenance (nil) and those on intermittent therapy (8%, p less than 0.05).

Adolescent↗
PubMed1991

alpha-Interferon for remission maintenance: preliminary report on the Southwest Oncology Group Study.

This preliminary report focuses on the therapeutic role of interferon in a large randomized trial evaluating combination chemotherapy induction and interferon maintenance, as compared with no maintenance therapy, in patients with newly diagnosed multiple myeloma. The trial also included an evaluation of the combination of interferon and dexamethasone therapy for patients who failed to respond to induction chemotherapy or who had achieved only a partial remission. Case accrual is completed for remission induction with 505 eligible patients registered on study, but is still open for additional maintenance registrations. As of January 1991, 161 patients have been randomized to interferon versus observation, but the therapeutic results of this aspect of the study remain coded. Toxicity of interferon maintenance was generally of a mild to moderate degree, and less severe than that of the interferon/dexamethasone combination, which was due to the addition of steroid side effects. Among 41 patients who failed to achieve remission with chemotherapy, 13 (32%) achieved at least a partial remission with interferon/dexamethasone, and only five others (12%) have had progressive disease. Of 12 partial responders on induction chemotherapy, five (42%) achieved remission (75% tumor regression) with interferon/dexamethasone. To date, more than 65% of patients receiving interferon/dexamethasone remain alive, suggesting that this regimen will be useful for patients who fail to achieve remission with induction chemotherapy.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1991

[Acoustic evoked potentials of medium latency and intraoperative wakefulness during anesthesia maintenance using propofol, isoflurane and flunitrazepam/fentanyl].

Auditory evoked potentials have been used as an indicator of awareness. During combined local and general anesthesia clinical signs of adequate anesthesia are difficult to evaluate. In the present study we combined peridural analgesia with three techniques of general anesthesia. Intraoperative wakefulness was documented and correlated with cardiocirculatory parameters as well as with mid-latency auditory evoked potentials (MLAEP). METHODS. After institutional approval and informed consent 30 patients undergoing elective laparotomy were studied as follows: first, continuous peridural analgesia was instituted in all patients to block painful sensation of surgical stimuli and the anesthetic level was maintained at T5. Then general anesthesia was induced with propofol 2.5 mg/kg i.v. (group I, n = 10), thiopental 5 mg/kg i.v. (group II, n = 10), or etomidate 0.2 mg/kg i.v. (group III, n = 10) and maintained with propofol 3-5 mg/kg per hour i.v. (group I), isoflurane 0.4-0.8 vol.-% (group II), or flunitrazepam 0.005-0.01 mg/kg i.v. and fentanyl 0.0025-0.005 mg/kg i.v. bolus injections every 20-30 min (group III). Heart rate and arterial pressure were registered continuously. Purposeful movements of the limbs, eye-opening, or other movements as well as coughing were documented as signs of intraoperative wakefulness. AEP were recorded in the awake state, after induction, and during maintenance of general anesthesia. Latencies of the peaks V, Na, and Pa were measured. By fast-Fourier transformation corresponding power-spectra were calculated to analyze the energy content of the AEP frequency components. RESULTS. Intraoperative wakefulness occurred statistically significantly more often in the patients of group III than in those of groups I and II. There was no correlation between wakefulness and cardiocirculatory parameters. Latencies of peaks V, Na, and Pa in the awake patients were in the normal range; the corresponding power-spectra had their major energy content in the 30-40-Hz range. After induction of general anesthesia with propofol, thiopentone, and etomidate as well as during maintenance of general anesthesia with propofol and isoflurane peak latencies of Na and Pa increased, frequencies in the 30-40 Hz range became suppressed, and MLAEP energy maxima shifted to the low-frequency range. In contrast, during maintenance of general anesthesia with flunitrazepam/fentanyl peak latencies of Na and Pa returned to awake values and frequencies in the range of 30 Hz regained energy dominance in the corresponding power-spectra. CONCLUSIONS. The maintenance of MLAEP and the primary cortical complex Na/Pa correlates with the incidence of motor signs of wakefulness. During the combination of regional and general anesthesia, isoflurane and propofol seem to provide better suppression of intraoperative wakefulness than bolus injections of flunitrazepam/fentanyl.

Adult↗
PubMed1990

[Towards the rehabilitation of maintenance electroconvulsive therapy?].

ECT is a reliable treatment of serious affective disorders more efficacious than antidepressants either used alone or combined with mood stabilizers or neuroleptics. Recurrent affective disorders refractory to all treatments presently available have been tentatively treated by prophylactic ECT since the beginning of ECT. In this study, 16 cases of recurrent affective disorders treated with maintenance ECT are discussed. Six continue to show a good response to maintenance ECT. Six remain improved although they discontinued ECT. ECT failed to improve 4 patients. Indications and inclusion criteria of maintenance ECT are defined. Good responses in cases refractory to all other treatment strategies are promising but still require prospective studies, difficult to implement, in order to confirm the efficacy of maintenance ECT.

Aged↗
PubMed1990

[Anesthesia using propofol during surgery of strabismus in children. A comparison of two different protocols of induction and maintenance].

The purpose of this study is an investigation of two protocols using propofol as induction and maintenance agent in 100 children scheduled for strabismus surgery (4-8 year, ASA I, NYHA I). Protocol I; Propofol 6 mg.kg-1 in 60 s with fentanyl 2 micrograms.kg-1 and vecuronium bromide 0.08 mg.kg-1 for induction, followed by propofol 11 mg.kg-1 for maintenance; Protocol II; Propofol 3 mg.kg-1 in 20 s with fentanyl 3 micrograms.kg-1 for induction, followed by propofol 12 mg.kg-1.h-1 for maintenance. It appears that the use of protocol I offers significant advantages compared with protocol II: a better quality of induction with a lesser incidence of pain during injection of propofol; a better quality of maintenance with very infrequent bradycardia from oculocardiac reflectivity; and a better recovery with a greatly reduced frequency of nausea and vomiting.

Anesthesia, Intravenous↗
PubMedDate not supplied

[Leukemia and malnutrition. II. The magnitude of maintenance chemotherapy as a prognostic factor in the survival of patients with standard-risk acute lymphoblastic leukemia].

In previous papers we have shown that malnutrition is an adverse prognostic factor in the outcome of treatment in patients with standard-risk acute lymphoblastic leukemia. The reason why undernourished children do poorly as compared with well nourished children is that malnourishment leads to a diminished bone marrow reserve thus making necessary to delivery of suboptimal doses of maintenance chemotherapy (less than that calculated according to body surface). Undernourished children receive less 6-MP and MTX and relapse more frequently in the bone marrow, finally reflecting a 5 yr disease-free survival of 26% as compared with 83% in well-nourished children (p less than 0.001). In this paper we have analyzed the impact of the variable delivery of sub-optimal doses of maintenance chemotherapy in a group of 43 pediatric patient with standard-risk acute lymphoblastic leukemia. The 5 year disease free survival of children receiving suboptimal maintenance chemotherapy was 7% as compared with 65% for those receiving full doses of both 6-MP and MTX (p less than 0.001), and more frequent relapse involving the bone marrow in children receiving low doses (71% versus 3%, p = 0.000005). The impact of the variable suboptimal doses of chemotherapy was present in children with both normal and deficient nourishment status. It is concluded that the delivery of suboptimal doses of maintenance chemotherapy, due to bone marrow toxicity related to an abnormal myelopoietic reserve, is an adverse prognostic factor in the outcome to treatment of patients with lymphoblastic leukemia.

Adolescent↗
PubMed1990

A study of the clinical efficacy of maintenance ECT.

Six cases of maintenance electroconvulsive treatment (ECT) in elderly patients with major mood disorders were followed for 1 to 6 years. Documented duration of illness before instituting maintenance ECT ranged from 6 to 53 years (mean +/- SD = 22 +/- 18 years). Measures of effectiveness and safety of maintenance treatment and measures of functional status were prospectively obtained during periods of outpatient ECT administration, and functional status measures were retrospectively obtained for equivalent pre-ECT periods. Such measures included mean frequency of annual hospital admissions and average annual length of inpatient stay, mean scores on standard rating instruments of global functioning and cognitive performance, the average number of prescribed psychotropic medications, and ratings of affect. Some of the authors' findings support the contention that maintenance ECT may help sustain remission in the course of affective illness.

Aged↗
PubMed1989

[Maintenance care for dental implant].

Dental implant has tried at the early stage in 19th century recovering an oral function and esthetics. Technological revolutions in biochemical and new materials have developed on the remarkable change in the dental implants, nowadays we call the three generation therapy for dental implantology. There are many kinds of methods and techniques in dental implants, however a lot of troublesome complication on the process of surgical phase, construction of prothodontics and prognosis of maintenance care. In the proceedings of this symposium, I would like to propose you how to manage the maintenance care for various kind of dental implants through the methodology and case presentations. Tendenay and future for dental implants The current outlook of dental implant has increasing supply and demand not only dentists but also patients. According to Japanese Welfare Ministry's report in 1987, average missing teeth over sixty years old generations are approximately 42% in accordance with NIDR (U.S.A.) research. They are missed on ten over teeth in full 28th teeth dentitions owing to dental caries and periodontal diseases. Generally speaking, latent implant patients are occupied on the same possibility of needs for dental implants both Japan and U.S.A. Management of maintenance care The patients hardly recognized the importance of plaque control for the maintenance care in the intraoral condition after implantation. Dentists and dental staffs must be instruct patients for importance of plaque removal and control, because they already had forgotten the habit of teeth cleaning, especially in the edenturous conditions. 1) Concept of establishment in oral hygiene. Motivation and instruction for patients include very important factors in dental implants as well as in periodontal diseases. Patients who could not achieve on good oral hygiene levels obtained no good results in the long term observations. To establish good oral hygiene are how to control supra plaque surrounding tissues with patient himself. Ultimate concept of implantology have supported common concordance with periodontal therapy. 2) Patients consent and co-operation the right of informed consent, agreement to treatment by the patient has been gaining increased importance to implantology. Even the patient has consent, they must co-operate the process of dental implant with co-therapist (Fig. 2). 3) The clinical examination of clinical parameters in dental implants. (1) Plaque Index (Silness & Loe 1964) and Plaque Control Record (0 Leary 1978) (Table 5). (2) Gingival inflammation (Fig. 3). Ordinarlly, Gingival Bleeding Index (GBI Ainamo & Bay 1975) and Papilla Bleeding Index (Saxer & Jühlemann 1975) are used. (3) The depth of peri-implant sulcus with the plastic probe. (NDU style) (Fig. 4).(ABSTRACT TRUNCATED AT 400 WORDS)

Dental Implants↗
PubMed1989

Pediatric organ donor maintenance: pathophysiologic derangements and nursing requirements.

A retrospective chart review was conducted of 26 organ donors to determine hemodynamic and metabolic derangements encountered and nursing requirements for donor organ maintenance. There were 15 boys and 11 girls with a mean age 6.57 +/- 5.46 years. Mean donor maintenance time was 10.5 +/- 6.7 hours. Cardiorespiratory derangements included hypotension in 16, hypertension in 6, arrhythmias in 17 (premature ventricular contraction in 4, bradycardia in 8, paroxysmal atrial tachycardia in 3, and ventricular tachycardia in 2), asystolic events in 5, pulmonary insufficiency in 6, anemia in 8, and thrombocytopenia in 8. Metabolic and hormonal derangements included hyperglycemia in 18, hypokalemia in 20, hyperkalemia in 4, hyponatremia in 3, hypernatremia in 17, metabolic acidosis in 10, and diabetes insipidus in 15. Hypothermia (temperature 33.3 degrees +/- 0.4 degrees C, mean +/- SD) occurred in 14 donors. The mean physiologic Stability Index score was 22.2 +/- 4.7 and mean Therapeutic Intervention Score was 46.7 +/- 5.8. Total number of nursing hours spent in donor maintenance was 424.5 hours. Therapies offered included diuretics in 10, sodium bicarbonate in 8, antibiotics in 6, insulin in 12, pitressin in 13, verapamil in 3, isoproterenol in 3, dopamine in 17, and intravenous potassium boluses in 14. Of the potential 26 donors, 46 kidneys, 8 hearts, 14 livers, 3 pancreas, and 9 corneas were retrieved in transplantable condition. With appropriate donor maintenance, organs suitable for transplantation can be retrieved despite significant pathophysiologic derangements. Physicians intending to provide donor support should be comfortable with invasive monitoring and cardiorespiratory support and be prepared to provide a nurse to patient ratio of 2:1 at the bedside.

Adolescent↗
PubMed1988

Implications of methadone maintenance for theories of narcotic addiction.

Clinical success in rehabilitation of heroin addicts with maintenance treatment requires stability of the blood level in a pharmacologically effective range (optimally, 150 to 600 ng/mL)-a phenomenon that emphasizes the central importance of narcotic receptor occupation. It is postulated that the high rate of relapse of addicts after detoxification from heroin use is due to persistent derangement of the endogenous ligand-narcotic receptor system and that methadone in an adequate daily dose compensates for this defect. Some patients with long histories of heroin use and subsequent rehabilitation on a maintenance program do well when the treatment is terminated. The majority, unfortunately, experience a return of symptoms after maintenance is stopped. The treatment, therefore, is corrective but not curative for severely addicted persons. A major challenge for future research is to identify the specific defect in receptor function and to repair it. Meanwhile, methadone maintenance provides a safe and effective way to normalize the function of otherwise intractable narcotic addicts.

Drug Administration Schedule↗
PubMed1988

Recent developments in single-subject methodology: methods for analyzing generalization, maintenance, and multicomponent treatments.

At the outset of this chapter we asked whether or not single-subject methodology has outlived its usefulness to behavior therapy. We did so because serious doubts have been expressed about the ability of single-subject methodology to address the salient issues of the day. This chapter allays many of these doubts. This chapter reveals that single-subject researchers are far from helpless when investigating generalization and maintenance and identifying the active (and inactive) components in their compound treatments. In fact, a number of powerful strategies are at their disposal--strategies that are not strangers to the armamentarium of single-case researchers. These strategies are in essence nothing more than extensions of the reversal, multiple baseline, and simultaneous and alternating-treatments designs. In the case of the assessment of generalization, these extensions involve little more than the inclusion of continuous measures (or regular probes) of untrained responses throughout the investigation. In the case of the assessment of maintenance, they involve the replacement of a comparison of two or more acquisition procedures with a comparison of two or more maintenance procedures. And in the case of the identification of active (and inactive) components of compound treatments, they involve the aggregation of the findings from a series of single-subject investigations. When the requirements of single-subject designs and their extensions cannot be met, investigators still have available a set of traditional group designs (e.g., factorial and additive designs) for attacking these same issues. Assessment of generalization, maintenance, and the components of compound treatments are not the only salient issues facing behavior therapy today. Another is the widening gap between the researcher and the practitioner (e.g., Barlow, 1980; Wilson, 1981). It is thought by some that single-subject methodology may be the means of bridging this gap; that through single-subject methodology a new breed of practitioner will appear: the empirical clinician (e.g., Barlow et al., 1984; Goldfried, 1984; Hayes, 1981). This new breed of practitioner will be made up of persons who, for economic and pragmatic reasons, are concerned with accountability and who use single-subject designs to achieve it (Barlow et al., 1984). The present chapter does little to help bridge the gap between the researcher and the practitioner; thus, the present chapter does little to help bring about the creation of this new breed of practitioner, the empirical clinician. In fact, the single-subject strategies described in these pages appear to be suitable for use only by the researcher.(ABSTRACT TRUNCATED AT 400 WORDS)

Behavior Therapy↗
PubMed1988

Maintenance treatment of adults with chronic refractory immune thrombocytopenic purpura using repeated intravenous infusions of gammaglobulin.

Intravenous infusion of gammaglobulin (IVGG) has been extensively used in the treatment of immune thrombocytopenic purpura (ITP) in adults to acutely raise the platelet count but not as a maintenance therapy. This report describes the maintenance treatment of adults with chronic ITP using repeated infusions of 800 to 1,000 mg/kg of IVGG. Sixteen of 40 patients were able to discontinue all therapy after receiving between one and 15 infusions. Five patients achieved remission and 11 other patients became stable without therapy (SWT) maintaining a platelet count greater than 20,000/microL without bleeding. The average quantity of gammaglobulin received for all patients was 606 g per patient. Of the 30 patients who underwent but did not respond to splenectomy, 11 (37%) were able to discontinue all therapy by either achieving remission (5) or becoming SWT (6). None of the five patients who achieved remission did so after only the initial therapy; all first received between one and 12 maintenance infusions. The ten splenectomized patients who were unresponsive to IVGG also failed to subsequently respond to conventional therapy including immunosuppressive agents and androgens. No toxicity of IVGG was seen except for postinfusion headaches. IVGG is an effective although expensive maintenance therapy for adults with ITP and is useful in patients who have not responded to splenectomy.

Adult↗
PubMedDate not supplied

Feasibility of discontinuation of corticosteroid maintenance therapy in heart transplantation.

Corticosteroid maintenance immunosuppression therapy was successfully discontinued in 24 of 46 patients (52%) who underwent orthotopic heart transplantation between March 8, 1985 and September 1, 1986. In the remaining 22 patients three or more rejection episodes occurred within a 4-month period, and these patients were subsequently maintained on low to moderate dosages of corticosteroids. Patients successfully withdrawn from corticosteroid maintenance (group 1) have remained rejection free for 208 +/- 33 days (mean +/- SEM) after discontinuation of the maintenance therapy with corticosteroids, and their immunosuppression therapy has consisted only of cyclosporine (mean overall cumulative dose 198 +/- 11 mg/m2/day [5.17 +/- 0.35 mg/kg/day]) and azathioprine (mean overall cumulative dose 67.7 +/- 5.4 mg/m2/day [1.74 +/- 0.13 mg/kg/day]), with the most recent serum cyclosporine level and white blood cell count being 146 +/- 10 ng/ml and 5400 +/- 200/microliters, respectively. In contrast to the patients who continue to require maintenance therapy with corticosteroids (group 2), group 1 patients developed their first episode of rejection later (46.8 +/- 8.3 days versus 25.4 +/- 6.1 days, p = 0.040) and reject less frequently during the first 4 months after transplantation (1.7 +/- 0.2 episodes versus 2.6 +/- 0.2 episodes, p = 0.005) as well as during the entire follow-up period (0.21 +/- 0.02 episodes/month versus 0.30 +/- 0.02 episodes/month, p = 0.005). The decreased propensity to reject and subsequent corticosteroid discontinuation resulted in a decreased cumulative dose of corticosteroids in group 1 patients (10.9 +/- 1.9 mg prednisone equivalent/m2/day [0.28 +/- 0.04 mg/kg/day] versus 17.0 +/- 1.2 mg prednisone equivalent/m2/day [0.42 +/- 0.04 mg/kg/day], p = 0.011 [p = 0.026]).(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenal Cortex Hormones↗
PubMed1986

[Laboratory maintenance of Trypanosoma (Herpetosoma) rangeli Tejera, 1920].

Two laboratory maintenance systems of Trypanosoma rangeli were compared. The maintenance by weekly subinoculations in Tobie's culture medium and the intrafemoral inoculation of Rhodnius prolixus with cultured flagellates, resulted in loss of infectivity of the metacyclic salivarian trypomastigotes for mice, ten months after maintenance in culture. With the system of cyclical passes through culture-Rhodnius-mouse-culture-Rhodnius, the infectivity of the metacyclic trypomastigotes for mice, was maintained during the three years of the experiment. The number and percentage of metacyclic trypomastigotes formed in the salivary glands of R. prolixus, previously inoculated intrafemorally or intracoelomically with culture forms of T. rangeli, did not show correlation with the inoculated dose, however the inoculated quantity demonstrated a direct relation with the mortality rate of the insects. The results indicate that T. rangeli requires an adequate maintenance system, so that under experimental condition the biological characteristics, normally expressed under natural conditions, are conserved.

Animals↗