• Title/Summary/Keyword: infusion therapy

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Evaluation of Ascorbic Acid Treatment in Clinical and Subclinical Mastitis of Indian Dairy Cows

  • Naresh, Ram;Dwivedi, S.K.;Swarup, D.;Patra, R.C.
    • Asian-Australasian Journal of Animal Sciences
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    • v.15 no.6
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    • pp.905-911
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    • 2002
  • A study was carried out to assess the therapeutic effect of ascorbic acid in mastitis of dairy cows. The herd with a population of 250-275 lactating cows was screened for clinical and subclinical mastitis for a period of 5 months. Based on inclusion and exclusion criteria, eighteen animals each with clinical and subclinical mastitis in one quarter only were selected as study population. Twelve cows (group A) with normal udder and health were also selected as a healthy control. Clinical mastitis cows were grouped as B (n=12) and C (n=6). Cows of group B were treated with ascorbic acid at 25 mg/kg, subcutaneously for 5 consecutive days and intramammary infusion (Ampicillin sodium 75 mg and Cloxacillin sodium 200 mg/infusion) based on antibiotic sensitivity test, till complete recovery. Group C cows received only intramammary infusion till the complete recovery. Eighteen subclinical mastitis cows were divided in group D (n=12) and E (n=6). Cows of group D were treated with ascorbic acid at 25 mg/kg subcutaneously for 5 consecutive days while group E did not receive any treatment. California mastitis test (CMT), somatic cell count (SCC), physical changes of udder and milk were used to diagnose and classify the mastitis. Evaluation of the therapy was based on CMT score and physical changes of udder and milk. Sample size calculation was also performed but was not followed for control groups due to scarcity of cases. Adequate blinding was done when and where required to avoid the biases. Confounding variables like herd, age of the cow, stage of the lactation, season and geographical region were duly considered and adequate blocking was followed. Ascorbic acid was administered in clinical and subclinical cases even after cure considering its immunostimulatory and healing inducing effects. The recovery rate was faster in cases of clinical mastitis treated with ascorbic acid along with an intramammary infusion (group B) than the quarters of group C cows. Quarter wise the average duration/number (3.16${\pm}$0.11 days) of antimicrobial intramammary infusion was significantly (p<0.01) less in group B than that of average duration/number (5.33${\pm}$0.20 days) of group C. Subclinical mastitis cows treated with ascorbic acid showed 83.33% recovery while 16.77% did not respond to treatment till last day of study. Cows of group E (untreated) did not recovered from the mastitis. Subjective parameters viz. swelling, pain reflex of udder and physical changes in milk from quarter of ascorbic acid treated cows (group B) disappeared earlier than that of group C cows. It is concluded from this study that the ascorbic acid might be useful as an adjunct in case of clinical mastitis to get quick recovery with less number of intramammary infusions. High recovery rate in subclinical mastitis quarters of group D cows is appreciable and opens a new avenue to conduct further trials in a larger population in various field conditions. However, the pharmacology of ascorbic acid with particular reference to health of mammary gland needs to be investigated.

Safety and Effect of Oriental Medicine and Continuous Intravenous Urokinase combined Therapy in Acute Ischemic Stroke(open clinical trial) (급성 허혈성 뇌졸중에 있어 한방치료와 지속적 유로키나제 정주요법과의 병행요법의 효과와 안전성)

  • Kim, Tae-Youn;Jo, Young;Lee, Jun-Hee;Lew, Jae-Hwan;Lee, Beom-Jun
    • The Journal of Internal Korean Medicine
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    • v.22 no.4
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    • pp.633-638
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    • 2001
  • Objective : Stroke is the most frequent cause of death in Korea. Because it remains severe disablities disturbing normal life, it is important to carry out intervention preventing from progression of condition in patients with acute ischemic stroke within therapeutic time window. Thus early thrombolysis is beneficial for patients with acute ischemic stroke. However its therapeutic efficacy is not known in combination with oriental medical therapy. In this study, we investigated the safety and the clinical effect of continous intravenous urokinase therapy and oriental medical therapy. Methods : Twenty eight patients with acute onset of ischemic stroke no later than three days received continous infusion of urokinase and oriental medical therapy. We estimated the subjects's neurological deficit and functional status with National institute of Neurologic Disorders and Stroke Scale(NIHSS) and Europian Stroke Scale (ESS) prior to therapy, on day 3, 7, 14 after the starting urokinase therapy and on day at discharge. Results: After day 7, the scores of NIHSS and ESS were improved significantly. There are no differences in therapeutic effects of the interval between onset of stroke and initiation of therapy. Complication were noted in four(14%) patients, but these are not fatal complication and make no neurological deficiency. Conclusion : The results of these investment suggest that continuous intravenous urokinase with oriental medical therapy could be a safe and effective intervention to prevent from progression in acute ischemic stroke. But this findings should be confirmed in multicenter double blind controlled trial.

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Oxaliplatin, 5-Fluorouracil and Leucovorin (FOLFOX-4) as First Line Chemotherapy in Elderly Patients with Advanced Gastric Cancer

  • Haghighi, Shirin;Kasbkar, Hadi;Esmaeilpour, Keihan;Yasaei, Mehrdad
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.7
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    • pp.3277-3280
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    • 2016
  • Background: Gastric cancer is considered the fourth most common cancer and second most common cause of cancer-related mortalities worldwide. Gastric cancer develops more frequently among elderly. The oxaliplatin/5FU/leucovorin (FOLFOX) regimen has shown a notable activity against gastric cancer. Aim: To evaluate the responses and complications of FOLFOX-4 regimen as first line chemotherapy in elderly patients with advanced gastric cancer. Materials and Methods: From October 2014 to November 2015, a total of 21 patients with metastatic or local AGC (advanced gastric cancer) were analyzed. All patients were administered a FOLFOX-4 regimen consisting of a 2h infusion of oxaliplatin $85mg/m^2$ (day 1), continuous infusion of $1000mg/m^2$ 5-Fu in 24h., and leucovorin $200mg/m^2$ in 2h infusion as a first-line chemotherapy. Results: A total of 18 patients were assessable for efficacy and toxicity. One of 18 patients achieved a complete response, and 12 had partial responses, giving an overall response rate of 72.6%. Three (16%) patients demonstrated stable disease and 2 (12%) progression. The median progression free survival was 7.3 months, and the median overall survival was 11.9 months. One patient had grade 3 neuropathy. No other grade 3 or 4 NCI-CTC were seen. Conclusions: The FOLFOX-4 regimen used in our study was both active and acceptable for AGC in elderly patients as neoadjuvant and main therapy.

Implantation of an Intrathecal Drug Administration System -A report of two cases- (척수강 내 약물 주입기의 이식 -증례보고-)

  • Lee, Sang Jin;Nam, Sang Kun;Kim, Jang Hyun;Kim, Hyun Joo;Lee, Sang Chul;Kim, Yong Chul
    • The Korean Journal of Pain
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    • v.22 no.1
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    • pp.68-73
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    • 2009
  • Opioids profoundly inhibit evoked discharges of spinal nociceptive neurons, thereby inhibiting the transmission of pain. Intrathecal administration of opioids using implantable continuous infusion systems is an effective method of pain relief when other treatments have failed, as well as for patients with adequate analgesia on high dose therapy that produces unacceptable side effects. We report two cases of intrathecal pump implantation performed in patients suffering from intractable chronic pain. A test dose of 3 mg morphine was injected into the epidural space. No side effects were noted and patients experienced considerable pain relief. Implantation was performed one day after the test. The initial intrathecal morphine delivery dose was half of the equivalent dose of daily oral intake opioids and the infusion rate was increased gradually under close observation for opioid side effects. Two days post-implantation, both patients were discharged without any complications.

Intraarterial Nimodipine Infusion to Treat Symptomatic Cerebral Vasospasm after Aneurysmal Subarachnoid Hemorrhage

  • Kim, Jong-Hoon;Park, In-Sung;Park, Kyung-Bum;Kang, Dong-Ho;Hwang, Soo-Hyun
    • Journal of Korean Neurosurgical Society
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    • v.46 no.3
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    • pp.239-244
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    • 2009
  • Objective : Cerebral vasospasm leading to cerebral ischemic infarction is a major cause of morbidity and mortality in the patients who suffer with aneurysmal subarachnoid hemorrhage. Despite adequate treatment, some patients deteriorate and they develop symptomatic vasospasm. The objective of the present study was to investigate the efficacy and clinical outcome of intraarterial nimodipine infusion on symptomatic vasospasm that is refractory to hemodynamic therapy. Methods : We retrospectively reviewed the procedure reports, the clinical charts and the transcranial doppler, computed tomography and digital subtraction angiography results for the patients who underwent endovascular treatment for symptomatic cerebral vasospasm due to aneurysmal SAH. During the 36 months between Jan. 2005 and Dec. 2007, 19 patients were identified who had undergone a total of 53 procedures. We assessed the difference in the arterial vessel diameter, the blood flow velocity and the clinical outcome before and after these procedures. Results : Vascular dilatation was observed in 42 of 53 procedures. The velocities of the affected vessels before and after procedures were available in 33 of 53 procedures. Twenty-nine procedures exhibited a mean decrease of 84.1 cm/s. We observed clinical improvement and an improved level of consciousness with an improved GCS score after 23 procedures. Conclusion : Based on our results, the use of intraarterial nimodipine is effective and safe in selected cases of vasospasm following aneurysmal SAH. Prospective, randomized studies are needed to confirm these results.

Two cases of postoperative chylothorax treated with parenteral octreotide and conservative therapy (보존요법과 함께 octreotide 주입을 이용한 수술후 유미흉 치험 2례)

  • Choi, Eun Jin;Lee, Sub
    • Clinical and Experimental Pediatrics
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    • v.50 no.3
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    • pp.298-301
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    • 2007
  • Chylothorax is a rare complication following cardiac surgery for congenital heart diseases. Although conservative management is successful in the majority of cases, surgical intervention is required in a refractory one. Recently, subcutaneous or intravenous infusion of octreotide has been used as a safe treatment that helps avoiding surgical intervention. Herein, we report two cases of postoperative chylothorax treated with parenteral octreotide and conservative therapy.

Japanese-B Viral Encephalitis with a Biphasic Illness Pattern and Recovery after Intravenous Immunoglobulin Therapy (이상성 경과를 보이고 정맥면역글로불린 치료 후 호전된 일본뇌염)

  • Lee, Byung-Chan;Jeon, Ji Ye;Moon, Hye-Jin;Lim, Jeong Geun;Cho, Yong Won
    • Annals of Clinical Neurophysiology
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    • v.16 no.1
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    • pp.35-38
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    • 2014
  • Japanese-B viral encephalitis (JE) usually has a monophasic illness pattern. A 45-year-old woman in an altered mentality had improved over 1 month. About 1 week after the initial improvement, the patient became comatose with aggravated EEG and MRI findings. Assays of cerebrospinal fluid and serum were positive for the IgM antibody to Japanese-B virus. After intravenous immunoglobulin (IVIG) infusion, the patient recovered. We report a patient with JE who showed a biphasic illness pattern and recovered after IVIG therapy.

The Meal Management of Korean Type 2 Diabetes Patients Using Carbohydrate Counting (Carbohydrate counting 을 이용한 제2형 당뇨병 환자의 식사 관리)

  • Park, Seon-Min;Choe, Su-Bong
    • Journal of the Korean Dietetic Association
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    • v.5 no.1
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    • pp.64-73
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    • 1999
  • Carbohydrate(CHO) counting is a meal planning approach used with diabetic patients that focuses on carbohydrate as the primary nutrient affecting post-prandial glycemic response. However, it has not been used in meal management of diabetic patients in Korea. CHO counting can be used by clients with type 1 and 2 diabetes. The purpose of the study was to determine the barriers to utilize the CHO counting when three levels of CHO counting were educated to type 2 diabetic patients who started continuous subcutaneous insulin infusion (CSⅡ) therapy by nutrition lectures and counseling. And the CHO-to-insulin ratios were determined for the individual patients who followed the carbohydrate counting as a meal management, and the factors to influence the CHO-to-insulin ratios were selected through the stepwise regression analysis. Twenty- four subjects were received three lectures, and one or two nutritional counseling for a month. The average age of the subjects was 50.7 years, and the duration of diabetes was 9.4 years. Their body mass index (BMI) was 21.5 kg/$m^2$. The difficulties of using CHO counting were 1) confusing the CHO exchange system to diabetic food exchange system, 2) lack of basic nutrition and not distinguishing nutrients such as CHO, fat and calorie, and 3) lack of motivation to make effort to count and record the amount of carbohydrates eaten. Nutritional counseling replenished the nutrition education and made patients practice CHO counting. Average CHO-to-insulin ratios at breakfast, lunch and dinner were 4.1$\pm$3.3, 2.9$\pm$2.6 and 2.9$\pm$3.0units/23g of CHO, respectively. CHO-to-insulin ratios were influenced by gender, age, BMI, post-prandial blood glucose levels and post-prandial c-peptide levels. The effective education and nutritional counseling of CHO counting can make CHO counting applicable to type 2 diabetic patients as meal management for improving glycemic control with less hypoglycemic episode.

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Air in the Left Brachiocephalic Vein Accompanied with Pulmonary Edema (폐부종을 동반한 왼팔머리정맥 내의 공기 음영)

  • Lee, Sung Won;Kang, Hyeon Hui;Kim, Min Hee;Kwon, Hyuk Min;Lee, Ji Myoung;Lee, Jong Yul;Oh, Su Jin;Lee, Sang Haak;Moon, Hwa Sik
    • Tuberculosis and Respiratory Diseases
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    • v.65 no.1
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    • pp.57-60
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    • 2008
  • A fifty-seven year old female patient visited the emergency department with tachypnea and a decreased mental status. The patient had been receiving fluid therapy at home and a bolus of air was injected into the fluid bottle in order to increase the infusion speed. Chest computed tomography revealed air in the left brachiocephalic vein that was accompanied with pulmonary edema the diagnosis of venous air embolism was made. Venous air embolism can result from various procedures that are performed in almost all clinical specialties and they can be fatal in cases of massive air embolism. Therefore, it is important for all clinicians to be aware of this problem.

Clinical Effects of the Combination Chemotherapy of Heptaplatin and 5-Fluorouracil in Advanced Gastric Cancer (진행성 위암 환자에서 Heptaplatin과 5-Fluorouracil 복합요법의 임상효과)

  • Shin, Gashil;Oh, Jung Mi
    • Korean Journal of Clinical Pharmacy
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    • v.14 no.2
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    • pp.61-70
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    • 2004
  • Heptaplatin is a new platinum derivative with antitumor activity against gastric cancer. Preclinical studies showed that it is less toxic than other platinum analogues. The purpose of this study is to evaluate the efficacy and toxicity of the combination therapy of heptaplatin and 5-fluorouracil in Korean advanced gastric cancer patients. This study was investigated retrospectively. The patients group consisted of 65 advanced gastric cancer patients with no prior radiotherapy. All patients received heptaplatin $400\;mg/m^2$ by 2-3 hour infusion on Day 1 and 5-FU $1000\;mg/m^2by 12-24 hour continuous infusion for 5 days. After the first cycle, subsequent doses were adjusted according to the toxicity. Courses were repeated every 28 days. As results, objective response occurred in 16 patients $(24.6\%)$. Two were complete and 14 were partial response. Median progression free survival was 32 weeks with $29\%$ of patients progression free at 1 year. The most common hematologic toxicity was anemia. Grade 3 or 4 anemia was seen at $2.7\%$ of treatment cycles. Grade 3 or higher leucopenia was seen at $1.2\%$ of cycles. Grade 3 or 4 neutropenia and thrombocytopenia occurred at $6.1\%\;and\;1.5\%$ of cycles, respectively. The most common nonhematologic toxicity was proteinuria. Though no patients experienced grade 3 or 4 proteinuria, proteinuria was a considerable factor for this chemotherapy. Grade 3 or higher gastrointestinal toxicities were nausea and vomiting ($4.6\%$ of patients) and diarrhea ($1.5\%$ of patients). Grade 2 renal toxicity with elevation of serum creatinine was seen in $0.3\%$ of cycles, which is less than that of other platinum analogues. This study showed that combination therapy of heptaplatin and 5-FU have modest antitumor activity against advanced gastric cancer without severe renal toxicity.

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