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Arch ophthalmol 1990; 1 60 freedman fs, freedman jn, shields bm, lobaugh b, samsa pg, keates ue, et al effects of ocular carteolol and timolol on plasma hdl cholesterol levels.
The primary study population consisted of 212 consecutive patients with BPH referred for elective electroresection of the prostate. 57 patients were not included in the analysis because of a lack of data. The mean age of the patients was 69 years range 49-86 ; . The mean prostatic volume determined by transrectal sonography Bruel & Kjaer ; before TURP was 50.4 cm3 range 14.0 - 107.0 cm3 ; . The mean weight of the prostate chips resected in TURP was 27.4 g range 3 96 g ; Incidental malignancies were diagnosed from the chips in only three of the 155 patients 2% ; . On the day before TURP, each patient filled in a questionnaire related to this study in our hospital. The questionnaire consisted of 22 items pertaining to various aspects of sexual function, including the patients` life styles and general health, libido, satisfaction with their current sex life, occurrence of early morning erections, coital frequency, sexual potency, satisfaction with erection and ejaculation, percentage of successful intercourses, and the possible detrimental effect of the procedure on potency. When necessary, the staff helped the patient to fill in the questionnaire. The patients completed the same questionnaire 6 and 12 months after TURP. The Prat test was used to compare the different sexual functions before and after TURP.
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The trial was approved by the ethical committee of University of Padua and that of the Lombardy region and the parents gave written informed consent. 18 deambulant patients with Duchenne muscular dystrophy confirmed by dystrophin immunohystochemistry from two Italian neuromuscular centers Pavia and Padua ; were randomized in two groups with equivalent dosage of deflazacort and prednisone 0, 9 mg Kg die versus 0, 75 mg Kg die ; . The two groups were randomized on the basis of age and disease severity, so no differences were present at the beginning of treatment. The patients in Deflazacort had a mean age of 8, 6 years range 5, 3-14, 6 ; while the patients in Prednisone had a mean age of 7, 5 years range 5, 1-10 ; . All patients underwent two visits before the beginning of the trial to assure complete compliance with the functional tests and a monitor controlled the correct application of the protocol in the two centers. In the second center Pavia ; the patients were filmed after informed consent, to permit a double blind check of the results. One patient was treated with the two drugs: first 6 months with prednisone and after with deflazacort. This patient has not been considered in the evaluation of results.
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Generous donations to the Anne B. Morris Fund are helping support CRI's investigator-initiated research, including the FOTO study. The Fund also allowed CRI staff to attend the International AIDS Conference in Toronto in August. Dr. Morris, CRI's Associate Research Director Springfield, who died suddenly in August 2005, believed in the power of sharing information and collaboration with colleagues around the world. Donations to the Anne B. Morris Fund honor her memory, her work, and her dedication to those living with HIV and ting.
Table 1 Relative shelter tube use of solitary fish Shelter use of solitary fish % ; 6 SD Shelter tube diameter mm ; 24 21 Burbot n 235 ; 70.4 22.0 ; A 17.4 10.5 ; B 11.7 15.5 ; B 0C 0C Stone loach n 170 ; 21.5 17.0 24.4 ; A 13.2 ; A 18.9 ; A 3.0 ; A 13.7 ; A 0.1 ; A.
Tremor, rigidity, bradykinesia, stooped posture, and shuffling gait. The more common causes of Parkinsonism are Parkinson's Disease, striatonigral degeneration, and a reversible syndrome induced by major tranquillising drugs and tinzaparin.
The extraocular muscles. C. Prevention 1. Retrobulbar block is not uniformly effective in preventing the reflex retrobulbar block may elicit the oculocardiac reflex ; . 2. Anticholinergic medication can be effective, however caution must be used in the elderly. 3. Deepen anesthesia. 4. Factors associated with increased susceptibility include anxiety, hypoxia, hypercarbia, and light anesthesia. D. Treatment 1. Request the surgeon to stop manipulation. 2. Assess adequate ventilation, oxygenation, and depth of anesthesia. 3. If severe or persistent bradycardia, give atropine 7-10 mcg kg ; . 4. recurrent episodes, infiltration of the rectus muscles with local anesthetics. Intraocular gas expansion A. A gas bubble may be injected into the posterior chamber during vitreous surgery to flatten a detached retina. B. The air bubble is absorbed within 5 days by gradual diffusion. C. Sulfur hexafluoride, an inert gas that is less soluble in blood than nitrogen, provides a longer duration up to 10 days ; than an air bubble. D. Nitrous oxide should be discontinued at least 15 minutes prior to the injection of air or sulfur hexafluoride. Nitrous oxide should be avoided until the bubble is absorbed 5 days for air and 10 days for sulfur hexafluoride ; . Anesthetic drugs A. Most anesthetic drugs either lower or have no effect on intraocular pressure. An exception is ketamine, and possibly etomidate. B. Ketamine effects are controversial, but is generally felt to moderately increase intraocular pressure. Ketamine increases choroidal blood flow, increases nystagmus, and increases extraocular muscle tone via blepharospasm. C. Etomidate, which is associated with a high incidence of myoclonus 10-60% ; , may increase intraocular pressure. D. Succinylcholine can cause a 5-10 mmHg increase in intraocular pressure for 5-10 minutes. Succinylcholine can potentially increase intraocular pressure by dilating choroidal blood vessels and increases in extraocular muscle tone. Pretreatment with a defasiculating dose of a nondepolarizing muscle relaxant does not reliably eliminate the effect of succinylcholine on intraocular pressure. Nondepolarizing muscle relaxants do not increase intraocular pressure. Systemic effects of ophthalmic drugs A. Anticholinesterases echothiophate, phospholine iodide ; : systemic absorption leads to inhibition of plasma cholinesterase which may lead to prolongation of the duration of action of s u pseudocholinesterase levels to return to 50% of normal. The metabolism of mivacurium and ester type local anesthetics may also be affected. B. Cholinergics pilocarpine, acetylcholine ; : used to induce miosis; toxicity may manifest in bradycardia or acute bronchospasm. C. Anticholinergics atropine, scopolamine ; : used to cause mydriasis; systemic absorption may lead to tachycardia, dry skin, fever, and agitation. D. Beta-blockers timolol maleate ; : systemic absorption may cause beta-blockade bradycardia, bronchospasm, or exacerbation of congestive heart failure ; . Betaxolol seems to be oculo-specific with minimal side effects. E. Carbonic anhydrase inhibitors acetazolamide, Diamox ; : used to decrease aqueous production; induces an alkaline diuresis. Side effects include diuresis and hypokalemic metabolic acidosis. Retrobulbar blockade A. Technique: local anesthetic is injected behind the eye into the cone formed by the extraocular muscles. Lidocaine and bupivacaine are the most commonly used local anesthetics. Hyaluronidase, a hydrolyzer of connective tissue polysaccharides, is commonly added to enhance the spread of local anesthetic. B. Complications: retrobulbar hemorrhage, globe perforation, optic nerve atrophy, convulsions, oculocardiac reflex, loss of consciousness, and respiratory arrest. C. Post-retrobulbar apnea syndrome: due to injection of local anesthetic into the optic nerve sheath with spread into the cerebrospinal fluid. Apnea typically occurs within 20 minutes and may last 15-60 minutes. Ventilation must be constantly monitored in patients with retrobulbar blocks. D. Facial nerve block prevents squinting of the eyelid.
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Or 1.98%pred at the Year 1 visit Figure 1; see also Figure 5 in Reference 13 ; . Between Year 1 and Year 5, the sustained quitters had a rate of decline in FEV1 of 31 48 0.27% pred yr. In contrast, continuing smokers showed a more rapid rate of decline in FEV1, both during the first year and between Year 1 and Year 5. At the Year 1 visit, FEV1 had decreased by 49 ml 0.74% pred. Between Year 1 and Year 5, FEV1 decreased by 62 55 yr, twice the rate observed in sustained quitters p 0.001, Table 2 ; . Participants who quit during the first year and then relapsed after Year 1 showed a 1.59 5.04% decline in FEV1% pred after relapsing p 0.001 ; . Those participants who quit smoking after the first year showed a 1.61 5.62% improvement in FEV1%pred after quitting p 0.001 ; , which was also comparable to the benefit observed in SI-P quitters at Year 1 Figure 1 and tipranavir.
In contrast, coadministration of 0.3 g kg i.v. L-768673 1.0 g kg i.v. timolol suppressed the induction of VT by PVS 8 10, 80% rendered noninducible versus 1 10, noninducible in vehicle group; p 0.01 ; and prevented the development of acute ischemic lethal arrhythmias 3 10, 30% incidence versus 8 10, 80% incidence in vehicle group; p 0.05 ; . Concomitant administration of low-dose L-768673 timolol produced modest increases in QTc and paced QT intervals 4.5 1.2 and 5.5 1.4%; both p 0.01 ; , increases in noninfarct zone relative and effective refractory periods 7.0 1.7 and 12.3 3.0%; both p 0.01 ; , and lesser increases in infarct zone relative and effective refractory periods 5.3 1.6 and 5.8 1.4%; both p 0.01 ; . These findings suggest that concomitant low-dose IKs and -adrenergic blockade may constitute a potential pharmacologic strategy for prevention of malignant ischemic ventricular arrhythmias
The Personal Touch. Rather than immediately plunging into course content and requirements, take a few moments to allow students to become acquainted with each other. Ask them to stand and introduce themselves and state what they hope to gain from the course. By developing a cooperative atmosphere in which students feel a part of the group and not isolated, you can help to allay fears. Research has shown that a strongly supportive peer group in a learning situation helps students to cope successfully with the frustrations inherent in learning a new skill and tobi.
Purpose. To determine whether a nocturnal increase of ciliary process ?-adrenergic receptor responsiveness can explain the observation that timolol decreased the aqueous flow rate and intraocular pressure IOP ; during the night but not during the day in rabbits. Methods. Rabbits were housed in alternating 12-hour periods of light and dark. In vitro stimulation of tissue cyclic adenosine monophosphate cAMP ; levels by isoproterenol ISO ; , vasoactive intestinal peptide VIP ; , pituitary adenylate cyclase activating polypeptide PACAP ; , or a soluble derivative of forskolin sFSK ; was measured in ciliary processes harvested at midlight phase and early and late dark phase. Inhibition of ISO and VIP stimulation of ciliary process cAMP by an a2-adrenergic agonist and maximal binding of [125I]I-pindolol, [I25I]IVIP, and [125I]I-PACAP in ciliary process membranes were measured at the same three times. Results. Although there may have been a nocturnal increase in the sensitivity of ciliary process cAMP levels to stimulation by ISO, this was not observed consistently. VIP, but not PACAP, stimulation increased at night, but there was no change in the response to sFSK. Inhibition by apraclonidine of elevated ciliary process cAMP levels was constant at all three times. Ligandbinding studies showed little change in ciliary process ?-adrenergic, VIP-, or PACAP-receptor levels at the three times. Conclusions. There is no convincing evidence for a nocturnal increase in ?-adrenergic receptor sensitivity in rabbit ciliary processes that could explain the difference between day and night effects of timolol on aqueous flow and IOP. Invest Ophthalmol Vis Sci. 1997; 38: 17O8-1718.
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ISTA is a specialty pharmaceutical company focused on the commercialization and development of unique and uniquely improved ophthalmic products. ISTA's products seek to address serious diseases and conditions of the eye such as ocular inflammation, glaucoma, 2005 6 Milestones dry eye, vitreous hemorrhage, diabetic retinopathy, and Launch of Vitrase, January '05 hyphema. ISTA markets three products: XibromTM bromfenac sodium ophthalmic solution ; 0.09% for the treatment of post-operative inflammation following cataract surgery; Istalol timolol maleate ophthalmic solution ; 0.5% for the treatment of glaucoma, and Vitrase hyaluronidase for injection ; Lyophilized, Ovine, for use as a spreading agent. In addition to its three approved products, ISTA has a diversified portfolio of prescription ophthalmic products in late-stage development for the U.S. market and tolmetin.
Data are given as mean SD intraocular pressure reduction from baseline measured in millimeters of mercury ; . P .001 for all reductions baseline vs timolol and baseline vs latanoprost-timolol fixed combination and timolol.
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