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Biomedical subjects

C Massion

Publications and source records attributed to C Massion.

4 recordsLinked to original sources

Continuous intravenous infusion of a plasma-derived factor IX concentrate (Mononine) in haemophilia B.

This prospective, multicentre, open-label study evaluated the efficacy and safety of a plasma-derived factor IX concentrate [Mononine, Coagulation Factor IX (Human) Monoclonal Antibody Purified] administered by continuous intravenous (CIV) infusion to patients with haemophilia B. Admission criteria included documented diagnosis of haemophilia B (mild, moderate, or severe). Twenty-eight patients (25 surgery, two trauma, one severe spontaneous haemorrhage) were enrolled to receive a therapeutic bolus dose followed by CIV infusion of factor IX (FIX) to maintain FIX:C plasma levels of 0.4-1.0 IU mL(-1) (i.e. 40-100%). A median intravenous bolus dose of 54.2 IU kg(-1) FIX was administered to a subset of 13 non-emergency patients 7-21 days prior to CIV infusion to determine pharmacokinetic parameters in order to guide the dosing for CIV. For treatment, a bolus injection (median FIX dose; 89.6 IU kg(-1)) (range, 12.4-108.3), followed by a median total CIV infusion dose of 396.4 IU kg(-1) (range, 44.9-785.5) was administered at a median rate of 3.84 IU kg(-1) h(-1) (range, 1.74-7.33) for 107.17 h (range, 31.75-144). Twenty-four patients completed 72-120 h of FIX CIV infusion. Overall, 'excellent' (i.e. achievement of normal haemostasis) efficacy was reported in 23 of 24 (96%) evaluable patients, and 'good' (i.e. slight oozing) efficacy was reported in one (4%) patient. Median FIX:C was 72-86% for all patients receiving FIX by CIV on all days. Nine patients reported 13 adverse events that were possibly related to study medication but were not deemed serious by the investigator and were mainly because of local irritation at the infusion site. FIX CIV infusion therapy is safe and effective in the treatment of haemophilia B patients undergoing surgery, exposed to trauma, or experiencing severe spontaneous haemorrhage.

Adolescent↗

Screening for gestational diabetes in a high-risk population.

One hundred eighty-one pregnant Navajo women were screened for gestational diabetes. The 50-g oral glucose screening test was greater than 7.2 mmol/L (130 mg/dL) in 44 of 181 subjects (24.3 percent) and greater than 8.3 mmol/L (150 mg/dL) in 23 of 181 subjects (12.7 percent). The incidence of gestational diabetes in the study population was 6.1 percent of all pregnancies by standard oral glucose tolerance testing. Incidence of gestational diabetes was 9.5 percent in 21 subjects whose screening test was 7.2 to 8.3 mmol/L (130 to 149 mg/dL) and 39.1 percent in 23 subjects whose screening test was 8.3 mmol/L (150 mg/dL) or greater. Using equal to or greater than 7.2 mmol/L (130 mg/dL) of glucose as the definition of an abnormal screening test yielded a 0.80 specificity and a 0.25 positive predictive value, while the cost for each case of gestational diabetes detected was $114. Using equal to or greater than 8.3 mmol/L (150 mg/dL) of glucose as the definition of an abnormal screening test yielded a 0.81 sensitivity, 0.58 specificity, and 0.39 positive predictive value, while the cost for each case of gestational diabetes detected was $106. Logistic regression analyses demonstrated that the screening test was more strongly associated with the diagnoses of gestational diabetes than any other risk factor for gestational diabetes. Universal screening of gestational diabetes is recommended in this high-risk population using equal to or greater than 7.2 mmol/L (130 mg/dL) of glucose as the definition of an abnormal screening test.

Adult↗

Newborn home visits.

A randomized controlled trial was conducted comparing home visits with office visits by physicians to families with newborns within the first two weeks of life. Results showed that physicians were significantly more satisfied and rated their relationship with the family significantly higher after home visits than after office visits. Fathers were present at 50 percent of the home visits compared with 26 percent of office visits (P less than .05). Mothers in the home visit group rated caring for their baby as significantly easier than the office visit group. There was no difference in infant immunization rate or number of well-child visits, although infants in the home visit group had significantly more visits to their own physician. The mean length of visit was 33 minutes (not including travel time) for home visits and 23 minutes for office visits. Physicians were better able to note home environment and family interactions during home visits. This study supports the view that home visits by physicians enhance the physician-family relationship.

Clinical Trials as Topic↗