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Biomedical subjects

Catherine A Heyneman

Publications and source records attributed to Catherine A Heyneman.

6 recordsLinked to original sources
PubMed2004

Nephrotoxic potential of selective cyclooxygenase-2 inhibitors.

OBJECTIVE: To determine the relative nephrotoxic potential of cyclooxygenase (COX)-2 inhibitors. DATA SOURCES: A MEDLINE search (1996-February 2004) identified clinical trials evaluating the nephrotoxicity of COX-2 inhibitors versus traditional nonsteroidal antiinflammatory drugs (NSAIDs). Key search terms included cyclooxygenase inhibitors, nonsteroidal antiinflammatory agents, nephrotoxicity, and chemically induced. DATA SYNTHESIS: Three clinical trials determined that COX-2 inhibitors have similar adverse effects on the kidney when compared with nonselective NSAIDs, while 2 studies concluded that COX-2 inhibitors are less nephrotoxic than nonselective NSAIDs. All 5 trials utilized low numbers of subjects, short-term therapy, and surrogate markers of kidney damage. CONCLUSIONS: COX-2 inhibitors may not offer distinct advantages over nonselective NSAIDs with respect to kidney function. Longer trials in patients with comorbidities are warranted. These agents should be used cautiously or not at all in patients with predisposing conditions.

Cyclooxygenase 2↗
PubMed2002

Conjugated heptavalent pneumococcal vaccine.

OBJECTIVE: To review the immunogenicity, efficacy, and safety of the heptavalent conjugated pneumococcal vaccine (PCV7). DATA SOURCES: A MEDLINE search (1993-August 2001) of research limited to humans published in the English language was conducted. STUDY SELECTION: Findings from randomized, controlled, multicenter trials were reviewed. Literature regarding epidemiology, control, and treatment of invasive pneumococcal diseases in different populations and the Advisory Committee on Immunization Practices recommendations were also reviewed. DATA SYNTHESIS: PCV7 administered to infants aged 2, 4, and 6 months, with a booster dose at 12-15 months, has been shown to be immunogenic. It decreases the incidence of invasive pneumococcal disease; individual data on bacteremia and meningitis are unavailable. Findings from clinical trials showed that invasive pneumococcal disease caused by vaccine serotypes was reduced by 87%, 58%, and 62% for children <1 year, <2 years, and <5 years of age, respectively, after introduction of routine vaccine use. The overall incidence of acute otitis media did not decrease significantly. However, culture-confirmed episodes and episodes due to pneumococcal serotypes included in the vaccine were reduced. The vaccine was immunogenic in children with sickle cell disease, but its efficacy in preventing invasive pneumococcal diseases remains unclear. Although immunogenicity and efficacy trials are lacking, the vaccine is recommended for Alaskan Native or American Indian children between 24 and 59 months of age, and for children with underlying conditions such as HIV infection, AIDS, other immunocompromising conditions, and chronic illnesses. At the manufacturer's list price of 58 dollars/dose, PCV7 is not projected to be cost-effective after 4 doses. Postmarketing analysis evaluating immunogenicity and efficacy in the excluded population may favorably change this. CONCLUSIONS: Based on published efficacy and immunogenicity data, pharmacy formularies should include PCV7.

Carrier State↗
PubMed2002

Fluticasone versus salmeterol/low-dose fluticasone for long-term asthma control.

OBJECTIVE: To evaluate the relative clinical superiority of increasing the dose of fluticasone propionate versus the addition of salmeterol to low-dose fluticasone propionate for long-term asthma control. DATA SOURCES: Literature was identified by a MEDLINE search (1966-October 2002). Key search terms included asthma, inhalation, corticosteroid, beta-adrenergic agonist, and combination drug therapy. DATA SYNTHESIS: Current guidelines for long-term control of asthma include treatment with either inhaled corticosteroids (medium dose) or inhaled corticosteroids (low to medium dose) in combination with a long-acting bronchodilator. Previous studies evaluating salmeterol or formoterol combination therapy with beclomethasone or budesonide have generally produced superior results compared with increasing the dose of the inhaled corticosteroid. Four recent controlled clinical trials have compared the clinical utility of fluticasone propionate monotherapy versus salmeterol/low-dose fluticasone propionate for long-term asthma control in patients with moderate to severe persistent asthma. Based on spirometry data, rescue albuterol use, and symptom scores, the addition of salmeterol to low-dose fluticasone propionate was superior to increasing the dose of fluticasone propionate. CONCLUSIONS: Based on improvements in forced expiratory volume in 1 second, peak expiratory flow, and symptom control, the addition of salmeterol to low-dose fluticasone propionate provides better control of asthma than increasing the dose of fluticasone propionate.

Albuterol↗
PubMed2002

Relationship between vaccinations and multiple sclerosis.

OBJECTIVE: To evaluate recent reports of vaccinations causing or exacerbating multiple sclerosis (MS). DATA SOURCES: Literature was identified through MEDLINE (1966-December 2001). Key search terms included vaccinations, hepatitis B, influenza, tetanus, and multiple sclerosis. DATA SYNTHESIS: Case reports of MS temporally associated with hepatitis B vaccination have prompted some researchers to propose that vaccines may provoke demyelinating diseases. Recently, studies have been performed to determine whether vaccinations are capable of causing or exacerbating MS symptoms. CONCLUSIONS: Recent studies reaffirm that vaccinations do not increase the risk of symptom exacerbation in patients with MS or constitute a causative agent in the disease.

Humans↗