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Biomedical subjects

D S Seidman

Publications and source records attributed to D S Seidman.

At least 55 records · Page 3Linked to original sources
PubMed1999

Predicting the risk of jaundice in full-term healthy newborns: a prospective population-based study.

OBJECTIVE: The need to recognize infants that are at high risk for developing significant jaundice is apparent in the era of routine early discharge. The aim of the present study was to prospectively determine the ability to predict severe hyperbilirubinemia in term healthy newborns (defined as total serum bilirubin of > 10.0 mg/dl at day 2, > 14.0 mg/dl at day 3, and > 17.0 mg/dl at days 4 and 5 of life). DESIGN: Prospective study of 1177 healthy term newborns. SETTING: Two university-affiliated community hospitals in Jerusalem. RESULTS: Using a multiple logistic regression analysis, neonatal jaundice was best predicted (p < 0.0001) by day 1 serum bilirubin (adjusted odds ratio of 3.1 [per mg/dl] [95% confidence limits of 2.4 to 4.1]) and by a change in serum bilirubin from the first to the second day of life (2.4 [per mg/dl] [1.9 to 3.0]). Maternal blood type 0 (2.9 [1.5 to 5.8]), age (1.1 [per year] [1.0 to 1.2]), schooling (0.8 [per year] [0.7 to 0.9]), and full breastfeeding (0.4 [0.2 to 0.9]) were also associated with jaundice (p < 0.005). Other factors considered in the regression model but not found to be significantly related to jaundice included maternal ethnic origin, smoking, hypertension, diabetes mellitus, intranatal administration of oxytocin, meperidine, anesthesia, premature rupture of the membranes, parity, newborn sex, birth weight, gestational age, presentation. Apgar scores, blood type, hematocrit, cephalohematoma, and history of jaundice in other siblings. A model for predicting neonatal jaundice based on the above factors had a sensitivity of 81.8%, a specificity of 82.9%, a false positive rate of 80.2%, and a false negative rate of 1.1%. CONCLUSION: Individual risk assessment on discharge in association with day 1 total serum bilirubin is of value in identifying infants at greater risk for neonatal jaundice.

Bilirubin↗
PubMed1999

Development of the fetal uterus between 19 and 38 weeks of gestation: in-utero ultrasonographic measurements.

In-utero assessment of the internal female genitalia is important for determination of fetal gender in fetuses with suspected genital tract anomalies. We therefore measured fetal uterine transverse width and circumference from 19 weeks of gestation until term, using transvaginal and transabdominal high-resolution ultrasound techniques in order to establish nomograms. A prospective, cross-sectional study on 180 normal singleton pregnancies was performed. Data were obtained for 140 normal fetuses. The mean +/- SD uterine width and circumference were 12.9 +/- 4.1 mm (95% confidence interval 12.1-13.7), and 40.2 +/- 12.5 mm (95% confidence interval 37.9-42.5) respectively. Uterine size as a function of gestational age was expressed by the regression equations: uterine width (mm) = 12.9 + 0.7 x gestational age (weeks), and uterine circumference (mm) = 40.2 + 2.1 x gestational age. The correlation coefficients, r = 0.885 and r = 0.888, for uterine width and circumference, by gestational age respectively, were highly statistically significant (P < 0.001). A nomogram of uterine width and circumference per gestational week, and the 95% prediction limits were defined. The present data offer baseline measurements of the fetal uterus that may allow intrauterine assessment of the female genital tract and associated fetal gender.

Cross-Sectional Studies↗
PubMed1999

Pregnancy following laparoscopic myomectomy: preliminary results.

The objective of this study was to assess the outcome of pregnancy in a series of women who underwent laparoscopic myomectomy. A total of 115 women underwent laparoscopic myomectomy for pressure and pain (76.5%), abnormal bleeding (52.2%) and/or infertility (29.6%). Follow up data were obtained either by reviewing the patient's chart or returned questionnaire. Of the 115 women, there were 42 pregnancies in 31 patients. Two women were lost to follow-up. Of the remaining 40 pregnancies, six ended with vaginal delivery at term. Caesareans were performed in 22 cases, including 21 at term and one at 26 weeks gestation. Two pregnancies were associated with a normal delivery, but the mode of delivery is unknown. Eight resulted in first trimester pregnancy loss, one was an ectopic pregnancy, and one patient underwent elective termination. Spontaneous uterine rupture was not noted during pregnancy or at term in any of the cases. Average length of follow-up from the date of surgery was 43 months, with a range of 9-99 months. Our series did not confirm the hypothesis that laparoscopic myomectomy is associated with an increased risk for uterine dehiscence during pregnancy. However, a larger series is needed to make a conclusive judgement.

Adult↗
PubMed1998

Laparoscopic surgical management of diaphragmatic endometriosis.

OBJECTIVE: To review the clinical presentations of and management options for diaphragmatic endometriosis. DESIGN: Retrospective review. SETTING: Referral center. PATIENT(S): Twenty-four women with endometriosis of the diaphragm. INTERVENTION(S): Surgical management. MAIN OUTCOME MEASURE(S): Diagnostic accuracy and therapeutic feasibility of operative laparoscopy. RESULT(S): Operative findings in 17 patients included 2-5 spots of endometriosis on the diaphragm measuring <1 cm. Seven women had numerous lesions scattered across the diaphragm. Lesions were bilateral in 8 patients, limited to the right hemidiaphragm in 14 patients, and limited to the left hemidiaphragm in 2 patients. In 7 patients, six endometriosis lesions were directly in the line of the left ventricle and three lesions were adjacent to the phrenic nerve. Endometriosis was infiltrating into the muscular layer of the diaphragm in 7 patients. The symptoms in all 7 symptomatic patients decreased significantly after treatment, with a minimum follow-up period of 12 months. No postoperative complications occurred. CONCLUSION(S): The abdominal diaphragm can be involved with endometriosis and can be diagnosed and treated effectively with the use of videolaparoscopy.

Adolescent↗
PubMed1998

Outcome of in vitro fertilization and intracytoplasmic injection of epididymal and testicular sperm extracted from patients with obstructive and nonobstructive azoospermia.

OBJECTIVE: To evaluate IVF outcome after epididymal and testicular sperm retrieval in patients with obstructive or nonobstructive azoospermia. DESIGN: Retrospective clinical analysis. SETTING: Public university-affiliated IVF unit. PATIENT(S): One hundred twenty-three azoospermic patients (178 cycles). INTERVENTION(S): Sixty-three patients (103 cycles) with obstructive azoospermia (group 1) underwent either epididymal or testicular sperm retrieval, and 60 patients (75 cycles) with nonobstructive azoospermia (group 2) underwent testicular sperm retrieval combined with IVF treatment. Mature oocytes were fertilized using intracytoplasmic sperm injection. After sperm preparation, supernumerary spermatozoa were cryopreserved. MAIN OUTCOME MEASURE(S): Oocyte fertilization rate and clinical pregnancy rate (PR). RESULT(S): The oocyte fertilization rate was 48.4% (534/1,104) in group 1 and 41.5% (312/751) in group 2 (not significant [NS] difference). A total of 100 cycles (97.1%) and 62 cycles (82.7%) in the obstructive and nonobstructive groups, respectively, had embryos for replacement (NS difference). The clinical PRs per ET cycle were 24% (24/100) and 17.7% (11/62) in the two groups, respectively. Oocyte fertilization rates, when fresh (46.4%) or frozen-thawed (41.8%) spermatozoa were used, were not significantly different in the two groups. The PR when fresh sperm were used was 23.6% (30/127), versus 14.3% (5/35) when frozen sperm were used (NS difference). The PR for women aged < or = 35 years was similar to that for women >35 years of age (20.7% or 29/140 and 18.2% or 4/25, respectively). CONCLUSION(S): Epididymal and testicular sperm obtained in azoospermic patients can fertilize oocytes successfully and may lead to high fertilization rates and PRs. Freezing of these spermatozoa does not reduce the outcome of treatment significantly.

Adult↗
PubMed1998

Long-term outcome of laparoscopic presacral neurectomy for the treatment of central pelvic pain attributed to endometriosis.

OBJECTIVE: To evaluate the long-term pain reduction achieved by laparoscopic presacral neurectomy. METHODS: One hundred seventy-six women with median (range) age 30 (18-45) years underwent presacral neurectomy combined with excision and vaporization of endometriotic lesions and were observed, using structured questionnaires, for up to 72 months postoperatively. The study included a convenience sample of the first 100 questionnaires returned. Forty of the women were studied for 12-23 months, and 60 for 24-72 months. The main outcome measures were reduction of pelvic pain, dysmenorrhea, and dyspareunia after surgery. RESULTS: Pelvic pain, dysmenorrhea, and dyspareunia were reportedly reduced by more than 50% in 74, 61, and 55 patients, respectively, more than 12 months after laparoscopic presacral neurectomy. More than 50% reduction in pelvic pain was reported by 69.8%, 77.3%, 71.4%, and 84.6% of the patients, respectively, with endometriosis stages I-IV, using the revised classification of the American Fertility Society. Comparatively, more than 50% reduction in dysmenorrhea was reported by 52.8% of the patients with stage I endometriosis, 68.2% with stage II, 71.4% with stage III, and 69.2% with stage IV. Reduction of dyspareunia by more than 50% was reported by 54.7% of the patients with stage I endometriosis, 50.0% with stage II, 28.6% with stage III, and 61.5% with stage IV. CONCLUSION: Long-term outcome of laparoscopic presacral neurectomy is satisfactory in the majority of patients. The stage of endometriosis is not related directly to the degree of pain improvement achieved.

Adolescent↗
PubMed1998

Effect of very advanced maternal age on pregnancy outcome and rate of cesarean delivery.

OBJECTIVE: To determine outcomes of pregnancies in women at least 44 years of age and to determine factors predicting cesarean delivery in these patients. METHODS: Between January 1988 and December 1995, 109 women at least 44 years old delivered in our medical center. These women were matched to a group of 309 women 20-29 years of age. Multiple logistic regression analysis was used to evaluate the association between maternal age and outcome variables, controlling for possible confounding factors. Based on the logistic regression, a predictive model was calculated for cesarean delivery and validated prospectively in a separate group of 30 consecutive women at least 44 years old, who delivered during the first 8 months of 1996. RESULTS: Very advanced maternal age, compared with younger age, was associated with a significantly higher rate of medical complications (hypertensive disorder and diabetes) (odds ratio [OR] 2.5; 95% confidence interval [CI] 1.5, 4.1; P < .001), instrument-assisted vaginal delivery (OR 7.5; 95% CI 2.2, 25.0; P < .004), and cesarean delivery (OR 7.3; 95% CI 2.2, 16.7; P < .001). The incidences of preterm labor, premature rupture of membranes, emergency cesarean delivery, meconium-stained amniotic fluid, small for gestational age newborns, and 5-minute Apgar scores of 7 or lower were not influenced by maternal age. The regression model showed an increased risk for cesarean delivery associated with age of at least 44 years (OR 7.3; 95% CI 2.2, 16.7), primiparity (OR 3.5; 95% CI 1.3, 9.8), infertility treatment (OR 3.6; 95% CI 1.5, 8.8), and egg donation (OR 19.5; 95% CI 6.1, 62.2), with positive and negative predictive values of 94 and 86%, respectively. CONCLUSION: Maternal age of at least 44 years is associated with medical complications in pregnancy and more interventions during labor. However, overall pregnancy outcomes are favorable. Cesarean delivery can be predicted accurately based on maternal age, parity, and infertility treatment.

Adult↗
PubMed1998

Recurrence rate after laparoscopic myomectomy.

STUDY OBJECTIVE: To determine the recurrence rate of myomas after laparoscopic myomectomy. DESIGN: Retrospective review (Canadian Task Force classification II-2). SETTING: Tertiary referral center. PATIENTS: One hundred fourteen women (age 25-51 yrs, median 38 yrs) who were followed for an average of 37 months (range 6-120 mo). INTERVENTION: Laparoscopic myomectomy. MEASUREMENTS AND MAIN RESULTS: Follow-up data were obtained by chart review and from returned questionnaires. Variables were date of surgery, first diagnosis of recurrence, and last follow-up visit. There were 38 (33.3%) recurrences after an average interval of 27 months. Twenty-four of these women did not require treatment. Eight underwent a second laparoscopic myomectomy, and one had a third. One patient had myomectomy and then hysterectomy, and six patients chose hysterectomy to treat the first recurrence. Cumulative risk of recurrence (Kaplan-Meier curve) was 10.6% after 1 year, 31.7% after 3 years, and 51.4% after 5 years. CONCLUSION: Although laparoscopic myomectomy is associated with less morbidity than removal by laparotomy, our results suggest that recurrence of myomas may be higher with the laparoscopic approach. Of 38 women with recurrent myoma, however, only 14 (36.8%) required additional surgery.

Adult↗
PubMed1998

Laparoscopic appraisal of the anatomic relationship of the umbilicus to the aortic bifurcation.

STUDY OBJECTIVE: To determine the cephalocaudal relationship among the umbilicus, aortic bifurcation, and iliac vessels by direct measurement during laparoscopy. DESIGN: Prospective, consecutive study (Canadian Task Force classification II-1). SETTING: Tertiary referral center. PATIENTS: Ninety-seven women undergoing operative laparoscopy. INTERVENTIONS: The distance from the aortic bifurcation relative to the umbilicus was measured in both the supine and Trendelenburg positions with a marked suction-irrigator probe. Patients were stratified into three groups based on body mass index (kg/m2). The anatomic location of the common iliac vessels and course of the left common iliac vein were identified in 68 women. MEASUREMENTS AND MAIN RESULTS: The position of the aortic bifurcation ranged from 5 cm cephalad to 3 cm caudal to the umbilicus in the supine position, and from 3 cm cephalad to 3 cm caudal in the Trendelenburg position. In the supine position, the aortic bifurcation was located caudal to the umbilicus in only 11% of patients compared with 33% in the Trendelenburg position. This difference was statistically significant for the total study population (p <0.0001) and for the nonoverweight group (p <0.01). In both positions no significant correlation was found between the distance from the aortic bifurcation to the umbilicus and body mass index. Mean +/- SD distance of the aortic bifurcation from the umbilicus in the supine position was 0.1 +/- 1.2 cm for the nonoverweight group, 0.7 +/- 1.5 cm for the overweight group, and 1. 2 +/- 1.5 cm for the very overweight group. Respective values in Trendelenburg position were 1.0 +/- 1.1, -0.4 +/- 1.2, and -0.2 +/- 1.3 cm. The common iliac artery was caudal to the umbilicus in four women. The space between common iliac arteries was always at least partly occupied by the left common iliac vein, and was completely filled in 19 women (28%). CONCLUSIONS: The cephalocaudal relationship between the aortic bifurcation and umbilicus varies widely and is not related to body mass index in anesthetized patients. Regardless of body mass index, the aortic bifurcation is more likely to be located caudal to the umbilicus in the Trendelenburg compared with the supine position. Its presumed location can be misleading during Veress needle or primary cannula insertion, and a more reliable guide is necessary for this procedure to avoid major retroperitoneal vascular injury.

Adolescent↗
PubMed1998

Macrosomia does not predict overweight in late adolescence in infants of diabetic mothers.

OBJECTIVE: To determine the predictive value of macrosomia for overweight later in adult life in infants of diabetic mothers. DESIGN: Data from the computerized records of the Jerusalem Perinatal Study were matched to measurements made at age 17 obtained from the military draft medical examination records. PARTICIPANTS: 10,891 infants born in Jerusalem between November 1974 and February 1976. MAIN OUTCOME MEASURES: Macrosomia based on 90th percentile birth weight for gestational age and overweight defined as the 90th percentile for body mass index at age 17. RESULTS: Diabetes was diagnosed in 87 (0.8%) of the mothers. Thirty-one (35.6%) of the infants of the diabetic mothers were macrosomic compared to 1012 (9.4%) of the siblings of nondiabetic mothers (p < 0.001). At 17 years of age 10.3% vs. 9.4% of the siblings of diabetic vs. nondiabetic mothers were overweight (p > 0.05). The rate of adolescent overweight in macrosomic vs. nonmacrosomic subjects was 12.3% vs. 9.7% (p < 0.01) in siblings of nondiabetic mothers, and 16.1% vs. 7.1% (p > 0.05) for diabetic mothers. The sensitivity and specificity, in diabetic mothers, of macrosomia for overweight at age 17 was 44.4% and 66.7%, respectively. The positive and negative predictive value of macrosomia for overweight at age 17 was 16.1% and 92.9%, respectively. CONCLUSIONS: The risk of adolescent overweight was significantly increased among macrosomic infants, although this trend did not reach statistical significance in the smaller group of infants born to diabetic mothers. Macrosomia among infants of diabetic mothers had little predictive value for overweight in late adolescence.

Adolescent↗
PubMed1998

The development of the foetal thyroid: in utero ultrasonographic measurements.

OBJECTIVE: The early recognition of potentially treatable thyroid disease in the foetus frequently depends on the detection of abnormal growth of the foetal thyroid gland. We have therefore established nomograms for foetal thyroid transverse width and circumference from 14 weeks of gestation until term, using transvaginal and transabdominal high-resolution ultrasound techniques. DESIGN: A prospective, cross-sectional study of 193 normal singleton pregnancies was performed. MEASUREMENTS: Thyroid size was measured by transvaginal ultrasonography between 14 and 17 weeks, and by abdominal ultrasound from 18 to 37 weeks of gestation. RESULTS: Data was accurately obtained for 193 foetuses. The mean +/- SD thyroid width and circumference were 11.7 +/- 4.1 mm (95% confidence interval 11.1-12.3) and 39.5 +/- 14.1 mm (95% confidence interval 37.4-41.6), respectively. Thyroid size as a function of gestational age was expressed by the regression equations: thyroid width (mm) = -3.94 + 0.68 x gestational age (weeks), and thyroid circumference (mm) = -1.38 + 0.23 x gestational age (weeks). The correlation coefficients, r = 0.91 and r = 0.93, for thyroid width and circumference, respectively, were found to be highly statistically significant (p < 0.0001). The normal mean of thyroid width and circumference for each week of gestational age and the 95% prediction limits were defined. CONCLUSIONS: The present data offer normative measurements of the foetal thyroid that may facilitate the prenatal diagnosis of foetal goitre and make early administration of in utero treatment possible.

Cross-Sectional Studies↗
PubMed1998

Hysterosalpingography with a balloon catheter versus a metal cannula: a prospective, randomized, blinded comparative study.

A prospective, randomized, blinded study was conducted to compare the use of a balloon catheter for performing hysterosalpingography (HSG) with the use of a traditional metal cannula. Sixty-one consecutive women who underwent HSG for evaluation of infertility were prospectively randomized to undergo the procedure with either a metal cannula (n = 31) or the balloon catheter (n = 30). The HSG procedure was identical in both groups. HSG using the balloon catheter, compared to the metal cannula, required significantly less fluoroscopic time (57.4 +/- 17.6 versus 75.6 +/- 40.5 s), smaller amounts of contrast medium (7.8 +/- 3.9 versus 20.1 +/- 15.8 ml), produced less pain (3.8 +/- 2.0 versus 5.6 +/- 2; on a scale of 1-10), and was easier for the physician to perform (8.8 +/- 1.1 versus 6.4 +/- 1.9; on a scale of 1-10) (P < 0.01). Eight patients (13%) were diagnosed as having proximal tubal occlusion. It was possible to offer an immediate transcervical tubal catheterization for further diagnosis and treatment of the occlusion only to the five patients with this condition from the balloon catheter group. We conclude that the balloon catheter is superior to the traditional metal cannula for performing HSG. Furthermore, if proximal tubal occlusion is diagnosed, an immediate selective salpingography and transcervical tubal catheterization can be performed without the need to replace the cannula or to reschedule the patient.

Adult↗
PubMed1998

Light-emitting diodes: a novel light source for phototherapy.

High intensity light-emitting diodes (LEDs) are being studied as possible light sources for the phototherapy of hyperbilirubinemic neonates. These power-efficient, low heat-producing light sources have the potential to deliver high intensity light of narrow wavelength band in the blue-green portion of the visible light spectrum, which overlaps the absorption spectrum of bilirubin (BR). We compared the efficacy between single LEDs of different color and then constructed a prototype phototherapy device using 300 blue LEDs. The efficacy of this device was compared with that of conventional phototherapy devices by measuring the in vitro photodegradation of BR in human serum albumin. When blue, blue-green, green, and white LEDs were compared, the blue light was the most effective in degrading BR by 28% of dark control, followed by blue-green (18% of control), and then white light (14% of control). Green light was the least effective (11% of control). The prototype device with three focused arrays, each with 100 blue LEDs, generated greater irradiance (> 200 microW.cm-2.nm-1) than any of the conventional devices tested. It also supported the greatest rate of BR photodegradation. We conclude that light from LEDs should be considered a more effective treatment for hyperbilirubinemia than light from presently used phototherapy devices. Furthermore, the unique characteristics of this light source may make it especially suitable for use in safe and lightweight home phototherapy devices.

Color↗
PubMed1998

Combined somatostatin analog and follicle-stimulating hormone for women with polycystic ovary syndrome resistant to conventional treatment.

This study was undertaken to determine whether somatostatin analog in combination with human urinary follicle-stimulating hormone (FSH) improves ovulatory performance in patients with polycystic ovarian syndrome (PCOS) who failed to respond to FSH alone. A comparative prospective study was performed in six insulin-resistant, hyperandrogenic, PCOS women treated with somatostatin analog combined with FSH for one cycle. Individual ovulatory performance was compared to the cumulative ovulatory response of three previous cycles. Somatostatin analog was administered subcutaneously by means of an infusion pump, providing a total daily dose of 200 micrograms starting from days 1-3 of the cycle. Induction of ovulation with FSH was initiated on day 5 of the stimulated cycle. Vaginal ultrasonography for follicular surveillance was performed before the pump setting and during the treatment cycle. A significant decrease in insulin, insulin-like growth factor (IGF-I), growth hormone (GH) and luteinizing hormone (LH) was observed during the combined somatostatin analog-FSH treatment cycles. The follicular growth patterns and the incidence of ovarian hyperstimulation syndrome (OHSS) was not affected. These observations suggest that adjuvant therapy with somatostatin analog may have a beneficial effect on the hormonal response of PCOS patients to gonadotropin induction of ovulation.

Adult↗
PubMed1997

Size at birth, maternal nutritional status in pregnancy, and blood pressure at age 17: population based analysis.

OBJECTIVE: To assess the effect of size at birth, maternal nutrition, and body mass index on blood pressure in late adolescence. DESIGN: Population based analysis of birth weight corrected for gestational age, mother's weight before pregnancy and weight gain in pregnancy, obtained from the Jerusalem perinatal study, and blood pressure and body mass index at age 17, available from military draft records. SETTING: Jerusalem, Israel. SUBJECTS: 10,883 subjects (6684 men and 4199 women) born in Jerusalem during 1974-6 and subsequently drafted to the army. MAIN OUTCOME MEASURES: Systolic and diastolic blood pressures measured at age 17 and their correlation with birth weight, size at birth, mother's body mass index and weight gain during pregnancy, and height and weight at age 17. RESULTS: Systolic and diastolic blood pressures were significantly and positively correlated with body weight, height, body mass index at age 17, and with mother's body weight and body mass index before pregnancy, but not with birth weight or mother's weight gain in pregnancy. CONCLUSION: Variables reflecting poor intrauterine nutrition, including low maternal body mass index before pregnancy, poor maternal weight gain in pregnancy, and being born small for gestational age, were not associated with a higher blood pressure in late adolescence.

Adolescent↗
PubMed1997

Chronic colchicine treatment does not impair glucose tolerance in familial Mediterranean fever patients.

OBJECTIVE: To investigate a long-term colchicine treatment in inhibiting normal release of insulin, in response to a glucose load. SETTING: The Heller Institute of Medical Research, Sheba Medical Center, Tel-Hashomer. PATIENTS: Thirty-one familial Mediterranean fever (FMF) patients, treated continuously with colchicine (1.0-2.0 mg.day-1) for 2-13 years. METHODS: A standard oral glucose tolerance test (OGTT) was performed to study the effect of long-term colchicine treatment on glucose-induced insulin response. An intravenous glucose tolerance test (IVGTT) was then performed on randomly chosen FMF patients (n = 9) and age-matched controls (n = 5). Glucose was administered 30 min after intravenous colchicine (2 mg) infusion. The sum of 1st- and 3rd-min insulin levels served as an index of early-phase insulin release. RESULTS: Based on the Office Guide to Diagnosis of Glucose Intolerance [13], one subject exhibited impaired glucose tolerance and two others had abnormal dynamics of glucose during the test but normal values at 120 min. Insulin values were normal in all participants. No significant differences were found in maximal glucose and insulin concentration, nor in the insulin release index between FMF colchicine-treated and healthy controls. CONCLUSIONS: Based on these findings, no impairment in glucose dynamics could be demonstrated in chronically colchicine treated patients, compared to untreated controls.

Administration, Oral↗