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H Watts

Publications and source records attributed to H Watts.

38 records · Page 3Linked to original sources

The orthopedic management of conjoined twins: a review of 13 cases and report of 4 cases.

We reviewed 13 pairs of conjoined twins treated at Children's Hospital of Philadelphia between 1957 and 1988. Orthopedic problems were related to the ischiopagus type. These included problems related to separation and to the correction of associated deformities. The technique for separation has evolved through improved preoperative imaging and with increased experience, resulting in preservation of a longer and more functional "shared leg." Better preservation of skin to cover both infants and enough of the "shared leg" to insure a functional knee has been possible with posterior iliac osteotomies to close the pelvic ring, as well as the use of tissue expanders.

Female↗

Pharmacokinetics of saquinavir-SGC in HIV-infected pregnant women.

PURPOSE: To evaluate saquinavir (SQV) pharmacokinetics, tolerance, and safety in 10 HIV-infected pregnant women between 14-32 weeks gestation. METHOD: This was a phase I, prospective, area-under-the-curve (AUC) targeted study. Antepartum treatment consisted of SQV 1200 mg tid, lamivudine 150 mg bid, and zidovudine 200 mg tid. The SQV targeted exposure was an 8-hour AUC (AUC(8)) of 3000 ng. h/mL; the study was to be halted if the first 4 participants did not achieve this AUC(8). Cord blood and plasma samples were collected in neonates at birth. RESULTS: Four women completed the SQV pharmacokinetic assessments. Exposure in all 4 patients was below the target AUC(8). Median (range) AUC(8) and trough (C8H) were 1672 (738-2614) ng. h/mL and 60 (<15-332) ng/mL, respectively. Oral clearance (CL/F) was 9.3 (5.1-16.6) L/h/kg and C(max) was 599 (177-953) ng/mL. Cord and neonate plasma concentrations were mostly undetectable; 1 of 5 infants was HIV-infected at 24 weeks. CONCLUSION: These data suggest highly variable SQV pharmacokinetics in pregnant women, and exposure at 1200 mg tid may not be adequate for longer term therapy; both the AUC(8) and C8H were considerably below average. Because ritonavir has been shown to significantly increase SQV concentrations, this combination should be further explored in this population.

Adult↗