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Biomedical subjects

R Bachand

Publications and source records attributed to R Bachand.

13 recordsLinked to original sources
PubMed2003

Evaluation of the pharmacokinetic profiles of the new testosterone topical gel formulation, Testim, compared to AndroGel.

A two-period, randomized, complete crossover study was performed to evaluate the pharmacokinetic profiles of Testim (AA2500), a new 1% testosterone topical gel formulation, compared to AndroGel, an already available 1% testosterone topical gel. Twenty-nine hypogonadal subjects received a single dose (50 mg testosterone) of each formulation seven days apart. C(max) estimates for total testosterone, dihydrotestosterone and free testosterone were greater (30, 19 and 38%, respectively) following the application of Testim compared to AndroGel. Similarly, AUC(0-24) estimates for total testosterone, dihydrotestosterone, and free testosterone were greater (30, 11 and 47%, respectively) following the application of Testim compared to AndroGel. Confidence intervals for C(max) and AUC(0-24) were not wholly contained within the bioequivalence limits for testosterone, therefore Testim trade mark and AndroGel are not bioequivalent with Testim providing higher serum levels and greater bioavailability than AndroGel.

Administration, Topical↗
PubMed2003

AA2500 testosterone gel normalizes androgen levels in aging males with improvements in body composition and sexual function.

Testosterone replacement in hypogonadal men improves body composition, mood, and sexual functioning. In this 90-d study, we compared the pharmacokinetics and treatment effectiveness of a topical testosterone gel (AA2500) at two concentrations, 50 mg/d and 100 mg/d, to a testosterone patch and placebo gel in 406 hypogonadal men. Pharmacokinetic profiles were obtained, body composition was measured, and mood and sexual function were monitored. AA2500 treatments resulted in dose-dependent improvements in all pharmacokinetic parameters, compared with testosterone patch and placebo. Mean average concentrations at d 90 T were 13.8, 17.1, 11.9, and 7.3 nmol/liter for 50 mg/d AA2500, 100 mg/d AA2500, testosterone patch, and placebo, respectively. At d 90, the 100 mg/d AA2500 treatment improved lean body mass by 1.7 kg and percentage of body fat by 1.2% to a significantly greater degree than either control treatment. Significant improvements in spontaneous erections, sexual desire, and sexual motivation were also evidenced with the 100 mg/d AA2500 dose in comparison with placebo. Testosterone gel was well tolerated; however, the testosterone patch resulted in a high rate of application site reactions. Overall, AA2500 is an effective, well tolerated treatment for hypogonadism.

Administration, Cutaneous↗
PubMed1991

The safety and efficacy of clarithromycin in patients with Legionella pneumonia.

Clarithromycin, a new macrolide antibiotic, is at least four times more active in vitro than erythromycin against Legionella pneumophila. In this study the safety and efficacy of orally administered clarithromycin (500 to 1,000 mg bid) in the treatment of Legionella pneumonia were evaluated. Forty-six patients were enrolled in the study, 15 of whom had not responded to previous routine anti-Legionella therapy (erythromycin, ofloxacin, rifampin [rifampicin], or tetracycline). Twelve patients prematurely discontinued the study (nine by the patient's request while feeling well; one because of cancer diagnosis; and two because of adverse events). The response rates after treatment were as follows: clinical cure rate, 98 percent (43/44); clinical success (cure or improved), 100 percent (44/44); radiographic success (cure and improved), 93 percent (28/30); direct antigen fluorescence resolution, 100 percent (40/40); and bacteriologic cure, 100 percent (13/13). Ten patients reported 13 adverse events (seven mild, four moderate, and two severe). Clarithromycin is a safe effective treatment for patients with severe chest infections due to Legionella pneumophila.

Adolescent↗
PubMed1976

Airway obstruction with cuffed flexometallic tracheal tubes.

The occurrence of an airway obstruction with a cuffed flexometallic tracheal tube is reported. The cause of the obstruction is attributed to internal herniation of the distal extremity of the tube secondary to diffusion of anaesthetic gases into the tracheal tube cuff and subsequently between the two layers of the distal extremity of the tube. Methods to avoid overdistension of the cuff volume are described.

Adult↗
PubMed1975

Physiological changes associated with unilateral pulmonary ventilation during operations on the lung.

No important changes in the respiratory parameters were observed during one-lung anaesthesia. However, this kind of thoracic intervention can be accompanied by a dramatic fall in arterial oxygen tension. Methods to avoid tissue hypoxia have been described. In our series no complications whatever occurred in the operative and post-operative periods which could be related to the oxygenation of the patient.

Adult↗
PubMedDate not supplied

A pilot study of recovery room bypass ("fast-track protocol") in a community hospital.

PURPOSE: To evaluate the effectiveness of short-acting anesthetic drugs and techniques to achieve recovery room bypass criteria after minor surgery in a community hospital environment. METHODS: After agreement by a multidisciplinary committee, a pilot project was undertaken to assess the usefulness of ultra- short acting anesthetic drugs and pre-emptive analgesia to facilitate rapid recovery from general anesthesia. A cohort of 100 ASA I-II patients aged 18-65 yr undergoing simple knee arthroscopy or minor peripheral orthopedic procedures was compared to a similar cohort treated in the three months prior to the study period. Outcomes of interest included patient morbidity, success in achieving post-anesthesia care unit (PACU) bypass criteria, impact upon nursing resources, duration of operating room (OR) and hospital stay, and pharmaceutical costs before and after implementation. RESULTS: No patient morbidity was demonstrated prior to discharge home, and successful PACU bypass occurred in 83% of cases. Achievement of PACU discharge criteria while in the OR did not prolong the OR time, and discharge from hospital occurred earlier in the patients who did not require PACU care (P=0.0006 all "fast-track cases" vs all "controls"). Nursing complaints were more numerous when the day surgery personnel did not normally participate in PACU care. The cost of anesthetic care was significantly more using ultra-short acting drugs (CDN $14.17 vs CDN $20.57), but closer adherence to protocol could reduce this differential (CDN $18.84). CONCLUSION: Not all patients who receive a general anesthetic require admission to a phase I recovery facility. However, the justification for use of more expensive pharmaceuticals to achieve PACU bypass requires extensive changes in operating systems and voluntary professional behaviours.

Adolescent↗
PubMedDate not supplied

Laboratory diagnosis of iron deficiency in a developing country, Pakistan.

In developing countries, such as Pakistan, laboratories do not routinely screen for iron deficiency unless the patient presents with symptoms of anaemia. Efforts to prevent the often serious consequences of iron depletion are hampered in developing countries by the expense and impracticality of routinely screening patients using bone marrow examination. Assays for serum iron concentrations, total iron-binding capacity or haemoglobin and examinations of blood films, although more practical, cannot detect the earliest stages of iron deficiency. Serum ferritin appears to be a sensitive, early indicator of iron deficiency and can be easily and relatively inexpensively determined using an immunoassay kit. In the present study, serum ferritin levels were determined using immunoassay and compared to blood films, serum iron levels and total iron-binding capacity values in 300 apparently healthy Pakistanis. In the early stages of iron deficiency, serum ferritin appeared to be a sensitive measure of iron depletion.

Adult↗