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Biomedical subjects

R J Barrett

Publications and source records attributed to R J Barrett.

At least 55 records · Page 3Linked to original sources

Drug discrimination is a continuous rather than a quantal process following training on a VI-TO schedule of reinforcement.

Debate continues as to whether drug discrimination in animals is an inherently quantal or continuous process. This issue is important in determining the appropriate interpretation of results from drug discrimination studies designed to assess the nature of drug-induced interoceptive cues. The quantal approach holds that subjects perceive a drug cue in an all-or-none manner, while the continuous view proposes that when appropriate training and testing procedures are used, subjects can discriminate along a continuum of interoceptive cues. Data consistent with the quantal view have consistently been generated by animals trained to respond on schedules of reinforcement having an FR component. Since quantal responding is a characteristic of these schedules, results from drug discrimination studies using training schedules with FR components are of little value in empirically determining whether drug discrimination reflects a quantal or continuous process. Use of variable schedules of reinforcement might be more appropriate because the pattern of responding generated does not preclude results consistent with either of the competing views. Data from the following studies that trained subjects using VI schedules with a concurrent TO for incorrect lever responding were analyzed: Barrett et al. (1982): L-5-hydroxytryptophan versus saline; Smith (1990): diazepam versus pentylenetetrazol; Barrett et al. (1992): amphetamine versus haloperidol; Barrett and Steranka (1983): amphetamine versus haloperidol. In every case, when experimental conditions produced a group mean intermediate to that for the training drugs, the distribution of scores for individual animals was normally rather than bimodally distributed.

5-Hydroxytryptophan↗

Hot and cold in transformation: is Iban medicine humoral?

Iban categories of hot and cold are examined in the context of humoral medical systems in southeast Asia. These categories are more than binary and oppositional: they are also contradictory and can only be understood in terms of their capacity for transformation in 'depth'. Analysis of the Iban epistemology of temperature sensation reveals the limitations of reductionist empirical approaches to hot and cold. Illness is apprehended, at one level, in terms of unusual conjunctions of opposite temperatures which signify a deeper disturbance in the relationship between body and soul, humans and spirits. Iban therapy redefines and relocates these categories in their proper place and at their appropriate level. It progresses from hot lay treatments to cool ritual treatments, yet cannot be accounted for within a limited framework of homeostatic balance. This paper develops an ethnographically grounded definition of humoralism which emphasizes non-reductive logic, cultural practice and transformation. The key element, transformation, is defined as a transition between categories and a shift in the level of interpretation which fundamentally alter the Iban experience of body and illness.

Borneo↗

Mitochondrial DNA diversity in the pea aphid Acyrthosiphon pisum.

The pea aphid Acyrthosiphon pisum has been established in North America for at least a century and occurs on a broad range of host plants. Despite its importance as a crop pest, there is little understanding of the genetic structure of its populations or the extent of genetic divergence associated with different host plant utilization. This study examined the extent of mitochondrial DNA (mtDNA) diversity among 35 clones of pea aphids from alfalfa. Polymorphisms were detected at only 2 of 126 restriction sites, suggesting the same impoverished level of genetic diversity found in prior allozyme studies. However, length variation was common and apparently arose as a result of tandem repeats in two regions of the mtDNA molecule. Region 1 occurred in proximity to the control region of the molecule, while region 2 was close to a cluster of tRNA genes flanking the NAD-dehydrogenase subunit 3 gene on the opposite side of the mtDNA molecule. Each of the aphid clones was homoplasmic for a single length variant in region 1, which varied with respect to the number of copies of a 120-bp repeat. By contrast, one-third of the clones were heteroplasmic at region 2, where they possessed a variable number of copies of a 210-bp repeat. Reanalysis of clones after 30 generations of parthenogenetic reproduction established the stability of length variants over this interval, suggesting their value in studies of the genetic structure of aphid populations.

Animals↗

Phase II trial of paclitaxel in patients with progressive ovarian carcinoma after platinum-based chemotherapy: a Gynecologic Oncology Group study.

PURPOSE: This Gynecologic Oncology Group (GOG) trial of paclitaxel (Taxol; Bristol-Myers Squibb Co, Princeton, NJ) as salvage therapy for recurrent epithelial carcinoma of the ovary sought to confirm activity reported previously. If positive, the trial was to serve as a basis for phase III trials of Taxol in combination with platinum compounds in first-line therapy. PATIENTS AND METHODS: Patients with recurrent, persistent, or progressive ovarian carcinoma during or after platinum-based chemotherapy received Taxol 170 mg/m2 intravenously once over 24 hours every 3 weeks. All patients had measurable disease and received premedication (dexamethasone, diphenhydramine, and ranitidine) followed by Taxol. RESULTS: Of 49 patients, 45 were eligible and assessable. Among 43 patients who were assessable for response, there were eight complete and eight partial responses (37%). The median progression-free interval was 4.2 months, and median survival 16 months. Among 27 resistant patients who progressed during or within 6 months of prior platinum-based therapy or had stable disease as the best response, five complete (18%) and four partial (15%) responses were observed (33%). The median progression-free interval was 4 months. Among 16 sensitive patients who responded and progressed more than 6 months after prior platinum-based treatment, three complete (19%) and four partial (25%) responses were observed (44%). The median progression-free interval was 4.9 months. Grade 4 neutropenia (< 500/microL), the most frequent and severe toxicity, occurred in 73% of patients. Other hematologic effects were less frequent and less severe. Cardiac problems and hypersensitivity reactions were observed in one patient each. CONCLUSION: Taxol is a highly active agent in ovarian carcinoma, even in patients who are clinically resistant to platinum-based chemotherapy, and produces frequent and severe, albeit manageable, myelosuppression. It is clearly active as salvage therapy for ovarian carcinoma.

Adult↗

A selective adenosine A1 receptor antagonist attenuates renal dysfunction during controlled hypotension with adenosine in rats.

Adenosine infusion produces sustained, reversible, controlled hypotension in humans, but markedly compromises renal function. Since adenosine inhibits renal perfusion and filtration via stimulation of intrarenal A1 receptors, we hypothesized that antagonism of A1-subtype receptors with the selective adenosine A1-receptor antagonist (+-)N6-endonorbornan-2-yl-9-methyladenine (N-0861) would attenuate adenosine-induced renal dysfunction while still allowing induction and maintenance of hypotension. Systemic and renal hemodynamic and excretory responses were measured in clearance studies conducted in six groups of anesthetized rats treated with: vehicle+saline, vehicle+adenosine, N-0861 (10 or 30 mumol/kg intravenously [i.v.])+saline, or N-0861 (10 or 30 mumol/kg i.v.),+adenosine. The A1-receptor antagonist had little effect on the magnitude, maintenance, or reversibility of controlled hypotension produced by adenosine infusion. Oliguria, hypofiltration, and electrolyte retention induced by adenosine infusion were attenuated in rats pretreated with N-0861. Adenosine A1-receptor antagonism also reduced the rebound hyperfiltration and hyperperfusion associated with cessation of adenosine infusion. N-0861 alone had only a modest effect on renal or systemic hemodynamics, but produced significant dose-related diuresis/natriuresis. These results suggest that coadministration of, or pretreatment with, a selective adenosine A1-receptor antagonist may attenuate the undesirable renal effects of adenosine while allowing maintenance of controlled hypotension.

Adenine↗

Discrimination of A1 versus A2 receptor subtype selectivity of adenosine receptor agonists in vivo.

Previous attempts to discern and quantify the selectivity of agonists for A1 versus A2 adenosine receptors in vivo have been confounded by the activation of baroreceptor reflexes and/or simultaneous expression of responses to both A1 and A2 receptor activation. In anesthetized, vagotomized rats with isolated in situ constant-flow perfused hindquarters (HQ), bradycardic responses to i.v. agonist injections measured A1 receptor activation and HQ vasodilation elicited by i.a. agonist injections measured the stimulation of A2 receptors. Adenosine and 5'-N-ethylcarboxamidoadenosine (NECA) produced A2 receptor-mediated HQ vasodilation at doses 8- and 4-fold lower (-log ED50 values, 7.3 +/- 0.04 mol and 8.7 +/- 0.06 mol, respectively) than those required to evoke A1 receptor-mediated bradycardia (-log ED50 values, 6.4 +/- 0.01 mol and 8.1 +/- 0.07 mol, respectively). N6-cyclopentyladenosine (CPA) was approximately 8-fold selective for A1 receptors (-log ED50 values, A1, 8.5 +/- 0.05 mol; A2, 7.6 +/- 0.16 mol). 2-(Phenylamino)adenosine (CV-1808) and 2[2(4-fluorophenyl)ethoxy]adenosine (FPEA) were at least 125- and 200-fold more potent agonists at A2 receptors (-log ED50 values, 7.7 +/- 0.10 mol and 8.0 +/- 0.24 mol, respectively) than at A1 receptors (-log ED50 values, 5.6 +/- 0.08 mol and 5.7 +/- 0.01 mol, respectively). These studies demonstrated that stimulation of A1 and A2 receptors may be discriminated in vivo and that such responses are selective, reproducible, dose-dependent and quantifiable.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenosine↗

Use of ultrasonography and secondary wound closure to facilitate diagnosis and treatment of a cranial mediastinal abscess in a dog.

A 3-year-old dog was examined because of acute, severe respiratory distress. Harsh inspiratory sounds, oral abrasions, and pyrexia were identified. On thoracic and cervical radiographs, the trachea appeared to be ventrally displaced and narrowed for several centimeters of its length at the thoracic inlet. Cytologic examination of a transcutaneous aspirate from the caudal cervical region revealed a neutrophilic exudate with extracellular bacteria. The ultrasonographic appearance of the thoracic inlet lent support to a diagnosis of cranial mediastinal abscess. Drainage and debridement of the abscess was accomplished via a ventral midline cervical approach, and the site was managed as an open wound. After 6 days, secondary wound closure was performed. The ventral cervical approach prevented contamination of the pleural space, and treatment as an open wound allowed inspection of the affected tissues to determine optimal time for wound closure. The cause of this cranial mediastinal abscess was unknown.

Abscess↗

Oral contraceptives and endometrial cancer: do other risk factors modify the association?

The joint effect of use of combination-type oral contraceptives and other exposure factors on risk of endometrial cancer was examined in data from a multicenter case-control study conducted in 5 areas of the United States. Cases were 405 women with histologically confirmed invasive epithelial endometrial cancer first treated at one of 7 participating hospitals. A total of 297 population-based controls of similar age, race, and geographic area were selected as a comparison group. Information on exposure factors was derived from in-person interviews. Combination-type oral contraceptive (COC) use was associated with a significant reduction in risk of endometrial cancer, with an adjusted odds ratio (OR) of 0.4 (95% confidence interval 0.3 to 0.7) for ever compared to never use. Long-term (> or = 10 years) users experienced a markedly lower risk (OR = 0.2). Women who discontinued COC use > or = 20 years earlier remained at reduced risk (OR = 0.7) compared with non-users. The negative association with COC use was apparent regardless of the presence or level of several other risk factors for endometrial cancer, including age, menopausal status, parity, obesity, ever-use of menopausal estrogens, smoking history, or history of infertility. The magnitude of the negative association observed in COC users, however, was considerably diminished in women with no full-term births and in women who subsequently used replacement estrogens for 3 or more years. These results provide new evidence that the protective effect of COC use lasts for 20 or more years after use is discontinued, and highlight several sub-groups of users in whom the level of protection is attenuated by the presence of other risk factors for this disease.

Adult↗

Cigarette smoking and the risk of endometrial cancer.

A case-control study involving 405 cases of epithelial endometrial carcinoma (newly diagnosed between 1987 and 1990 in five US areas) and 297 population controls enabled evaluation of risk in relation to detailed smoking characteristics. Cigarette smokers were at a reduced risk of disease, with the effect primarily restricted to women whose diseases were detected postmenopausally (relative risk (RR) = 0.6, 95% confidence interval 0.4-0.9). Among postmenopausal women, current smokers showed the greatest reduction in risk (RR = 0.4, 95% confidence interval 0.2-0.7), with former smokers, including those who had recently stopped, being less affected (RR = 0.8). Other measures of smoking were highly correlated with currency of smoking, but there were no clear patterns of risk with either duration or intensity of smoking. Smoking appeared to reduce risk to the greatest extent in subjects who were multiparous, obese, or nonusers of exogenous hormones, but none of these relations was statistically significant. The results support the notion that smoking reduces the risk of endometrial cancer through extraovarian endogenous hormonal mechanisms, but further studies are needed to clarify why reduced risks are most pronounced among postmenopausal women and those currently exposed to cigarette smoke.

Adult↗

Dietary associations in a case-control study of endometrial cancer.

Despite the established role of obesity in the etiology of endometrial cancer, limited data are available from analytical epidemiologic studies on the association of risk with dietary factors. A case-control study of 399 cases and 296 controls conducted in five areas of the United States from 1 June 1987 to 15 May 1990, enabled evaluation of risk related to dietary intakes adjusted for potential confounders. Caloric intake was associated modestly with increased risk (odds ratio [OR] = 1.5, 95 percent confidence interval [CI] = 0.9-2.5 for highest cf lowest quartiles of intake), with the principal contributors being fat and protein calories. After adjustment for other risk factors, including body mass, increased risk was associated with higher intakes of fat. Several components of fat investigated were associated with increased risk, although associations were slightly stronger for saturated fat (OR = 2.1, CI = 1.2-3.7) and oleic acid (OR = 2.2, CI = 1.2-4.0) than for linoleic acid (OR = 1.6, CI = 0.9-2.8). Food-group analyses showed intake of complex carbohydrates--and specifically of breads and cereals--associated with reduced risks (OR = 0.6, CI = 0.4-1.1), whereas animal fat and fried foods were associated with elevated risks (OR = 1.5 and 1.7, respectively). The relations of endometrial cancer with animal fat and complex carbohydrates were independent. No consistent associations were noted for intakes of cholesterol, fiber, vitamins A and C, individual carotenoids, or folate-rich foods. These data imply an etiologic role for a diet rich in total fat and/or animal fat and low in complex carbohydrates with endometrial cancer.(ABSTRACT TRUNCATED AT 250 WORDS)

Body Mass Index↗

Past and present physical activity and endometrial cancer risk.

We examined the relation between physical activity and endometrial cancer using data from a multicentre case-control study involving 405 endometrial cancer cases and 297 population controls. Estimates of recreational (i.e. active sport, walks and hikes) and nonrecreational activity (i.e. house cleaning, climbing stairs and walking or standing on the job) were obtained using interview information. After adjustment for age, study area, education, parity, years of use of oral contraceptives, years of use of menopausal oestrogens and cigarette smoking, recent recreational inactivity was associated with increased risk (RR = 1.9 for lowest vs highest tertile). Similarly, recent nonrecreational inactivity was associated with increased risk (RR = 2.2 for lowest vs highest tertile). Further adjustment for body mass and nonrecreational activity attenuated the association between risk and recent recreational inactivity (RR = 1.2; 95% CL = 0.7-2.0) but adjustment for body mass and recreational activity did not alter the association between risk and recent nonrecreational inactivity (RR = 2.0; 95% CL = 1.2-3.1). To evaluate the relation between risk and sustained inactivity, we simultaneously examined activity levels at three periods (RR i.e. age 20-29, age 30-39 and recently) in women age 50 and older. After adjustment for potential confounders and body mass, risk was elevated among women who were always recreationally inactive (RR = 1.5 for always active vs always inactive) and among women who were always nonrecreationally inactive (RR = 1.6 for always active vs always inactive). This study suggests that physically inactive women may be at increased risk of endometrial cancer because they are more likely to be overweight or obese. Our data also suggest that inactivity per se may be associated with an increased risk of endometrial cancer. However, we cannot rule out the possibility that our results, particularly those for nonrecreational activity, reflect unmeasured confounding factors. Future studies should attempt to obtain more detailed assessments of physical activity, including the intensity with which an individual engaged in an activity and the actual time involved in exertion.

Adult↗

Randomized comparison of the antiemetic efficacy of a serotonin type 3 receptor antagonist (MDL 72,222) with a high-dose metoclopramide regimen.

This pilot randomized study compared MDL 72,222, a highly selective 5-HT3 receptor antagonist, with a high-dose metoclopramide regimen (HDM) for chemotherapy-induced nausea and vomiting. MDL 72,222 was given in 20 mg intravenous doses 30 minutes before chemotherapy, as well as 2, 6, and 12 hours after chemotherapy infusion. The HDM was composed of diphenhydramine 50 mg i.v., metoclopramide 2 mg/kg i.v., and lorazepam 0.04 mg/kg i.v. administered 30 minutes before chemotherapy and 2, 4, 6, and 8 hours after chemotherapy. Patients were randomized to either MDL 72,222 (n = 12) or the HDM (n = 12) and were matched for age, weight, Karnofsky performance status, and chemotherapy. More patients in the MDL 72,222 group had received prior cisplatin. The MDL 72,222 group and the HDM group received a mean cisplatin dose of 66 mg/m2 and 62 mg/m2, respectively. Patients were observed for retching and/or emesis for 24 hours and completed a visual analog scale (VAS) for nausea. Six MDL 72,222 and five HDM patients had no vomiting. One MDL 72,222 and two HDM patients had one episode of emesis within 24 hours of chemotherapy. The median number of emetic episodes in the first 24 hours was 0.5 for MDL 72,222 and 1.0 for HDM patients. HDM patients were frequently asleep and were not awakened for evaluation of nausea with the VAS; 58% (70 of 120) of the HDM (mean score: 19.1 mm) and 14% (17 of 119) of the MDL 72,222 (mean score: 17.1) patients could not have VAS scores obtained (X2 = 50.74, p < 0.001). MDL 72,222 had similar efficacy with less sedation, and further trials are warranted.

Adult↗

Circadian-timed combination doxorubicin-cisplatin chemotherapy for advanced endometrial carcinoma. A phase II study of the Gynecologic Oncology Group.

Patients with advanced or recurrent endometrial cancer of any cell type having measurable disease have been entered into this study to determine the effectiveness and toxicity of circadian-timed doxorubicin-cisplatin chemotherapy. This Phase II study involved no randomization with treatment initiated with doxorubicin 60 mg/m2 over 30 minutes at 6:00 a.m., followed by cisplatin 60 mg/m2 over 30 minutes at 6:00 p.m. every 28 days. Treatment was continued for eight cycles or to a maximum tolerable doxorubicin dose of 480 mg/m2 for patients without progression. Thereafter, responders continued on cisplatin alone. A review of 30 evaluable patients showed 6 (20%) complete responses, 12 (40%) partial responses, and 7 (23%) with stable disease. The number of treatment courses ranged from 2 to 14 with a median of 6.5. the median white blood cell nadir for the 27 patients experiencing leukopenia was 1,600/mm3 (range: 300-3,600/mm3) For the 16 patients experiencing thrombocytopenia the median nadir was 48,500/mm3 (range: 8,000-138,000/mm3). There were no treatment-related deaths. Circadian-timed delivery of doxorubicin-cisplatin chemotherapy was reasonably well tolerated and demonstrated notable response rates in patients with advanced or recurrent endometrial carcinoma.

Adult↗

A phase II trial of tricyclic nucleoside phosphate in patients with advanced squamous cell carcinoma of the cervix. A Gynecologic Oncology Group Study.

A Phase II trial of TCN-P was conducted in metastatic or recurrent squamous cell carcinoma of the cervix using a 5-day continuous infusion schedule. The starting dose was 35 mg/m2 x 5 days and courses were repeated every 6 weeks. Among 21 evaluable patients, 2 responses were observed. One patient had a complete response for 19+ months. Another patient had a partial response for 5+ months, but developed symptomatic hypocalcemia, requiring discontinuation of the drug. Using this dose and schedule TCN-P appears to have limited activity in metastatic or recurrent squamous cell cancer of the cervix.

Acenaphthenes↗

Moderate alcohol consumption and the risk of endometrial cancer.

In a multicenter case-control study that included 400 cases and 297 controls, we examined the relation of moderate alcohol consumption to risk of endometrial cancer. We estimated average weekly intake of alcohol during adulthood from the reported frequency of intake of beer, wine, and liquor. The relative risk of endometrial cancer was 0.82 (95% confidence interval = 0.6-1.2) among women who drank, compared with lifelong abstainers. The weak protective effect of alcohol was due to a stronger inverse association among young women (< 55 years). In young women, the age-adjusted relative risks for three levels of drinking ( < 1, 1-4, > 4 drinks per week), from lowest to highest, were 0.78, 0.64, and 0.41 compared with nondrinkers. The risk estimates were not materially altered after adjustment for a variety of factors related to alcohol intake and to low risk of the disease (for example, smoking, oral contraceptive use, low body mass index, increased physical activity). The protective effect of alcohol could not be attributed to one particular type of alcohol-containing beverage, but beer appeared to have the most pronounced effect. These results suggest an inverse association between moderate alcohol consumption and endometrial cancer risk among young women, but support for a causal association is qualified and requires confirmation.

Adult↗

Interactions of adenosine A1 receptor-mediated renal vasoconstriction with endogenous nitric oxide and ANG II.

Renal vasoconstrictor responses to the adenosine A1 agonist N6-cyclopentyladenosine (CPA) were compared in the in situ autoperfused rat kidney to responses evoked by angiotensin II (ANG II), endothelin-1 (ET-1), arginine vasopressin (AVP), carbocyclic thromboxane A2 (CTxA2), phenylephrine (PE), and 5-hydroxytryptamine (5-HT). On the basis of their ED50 values (dose of agonist, in mass units, that produced 50% of maximal response to that agonist), the order of vasoconstrictor potency was ANG II > or = AVP > ET-1 > CPA > 5-HT > or = PE > CTxA2. Dose-response curves to CPA were shallower and maximal responses were weaker than those produced by the other agonists. Maximal responses, the log ED50, and the slope of the dose-response curve to CPA were markedly potentiated in the presence of the nitric oxide (NO) synthase inhibitor N omega-nitro-L-arginine methyl ester (L-NAME). Selective antagonism of A1 receptors increased renal blood flow and markedly attenuated CPA-induced renal vasoconstriction in the absence or presence of L-NAME but had no effect on the maximal responses to ANG II. Conversely, AT1 receptor antagonism attenuated renal vasoconstriction produced by ANG II but had little effect on the produced by CPA. These results suggest that endogenous NO modulates renal vasoconstriction produced by A1 receptor stimulation and provide evidence against an interaction between renovascular adenosine A1 and angiotensin AT1 receptors.

Adenine↗

In vitro and in vivo pharmacological characterization of N6-cyclopentyl-9-methyladenine (N-0840): a selective, orally active A1 adenosine receptor antagonist.

The pharmacological and biochemical profile of N6-cyclopentyl-9-methyladenine (N-0840) was elucidated in vitro and in vivo. In radioligand binding assays, N-0840 had 14- to 400-fold greater affinity for A1 than A2 adenosine receptors and did not inhibit radioligand binding to alpha-1, alpha-2, beta, 5-hydroxytryptamine 1a, muscarinic, D1 or D2 receptors at concentrations < or = 10,000 nM. In guinea pig tissues, N-0840 competitively antagonized A1 receptor-mediated, 5'-N-ethylcarboxamidoadenosine-induced negative inotropism (paced left atria, KB = 0.83 microM), chronotropism (spontaneously beating right atria, KB = 0.91 microM) and dromotropism (Langendorff heart; KB = 0.72 microM). However, at concentrations up to 100 microM, N-0840 did not antagonize A2 adenosine receptor-mediated, 5'-N-ethylcarboxamidoadenosine-induced relaxations of the guinea pig aorta. N-0840 was a poor inhibitor of total cyclic nucleotide phosphodiesterase activity and of adenosine uptake (IC50 > 200 microM), and it did not inhibit adenosine deaminase activity. In anesthetized rats, N-0840 selectively antagonized A1 adenosine receptor-mediated bradycardia, but generally failed to affect A2 adenosine receptor-mediated vasodilation in the in situ perfused hindquarters (A2/A1 selectivity: > or = 33-fold). The duration of action of N-0840 ranged from 1 min (after 3 mumol/kg i.v.) to 8 hr (after 100 mumol/kg p.o.). N-0840 (< or = 100 mumol/kg i.v.; < or = 1,000 mumol/kg p.o.) had little or no effect on blood pressure or heart rate and produced no adverse drug reactions.(ABSTRACT TRUNCATED AT 250 WORDS)

3',5'-Cyclic-AMP Phosphodiesterases↗

Topical sucralfate in the treatment of vaginal ulceration.

BACKGROUND: Non-neoplastic vaginal ulceration is at times recalcitrant to traditional methods of treatment. Sucralfate, a basic aluminum salt of sucrose octasulfate, binds preferentially to ulcerated areas and promotes healing, an effect that does not appear to be acid-dependent. CASE: Three cases of vaginal ulceration were treated with vaginal douches of sucralfate 10% suspension twice daily. One of the cases was due to laser ablation for intraepithelial neoplasia, one was of uncertain etiology, and one was caused by pessary use. CONCLUSION: After failure of the initial therapeutic regimens, sucralfate treatment was successful in all three cases and was well tolerated without side effects. Sucralfate vaginal douches should be considered for the treatment of non-neoplastic vaginal ulcerations, particularly when other therapy has failed.

Administration, Topical↗