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At least 217 records · Page 12Linked to original sources

PubMed1996

Circumferential scalp reduction with a suture-in-place Silastic-Dacron extender.

BACKGROUND: Circumferential scalp reduction combined with a suture-in-place Silastic-Dacron extender is described as a viable alternative for those surgeons wishing not to perform extensive scalp-lifting. The primary advantage of the Silastic-Dacron extender is that it allows the time interval between surgeries to be shortened to 1 month. OBJECTIVE: To incur the benefits of circumferential scalp reduction (minimal stretch-back and decreased slot formation) and the decreased time between sessions offered by a suture-in-place Silastic-Dacron extender. METHODS: A circumferential scalp reduction is first performed and a tunnel is made under the central bald peninsula. Once this is completed, a 4-cm-wide Silastic-Dacron strip is passed through the tunnel and is sutured to both lateral edges of the galea under tension. The way to determine the proper length of the strip is described. RESULTS: The combination of circumferential scalp reduction with a suture-in-place Silastic-Dacron extender gives results that are comparable to scalp-lifting; however, more procedures are required and not as much upward movement into the crown is accomplished. The memory of the Silastic-Dacron extender has been found to eliminate stretch-back and quickly improve scalp laxity. CONCLUSION: Circumferential scalp reduction combined with a suture-in-place Silastic-Dacron extender is an extremely viable method to treat patients with extensive baldness. The decrease in slot formation and minimal stretch-back afforded by circumferential scalp reduction and the shortened 1-month time interval between surgeries brought about by the Silastic-Dacron extender make this a procedure that hair replacement surgeons should have in their armamentarium.

Alopecia↗

PubMed2000

Treatment options for extended-spectrum beta-lactamase-producers.

A review of antibiotic options for the treatment of infections caused by extended-spectrum beta-lactamase-producing isolates is presented. The use of the third-generation cephalosporin, cefotaxime, for infections caused by isolates producing ceftazidimase-type extended-spectrum beta-lactamases is controversial, despite in vitro susceptibility to the antibiotic in many instances. The fourth-generation cephalosporin, cefipime, although active against most extended-spectrum beta-lactamases, is reported to show a marked inoculum effect. The cephamycins, such as cefoxitin. are generally effective against Enterobacteriaceae producing TEM- and SHV-derived extended-spectrum beta-lactamases, but Klebsella pneumoniae strains are prone to cephamycin resistance as a result of porin loss. The use of beta-lactamase inhibitor combinations is variable. Sulbactam is less effective than clavulanate for the inhibition of SHV-derived extended-spectrum beta-lactamases and a marked inoculum effect has been noted, while the efficacy of tazobactam against SHV-derived extended-spectrum beta-lactamase producers is controversial. Furthermore, extended-spectrum beta-lactamases are often encoded by multi-resistant plasmids carrying genes conferring resistance to aminoglycosides, chloramphenicol, sulfonamides, trimethoprim and other antimicrobials, severely limiting even alternative therapies. Extensive susceptibility testing before the institution of antibiotic therapy is thus vital.

Anti-Bacterial Agents↗

PubMed1992

Detection of extended-spectrum beta-lactamases in members of the family Enterobacteriaceae: comparison of the double-disk and three-dimensional tests.

The three-dimensional and clavulanate double-disk potentiation tests were compared as procedures for the detection of extended-spectrum beta-lactamase production in 32 strains of Escherichia coli and Klebsiella pneumoniae, 31 of which produced TEM-1, TEM-2, TEM-3, TEM-4, TEM-5, TEM-7, TEM-8, TEM-9, TEM-10, TEM-12, TEM-101, SHV-1, SHV-2, SHV-3, SHV-4, SHV-5, CAZ-2, MIR-1, or an unidentified extended-spectrum beta-lactamase with a pI of 5.95, with some strains producing multiple beta-lactamases. The three-dimensional test, which was performed in conjunction with a routine disk diffusion test, detected extended-spectrum beta-lactamase production in 26 of 28 (93%) of the strains that produced extended-spectrum beta-lactamases. The clavulanate double-disk potentiation test detected extended-spectrum beta-lactamases in only 22 of the 28 strains (79%) when it was performed as currently recommended. The three-dimensional test, when performed in conjunction with the disk diffusion test, offered the advantages of providing simultaneous information about both antibiotic susceptibility and extended-spectrum beta-lactamase production, coupled with a greater sensitivity and earlier detection of extended-spectrum beta-lactamases.

Anti-Bacterial Agents↗

PubMed2004

Afferent synaptic transmission in a hair cell organ: pharmacological and physiological analysis of the role of the extended refractory period.

One feature of neuronal discharge proposed to play a role in coding temporal information is the relative refractory period that follows each action potential. In neurons innervating hair cells, there is an extended refractory period that can last </=100 ms. We have taken a pharmacological approach to examine the extended refractory period in the Xenopus lateral line organ. We show that each action potential in the afferent fiber, whether generated spontaneously or through an antidromic electrical pulse, decreases the probability of subsequent afferent discharge for a period of </=100 ms. We show that the extended refractory period can be modulated with drugs that alter glutamatergic transmission between the hair cell and the afferent fiber. The extended refractory period can be enhanced by perfusion with agents that reduce synaptic activity. These agents include blockers of voltage-dependent transmitter release, such as cobalt, as well as glutamate receptor antagonists, such as CNQX and kynurenic acid. Conversely, perfusion with agents that increase synaptic activity through activation of the glutamate receptors, such as AMPA or kainate, reduces the magnitude of suppression during the extended refractory period. The extended refractory period is greatly reduced by iberiotoxin and tetraethylammonium (TEA), indicating it may be mediated in large part by a calcium-dependent potassium channel. The ability to modulate the extended refractory period with changes in synaptic input suggests a simple, dynamic mechanism by which strong input (i.e., large or frequent excitatory postsynaptic potentials) can be strengthened and weak inputs weakened.

6-Cyano-7-nitroquinoxaline-2,3-dione↗

PubMed1984

Extended major histocompatibility complex haplotypes in type I diabetes mellitus.

We have studied major histocompatibility complex markers in Caucasian patients with type I diabetes mellitus and their families. The frequencies of extended haplotypes that were composed of specific HLA-B, HLA-DR, BF, C2, C4A, and C4B allelic combinations, which occurred more commonly than expected, were compared on random diabetic and normal chromosomes in the study families. We demonstrated that all of the previously recognized increases in HLA-B8, B18, B15, DR3, and perhaps DR4 could be ascribed to the increase among diabetic haplotypes of a few extended haplotypes: [HLA B8, DR3, SC01, GLO2]; [HLA-B18, DR3, F1C30]; [HLA-B15, DR4, SC33]; and [HLA-BW38, DR4, SC21]. In fact, HLA-DR3 on nonextended haplotypes was "protective", with a relative risk considerably less than 1.0. There was a paucity or absence among diabetic patients of several extended haplotypes of normal chromosomes, notably [HLA-B7, DR2, SC31] and [HLA-BW44, DR4, SC30]. The extended haplotype [HLA-BW38, DR4, SC21] is found only in Ashkenazi Jewish patients, which suggests that extended haplotypes mark specific mutations that arise in defined ethnic groups. The data show that no known MHC allele, including HLA-DR3 and possibly HLA-DR4, is per se a marker for or itself a susceptibility gene for type I diabetes. Rather, extended haplotypes, with relatively fixed alleles, are either carriers or noncarriers of susceptibility genes for this disease. Thus, the increased frequency (association) or the decreased frequency (protection) of individual MHC alleles is largely explainable by these extended haplotypes.

Alleles↗

PubMed2004

Evaluation of an extended stroke unit service with early supported discharge for patients living in a rural community. A randomized controlled trial.

OBJECTIVE: To evaluate the effect of an extended stroke unit service (extended service), with early supported discharge and co-ordination of further rehabilitation in co-operation with the primary health care system in three rural municipalities. DESIGN: A randomized controlled trial comparing extended service with ordinary stroke unit service (ordinary service). SUBJECTS: Sixty-two eligible patients with acute stroke living in the rural municipalities of Malvik, Melhus and Klaebu. MAIN MEASURES: The primary outcome was the proportion of patients who were independent according to Modified Rankin Scale (mRS) (independence = mRS < or = 2) 52 weeks after onset of stroke. Secondary outcomes were mRS at 6 and 26 weeks and Barthel Index (BI), Nottingham Health Profile (NHP) and Caregiver Strain Index (CSI) at 6, 26 and 52 weeks. Mortality and length of stay were registered during the 52 weeks. RESULTS: Twelve patients (39%) in the extended service group versus 16 patients (52%) in the ordinary service group were independent according to mRS at 52 weeks (p = 0.444). The odds ratio for independence (extended service versus ordinary service) was 0.33 (95% confidence interval (CI) 0.088-1.234). According to outcome by secondary measures there were no significant differences except less social isolation on NHP in the extended service group at 26 weeks (p = 0.046). There were no significant differences in length of stay. CONCLUSION: An extended stroke unit service with early supported discharge seems to have no positive effect on functional outcome for patients living in rural communities, but might give a trend toward better quality of life. There were no significant differences in length of stay.

Activities of Daily Living↗

PubMed2005

Risk stratification for lung cancer surgery: impact of induction therapy and extended resection.

STUDY OBJECTIVES: Current surgical strategies for lung cancer are directed toward the following two distinct targets: the increased prevalence of early-stage lung cancer; and locally advanced lung cancer treated with induction therapy (IT). To establish the risk stratification for operative morbidity from this viewpoint, we evaluated the impact of IT and/or an extended surgical procedure on operative results. DESIGN: Retrospective study. SETTING: A 674-bed teaching hospital. PATIENTS AND METHODS: The morbidity and mortality of 758 consecutive patients who underwent surgery for the treatment of non-small cell lung cancer were analyzed. There were 666 patients who underwent surgery alone (S group; 560 standard lobectomies and 106 extended resections) and 92 patients who received IT (IT group; 35 standard lobectomies and 57 extended resections). Comparisons between the groups were performed using unpaired t tests or chi(2) tests. Univariate and multivariate logistic regression analyses were used to determine the risk factors for operative morbidity and mortality. RESULTS: IT and extended surgery were strong independent factors for predicting postoperative morbidity (p < 0.0001). Significant differences were observed for pathologic stage (p < 0.0001), preoperative hemoglobin and Dlco levels (p < 0.001), the ratio of extended resection (p < 0.0001), and operation time and intraoperative bleeding (p < 0.001) between the S and IT groups. The overall morbidity and mortality rates were 16.8% and 0.9%, respectively, in the S group, and 55.4% and 5.4%, respectively, in the IT group (p < 0.01). The overall morbidity and mortality rates were 63.2% and 7.0%, respectively, for extended resection after IT, and 12.8% and 0.3%, respectively, for those who underwent a standard resection without IT. CONCLUSIONS: The morbidity and mortality of lung resection are both significantly increased after IT, and the patients with the greatest risk are those who have undergone IT and extended resection. The impact of IT on risk stratification should be emphasized in perioperative care.

Adenocarcinoma↗

PubMed2005

Specificity in the projections of prefrontal and insular cortex to ventral striatopallidum and the extended amygdala.

The basal forebrain functional-anatomical macrosystems, ventral striatopallidum, and extended amygdala are innervated by substantially coextensive distributions of neurons in the prefrontal and insular cortex. This suggests two alternative organizational schemes: convergent, in which a given cortical area projects exclusively to only one of these macrosystems and divergent, in which a given cortical area innervates both forebrain macrosystems. To examine the underlying organization and possibly discriminate between these alternatives, rats were injected with two retrograde tracers in different parts of ventral striatopallidum or extended amygdala (homotypic injection pairs) or with one tracer in each macrosystem (heterotypic). The prefrontal and insular cortex was evaluated microscopically for overlap of retrograde labeling and double labeling of neurons. Homotypic injection pairs in the ventral striatum and extended amygdala produced extensive overlap of retrogradely labeled neurons and significant double labeling, suggesting that cortical projections spread broadly within macrosystems. In contrast, heterotypic injection pairs produced significant overlap of retrograde labeling but negligible double labeling, indicating that ventral striatopallidum and extended amygdala receive inputs from separate sets of prefronto- and insular cortical neurons. The caudomedial shell of the nucleus accumbens, a supposed "transition" zone between striatopallidum and extended amygdala, had extended amygdala-like afferents but produced few double-labeled neurons and these only when paired with ventral striatopallidum. The data suggest that a modular organization of the basal forebrain, with postulated independent information processing by the ventral striatopallidal and extended amygdala macrosystems, is reflected in a corresponding segregation of output neurons in the prefrontal and insular cortices.

Amygdala↗

PubMed2003

Clarithromycin (Biaxin) extended-release tablet: a therapeutic review.

Clarithromycin (Biaxin) extended-release tablets, an advanced generation macrolide, were recently introduced into the USA for the treatment of acute exacerbations of chronic bronchitis, community-acquired pneumonia and acute maxillary sinusitis. The reformulation is intended to improve both patient compliance and tolerability. The extended-release tablets allow convenient once-daily dosing (1000 mg). The extended-release formulation has been shown to be equivalent to the immediate-release formulation concerning area under the plasma concentration time curve. In comparative clinical trials for acute exacerbations of chronic bronchitis, community-acquired pneumonia and acute maxillary sinusitis, clarithromycin extended-release tablets were equivalent to the immediate-release formulation concerning clinical efficacy and bacterial eradication, with improved gastrointestinal tolerability. Similar efficacy and gastrointestinal tolerability results were demonstrated in a recent comparative study of clarithromycin extended-release formulation and amoxicillin-clavulanate in patients with acute exacerbations of chronic bronchitis. Clarithromycin extended-release 1000 mg daily has also been shown to be equivalent to levofloxacin 500 mg daily for the treatment of community-acquired pneumonia in a recent study. The macrolide class of antimicrobials, including clarithromycin extended-release, continues to be a safe and efficacious choice for the out-patient management of community-acquired bacterial respiratory tract infections.

Anti-Bacterial Agents↗

PubMed2004

Evidence for extended prophylaxis in the setting of orthopedic surgery.

Patients undergoing orthopedic surgery represent one of the highest risk groups for the development of venous thromboembolism (VTE). Evidence shows that this risk extends beyond the period in which the patient is hospitalized, especially for patients undergoing hip surgery. Clinical trials have shown that extended prophylaxis with the low-molecular-weight heparins is effective in reducing the rate of total VTE, and a meta-analysis demonstrated a reduction in symptomatic VTE with extended prophylaxis after total hip replacement surgery. Based on these results, the American College of Chest Physicians gives a grade 2A recommendation for the use of extended prophylaxis after orthopedic surgery. Until recently, data evaluating the role of prophylaxis in patients undergoing hip fracture surgery were limited. Subsequently, a novel anticoagulant, fondaparinux, demonstrated significant benefit in these patients and has become the first and only agent approved by the United States Food and Drug Administration (FDA) for use in patients undergoing hip fracture surgery Despite the limitations of the older trials, their findings supported the need to evaluate extended prophylaxis in patients undergoing hip fracture surgery. In the first well-conducted trial of extended prophylaxis for hip fracture surgery, fondaparinux provided impressive results in reducing total and symptomatic VTE. The results of this trial have once again led to fondaparinux being the first and only agent to be granted FDA approval for the indication of extended prophylaxis in patients undergoing hip fracture surgery.

Anticoagulants↗

PubMed2000

Extended-release oxybutynin.

Extended-release oxybutynin (Ditropan XL) uses an osmotic system (OROS) to deliver a controlled amount of oxybutynin chloride into the gastrointestinal tract over a 24-hour period when taken once daily. Oxybutynin binds to M3 muscarinic receptors on the detrusor muscle of the bladder, preventing acetylcholinergic activation and relaxing the muscle. Mean peak plasma concentrations are lower with extended-release oxybutynin 15mg once daily than with conventional immediate-release oxybutynin 5mg taken 3 times daily. Relative bioavailabilities of parent drug and metabolite N-desethoxybutynin are 153 and 69%, respectively, for extended-release oxybutynin when compared with immediate-release oxybutynin. In short (< or =6 weeks) randomised, double-blind clinical trials of patients with detrusor instability, extended-release oxybutynin 5 to 30mg once daily significantly reduced the mean weekly number of urge incontinence episodes by 84 to 90%. Extended-release oxybutynin had similar efficacy to immediate-release oxybutynin. Adverse events reported by patients taking extended-release oxybutynin were dose-related anticholinergic effects, most frequently dry mouth, somnolence, constipation, blurred vision and dizziness. A large noncomparative study demonstrated that approximately two thirds of the patients prescribed extended-release oxybutynin for detrusor instability were still taking the medication 6 months later.

Aged↗

PubMed2006

Efficacy, tolerability, and safety of a novel once-daily extended-release metformin in patients with type 2 diabetes.

OBJECTIVE: The purpose of this study was to determine the efficacy and safety of a novel extended-release metformin in patients with type 2 diabetes. RESEARCH DESIGN AND METHODS: Adults with type 2 diabetes (newly diagnosed, treated with diet and exercise only, or previously treated with oral diabetic medications) were randomly assigned to receive one of three extended-release metformin treatment regimens (1,500 mg/day q.d., 1,500 mg/day twice daily, or 2,000 mg/day q.d.) or immediate-release metformin (1,500 mg/day twice daily) in a double-blind 24-week trial. RESULTS: Significant decreases (P < 0.001) in mean HbA(1c) (A1C) levels were observed by week 12 in all treatment groups. The mean changes from baseline to end point in the two groups given 1,500 mg extended-release metformin (-0.73 and -0.74%) were not significantly different from the change in the immediate-release metformin group (-0.70%), whereas the 2,000-mg extended-release metformin group showed a greater decrease in A1C levels (-1.06%; mean difference [2,000 mg extended-release metformin - immediate-release metformin]: -0.36 [98.4% CI -0.65 to -0.06]). Rapid decreases in fasting plasma glucose levels were observed by week 1, which continued until week 8, and were maintained for the duration of the study. The overall incidence of adverse events was similar for all treatment groups, but fewer patients in the extended-release metformin groups discontinued treatment due to nausea during the initial dosing period than in the immediate-release metformin group. CONCLUSIONS: Once- or twice-daily extended-release metformin was as safe and effective as twice-daily immediate-release metformin and provided continued glycemic control for up to 24 weeks of treatment.

Adolescent↗

PubMed1995

Role of extended lymph node dissection in the treatment of gastrointestinal tumours: a review of the literature.

UNLABELLED: Over recent decades the long-term survival of patients operated on for gastrointestinal cancer has shown little if any improvement, despite sometimes aggressive surgical procedures and a significant fall in postoperative mortality. BACKGROUND: We went through the literature to see if there were any eventual effects of extended lymph node dissection or survival. METHODOLOGY: We reviewed recent literature on the different types of gastrointestinal cancer. RESULTS: Japanese centres report excellent results when wide local excision is combined ith systematic extended lymph node dissection, especially in gastric and oseophageal cancer. The overall 5-year survival of over 50% for the large number of patients undergoing gastric resection for cancer seems to demonstrate convincingly the value of the extended lymphadenectomy. All oriental studies are uncontrolled, as are most reports from Western countries. The role of extended lymphadenectomy is therefore far from certain. The results from two randomized studies (British Medical Research Council and Dutch Gastric Cancer Trial) are awaited. It is evident from these prospective studies that the procedure adds a considerable operative risk. From non-randomized studies there is evidence that extended lymph node dissection in the treatment of pancreatic cancer might be of benefit to patients with small stage I and II tumours. In the treatment of proximal bile duct cancer the main goal of surgery is optimal relief of biliary obstruction. Whether there will ever be a role for extensive lymphadenectomy is doubtful. The extent of the surgical procedure in the treatment of gallbladder cancer is related to the depth of tumour infiltration. Extended resections are only recommended for patients with stage II to IV tumours. Extended lateral pelvic node dissection in the treatment of rectal cancer is demonstrated in Japanese retrospective studies to induce considerable urogenital problems, whereas the risk for local recurrence is still present. CONCLUSIONS: No firm conclusions can be drawn based on data as available from the studied literature. Trial results will have to be awaited. Specific subgroups such as gastric and rectal cancer might benefit from these more extensive procedures.

Bile Duct Neoplasms↗

PubMed1977

Effect of repeated inseminations with egg yolk semen extender on fertility in cattle.

Experiments were designed to determine if repeated inseminations of egg yolk diluent containing no semen would induce antibodies against egg yolk and would have an adverse effect on subsequent fertility under routine conditions of artificial insemination. Extender containing antibiotics polymyxin, dihydrostreptomycin, and penicillin and the enzyme beta amylase, with or without hen's egg yolk, was inseminated three to four times into virgin dairy heifers. The heifers subsequently were bred with bovine semen suspended in the extender containing egg yolk. Antibodies against antigens in the egg yolk extenders were not detected by complement fixation and agar gel immuno-diffusion, either in blood serum or in whole and homogenized cervical mucus taken before and after the repeat inseminations. Allergic reactions to the semen extender were not observed in any of the heifers. Calving rate from one service was 63.6% (7/11) for controls, 68.2% (15/22) after prior inseminations with egg yolk extender, and 69.2% (9/13) after prior inseminations with extender minus egg yolk. Under routine conditions of artificial insemination three to four exposures to extenders with or without egg yolk did not affect subsequent fertility adversely.

Animals↗

PubMed1982

Development of extender and techniques for frozen turkey semen. 1. Development.

An extender for turkey semen with a frozen-thawed recovery of greater than or equal to 50% motile spermatozoa and a vigorous swirl was developed. The effect of glucose, a comparison of 10 different sugars in the extender, the use of sodium acetate and potassium acetate, the ratio of dimethylsulfoxide to ethylene glycol, the percent total cryoprotectant, equilibration time, and osmotic pressure were all tested. Replacement of approximately half of the extender with an iso-osmolar glucose solution yielded higher percentages of motile spermatozoa with both fresh and frozen-thawed semen samples. Replacement of glucose with other carbohydrates did not enhance recovery of frozen-thawed semen. The proportion of sodium and potassium acetates to TESNaK2 in the extender had no effect on motility. Approximately equal proportions of ethylene glycol to dimethylsulfoxide, with a final concentration of 11.2% after dilution, produced at or near optimal recovery of spermatozoal motility after freezing. Twenty to 90 min equilibration times before freezing yielded significantly higher recovery of motile sperm postthaw than shorter periods. A wide range of extender osmotic pressures were compatible with recovery of spermatozoal motility postthaw. The final extender consisted of 4.70 g sodium acetate, 3.39 g potassium acetate 9.23 g TES, .353 g sodium hydroxide, .492 g potassium hydroxide, 32.00 g glucose, H2O q.s. 1000 ml, 370 mOsm/kg, pH 7.2. Ethylene glycol and dimethylsulfoxide were added (1:1 ratio) for a final concentration of 11.2% cryoprotectant after dilution. Semen was held undiluted for 6 min, extended 1:4 at 22 C, and equilibrated for 30 min at 0 C before pellet freezing.

Animals↗

PubMed2005

Extended radical operation of pancreatic head cancer: appraisal of its clinical significance.

AIM: To evaluate the significance of extended radical operation and its indications. METHODS: Between January 1995 and December 1998, 56 inpatients with pancreatic head cancer received operation. Among them 35 patients (group 1) experienced the Whipple operation, and 21 patients (group 2) received the extended radical operation. The 1-, 2-, 3-year cumulative survival rates were used to evaluate the efficacy of the two operative procedures. Clinical stage (CS) was assessed retrospectively with the help of CT. The indications for extended radical operation were discussed. RESULTS: There was no difference in hospital mortality and morbidity rates. Whereas the 1-, 2-, 3-year cumulative survival rates were 84.8%, 62.8%, 39.9% in the extended radical operation group, and were 70.8%, 47.6%, 17.2% in the Whipple operation group, there was a significant difference between the two groups (P<0.001, P<0.001, P<0.001, respectively). Most of the deaths within 3 years after operation were due to recurrence in the two groups. However, the 1-, 2-, 3-year cumulative rates of death due to local recurrence were decreased from 37.4% in patients that received the Whipple procedure to 23.8% in those who received by extended radical operation. Patients who survived for more than 3 years were only noted in those with CS1 in the Whipple procedure group and were founded in cases with CS1, CS2 and part of CS3 in the extended radical operation group. CONCLUSION: The extended radical operation appears to benefit patients with pancreatic head carcinoma which was indicated in CS1, CS2 and part of CS3 without severe invasion.

Aged↗

PubMed2003

Pharmacokinetics, metabolism, and saliva output during transdermal and extended-release oral oxybutynin administration in healthy subjects.

OBJECTIVE: To compare the pharmacokinetics and adverse effect dynamics of 2 modified-release oxybutynin treatments. SUBJECTS AND METHODS: Between October 15 and November 6, 2001, 13 healthy subjects (7 men and 6 women) participated in a randomized, 2-way crossover study of transdermal (Oxytrol, 3.9 mg/d) and extended-release oral (Ditropan XL, 10 mg) oxybutynin. Multiple blood and saliva samples were collected. Pharmacokinetic parameters and total salivary output were assessed. Statistical analyses included 95% confidence intervals, paired t test, analysis of variance, and linear regression. RESULTS: Steady-state plasma concentrations were achieved after the first transdermal application and after the second extended-release oral dose. Mean +/- SD 24-hour oxybutynin areas under the concentration-time curve were comparable during transdermal and oral extended-release treatments, 10.8 +/- 24 vs 9.2 +/- 33 ng x h(-1) x mL(-1), respectively. However, the ratio of area under the curve (N-desethyloxybutynin/oxybutynin) after transdermal administration (1.2 +/- 03) was significantly lower (P < .001) than after extended-release oral administration (4.1 +/- 0.9). Mean plasma concentrations were less variable during transdermal compared with extended-release oral administration. Mean +/- SD saliva output was greater during transdermal than extended-release oral treatment (15.7 +/- 93 vs 12.2 +/- 6.8 g, respectively; P = .02). Lower N-desethyloxybutynin during transdermal application was associated with greater saliva output (r = -059, P = .04). No clinically important treatment-related adverse effects were observed. CONCLUSIONS: Transdermal oxybutynin administration results in greater systemic availability and minimizes metabolism to N-desethyloxybutynin compared with extended-release oral administration. Lower N-desethyloxybutynin plasma concentration and greater saliva output during transdermal treatment correspond to the reported low incidence of dry mouth in patients with overactive bladder.

Administration, Cutaneous↗

PubMed1975

Effect of timing of insemination, numbers of spermatozoa and extender components on the pregnancy rate in mares inseminated with frozen stallion semen.

Fertilization rate was highest in mares inseminated with frozen semen within 12 hr of ovulation. Foaling rate was improved (P less than 0-05) by increasing the number of motile spermatozoa inseminated from 40 X 10(6) to 80 X 10(6) but was not further improved by increasing the number to 160 X 10(6) or by increasing the frequency of insemination from once to twice daily. The fertilizing capacity of spermatozoa frozen in one of the hydrogen ion extenders studied was dependent upon relative osmotic pressure and method of freezing (ampoules or pellets). Adjusting glycerol concentration from 7% to 2%, addition of glycerol 15 min before freezing and freezing 2 hr after extension all enhanced the fertilizing capacity of spermatozoa. Pregnancy rate per mare service period was higher (P less than 0-01) for mares inseminated with unextended semen (75%) than for extended semen containing no glycerol (50%) or extended semen containing 7% glycerol (35%). Although wide variability in the fertilizing capacity of spermatozoa from individual stallions was observed when semen was extended or extended and frozen, pregnancy rate was depressed in all stallions. It was concluded, therefore, that hydrogen ion extenders depress fertilizing capacity of stallion spermatozoa immediately after extension and show little promise as semen extenders for short- or long-term storage of stallion semen.

Animals↗