Effect of 2,5-di(4-methyl phenyl)-1,3,4-oxadiazole on pregnancy in golden hamster.
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Peptides/proteins are an important class of drugs which are usually administered by parenteral route. In recent years, pharmaceutical research has been directed towards developing a nonparenteral route of delivery of peptide/protein drugs. These studies report that it may be possible to administer the peptides/proteins especially insulin, by nasal, buccal, rectal, or even transdermal route. Therefore, there is a great potential for future development of a nonparenteral route of delivery of peptide/protein drugs. The primary objective of this review is to report the present status of research involving nonparenteral administration of macromolecular peptides/proteins, with special emphasis on insulin.
The antiinflammatory effect of benzydamine compared with a placebo in a randomized study is reported in the treatment of trichomonas- and candida-induced vaginitis. The reduction of inflammation and its clinical manifestations was determined and statistically analysed, demonstrating that benzydamine has a definite effect on the early reduction of functional pain and symptoms.
The bioavailability of micronized progesterone (P) was studied by measuring sequential serum P concentrations after a single bolus of 50-200 mg P given sublingually, orally (capsule and tablet), vaginally and rectally (suppositories) during the follicular phase in a group of normally menstruating women. When compared to other modes of P administration, the area under the curve during the first eight hours was twice as high with the rectal route. With 50 and 100 mg P given sublingually and 100 and 200 mg ingested as tablets, peak levels and area under the curve were twice as high with the higher dosage. The response was more sustained with the higher dosage. All subjects exhibited a significant increase in serum P levels over baseline that persisted for at least eight hours. P levels were still increased over baseline at 24 hours in all subjects after the administration of 100-mg vaginal and rectal suppositories and 200-mg tablets. These findings are in general agreement with previous reports showing that luteal phase serum P concentrations can be reached easily with non-parenteral modes of administering micronized P and that oral P administration could become an attractive alternative to the currently used oral mode of administering synthetic progestins.
Epizootiologic evaluation is made of the oral and the vaginal Salmonella abortus ovis infection in sheep in view of the occurrence and persistence of the infection within the sheep flocks. It has been established that the presence of carriers of infection depends on the physiologic status of the animals at the time of contracting the infection. Abortion, lambing, and the setting in of estrus were shown to affect favourably the existing carrier status. Salmonella abortus ovis organisms were most commonly isolated from the uterus, ovaries, mesenterial lymph nodes, and the duodenum.
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Ninety patients were studied in a controlled, randomized fashion to evaluate the effectiveness of topical 5-fluorouracil in reducing the recurrence rate of human papillomavirus-associated lesions of the vulva and vagina. Following complete ablation of the lesions by one or more treatment modalities, 45 patients applied a single dose of 5% 5-fluorouracil cream biweekly to the vagina and/or vulva for at least six months. Forty-five patients used no prophylactic 5-fluorouracil cream. Patients in both groups were comparable with regard to race, age, and immune status, as well as the number, location, duration, clinical appearance, histology, and prior treatment of the lesions. Six patients (13%) with 5-fluorouracil prophylaxis and 17 (38%) without additional treatment (P less than .01) developed recurrent lesions during a follow-up time of nine to 22 months (mean = 14.4 months). Maintenance therapy with 5-fluorouracil was most effective in women with multiple lesions, multiple organ involvement, or with a depressed immune system.
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Abortifacient effects of 16,16-dimethyl-trans delta 2-PGE1 methyl ester (ONO-802) were studied clinically. The uterine contractile effect of the agent was compared with those of PGF2 alpha and oxytocin (OXY) in the unanesthetized rabbit. 1. Intermittent intravaginal administration of ONO-802 was applied to 32 cases of legal abortion, 15 of missed abortion and 17 of hydatid mole. Eighty eight, 100 and 81 per cent of these patients resulted in abortion, respectively, with fewer side effects than those of natural PGs. 2. In the five groups of non- or pseudo-pregnant rabbits and those in their 7-9, 14-16 and 19-28 days in pregnancy, uterine contractile effects of these agents were assessed by both the contractile patterns and area of contractile curves of initial 5 minutes. The results are as follows: 1) In the non-pregnant rabbits, all of these agents revealed marked uterine contractile effect. 2) ONO-802 induced uterine contraction characterized by its wedge-shaped curves continued considerably longer than that induced by others. 3) ONO-802 revealed much stronger effect on uterine contraction in 7-9 day-of-pregnant rabbits. 4) Fourteen-16-day-of-pregnant rabbits were least influenced by the three agents as regards their uterine contraction in accordance with the highest progesterone levels in their sera among the three groups of pregnant rabbits.
Prostaglandin F2 alpha (PGF2 alpha) and its synthetic analog, 15-methyl-PGF2 alpha effects on the receptor content of estrogens and progesterone in the human decidual tissue were studied in vitro and in vivo experiments. The receptor content in vivo experiments was determined by Sketchard's technique and in vitro by the saturation method. Three hours after intravaginal administration of 15-methyl-PGF2 alpha suppositories to pregnant women the level of estrogen and progesterone receptors in decidual tissue cytosol significantly increased. Affinity of receptors with hormones remained unchanged. 10, 20, 50 and 100 mcg/ml concentrations of PGF2 alpha produced a significant and dose-dependent increase in the receptor content of estrogens following 15, 30, 60 and 180 minutes incubation of decidual tissue sections. The receptor level of progesterone remained unchanged. In experiments with inhibitors of protein and RNA biosynthesis, it was shown that an augmentation of the estrogen receptor content under PGF2 alpha action is not associated with biosynthesis of receptors de novo.
Even today hormone replacement therapy concerns still only a rather small number of post-menopausal women: 19% of women aged 50-75 on the basis of prescriptions. The compliance of oestrogen substitution reflects even more a general reticence against the use of hormones within the public opinion and among physicians. Thus, hard work for widespread information remains to be achieved, based on scientifically well established data. The purpose of this presentation is to describe benefits and drawbacks of the modes of administration of oestrogens and of oestro-progestative associations and to consider the new developments in this matter.
Vaginal immunization with the Simian immunodeficiency virus (SIV) was investigated in macaques in order to study genital mucosal antibodies. A combined route of genital- and gut-associated lymphoid tissues was used to stimulate IgA and IgG antibodies in vaginal fluid, serum and saliva. Macaques were immunized with a recombinant, particulate SIV antigen (SIV gag P27), covalently linked to the mucosal adjuvant cholera toxin B subunit (CTB). The animals were immunized sequentially as follows: vaginal (x2) followed by oral (x3), or the reverse sequence of immunization. The results show that both vaginal followed by oral immunization or the reverse sequence induces specific p27 IgA and IgG antibodies in the vaginal fluid and serum. IgA antibodies were also detected in saliva. Vaginal IgA antibodies have the secretory component and J chain suggesting that they are of secretory origin.
Rhesus monkeys were immunized by the vaginal and oral routes using a recombinant particulate simian immunodeficiency virus (SIV) antigen. Augmenting vaginal by oral immunization in macaques elicits proliferative CD4+ T cells in the circulation which are specific to the immunizing p27 antigen. Reconstitution of enriched CD4+ T cells, B cells and macrophages from circulating mononuclear cells help B cells in specific IgA anti-p27 antibody synthesis. The results suggest that augmented vaginal immunization induces systemic CD4+ T and B cell responses which may play a part in the protective immunity against SIV (HIV) infection.
Bioavailability of Vagimid 500 tablets (film coated, 500 mg metronidazole) and absorption of metronidazole into the systemic circulation after vaginal administration of Vagimid vaginal tablets (100 mg metronidazole) relative to respective listed references were studied in 16 female healthy volunteers (age 21-37 years, weight 45-67 kg, height 158-179 cm). Metronidazole and its main hydroxylated metabolite were measured using an HPLC-method with detection limits of 0.025 and 0.25 micrograms/ml (for vaginal and oral studies), respectively. Extent of absorption was assessed by AUC0-infinity (bioequivalence range 0.80-1.25), rate of absorption by Cmax/AUC0-infinity (bioequivalence range 0.70-1.43). Geometric means and 90%-confidence intervals of the ratios of these primary characteristics were calculated using a multiplicative model. Vagimid 500 tablets were bioequivalent to the reference formulation with regard to extent and rate of absorption of metronidazole because of AUC0-infinity = 0.995 (0.84-1.18) and Cmax/AUC0-infinity = 1.11 (0.94-1.30). The absorption of metronidazole into the systemic circulation after vaginal administration of Vagimid vaginal tablets caused maximal serum concentrations between 433 and 1,156 ng/ml after 8-20 h which are bactericidal only for the most susceptible anaerobic germs and which are most likely only of marginal importance for drug safety.
Reinfection from the lower gastrointestinal tract is a possible source of recurrent vulvo-vaginal candidiasis. A prospective study to assess the prevalence of yeast carriage in various orifices (including the rectum) in controls and patients, and the relationship to acute vaginitis, was conducted. Cultures for yeast were obtained from the mouth, rectum, vulva, and vagina every 1-2 months for 1 y from the patients. The prevalence of yeast carriage in healthy controls was 3/37 (8.1%) from the vulva, vagina, and rectum, and 4/37 (10.8%) from the mouth. In patients, yeast carriage during episodes of vaginitis was: from the vagina, 190/193 (98.4%); from the vulva, 107/193 (55.4%); from the rectum, 93/193 (48.2%); and from the mouth, 52/193 (26.9%). During visits without vaginitis, yeast carriage was lower: in the rectum, 59/587 (10.1%); in the vulva, 53/459 (11.6%); in the vagina, 77/587 (13.1%); and in the mouth, 89/587 (15.2%). Yeast in the lower bowel during symptomatic vaginitis is higher (p = 0.0001) than in controls, but not significantly greater during asymptomatic periods. Recurrence of Candida vaginitis is not dependent on yeast reservoir in the lower gut between symptomatic episodes.
Recent development of transdermal therapy permits application of estrogen, usually produced in the ovaries, in physiological dosage by means of continuous release from either an epidermal patch or dermal application of a gel. Transdermal therapy with progesterone, however is impossible due to poor dermal absorption and high dose requirements (release from corpora lutea: 25 mg/24 hours). Two other possibilities have been proposed. On one hand it is possible to apply norethisterone-acetate (NETA), another gestagen, epicutaneously. This mode of administration carries the same problems as oral application thus allowing for a dose reduction. On the other hand progesterone can be applied vaginally. This mode leads to significantly higher plasmatic concentrations of progesterone and has effects on the uterine mucosa similar to those in a normal cycle. This modality thus permits application of estradiol and progesterone in a physiological manner by a non oral route. It appears particularly interesting in patients at cardiovascular risk.