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Results: 208 patients were included. The mean age was 24 years range 7-64 ; , median age was 23 years, median follow up time was 39 months range 1-288 ; . Histology were confirmed MOGCT included dysgerminoma for 62 patients, non-dysgerminoma for 146 patients. All patients underwent operation: radical surgery for 118 patients 56.73% ; and fertility sparing surgery for 90 patients 43.27% ; . According to FIGO 1987 staging system; 89, 25, 67 and 27 patients were classified in stage I, II, III and IV respectively. 195 patients were treated by chemotherapy but evaluable patients were achieved in 167 patients. Outcomes of these patients were complete response 133 patients 79.6% ; . Failure to fist line chemotherapy occurred in 44 patients 29.3% ; mostly in non-dysgerminoma but only 10 of 44 22.7% ; were completely responded to second line chemotherapy and still free of disease. Recurrence occurred in 11 patients 6.4% ; but 7 out of 11 patients 63.6% ; who relapsed were successful salvaged. Overall 5-year survival rate was 80.77%. The 5-year survival rate for dysgerminoma and non-dysgerminoma were 93.8 and 72.9% respectively. The 5-year survival rate for radical and conservative surgery were 77 and 81% P 0.05 ; . In analysis of prognostic factors for survival showed that advanced stage and non-dysgerminoma were independent prognostic factors P 0.05 ; . Conclusions: This retrospective review is one of a large series to understand natural history, outcomes and prognostic factors. Advanced stage and non-dysgerminoma remained the most significantly adverse prognostic factors. Conservative surgery or fertility sparing surgery must be considered and did not affect overall survival outcome in malignant ovarian germ cell tumors. P3.16.23 MALIGNANT TRANSFORMATION OF MATURE TERATOMAS REPORT OF TWO CASES A. Pregal, D. Costa, N. Afonso, J.M. Furtado, P. Vieira de Castro, D. Pereira, J. Pinto de Oliveira, M. Osrio, 1 ; Dept OB\GYN; Sra Oliveira Hospital, Guimares, Portugal, 2 ; Dept of Medical Oncology, Instituto Portugues Oncologia, Oporto, Portugal Malignant transformation of mature teratomas is rare 1, 8% ; with squamous cell carcinoma being the most frequent histological type 80% ; .These tumors carry a worse prognosis than all other types of epithelial ovarian cancer and grade of differentiation and vascular invasion represent the most important prognostic factors. Surgical extirpation seems to be the procedure of choice but radiotherapy and combined multi-agent chemotherapy are being further evaluated especially in those cases with pelvic and peritoneal metastasis, associated with poor prognosis. The authors describe the cases of two patients aged 70 and 49 years diagnosed with mature teratoma with squamous cell malignization. Both patients' first complaint was abdominal enlargement and diagnosis was made at laparotomy. The older of the patients staged Ic GII ; has a very short follow up time. The other patient was staged IIIc GII, received adjuvant chemotherapy and is alive and disease free nine months after diagnosis. Review of the literature concerning this pathology was made and discussion about diagnosis, treatment and prognosis is presented. P3.16.24 MANAGEMENT OF ENDODERMAL SINUS TUMORS OF OVARY WITH ALPHAFETOPROTEIN T. Hoshino, Y. Taguchi, T. Okamoto, S. Hamada, H. Kuroda, K. Nakamura, T. Komatsu, M. Shiotani, H. Shimada, Y. Ihara, Dept. OB.GYN, Kobe City General Hospital, Kobe, Hyogo, Japan. Objectives: The aim of the study is to improve the management of patients with endodermal sinus tumors EST ; of the ovary, monitoring serum alphafetoprotein AFP ; level. Study Methods: Preoperative and postoperative AFP were examined serially. Four patients now have no evidence of disease NED ; , but 3 died from the disease. The half time of AFP was calculated in the postoperative course. In NED cases long survivors ; , mean and standard deviation M and SD ; of SFP were calculated. Results: The half time of AFP was relevant to the prognosis. In NED cases, AFP values were changing within the very small range and M were different to each other in statistically significant level.
Ezetimibe, 20 ezetimibe simvastatin, 20 famotidine, 31 FARESTON, 17 felbamate, 22 FELBATOL, 22 FELDENE, 13 felodipine ext-rel, 21 FEMARA, 18 FEMHRT, 29 FEMRING, 29 fenofibrate, 20 fenoprofen, 13 fentanyl transdermal, 14 fexofenadine, 35 filgrastim, 32 FINACEA, 39 finasteride, 32 FIORICET, 14 FIORINAL, 14 FLAGYL, 17 FLAREX, 40 flecainide, 19 FLEXERIL, 25 FLOMAX, 32 FLONASE, 36 FLORINEF, 29 FLOVENT HFA, 36 FLOXIN OTIC, 41 fluconazole, 15, 32 fludrocortisone, 29 FLUMADINE, 17 flunisolide, 36 flunisolide spray, 36 fluocinolone acetonide crm, oint 0.025%, 38 fluocinolone acetonide soln 0.01%, 38 fluocinonide crm, gel, oint, soln 0.05%, 38 fluoride drops, 34 fluoride tabs, 34 fluorometholone, 40 fluorometholone acetate, 40 FLUOROPLEX, 37 fluorouracil, 37 fluoxetine, except 40 mg capsules, 23 fluphenazine, 24 flurandrenolide lotion 0.05%, 38 flurandrenolide tape, 38 flurazepam, 24 flurbiprofen, 13 flutamide, 17 fluticasone propionate crm 0.05%, oint 0.005%, 38 fluticasone spray, 36 fluticasone, CFC-free aerosol, 36 fluticasone salmeterol, 36 fluticasone salmeterol, CFC-free aerosol, 36 FML, 40 FOCALIN, 24 FOLGARD OS, 34 folic acid, 34 FORADIL AEROLIZER, 35 formoterol inhalation caps, 35 FORTOVASE, 16 FOSAMAX, 27 FOSAMAX PLUS D, 27 49.
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The Veterans Health Administration nationwide is composed of 23 Veterans Integrated Service Networks. Each network comprises hospitals, ambulatory facilities, and community-based outpatient centers. In Veterans Integrated Service Network 9, located in the mid-south and including the states of Kentucky and Tennessee, there, for instance, fludrocortisone orthostatic.
Ds sherman , cl kass , dn fish department of pharmacy practice, school of pharmacy, university of colorado health sciences center, denver, usa objective: to report the use of fludrocortisone for heparin-induced hyperkalemia and to briefly review the available literature relating to heparin-induced hyperkalemia.
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Weight Reduction Weight reduction programs, including all related diagnostic testing and other services. Anti-obesity medications, including but are not limited to appetite suppressants and lipase inhibitors, are also excluded.
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A change in the Department of Health and Human Services HHS ; policy for reviewing regulatory letters in late 2001 has reduced the FDA's effectiveness in issuing regulatory letters in a timely manner--a key component of the FDA's oversight. Any inaccurate impressions of a drug that are caused by a misleading advertisement are minimized if the advertisement is quickly removed from dissemination. FDA officials told us that prior to the policy change, regulatory letters were issued within several days of the receipt of an advertisement identified as misleading. In late 2001 HHS instructed the FDA that no regulatory letters could be issued until the FDA's Office of the Chief Counsel OCC ; reviewed them. HHS implemented this new policy to ensure that all draft regulatory letters from the FDA were reviewed for "legal sufficiency and consistency with agency policy." Since the policy change, OCC reviews of draft regulatory letters from the FDA have taken so long that misleading advertisements may have completed their broadcast life cycle before the FDA issued the letters. Five draft regulatory letters were submitted to the OCC between the date the policy took effect, 31 January 2002, and 5 September 2002 and were subsequently issued. The letters were issued from thirteen to seventy-eight days after they were first submitted to the OCC. However, we found that many television DTC advertisements are on the air for only a short time-- about one-fifth of them for one month and about one-third for two months or less. Although we do not know the broadcast status of the advertisements targeted by the FDA's draft regulatory letters, misleading advertisements could remain on the air after they are identified if the FDA maintains its current review policies and fenofibrate.
While they may consent after they have been informed in broad terms of the material risks associated with the operation, procedure or treatment, this consent will not amount to the exercise of choice, unless it is made on the basis of relevant information and advice. Failure to provide this information and advice may be a breach of the practitioner's duty of care to the patient and could give rise to a legal action for negligence. Medication Administration for Enrolled Nurses 2003 ; Depending on where you work it is not always as straightforward as this. Do you work in the mental health field? Go back to dms.dpc.vic.gov.au This will give you the Victorian Legislation and Parliamentary Documents. Then look at Victorian Acts and go to the Mental Health Act 1986, Version 080Act No 59 1986, incorporating amendments as at 6th December 2004. This field of nursing highlights the complications that may arise as a result of the people being unable to care for themselves.
DIRECT MJGIOPL&STY FOR ACUTE MYOC&RDIAL INFARCTION RESULT OF A PROSPECTIVE STUDY GARY Y K MAK, K K TSE, H K CHUNG, W CHAM, J. HO, J, LO, J, SANDERSON K S WOO, DEPARTMENT O21 MEDICINE, CUHK Intravenous thromboiytic therapy is considered the standard therapy for patients in the sarly phase of acut: e myocardial infarction. Direct balloon angioplasty PTC A ; without prior thromboiytic therapy had been showed to be an effective alternative for this group of patients. We reported a prospective study of direct PTCA on 24 patients admitted within 8 hours of onset of acute snyocardial infarction. There were 20 male and 4 female with age ranging form 31-73 years mean 58 yrs ; . There were 19 anterior MI and 5 inferior MI. Five patients f20% ; had hypotension systolic BP 80 mmHg or cardiogenic shock. 17 patients had SVD and 7 patient had 2VD. One patient had persist ant occlusion despite dilatation . The results of the successful cases were tabulated as follow : % stenosis % ; vessel patency LVEF % ; Kestenosis % ; Pre Post Dl 94.8 18.3 27.9 and tricor.
National Institute For Clinical Excellence Appraisal of Surgery for People with Morbid Obesity BioEnterics Corporation & Mantis Surgical; September 2001 patients undergoing the LAP-BAND procedure. It accomplishes by a single operation satisfactory treatment of these two disturbing diseases." A prospective study of the effect of the LAP-BAND System on gastroesophageal reflux in 20 patients was conducted by Justin et al.175 using 24 hour esophageal pH monitoring pre-operatively and at 6 weeks and 6 months after the procedure. The results showed a hiatal hernia in 75% of the patients and esophagitis in 65% of the patients prior to surgery. After the surgery there was a significant reduction in heartburn and a reduction in the use of antisecretory drugs for patients with very small proximal pouches. In this regard the authors noted "in all patients in whom esophageal acid exposure at 6 weeks or at 6 months was higher than before the operation the postoperative upper GI series revealed the presence of a gastric pouch proximal to the band." The authors concluded that the LAP-BAND System "decreases gastroesophageal reflux as measured by 24-hour pH monitoring, symptom assessment and assessment of medication use." In a later published abstract the authors stated "LAGB decreases gastroesophageal reflux as measured by 24-hour pH monitoring, symptom assessment and assessment of medication use. A Eno pouchi small pouch ; procedure is required to obtain this antireflux effect." Iovino et al.176 evaluated 40 consecutive obese patients prospectively for GERD by means of a standardized questionnaire, 24 hour ambulatory pH-manometry and an upper GI endoscopy. In addition, hiatal hernia and esophageal motility pattern were evaluated by barium meal and stationary manometry using a constantly perfused multilumen catheter. Of the 40 patients studied, 12 with GERD were selected for LAP-BAND System placement with 4 33% ; of these 12 patients having a hiatal hernia. One year after LAP-BAND system placement the researchers found that 11 of the 12 patients had a negative GERD esophageal symptom score as well as negative pH-manometry. The one patient who did not have a resolution of GERD presented with proximal gastric pouch dilatation. The researchers found a significant increase in lower esophageal sphincter pressure after LAP-BAND System surgery and concluded that the "LAP-BAND procedure is an effective treatment for GERD in obese patients with and without hiatal hernia." In addition, a "no pouch" procedure is required to obtain the antireflux effect.
Capsule: 250 mg, tid or qid, orally Suppository: 200 mg, tid or qid, rectally Capsule: 510 mg, tid or qid, orally Suppository: 25 mg, bid, rectally Tablet: 2 mg, bid or tid, orally Intravenous: 10 g kg infused over 5 min beginning 30 min before initiation of chemotherapy Tablet: 8 mg 30 min before chemotherapy, then every 8 hours for two more doses, orally Intravenous: 0.15 mg kg over 15 min beginning 30 min before initiation of chemotherapy, then 0.15 mg kg 4 and 8 hours after first dose Tablet: 1015 mg, qid, ac and hs, orally Tablet: 10 mg, qid, 15 min ac and hs, orally and flavoxate.
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