ABSTRACT
The authors report a case of a woman with chronic schizophrenia who developed anorexia nervosa in middle age. The reported rarity of this diagnostic combination and the need to be aware of treatment issues in all patients with coexisting psychoses and eating disorder symptoms are discussed.
Subject(s)
Anorexia Nervosa/complications , Schizophrenia/complications , Age of Onset , Anorexia Nervosa/diagnosis , Chronic Disease , Female , Humans , Middle Aged , Time FactorsABSTRACT
High-risk patients with dyslipidemias resistant to diet and single-agent pharmacotherapy may require combination therapy to achieve target levels of low density lipoprotein, triglycerides, and high density lipoprotein. Combinations of fibrates and 3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitors are effective, but because of safety concerns related to myopathy and rhabdomyolysis, it is important to consider the possibility of pharmacokinetic interactions when such combinations are used. In this study, the area under the curve, maximum plasma concentration, and time to maximum concentration for fluvastatin and gemfibrozil are compared, when used alone and in combination, in patients with hyperlipidemia and either coronary or carotid atherosclerosis, or a family history of coronary artery disease. A total of 17 patients were studied in a random sequence, open-label, crossover study of fluvastatin at 20 mg twice daily, gemfibrozil at 600 mg twice daily, and the combination of the 2 drugs. No significant difference was observed in area under the curve, maximum plasma concentration, and time to maximum concentration when comparing the combination with each drug alone. These pharmacokinetic data add support to the clinical observations that the combination of fluvastatin and gemfibrozil is both effective and safe.
Subject(s)
Anticholesteremic Agents/pharmacokinetics , Fatty Acids, Monounsaturated/pharmacokinetics , Gemfibrozil/pharmacokinetics , Hydroxymethylglutaryl CoA Reductases/pharmacokinetics , Hydroxymethylglutaryl-CoA Reductase Inhibitors , Hyperlipidemias/drug therapy , Indoles/pharmacokinetics , Anticholesteremic Agents/administration & dosage , Anticholesteremic Agents/therapeutic use , Arteriosclerosis/blood , Arteriosclerosis/complications , Carotid Stenosis/blood , Carotid Stenosis/complications , Coronary Artery Disease/blood , Coronary Artery Disease/complications , Coronary Disease/blood , Coronary Disease/genetics , Cross-Over Studies , Drug Combinations , Fatty Acids, Monounsaturated/administration & dosage , Fatty Acids, Monounsaturated/therapeutic use , Female , Fluvastatin , Gemfibrozil/administration & dosage , Gemfibrozil/therapeutic use , Humans , Hydroxymethylglutaryl CoA Reductases/administration & dosage , Hydroxymethylglutaryl CoA Reductases/therapeutic use , Indoles/administration & dosage , Indoles/therapeutic use , Lipoproteins, HDL/blood , Lipoproteins, LDL/blood , Male , Middle Aged , Pilot Projects , Placebos , Safety , Triglycerides/bloodABSTRACT
Seed was readily obtained from V. corymbosum zygotes using embryo rescue techniques, even when embryos were cultured at proembryonic stages. Best in vitro seed development was obtained when ovules were cultured attached to placental tissues. Successful fruit and seed development in culture occurred only when the fruit was cut longitudinally or when the basal portion of the fruit was removed previous to plating. Addition of various vitamins, amino acids, and growth regulators to the nutrient medium did not increase seed production. Attempts to rescue hybrid embryos from V. croymbosum (tetraploid) x V. elliottii (diploid) crosses by in ovulo and in ovary culture gave a few presumably hybrid seed, but at a rate no greater than when normal crossing procedures are used.
