ABSTRACT
The problems of preparation of different pharmaceutically compounded formulations of prescribed omeprazole suspensions are discussed. Problems that can be cited are: inadequate preparation, chemical and physical stability problems, taste problems and low bioavailability. The formulation of the omeprazole suspension is optimized, taking into account the cited problems. At the same time, some formulations are presented, ensuring chemical stability of omeprazole and its bioavailability.
Subject(s)
Anti-Ulcer Agents/therapeutic use , Omeprazole/therapeutic use , Anti-Ulcer Agents/administration & dosage , Anti-Ulcer Agents/pharmacology , Chemistry, Pharmaceutical , Drug Compounding , Humans , Omeprazole/administration & dosage , Omeprazole/pharmacology , SuspensionsABSTRACT
Preterm delivery remains the most important complication of multiple pregnancies. We describe six cases of successful delay of the subsequent child(ren) after very preterm birth of the first-born, with intervals ranging between 14 and 117 days. Based on our findings and on the available literature, we propose a set of guidelines for the management of early preterm multiple birth deliveries, including tocolysis, antimicrobial therapy and corticosteroids.
Subject(s)
Delivery, Obstetric/methods , Pregnancy, Multiple , Adult , Child , Female , Follow-Up Studies , Gestational Age , Guidelines as Topic , Humans , Infant Mortality , Infant, Newborn , Intellectual Disability , Maternal Age , Obstetric Labor, Premature , Pregnancy , Tocolytic Agents/therapeutic use , Triplets , TwinsABSTRACT
OBJECTIVE: To evaluate the efficiency of withholding gonadotropins and deferring the administration of hCG until E2 levels start dropping (coasting) in the prevention of ovarian hyperstimulation syndrome (OHSS) in a high-risk population. DESIGN: Retrospective case-control study. SETTING: In vitro fertilization program at a university center. PATIENT(S): The case group consisted of 120 women undergoing ovarian stimulation for IVF who were considered to be at risk for ovarian hyperstimulation (serum E2 levels >2,500 pg/mL or >20 follicles at the time of hCG administration). INTERVENTION(S): Gonadotropin administration was withheld when serum E2 levels exceeded 2,500 pg/mL, and hCG administration was delayed until E2 levels dropped below 2,500 pg/mL. Outcomes were compared with those from 120 matched patients in whom serum E2 levels and the number of follicles at the time of hCG administration were comparable to those at the beginning of coasting (control group). MAIN OUTCOME MEASURE(S): Incidence of moderate and severe OHSS. The number of oocytes retrieved and pregnancy rate (PR) were compared in both groups. RESULT(S): Coasting decreased the incidence of moderate and severe OHSS. The odds ratio of severe OHSS in the coasting group was 0.11 (95% confidence interval 0.01-0.86). Although the number of oocytes was significantly lower in the coasting group (19.7 +/- 0.6 versus 22.1 +/- 0.6), coasting did not affect the PR (37.5% versus 36.7%). CONCLUSION(S): Our study indicates that coasting is an efficient method for reducing the incidence and severity of OHSS without compromising the PR.
Subject(s)
Estradiol/blood , Fertilization in Vitro , Ovarian Hyperstimulation Syndrome/prevention & control , Adult , Chorionic Gonadotropin/administration & dosage , Drug Administration Schedule , Female , Humans , Pregnancy , Reference Values , Retrospective Studies , Treatment OutcomeABSTRACT
OBJECTIVE: To investigate a method of assisted activation of human oocytes for the treatment of infertility resulting from globozoospermia associated with deficient oocyte activation capacity. DESIGN: The mouse oocyte activation test was used to analyze the oocyte activation capacity of the sperm cells of a patient with globozoospermia. Fresh donor human oocytes were used for determining the most appropriate procedure for oocyte activation. SETTING: Infertility Center, University Hospital of Ghent. PATIENT(S): A couple with infertility resulting from globozoospermia. INTERVENTION(S): Intracytoplasmic sperm injection, assisted oocyte activation, and embryo transfer. MAIN OUTCOME MEASURE(S): Oocyte activation and fertilization rates, implantation, and pregnancy. RESULT(S): Deficiency in oocyte activation capacity was found in the sperm of a patient with globozoospermia. This deficiency was proven by the mouse oocyte activation test and was confirmed further by lack of activation of human oocytes after simple sperm injection. Only human oocytes that were injected with sperm and subjected to calcium chloride and ionophore treatment underwent activation. Transfer of embryos obtained by this procedure of assisted oocyte activation resulted in an ongoing pregnancy. CONCLUSION(S): Assisted oocyte activation of human oocytes is useful when globozoospermia is associated with absence of oocyte activation capacity in the sperm. These cases can be identified by the mouse oocyte activation test.
