Active substances: Norfloxacin
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Northup. Until recently, the lack of an established alternative concept of hemostasis has meant that most physicians view the cascade as a model of physiology. This view has been reinforced by the fact that screening coagulation tests APTT, prothrombin time - INR are often used as though they are generally predictive of clinical bleeding.
The shortcomings of this older model of normal coagulation are nowhere more apparent than in its clinical application to the complex coagulation disorders of acute and chronic liver disease.
In this condition, the clotting cascade is heavily influenced by numerous currents and counter-currents resulting in a mixture of pro- and anticoagulant forces that are themselves further subject to change with altered physiological stress such as super-imposed infection or renal failure.
This report represents a summary of a recent multidisciplinary symposium held in Charlottesville, VA.
We present an overview of the coagulation system in liver disease with emphasis on the limitations of the current clinical paradigm and the need for a critical re-evaluation of the current tenets governing clinical practice.
With the realization that there is often limited or conflicting data, we have attempted to represent diverse opinion and experience from the perspectives of both hepatology and hematology beginning with a brief update on the physiology of normal coagulation.
All rights reserved. This phase I, placebo-controlled, double-blind study evaluated the antiviral activity, pharmacokinetics, and safety of VX-950 in patients with chronic hepatitis C CHC.
Methods: Thirty-four patients with genotype 1 CHC were randomized to receive placebo or VX-950 at doses of 450 mg or 750 mg every 8 hours or 1250 mg every 12 hours for 14 days.
Patients were monitored for safety and tolerability of VX-950. In the 750-mg-dose group, which had the highest trough plasma drug concentrations, the median reduction of HCV RNA was 4.
In the 450-mg and 1250-mg groups, the maximal effect was seen between days 3 and 7 of dosing, and median HCV RNA increased between days 7 and 14; median reductions at day 14 were 2.
Median alanine aminotransferase levels decreased during dosing in all VX-950 groups.
Conclusions: VX-950 was well tolerated and demonstrated substantial antiviral activity. Some patients had viral breakthrough during dosing, related to selection of variants with decreased sensitivity to VX-950.
Investigation of this problem has been hampered by the lack of a reliable ambulatory technique to measure abdominal girth. The aim of this study was to use the technique of abdominal inductance plethysmography to compare diurnal variation in girth in IBS patients and healthy volunteers, relating these changes to the sensation of bloating.
All subjects pursued normal daily activities, recording their symptoms of bloating and pain together with bowel habit. Neither bloating nor distention in IBS was related to body mass index, age, parity, or psychologic status.
Conclusions: Abdominal distention is a clearly definable phenomenon in IBS that can reach 12 cm.
However, it only occurs in half of patients reporting bloating, and the 2 only correlate in IBS-constipation. We developed a risk index based on age, sex, and family history from the derivation group.
Results were validated in the validation subgroup.
Unlike universal CTC, the stratified strategy was independent of assumptions for CTC sensitivity, specificity, and threshold for colonoscopy.