Relative bioavailability of single doses of prolonged-release tacrolimus administered as a suspension, orally or via a nasogastric tube, compared with intact capsules: a phase 1 study in healthy participants

Conclusions Compared with intact capsules, the rate of absorption of prolonged-release tacrolimus from suspension was faster, leading to higher peak blood concentrations and shorter time to peak; relative bioavailability was similar with suspension administered orally.
Source: BMJ Open - Category: Journals (General) Authors: Tags: Open access, Pharmacology and therapeutics, Qualitative research Source Type: research

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Abstract Recurrent Clostridioides (formerly Clostridium) difficile infection (rCDI) is common, and patients who have had one recurrence are more likely to have multiple recurrences. Frequent recurrences have been associated with increased morbidity and mortality, high healthcare costs, and lower quality of life. In this review, we compare the efficacy of interventions designed to prevent rCDI. We performed a systematic review of the English literature, including randomized controlled trials (RCTs) that evaluated rCDI as an outcome. Studies were included irrespective of patient demographics, disease severity, type ...
Source: Anaerobe - Category: Microbiology Authors: Tags: Anaerobe Source Type: research
Source: Clinical Nutrition - Category: Nutrition Authors: Tags: Nutrition and cancer II Source Type: research
CONCLUSION: Inpatient PN use is common in childhood cancer. Indications include mucositis, feed intolerance, and surgical management. Patterns of use are influenced by cancer diagnosis and treatment, with greater use in children with hematological cancer and HSCT. Improved understanding and specific indications may guide appropriate PN prescription and minimize unnecessary risk, cost, and inconsistency in care. PMID: 31332795 [PubMed - as supplied by publisher]
Source: JPEN Journal Of Parenteral And Enteral Nutrition - Category: Nutrition Authors: Tags: JPEN J Parenter Enteral Nutr Source Type: research
Nutrition support is an important component of care to prevent malnutrition during allogeneic haematopoietic progenitor cell transplantation (HPCT) however there is no consensus on the optimal method of nutrition support. It is currently unclear whether enteral nutrition (EN) via nasogastric (NG) feeding is tolerated and improves clinical outcomes in comparison with parenteral nutrition (PN). This randomised study aimed to determine the tolerability and outcomes of proactive EN in comparison to PN (standard care).
Source: Clinical Nutrition - Category: Nutrition Authors: Tags: Randomized Control Trials Source Type: research
CONCLUSIONS In contrast to previously reported findings in healthy volunteers, nasogastric administration of prolonged--release tacrolimus suspension in liver transplant patients did not substantially affect the PK profile of tacrolimus vs. intact capsules. Nasogastric administration is thus a feasible option to ensure appropriate early tacrolimus exposure in de novo liver transplant recipients. PMID: 31086126 [PubMed - in process]
Source: Annals of Transplantation - Category: Transplant Surgery Authors: Tags: Ann Transplant Source Type: research
We report results in 10 adult patients colonized with multidrug-resistant bacteria, undergoing fecal microbiota transplantation before (n=4) or after (n=6) allogeneic hematopoietic stem cell transplantation for hematologic malignancies. Stools were obtained from healthy related or unrelated donors. Fecal material was delivered either by enema or via nasogastric tube. Patients were colonized or had infections from either carbapenemase-producing bacteria (n=8) or vancomycin-resistant enterococci (n=2). The median age at fecal microbiota transplantation was 48 (range 16-64) years. Three patients needed a second transplant fro...
Source: Haematologica - Category: Hematology Authors: Tags: Haematologica Source Type: research
In conclusion, FMT proved to be very effective, particularly in recurrent infections and in cases where conventional treatment had failed. PMID: 30585500 [PubMed - as supplied by publisher]
Source: Acta Microbiologica et Immunologica Hungarica - Category: Microbiology Authors: Tags: Acta Microbiol Immunol Hung Source Type: research
Conclusions: We demonstrate for the first time the utility of fecal microbiota transplantation in orally administered capsules for the treatment of severe intestinal acute GVHD. The capsules were well tolerated and safe. Metagenomic sequencing proved that a bacterial infection following FMT was not related to the procedure. Sequencing of the stool sample revealed bacterial domination with E.coli in 4/7 patients prior to the first FMT. Following FMT, bacterial diversity increased. Finally, 2/7 patients attained a complete response following therapy, suggesting a potential role of FMT in patient management.Figure. (A) Heatma...
Source: Blood - Category: Hematology Authors: Tags: 722. Clinical Allogeneic Transplantation: Acute and Chronic GVHD, Immune Reconstitution: Poster I Source Type: research
CONCLUSIONS: This case series confirms that FMT is a safe and effective therapy for recurrent CDAD. In most cases it can be administered via the nasogastric route in the outpatient department. We propose that the recently published South African Gastroenterology Society guidelines be reviewed with regard to recommendations for the route of administration of FMT and hospital admission. Meticulous prescription practice by clinicians practising in hospitals and outpatient settings, with particular attention to antimicrobials and chronic medication, is urgently required to prevent this debilitating and potentially life-threate...
Source: South African Medical Journal - Category: African Health Tags: S Afr Med J Source Type: research
Abstract Fecal microbial transplant (fmt) is reasonably safe and effective. In patients who have had multiple Clostridium difficile infections (CDIs), fecal microbial transplant (FMT) results in a 65% to 80% cure rate with one treatment and 90% to 95% cure rate with repeated treatments compared with a 25% to 27% cure rate for antibiotics (strength of recommendation [SOR]: B, small open-label randomized controlled trials [RCTs]). Fresh and frozen donor feces, administered by either nasogastric tube or colonoscope, produce equal results (SOR B, RCTs). FMT has an overall adverse event rate of 30%, primarily involving...
Source: The Journal of Family Practice - Category: Practice Management Authors: Tags: J Fam Pract Source Type: research
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