The Experts below are selected from a list of 315 Experts worldwide ranked by ideXlab platform
Nivedita Sarda - One of the best experts on this subject based on the ideXlab platform.
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Sublingual versus vaginal Route of misoprostol for cervical ripening prior to surgical termination of first trimester abortions
European Journal of Obstetrics & Gynecology and Reproductive Biology, 2006Co-Authors: Pikee Saxena, Sudha Salhan, Nivedita SardaAbstract:Abstract Background Sublingual and vaginal Routes of misoprostol have been found to be effective for pharmacological ripening prior to surgical termination of first trimester abortions. We conducted this study to compare the effectiveness and acceptability of Sublingual versus vaginal Route of misoprostol for cervical priming prior to vacuum aspiration (VA). Methods In this prospective clinical trial, a total of 100 women with period of gestation between 6 and 12 weeks scheduled for day surgery abortion were sequentially allocated into two groups of 50 each. All participating women received 400μg of misoprostol 3h prior to VA either by Sublingual (self-administered at home) or by vaginal Route (inserted by the doctor in hospital) after wetting the tablet with water. Results Demographic characteristics of both the groups were comparable. For all periods of gestation, Sublingual misoprostol significantly improved cervical dilatation ( p p p =0.57). Misoprostol tablet was found intact in the vagina of three patients and was only partially absorbed amongst five patients at the time of VA. Conclusion Sublingual Route is an effective and convenient alternative to vaginal administration of misoprostol for cervical dilatation. It can be conveniently self-administered at home thereby decreasing hospital stay and cost. It also has a good patient acceptability rate.
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comparison between the Sublingual and oral Route of misoprostol for pre abortion cervical priming in first trimester abortions
Human Reproduction, 2004Co-Authors: Pikee Saxena, Sudha Salhan, Nivedita SardaAbstract:BACKGROUND: Misoprostol has been used for achieving cervical priming before suction evacuation (SE) by the oral or vaginal Route, although both Routes have their shortcomings. We evaluated the efficacy of the Sublingual versus oral Route of misoprostol for cervical priming before SE. METHODS: A prospective clinical trial was carried out in 100 women with a period of gestation of between 6 and 12 weeks who were sequentially allocated to two groups of 50 each. Both groups received 400 microg of misoprostol 3 h prior to SE by either the Sublingual or the oral Route. RESULTS: Demographically, both groups were similar. For all periods of gestation, Sublingual misoprostol significantly improved cervical dilation (P<0.001) with a reduction in duration of surgery (P=0.024) compared with the oral Route. Mean (+/- SD) pain scores for the Sublingual and oral groups were similar (2.6 +/- 1.4 versus 3.5 +/- 1.1). No major complications occurred in either of the two groups. CONCLUSION: the Sublingual Route is an effective alternative to oral administration of misoprostol for cervical dilation. To the best of our knowledge, this is the first study to compare the efficacy of the Sublingual versus the oral Route of misoprostol for cervical priming before SE.
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Role of Sublingual misoprostol for cervical ripening prior to vacuum aspiration in first trimester interruption of pregnancy.
Contraception, 2003Co-Authors: Pikee Saxena, Sudha Salhan, Nivedita SardaAbstract:This is a prospective randomized clinical trial evaluating, for the first time, the effectiveness of Sublingual Route of misoprostol for cervical priming prior to vacuum aspiration (VA). The trial included 100 women seeking first trimester abortion who were sequentially randomized into two groups of 50 each. Patients of study group received 400 μg Sublingual misoprostol 3 h prior to VA while those of the control group did not receive any premedication for cervical ripening. For all periods of gestation between 6 and 12 weeks, misoprostol significantly reduced pain score, blood loss, time duration and rate of complications without increasing the side effects. Sublingual misoprostol is an effective alternative to mechanical cervical dilatation. It can be self-administered and has a good patient-acceptability rate. As no study has evaluated the role of Sublingual Route of misoprostol for cervical priming before VA, wider studies should be done to advocate its routine use.
G.p. Anderson - One of the best experts on this subject based on the ideXlab platform.
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Sublingual allergen immunotherapy : Immunological mechanisms and prospects for refined vaccine preparations
Current Medicinal Chemistry, 2007Co-Authors: Robyn E. O'hehir, Alessandra Sandrini, G.p. Anderson, Jennifer M. RollandAbstract:Allergic diseases constitute a major health issue worldwide. Mainstay treatment constitutes allergen avoidance and pharmacotherapy for symptom relief, but allergen immunotherapy offers advantages of specific treatment with long lasting efficacy, and being able to modify the course of the disease. Conventional immunotherapy involves the subcutaneous injection of gradually increasing amounts of allergen extract but the use of current whole allergen extracts is restricted by the risk of adverse IgE-mediated events especially for potent allergens such as peanut and latex and for asthmatics. This has lead to interest in alternative Routes of immunotherapy. Oral tolerance is a well-documented immune process and the Sublingual Route of administration of allergen immunotherapy is attracting interest. Recent meta-analyses show that Sublingual allergen immunotherapy for grass pollen and house dust mite allergy is clinically effective and safer than injection immunotherapy. Some studies show SLIT induces changes of T cell anergy, immune deviation, blocking antibodies, and induction of regulatory T cells, as described for injection immunotherapy pointing to the need to target allergen-specific T cells, there is emergent evidence that the oral mucosa presents distinct regulatory features. Evidence suggests that oral dendritic cells play a key role in inducing tolerance especially when allergen is taken up via Fc receptor bound IgE. This suggests that although both would target allergen-specific T cells, allergen formulations may differ with respect to IgE epitopes for optimal SLIT compared with SCIT. Identification of the molecular nature of the allergen-DC receptor interaction is required to determine whether short peptides or recombinant allergen preparations and of suitable adjuvants specifically tailored for the Sublingual Route will allow the development of improved allergen formulations and delivery strategies for efficacy of treatment whilst decreasing IgE-mediated adverse effects.
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Sublingual allergen immunotherapy: Immunological mechanisms and prospects for refined vaccine preparations
Current Medicinal Chemistry, 2007Co-Authors: Robyn E. O'hehir, Alessandra Sandrini, G.p. AndersonAbstract:Allergic diseases constitute a major health issue worldwide. Mainstay treatment constitutes allergen avoidance and pharmacotherapy for symptom relief, but allergen immunotherapy offers advantages of specific treatment with long lasting efficacy, and being able to modify the course of the disease. Conventional immunotherapy involves the subcutaneous injection of gradually increasing amounts of allergen extract but the use of current whole allergen extracts is restricted by the risk of adverse - IgE-mediated events especially for potent allergens such as peanut and latex and for asthmatics. This has lead to interest in alternative Routes of immunotherapy. Oral tolerance is a well-documented immune process and the Sublingual Route of administration of allergen immunotherapy is attracting interest. Recent meta-analyses show that Sublingual allergen immunotherapy for grass pollen and house dust mite allergy is clinically effective and safer than injection immunotherapy. Some studies show SLIT induces changes of T cell anergy, immune deviation, blocking antibodies, and induction of regulatory T cells, as described for injection immunotherapy pointing to the need to target allergen-specific T cells, there is emergent evidence that the oral mucosa presents distinct regulatory features. Evidence suggests that oral dendritic cells play a key role in inducing tolerance especially when allergen is taken up via Fc receptor-bound IgE. This suggests that although both would target allergen-specific T cells, allergen formulations may differ with respect to IgE epitopes for optimal SLIT compared with-SCIT. Identification of the molecular nature of the allergen-DC receptor interaction is required to determine whether short peptides or recombinant allergen preparations and of suitable adjuvants specifically tailored for the Sublingual Route will allow the development of improved allergen formulations and delivery strategies for efficacy of treatment whilst decreasing, IgE-mediated adverse effects. (copyright) 2007 Bentham Science Publishers Ltd.
Pikee Saxena - One of the best experts on this subject based on the ideXlab platform.
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Sublingual versus vaginal Route of misoprostol for cervical ripening prior to surgical termination of first trimester abortions
European Journal of Obstetrics & Gynecology and Reproductive Biology, 2006Co-Authors: Pikee Saxena, Sudha Salhan, Nivedita SardaAbstract:Abstract Background Sublingual and vaginal Routes of misoprostol have been found to be effective for pharmacological ripening prior to surgical termination of first trimester abortions. We conducted this study to compare the effectiveness and acceptability of Sublingual versus vaginal Route of misoprostol for cervical priming prior to vacuum aspiration (VA). Methods In this prospective clinical trial, a total of 100 women with period of gestation between 6 and 12 weeks scheduled for day surgery abortion were sequentially allocated into two groups of 50 each. All participating women received 400μg of misoprostol 3h prior to VA either by Sublingual (self-administered at home) or by vaginal Route (inserted by the doctor in hospital) after wetting the tablet with water. Results Demographic characteristics of both the groups were comparable. For all periods of gestation, Sublingual misoprostol significantly improved cervical dilatation ( p p p =0.57). Misoprostol tablet was found intact in the vagina of three patients and was only partially absorbed amongst five patients at the time of VA. Conclusion Sublingual Route is an effective and convenient alternative to vaginal administration of misoprostol for cervical dilatation. It can be conveniently self-administered at home thereby decreasing hospital stay and cost. It also has a good patient acceptability rate.
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comparison between the Sublingual and oral Route of misoprostol for pre abortion cervical priming in first trimester abortions
Human Reproduction, 2004Co-Authors: Pikee Saxena, Sudha Salhan, Nivedita SardaAbstract:BACKGROUND: Misoprostol has been used for achieving cervical priming before suction evacuation (SE) by the oral or vaginal Route, although both Routes have their shortcomings. We evaluated the efficacy of the Sublingual versus oral Route of misoprostol for cervical priming before SE. METHODS: A prospective clinical trial was carried out in 100 women with a period of gestation of between 6 and 12 weeks who were sequentially allocated to two groups of 50 each. Both groups received 400 microg of misoprostol 3 h prior to SE by either the Sublingual or the oral Route. RESULTS: Demographically, both groups were similar. For all periods of gestation, Sublingual misoprostol significantly improved cervical dilation (P<0.001) with a reduction in duration of surgery (P=0.024) compared with the oral Route. Mean (+/- SD) pain scores for the Sublingual and oral groups were similar (2.6 +/- 1.4 versus 3.5 +/- 1.1). No major complications occurred in either of the two groups. CONCLUSION: the Sublingual Route is an effective alternative to oral administration of misoprostol for cervical dilation. To the best of our knowledge, this is the first study to compare the efficacy of the Sublingual versus the oral Route of misoprostol for cervical priming before SE.
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Role of Sublingual misoprostol for cervical ripening prior to vacuum aspiration in first trimester interruption of pregnancy.
Contraception, 2003Co-Authors: Pikee Saxena, Sudha Salhan, Nivedita SardaAbstract:This is a prospective randomized clinical trial evaluating, for the first time, the effectiveness of Sublingual Route of misoprostol for cervical priming prior to vacuum aspiration (VA). The trial included 100 women seeking first trimester abortion who were sequentially randomized into two groups of 50 each. Patients of study group received 400 μg Sublingual misoprostol 3 h prior to VA while those of the control group did not receive any premedication for cervical ripening. For all periods of gestation between 6 and 12 weeks, misoprostol significantly reduced pain score, blood loss, time duration and rate of complications without increasing the side effects. Sublingual misoprostol is an effective alternative to mechanical cervical dilatation. It can be self-administered and has a good patient-acceptability rate. As no study has evaluated the role of Sublingual Route of misoprostol for cervical priming before VA, wider studies should be done to advocate its routine use.
Robyn E. O'hehir - One of the best experts on this subject based on the ideXlab platform.
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Sublingual allergen immunotherapy : Immunological mechanisms and prospects for refined vaccine preparations
Current Medicinal Chemistry, 2007Co-Authors: Robyn E. O'hehir, Alessandra Sandrini, G.p. Anderson, Jennifer M. RollandAbstract:Allergic diseases constitute a major health issue worldwide. Mainstay treatment constitutes allergen avoidance and pharmacotherapy for symptom relief, but allergen immunotherapy offers advantages of specific treatment with long lasting efficacy, and being able to modify the course of the disease. Conventional immunotherapy involves the subcutaneous injection of gradually increasing amounts of allergen extract but the use of current whole allergen extracts is restricted by the risk of adverse IgE-mediated events especially for potent allergens such as peanut and latex and for asthmatics. This has lead to interest in alternative Routes of immunotherapy. Oral tolerance is a well-documented immune process and the Sublingual Route of administration of allergen immunotherapy is attracting interest. Recent meta-analyses show that Sublingual allergen immunotherapy for grass pollen and house dust mite allergy is clinically effective and safer than injection immunotherapy. Some studies show SLIT induces changes of T cell anergy, immune deviation, blocking antibodies, and induction of regulatory T cells, as described for injection immunotherapy pointing to the need to target allergen-specific T cells, there is emergent evidence that the oral mucosa presents distinct regulatory features. Evidence suggests that oral dendritic cells play a key role in inducing tolerance especially when allergen is taken up via Fc receptor bound IgE. This suggests that although both would target allergen-specific T cells, allergen formulations may differ with respect to IgE epitopes for optimal SLIT compared with SCIT. Identification of the molecular nature of the allergen-DC receptor interaction is required to determine whether short peptides or recombinant allergen preparations and of suitable adjuvants specifically tailored for the Sublingual Route will allow the development of improved allergen formulations and delivery strategies for efficacy of treatment whilst decreasing IgE-mediated adverse effects.
-
Sublingual allergen immunotherapy: Immunological mechanisms and prospects for refined vaccine preparations
Current Medicinal Chemistry, 2007Co-Authors: Robyn E. O'hehir, Alessandra Sandrini, G.p. AndersonAbstract:Allergic diseases constitute a major health issue worldwide. Mainstay treatment constitutes allergen avoidance and pharmacotherapy for symptom relief, but allergen immunotherapy offers advantages of specific treatment with long lasting efficacy, and being able to modify the course of the disease. Conventional immunotherapy involves the subcutaneous injection of gradually increasing amounts of allergen extract but the use of current whole allergen extracts is restricted by the risk of adverse - IgE-mediated events especially for potent allergens such as peanut and latex and for asthmatics. This has lead to interest in alternative Routes of immunotherapy. Oral tolerance is a well-documented immune process and the Sublingual Route of administration of allergen immunotherapy is attracting interest. Recent meta-analyses show that Sublingual allergen immunotherapy for grass pollen and house dust mite allergy is clinically effective and safer than injection immunotherapy. Some studies show SLIT induces changes of T cell anergy, immune deviation, blocking antibodies, and induction of regulatory T cells, as described for injection immunotherapy pointing to the need to target allergen-specific T cells, there is emergent evidence that the oral mucosa presents distinct regulatory features. Evidence suggests that oral dendritic cells play a key role in inducing tolerance especially when allergen is taken up via Fc receptor-bound IgE. This suggests that although both would target allergen-specific T cells, allergen formulations may differ with respect to IgE epitopes for optimal SLIT compared with-SCIT. Identification of the molecular nature of the allergen-DC receptor interaction is required to determine whether short peptides or recombinant allergen preparations and of suitable adjuvants specifically tailored for the Sublingual Route will allow the development of improved allergen formulations and delivery strategies for efficacy of treatment whilst decreasing, IgE-mediated adverse effects. (copyright) 2007 Bentham Science Publishers Ltd.
Franco Frati - One of the best experts on this subject based on the ideXlab platform.
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the role of allergoids in allergen immunotherapy from injective to Sublingual Route
European annals of allergy and clinical immunology, 2020Co-Authors: Enrico Compalati, Cristoforo Incorvaia, C Cavaliere, Simonetta Masieri, A Gargiulo, Franco FratiAbstract:Summary Summary Allergen immunotherapy (AIT) is aimed at inducing tolerance to allergens, such as pollens, dust mites or moulds, by administering increasing amounts of the causative allergen through subcutaneous or Sublingual Route. The evidence of efficacy of AIT is high, but the issue of safety, especially for the subcutaneous Route, must be taken into account. The search for safer AIT products aimed at reducing the allergenicity, and thus adverse reactions, while maintaining the immunogenicity, that is essential for effectiveness, gave rise to the introduction of allergoids, which were conceived to fulfill these requirements. In the first allergoids glutaraldehyde or formaldehyde were used as cross-linking agent to polymerize allergens, this resulting in high molecular weight molecules (200,000 to 20,000,000 daltons) which were significantly less allergenic due to a decreased capacity to bridge IgE on its specific receptor, while maintaining the immunogenicity and thus the therapeutic efficacy. In recent years further agents, acting as adjuvants, such as L-tyrosine, monophosphoryl lipid A, aluminium hydroxide, were added to polymerized extracts. Moreover, a carbamylated monomeric allergoid was developed and, once adsorbed on calcium phosphate matrix, used by subcutaneous Route. At the same time, in virtue of its peculiarities, such allergoid revealed particularly suitable for Sublingual administration. A lot of clinical evidences show that it is well tolerated, largely safer and effective. Importantly, the higher safety of allergoids allows faster treatment schedules that favor patient compliance and, according to pharmaco-economic studies, they might be more cost-effective than other AIT options.
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specific immunotherapy by the Sublingual Route for respiratory allergy
Allergy Asthma & Clinical Immunology, 2010Co-Authors: Cristoforo Incorvaia, Simonetta Masieri, Patrizia Berto, Silvia Scurati, Franco FratiAbstract:Specific immunotherapy is the only treatment able to act on the causes and not only on the symptoms of respiratory allergy. Sublingual immunotherapy (SLIT) was introduced as an option to subcutaneous immunotherapy (SCIT), the clinical effectiveness of which is partly counterbalanced by the issue of adverse systemic reactions, which occur at a frequency of about 0.2% of injections and 2-5% of the patients and may also be life-threatening. A large number of trials, globally evaluated by several meta-analyses, demonstrated that SLIT is an effective and safe treatment for allergic rhinitis and allergic asthma, severe reactions being extremely rare. The application of SLIT is favored by a good compliance, higher than that reported for SCIT, in which the injections are a major factor for noncompliance because of inconvenience, and by its cost-effectiveness. In fact, a number of studies showed that SLIT may be very beneficial to the healthcare system, especially when its effectiveness persists after treatment withdrawal because of the induced immunologic changes.
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physical exercise does not favour adverse reactions to allergen immunotherapy by the Sublingual Route
European annals of allergy and clinical immunology, 2005Co-Authors: Gianenrico Senna, Cristoforo Incorvaia, Franco Frati, Patrizia Bonadonna, M Crivellaro, L Sensi, Francesco MarcucciAbstract:: It is generally recommended in consensus documents on allergen immunotherapy to avoid any kind of physical exercise in the 24 hours following the administration of the allergen extract but such recommendation is not supported by scientific evidence. We evaluated the risk of developing adverse reactions in a group of patients submitted to Sublingual immunotherapy by performing a controlled exercise test. Eleven patients were included in the study, 8 treated with grass pollen and 3 with Parietaria pollen extract by Staloral300 (Stallergenes, Antony, France), with the build-up phase in 11 days suggested by the manufacturer and a top dose of 300 IR. At the first maintenance dose, in all patients were measured heart rate, blood pressure, FEV1, and tryptase in blood. Then the maintenance dose was assumed and the physical exercise performed by cycloergometer maintaining a heart rate around 100 b/min and measuring again tryptase, blood pressure and FEV1. The results showed that no patient had adverse reaction following physical exercise, neither showed significant changes in FEV1, blood pressure, or tryptase level, which was 5.57 +/- 4.54 mcg/l before and 5.81 +/- 4.34 mcg/l after exercise. This suggests that there is no reason to advise against physical exercise, and particularly sporting activity, in patients treated with Sublingual immunotherapy thus avoiding to interfere with the subject's lifestyle and consequently with his quality of life.
