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Uncorrected visual acuity UCVA ; , manifest refraction MR ; , best corrected visual acuity BCVA ; , central pachymetry, corneal topography and slit lamp examination. Statistical Analysis All statistical analyses were performed using SAS v 8.02. One sample T-test was used to compare means achieved flap thickness to the intended thickness. Pearson Correlation coefficients were used to determine relationship between achieved flap thickness and preoperative central corneal thickness and average keratometry. A p value of 0.05 was considered statistically significant. Results Clinical Outcomes No intra-operative or post-operative flap complications were noted in any eye, either during the initial flap creation or the subsequent re-lift and excimer treatment. All eyes retained their preoperative manifest refraction following the initial flap creation procedure, with no loss of BCVA. Following excimer treatment, all eyes attained UCVA of 20 better by 1 month postoperatively. Central Corneal Thickness Measurements CCT was measured at four different time points; after placement of lid speculum, following placement of lid speculum and suction ring, 45 minutes following flap creation after resolution of gas bubbles ; , and prior to re-lift procedure 4 weeks after flap creation. As seen in Table 1, statistically significant differences were noted at each of these time points. Table 1 Central Corneal Thickness Measured at Different Time Points CCT Measurement Time Point After placement of lid speculum Following placement of lid speculum and suction ring 531 26 -18 10 45 minutes following flap creation after resolution of gas bubbles ; 567 25 18 Prior to re-lift procedure 4 weeks after flap creation 559 28 11 On average, corneal thinning of 18 m was noted following suction ring placement, while an average of 18 m thickening was noted 45 minutes following flap creation. The majority of this thickening was also noted 4 weeks later 11 m, prior to the re-lift procedure, suggesting a predominately biomechanical etiology, rather than transient corneal edema. Flap Thickness Calculations Corneal bed thickness CBT ; measurements could be attained reliably when gas bubbles were no longer present, approximately 30-45 minutes after the flap creation procedure. Mean corneal flap thickness CFT ; was calculated by subtracting CBT from the corresponding CCT at 45 minutes and 1 month Table 2 ; Table 2 Calculated Flap Thickness at 45 minutes and 4 weeks 45 Minutes After Flap Creation Achieved Flap Range Thickness um ; Mean SD um ; 132 15 106175 Weeks After Flap Creation Mean SD Range Flap um ; Thickness um ; 132 15 103180, because long term use of aciphex. Drug metab dispos 20 : 547-5 0.
Torre Lazur McCann Parsippany, N.J. ; -- Healthcare accounts: Eisai Janssen Pharmaceuticals: Aciphex; GlaxoSmithKline: Paxil, ReQuip; GlaxoSmithKline Consumer: Abreva, Alluna, Citrucel, Denavir, Tums; Pharmacia: Zyvox U.S. and global ; , Arthrotec. Accounts gained: Pharmacia: Fragmin; Dermik Laboratories: New Fill U.S. and global Orasure: Intercept, OraQuick HIV; Ortho McNeil: Topamax U.S. and global ; , Axert; Ross Products: Glucerna, Ensure, Weight-Loss Line; Watson: Oxytrol; Dr. Reddy: cardiovascular. Accounts lost: GlaxoSmithKline: Famvir; Novartis: Diovan. Torre Lazur Chicago -- Healthcare accounts: Abbott: Humira U.S. and global ; , Kaletra, Immunology Franchise, Virology Franchise; Ferndale: Locoid.
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There are also limited trial and long-term safety data relating to the concomitant administration of these two drugs, for instance, side affects of aciphex. Etiology When an etiologic organism is isolated in the setting of cervicitis, it is typically C. trachomatis or N. gonorrhoeae. Cervicitis also can accompany trichomoniasis and genital herpes especially primary HSV-2 infection ; . However, in the majority of cases of cervicitis, no organism is isolated, especially in women at relatively low risk for recent acquisition of these STDs for example, women aged 30 years ; . Limited data indicate that infection with M. genitalium and BV as well as frequent douching might cause cervicitis 117119 ; . For reasons that are unclear, cervicitis can persist despite repeated courses of antimicrobial therapy. Because the majority of persistent cases of cervicitis are not caused by relapse or reinfection with C. trachomatis or N. gonorrhoeae, other determinants e.g., persistent abnormality of vaginal flora, douching or exposure to chemical irritants, or idiopathic inflammation in the zone of ectopy ; might be involved. Diagnosis Because cervicitis might be a sign of upper genital tract infection endometritis ; , women who seek medical treatment for a new episode of cervicitis should be assessed for signs of PID and should be tested for C. trachomatis and for N. gonorrhoeae with the most sensitive and specific test available, NAAT. Women with cervicitis also should be evaluated for the presence of BV and trichomoniasis, and these conditions should be treated, if present. Because the sensitivity of microscopy to detect T. vaginalis is relatively low approximately 50% ; , symptomatic women with cervicitis and negative microscopy for trichomonads should receive further testing i.e., culture or antigen-based detection ; . Although HSV-2 infection has been associated with cervicitis, the utility of specific testing i.e., culture or serologic testing ; for HSV-2 in this setting is unclear. Standardized diagnostic tests for M. genitalium are not commercially available. NAAT for C. trachomatis and N. gonorrhoeae are preferred for the diagnostic evaluation of cervicitis and can be performed on either cervical or urine samples. A finding of 10 WBC in vaginal fluid, in the absence of trichomoniasis, might indicate endocervical inflammation caused specifically by C. trachomatis or N. gonorrhoeae 116, 120, 121 ; . Treatment Several factors should affect the decision to provide presumptive therapy for cervicitis or to await the results of diagnostic tests. Treatment with antibiotics for C. trachomatis should be provided in women at increased risk for this common STD age 25 years, new or multiple sex partners, and unprotected sex ; , especially if follow-up cannot be ensured and if a relatively insensitive diagnostic test not a NAAT ; is and allegra.

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