A pilot study on the use of letrozole with either misoprostol or mifepristone for termination of pregnancy up to 63 days

Background: Letrozole is a third-generation selective aromatase inhibitor. Animal data suggested that it might be useful in medical abortion. We performed two pilot studies to assess the feasibility of using letrozole in combination with either mifepristone or misoprostol for termination of pregnancy up to 63 days. Study Design: We recruited 40 subjects who requested legal termination of pregnancies up to 63 days. Medical abortion was performed with letrozole 7.5 mg daily for 2 days followed by 800 mcg vaginal misoprostol in 20 subjects and letrozole 7.5 mg combined with 200 mg mifepristone in another 20 subjects. Results: The mean induction-to-abortion interval of the regimen of letrozole and misoprostol was 9.1 h (median 7.9 h, range 2.7-23.6 h). The complete abortion rate was 80% (95% CI: 56.3-94.3%). For those with gestation of ≤49 days, the complete abortion rate was 87.5% (14/16; 95% CI: 61.7-98.5%). The mean induction-to-abortion interval of letrozole combined with mifepristone was 90.1 h (median 93.4 h, range 66.0-121.2 h). The complete abortion rate was 71.4% (95% CI: 47.8-88.7%). Conclusion: These preliminary results suggest that a regimen of letrozole and misoprostol may be useful in medical abortion, but the combination with mifepristone is less effective and takes longer. Randomized studies comparing letrozole and misoprostol to misoprostol alone are warranted. © 2011 Elsevier Inc. All rights reserved.postprin

Prevention of Dehydration in Hospital Patients

Dehydration is widely linked to increased risk of mortality in patients who are acutely unwell, and also increases the risk of further illness. Despite being recognised nationwide as a cause for concern, 45% of hospital patients will become dehydrated upon admission; suggesting more needs to be done to prevent dehydration. The use of bedside water devices allow patients to drink freely without assistance. Access to bedside water devices can reduce a patients length of stay in hospital and minimise the risk of a UTI developing, however further research is needed to fully assess the impact of such devices

A prospective double-blinded, randomized, placebo-controlled trial on the use of letrozole pretreatment with misoprostol for second-trimester medical abortion

Background: The aim of this randomized trial was to evaluate the abortion rate of combined regimen of letrozole and misoprostol in second-trimester abortion. Study Design: This was a randomized, double-blinded, placebo-controlled trial of 130 women requesting legal termination of pregnancy at gestational age between 12 and 20 weeks. Letrozole 7.5 mg or placebo were given for 3 days, followed by misoprostol 400 mcg vaginally every 3 h up to a maximum of five doses on the third day. Results: The abortion rate in 24 and 48 h were similar for the letrozole and placebo groups (24 h: 93.8% vs. 90.8%, respectively, p=.718; 48 h: 98.5% vs. 95.4%, respectively, p=.496). The median induction-to-abortion interval was also similar for the letrozole and placebo groups (9.6 h vs. 10.6 h, p=.145). All the side effects were comparable between the two groups. Conclusion: The use of letrozole pretreatment (7.5 mg daily for 3 days) with misoprostol in second-trimester abortion does not significantly improve the abortion rate of the misoprostol-only regimen. © 2011 Elsevier Inc. All rights reserved.link_to_subscribed_fulltex

Effect of letrozole on uterine artery Doppler flow indices prior to first-trimester termination of pregnancy : a randomized controlled trial

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