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Biomedical subjects

B R Hughes

Publications and source records attributed to B R Hughes.

36 records · Page 2Linked to original sources
PubMed1989

Strategy of acne therapy with long-term antibiotics.

A study of the outcome of conventional antibiotic treatment in 543 patients with acne was performed. All were treated initially with erythromycin 1 g/day and topical 5% benzoyl peroxide. The median improvement at 6 months was 78%, with an interquartile range of 67-90%. Four-hundred and eight of the 492 who completed 6 months' treatment showed over 50% improvement and 247 of the 279 patients treated for a subsequent 6 months with benzoyl peroxide alone, continued to do well. Another subgroup of 174 patients, was continued for 6 months with systemic antibiotic and 5% benozyl peroxide. No significant benefit was gained, however, by maintaining successfully treated patients on a further 6 months of systemic antibiotics. Of the 84 patients who did less well, 18 were given alternative treatment (Diane, isotretinoin). The other 60, subsequently referred to as slow responders, were continued on antibiotics (erythromycin, 31; minocin, 29; cotrimoxazole, 4; trimethoprim, 2) and benzoyl peroxide. Those prescribed minocycline for the second 6 months appeared to have greater benefit (64%) than those receiving erythromycin (57%). This level of improvement was still lower than that seen in those who responded well within 6 months (78%). Of the risk factors analysed, the poorest response occurred in males with truncal acne. Age at presentation, duration and severity did not adversely affect therapeutic outcome. Side-effects were minimal.

Acne Vulgaris↗
PubMed1988

Clinical response and tissue effects of etretinate treatment of patients with solar keratoses and basal cell carcinoma.

Patients with basal cell carcinoma and solar keratoses were treated with etretinate. Substantial and prolonged clinical improvement was seen. All patients with solar keratoses showed a decrease in the mean area and number of lesions and eight patients demonstrated complete healing clinically. Two patients experienced recurrence at 9 months after completion of treatment. Histometric and cell kinetic measurements on the epidermis of skin samples from these patients were performed. They revealed epidermal thickening and increased deoxyribonucleic acid (DNA) synthesis both in lesions and in clinically uninvolved skin following treatment. Assessments were also made of enzyme activities in lesions and uninvolved skin with the use of established quantitative cytochemical techniques. Significant reduction in levels of succinic dehydrogenase activity following etretinate treatment was detected in solar keratoses and in basal cell carcinomas. This was also the case for uninvolved skin of patients with solar keratoses. Glucose-6-phosphate dehydrogenase (G6PD) activity was significantly reduced following etretinate treatment in solar keratoses and in basal cell carcinomas, but uninvolved skin did not exhibit significant changes. These changes are in contrast to those previously reported in normal subjects, where the activity increased, but are similar to those observed in patients with ichthyotic disorders. The alterations in the cytochemical profile following administration of etretinate in the lesions of patients reported here are consistent with the view that the drug promotes a more normal pattern of epidermal differentiation. We favor the view that etretinate's antineoplastic action is exerted by preferentially allowing differentiation of normal epidermal cells and inhibiting dysplastic cells.

Aged↗
PubMed1988

Malignant melanoma, benzoyl peroxide and acne: a pilot epidemiological case-control investigation.

A case-control study utilizing available medical records was carried out to investigate possible links between use of topical benzoyl peroxide for acne, and malignant melanoma. One hundred and fifty nine cases and 213 matched controls were used in the analysis which shows no significant association between the use of benzoyl peroxide and the occurrence of malignant melanoma, nor between the occurrence of acne and malignant melanoma.

Acne Vulgaris↗
PubMed1988

Tolerance of spironolactone.

A survey of 54 patients taking spironolactone for hirsutes or acne showed that side-effects occurred in 91%; in 80% of patients, these were related to the anti-androgenic mechanism of the drug (menstrual disturbances, and breast enlargement and tenderness). The concomitant use of a contraceptive pill gave a lower incidence of menstrual abnormalities. Only seven patients (13%) had to stop the drug. In a further eight patients, a reduction in dose to between 125 and 175 mg daily achieved a compromise of controlling the disease and the side-effects. Side-effects tended to occur early and so regular review during the initial 3 months of treatment is advised. Two patients in our study developed 'chloasma'--a previously unreported complication of spironolactone. This was the only side-effect which occurred late in treatment.

Acne Vulgaris↗
PubMed1988

Clinical markers of androgenicity in acne vulgaris.

Androgenic stimulation of sebaceous glands is necessary for development of acne. If hyperandrogenaemia were a major determinant of acne in women, the frequency of other clinical markers of androgenicity should increase with acne severity. To investigate this, 268 female subjects (aged 12-44 years) were studied. Subjects were divided into groups on the basis of acne severity: physiological, moderate, and severe. With exclusion of women taking oral contraceptives or anti-androgen therapy, subjects in each group were similar with respect to age at menarche and incidence of menstrual irregularity of amenorrhoea. Reports of excessive body hair, and clinical hirsutes on examination were few and there were no significant differences between acne severity groups. No correlation was observed between acne and hirsutes grades in all subjects (rank correlation coefficient = 0.096). Mild male pattern androgenic alopecia occurred in similar proportions of subjects in the three groups. Female pattern androgenic alopecia was observed in only two subjects. We have shown no correlation between acne severity and clinical markers of androgenicity in women. This suggests that in most cases factors other than hyperandrogenaemia are necessary for the development of acne.

Acne Vulgaris↗
PubMed1987

Trimethoprim associated fixed drug eruption.

We report two cases of fixed drug eruption due to trimethoprim. Fixed drug eruption is a distinct entity characterized by the development of circular erythematous skin lesions which over a period of time become violaceous and leave an area of hyperpigmentation. Mucous membranes also may be affected. With re-administration of the drug the lesions recur in the same area but may extend to further new areas with each challenge.

Adult↗
PubMed1987

An acne naevus.

Explore the source record for details and available documents.

Acne Vulgaris↗
PubMed1987

Metabolism and urinary excretion of 5-amino salicylic acid in healthy volunteers when given intravenously or released for absorption at different sites in the gastrointestinal tract.

In six healthy subjects serum concentrations of 5 amino salicylic acid (5ASA) and acetyl 5ASA were measured for up to 24 hours, and urinary excretion over 48 hours. After an intravenous injection of 3.26 mmol 5ASA serum concentrations fell rapidly with a distribution half-life of 17 +/- 2 min and an elimination half-life of 42 +/- 5 min. After 45 minutes acetyl 5ASA became the dominant compound and after seven hours serum concentrations of both components were almost unrecordable. Orally ingested 5ASA in three preparations to ensure its release in the stomach, small intestine and ileocaecal region respectively gave lower serum concentrations and urinary excretion than those obtained after an intravenous infusion. Bioavailabilities which ranged from 19% for ileocaecal release to 75% for release in the upper gastrointestinal tract, were calculated from areas under the serum concentration curves. Urinary excretion of 5ASA and its acetyl metabolite over 48 hours was 78%, 52%, 55%, and 21% respectively of the dose given intravenously and orally for gastric, small intestinal and ileocaecal release.

Adult↗
PubMed1986

Doppler ultrasound as an adjunct to the differential diagnosis of pigmented skin lesions.

One hundred and forty-one pigmented skin tumours were examined with a 10 MHz ultrasound Doppler flowmeter to investigate the value of detecting blood flow in the diagnosis of raised pigmented skin lesions. Most of the benign lesions except for those with an angiomatous basis were devoid of blood flow signals while all basal cell carcinomas and 96 per cent of thick melanomas (greater than or equal to 0.9 mm) were associated with detectable Doppler frequency shift signals. While the characteristics of analysed Doppler waveforms are of research interest, the simple detection of blood flow by a hand held instrument gives sufficient information for clinical purposes. In practice this simple test has been sufficiently reliable to prove a useful adjunct in the diagnosis of raised pigmented skin lesions. It has been found particularly helpful in the common clinical problem of differentiation of nodular melanoma from basal cell papilloma and benign intradermal naevus. If such a lesion is thought to be benign, and has detectable flow signals, one should reconsider the diagnosis. Absence of flow signals is strong confirmation of a benign clinical diagnosis. The test should be regarded as an adjunct to clinical diagnosis since, in common with all noninvasive diagnostic techniques, false negative and false positive cases will be encountered. The technique is not appropriate to macular lesions since these are usually flow negative, irrespective of the pathology.

Adolescent↗
PubMed1981

Many parents think their child is dying when having a first febrile convulsion.

Fifty parents of 36 consecutive children admitted to hospital with their first febrile convulsion were interviewed shortly after the event. Very few parents voluntarily said that they had thought their child was dying, but when asked specifically the majority said they had thought the child was dying or likely to die. This common fear should be kept in mind when discussing febrile convulsions with parents, who are unlikely to volunteer the information.

Adult↗
PubMedDate not supplied

Teaching children about skin cancer: the draw-and-write technique as an evaluation tool.

Childhood exposure to sunlight is a risk factor for melanoma. To formulate a meaningful program to educate children about the ill effects of the sun, their extant knowledge base must be determined. We have used the "draw-and-write" technique to assess children's perceptions about the sun, suntans, and skin cancer. A total of 693 school children aged 4 to 13 years were asked to draw pictures and label them in response to a series of carefully worded questions. Awareness of the need to apply sunscreen increased from 44% in children aged 4 to 6 years to 95% in children aged 9 to 10 years. Ten percent of children aged 4 to 6 years already perceived a suntan as attractive. While almost all children were aware of the negative immediate effects of sun exposure, namely sunburn, just 30% of American children aged 11 to 13 were aware that sun exposure is a risk for skin cancer. No differences between boys and girls were seen. The "draw-and-write" technique allows assessment of the attitudes and perceptions of children regarding the sun and skin cancer. It also provides valuable information on which to base health education and evaluate its cost-effectiveness.

Adolescent↗
PubMedDate not supplied

Construction of affinity sorbents utilizing glutathione analogs.

Solution-phase N-fluorenylmethoxycarbonyl (Fmoc) mediated peptide synthesis has been adapted to the synthesis of glutathione (gamma-glutamyl-cysteinyl-glycine) analogs. A protecting group strategy has been devised in which all of the masking groups are removed with mild base. This allows for the synthesis of acid-sensitive materials and lessens concerns about the alkylation at sulfur by carbocations known to be present in the trifluoroacetic acid mixtures usually employed for deprotection of peptides made by the Fmoc methodology. A series of structurally varied glutathione analogs were prepared by modifying the peptide in two ways. The first involved C-terminal substitution for glycine by one of several different amino acids. The second involved substitution of one of five alkyl or aryl groups onto the cysteine sulfhydryl. The complete set of all combinations would yield 48 reagents, of which 25 have actually been synthesized. Following confirmation of the structures by FAB mass spectrometry, the peptides were immobilize by conjugation to epoxyfunctionalized Sepharose at pH 11-12. The amount and identity of immobilized peptide was assayed by amino acid analysis of acid-hydrolyzed resin. One of the tripeptides was purified by ion-exchange and preparative HPLC.

Amino Acid Sequence↗