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Biomedical subjects

D J Margolis

Publications and source records attributed to D J Margolis.

At least 55 records · Page 3Linked to original sources
PubMed1993

Planimetric rate of healing in venous ulcers of the leg treated with pressure bandage and hydrocolloid dressing.

BACKGROUND: Venous leg ulcers are a common cause of morbidity, but few predictive parameters exist that can be used to follow their progress. OBJECTIVE: We investigated the use of healing rate as a useful parameter in the treatment of venous ulceration. METHODS: Twenty-seven venous ulcers being treated with a standard regimen were evaluated. We calculated the initial (4-week) and overall healing rates using the Gilman method (delta A/p). RESULTS: The average initial healing rate for all ulcers combined, the healed group, and the nonhealing group was 0.069, 0.087, and -0.005 cm/wk, respectively. Similarly, the average overall healing rate for all ulcers combined, the healed group, and the nonhealing group was 0.062, 0.089, and -0.043 cm/wk, respectively. CONCLUSION: The initial healing rate (delta A/p(0-4)) may be an appropriate end point for clinical investigations comparing therapies for the treatment of chronic venous leg ulcers.

Bandages↗
PubMed1993

Venous leg ulcers: an analysis of underlying venous disease.

Patients with venous leg ulcers have a readily recognized clinical syndrome of shallow ulcers, oedema, leg pain, venous ankle blush, lipodermatosclerosis, varicose veins, hyperpigmentation, and atrophie blanche, and they are assumed to have venous abnormalities. We examined 43 patients with venous leg ulcers, and compared those with obvious venous abnormalities (defined as historical or clinical evidence of deep venous thrombosis or varicose veins) with those with presumed venous abnormalities (defined as lacking any such evidence), to see if they presented with different clinical features. We found that both groups had similar clinical features, with the exception that lipodermatosclerosis was present more frequently in those patients with obvious venous abnormalities (94 vs. 36%, P < 0.001). Most patients with presumed venous abnormalities had musculoskeletal conditions which might cause calf pump dysfunction (91%). Using air plethysmography, we were unable to confirm that all patients with presumed venous abnormalities did have intrinsic venous abnormalities. We propose that ulcers occurring in this clinical syndrome be designated as calf pump dysfunction ulcers (CPD ulcers), rather than venous ulcers.

Arteriosclerosis↗
PubMed1993

Hydroxyurea and lower leg ulcers.

We report four cases of cutaneous lower leg ulcers associated with hydroxyurea treatment for myeloproliferative disorders. This association has been reported in one other series of patients who had chronic myelogenous leukemia and were treated with hydroxyurea. A review of the literature and survey of possible pathogenetic mechanisms is presented.

Aged↗
PubMed1992

Alterations in renal function in psoriasis patients treated with cyclosporine, 5 mg/kg/day.

BACKGROUND: Cyclosporine has been used to treat a variety of cutaneous and immune-mediated diseases. Nephrotoxicity is the most common major adverse side effect. OBJECTIVE: The study was designed to investigate the frequency of alterations in serum creatinine in patients with psoriasis receiving 5 mg/kg/day of cyclosporine. METHODS: Sixteen patients with severe refractory psoriasis received cyclosporine, 5 mg/kg/day, for 12 weeks. Serum creatinine was evaluated with respect to each patient's baseline. RESULTS: Serum creatinine levels remained in the normal range, but 10 of 16 patients had a 30% elevation and 5 of 16 patients had a 50% elevation of serum creatinine compared with the patient's baseline value. CONCLUSION: These results indicate that a significant elevation in serum creatinine occurs in many patients who receive cyclosporine for psoriasis.

Adult↗
PubMed1991

Neutrophilic eccrine hidradenitis: a case report and review of the literature.

A case of neutrophilic eccrine hidradenitis is presented, with a review of the literature. Although the histologic appearance of this disorder is distinct and infrequently reported, the clinical presentation is common. Neutrophilic eccrine hidradenitis may be an under-reported benign drug reaction in patients with white blood cell disorders.

Adult↗
PubMedDate not supplied

Interobserver agreement, sensitivity, and specificity of a "healed" chronic wound.

The primary end point of most wound healing studies is the clinically subjective evaluation of whether a wound is healed. Recently the Wound Healing Society proposed a definition of an acceptably healed wound. With the use of color transparencies of wounds with known clinical outcomes, the investigation presented here evaluated the reliability and validity of this definition as interpreted by 16 untrained observers. Interobserver reliability (Kappa statistic) was 0.68 (95% confidence interval: 0.66, 0.70), sensitivity 0.84 (confidence interval: 0.81, 0.90), specificity 0.92 (confidence interval: 0.88, 0.97), and positive predictive value 0.93 (confidence interval: 0.89, 0.97). We conclude that reliability and validity of judgments of wound healing are good using this definition of a healed wound, permitting its use in clinical investigations and routine clinical care.

Journal Article↗
PubMedDate not supplied

The accuracy of using a wound care specialty clinic database to study diabetic neuropathic foot ulcers.

Few epidemiologic studies have examined the effect of clinical risk factors on the probability that a patient with a chronic wound will heal or develop another wound. Curative Health Services maintains one of the few databases that contain detailed patient record information on patients with chronic wounds. The purpose of this study was to evaluate the reliability and validity of using this database to study individuals with diabetic neuropathic foot ulcers. 154 patient medical records were randomly selected from the database and abstracted using a standardized questionnaire and protocol. We assessed three key variables: diagnosis of diabetic neuropathic foot ulcer, whether the patient healed, and if the patient received an autologous product called platelet releasate. These variables in the database very accurately agreed with the information in the patient medical records, with positive predictive values of 98% (95% confidence interval [0.89, 0.99]), 93% (95% confidence interval [0. 68, 0.99]), and 100%, respectively. We have shown that, with respect to these three variables, the database is very accurate when compared to the medical record. It therefore represents a valuable tool with which to study patients with diabetic insensate foot ulcers.

Databases, Factual↗
PubMedDate not supplied

Clinical protocol: Phase I trial to evaluate the safety of H5.020CMV.PDGF-B for the treatment of a diabetic insensate foot ulcer.

Most patients with chronic wounds fail to heal in a reasonable period of time. Despite considerable advances in elucidating the molecular basis of wound repair, attempts at developing new therapies have been disappointing. In fact, in the few studies where cytokine growth factors have been efficacious, their effect has been dramatically less than would have been predicted from animal studies. We hypothesize that platelet-derived growth factor-BB, a growth factor associated with wound healing, when produced in large quantities within the wound bed due to adenovirus mediated gene overexpression by the cells of the wound bed will dramatically enhance wound healing. Simply stated, we plan to insure the delivery of the growth factor by using gene therapy techniques so that cells locally involved in the wound healing process will temporarily increase their production of platelet-derived growth factor-BB. We present the first step in the series of human investigations to test this hypothesis which is a phase I clinical trial. Our proposed study is designed to assess local and systemic toxicity, and the feasibility of using the maximum tolerated dose of H5.020CMV.PDGF-b associated with in vivo platelet-derived growth factor-BB gene transduction via an intraulcer injection of H5.020CMV.PDGF-b in patients with a diabetic insensate foot ulcer.

Animals↗