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Biomedical subjects

E Paul

Publications and source records attributed to E Paul.

At least 91 records · Page 5Linked to original sources
PubMed1991

[Treatment of pruritic skin diseases with loratadine. Results of an open multicenter study].

Within the framework of a field study, Loratidine (Lisino) was administered to a total of 5,806 patients suffering from pruritic dermatological disorders, i.e. urticaria, neurodermatitis and eczema. As a guideline for the duration of the treatment, a period of three weeks was selected; however, many patients showed a response in a shorter time. The standard dose of loratidine was one 10-mg tablet a day. At the end of the treatment period, 69.6% the urticaria patients were free from pruritus, and 77.6% were free from wheals. In the case of the eczema patients, 47.6% were pruritus-free, while the remaining patients all showed some improvement. In the majority of cases pruritus decreased appreciably after only one hour, but at the latest on the first day of treatment. Treatment with loratidine was tolerated without side effects by 5,593 patients (96.3%).

Adolescent↗
PubMed1991

[Treatment of recurrent herpes labialis using a herpes simplex Type-I subunit vaccine. A prospective randomized double-blind multicenter study].

A herpes simplex type I subunit vaccine developed by Behring-Werke (Marburg/Lahn, FRG) was compared with placebo for therapeutic effectiveness in the treatment of recurrent orolabial herpes simplex in a multicentre study involving the major hospitals in Frankfurt/Main (n = 34), Hamburg (n = 18), Giessen (n = 17) und Kassel (n = 14). The effectiveness of the vaccine was judged on the reduction in the frequency of recurrences. Within the period of the 8-month study there was no statistically significant difference in the frequency of recurrences with vaccine or placebo. Both placebo and verum led to a significant decrease in the number of recurrences of orolabial herpes simplex, but the effect of placebo was slightly more pronounced.

Adult↗
PubMed1991

[Epidemiology of urticaria diseases].

In a prospective analysis, all patients presenting with urticaria in the practices of a general practitioner and a dermatologist and at a university clinic in the course of a year were ascertained and underwent diagnostic examination according to a uniform scheme. Urticarias are common skin diseases, affecting, at a modest estimate, about 1.3% of the population. Of all the general practitioner's patients about 3% had one of the many types of urticaria. The same percentage was found in the dermatologist's practice and among the patients attending the university clinic. The incidence of the different types of urticaria differs considerably at the different levels of medical care. This may be due to the fact that the patients are referred to a specialist or to a clinic only when the diagnosis or treatment is problematic. Half the general practitioner's urticaria patients suffer from physical urticarias (this includes the minor variants that do not necessarily require medical care). In the clinic, however, only a quarter of all patients with urticaria had physical variants. Patients with chronic urticaria accumulate in clinics because they have been referred for diagnosis and therapy. Predominantly young people were affected by physical urticaria, the peak being between 10 and 40 years. Patients with chronic "endogenous" urticaria were significantly older. About 30% of all patients also had angio-oedema, at least temporarily. Isolated swelling without urticaria occurred in only 3.9% of all patients. In urticaria, there was a slight female predominance: of all patients with physical urticaria, 61.1% were female, and the corresponding figure for nonphysical types was 53.6%. An almost equal sex distribution was found in chronic urticaria (51.9% female). In our prospective study patients presenting with urticaria only as a minor symptom was also ascertained. Many minor variants of physical urticaria were seen in these patients. In the dermatological practice, urticaria was diagnosed incidentally in 6-8% of cases. In the clinic, however, 20% of the physical urticarias and 10% of the acute nonphysical urticarias were recorded as incidental findings.

Adolescent↗
PubMed1990

[Wound healing with Iruxol. Results of a multicenter study].

In a multicenter study, a total of 100 wounds in 94 patients were treated with Iruxol ointment over a period of 3 weeks. The ointment was applied to the wound surface once or twice daily. The target parameters, wound debridement, granulation and epithelialization were assessed qualitatively. The area of the ulcers was determined quantitatively and approximately. In wounds considered to be uncomplicated, the results were clearly better than in so-called problem wounds, in which the blood supply obviously played a considerable role in the healing process. Postoperatively the wounds shrank by only two-thirds, while the area of problem wounds, i.e. "skin ulcerations", was reduced by only about 46%. On the whole Iruxol ointment was well tolerated. However, in two out of 32 patients with leg ulcers treatment had to be terminated due to contact dermatitis.

Chloramphenicol↗
PubMed1990

Understanding hospital referral rates: a user's guide.

Detailed referral information from one practice was used to investigate the effect of calculating referral rates in several different ways. Referral rates for individual general practitioners should be related to the number of consultations carried out and not to the number of registered patients; for whole practices list size may be used as the denominator. Most doctors will not need to control for age and sex of patients when comparing referral rates but may need to control for case mix when comparing referral rates to individual specialties. In addition, a method is described for distinguishing systematic variation between the referral rates of individual doctors from the random variation that may arise from data based on fairly small numbers of referrals. The method indicates whether systematic variation is greater than would be expected by chance, and it can be extended to indicate whether variability in referral rates is greater in one specialty than another. Because of random variation with time a year's data may not be sufficient to allow reliable interpretation of referral rates to individual specialties, except for the largest. At present there is no known relation between high or low referral rates and quality of care. Nevertheless, if doctors are to interpret their own rates of referral they need those rates to be reliable and valid. Use of the 10 guidelines described in this paper will help to prevent unwarranted conclusions being drawn from information on general practitioners' rates of referral to hospital.

Adolescent↗
PubMed1990

Effects of Partial O(2) Pressure, Partial CO(2) Pressure, and Agitation on Growth Kinetics of Azospirillum lipoferum under Fermentor Conditions.

Azospirillum lipoferum crt1 was grown in batch cultures under standard conditions at 85% saturation of dissolved oxygen (DO) and 30-g/liter glucose concentrations. Kinetic studies revealed nutritional limitations of growth and the presence of an initial lag phase prior to consumption of glucose. The influences of various gaseous environments and shear stress on growth, i.e., various conditions of agitation-aeration, were characterized. Faster growth in the first stages of the culture and shorter duration of the lag phase were observed at DO concentrations of <30% saturation. The possible influences of dissolved CO(2) concentration or shear stress or both were discounted, and we confirmed the detrimental effect of high DO levels (up to 80% saturation) and the favorable influence of low DO concentrations (lower than 30% saturation) on growth. It was concluded that the gaseous environment, i.e., the DO concentration, needs to be considered as an operating parameter and be accurately controlled to ensure optimal growth of Azospirillum cells.

Journal Article↗
PubMed1990

Pathogenic anti-DNA antibodies in SLE: idiotypic families and genetic origins.

We have adopted an idiotypic approach to study the double stranded DNA (dsDNA) binding antibodies of systemic lupus erythematosus (SLE). Three anti-idiotypic reagents, 8.12, 3I, and F4, identify cross reactive idiotypes that are each expressed on anti-dsDNA antibodies in the sera of many patients with SLE. These idiotypic antibodies are implicated in the pathogenesis of SLE as they are present in immune complex deposits in the kidneys of patients with SLE glomerulonephritis. The autoantibody associated idiotypes are also expressed on antibodies that do not bind DNA. We are investigating the origin of the pathogenic anti-dsDNA antibodies of SLE by comparing the autoantibodies, the antibodies to foreign antigens, and the myeloma proteins that express each SLE associated idiotype. In conjunction with serological analysis of these idiotypic systems, molecular genetic studies indicate that both the 8.12 and the 3I autoantibody associated idiotypes may be germline encoded, while the F4 idiotype is generated by somatic mutation. The data further suggest that the antigenic specificity of the pathogenic anti-DNA antibodies of SLE is acquired through somatic mutation of germline immunoglobulin genes. By studying the regulation of genes capable of encoding pathogenic autoantibodies, in both SLE patients and non-autoimmune individuals, we may be able to elucidate the pathogenesis of autoimmune disease and begin to design more effective therapeutic interventions.

Antibodies, Antinuclear↗
PubMed1990

Primary bipolar total hip arthroplasty.

A retrospective clinical and radiographic review of 140 primary total hip arthroplasties using a bipolar acetabular component and an uncemented AML femoral component (Depuy, Warsaw, IN) was done. The length of follow-up was from 2 to 5 years with a mean of 44.2 months. A mean postoperative Harris hip score of 84.3 points and a mean postoperative Harris pain score of 38.8 points were identified. Five hips required revision surgery, three for recurrent dislocations and two for infection. Nine percent of acetabular components were noted to have migrated within the bony pelvis by 2 mm or more. However, the presence of migration was not statistically associated with low pain or function scores. Ninety-eight percent of patients with surviving implants felt satisfied with the results of their surgery. Total hip arthroplasty using a bipolar acetabular component appears to be a successful method of hip replacement.

Adult↗
PubMed1990

Comparative effects of loratadine and terfenadine in the treatment of chronic idiopathic urticaria.

Loratadine is a new selective peripheral histamine H1-receptor antagonist, that is orally effective, long-acting, and devoid of significant central and autonomic nervous system activity. Its safety and efficacy were evaluated in a 28-day study conducted in patients with chronic idiopathic urticaria. Patients were randomly assigned to one of three treatment groups (loratadine, 10 mg OD; terfenadine, 60 mg BID; or placebo). Evaluation of efficacy included weekly assessments of the individual disease signs and symptoms, the overall disease condition, and therapeutic response to treatment. Throughout the 28-day treatment period progressive improvement was observed in the loratadine and terfenadine treatment groups; however, at each evaluation, loratadine was significantly more effective than placebo (P less than .01) and clinically more effective than terfenadine in reducing disease signs and symptoms. Terfenadine was significantly more effective than placebo at day 7 and endpoint (last valid visit). The overall therapeutic response at the endpoint of treatment was rated as marked or complete relief of symptoms in 64%, 52%, and 25% of the patients in the loratadine, terfenadine, and placebo treatment groups, respectively. Loratadine was well tolerated and comparable to terfenadine and placebo in incidence of adverse experiences. Sedation was reported in one patient each in the terfenadine and placebo treatment groups and an anticholinergic side effect (dry mouth) in one terfenadine-treated patient. No sedative or anticholinergic side effects were observed in patients receiving loratadine. We concluded that loratadine, 10 mg, once daily is a safe and effective treatment for symptomatic relief of chronic idiopathic urticaria.

Adolescent↗
PubMed1990

Effect of the PAF antagonist BN 52021 in ovine endotoxin shock.

It has been reported that a platelet-activating factor (PAF) antagonist ONO-6240 had little effect on pulmonary hypertension and lung lymph in sheep injected with endotoxin lipopolysaccharide (LPS); consequently we evaluated a new PAF antagonist, BN 52021. Twelve adult sheep were surgically prepared for chronic study including lung lymph drainage. LPS (S. abortus equii, 36 ng/kg/h over 7 h) was then administered with (BN group) or without (control group) infusion (1 h before LPS) of the PAF antagonist BN 52021 (4 mg/kg/30 min). Comparison of the hemodynamic data between the control group and the BN group reveals an almost identical pattern. In contrast, we find differences in the pulmonary response of the two experimental groups. The early elevation of pulmonary artery pressure after LPS administration is less in the treatment group, as is the duration of pulmonary hypertension. Similarly, thromboxane levels are lower in the treated animals. The increases in lymph flow (LQ) and transvascular protein clearance (L/P X LQ) as well as the protein flux were less prominent in the treatment group. The mean lymph flow per hour was significantly higher in the control group. The mean lymph flow per hour was significantly higher in the control group, as were the corresponding parameters for clearance and protein flux. Thus the pulmonary vasculature and lung fluid balance disruption produced by LPS was markedly reduced by treatment with the PAF blocker.

Animals↗
PubMed1990

Efficiency of acitretin in combination with UV-B in the treatment of severe psoriasis.

Compared with the antipsoriatic retinoid etretinate, the new aromatic retinoid acitretin represents an important advance due to its rapid elimination kinetics. Since in psoriasis vulgaris retinoids are used predominantly in combination regimens, we investigated the therapeutic efficacy of acitretin and UV-B compared with placebo and UV-B in a double-blind, randomized multicenter trial in 82 patients with severe psoriasis. They were treated with 35 mg of the study medication during the first 4 weeks of therapy and 25 mg thereafter, concomitantly with UV-B irradiation in increasing energy doses. Forty patients who underwent therapy with acitretin and UV-B and 38 patients who underwent therapy with placebo and UV-B were evaluated for efficacy. The target variables--psoriasis severity index and total UV-B dose--were reported at intervals of 2 weeks over a maximum period of 8 weeks. At the end of treatment, the psoriasis severity index decrease was 79% in the acitretin and UV-B group and 35% in the placebo and UV-B group. The response rate, defined as greater than or equal to a 75% decrease of the psoriasis severity index, was 60% for the combination treatment and only 24% for the control treatment. This treatment response was achieved with markedly lower cumulative UV-B energy. The median cumulative UV-B energy applied to reach 75% clinical improvement was 11.8 J/cm2 vs 6.9 J/cm2. Side effects showed a similar pattern in both groups. Our data show that the acitretin dramatically improves the results of UV-B treatment in patients with severe psoriasis. In addition, it markedly decreases the effective cumulative UV-B dose, thereby reducing the potential long-term hazards of UV irradiation. We conclude that the acitretin plus UV-B combination treatment represents a highly effective therapeutic regimen in severe psoriasis.

Acitretin↗
PubMed1990

[Satellite recurrence of eruptive angioma. A clinical, histologic and immunocytochemical study].

Some weeks after operative removal of an eruptive angioma, satellite angiomas may develop within and around the scar. During the further course they remit spontaneously. So far these recurrences have been observed almost exclusively on the trunk in children and young adults, especially in male patients. Four new cases are reported. The course is consistent with earlier observations. Histologically, the cell proliferations follow the ramifications of afferent arteries. In older satellites, there are focal changes of intravascular papillary endothelial hyperplasia. These are interpreted as regression phenomena. Immunocytochemically, desmin-negative cells positive for muscle-actin are found in addition to endothelial cells. They are considered to be pericytes and myofibroblasts. Because of the close relationship with the afferent arterioles, disturbances in the vascular system are thought to be responsible for the development of angioma. If such underlying vascular disorders are not corrected by primary excision, satellite recurrences may occur. Because of their tendency to spontaneous remission, active therapeutic measures are not recommended.

Actins↗
PubMed1990

[Metastasizing malignant melanoma from unknown primary tumor].

Among a total of 1426 patients with malignant melanoma, the site of the primary tumor was unknown in 24 patients (1.7%), most of whom were male (20 of these 24 patients were male, the remaining 4, female). The average age of these 24 patients correlates with the age distribution of the 1426 patients. In half the patients under scrutiny, the first metastases were found in lymph nodes, and one quarter of these developed metastases to the brain or skin. The 21 patients it was possible to follow up over the entire period of their case history had a poor prognosis. The 5-year survival rate after excision of the first metastases was only 14%. In 8 patients the medical history indicated a previous pigmented tumour on the skin. In 4 of these patients melanophages were also found within depigmented scars located in the drainage area of the lymph nodes involved. However, there were no signs of a primary tumour either on the mucous membranes or in the eyes in any of the other patients.

Adult↗
PubMed1989

[The growth dynamics of malignant melanomas. Long-term establishment of melanomas].

Malignant melanomas have become common skin tumors, with an annual incidence of new cases of about 11/100,000 population (applies to Hesse, 1984). Early detection and excision of the lesion has found general acceptance. It can be calculated from tumor kinetics that, on average, it takes about 10 to 15 years for an initial-invasive, superficially spreading melanoma to develop into an advanced tumor with invasion of the subcutaneous tissue. On the basis of its localisation in the skin, striking pigmentation, and the protracted growth of the initial melanoma, early detection ought to be possible in the majority of cases. The clinical aspect of the lesion should, in the first instance, be decisive for excision, since anamnestic information provided by the patient can lead to wrong conclusions. Patients with a light skin sensitive to the sun, and numerous, possibly dysplastic, birthmarks, are considered to be at increased risk, and should therefore be examined prophylactically every year.

Cell Division↗