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At least 217 records · Page 12Linked to original sources

Quantitative sacroiliac scintiscanning: a sensitive and objective method for assessing efficacy of nonsteroidal, anti-inflammatory drugs in patients with sacroiliitis.

Serial computer assisted quantitative sacroiliac scintiscanning (SI joint/sacrum ratios) 3 hours after low dosage (5 mCi) 99mTc methylene diphosphonate has been used as an objective index of sacroiliitis in a single blind 14-day cross-over comparison of azapropazone 600 mg b.d. and naproxen 500 mg b.d. in 18 patients with active sacroiliitis. Clinical assessments included visual analogue scales for measurement of pain and early morning stiffness, chest expansion, a modified Schober test, and goniometric measurement of thoracolumbar spinal flexion by means of an inclinometer. Statistically significant decreases in pain (p less than 0.001) and early morning stiffness (p less than 0.001) followed treatment with each NSAID, but there was no significant difference in the fall in these parameters, although 15 out of 18 patients expressed a preference for naproxen. Chest expansion and thoracolumbar flexion were not significantly affected by either drug. Serial quantitative scintigraphy showed a mean fall in joint sacrum ratios following each treatment which was statistically significant (p less than 0.02) only after naproxen. Serial quantitative scintigraphy can be used as an objective method of assessing sacroiliitis and was sufficiently sensitive to reflect the patients' subjective preference in a short-term comparison of 2 NSAID.

Adult↗

Inhibition of the bronchial response to respiratory heat exchange by increasing doses of terbutaline sulphate.

Ten asthmatic patients inhaled terbutaline sulphate (250, 500, or 1000 micrograms) or placebo on separate days, double blind and in random order, 30 minutes before isocapnic hyperventilation induced by cold air inhaled in doses that increased in a precisely controlled manner. The respiratory heat exchange (RHE) was calculated for each level of ventilation and the results were expressed as the RHE causing a fall in FEV1 of 10% (PD10RHE). The PD10RHE after placebo was highly reproducible. After terbutaline inhalation there was a highly significant shift in the RHE dose-response curves to the right and a trend towards a linear increase in PD10RHE with increasing doses of terbutaline. The subjects who were most responsive to the RHE required more terbutaline to inhibit the response completely. The results indicate that RHE dose-response curves are a precise method to examine the effects of drugs on hyperventilation-induced asthma, that increasing doses of terbutaline can produce increasing protection, and that the degree of protection is dependent on the level of increased bronchial responsiveness to RHE.

Adult↗

Comparison of endoscopic retrograde cholangiopancreatography with MR cholangiopancreatography in patients with pancreatitis.

PURPOSE: To assess the usefulness of magnetic resonance (MR) cholangiopancreatography (MRCP) in the evaluation of disease in patients with acute or chronic pancreatitis. MATERIALS AND METHODS: MR imaging was performed at 1.5 T in 39 patients with chronic (n = 30) or acute (n = 9) pancreatitis. The patients underwent a pancreas MR imaging protocol that included an MRCP sequence. Comparison was made with findings at endoscopic retrograde cholangiopancreatography (ERCP), performed within 30 days. Three blinded readers used a scoring system to evaluate nine segments of the pancreatic and biliary ducts as depicted on the ERCP and MRCP images. MRCP image quality was also evaluated. RESULTS: Of 196 segments analyzed, 17 were not seen at MRCP (sensitivity, 91%). Of the segments visualized at MRCP, 14 were incorrectly characterized (accuracy, 92%). At MRCP, segments not detected or mischaracterized were either normal, slightly dilated, or narrowed. At ERCP, 42 segments in 19 patients were not visualized. MRCP findings were considered useful in all those cases. MRCP image quality was not interpretable in two cases due to artifacts. CONCLUSION: Very good correlation between ERCP and MRCP findings was demonstrated. Both modalities failed to depict pathologic conditions depicted by the alternative method. MRCP may obviate ERCP, particularly in patients who cannot undergo ERCP or in whom ERCP has been unsuccessful.

Acute Disease↗

Beneficial effects of softened fabrics on atopic skin.

There is general concern about the possible cutaneous adverse effects of wearing garments treated with household laundry products, particularly on atopic skin. Our objective was to compare softened and non- softened fabrics in a forearm wet and dry test, under conditions simulating real-life conditions. Twenty atopic volunteers entered a single-blind 12-day (3 sessions per day) forearm wetting and drying test. Cotton fabrics were machine washed and liquid fabric conditioner was added or not to the final rinse. To simulate conditions of skin damage, a dilute solution of sodium lauryl sulphate was applied under occlusion to the forearm of each volunteer before the start of the study. Skin effects were evaluated by visual grading (redness, dryness and smoothness), squamometry and in vivo instrumental measurements (capacitance, transepidermal water loss and colorimetry). Rubbing of atopic skin with fabrics generally resulted in discrete to moderate alterations of the structure of the stratum corneum. Both for control and pre-irritated skin, all measured parameters indicated that softened fabric was less aggressive to the skin than unsoftened fabric. In the case of pre-irritated skin, the recovery of the skin was significantly faster when rubbed with softened than with unsoftened fabrics. In conclusion, softened fabrics help mitigate the skin condition in atopic patients.

Adult↗

Evaluation of inhalation aids of metered dose inhalers in asthmatic children.

Many patients have incorrect aerosol inhalation technique with metered dose inhalers (MDI). Several inhalation aids have been developed and marketed for these patients. Even those who have correct inhalation technique may benefit from these devices. We compared bronchodilator efficacy of two puffs of albuterol aerosol administered either directly from a MDI mouthpiece, or from an inhalation aid (InspirEase, Aerochamber, Aerosol Bag) in 20 children who had previously demonstrated proper inhalation technique. The children received two puffs of aerosol from a MDI in each of two modalities tested each day on four different days (double blind). One modality contained albuterol aerosol and the other placebo. Pulmonary function was tested before and at 15, 30, 60, 120, and 180 minutes after treatment. Forced expiratory volume in 1 second (FEV1) increased similarly after all four modes of administration. Six patients who had incorrect inhalation technique benefited from the three inhalation aids. The aerosol bag and InspirEase produced slightly greater bronchodilator response than the Aerochamber. The inhalation aids are useful devices for those who have incorrect inhalation technique, but those who have correct technique do not derive any benefit from these devices.

Adolescent↗

Pathological effects of angioplasty on vasospastic carotid arteries in a rabbit model.

To define the pathological effects of angioplasty on vasospastic arteries, 36 rabbits underwent angiography and induction of vasospasm by placement of blood-filled (vasospasm groups) or empty (control group) silastic sheaths around the cervical carotid arteries. Two (Day 2) or 7 days (Day 7) later, angiography was repeated and one carotid artery in each animal was dilated by balloon angioplasty. The rabbits were sacrificed 1 day, 7 days, or 3 to 4 weeks after angioplasty. Significant vasospasm developed after placement of silastic sheaths with blood (mean reductions in diameter 39% +/- 6% at Day 2 and 48% +/- 5% at Day 7). Arterial narrowing was less apparent in the control groups at Day 2 (24% +/- 7%). Angioplasty performed on Day 2 significantly increased arterial diameters of vasospastic arteries (50% +/- 7%; p < 0.05) but not those of control arteries (10% +/- 6%, p > 0.05). Angioplasty performed on Day 7 increased the arterial diameters by a similar degree (47% +/- 13%, not significant). Arteries remained dilated after angioplasty, although there was significant vasospasm 7 days after angioplasty when angioplasty was performed on Day 2. Blinded, semiquantitative histopathological study of the arteries showed that 3 to 4 weeks after angioplasty, there was significant endothelial proliferation and a trend for thinning of the tunica media. There were no significant changes in control arteries subjected to angioplasty. Angioplasty was not associated with significant arterial fibrosis as measured by hydroxyproline content (analysis of variance). The increase in endothelial proliferation and decrease in the thickness of the tunica media suggest that, in the rabbit model, angioplasty damages endothelial and smooth-muscle cells. This may be the basis for the observation that vasospastic arteries do not reconstrict after angioplasty.

Analysis of Variance↗

Comparative intraoral tolerance of sodium hexametaphosphate and pyrophosphate antitartar dentifrices.

A randomized, controlled clinical trial was conducted to assess the relative acute oral tolerance of a novel, dual-phase, tartar control dentifrice containing 7.0% sodium hexametaphosphate (5% hexametaphosphate anion). In this 4-day study, 159 healthy adult volunteers were randomly assigned to the experimental sodium hexametaphosphate dentifrice or a marketed, single-phase, antitartar dentifrice control containing 5.0% ionic pyrophosphate. A detailed oral soft tissue examination and interview were conducted each day by blinded evaluators to elicit clinical signs and symptoms associated with ad libitum use of the assigned dentifrice. A total of 24 subjects (15% of the study population) had new symptoms/signs after baseline. By treatment, 9% of subjects in the sodium hexametaphosphate group had new findings, compared to 21% of subjects in the pyrophosphate group, and these groups differed statistically (p < 0.03, two-sided) with respect to occurrence. In addition, onset, severity, duration and clinical presentation were generally milder in the sodium hexametaphosphate group compared to the pyrophosphate control. Only one subject (in the pyrophosphate group) discontinued treatment early due to oral intolerance. In this study, the 7.0% sodium hexametaphosphate dentifrice was well-tolerated, with significantly fewer symptoms and superior overall tolerance compared to the marketed antitartar dentifrice control.

Adult↗

[Present-day sports activities among the blind and persons with poor vision in different countries of the world].

The approach of a country to persons with limited physical abilities is an important component of country's social-and-cultural policy. Blindness is a most severe variety of health disorders leading to social defect and social insufficiency. The role of adaptive physical culture is important within the system of the social-and-medical rehabilitation of the blind because the sedentary life mode has a negative effect on organisms of the disabled due to vision. Sports is not only a method for correcting the general somatic condition, but it is also an important social-and-physiological factor that enables the blind to comprehend their abilities as an example for others. As for our country, the information about the modern sports activities among the disabled due to vision is absolutely insufficient for the public at large. An analysis of results of examination (conducted by using the computer data base of the International Blind Sportsmen Association--IBSA) of 2386 blind and impaired vision sportsmen is presented in the paper. Data about sport disciplines and types of ophthalmic pathologies encountered among the high-class blind and impaired vision athletes from different world countries are described. The above data can be helpful in elaborating the rehabilitation programs for persons with severe disorders of the organ of vision to be used in rehabilitation centers, sport federations and clubs of the disabled as well as in other institutions dealing with rehabilitation of the disabled due to vision in our country.

Blindness↗

[Objective evaluation of respiratory ventilation at work by measuring peak expiratory flow rate (PEFR)].

Eleven patients suffering from baker's asthma, 27 patients with bronchitis and 2 patients with suspected bronchial asthma resulting from occupational exposure to formaldehyde were subjected to a single blinded 3-day observation. Clinical symptoms' analysis and PEFR were performed to diagnose asthmatic symptoms at the workplaces. In all the patients with barker's asthma bronchoconstriction was observed as a result of exposure to formaldehyde on both "no drug" and "placebo" days. No bronchoconstriction on the "bronchodilator" day was observed. Reactions to other asthmatic and bronchitic patients differed significantly. The proposed model seems to be useful as a routine diagnostic procedure in occupational asthma.

Allergens↗

[Clinical analysis of 107 cases with chemical burns].

From 1978 to 1987 107 cases of chemical burns were treated. The patients were mainly young and middle age people (83.08%), with mean burned areas 17.8%. The majority of involved parts were low extremities. 57.44% of burned eyes became blind. Mean days in hospital were 43 days. Cure rate was 98.13% and death rate 1.87%. We emphasized that burned wounds must instantly be washed down with water, intoxication resulting from chemical matters must be effectively treated. Diagnosis of depth of burned wound by acids and means of prevention of chemical burns were also discussed.

Adolescent↗

Etodolac compared with aspirin: an endoscopic study of the gastrointestinal tracts of normal volunteers.

Forty-eight normal men participated in a 14-day, single blind, single center, multiple dose study of gastric irritation using endoscopy. Subjects were randomly assigned to one of 4 treatment groups after a one week lead-in period, as follows: etodolac 200 mg BID, 400 mg BID, 600 mg BID, or aspirin 975 mg QID. Etodolac at all dose levels produced significantly (p less than or equal to 0.0001) less gastrointestinal irritation than aspirin as assessed by endoscopic examination of the gastric and duodenal sites. There were no significant differences among the 3 etodolac groups.

Acetates↗

The prospective diagnostic value of real-time cholecystosonography.

A series of 82 consecutive patients scheduled for operation, with pre-operatively obtained P.O. cholecystography and in some cases also I.V. cholangiography, is presented. All patients had cholecystosonography performed "blindly" the day prior to the operation (76 had a cholecystectomy and six had a vagotomy). Based upon the operative findings, the diagnostic value of ultrasonic examination for gallstones can be calculated to predictive value of positive test--1.00; predictive value of negative test--0.71. The diagnostic failures are discussed but it is not possible to predict which patients will benefit more from peroral cholecystography rather than from ultrasound. It is concluded that cholecystosonography is a safe alternative to peroral cholecystography.

Cholangiography↗

[Hypotensive effect and tolerability of a short course of treatment with prazosin (pratsiol) and hydralazine (apressin) in a cooperative study of new drugs for the prevention of arterial hypertension].

The hypotensive effect and tolerance of a 2-3 week course treatment with pratsiol (n = 59) and apressin (n = 60) were studied in patients with stage II essential hypertension and symptomatic arterial hypertension requiring no special therapy (diastolic arterial pressure in the horisontal position being 95 mm Hg and over). Seven patients were treated with apressin and pratsiol for 14 days under blind cross-over conditions. When used along for 2-3 weeks, apressin and pratsiol induced a hypotensive effect in 53% and 75% of the patients (p less than 0.05), respectively. When used in conjunction with hydrochlorothiazide, the hypotensive effect of apressin was 85%, that of pratsiol 93%. The daily effective dose of apressin equalled 155 +/- 9.9 mg, of pratsiol 9.3 +/- 0.6 mg. Side-effects of apressin were observed 3 times as often as with pratsiol (79% and 27%, respectively; p less than 0.01). The rate of discontinuation of apressin for side-effects reached 35% of the patients, whereas in pratsiol treatment it was only 1.6%.

Adult↗