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At least 541 records · Page 30Linked to original sources
PubMed2001

[Efficacy of lidocaine cream in protecting against thermal stress during hyperthermia].

Hyperthermia is performed in combination with chemotherapy as multimodal treatment for recurrent and advanced cancer. It is generally believed that the temperature cannot be raised higher because of thermal stress. In this study, we examined the efficacy of lidocaine cream in protecting against thermal stress during hyperthermia. We devised a new local anesthetic cream containing 5% lidocaine. The subjects were eighteen patients with stomach cancer, liver cancer, or large intestine cancer. This cream was applied locally to the skin with an occlusive dressing for about one hour before hyperthermia was performed, and was wiped away just before hyperthermia. The pain scores in the treatment group were significantly lower than in the no-treatment group (p < 0.05). The scores for sensation of heat in the treatment group were lower, though not to a significant extent, than those in the no-treatment group. No adverse effects were observed. Plasma concentrations of lidocaine were lower than 0.5 microgram/ml, and percutaneous absorption of lidocaine from the lidocaine cream was minimal.

Anesthetics, Local↗
PubMed2001

[Clinical effect of salicylic acid and high dose urea applied according to the standardized New German Formulary].

OBJECTIVE: To determine whether salicylic acid and high dose urea in five different NRF (New German Formulary) formulations have an effect on stratum corneum. METHODS: 20 healthy volunteers had their stratum corneum blacked with silver nitrate and a photographic developer, and a chromameter (a*-value) was used to determine the amount of discoloration produced by the study products and the drug free vehicles after 24 hours semiocclusive application and 24 hours later. The change in fingerpad ridge width produced by the study formulations and drugfree vehicles was determined at the same time, using the Hikoscope Dermatoscope after 30 and 35 minutes' use under an occlusive dressing. The results obtained with the two methods were correlated. RESULTS: All study formulations were effective. There were differences in the time course of the effects on the stratum corneum. The fingerpad ridge width method is not a measure of keratolytic activity because there were no significant correlations between the results obtained with the two methods. Also, 40% urea was keratolytic in the silver nitrate test, but had no effect of fingerpad ridge width. CONCLUSIONS: All NRF study formulations were effective in the stratum corneum. The fingerpad ridge width method is not a measure of keratolytic activity but rather of an other unknown effect of salicylic acid.

Administration, Topical↗
PubMed1965

Ultraviolet-induced acantholysis in pemphigus.

Ultraviolet irradiation produced an acantholytic phenomenon in normal skin of seven patients with pemphigus foliaceus. In six of the seven patients, this reaction was manifested by a positive Nikolsky sign and was confirmed by biopsy in four. Friction alone, infrared irradiation, occlusive dressing, and a rubefacient failed to produce a similar reaction. The thermal burn in the skin of patients having pemphigus was of subepidermal type. Ultraviolet-induced acantholysis was inhibited by chloroquine phosphate, taken orally, in the two patients tested. Prednisone had no such effect. It is concluded that ultraviolet light is a major aggravating stimulus for pemphigus foliaceus.

Acantholysis↗
PubMed2002

Cushing's syndrome caused by topical steroid therapy for psoriasis.

A 72-year-old woman developed manifestations of Cushing's syndrome after long-term topical steroid therapy for psoriasis. Shortly after tapering the dose of topical steroids she developed signs of adrenal insufficiency (provoked by a urinary tract infection) requiring intravenous administration of a stress dose of hydrocortisone. There have only been a few reports of systemic side effects of topically applied corticosteroids in adults. Considering their serious consequences physicians should be alert to signs of Cushing's syndrome in patients on long-term topical steroid therapy. Furthermore, clobetasol propionate ointment doses exceeding 50 g a week should not be prescribed and use of occlusive dressings should be avoided.

Administration, Topical↗
PubMed2002

Using oral tetracycline and topical betamethasone valerate to treat acrodermatitis continua of hallopeau.

Acrodermatitis continua of Hallopeau (ACH) is a rare type of localized pustular psoriasis. We report the case of a 65-year-old alcoholic woman who had severe inflammatory ACH for 10 years. Initial therapy with sulfasalazine was unsuccessful. The patient was then treated with oral tetracycline and topical betamethasone valerate with occlusive dressing. Her condition improved dramatically after one week.

Acrodermatitis↗
PubMed2003

Evaluations of inhibitory effect on the motor cortex by cutaneous pain via application of capsaicin.

To evaluation the effect of experimental tonic cutaneous pain on motor cortex excitability by means of transcranial magnetic stimulation (TMS). Thirty healthy adults (male: 12, female: 18) were tested with TMS. Cutaneous pain was induced by topical application of capsaicin cream (0.025%) on the skin overlying the flexor carpi radialis of dominant limb. And the cream had been under an occlusive dressing for 40 minutes until we removed it. Magnetic stimulation was performed to the contralateral cortex with a circular coil at 80% intensity of maximum stimulator output. MEPs were recorded at flexor carpi radialis (FCR), extensor carpi radialis (ECR) and opponens pollicis (OP) with constant isometric contraction of 10%, 30% maximal voluntary contraction (MVC). Main outcome measures the intensity of pain by visual analog scale (VAS). The latency, amplitude and silent period of motor evoked potentials (MEPs). Values at baseline and 20, 40, 60, 80 minutes from applying capsaicin were compared. VAS score reached the peak value at 40 minutes. Amplitudes of MEPs at FCR progressively decreased up to 40 minutes than returned to nearly baseline value at 80 minutes. The decrease in MEP amplitude at FCR was accompanied by the increase in VAS score significantly and sustained for 20 min after washing out capsaicin cream. At ECR & OP, we could not demonstrate any changes in amplitude with time. Silent period at FCR only was significantly prolonged with the increase in VAS score. The present findings support that noxious cutaneous stimulation inhibit motor cortex excitability by so-called cortico-cortical circuits.

Administration, Cutaneous↗
PubMed2003

[Latent sources of contact allergy].

In individuals sensitized to many contact allergens in the course of 4th immunological mechanism, in whom allergic contact dermatitis develops at the site of exposure to haptens, disseminated eczematous skin lesions might be provoked by latent source of hapten, which penetrates to the body omitting the skin. The most frequent clinical situations include: allergy to drugs, food additives, inhaled chemicals originated from plants, allergic reactions to metal endoprostheses used in orthopaedics and/or dentistry, and all conditions facilitating penetration of hapten directly to the blood through damaged skin (erosions, ulcers, etc.) and/or under occlusive dressings.

Dermatitis, Contact↗
PubMed1992

Evaluation of the local anaesthetic activity of dimetindene maleate by means of laser algesimetry in healthy volunteers.

Dimetindene maleate (DMM, Fenistil, CAS 3614-69-5) a specific H1-receptor antagonist, is therapeutically used for the treatment of respiratory allergies, urticaria, itching dermatoses and generally pruritic sensations occurring with various diseases. As it exhibits local anaesthetic activity in the rabbit cornea and the local anaesthetic activity of a couple of H1-antagonists was found to be linearly correlated to the H1-potency represented by the pA2-values--and dimethindene maleate demonstrates a high pA2-value--it seemed worth investigating the local anaesthetic potency in man making use of an objective and well validated pain model, the Laser algesimetry. The study was carried out with 24 healthy volunteers in a double-blind placebo- and reference-controlled, randomized, cross-over design. Three different medications were applied with occlusive dressing: DMM, lidocaine, and placebo. Selective thermo-noxious stimulation of A-delta- and C-fibers was induced by a CO2-laser. Somato-sensory evoked vertex potentials (SEPs) were simultaneously recorded. Both verum treatments showed a remarkable analgesic potency compared to placebo. Effects were preferably concentrated on the peripheral N1-component of the SEPs. The overall means of the N1-amplitudes were suppressed compared to placebo by both active drugs, with the effects being more pronounced for DMM.

Adolescent↗
PubMedDate not supplied

Ablative laser resurfacing -- postoperative care.

Wound care after laser skin resurfacing (LSR) is critical for achieving a successful result. The superficial thermal injury created by LSR heals more quickly and with a reduced risk of scarring under occlusion. While open and closed wound care regimens can be employed to expedite reepithelialization, closed methods with semi-occlusive dressings may decrease morbidity. Effective medications and management techniques can help to minimize expected effects of the procedure such as crusting, discomfort, pruritus, erythema, and swelling.

Aged↗
PubMed1992

Intravenous access. Part 1. Peripheral i.v.s.

The nursing care of the patient with a peripheral IV requires the implementation of the basic principles of intravenous care. Because the integrity of the skin is broken, measures are implemented to prevent the occurrence of infection. Skin preparation of the venipuncture site is important in preventing the introduction of organisms into the IV insertion site. The regular care of the insertion site and maintenance of an occlusive dressing prevent further IV site contamination. The use of peripheral IVs constructed of certain materials, the use of normal saline over heparin flush solution to maintain IV patency, and an established routine of changing IV sites at regular intervals remain controversial issues. Nurses need to keep abreast of new IV products and new research findings to better care for patients with peripheral IVs.

Catheterization, Peripheral↗
PubMed2004

Clinical presentations of patients sensitive to natural rubber latex.

BACKGROUND: Eczematous reactions to natural rubber latex (NRL) have been associated with both immediate and delayed hypersensitivity. OBJECTIVE: To determine clinical cases that might require testing for immediate sensitivity or patch testing for delayed hypersensitivity to latex fabric. METHODS: Patients with suspected sensitivity to NRL were given in vitro testing by radioallergosorbent test (RAST) or ImmunoCAP test and if negative, were prick-tested. If prick-test results were negative and the patients were still available, patch testing was done with latex glove fabric. Case histories of persons with positive results on RASTs, ImmunoCAP tests, prick tests, and patch tests were reviewed for clinical presentation and relevance. RESULTS: Of 92 persons with positive responses, 26 had positive RAST results, 26 had positive ImmunoCAP test results, 33 had positive prick-test results, and 7 had a positive patch-test result. Presentations included hand urticaria or eczema (46 patients), eyelid dermatitis (14), shoe dermatitis (10), atopic eczema (6), waistband dermatitis (5), clothing dermatitis (3), contact eczema to elastic in a mask (2), urticaria to a phlebotomy tourniquet, and eczema over the elbows and from an elastic bandage used for occlusive dressing therapy. Several other presentations were less likely to be relevant. CONCLUSION: Persons with putative contact dermatitis in areas that may come into contact with NRL deserve not only to be patch-tested with rubber chemicals but also to be tested for immediate sensitivity and, if results are negative, to be patch-tested with NRL.

Adolescent↗
PubMed2005

Near-miss injection of an anesthetic agent into a cerebrospinal fluid external ventricular drain: special report.

OBJECTIVE AND IMPORTANCE: Human error has been increasingly recognized as a cause of patient morbidity and mortality. One method of error prevention is the reporting of a near-miss event. We report that intravenous anesthetic agents were nearly injected into the external ventricular drainage (EVD) of a patient during an emergency shunt procedure. CLINICAL PRESENTATION: A 3-year-old male patient with multiple cerebrospinal fluid shunts and shunt infection had an external ventricular drain catheter tunneled to exit just inferior to the left clavicle during a previous procedure. The exit site was covered by an occlusive dressing. This particular system, the Codman external drainage system II collection bag and tubing set (Codman & Shurtleff, Inc., Raynham, MA), contains two access ports (a three-way stoppered port and an angled rubber stoppered injection port). At induction of anesthesia, the EVD system was mistaken for a central venous line and was nearly injected with propofol and rocuronium. Fortunately, the error was quickly recognized and the patient came to no harm. INTERVENTION AND TECHNIQUE: A modified EVD system has recently been released that does not include the three-way port, and features an embedded bright green stripe in the tubing to distinguish it from intravenous tubing. CONCLUSION: We recommend using caution when tunneling EVDs to sites that might be confused with central venous access sites. EVD system tubing should be designed so it can be easily distinguished from intravenous tubing, and it should be clearly labeled as an EVD line.

Anesthetics↗
PubMed2005

Cumulative irritation potential of adapalene 0.1% cream and gel compared with tretinoin microsphere 0.04% and 0.1%.

Despite the many beneficial effects of dermatologic applications, most of the current treatments for acne cause local irritation. The objective of this study was to compare the ability of the epidermis to tolerate adapalene 0.1% cream and gel and tretinoin microsphere in concentrations of 0.04% and 0.1%. A total of 31 subjects were enrolled in the study. The test products were applied under occlusive dressings on the upper back for approximately 24 hours, 4 times a week, and for 72 hours, once a week, for a period of 3 weeks. Skin reactions (erythema score plus other local reactions) at the product application sites were assessed 5 to 30 minutes after dressing removal. Twenty-six subjects completed the study. A total of 10 subjects discontinued use of 1 or more of the test products because of irritation scores reaching severe or greater, all of these discontinuations were at sites treated with the tretinoin products. The mean 21-day cumulative irritancy indices for adapalene 0. 1% cream and gel were significantly lower (P<.01) than those for tretirnoin microsphere 0.04% and 0. 1% and not higher than that of the negative control product.

Adapalene↗
PubMed2005

Cumulative irritation potential of adapalene 0.1% cream and gel compared with tazarotene cream 0.05% and 0.1%.

Despite the many beneficial effects of dermatologic applications, most of the current treatments for acne cause local irritation. The objective of this study was to compare the ability of the epidermis to tolerate adapalene 0.1% cream and gel and tazarotene cream in concentrations of 0.05% and 0.1%. A total of 30 subjects were enrolled in the study. The test products were applied under occlusive dressings at randomized sites on the upper back for approximately 24 hours, 4 times a week, and for 72 hours, once a week, for a period of 3 weeks. Skin reactions (erythema score plus other local reactions) at the product application sites were assessed 15 to 30 minutes after dressing removal. Twenty-six subjects completed the study. A total of 16 subjects discontinued use of 1 or more of the test products because of irritation scores reaching severe or greater; all but one of these discontinuations were at sites treated with the tazarotene products. The mean 21-day cumulative irritancy indices for adapalene 0.1% cream and gel were significantly lower (P=.05) than those for tazarotene cream 0.05% and 0.1% and not notably higher than that of the negative control product.

Acne Vulgaris↗
PubMed1991

[Direct comparison of the effect of various synthetic skin replacement materials on the defect].

The reaction of wounds up to 6 days old to the influence of six different temporary skin replacement materials was studied in rats. The histological work-up 1-7 days later showed material-dependent differences in wound reaction. The rate of adherence to the wound surface and the amount of granulation tissue, vascularization, and reepithelization was determinded. There is no ideal material; the special properties of each temporary skin substitute should be used according to the different surgical aims.

Animals↗
PubMed1991

Pressure ulcers. Physical, supportive, and local aspects of management.

Pressure ulcers are a common and serious problem predominately among elderly persons who are confined to bed or chair. Additional factors associated with pressure ulcer development include cerebrovascular accident, impaired nutritional intake, urinary or fecal incontinence, hypoalbuminemia, and previous fracture. Implementation of preventive measures, such as an in-depth assessment for mobility, a pressure-relieving device combined with adequate repositioning, and thorough evaluation for nutritional status and urinary incontinence, significantly reduce pressure ulcer incidence. If the pressure ulcer is a partial thickness (stage II) wound, the causative factors are probably friction or moisture. If the ulcer is full thickness (stage III and IV), it is secondary to pressure or shearing forces. The development of wound infection is the most common complication in the management approach. Osteomyelitis is not an uncommon occurrence and must be initially ruled out in all full thickness pressure ulcers. Surgical debridement of necrotic tissue is necessary prior to further treatment and assessments. Antibiotic therapy is indicated only upon evidence of infection (cellulitis, osteomyelitis, leukocytosis, bandemia, or fever). Topical pharmacologic agents may be used to prevent or treat infection but must be carefully controlled to avoid such adverse effects as toxicity to the wound, allergic reaction, and development of resistant pathogens. Proper use of occlusive dressings increase patient comfort, enhance healing, decrease the possibility of infection, save time, and reduce costs. A patient presenting an ulcer that fails to improve or, because of its size, will take a great deal of time to heal should be evaluated for surgical closure.

Aged↗
PubMed1991

Restoring nitrogen balance after burn injury.

The metabolic response to burn injury is characterized by weight loss and marked protein wasting. This phenomenon is mediated hormonally, resulting in hypermetabolism. Energy expenditure increases linearly with the extent of burn injury, reaching a plateau of twice resting energy expenditure when 50% of the total body surface area is involved. It is therefore essential to minimize other factors that may further augment postburn catabolism. Occlusive dressings, a warm ambient environment, analgesics, and timely closure of the burn wound are all important therapeutic measures in this regard. Furthermore, it is imperative to institute early nutritional support in order to offset the negative metabolic effects of severe burn injury.

Burns↗
PubMed1990

The effect of nicardipine, a calcium channel blocker, on the sweat test in adult patients with cystic fibrosis.

In vitro studies have suggested a potential role for calcium channel blockers in manipulating the basic ionic defect of cystic fibrosis. In 17 adult patients with cystic fibrosis nicardipine was administered either intravenously or topically using iontophoresis or occlusive dressings. Sweat tests were performed before and after drug administration and examined using two way analysis of variance. No statistically significant difference was observed. We conclude that nicardipine used in vivo does not exert the easily demonstrable effect on the chloride ion defect that has been observed with other agents in vitro.

Adult↗