bluuebunny/crossref_metadata_2025 huggingface dataset:
Plasma Lactoferrin as a Marker of White Cell Degranulation in Venous Disease
Authors: Shields D. A. , Andaz S. , Abeysinghe R. D. , Porter J. B. , Scurr J. H. , Smith P. D. Coleridge
Published: January 2017

Objective:

To measure plasma lactoferrin as a marker of neutrophil degranulation in groups of patients with varying severity of venous disease and compare with age- and sex-matched control subjects.

Design:

Prospective study of patients with varicose veins compared with a group of control subjects with no history or clinical findings of varicose veins.

Setting:

The Middlesex Hospital Vascular Laboratory, Mortimer Street, London WIN 8AA, UK.

Patients:

Patients referred to the Middlesex Hospital Vascular Laboratory for investigation of venous disease. Control subjects were obtained from within the laboratory and hospital staff, and from a group of Patients attending the London Foot Hospital for routine chiropody. Neither group had arterial disease nor any other illness or medication known to alter white cell activity.

Interventions:

10 ml of blood taken from an arm vein into EDTA for a neutrophil count and measurement of Plasma lactoferrin using an ELISA.

Results:

Significantly raised plasma lactoferrin was found in all four groups of patients compared with their controls ( p = 0.0156 for uncomplicated varicose veins, P = 0.01 for lipodermatosclerosis, p = 0.0413 for active venous ulceration, and p = 0.0005 for healed ulcers, Mann-Whitney U-test). Differences between medians (95% confidence interval) for the four groups were 269 (62–603), 199 (60–314), 133 (44–218) and 215 (98–349) ng/ml respectively. There was no difference in the neutrophil count between the patient and control groups, and correcting plasma lactoferrin for the neutrophil count did not remove significance in any group.

Conclusions:

This study shows evidence of increased neutrophil activation as shown by increased degranulation in patients with venous disease.
An Investigation of the Vasa Venarum in a Canine Vein Using Radial Reflux Perfusion
Authors: Crotty T. P.
Published: January 2017

Objective:

A general investigation of the vasa venarum network in a segment of canine peripheral vein, isolated between cannulae in an amputated hindlimb.

Technique:

The vasa venarum were perfused with ink by reflux from the lumen of the segment. The technique worked only when the vein segment was actively constricted and its flow made turbulent.

Results:

Vasa venarum were found to have the potential to drain, by unvalved channels, directly into their parent segment, into neighbouring veins, into the vasa networks of neighbouring arteries, veins and lymphatics, and into the postcapillary networks of every tissue in the hindlimb. The network contained dedicated arteriovenous anastomoses which drained by valved channels into the parent segment. A feature of the perfusion technique was the production of acute experimental varices.

Conclusions:

The drainage of the vasa venarum is far more complex than it is believed to be at present. The demonstration that reflux is possible from a vein with competent valves and is associated with the production of varices may have clinical implications.
Phlebography in the Management of Recurrent Varicose Veins
Authors: Mosquera D. A. , Manns R. A. , Duffield R. G. M.
Published: January 2017

Objectives:

(1) To report the results of phlebography (varicography and venography) in the identification of important venous communications in patients with reurrent varicose veins. (2) To assess whether phlebography provides additional valuable information when compared with clinical and hand-held Doppler examination.

Design:

Retrospective review.

Setting:

Vascular unit, district general hospital.

Patients:

A consecutive series of 46 patients attending with recurrent varicose veins.

Interventions:

Clinical examination, hand-held Doppler, venography and varicography.

Main outcome measures:

(1) Sites of incompetent venous communications. (2) Assessment of value of preoperative phlebography when compared with clinical and hand-held Doppler examination.

Results:

Sixty-four venograms were performed on 46 patients of mean age 52 years, range 30–81 years. Calf perforator (88%) and mid-thigh perforator incompetence (38%) were common. Groin recurrence (33%) included examples of neovascularization, inadequate previous surgery and inadequate assessment. Popliteal recurrence (34%) secondary to incompetent gastrocnemius, popliteal fossa and short saphenous veins also present. Preoperative phlebography supplied valuable additional information in 75% of Patients.

Conclusion:

Phlebography of recurrent varicose veins provides useful information supplementary to that furnished from clinical examination alone.
Comparison of Three Exercises for Evaluation of the Calf Muscle Pump
Authors: Ohgi S. , Tanaka K. , Maeda T. , Kanaoka Y. , Ikebuchi M. , Hara H. , Mori T.
Published: January 2017

Objective:

To evaluate accurately the calf muscle pump in patients with venous insufficiency using foot vein pressure measurements during three different exercises.

Design:

Prospective study in three groups, comparing patients with venous disease with controls.

Setting:

Second Department of Surgery, Tottori University Faculty of Medicine.

Patients:

Twenty normal legs, 29 legs previously affected by deep vein thrombosis and 36 legs with primary varicose veins.

Main outcome measures:

The foot vein pressure was measured during ankle dorsiflexions, knee-bending and walking on the spot at 40 paces per minute during which minimum ambulatory venous pressure (AVP) and venous refilling time (VRT) were assessed.

Results:

The three groups differed significantly from each other in AVP and VRT after dorsiflexion and in AVP during walking on the spot, but not after knee-bending.

Conclusion:

Dorsiflexion is the most useful exercise distinguishing various severities of venous insufficiency, but walking on the spot is more useful for accurately evaluating the calf muscle pump.
The Role of Oedema Protective Drugs in the Treatment of Chronic Venous Insufficiency: A Review of Evidence Based on Placebo-Controlled Clinical Trials with Regard to Efficacy and Tolerance
Authors: Diehm C.
Published: January 2017

Objective:

To review the therapeutic efficacy and tolerability of oedema protective agents such as diosmin, horse chestnut extract and O-(β-hydroxyethyl)-rutosides in the treatment of chronic venous insufficiency (CVI).

Data selection:

Relevant clinical studies were selected if they were performed using a double-blind, placebo-controlled design with validated instrument measurement of objective criteria and measurement of subjective criteria by standardized methods.

Data synthesis:

Judgement of clinical effectiveness of drug treatment with venoprotective/venotropic agents was based on the signs and symptoms of CVI. Measurements; Accepted for consideration included reduction of leg oedema, related subjective symptoms, improvement of haemodynamics and microcirculation, and improved healing of venous ulcers. Tolerability of the compounds in therapeutic use was assessed by comparing the frequency of side-effects in treatment and placebo groups.

Conclusion:

Oedema protective agents such as diosmin, horse chestnut extract and O-(β-hydroxyethyl)-rutosides are an appropriate option in the management of CVI. The clinical efficacy can be measured objectively and quantified by assessing oedema reduction or in the case of venous ulcers by ulcer healing rates. The extent of oedema reduction in patients with CVI is equivalent to the reduction achieved by compression therapy with elastic stockings as seen in a recent clinical study. Combined treatment of oedema protective agents and compression therapy has a better clinical benefit compared with treatment with either alone. The compounds have a favourable benefit/risk ratio. They combine proven therapeutic efficacy with excellent safety of use confirmed in a large number of patients treated in clinical trials.
Cutaneous Blood Flow in Legs with Severe Chronic Venous Insufficiency Recorded before and after a Single Treatment Using Intermittent Pneumatic Compression
Authors: Malanin K. , Kolari P. J. , Haapanen A. , Helander I. , Havu V. K.
Published: January 2017

Objective:

To investigate the skin laser Doppler flux (LDF) in legs with severe chronic venous insufficiency (CVI).

Design:

Comparison of the legs with severe CVI with the healthy legs and with the patients' contralateral legs.

Setting:

Department of Dermatology, University of Turku, Turku, Finland.

Patients and control subjects:

Ten patients and eight age-matched subjects with healthy legs.

Interventions:

A single treatment using intermittent pneumatic compression (IPC) of 45 min duration.

Main outcome measures:

Laser Doppler flowmetry with the subjects in a recumbent and a sitting position.

Results:

The LDF values were higher for the legs with severe CVI than for the legs of healthy subjects ( p<0.001 in a recumbent and p<0.01 in a sitting position). A single IPC increased the LDF in a recumbent position in the patients' legs with severe CVI ( p=0.019) but had no significant effect on the LDF value in the sitting position. The venoarteriolar response was significantly better in the legs with severe CVI than in the legs of healthy subjects ( p<0.05).

Conclusions:

The LDF is increased in legs with severe CVI and a single IPC further increases it in a recumbent position. The venoarteriolar response is not impaired in legs with severe CVI.
Prevalence and Aetiology of Leg Ulcers in a Defined Population of Industrial Workers
Authors: Nelzén O. , Bergqvist D. , Fransson I. , Lindhagen A.
Published: January 2017

Objective:

To assess leg ulcer prevalence and aetiology in people below retirement age.

Design:

A validated cross-sectional questionnaire survey. Respondents with a history of leg ulcers were examined.

Setting:

A defined population of industrial workers.

Subjects:

All 2785 employees, aged 30–65 years, at the Volvo motor engine factories in Skövde were included. Men predominated (81%) and the median age was 44 years in both men and women. A questionnaire was used to select people with a history of ulceration. A leg ulcer was defined as ‘any wound below the knee (foot ulcers included) that did not heal within a 6-week period after onset of ulceration’.

Main outcome measures:

Point prevalence of open leg ulcers, overall prevalence of leg ulcer history and aetiological classification.

Results:

The overall response rate was 87%, and 131 out of 153 subjects with a ‘history of leg ulcers’ were examined (86%). In 98% of positive responders the answers were validated. The overall false-positive response rate was 64%. Fifty-four had a true history of ulcers, of whom 16 had open ulcers. Of the latter, 12 were self-caring (75%). Overall venous causation dominated (41%). The ratio of open to healed ulcers was 1:2. The point prevalence for open ulcers was 0.6% and the overall prevalence of ulcer history was 1.6%, if excluding pure traumatic ulcers. The point prevalence was tenfold higher in people aged below 50 years and seven times higher in the age decade 50–59 years if compared with previous estimates based on patients known to health-care professionals.

Conclusion:

Leg ulcer prevalence has been underestimated in people of working age because they are often self-caring. Since many ulcers have curable causes it is necessary to inform the public of the importance of seeking professional help early.
Venous Aneurysm of the Upper Limb
Authors: Rogers C. A. , Colin J. F.
Published: January 2017

Objective:

To report a case of primary venous aneurysm arising in the antecubital fossa.

Design:

Case report.

Setting:

Department of General Surgery, Norfolk & Norwich Hospital, Norwich.

Patient:

Patient with clinical and radiological evidence of venous aneurysm.

Interventions:

Surgical repair.

Main outcome measures:

Avoidance of pulmonary embolism.

Results:

Satisfactory post-operative recovery. No complications or subsequent pulmonary embolus.
A Pilot Study Comparing the Use of Below-Knee and Above-Knee Graduated Stockings in Patients with Superficial Venous Incompetence
Authors: Berridge D. C. , Mercer K. G. , Thornton C. , Weston M. J. , Scott D. J. A.
Published: January 2017

Objective:

Investigation of the effects of high- and low-ankle-pressure, above- and below-knee compression stockings on the haemodynamics of normal and superficially incompetent venous systems.

Design:

Prospective duplex study of a normal group and a venous incompetence group randomised to high- or low-pressure stockings.

Setting:

Vascular services of a University Hospital.

Subjects:

Six subjects with normal venous haemodynamics (12 limbs) and 12 patients with superficial venous incompetence (20 limbs).

Methods:

Subjects wore below-knee and then above-knee stockings for 1 week each. Duplex scans were performed at the outset and end of the study and on fitting and after wearing each stocking type.

Main outcome measures:

Duplex-derived femoral and popliteal venous velocities were measured and indexed against the initial velocity.

Results:

Below-knee stockings produced only minor changes. Above-knee stockings produced increased velocities in normal subjects. Similar changes were only seen with higher-pressure stockings in patients with incompetence.

Conclusion:

Above-knee, high-ankle-pressure stockings produce increased deep venous flow velocities.
Randomised Trial Comparing Two Four-Layer Bandage Systems in the Management of Chronic Leg Ulceration
Authors: Moffatt C. J. , Simon D. A. , Franks P. J. , Connolly M. , Fielden S. , Groarke L. , McCollum C. N.
Published: January 2017

Objective:

To compare a new four-layer bandage system (Profore) with the original 4LB in the closure of chronic leg ulceration.

Design:

Prospective randomised stratified parallel-groups open trial.

Methods:

Patients newly presenting to community leg ulcer services with chronic leg ulceration were screened for inclusion in this trial. Patients with arterial disease (ankle brachial pressure index <0.8) and causes of ulceration other than venous disease were excluded. In patients with bilateral ulceration, the limb with the larger area of ulceration was studied. The ulcer was dressed with a simple low-adherent dressing and all bandages were changed weekly unless required more frequently. Patients were randomised to receive either the original four-layer bandage or the newer system (Profore).

Results:

In all 233 patients were randomised, of whom 232 attended at least one follow-up visit (115 original, 117 Profore). At 12 weeks complete healing of the ulcerated limb, analysed by ‘intention-to-treat’ was 60% using the original 4LB compared with 72% using Profore. The difference of 11.8% (95% confidence interval (CI) −0.3% to 23.9%) had largely disappeared after 24 weeks, with 73% healed using the original 4LB and 76% using Profore, a difference of 3.0% (95% CI −8.2% to 14.2%). After 24 weeks of treatment the Kaplan-Meier estimate of complete healing was 82% using the original system and 84% using the Profore system. Overall, there was a higher healing rate for patients on Profore (hazard ratio = 1.18, 95% CI 0.87 to 1.59), but this did not achieve statistical significance ( p = 0.28).

Conclusion:

Ulcer healing using the newer Profore system is as good as with the original four-layer system.
Propranolol — B.P. (‘Inderal’) and Hydrochlorothiazide Combination in Hypertension
Authors: Nigam P D , Ravishankar R , Ramachandren K A , Sikand P C
Published: January 2017

Twenty patients with mild and moderate hypertension were treated with varying doses of propranolol along with hydrochlorothiazide 25 mg daily. In eighteen patients ( 90%) the blood pressure control was good. Bronchospasm, congestive heart failure, significant postural hypotension and other bothersome side-effects were not observed. Propranolol has the merit of causing a slow reduction in blood pressure without troublesome side-effects.
A Clinical Study of Bradilan (Tetranicotinoylfructose) in Diabetic Patients with Peripheral Vascular Disease
Authors: Boroda Cyril
Published: January 2017

Nineteen diabetic patients with peripheral vascular disease treated with Bradilan (tetranicotinoylfructose) tablets showed cure or improvement in 14 cases with no adverse effect on their diabetic control. It must therefore be considered a useful drug in the treatment of such diabetic patients with peripheral vascular problems.
Double-Blind Trial of the New Analgesic and Anti-Inflammatory Drug Indoprofen in Post-Episiotomic Pain
Authors: Pedronetto S , Gorini F , Mandelli V , Fuccella L M
Published: January 2017

A double-blind, placebo-controlled trial of indoprofen, a new anti-inflammatory and analgesic drug, was carried out in women with pain due to episiotomy. A single 100 mg dose of the drug proved to be significantly more active than placebo in decreasing pain and was devoid of any side-effects.
Pyritinol* in the Treatment of Chronic Alcoholics
Authors: O'Kelly D J Lane
Published: January 2017

Pyritinol, a drug which is capable of increasing cerebral glucose uptake, has been used in the treatment of 15 alcoholic patients, in conjunction with routine measures. The results of treatment assessed by liver function tests as well as by subjective response, showed that the addition of pyritinol to the routine therapy of such patients increased the rate of recovery.
A Non-Amphetamine Anorectic Agent: Preclinical Background and a Double-Blind Clinical Trial
Authors: Schwartz Louis N
Published: January 2017

Preclinical data suggesting potential advantages for mazindol prompted the design of a double-blind comparative trial with 60 obese patients. In it, mazindol, 2 mg once a day, was compared for 12 weeks to placebo. Weight loss was significantly greater with mazindol than placebo throughout the trial. After the 12 weeks, the mazindol patients had lost an average of 18.5 lbs compared to 2.4 lbs with placebo.

Constant efficacy at the fixed once-daily dosage was obtained with no signs of tolerance. No significant adverse effects or other signs of toxicity to mazindol were encountered. Extensive clinical evaluation of this drug in relation to the established anorectics is strongly recommended.
Amikacin Concentration in the Cerebrospinal Fluid of Children with Acute Bacterial Meningitis
Authors: Trujillo Hugo , Salgado Heli , Uribe Alvaro , Agudelo Nancy , Zapata Carmen Tulia , de Vidal Esther Luisa , Zuluaga Ana Isabel
Published: January 2017

Penetration of the aminoglycoside, amikacin, into the cerebrospinal fluid (CSF) of twenty children with acute bacterial meningitis was studied at various times after intramuscular administration and at various stages of therapy. Six of the patients were evaluated during therapy with amikacin at 7–5 mg/kg (intramuscularly) every 12 hours plus ampicillin every 6 hours at 300 mglkg/day (intravenously); thirteen of the remaining fourteen patients were treated with ampicillin alone, but were given a single intramuscular dose of 7–5 mg/kg of amikacin for evaluation of CSF concentration. Amikacin concentration in CSF with respect to time after administration followed essentially the same pattern as in serum. A minimum concentration of 2 μg/ml was found in 76% of the CSF samples obtained between 0.5 and 7 hours after administration. A mean amikacin serum/CSF ratio of 3:1 was demonstrated up to 7 hours after dose in all patients who underwent clinical improvement. Patient response was predictable by a correlation of in vitro MIC values with in vivo CSF concentration in three of the six patients who received amikacin therapy.
Tolmetin and G-6-PD Erythrocyte Deficiency: Research in Vitro
Authors: Passiu G , Piras M G , Perpignano G , Ibba G , Carcassi U
Published: January 2017

In thirty-two patients, divided into four groups: normal, G-6-PD deficient, β-thalaxemic heterozygote and carriers of both anomalies, the variations in erythrocyte GSH were studied after incubation with APH and a nonsteroidal anti-inflammatory drug: tolmetin sodium. The results obtained show a considerable fall in GSH after incubation with APH above all in the G-6-PD deficient patients and in the carriers of both anomalies.

On the other hand, after incubation with the drug under examination there were no significant variations in the erythrocyte GSH.
Global and Effective Synergism of Amikacin, Gentamicin or Tobramycin when Combined with Carbenicillin against Pseudomonas Aeruginosa
Authors: Ximenes José , Hirai Cláudio K , Takenaka Ivone M
Published: January 2017

The authors describe a study to evaluate the synergistic effects of the combinations of amikacin-carbenicillin, gentamicin-carbenicillin and tobramycin-carbenicillin at the associated minimal bactericidal concentrations and at doses related to the serum levels reached by the drugs in the blood.
Comparative Trial of a New Hypnotic (Finorgal) with Nitrazepam and Triclofos Sodium
Authors: Baiotti Gianni
Published: January 2017

Thirty patients complaining of insomnia were studied in a double-blind trial with crossover of Finorgal, nitrazepam and triclofos sodium. Finorgal given as a hypnotic produced similar results to nitrazepam and triclofos sodium in terms of induction of sleep, duration and quality of sleep, dream recall and morning ‘hangover’. Reported side-effects were not serious and occurred less frequently in association with Finorgal treatment than with nitrazepam or triclofos sodium. Laboratory investigations gave no indication of the development of any drug toxicity during the three-week period of the trial.
The Role of Mesna in the Treatment of Status Asthmaticus in Children
Authors: Kyncl V , Pokorný J , Mega J , Skondia V
Published: January 2017

Status asthmaticus in children is a life-threatening condition that calls for a comprehensive set of therapeutic measures, viz. evacuation of tracheobronchial secretions, parenteral drug administration and improvement of alveolar gas exchange.

In the authors' experience, that therapeutic procedure can be much improved by bronchial lavage with mesna. This is illustrated by the good results obtained in fourteen patients with status asthmaticus and in another forty-four cases of global respiratory insufficiency. Evaluation was by blood gas values and X-ray pictures. The method used for bronchial lavage is described.
Hydrocortisone in an Improved Vehicle
Authors: Pilgaard C E , Nørholm A
Published: January 2017

A comparison of Hydroderm and Hydrokortison DAK on the effect on the symptoms of eczematous disease revealed that in the long run there was no detectable difference of efficacy of the two compounds. The action of Hydroderm, however, was faster than that of Hydrokortison DAK. There were no side-effects of either formulation.
Asymptomatic Hyperuricaemia and its Early Treatment
Authors: Scott W A McDonald
Published: January 2017

Sixteen patients with asymptomatic hyperuricaemia were treated with ‘Citro-Soda®”, an urinary alkanlinizing agent, in a dose of 4 g four times daily for one month. Ten of the sixteen patients exhibited a meaningful reduction in serum uric acid (> 15%). No adverse effects were noted and various haematological and urinary laboratory tests were all normal. ‘Citro-Soda®’ could, therefore, be considered a useful and well-tolerated adjunct in the treatment of hyperuricaemia.
Therapeutic Effect of Pyritinol on Sequelae of Head Injuries
Authors: Kitamura K
Published: January 2017

Two hundred and seventy patients suffering from the sequelae of different forms of brain injury have been treated orally with pyritinol 200 mg three times a day for a period of 6 weeks. It has been shown that, compared with placebo therapy, pyritinol produces statistically significant improvement in the clinical and psychoneurological manifestations. It is concluded that pyritinol is a drug of therapeutic benefit in the treatment of the sequelae of cerebral trauma.
A Double-Blind Trial of Budesonide Ointment and Betamethasone-17-Valerate Ointment in Psoriasis
Authors: Schmidt H , Hjorth N , Salde L
Published: January 2017

In a double-blind within-patient clinical trial in psoriasis, budesonide 0.025% ointment has been shown to be at least as efficient as betamethasone 17-valerate 0.1% ointment. A lower concentration of budesonide ointment, 0.01%, was used for 4 weeks of maintenance treatment. This concentration controlled residual symptoms well in a majority of the patients, thirty-two in number.
A Double-Blind Study of Trazodone and Mianserin in the Treatment of Depression in General Practice
Authors: Richards H H , Midha R N , Miller S
Published: January 2017

The antidepressant and anxiolytic efficacy of trazodone (100–200 mg daily), mianserin (60–120 mg daily) and diazepam (15–30 mg daily) was evaluated in ninety-three patients suffering from mild to moderate depression, with or without anxiety, over 6 weeks in a double-blind non-crossover general practice study. Efficacy was evaluated using the Hamilton Depression Rating Scale, Patient Self-Rating Visual Analogue scales, physician global assessments and the Zung Self-Rating Anxiety Scale.

All three treatments significantly reduced symptoms of depression, as measured on the Hamilton Depression Rating Scale and the physician's assessment of Global Improvement. Trazodone was significantly superior to both mianserin and diazepam. As assessed using Visual Analogue Scales, trazodone was also shown to be significantly superior to diazepam in improving the patient's ability to concentrate and in reducing daytime tiredness. Although evidence of efficacy was found, there were no differences in activity between the treatment groups using the physician's assessment of Current Severity or on assessment of Therapeutic Effect. The treatments all caused a reduction in anxiety as assessed by the Zung Self-Rating Scale.

The overall incidence of side-effects was similar between groups. For those side-effects considered to be significantly interfering with the patient's function, but not outweighing the therapeutic effect, a reduction of dosage was effective. Several patients complaining of drowsiness or lethargy as an unacceptable daytime side-effect were switched successfully from twice daily to night-time dosing. Significantly more patients with side-effects (outweighing therapeutic effect or in the presence of no improvement) were withdrawn from the mianserin group than from the trazodone or diazepam groups.

Overall, the therapeutic efficacy in relation to the incidence of clinically significant side-effects, favoured trazodone for the treatment of general practice patients suffering from depression, with or without anxiety.
Long-Term Treatment with Pivmecillinam in Patients with Recurrent Bacteriuria
Authors: Bresky B , Lincoln K
Published: January 2017

Thirty out-patients with chronic recurrent urinary tract infections, who had failed to respond to 10 days treatment with either pivmecillinam and/or amoxycillin, received a 3-month course of pivmecillinam at a dose of 200 mg, three times daily. Twenty-seven patients had bacteriuria due to Enterobacteriaceae, mainly Escherichia coli, sensitive to mecillinam in vitro. Pivmecillinam eradicated all the initial urinary pathogens. Reinfections occurred during treatment in three patients, who remained asymptomatic.

Four subjects complained of gastro-intestinal side-effects, and therapy was withdrawn in three instances. Another three patients described unusual adverse events towards the end of the course of treatment, described as an odd sensation in the body and a desire for salt. The sensation disappeared a few days after the end of treatment.

Treatment with pivmecillinam had no adverse effect on haematopoietic, hepatic or renal function.
The Acceptability of a Non-Benzodiazepine Hypnotic (Zopiclone) in General Practice
Authors: Chaudoir P J , Jarvie N C , Wilcox G J
Published: January 2017

The hypnotic effects of Zopiclone, a novel cyclopyrrolone derivative, were compared with placebo in a double-blind randomized crossover study in insomniac patients. Subjective morning assessments by the patients showed that Zopiclone 7·5 mg improved the quality of sleep, with a reduction in the sleep onset latency and the number of nocturnal awakenings. Zopiclone was judged by the physicians to be superior to placebo and was preferred by the patients. Subjective residual effects and adverse reactions were minimal.
Absorption of Phenoxymethylpenicillin from Mixtures and Tablets in Healthy Volunteers
Authors: Josefsson Kenneth , Magni Lennart
Published: January 2017

The absorption of the potassium, calcium and benzathine salts of Phenoxymethylpenicillin, given as mixtures, was investigated in twelve healthy volunteers. The potassium salt gave the fas test and highest serum peak levels. Also the relative bioavailability of the potassium salt was greatest, as indicated by the areas under the serum concentration/time curves (AUC). In a second study with twelve other volunteers, the absorption of the mixtures and tablets of the potassium salt was studied. The peak serum levels and AUC were comparable after these preparations. The results in our two studies indicate that, from a pharmacokinetic point of view, the potassium salt of Phenoxymethylpenicillin in mixtures should be preferred in clinical practice. It also appears that the absorption of Phenoxymethylpenicillin from the tablets and mixtures of the potassium salt is comparable, giving the same relative bioavailability.
Hydrocortisone 17-Butyrate (Locoid®) 0·1% Cream versus Hydrocortisone (Uniderm®) 1% Cream in the Treatment of Children Suffering from Atopic Dermatitis
Authors: Veien N K , Hattel T , Justesen O , Nørholm A , Verjans H L
Published: January 2017

A randomized, double-blind, left-right study to compare the therapeutic efficacy of hydrocortisone 17-butyrate (Locoid) 0·1% cream with hydrocortisone (Uniderm) 1% cream was performed in forty children suffering from atopic dermatitis. The medications were applied to symmetrical bilateral skin lesions twice daily for a maximum of 4 weeks or until complete clinical clearance of such lesions had occurred.

Complete clearance of skin symptoms was found in 36% of the Locoid-treated sides and in 23% of the Uniderm-treated sides following 2 weeks of therapy and in 60% and 30%, respectively, after 4 weeks of treatment. This difference in clearance rate after 4 weeks between both preparations was significantly in favour of Locoid cream.

The expressed preferences of patients/parents and investigator were also significantly in favour of Locoid cream, both after 2 and 4 weeks.

No serious side-effects were reported during this study. It is concluded that Locoid cream is significantly superior to Uniderm cream in the treatment of atopic dermatitis in children.
Antianginal Effect of Isosorbide Dinitrate Spray in Patients with Exercise-Induced Stable Angina
Authors: Äärynen Matti , Soininen Kari
Published: January 2017

Ten patients with stable exercise-induced angina took part in this study. Isosorbide dinitrate and placebo sprays were administered in a double-blind, randomized crossover study. The dose of isosorbide dinitrate given was two squirts (=2–5 mg) 2 min before testing. When taken before exercise it significantly improved (p≤0.014) exercise tolerance. Significant (p≤0.0005) ischaemic changes in the electrocardiogram also occurred. These effects occurred later than with placebo. Exercise time was prolonged with the active drug. The results of this study show that isosorbide dinitrate spray improves the exercise tolerance of patients with ischaemic heart disease.
Effect of Esaprazole on Gastric Mucosal Potential Difference after Oral Administration of Aspirin (ASA)
Authors: Ardizzone S , Sangaletti O , Ghirardosi C , Porro G Bianchi
Published: January 2017

The potential protective properties of esaprazole on the gastric mucosa following administration of aspirin were evaluated by measurement of the potential difference across the gastric mucosa. Twelve patients with non-ulcer dyspepsia were admitted to the study and were divided into two groups of six patients each. In association with a randomized double-blind scheme the two groups of patients underwent two tests, with placebo and esaprazole 600 or 900 mg. After 30 min of basal recording of the potential difference, patients received either esaprazole or placebo i.v. and recording was continued for a further 30 min. Afterwards, 600 mg of unbuffered aspirin was instilled into the stomach through a nasogastric tube and the potential difference was measured for 60 min. Esaprazole 600 mg did not prevent the fall in the potential difference across the gastric mucosa caused by aspirin. A higher dose of esaprazole, however, did significantly (p≤0.05) reduce the fall. These results suggest that esaprazole exerts a dose-dependent cytoprotective effect on the gastric mucosa in man.
Clinical Epidemiological Survey of Legionella pneumophila Infections in Italy
Authors: Andreoni G , Bonazzi L , De Crescenzo G , De Rosa F , Foddai G A , Fumarola D , Ghinelli F , Gritti F M , Logroscino C , Mansueto S , Moroni M , Pompei R , Satta G
Published: January 2017

A clinical epidemiological survey of Legionella pneumophila infections occurring in Italy between 1 December 1985 and 31 May 1986 was carried out to evaluate the incidence of sporadic, epidemic and nosocomial L. pneumophila pneumonia. A total of 355 cases of pneumonia were studied of which 11.5% were due to Gram positive bacteria, 11% were due to Gram negative bacteria, 7.9% were due to Mycoplasma pneumoniae, 4.5% were due to L. pneumophila and 8.5% were due to sundry aetiological agents. The remainder (45.6%) could not be diagnosed accurately. In addition, the anti L. pneumophila antibody titres were assessed. The results are discussed in terms of the occurrence of the disease in Italy and regarding the importance of considering the possibility of legionellosic aetiology when diagnosing pneumonia.
Domiodol Treatment for Bronchopulmonary Diseases in the Paediatric Age Group: A Double-Blind Controlled Clinical Trial versus Placebo
Authors: Fiocchi A. , Grasso U. , Zuccotti G. , Arancio R. , Riva E. , Giovannini M.
Published: January 2017

Thirty children (25 males, five females), mean age 9.33 ± 2.57 years, with acute infectious pulmonary diseases or acute flare-ups of chronic bronchitis, were randomly treated with either domiodol or placebo. The study was conducted between November 1986 and February 1987. Domiodol was administered orally for 14 days in doses of 0.5 mg/kg three times daily. Subjective symptoms (cough, sputum viscosity, difficulty in raising sputum and sputum characteristics) were assessed semi-quantitatively. They were all reduced significantly in the group treated with domiodol compared to those given placebo. Spirometric measures of vital capacity and peak expiratory flow rate were also improved in patients given domiodol compared with placebo. Conversely, no differences were noted in forced expiratory volume in 1 s, Tiffenau index, or mid-expiratory flow. There were no clinical side-effects and no changes in any other parameters measured; in particular, levels of thyroid hormone and thyroid stimulating hormone were unchanged. Thus, domiodol proved effective in reducing the symptoms of infection of the lower respiratory tract and in improving the consistency of mucus in children.
Flavoxate Hydrochloride for Urinary Urgency after Pelvic Radiotherapy: Comparison of 600 mg versus 1200 mg Daily Dosages
Authors: Milani R. , Scalambrino S. , Carrera S. , Pezzoli P. , Ruffmann R.
Published: January 2017

This preliminary communication reports on a non-randomized pilot type trial of 34 females with urgency after pelvic radiotherapy who were treated with flavoxate hydrochloride for 4 weeks. A dosage of 600 mg/day was given to 21 patients and 1200 mg/day to 13 patients. Clinically, both regimens achieved comparable results. Urodynamically (first desire volume, bladder capacity and pressure at capacity) treatment with 1200 mg/day was significantly superior to 600 mg/day. Both schedules were equally well tolerated by patients and no treatment interruption occurred. A randomized double-blind trial comparing 600 and 1200 mg/day flavoxate hydrochloride is currently underway the results of which will be reported in due course.
Single-Dose Clavulanate-Potentiated Amoxycillin versus Three-Dose Cefotaxime in the Prevention of Wound Infection following Elective Cholecystectomy: A Prospective Randomized Study
Authors: El Mufti M. B. , Glessa A. , Amery K. V.
Published: January 2017

A prospective randomized study was carried out to evaluate the efficacy of clavulanate-potentiated amoxycillin with that of cefotaxime as prophylactic agents for the prevention of sepsis following elective cholecystectomy. One hundred patients were randomized into two treatment groups. In the first group, each patient received a single intravenous dose (1200 mg) of clavulanate-potentiated amoxycillin 2 h before surgery. In the second group, patients were given intravenous cefotaxime, in three doses (2 g each) during surgery, and 6 and 12 h after their operation. No case of serious post-operative sepsis occurred in either group. Superficial wound infection occurred in 2% of patients receiving a single pre-operative dose of clavulanate-potentiated amoxycillin and in 6% of those given cefotaxime according to the three-dose regimen.
Twice Daily Netilmicin Therapy in Paediatric Patients with Systemic Infections
Authors: Bodino J. , Lopez E. , Rivas A.
Published: January 2017

This open investigation evaluated twice daily administration of netilmicin in infants and children with systemic infections. Thirty-four patients aged 2–41 months, were enrolled; 28 and 34 were evaluable for efficacy and safety, respectively. Netilmicin was administered intravenously or intramuscularly every 12 h at a dosage of 2.0–4.4 mg/kg (mean 3.5 mg/kg) for 5–15 days (mean 11 days). Throughout the trial, signs and symptoms of infection were evaluated in conjunction with laboratory data to determine patients' clinical response; specimens from appropriate sites were cultured to determine bacteriological response; and laboratory tests were performed to monitor haematopoietic, hepatic and renal functions. Peak and trough serum netilmicin levels were measured during treatment. Clinical responses included complete resolution in 26/28 (93%) patients, improvement in 1/28 (4%) and failure in 1/28 (4%). Bacteriological responses included elimination of 34/36 (94%) pathogens and persistence of 1/36 (3%); response was indeterminate for 1/36 (3%). Peak serum netilmicin levels of 5.1–14.1 μg/ml and trough serum netilmicin values of 0.1–1.5 μ/ml remained within acceptable ranges during treatment. No clinically significant changes in haematopoietic, hepatic and renal functions were evident during the trial. Untoward reactions were limited to redness and/or induration at the administration site in 4/34 (12%) patients.
Comparison of Intravenously Administered Doxofylline and Placebo for the Treatment of Severe Acute Airways Obstruction
Authors: Dolcetti A. , Osella D. , De Filippis G. , Carnuccio C. , Grossi E.
Published: January 2017

This double-blind, randomized, placebo-controlled study investigated the therapeutic effects of a single dose of doxofylline, a methylxanthine derivative, in 10 patients aged 26–79 years. All patients had acute exacerbation of chronic obstructive airways disease partially reversible with salbutamol inhaler. Doxofylline was administered intravenously at a dose of 200 mg over 15 min on two different occasions separated by at least 24 h. Doxofylline increased forced expiratory volume in the first second of expiration compared with baseline as follows: +20% after 2 h ( P<0.01); +31% after 4 h ( P<0.01); and +13% after 6 h (NS). Changes produced by placebo at these times were −4.4%, −14% and −5% (all NS). The average differences between the groups were significant at all observation times. At the end of the observation period eight out of 10 patients given doxofylline and one out of 10 patients given placebo had improved clinically according to the patients' own opinion. Clinical tolerability of doxofylline proved to be good since no signs of local or general side-effects were observed in any of the patients treated.
Effects of the Protein-Bound Polysaccharide Preparation, PSK on Spontaneous Breast Cancer in Mice
Authors: Fujii T. , Saito K. , Oguchi Y. , Matsunaga K. , Kobayashi Y. , Yoshikumi C. , Taguchi T.
Published: January 2017

The protein-bound polysaccharide preparation, PSK was tested for its ability to suppress carcinogenesis in spontaneous tumours in C3H/OuJ mice. They were divided into two groups of 40 individuals each. A normal diet was given to one group, establishing a control population, while the other group had 2% PSK added to their feed. Amount of feed consumed, body weight and tumour size were recorded weekly for 1 year. Within 15 weeks, 90% of the control population had developed tumours. In the test group the incidence of cancer and the number of tumours was significantly suppressed, and survival rates were improved. The amount of feed consumed and body weights of control and test groups were about the same.
Effect of 24R,25-Dihydroxyvitamin D3 in Experimental Renal Insufficiency
Authors: Katoh T. , Maeda Y. , Yamato H. , Hirai T. , Fujii T. , Matsunaga K. , Kodaira T. , Konai Y.
Published: January 2017

This placebo-controlled study in JCL-Wistar rats showed that 100 μg/kg 24 R,25-dihydroxyvitamin D3, when given for 12 days consecutively, restored immune function which had deteriorated following aminonucleoside-induced nephrosis. Urinary creatinine excretion in five-sixths nephrectomized rats was also shown to be increased by 10 μg/kg 24 R,25-dihydroxyvitamin D3. Hypophosphataemic effects in both these cases of experimentally-induced renal insufficiency was also shown following administration of 24 R,25-dihydroxyvitamin D3.
A Single-Blind Crossover Study of Two Different Slow Release Theophylline Preparations
Authors: Tatsis G. , Danos J. , Gaga M. , Pantelakis D. , Veslemes M. , Jordanoglou J.
Published: January 2017

In a single-blind crossover study, two slow release theophylline preparations were evaluated in 18 patients with chronic bronchitis or asthma without cardiac, renal or liver disease. After randomization into two groups, patients were treated, in a crossover study design, with 600 mg choline theophyllinate or 300 mg anhydrous theophylline administered orally every 12 h for 7 days. A 2-day washout period separated the two periods of treatment evaluation. Blood samples in which plasma theophylline concentration was to be measured were taken at 7.30 a.m., 2.00 p.m. and 7.30 p.m. during the last 5 days of therapy with each drug. The mean fluctuation in plasma theophylline concentration was ≤40% in all 18 patients taking choline theophyllinate yet in only 15 (83%) patients administered anhydrous theophylline. Salbutamol inhaler was more frequently required for the relief of bronchospasm when taking anhydrous theophylline than when taking choline theophyllinate (total of 41 vs 25 puffs, respectively, over 7 days). Drug-related adverse reactions occurred in four patients while taking anhydrous theophylline and in one patient while taking choline theophyllinate.
Modified Release Tizanidine in the Treatment of Spasticity
Authors: Chantraine A. , Van Ouwenaller C.
Published: January 2017

A 6-week study of a modified release formulation of tizanidine designed for once daily administration was performed in 27 patients with spasticity due to cerebral lesions. The dosage of tizanidine used ranged from 6 to 18 mg/day. At the start of the study all patients had at least moderate spasticity and 20 (74%) patients had severe or very severe spasticity. All had a decrease in muscle strength. After 1 week of treatment 22 (81%) patients showed improvement in overall spastic state and, after 6 weeks, all 27 patients had improved. At the end of treatment 25 (93%) patients showed an improvement in overall disability. The drug was well tolerated. Side-effects were reported in only four patients, and these were minor and mostly mild. Tizanidine had no clinically important effects on blood pressure, heart rate, body weight or laboratory values. Overall, once daily treatment with modified release tizanidine is well tolerated and gives good clinical efficacy in patients with spasticity.
The Use of Low Dose Cyclosporin A in a Case of Recalcitrant Erythrodermic Psoriasis
Authors: Sutthipisal N. , Sriwatsantsak J. , Sirimachan S. , Nitidandhabaprabhas P.
Published: January 2017

A 48-year-old Thai female, who had stage 2 carcinoma of the breast presented with recalcitrant erythrodermic psoriasis which was unresponsive to conventional therapies. She was prescribed 6 mg/kg day cyclosporin A. The erythroderma responded rapidly and was completely cleared within 3 weeks. The dosage was reduced in a step-wise manner to 4 and then 2 mg/kg day and was stopped after 2 months of treatment. Complete clearing of the skin lesion was observed without any side-effects except mild nausea. The patient was then referred to surgery for mastectomy and chemotherapy. There was no clinical relapse during more than 1 year of follow-up and at present she is continuing to do well.
Results of a Phase IV Study Carried Out with Acipimox in Type II Diabetic Patients with Concomitant Hyperlipoproteinaemia
Authors: Lavezzari M. , Milanesi G. , Oggioni E. , Pamparana F.
Published: January 2017

The aim of this phase IV study was to assess the tolerability and efficacy of acipimox, a lipid-lowering drug, in 3009 type II diabetic out-patients with types II and IV hyperlipoproteinaemia. The study was carried out by 150 Italian diabetes centres. Acipimox was given at the dosage of one capsule (250 mg), two or three times daily for at least 2 months. Acipimox produced a mean fall of 43% in serum triglycerides and of 18% in total serum cholesterol levels compared with baseline. The lipid-lowering effect was present throughout treatment, but was most pronounced at the end of treatment. An increase in the serum concentration of high density lipoprotein cholesterol (15%) was also observed at the end of the trial. Fasting blood glucose and glycosylated haemoglobin levels showed a slight reduction during the study. Adverse events were reported in 263 (8.8%) cases and 165 (5.4%) patients discontinued the treatment. The female trial population showed a nearly two-fold greater incidence of adverse events than the males. In the majority of cases the adverse events experienced by patients were transient episodes of flushing and mild gastro-intestinal disturbances (e.g. gastric pain and pyrexia).
Calcitonin and Calcium Combined Therapy in Osteoporosis: Effects on Vertebra Trabecular Bone Density
Authors: Özoran K. , Paker N. , Basgöze O. , Hasçelik Z. , Erzen C. , Narman S. , Özker R.
Published: January 2017

Calcitonin is a hormone produced by the parafollicular cells of the thyroid gland. Like calcium salts, calcitonin acts by reducing bone resorption. In this study, 26 osteoporotic patients were given 100 III salmon calcitonin for 10 days and, thereafter, 100 IU calcitonin every other day for 80 days combined with 1000 mg/day calcium salts. Prior to and after the combined therapy, the mean trabecular bone densities from the levels of thoracic 12 and lumbar 1 and 2 were obtained and routine thoracic and lumbar radiography performed. Combined calcitonin and calcium therapy for 3 months produced significant increases in vertebra trabecular bone density. The evaluation of the trabecular bone density and the number of non-traumatic compression fractures in 26 osteoporotic patients prior to the therapy did not indicate any close relationship between them. It is concluded that, in addition to other factors reported previously, microtraumas during daily activities have some effect on the incidence of fractures.
Effects of Synthetic Salmon Calcitonin Therapy in Children with Osteogenesis Imperfecta
Authors: Rebelo I. , da Silva L. Pereira , Blanco J. Conde , Monteiro M. E. Sacramento , Ferreira N. Cordeiro
Published: January 2017

A total of four children with osteogenesis imperfecta, three with type I and one with type III forms of the disease, were treated with synthetic salmon calcitonin for 18 – 24 months. The annual fracture rate was decreased during calcitonin therapy compared with the period preceding it. No patient presented a marked inflexion in linear growth and a transient improvement was even noticed in two cases.