bluuebunny/crossref_metadata_2025 huggingface dataset:
Microcirculation in Chronic Venous Insufficiency
Authors: Steins Anke , Häfher Hans-Martin , Hahn Martin , Jünger Michael
Published: January 2017

Objective:

To study the microcirculation of the skin of the leg in patients with chronic venous disease of the lower limb, and to assess the effect of compression treatment.

Patients and Methods:

Patients were recruited from the vascular clinic and investigated by direct capillary pressure, transcutaneous oxygen tension, intravital video capillaroscopy and fluorescence video microscopy. The microcirculation was observed over the healing period in patients with venous leg ulcers. The effects of compression therapy on microcirculatory changes were studied in patients with Widmer stage I and II chronic venous disease.

Results:

In patients suffering from lipodermatosclerosis or venous leg ulcers retrograde pressure waves were detected in the nutritive capillaries of the skin by the ‘servo nulling’ pressure measurement during simulated calf muscle contraction. A close correlation was found between the degree of trophic skin change and the microangiopathy observed. Healing of venous ulcers occurred only if the cutaneous microcirculation in the ulcer area improved. Capillary density in base of the ulcer and at the border predicted venous ulcer healing.

Conclusions:

Cutaneous microangiopathy precedes the development of trophic skin alterations due to chronic venous disease and microcirculatory changes are closely related to the clinical stage of the disease as well as to the outcome of treatment.
Compression Stockings and their Effect on the Venous Pump — A Comparative Study
Authors: Struckmann Jan
Published: January 2017

A prospective study of 45 patients with venous insufficiency. The patients were divided into four different groups that were comparable in venous function, age and sex distribution. The effect of four different conventional compression stockings was evaluated by their clinical effect and the effect upon the musculo-venous pump as assessed by ambulatory strain-gauge plethysmography, over a 6-week treatment period. In this patient category, there could not be demonstrated any additional benefit of increasing compression, and patient acceptability was concomitantly reduced with increasing pressure. The pressure exerted by the stockings was assessed by the Borgnis Medical Stocking Tester, and pressures were found to increase in the upright position with an increase in the concomitant pressure gradient between ankle and knee.
Non-Invasive Screening for Deep Vein Thrombosis: Comparison between 99mTc-labelled Compounds, Thermography, 131 I-Fibrinogen Uptake Test and X-Ray Phlebography
Authors: Köhn Horst , Mostbeck Adolf , Lofferer Otto , König Beatrix , Swetly Christa
Published: January 2017

In 81 patients with clinically suspected deep vein thrombosis, the diagnostic accuracy of thermography, 99m Tc-plasmin and 99m Tc-fibrinogen uptake tests for detecting and localizing DVT was compared with a routinely used 131 I-FUT and X-ray phlebography as reference method. Sensitivity of these tests for detection of DVT was high (0.86–1.0). 99m Tc-labelled compounds and thermography should be used for detecting rather than for localizing DVT, since sensitivity of these tests was somewhat lower in the thigh. Clinical examination and exclusion of patients with inflammatory processes, hematoma or trauma markedly increases the specificity. Uptake tests with 99m Tc-labelled compounds are fast, reliable and suitable as bedside tests.
Assessment of a New One-Layer Adhesive Bandaging Method in Maintaining Prolonged Limb Compression and Effects on Venous Ulcer Healing
Authors: Travers J. P. , Dalziel K. L. , Makin G. S.
Published: January 2017

Objective:

To evaluate the effective duration of compression of acrylic adhesive bandaging compared to non-adhesive bandaging and to compare rate of venous ulcer healing using one layer adhesive bandaging as compared to standard three layer bandaging.

Design:

The first trial involved patients who had undergone bilateral operations for varicose veins. Adhesive acrylate bandage was applied to the experimental limb and non-adhesive crepe to the control limb. The second trial involved patients with venous ulcers randomly allocated to two groups. The experimental group used the one layer acrylic adhesive bandage whilst the control was treated by the three layer bandage technique (zinc oxide paste bandage followed by a non-adhesive compression bandage and tubular overlay).

Setting:

Hospital patients in the first trial and clinic patients in the second.

Patients, participants:

First trial, 11 patients with bilateral varicose veins of which 10 completed. Second trial, 15 patients in the experimental group and 12 patients in the control group all of which completed.

Results:

Non-adhesive bandaging lost effective compression after 24 hours. Acrylic adhesive bandage maintained effective compression after 1 week. The rate of venous ulcer healing was similar between the one layer adhesive bandage group and three layer group. One layer adhesive bandaging took only one quarter of the time to apply (p<0.01%).

Conclusions:

Adhesive bandaging produced more effective sustained compression than non-adhesive crepe. Adhesive bandaging was as effective as the currently used three layer bandaging technique in healing venous ulcers and was quicker to apply.
The Phlebographic Distribution of Deep Venous Thrombosis in the Calf and its Relevance to Duplex Ultrasound
Authors: Thomas M. Lea , Solis G.
Published: January 2017

Objective:

To assess the distribution of deep vein thrombosis in the calf by phlebography.

Setting:

Department of Vascular Radiology, St. Thomas' Hospital, London, England.

Patients:

Seventy patients with suspected deep vein thrombosis or pulmonary embolism were examined.

Interventions:

Bilateral ascending contrast phlebography was performed in all patients.

Main Outcome Measures:

The sites of any thrombus in the stem or muscle veins of the calf below the popliteal vein were recorded.

Results:

One hundred legs contained thrombus. In fifty-three legs thrombus was present solely in the calf veins below the popliteal vein. Isolated thrombus in either one or more of the three paired stem veins or the muscle veins was present in twenty-two calves.

Conclusions:

Because of the difficulty in visualising some calf veins by duplex ultrasound it is suggested that a detailed knowledge of the distribution of thrombus may assist ultrasonographers.
Complication Rate of Long Stripping of the Greater Saphenous Vein
Authors: Staelens I. , van der Stricht J.
Published: January 2017

Aims:

To evaluate the procedure of stripping by invagination of the long saphenous vein in the management of varicose veins.

Design:

Prospective study of 1,300 patients treated by stripping of the long saphenous vein by the invagination technique.

Setting:

Three quarters of the patients were treated at a private clinic and one quarter in a university hospital in Brussels, Belgium. Patients underwent stripping of the long saphenous vein under local or regional anaesthesia.

Main outcome measures:

The occurrence of peroperative haemorrhage, postoperative haematoma in the track of the long saphenous vein, when assessed by clinical examination and dysthaesia in the distribution of the saphenous nerve assessed by neurological examination.

Results:

In a total of 1,300 patients operated on using the author's technique there were only 6 haematomas in the track of the long saphenous vein and no serious peroperative haemorrhage was encountered. In 4 patients disturbances in the sensation in the area supplied by the saphenous nerve were detected.

Conclusion:

Stripping the long saphenous vein by invagination provides a safe alternative to conventional methods which may cause excessive damage to structures around the vein.
Treatment of Chronic Venous Ulcers Using Sequential Gradient Intermittent Pneumatic Compression
Authors: Schuler J. J. , Maibenco T. , Megerman J. , Ware M. , Montalvo J.
Published: January 2017

Objective:

To determine if a limited regimen of sequential gradient intermittent pneumatic compression (‘HomeRx’: HRx) is as effective in promoting the healing of chronic venous stasis ulcers as is the Unna's boot (UB), considered the ‘gold standard’ in compression therapy.

Design:

Fifty-three patients, aged 31–85 years, with ulcers ranging up to 31.8 cm2 (mean 9.9, SE 1.1) were Prospectively randomized to treatments with UB or HRx and followed weekly for 180 days or until healing was complete, whichever came first. The HRx group wore graduated compression stockings, which were removed only while intermittent pneumatic compression was applied bilaterally at home for 1 h each morning and 2 h each evening. The UB was re-applied at least weekly. The two groups were equivalent in their use of hydrocolloid dressings and periods of leg elevation.

Setting:

Therapy performed at home, with weekly visits to an outpatient clinic.

Main outcome measures:

Complete ulcer healing and the rate of healing, based on area and perimeter changes; amounts of wound exudate and pain.

Results:

Complete healing was achieved in 20 of 28 Patients (71%) in the HRx group, compared with 15 of 25 (60%) treated with UB. Three patients had an adverse reaction to UB, one had cellulitis and five were non-compliant. Correcting for these withdrawn patients by life table analysis, healing rates were 76% and 64%, respectively. Healing rates did not correlate with haemodynamic measurements made prior to treatment.

Conclusions:

Using HRx for just a few hours daily to supplement graduated elastic compression heals venous ulcers at least as well as does the UB, without its disadvantages (e.g. the need for frequent re-application by qualified personnel, difficulty bathing), affording patients greater convenience during treatment.
Full and hybrid iterative reconstruction to reduce artifacts in abdominal CT for patients scanned without arm elevation
Authors: Yasaka Koichiro , Furuta Toshihiro , Kubo Takatoshi , Maeda Eriko , Katsura Masaki , Sato Jiro , Ohtomo Kuni
Published: January 2017

Background

Abdominal computed tomography (CT) without arm elevation is associated with degraded image quality due to streak artifacts.

Purpose

To compare the degree of streak artifacts in abdominal CT images without arm elevation between full iterative reconstruction (IR), hybrid IR, and filtered back projection (FBP) using two commercially available scanners.

Material and Methods

First, a phantom study simulating CT examination without arm elevation was performed. Second, unenhanced axial images of 33 patients (17 and 16 patients for each vendor) who underwent CT without arm elevation were reconstructed with full IR, hybrid IR and FBP. A radiologist placed 50 parallel lines with lengths of 50 pixels vertical to the streaks and quantitatively evaluated the images for streak artifacts in the phantom study. Two radiologists evaluated the images of patients for streak artifacts (on the liver and the kidney) and diagnostic acceptability using a four-point scale.

Results

The phantom study indicated that full IR algorithms were more effective than FBP in reducing streak artifacts. In the clinical patient study, streak artifacts were significantly more reduced with full IR compared with FBP in both the liver and kidney ( P < 0.012). Streak artifact reduction was limited with hybrid IR. Model-based iterative reconstruction (MBIR) (one of the full IR algorithms) provided diagnostically more acceptable image quality ( P < 0.016) compared with FBP.

Conclusion

In abdominal CT without arm elevation, full IR enabled a more efficient streak artifact reduction compared with FBP and MBIR was associated with diagnostically more acceptable images.
Diclofenac Sodium (Voltaren): Results of a Multi-Centre Comparative Trial in Adult-Onset Rheumatoid Arthritis
Authors: Dürrigl T , Vitaus M , Pucar I , Miko M
Published: January 2017

A short-term trial has been performed under double-blind conditions in 50 adult patients with rheumatoid arthritis to compare diclofenac sodium (Voltaren) with both indomethacin and placebo for efficacy and tolerability. The duration of the trial was two weeks and was a between-patient comparison of 25 mg t.i.d. diclofenac sodium, 25 mg t.i.d. indomethacin or placebo using a double-dummy technique. Forty-eight patients completed the trial. In the majority of parameters examined, diclofenac sodium was superior to placebo and indomethacin in therapeutic effect. One patient was withdrawn from the trial because of intolerance to indomethacin and one other because of severe joint pain under indomethacin therapy. Neither active compound caused clinically significant changes in blood picture or urine analysis.
A Double-Blind Clinical Trial to Determine if an Interaction Exists between Diclofenac Sodium and the Oral Anticoagulant Acenocoumarol (Nicoumalone)
Authors: Michot F , Ajdacic K , Glaus L
Published: January 2017

A double-blind crossover trial between diclofenac sodium and placebo was carried out in 32 hospitalized patients who were thought to be stabilized on concurrent anticoagulant therapy with acenocoumarol. The object of the trial was to investigate any possible interaction between diclofenac and anticoagulant by monitoring prothrombin times daily through the four week period. No statistically significant difference between placebo and diclofenac could be shown and some problems of accurately monitoring prothrombin times are discussed.
Clinical Study on the Efficacy of O-(β-Hydroxyethyl) Rutoside (HR) in Varicosis of Pregnancy
Authors: Bergstein N A M
Published: January 2017

In a double-blind trial involving 69 patients, the effect of O-(β-hydroxyethyl) rutoside (HR)* in the treatment of varicosis of pregnancy has been investigated. The number of patients subjectively improving in the active drug group was significantly greater than in the placebo group; patients receiving HR also showed a small but significant decrease in leg circumference. Throughout the eight-week period of the trial, there were only minimal side-effects and healthy babies were delivered with good Apgar-scores.
Cases of Overdosage with Viloxazine Hydrochloride (Vivalan†)
Authors: Brosnan R D , Busby A M , Holland R P C
Published: January 2017

Twelve cases of viloxazine overdosage are reported. All patients recovered without sequelae and no ECG abnormalities were observed. Gastric lavage was performed in most cases and was probably beneficial. As viloxazine is rapidly absorbed ( Bayliss & Case 1975, Case & Reeves 1975) lavage should be carried out as soon as possible after the tablets are taken.

Since the drug is almost exclusively excreted in the urine, it is suggested that forced diuresis be carried out to reduce blood levels as quickly as possible.
A Comparison of the Dissolution and Bioavailability Characteristics of Three Spironolactone Tablet Formulations, Including Preliminary Data on Two Spironolactone Metabolites
Authors: Tidd M J , Collins W T , Chamberlain J
Published: January 2017

The bioavailabilities of three spironolactone tablet formulations specially selected for major differences in in vitro dissolution tests were compared in normal male volunteers by measuring plasma and urinary levels of the pharmacologically active spironolactone metabolite canrenone. It was possible to demonstrate small but statistically significant differences in plasma canrenone concentration-time curves derived from the three formulations together with significant differences in the time course of urinary canrenone excretion. The bioavailabilities of the three formulations did not differ significantly although the tablet with the poorest in vitro dissolution produced a significantly delayed peak canrenone concentration.

The dissolution rate methodology and results are described and an approach to the development of improved in vitro dissolution tests for spironolactone is suggested.

The use of a new method for canrenone estimation resulted in the incidental detection of two other quantitatively significant spironolactone metabolites and preliminary information is given on these.
Metabolic Studies with Formebolone (2-Formyl-17 (α)-Methylandrosta-1,4-Diene-11 (α), 17 (β)-Diol-3-One) in Humans
Authors: Gelli D , Vignati E
Published: January 2017

Controlled within-group and between-group clinical studies indicate that the administration of Formebolone, an anabolic steroid, increases protein synthesis in humans as expressed by a positive nitrogen balance.
Methenamine Hippurate (‘Hiprex’)† in the Treatment of Chronic Urinary Tract Infections: A Trial in a Geriatric Hospital
Authors: Parvio Salme
Published: January 2017

Fifty-two patients, all of whom were more than 66 years-old and who were hospitalized for periods in excess of two years were treated for chronic urinary tract infection. All patients received a course of antibiotic treatment for seven to ten days and were then put onto treatment with methenamine hippurate 1 g twice daily for six months.

Of the original fifty-two patients, twelve did not complete the six month course. During the six month period with ‘Hiprex’ there were far fewer re-infections than in the previous six months during which time they had received intermittent antibiotic therapy and other long-term treatment. There were no adverse reactions and bacterial resistance did not occur.
Clinical Experience with Cefadroxil in Upper and Lower Respiratory Tract Infections
Authors: Mercado F Flores , Santella P J , Fernandez C A
Published: January 2017

Cefadroxil is a new semisynthetic oral cephalosporin with a broad spectrum of activity against both Gram-positive and Gram-negative organisms. Absorption of cefadroxil is unaffected by food, its serum levels are prolonged and it is excreted in the urine at a relatively slow rate compared to cephalexin. In the treatment of 108 patients with upper or lower respiratory tract infections, cefadroxil effected 93% complete cures. Fifty-five of the patients had upper respiratory tract infections and fifty-three had lower respiratory tract infections; among them cefadroxil achieved clinical success rates of 100% and 96%, respectively. Cefadroxil was clinically successful in eight (89%) out of nine patients whose infections were caused by mixed aetiologies. The principal causative agents were Staphylococcus aureus, β-haemolytic streptococci, Streptococcus pneumoniae and Klebsiella pneumoniae. Overall bacterial eradication produced by cefadroxil was 112 (91%) of 123 organisms isolated from 108 patients. Reports of mild and transient side-effects in only 3.7% of the patients showed that the drug was well tolerated.
Rifampicin in Cutaneous Leishmaniasis
Authors: Iskandar I Onsy
Published: January 2017

A study is described which aimed at assessing the efficacy of rifampicin in the treatment of cutaneous leishmaniasis. A total of thirteen patients suffering from this condition were admitted to the study and were given rifampicin 600 mg daily. Three patients dropped out due to reasons unconnected with the trial and one patient left when the lesions improved appreciably and continued treatment abroad. The remaining patients continued under treatment until clinical resolution was attained, and this occurred in a period of one to four months. The author was impressed by the marked clinical resolution and the lack of scarring and side-effects, and recommends that further trials be carried out in the endemic areas where more cases can readily be found, treated and observed for longer periods of time than in this study.
Controlled Assessment of Oral Bronchodilators for Asthmatic Children
Authors: Falliers Constantine J , Cato Allen E , Harris Jane R
Published: January 2017

Various pulmonary function changes were determined in twenty paediatric patients after a single oral dose of theophylline, ephedrine, or their combination in a double-blind crossover study. The possible contributions of guaifenesin and butabarbital, components of some formulations in clinical use, were also examined. Bronchodilatory efficacy in decreasing order, when compared to placebo, was observed for theophylline-ephedrine and theophylline (nearly comparable), and for ephedrine-butabarbital and ephedrine (nearly comparable). Butabarbital and guaifenesin did not enhance or decrease bronchodilatory effect. Adverse reactions appeared to be more frequently related to ephedrine intake, although no serious reactions were noted.
Detection of Immune Complexes in the Sera of Human Newborns Suspected of Neonatal Infection
Authors: Hoyoux J , Delire M , Eyndels C , Vert P
Published: January 2017

The special characteristics and relative immaturity of the immune system in human neonates favour the constitution and persistence of circulating immune complexes after any antigenic invasion so that their detection in serum during the first week of life could be of particular interest for the early diagnosis of a neonatal infection.

In this study, using a technique based on the inhibition of a latex agglutination, we detected circulating immune complexes in sixty-four neonates suspected of infection, at a significantly higher titre than in eleven newborns considered to be completely devoid of any clinical abnormalities.

The level of those circulating immune complexes was related to the severity of a clinical score of infection and of a total score including several events of the pregnancy and delivery usually considered as a high risk of infection. On the other hand, no significant correlation was found between the infection score and the level of fibrinogen in the blood or the percentage of non-segmented neutrophils. Moreover, no correlation was demonstrated between each of these two classical biological tests and the level of circulating immune complexes.
A Comparative Crossover Study on the Treatment of Heartburn and Epigastric Pain: Liquid Gaviscon and a Magnesium – Aluminium Antacid Gel
Authors: Chevrel B
Published: January 2017

Forty-four patients with symptoms of gastro-oesophageal reflux were randomly assigned in a crossover trial to treatment for 15-day periods with Liquid Gaviscon (a reflux suppressant) or an antacid gel containing magnesium and aluminium hydroxide.

Good relief of symptoms was reported by 84% of patients during therapy with Liquid Gaviscon compared to only 23% during antacid therapy.

Relief of symptoms was obtained within 15 minutes by 68% of patients during therapy with Liquid Gaviscon compared to only 9% during antacid treatment.

The beneficial effect lasted for more than 4 hours in 75% of patients during treatment with Liquid Gaviscon compared to only 23% of patients obtaining long-term relief during antacid therapy.
A Double-Blind Controlled Evaluation of Diproderm® Cream 0·05%, Twice a Day Treatment in Comparison with Once a Day Treatment in Eczema
Authors: Gärtner L , Tarras-Wahlberg C
Published: January 2017

A double-blind study, carried out at two centres, comparing once and twice a day application of betamethasone-17, 21-dipropionate cream 0·05% (Diproderm®), has shown that the efficacy in treating eczema is the same after 1 week.
Rectal Administration of Nifedipine: Haemodynamic Effects and Pharmacokinetics in Hypertensives
Authors: Kurosawa S. , Kurosawa N. , Owada E. , Matsuhashi N. , Ito K.
Published: January 2017

The haemodynamic effects and pharmacokinetics of nifedipine suppositories, used mainly for hypertensive emergencies, were studied in 10 severely hypertensive patients. Following rectal administration, significant hypotensive effects occurred after 0.5 h and lasted until 7 h after administration. The mean (±SE) maximum decreases in systolic and diastolic blood pressures 1.5 h after administration were: systolic, 61.8 ± 7.9 mmHg ( P<0.001); and diastolic, 30.8 ± 4.0 mmHg (P<0.001). No serious side-effects were reported and heart rate did not change significantly. Mean nifedipine concentration in the blood peaked at 52.4 ng/ml, 1 h after administration and, after 7 h, was still 14.3 ng/ml which is higher than the minimum plasma concentration required for hypotensive effects to occur. There was a close correlation between nifedipine concentration in the blood and hypotensive effects. These results indicate that rectal administration of nifedipine should be regarded as a useful alternative treatment in hypertensive emergencies.
A Study of the Anticholinergic Activity of Terfenadine in Normal Volunteers
Authors: Vargas R. , McMahon F. G. , Ryan J. R.
Published: January 2017

The anticholinergic effects of single doses of terfenadine, chlorpheniramine and atropine on salivary flow were compared with those of placebo in a double-blind crossover study in 21 normal adults. Salivary flow was measured immediately before administering study medications and 3 h after dosing, for the evaluation of anticholinergic activity. Mean salivary flow decreased significantly after administration of chlorpheniramine and atropine ( P<0.01 and P<0.001, respectively), and was unchanged by terfenadine and placebo, indicating that terfenadine does not possess detectable anticholinergic activity. Mild drowsiness was reported by 57% and 29% of subjects who received chlorpheniramine and terfenadine, respectively.
Vegetable Foods in Weaning
Authors: Agostoni C , Riva E
Published: January 2017

Vegetable foods (cereals, non-starchy vegetables, legumes) make a unique nutritional and metabolic contribution during weaning. They provide proteins that are of low biological value individually but whose value can be raised by consuming appropriate combinations: minimal amounts of lipids, mostly essential polyunsaturated fats; complex carbohydrates; and soluble fibre, which are fermented by colonic flora to short-chain fatty acids that have beneficial effects. Insoluble fibre, minerals, trace elements and vitamins are also nutritionally important components of vegetable foods. Vegetable foods lower the calorific density of meals, modulate nutrient and antigen absorption, and promote a physiological copropoiesis. Recent nutritional surveys have shown that 12-month old children eat an excessive amount of animal proteins. Whole cereals and non-starchy vegetables, including whole legumes, should be routinely eaten during weaning to improve nutritional balance and to make children accustom to eating fibre, which has prophylactic properties. The daily intake of fibre should be progressively increased to 5 g during the first year of life.

Gli alimenti vegetali (cereali, verdure non amidacee, legumi) presentano caratteristiche nutrizionalie metaboliche comuni davvero uniche per la fase dello svezzamento. Essi forniscono proteine di valore biologico basso ma innalzabile attraverso opportune miscelazioni: quantità minime di lipidi (per lo più grassi polinsaturi essenziali); carboidrati complessi e fibra solubile che possono essere fermentati dalla flora del colon e trasformati in acidi grassi a catena corta. A loro volta, questi acidi hanno un effetto benefico sull'omeostasi locale egenerate. Anche la fibra insolubile, i minerali, gli oligoelementi e le vitamine danno un contributo importante al ruolo nutrizionale degli alimenti vegetali. Di conseguenza, come parte della dieta gli alimenti vegetali abbassano il contenuto calorico dei pasti, modulano l'assorbimento degli antigeni e delle sostanze nutritive e favoriscono la copropoiesi fisiologica. Alcuni recenti studi nutrizionali hanno dimostrato che i bambini di 12 mesi di et à consumano una quantità eccessiva di proteine animali. Durante lo svezzamento occorre quindi somministrare abitualmente cereali integrali, verdure non amidacee e legumi interi, onde ottenere un migliore equilibrio nutrizionale ed abituare i bambini al consumo della fibra, considerate le sue proprietà preventive. La dose giornaliera consigliata di fibra dovrebbe venire aumentata progressivamente fino a 5 g nel primo anno di vita.
Non-Steroidal Anti-Inflammatory Drug-Induced Gastropathy: A Comparative Endoscopic and Histopathological Evaluation of the Effects of Tenoxicam and Diclofenac
Authors: Al-Quorain A A , Satti M B , Marwah S , Al-Nahdi M , Al-Habdan I
Published: January 2017

A 4-week double-blind study compared the potential for 20 mg/day tenoxicam or 100 mg/day diclofenac sodium to induce gastropathy in 36 patients with joint disease and assessed the influence of gastric colonization by Helicobacter pylori. Endoscopic assessment at the end of 4 weeks indicated that the mucosa was normal in 79% of tenoxicam-treated patients and 59% of diclofenac-treated patients. Only 5% of patients in the tenoxicam group developed severe gastroduodenitis (> 11 haemorrhages or erosions) compared with 18% in the diclofenac group. Histological evaluation indicated that 58% and 47%, respectively, of tenoxicam-treated and diclofenac-treated patients retained normal mucosa after treatment. Diclofenac treatment was discontinued in two patients, due to a duodenal ulcer or severe erosive gastritis. Overall, 5/14 patients with moderate to severe colonization with Helicobacter pylori developed severe chronic active gastritis or ulceration, compared with the 1/22 patients in whom colonization was either absent or mild ( P = 0.02). Tenoxicam and diclofenac did not show major differences in terms of gastrointestinal safety, although the trends favoured tenoxicam. The presence of severe colonization of the gastric mucosa with Helicobacter pylori appears to be an important factor for development of severe gastritis or ulceration.
Comparison of Azithromycin and Co-Amoxiclav in the Treatment of Acute Tracheobronchitis and Acute Infectious Exacerbations of Chronic Bronchitis in Adults
Authors: Biebuyck X A ,   Azithromycin Study Group
Published: January 2017

Azithromycin, a broad-spectrum azalide, and co-amoxiclav were compared in a randomized, multicentre, open-label trial in 759 patients treated for acute tracheobronchitis ( n = 620) or acute infectious exacerbations of chronic bronchitis ( n = 139). Patients were randomized (2:1) to a 3-day regimen of two azithromycin 250 mg capsules once daily or a 5–10-day regimen of co-amoxiclav, one 625 mg tablet three times daily. Azithromycin produced a significantly higher cure rate (70.6% versus 61.1%) than ( P = 0.011) and there were fewer failures (7.8% versus 13.6%) and relapses in the azithromycin-treated group, giving a higher overall response rate for azithromycin (89.7% versus 80.2%, P = 0.0003). With azithromycin, compliance was better than with co-amoxiclav and there was a significantly shorter time to improvement or cure. A higher incidence of adverse events, mostly gastrointestinal, was reported by patients taking co-amoxiclav (21.3% versus 14%, P = 0.0097), causing more patients in this group to discontinue therapy (7% versus 1.2%, P = 0.00004).
The Effect of Nimodipine Monotherapy and Combined Treatment with Ketamine and Lignocaine in Aneurysmal Subarachnoid Haemorrhage
Authors: Langelaar G , Leeuwenkamp O R , Sterkman L GW , Torreman M , Hesselink J M Keppel
Published: January 2017

The clinical effects of nimodipine monotherapy were compared with the effects of nimodipine combined with ketamine and lignocaine (combination therapy) in a single-centre, one investigator, open study in patients with proven aneurysmal subarachnoid haemorrhage (aSAH). After clipping of the aneurysm, nimodipine was administered intravenously until day 5 – 7 after clipping. Thereafter the intravenous nimodipine was substituted by oral doses of nimodipine. These were decreased gradually and then discontinued within the following 6 days. For combination therapy, nimodipine was given together with both a bolus injection of 1 μg/kg ketamine followed by an infusion of the drug at a rate of 3 μg/kg/min and a bolus injection of 1.5 mg/kg lignocaine followed by an infusion of the drug at a rate of 12 μg/kg/min. During the study period, 173 patients were admitted to the hospital with subarachnoid haemorrhage (SAH). Of these patients, 115 with a proven aneurysm were operated on and evaluated: 66 patients received nimodipine monotherapy and 49 were given nimodipine combined with ketamine and lignocaine. These subgroups were comparable in terms of the baseline characteristics (age, Hunt and Hess score). The (baseline corrected) Hunt and Hess scores after surgery and a 0 – 5 clinical outcome score were applied as indices for clinical effects. Patients receiving nimodipine monotherapy and combined therapy showed a significant clinical improvement compared to baseline ( P = 0.001 and P = 0.006, respectively). The beneficial effect of nimodipine monotherapy is in line with previous double-blind, placebo-controlled studies. Although nimodipine monotherapy seems to be more effective than combined treatment, this was not statistically significant. Our data indicate that combined treatment with ketamine and lignocaine is not more effective than nimodipine monotherapy in patients with mild aSAH, but this does not rule out an effect in severe cases. There was no indication of a pharmacodynamic interaction between nimodipine and co-medication. No serious or clinically relevant adverse reactions were noted during the study.
The Effect of an α-Glucosidase Inhibitor and Insulin on Glucose Metabolism and Lipid Profiles in Non-Insulin-Dependent Diabetes Mellitus
Authors: Okada S , Ishii K , Hamada H , Tanokuchi S , Ichiki K , Ota Z
Published: January 2017

Studies were carried out to assess various ways of improving glycaemic control and lipid profiles of patients with non-insulin-dependent diabetes mellitus (NIDDM) in whom glucose metabolism was poor. Part or all of the dose of the sulphonylurea that had been used to treat patients in Group 1 ( n = 8) was replaced by an α-glucosidase inhibitor. Symptoms related to hypoglycaemia disappeared and the postprandial blood glucose level was significantly increased ( P < 0.043) but serum lipid levels were not significantly altered and the mean glycosylated haemoglobin level was unchanged. In Group 2 ( n = 10) patients, a large part of the insulin dose was replaced by an α-glucosidase inhibitor. Hypoglycaemia-related symptoms disappeared but there were no significant changes in lipid profiles, postprandial blood glucose or glycosylated haemoglobin levels. The third group of patients ( n = 9) had been treated with insulin alone and were given additional α-glucosidase inhibitor without changing their insulin dose. This did not significantly change their lipid profiles, postprandial blood glucose or glycosylated haemoglobin levels. In Group 4 ( n = 9) the addition of an α-glucosidase inhibitor to the initial sulphonylurea did not produce any significant changes in mean postprandial blood glucose or glycosylated haemoglobin levels. The results for individual patients indicated that the glycosylated haemoglobin levels had improved after the change of treatment only in those patients whose connective peptide immunoreactivity was > 6.0 ng/ml.
Clinical and Microbiological Evaluation of Pefloxacin in Lower Respiratory Tract Infections
Authors: Tatsis G , Tsoukalas G , Hatzinikolaou V , Boulbasakos G , Jordanoglou J
Published: January 2017

Patients with Gram-negative lower respiratory tract infections (acute exacerbation of chronic bronchitis ( n = 23), pneumonia ( n = 4), and bronchiectasis ( n = 5) were treated with pefloxacin, 400 mg twice daily, given either intravenously or orally. Symptoms, signs and sputum volume and colour were monitored daily. Chest X-rays, sputum culture and Gram-stain examinations were carried out on days 1 and 5, and immediately after the end of the treatment. There was a clinical improvement, as indicated by the incidence of cough, dyspnoea and rales, and by sputum volume and colour in 31 patients (97%). Microbiological improvement, as indicated by the complete elimination of sputum pathogens and pus cells, was achieved in 28 of the patients (88%). In one patient, an adverse effect, renal failure, occurred. These results suggest that pefloxacin is both clinically and microbiologically effective for the treatment of Gram-negative lower respiratory tract infections.
Motor Aphasia due to Prolonged Hypoglycaemic Coma in a Patient with Insulin-Dependent Diabetes Mellitus
Authors: Kurabayashi H , Kubota K , Tamura K , Akiba T , Shirakura T
Published: January 2017

A 45-year-old insulin-dependent diabetic man was in a hypoglycaemic coma for one month but recovered after continuous infusion of glucose and insulin. An isolated neurological deficit, motor aphasia, persisted after recovery from the coma. Repeated computerized tomography did not demonstrate any abnormal findings attributable to coma or aphasia. Precise follow-up examinations of aphasia showed improvement of Broca type motor aphasia to transcortical motor aphasia. Hypoglycaemic aphasia in a patient after recovery from prolonged coma is rare and its clinical course and pathogenesis are discussed with reference to the available literature.
Efficacy and Safety of Oral Levofloxacin Compared with Clarithromycin in the Treatment of Acute Sinusitis in Adults: A Multicentre, Double-Blind, Randomized Study
Authors: Lasko B , Lau CY , Saint-Pierre C , Reddington JL , Martel A , Anstey RJ ,   The Canadian Sinusitis Study Group
Published: January 2017

Adult patients with acute sinusitis ( n = 236) were randomized in a double-blind study to levofloxacin 500 mg orally once daily ( n = 119) or clarithromycin 500 mg orally twice daily ( n = 117) for 10 − 14 days. Between 2 and 5 days after therapy participants were evaluated as cured (no symptoms), improved (symptoms improved, no further therapy required), or failed (further therapy required). Clinical response rates (cured plus improved) for clinically evaluable patients were 93.9% for levofloxacin ( n = 98) and 93.5% for clarithromycin ( n = 93). The proportion of patients evaluated as cured was higher in the levofloxacin (40.8%) than in the clarithromycin arm (29.0%) and individual symptoms showed higher rates of resolution. Of patients receiving levofloxacin and clarithromycin, 22.5% and 39.3%, respectively, experienced adverse events related or possibly related to the study therapy. This study showed that, in the treatment of acute sinusitis, daily levofloxacin therapy is as effective as twice-daily clarithromycin therapy with more complete clearing of symptoms and a more tolerable side-effect profile.
Rapid and Sustained Efficacy of Mizolastine 10 mg Once Daily in Seasonal Allergic Rhinitis
Authors: Stern M , Blondin-Ertzbischoff P , Murrieta-Aguttes M , Hardwicke C , Emmerson EBM , Judd MS
Published: January 2017

This 28-day, double-blind, randomized study in 256 patients compared the efficacy and safety of mizolastine 10 mg daily with placebo in patients with seasonal allergic rhinoconjunctivitis. All four nasal symptoms (itch, rhinorrhoea, sneezing, obstruction) and three ocular symptoms (itch, tears, redness) were rated by investigators using both a 0 − 3 and a 0 − 9 rating scale. Compared with the placebo group total, nasal and ocular scores were all significantly lower in the mizolastine-treated patients at day 14 of the study ( P = 0.0002 − 0.0009, using the 0 − 9 scale) and relief was maintained throughout the 4-week study duration. Patient diary total scores showed that mizolastine was effective from the first day of treatment. The 0 − 9 scale appears to be more sensitive than the 0 − 3 scale for rating symptoms of seasonal allergic rhinitis.

En el ensayo clínico aleatorizado, a doble ciego, controlado con placebo, de 28 días de duración y con una muestra de 256 pacientes se comparó la eficacia y seguridad de 10 mg de mizolastina en pacientes con rinoconjuntivitis alérgica estacional. En total los investigadores evaluaron cuatro síntomas nasales (picor, rinorrea, estornudo, obstrucción) y tres síntomas oculares (picor, lagrimeo, eritema). Los resultados se clasificaron utilizando una escala de 0 − 3 y otra de 0 − 9. Las puntuaciones nasales y oculares obtenidas el día 14 del estudio en los pacientes tratados con mizolastina fueron significantemente menores comparadas con aquellas observadas en el grupo placebo (P = 0.0002 − 0.0009 utilizando la escala de 0 − 9) y el alivio se mantuvo durante las cuatro semanas de duración del estudio. Las puntuaciones cotidianas (evaluación del paciente) mostraron que la mizolastina es efectiva desde el primer día de tratamiento. La escala de 0 − 9 resultó ser más sensible para la evaluación de síntomas de rinitis alérgica estacional que la escala de 0 − 3.
Serum Levels of Soluble Intercellular Adhesion Molecule-1 and Soluble Vascular Cell Adhesion Molecule-1 in Asymptomatic Carriers of Hepatitis C Virus
Authors: Fukuda Y , Nakano I , Katano Y , Marui A , Hayakawa T
Published: January 2017

High levels of serum-soluble intercellular adhesion molecule-1 (sICAM-1) and soluble vascular cell adhesion molecule-1 (sVCAM-1) have been noted in patients with chronic hepatitis C. This study aimed to measure serum levels of sICAM-1 and sVCAM-1 in asymptomatic hepatitis C virus carriers and clarify the clinical significance of measuring soluble forms. Serum levels of sICAM-1 were significantly higher than in healthy controls but serum sVCAM-1 levels did not differ statistically from those in healthy controls. Liver biopsy obtained from 12 asymptomatic hepatitis C virus carriers showed evidence of hepatitis. Estimating sICAM-1 and sVCAM-1 in asymptomatic carriers may be helpful, especially in cases in which liver biopsy is not possible.
History Re-told
Authors: Davis John
Published: January 2017

Gadaffi telling the past as it never was
Diverting tactics
Authors: Strossen Nadine
Published: January 2017

The across-the-board assault on civil liberties heralded by the Republican ‘Contract with America’ is making serious inroads on a much older document, the US Bill of Rights. This, says the author, is ‘the original contract with America’
Nanny knows best
Authors: Lewis Anthony
Published: January 2017

The left, untypically, have joined the right in attacks on free expression. All with our best interests in mind, of course
Who goes home?
Authors: Webb W. L.
Published: January 2017

They made a peace in Dayton, Ohio. But in the Krajina villages still burn, the cities of Bosnia are flattened, the population is scattered on the winds of winter. To what and where do the refugees return?
Once and future shock
Authors: Kormilkin V.
Published: January 2017

Ten years on, the real tragedy of Chernobyl is that the disaster is still growing, often in secrecy, and is far worse than anyone predicted. The humanitarian, health and economic problems are overwhelming the states affected — and there are more Chernobyls waiting to happen
The year of the bully
Authors: Petley Julian
Published: January 2017

British TV censorship is largely a thing of the past. Far more threatening is the concert of pusillanimous management, government intimidation and the machinations of spin doctors
Cost of a miracle
Authors: Gittings John
Published: January 2017

Deng Xiaoping's reforms have changed the face of China: the economy has made epic strides, cities fly the banners of western capitalism, a new middle class aspires to full membership of the consumer society. In the process, political reform got left behind, repression of dissidents is as harsh as ever and a growing gap between rich and poor, town and country, threaten the stability of the Middle Kingdom
Han rejects
Authors: Hilton Isabel
Published: January 2017

The government's patriotic nationalism bodes ill for China's minorities, especially in Tibet
Trouble ahead
Authors: Binyan Liu
Published: January 2017

From his death bed, Deng Xiaoping looks out on a government that is the most corrupt and incompetent in China's history and a population that is more aware and more refractory than any before
Owners' options
Authors: Wrout Penny
Published: January 2017

The choice between free expression in their papers and the preservation of their business interests on the mainland presents proprietors with a dilemma. Or does it?
So many Shivas
Authors: Butalia Urvashi
Published: January 2017

Over 100 million children work as bonded labourers in India, a form of slavery from which there is no escape and to which they are doomed for life. The law is ineffectual and, despite the efforts of abolitionists, the subject remains ringed by a wall of silence
Body
Authors: Brooks Peter
Published: January 2017

I often feel that people come to me to be photographed as they would go to a doctor or a fortune teller - to find out how they are. So they're dependent on me. I have to engage them. Otherwise there's nothing to photograph… And when the sitting is over … there's nothing left except the photograph and a kind of embarrassment.
Planet
Authors: Tudge Colin
Published: January 2017

I attempt, through much of my work, to animate all things - even so-called ‘inanimate’ objects - with the spirit of man. I have come, by degrees, to realise that this extremely animistic projection rises, ultimately, from my profound fear and disquiet over the accelarating mechanisation of man's life… The creative photographer imparts humanity to the inhuman world around him
Temporomandibular disorders: Old ideas and new concepts
Authors: List Thomas , Jensen Rigmor Højland
Published: January 2017

Background

Temporomandibular disorders (TMD) is an umbrella term for pain and dysfunction involving the masticatory muscles and the temporomandibular joints (TMJs). TMD is the most common orofacial pain condition. Its prominent features include regional pain in the face and preauricular area, limitations in jaw movement, and noise from the TMJs during jaw movements. TMD affects up to 15% of adults and 7% of adolescents. Chronic pain is the overwhelming reason that patients with TMD seek treatment. TMD can associate with impaired general health, depression, and other psychological disabilities, and may affect the quality of life of the patient.

Assessment

Evaluations indicate that the recently published Diagnostic Criteria for TMD (DC/TMD) are reliable and valid. These criteria cover the most common types of TMD, which include pain-related disorders (e.g., myalgia, headache attributable to TMD, and arthralgia) as well as disorders associated with the TMJ (primarily disc displacements and degenerative disease). As peripheral mechanisms most likely play a role in the onset of TMD, a detailed muscle examination is recommended. The persistence of pain involves more central factors, such as sensitization of the supraspinal neurons and second-order neurons at the level of the spinal dorsal horn/trigeminal nucleus, imbalanced antinociceptive activity, and strong genetic predisposition, which also is included in DC/TMD.

Conclusion

The etiology is complex and still not clearly understood, but several biological and psychosocial risk factors for TMD have been identified. Several studies indicate that patients with TMD improve with a combination of noninvasive therapies, including behavior therapy, pharmacotherapy, physical therapy, and occlusal appliances. More stringently designed studies, however, are needed to assess treatment efficacy and how to tailor treatment to the individual patient.
Contact Dermatoses in Metal Workers
Authors: Papa G. , Romano A. , Quaratino D. , Di Fonso M. , Viola M. , Sernia S. , Boccia I. , Di Gioacchino M. , Venuti A. , Calvieri S.
Published: January 2017

We studied 150 metal workers occupationally exposed to metals and metalworking fluids (MWFs) to determine the prevalence and nature of contact dermatitis. 150 office workers were used as non-exposed control group. Questionnaires were administered to evaluate occupational and non-occupational exposure. All subjects underwent a dermatological examination and patch-testing with standard allergen series and MWFs used in the plant. Twenty-eight metal workers (18.6%) presented minor skin disorders involving the hands (vs. only 2% of the controls), ten (6.6%) had major disorders (similar to the figure for the control group − 5.4%), and 112 (74.8%) had no lesions, as opposed to 92.6% of the control group. Positive patch tests were found in ten metal workers: eight had major skin disorders (six to nickel, cobalt and chromium, one to nickel and cobalt, one to nickel) and the remaining two were asymptomatic (one positive for nickel and chromium, one for nickel). Among the controls there were three cases of positivity, all among asymptomatic subjects. Patch tests with MWFs were negative. The prevalence of dermatoses among the metal workers was significantly higher than that of controls (p < 0.01), and all cases of allergy in this group were provoked by metals themselves.