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Biomedical subjects

A Lassus

Publications and source records attributed to A Lassus.

At least 37 records · Page 2Linked to original sources

Roxithromycin in nongonococcal urethritis.

This presentation is a summary of five different studies on the efficacy and tolerance of roxithromycin in the treatment of non-gonococcal genital infections. Three of the studies were double-blind comparative and two were open studies. Of the 924 out-patients whose data were analysed for clinical efficacy, 637 received treatment with roxithromycin 150 mg bd. The standard dose of roxithromycin, 150 mg bd for ten days, was compared with doxycycline 200 mg daily, lymecycline 300 mg bd and roxithromycin 450 mg once daily. The overall clinical success rate was 90% (576 of 637 patients) for roxithromycin 150 mg bd. In the three comparative trials, no significant difference was found between the clinical success rates of roxithromycin 150 mg bd and the other drugs. The overall clinical success rate with roxithromycin 150 mg bd was 92% (512/558) in nongonococcal urethritis and 81% (64/79) in cervicovaginitis. Taking into account all patients treated with roxithromycin 150 mg bd, the bacteriological success rate was 90% (444/492). In the comparative trials, no significant difference could be found between the treatment groups. Roxithromycin 150 mg bd was effective in eradicating 97% (308/316) of the isolates of Chlamydia trachomatis, 88% (149/170) of Ureaplasma urealyticum, 73% (40/55) of Mycoplasma hominis and 57% (13/23) of Gardnerella vaginalis. The present findings show that a high cure rate can be achieved with a ten-day course of treatment with roxithromycin and that it is at least as effective as the tetracyclines commonly used in the treatment of nongonococcal urethritis. A higher dosage than 300 mg/day of roxithromycin did not offer any clear advantage in terms of efficacy.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent

Treatment of severe psoriasis with etretin (RO 10-1670).

Eighty patients with severe psoriasis were treated in a double-blind fashion with either an initial dose of 10 mg, 25 mg or 50 mg of etretin daily or with placebo. Follow-up examinations were carried out monthly and the efficacy of treatment was evaluated by using the PASI score. Adverse effects of the treatment were recorded monthly; liver enzymes, cholesterol and triglycerides were measured. After 2 months of treatment the maintenance dose was reduced in some of the patients either because of complete remission or adverse effects. After 2 months treatment, groups receiving 25 mg/day and 50 mg/day showed significantly lower PASI scores than the placebo group. The 10 mg/day group showed a response intermediate between the 25 mg and 50 mg groups and the placebo group. Thus, the optimal initial dose seems to be approximately 25 mg/day and the maintenance dose somewhat lower. Six months after the start of treatment there were no significant differences between the four groups; the last follow-up examination took place during the summer and some of the patients probably experienced spontaneous improvement. Although clinical adverse effects were frequent in all groups, severe side effects, namely hair loss and paronychia, occurred frequently only among patients treated with an initial dose of 50 mg of etretin daily. The effect of treatment on liver enzymes, cholesterol and triglycerides was minimal.

Acitretin

Response of solitary psoriatic plaques to experimental application of podophyllotoxin.

A 16-week double-blind study of parallel groups was carried out in the treatment of 152 patients suffering from stable psoriasis vulgaris. Podophyllotoxin was applied once daily at three different concentrations in an ointment base, namely 0.1, 0.25 and 0.5%. One stable psoriatic lesion was selected and monitored during the study course. All three concentrations of podophyllotoxin induced a statistically highly significant improvement (p less than 0.001) of the selected lesions. There was statistically highly significant difference between the treated and control lesions already after 2 weeks of treatment (p greater than 0.001), and this difference increased further during the study course. Eleven patients experienced adverse reactions - severe skin rash - spontaneously reported by the patients.

Adult

An epidemiological survey of psoriasis in the greater Helsinki area.

A questionnaire survey of all members of the Psoriasis Society of the Greater Helsinki area was carried out during March and April 1984 in order to determine the course of psoriasis. 1517 (85.4%) of the members responded; 1050 of them had psoriasis with skin symptoms only (psoriasis; P) and 400 had also joint symptoms (psoriatic arthritis; PA). In two thirds, the psoriasis had started before the age of 30 years. Skin lesions were more frequent in the PA-group than in the P-group, and more severe in men than in women in both groups. Of the 400 with PA, about 70% had moderate to very severe discomfort in their joints. Most of the patients had experienced their first joint symptoms at the age of 20 to 49 years. In the majority of the patients with PA the skin symptoms begun before the joint symptoms; in 7% the joint symptoms had preceded the skin symptoms; and in 10% both symptoms had begun simultaneously.

Adolescent

A dimethoxynaphthalene derivative (RS-43179 gel) compared with 0.025% fluocinolone acetonide gel in the treatment of psoriasis.

Thirty patients were entered into a double-blind trial comparing a dimethoxynaphthalene derivative (RS-43179 gel) and fluocinolone acetonide (Synalar gel) in the treatment of psoriasis. The two preparations were applied three times daily for 4 weeks, and the patients were assessed at weeks 1, 2, 3, 4, 7 and 9. No significant differences between the two preparations could be detected. By the end of the 4-week treatment period, the number of patients showing a 'Good, Excellent or Clear' therapeutic response was 25 out of 28 after RS-43179 treatment and 26 out of 28 after Synalar treatment. Four patients experienced irritation on the side treated with RS-43179. In two of these patients the reaction was severe and the treatment was discontinued, but in the other two patients, the local irritation was only moderate. No other adverse reactions were seen.

Adult

The effect of etretinate compared with different regimens of PUVA in the treatment of persistent palmoplantar pustulosis.

Eighty-four patients with persistent palmoplantar pustulosis (PPP) of long duration were treated with either etretinate or one of three PUVA regimens. PUVA was given either with oral methoxsalen (thirteen cases), with a 1% methoxsalen cream (thirty-three cases) or with trioxsalen baths (eighteen cases). Twenty patients were treated with etretinate. Patients were assessed every fourth week. A mean score for each group was calculated at each visit based on erythema, desquamation, induration and pustulation. In addition, the number of pustules was calculated at each visit. After 12 weeks four of twenty-eight patients treated with local methoxsalen and fourteen of seventeen patients treated with etretinate had completely cleared. At this stage no patient treated with local trioxsalen or oral methoxsalen showed complete clearance.

Chronic Disease

Oral acyclovir suppression of recurrent genital herpes: a double-blind, placebo-controlled, crossover study.

A randomised, double-blind, placebo-controlled, crossover study was conducted in 31 male patients with a history of frequently recurrent genital herpes who received consecutively 200 mg acyclovir and matching placebo by mouth four times a day for 12 weeks each. During acyclovir therapy recurrences were completely prevented in 24 (77%) and were reduced in both frequency and duration in the remainder compared with those occurring during treatment with placebo. The incidence and nature of adverse events reported during each treatment period was virtually identical. No long-term effects on recurrence rates were discernible but chronic suppressive therapy can be considered to offer the means of controlling the severe forms of disease experienced by some patients.

Acyclovir

Direct detection of Chlamydia trachomatis in clinical samples.

Some properties of a monoclonal antibody raised against the major outer membrane protein of Chlamydia trachomatis strain L2 are described. The antibody was fluorescein (FITC) conjugated and was provided as a diagnostic kit (Chlamyset Antigen Test, Orion Diagnostica). The monoclonal antibody reacted well with strains K, L1, L2, D, E, and G, and moderately well with the strains F, C, J, A, H and I of C. trachomatis. It did not react with the human C. psittaci strain Tw 183. The reagent had a sensitivity of 89.3% and a specificity of 98.7% when compared to parallel isolation in tissue culture. The monoclonal reagent seemed to be sensitive and very specific for rapid detection of Chlamydia trachomatis in clinical samples.

Antibodies, Monoclonal

Risk of cutaneous carcinoma in psoriatic patients treated with PUVA.

A total of 1047 psoriatic patients treated with PUVA were examined for lentiginosis, actinic keratosis and skin cancer. 128 patients had earlier been treated with arsenic, 4 with ionizing radiation and 6 with methotrexate. Lentiginosis was found in 6.2% and actinic keratosis in 1.8% of the patients. 2 patients had histologically verified basal cell carcinoma, 1 had squamous cell carcinoma and 1 Bowen's disease. In patients followed for more than 4 years, those who had received a cumulative dose of UVA greater than or equal to 1000 J/cm2, as well as those who had received more than 150 irradiations had significantly greater frequency of lentiginosis and actinic keratosis. This seemed to be the case also in patients with earlier arsenic treatment. The number of skin malignomas detected did not significantly exceed the expected incidence in the normal Finnish population of the same age-group.

Adult

Alclometasone dipropionate cream 0.05% versus clobetasone butyrate cream 0.05%. A controlled clinical comparison in the treatment of atopic dermatitis in children.

A randomized, double-blind, parallel-group study was conducted comparing the efficacy and safety of alclometasone dipropionate cream 0.05% and clobetasone butyrate cream 0.05% in the treatment of atopic dermatitis in 43 children. The medications were applied to study areas as a thin layer of cream twice daily for 2 weeks. Efficacy was assessed by evaluation of three disease signs (erythema, induration, and pruritus) and by mean of a physician's global evaluation following treatment. Safety was evaluated through patient-reported and clinically observed adverse experiences. Both treatments were effective. At the end of the trial, average reduction in disease signs was 85% for alclometasone dipropionate-treated patients and 86% in the clobetasone butyrate-treated group. In the global evaluation, the physician rated symptoms as cleared in 9 of 22 alclometasone dipropionate-treated patients and in 10 of 21 clobetasone butyrate-treated patients.

Administration, Topical

Motretinide versus benzoyl peroxide in the treatment of acne vulgaris.

30 patients with acne vulgaris were treated topically with motretinide 0.1% vanishing cream or benzoyl peroxide 5% gel in an open study. Good results were obtained in both groups. Benzoyl peroxide caused local irritation in 73% of the patients, whereas motretinide was well tolerated except in 1 case. Motretinide is considered an alternative in the treatment of papulopustular acne in young adults.

Acne Vulgaris

Assessment of atrophy of human skin caused by corticosteroids using chamber occlusion and suction blister techniques.

The effect of five corticosteroid ointments on epidermal thickness was studied using occlusive chamber application. Thinning of the epidermis and telangiectasia were noted 3 weeks after application of betamethasone-17-valerate (BV), budesonide (BD), clobetasol-17-propionate (CP), and fluocinolone acetonide (FA), but not of hydrocortisone (HC). Suction blisters were raised at the treated sites. Epidermal thinning was always associated with reduction in cell number. By combining different methods it seems possible to define more precisely the epidermal effects of various corticosteroid preparation.

Adrenal Cortex Hormones

Treatment of alopecia areata with three different PUVA modalities.

Seventy-six patients with severe alopecia areata were treated with either local or oral 8-methoxypsoralen and UVA irradiations. In 43 cases (57%) a good-to-excellent result was obtained. The number of irradiations required for regrowth varied, but 20-40 treatments were sufficient in most cases with a positive response. Patients with circumscribed or ophiasic alopecia responded better than patients with total or universal alopecia. Non-atopic patients responded better than patients with atopy, while a family history of alopecia areata did not seem to have any significance on the outcome of the therapy. The age of onset of the disease seemed to be of importance, as well as the duration of the treated attack. Patients over 20 years old at the first attack showed a better response than patients with an earlier onset of the disease. During a follow-up period of 6-68 months, 22 of 43 successfully treated patients had a relapse.

Adult