Direct reimbursement.
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Biomedical subjects
Publications and source records attributed to A Wenzel.
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The influence of the xanthine derivative pentoxifylline ('Trental' or BL191; Hoechst-Roussel) on exercise tolerance was measured in 38 subjects with stable, severe to moderately severe, intermittent claudication who completed a randomised, double-blind, placebo controlled, cross-over clinical trial. Patients received placebo tablets or 400 mg slow-release pentoxifylline tablets ('Trental 400') twice a day for one week, followed by three times daily for seven weeks, and then crossed over to receive the alternate preparation for another eight weeks. Claudication distance and walking distance were measured on a treadmill before starting treatment and again at four-week intervals during the trial. At the same times, red blood cell filterability, plasma fibrinogen concentration and blood viscosity, resting and post-ischemic calf muscle blood flow, and the resting and post-exercise ankle/brachial systolic pressure ratio were also measured. In this study, the observed effects of pentoxifylline treatment were no greater than those of placebo, even though serum levels of pentoxifylline and its hydroxy-metabolite were within the anticipated range. This was shown by a 'therapeutic effect ratio' of 0.98 for treadmill claudication distance and 0.96 for treadmill walking distance after within-patient analysis at the end of the cross-over (where a ratio of 1.0 means the test drug and placebo effects are identical). These ratios have 95% confidence limits of 0.72-1.34 and 0.74-1.25, respectively.
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New penem derivatives with various substituted, enantiomerically pure pyrrolidine-thio side chains at the C-2 position were synthesized and their chemotherapeutic potentials assessed in comparison with Sch 29482. The following criteria were used for preliminary evaluation: Antibacterial activity in vitro, beta-lactamase inhibition and apparent hydrolysis rates by crude murine and human kidney enzyme preparations. The most active compounds, 16e, 16f and 18 exhibit properties typical of this substance class with a tendency towards greater antibacterial potency in comparison with Sch 29482, especially against Pseudomonas aeruginosa. No clear-cut structure-activity relationships could be found with respect to beta-lactamase inhibition and stability against degrading renal enzymes.
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Radiographs of the left forelimb were obtained after slaughter in 16 14-month-old pigs. From age 8-14 months, eight pigs in the experimental group received 2 mg F-/kg body weight per day. Bone maturity in F-animals was the same as in controls. Cortical thickness was increased by 10 per cent in the fluorotic animals (p less than 0.01) and their plasma-fluoride levels increased throughout the experimental period to approximate those reported for man in endemic fluorosis areas. Thus fluoride given in the dose used and over that period, did not affect maturation in the long bones but increased cortical bone mass in the diaphyses.
The caries experience and dental fluorosis of 84 Danish children, who had used fluoride tablets for 1-4 yr in the period 1976-80, were compared with those of a group matching in sex, age, place of living, and socioeconomic status. The average age of the children at the time of examination was 5.8 yr. A recording of mothers' attitudes to dental care, knowledge about tooth brushing, attitudes to candy, and number of teeth in the maxilla showed no difference between the fluoride tablet group and the non-users' group. Moreover, there was no significant difference between the two groups with respect to dental caries. The findings are discussed in relation to recent reports on the decline of dental caries resulting from widespread use of local administration of fluorides.
The effect of intranasally administered corticosteroid (budesonide) on nasal symptoms, mode of respiration (nasal versus mouth breathing), and asthma was investigated in 37 asthmatic children who were mouth breathers because of chronic nasal obstruction. After a 2-wk run-in period, the children were allocated randomly to 4 wk of intranasal therapy with either budesonide (400 micrograms/day) or placebo spray. A double-blind, parallel design was used. Diaries for peak expiratory flow, asthma, and rhinitis symptom scores and degree of mouth breathing were recorded at home. Nasal eosinophilia, nasal airway resistance at a flow of 0.2 L/s (NAR0.2), and lung function at rest and after exercise challenge were assessed at the clinic immediately before and at end of the 4-wk treatment. Budesonide, when compared with placebo, significantly decreased nasal obstruction (p less than 0.05), secretion (p less than 0.01), and eosinophilia (p less than 0.02), as well as NAR0.2 (p less than 0.05) and mouth breathing (p less than 0.01). The improvement in nasal obstruction correlated closely to the changes in mouth breathing (r = 0.80, n = 17, p less than 0.001). Furthermore, intranasally administered budesonide resulted in less exercise-induced asthma (EIA) (p less than 0.02) and decreased cough and asthma severity significantly. Pulmonary mechanics were only marginally improved. The present study showed that intranasally administered budesonide is effective in the treatment of perennial allergic rhinitis. An attenuation of EIA and a tendency to less asthma after budesonide therapy suggest a decrease in bronchial reactivity, but the results gave no clear evidence of an association between nasal airway function and asthma.
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The influence of mouth breathing on craniofacial development has previously been demonstrated. Recent investigations do indicate, however, that head posture also might be related to craniofacial morphology. The aim of the present study was to analyze the effect of a topical steroid spray (Budesonide) on nasal respiratory resistance and head posture in children with asthma and nasal obstruction. Thirty-seven children, 8 to 15 years of age, with bronchial asthma, perennial allergic rhinitis, and subjectively assessed mouth breathing were selected for the study. Rhinomanometric and cephalometric analyses were performed. Head posture was defined as the position of the head relative to the cervical column and to the true vertical. After the first examination the children were randomly allocated to two groups, of which one group was treated intranasally with Budesonide (N = 18) and the other with placebo (N = 19), for a double-blind study. After one month of treatment, there was a statistically significant decrease in nasal resistance (p less than 0.001) and an increased flexing of the head (p less than 0.01) (paired t tests) in the children under active treatment. No significant changes were seen in the placebo group. The results indicate that Budesonide nasal spray is capable of reducing nasal obstruction in allergic children and that a reduced nasal resistance leads to a decrease in craniocervical angulation. The clinical importance of these results is yet to be clarified.
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Dental fluorosis was evaluated by a classification system, previously shown to be sensitive, and skeletal changes evaluated by bone maturity and structure. Dental fluorosis was more severe in posterior than in anterior teeth in both jaws irrespective of fluoride concentration of the drinking water. There appeared to be no dependence between fluoride content of the water and skeletal maturity or structure, but there was a definite relationship between the degree of dental fluorosis and skeletal maturity within the high fluoride area. Fluoride concentrations in the drinking water above 3 parts/10(6) seemed to affect all mineralizing tissues under formation. The unique pattern of enamel formation and mineralization renders it the only hard tissue which permits an early diagnosis of the biological effect of even low fluoride doses on the human body.