Biomedical subjects
Publications and source records attributed to C S Petersen.
Pseudoporphyria with formation of bullae and vulnerability of skin exposed to light, particularly the backs of the hands, may be provoked medicinally by nalidixinic acid, tetracyclin, nabumeton, pyridoxine, dapsone and high-dosage furosemide and by excessive use of solaria. The present article demonstrates that the condition may also be precipitated by quinidine and ibuprophen.
BACKGROUND: High-dose hydroxychloroquine is rarely used in the treatment of porphyria cutanea tarda (PCT). OBJECTIVE: The purpose of this study was to evaluate the efficacy and safety of a novel high-dose hydroxychloroquine regimen in patients with PCT. METHODS: Sixty-five first episodes and 28 recurrent episodes of PCT were treated with hydroxychloroquine, 250 mg three times daily, for 3 days. In patients with a high urine porphyrin concentration a single phlebotomy of 500 ml was performed before therapy of the first episode. Modified high-dose hydroxychloroquine regimens were used in patients with markedly elevated liver transaminases with or without associated chronic liver disease. RESULTS: Long-term follow-up data showed an overall relapse rate of 33%, significantly higher among male patients (45%) than among female patients (17%) (p less than 0.05). A transient hepatotoxic reaction occurred in the majority of patients. The reaction seemed to be especially severe among phlebotomized female patients. CONCLUSION: Hydroxychloroquine, 250 mg three times daily, is a rapid, efficacious, and safe treatment in patients with PCT.
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The safety and clinical impact of isoprinosine in HIV-infected individuals were assessed in a multicentre, randomized, double-blind, 24-week study phase, followed by an optional 24-week open treatment phase. The results of the double-blind phase have been reported. Of 866 HIV-seropositive patients randomized, 832 subjects were eligible for efficacy analysis. On completion of the double-blind phase, 596 patients started open treatment. All patients were evaluated with regard to progression to AIDS and/or death. Within 48 weeks, 10/412 (2.4%) patients assigned isoprinosine and 27/420 (6.4%) patients assigned placebo progressed to AIDS (P = 0.005). Intention-to-treat analysis showed identical results. Viewing the open treatment phase in isolation revealed no difference in progression rates between those treated and those not receiving the drug, perhaps reflecting the higher proportion of patients receiving zidovudine or PCP prophylaxis in the latter group. No severe adverse reactions or toxicities were observed. We conclude that HIV-seropositive patients without AIDS may be safely and effectively treated with isoprinosine.
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OBJECTIVES: To examine the sexual behaviour and the prevalence of sexually transmitted diseases (STD) among females attending an inner-city STD clinic before and after safer sex campaigns. SUBJECTS: In 1984 981 women and in 1988 684 women were interviewed immediately after the venerological examination. SETTING: Department of Dermato-Venereology, Bispebjerg Hospital, Copenhagen, Denmark. METHODS: In a face to face interview, details of symptoms, age at coitarche, number of sexual partners (lifetime and during the last year), obstetric history, and contraceptive methods were recorded. RESULTS: A substantially higher proportion of women used condoms in 1988 than in 1984. A dramatic decrease in the prevalence of gonorrhoea occurred (from 22% in 1984 to 6% in 1988, p < 0.01), whereas an increase in the number of patients with genital warts was observed (from 4% in 1984 to 10% in 1988, p < 0.05). The prevalence of chlamydia, genital herpes, and cervical dysplasia remained unchanged. No significant changes in the number of sexual partners, or the frequency of sexual intercourse or unplanned pregnancy could be detected from 1984 to 1988. CONCLUSIONS: The safer sex campaigns have only been partly successful, as a general reduction in all sexually transmitted diseases should be expected as a result of the increased use of condoms. Future campaigns should focus on the correct use of condoms, and encourage a lifestyle with stable sexual relationship.
The clinical presentation of molluscum contagiosum is described in detail in 16 HIV-infected patients. Atypical facial lesions with either multiple small papules or giant nodular tumors prevailed in patients with AIDS or AIDS-related complex. A theoretical basis for the atypical localization of the disease is lacking.
A patient with an otherwise recalcitrant chronic vesicular hand eczema responded with a dramatical improvement within 2 weeks of cyclosporin A (CsA) therapy 5.0 mg/kg daily. The patient was still free of eczema in spite of reducing the CsA dose to 2.5 mg/kg daily. CsA therapy was finally stopped due to a moderate increase in blood pressure, resulting in rapid recurrence of the hand eczema. The case report clearly demonstrates that oral CsA should be considered in patients with severe hand eczema that cannot be controlled on conventional immunosuppressive treatments.
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Acute HIV infection with a papular rash is described in a homosexual man ten weeks after a single episode of orogenital contact (fellatio). The "safe sex" recommendations are discussed.
Two cases of symptom-producing balanoposthitis associated with Human papillomavirus infection are described. These patients had spotty, macular, erythematous rash on the glans penis and prepuce. The symptoms and objective findings resemble those of Candida infection but the diagnosis can be established by histological examination of biopsy from the acetowhite elements.
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Systemic treatment modalities for eradication of multiple therapy resistant genital warts are so far not available. In this study laser treated patients with multiple genital warts received postoperatively either interferon alpha-2b subcutaneously (s.c.) 5 x 10(6) IU or matching placebo three times weekly for four weeks. At the conclusion of the study, 6-8 weeks after discontinuation of therapy, a significantly higher cure rate was found in the group of interferon-treated patients (14 of 27 (52%) patients cured) than among placebo treated patients (5 of 22 (23%) patients cured) (p less than 0.05). The side effects of fever, chills, myalgia, headache and leukopenia occurred more commonly in the interferon treated group than in the placebo group. However, only three of 32 patients discontinued interferon therapy because of side effects. We conclude that the addition of s.c. administered interferon alpha-2b to laser treated patients with chronic therapy resistant genital warts is fairly well tolerated and that it significantly enhances the chance of eliminating the disease.
Cervical biopsy specimens were taken from 55 Pap-smear-negative women with external genital warts in order to diagnose a concomitant cervical human papillomavirus (HPV) infection. HPV-DNA was demonstrated by in situ hybridization in 17 (31%) of the samples: HPV types 16/18 in 9, HPV types 6/11 in 5 and double infection (16/18 and 6/11) in 3. HPV-DNA was found in 10 (43%) of 23 biopsy specimens with koilocytotic atypia and in 5 (29%) of 17 specimens showing chronic inflammatory reaction, whereas only 2 (13%) of 15 women with normal cervical histology had HPV-DNA in the biopsy specimen. Overall histology and in situ hybridization indicated the presence of a cervical HPV infection in at least 30 (55%) of the 55 women examined. Colposcopic examination revealed abnormal acetowhite epithelium in 17 (74%) of 23 women with koilocytosis and/or HPV-DNA positivity, compared with 7 (32%) of 22 HPV-DNA-negative women with histology showing either chronic inflammatory changes or normal epithelium (p less than 0.01). It is concluded that a cervical focus of HPV infection is frequent among Pap-smear-negative women with external genital warts.
A sonicate of Treponema phagedenis biotype Reiter (Reiter treponemes) was used as sorbing agent in parallel with sorbent in the FTA-ABS test. By diluting the Reiter treponemal antigens in approximately 0.5 M NaCl, the Reiter sonicate could be produced in sufficient quantities for its use in routine FTA-ABS. In crossed immunoelectrophoresis against a rabbit anti-Reiter immunoglobulin, 40 Reiter antigens were detectable in the sonicate and only one in the sorbent. The diluted sonicate and the sorbent had similar osmolarity and almost similar pH. FTA-ABS with sonicate and sorbent had similar sensitivity in untreated early and late syphilis. Only in treated early syphilis was non-reactivity usually obtained somewhat earlier with sonicate than with sorbent. Both FTA-ABS with sonicate and sorbent had a specificity near 98%. It is concluded that replacement of sorbent with sonicate in the routine FTA-ABS test would increase the costs without substantial improvements of the test.
The seven makes of condom which are marketed in Denmark were examined for the nonoxynol content with the object of assessing whether the content of nonoxynol in the condoms is sufficient to present HIV spread in connection with use of the condom and assessed in relation to the defects in effectivity (tearing, holes, overflow of semen, sliding off). Compared with the declared content of nonoxynol of 40 mg (100%) per condom, the following nonoxynol quantities could be demonstrated by methanol/water extraction and subsequent high-performance liquid chromatography: One make of condom contained 65%, two 50-55% and four 25-33%. The nonoxynol content was found to be evenly distributed between the outer and inner surface of the condoms. With a theoretical distribution volume of 6 ml (tearing during vaginal coitus), it was found that three of the makes of condoms examined did not achieve the HIV-inhibiting nonoxynol concentration of 0.05%, by means of measuring the quantity of nonoxynol on the distal 5 cm of the condoms. In anal sex, the distribution volume is greater resulting in lower nonoxynol concentrations and thus increased risk for HIV infection. It is concluded that the nonoxynol content in the condoms marketed in Denmark should be increased in order to inactivate HIV in case of condom failure.
Human papilloma virus vulvitis with flat elements resembling leucoplakia may be diagnosed by application of a 5% acetic acid solution and subsequent biopsy and histological examination. The condition causes irritation with dyspareumia and is so frequent that the diagnosis and initial treatment may be undertaken by the general practitioner.
We performed a randomized, double-blind, placebo-controlled trial to assess the efficacy and safety of inosine pranobex (Isoprinosine) [corrected] in the treatment of patients with human immunodeficiency virus (HIV) infection but without manifest acquired immunodeficiency syndrome (AIDS). A total of 866 patients were enrolled in 21 centers in Denmark and Sweden. The patients were stratified in three groups according to their CD4+ cell count and randomly assigned to receive either inosine pranobex (1 g three times a day) (n = 429) or matching placebo (n = 437) for 24 weeks. Of the 831 patients who could be evaluated, AIDS developed in 17 in the placebo group as compared with 2 in the inosine pranobex group (P less than 0.001; odds ratio, 8.6 [95 percent confidence limits, 2.2 and 52.6]). There were no significant differences between the groups with respect to changes in CD4+ cell count or the development of other HIV-related conditions, with the exception of thrush, which developed in fewer patients in the inosine pranobex group (P = 0.05). No serious side effects were observed. We conclude that treatment with inosine pranobex delays progression to AIDS in patients with HIV infection. The duration of this beneficial effect, the optimal dose, and the mode of action of inosine pranobex remain to be clarified.