PubMed Health⌕ Search

Biomedical subjects

D Herman

Publications and source records attributed to D Herman.

At least 37 records · Page 2Linked to original sources
PubMed1995

A multicenter clinical study of the efficacy and tolerability of azelastine nasal spray in the treatment of seasonal allergic rhinitis: a comparison with oral cetirizine.

A new topically administered intranasal antiallergic drug, azelastine, was investigated in a large randomized multicenter study that compared it with oral cetirizine from the aspects of efficacy and safety. Patients were treated for 14 days, and efficacy was assessed on days 7 and 14 by means of an investigator rating scale measuring the severity of eight nasal and ocular symptoms of seasonal rhinitis. In addition, patients recorded the extent of individual symptoms on a visual analogue scale (VAS). Tolerability was assessed on the basis of adverse events reported. Data from a total of 129 patients were included in the analysis of drug efficacy. Treatment groups had significant reductions in the investigators' total symptom score during treatment. These reductions were 47% and 55% for azelastine and cetirizine, respectively, at day 7 and 61% and 67% at day 14. There were no differences between the two groups whether they were analyzed overall or separately for nasal and ocular symptoms. Patients' daily VAS scores showed a significantly better resolution of nasal stuffiness and rhinorrhea in the azelastine-treated group than in the cetirizine-treated group. There were no differences for any other symptom. Adverse events were reported by 12 patients in the azelastine group and 20 patients in the cetirizine group. Drowsiness was the only frequently occurring event and this was reported by 9 patients in the cetirizine group and 2 patients in the azelastine group (P = 0.003).

Administration, Inhalation↗
PubMed1995

[Ear prosthesis anchored on osseointegrated implants. Experience with 9 cases].

The use of osseointegrated titanium implants has improved the quality of auricle prosthesis fixation. Between december 1993 and july 1994, twenty two titanium fixtures have been surgically implanted in nine patients in the Ear Nose Throat department of the university hospital of Strasbourg. This method of auricle amputation repair achieves a good esthetic result with a low rate of postoperative complications.

Adolescent↗
PubMed1995

[Results of the use of parietal bone as bone graft donor site in facial reconstruction. Apropos of 71 cases].

The embryologic origin of the parietal bone is membranous bone. Experimentally, membranous bone grafts, maintain its original size, structure with good osteo-integration contrary to endochondral bone autografted (ilium, rib or tibia). The morbidity of skull bone grafts is much less than other donor site of bone. In our study, between 1988 and 1992, autogenous split calvarial bone grafts were used in maxillo-facial reconstruction of seventy-one patients. We observed no major complication. Patient followup has been from 2 to 6 years and results are better than endochondral grafts (iliac crest, ribs, tibia). Parietal grafts bone have been used in the following case: nasal reconstruction, rehabilitation of defects in the floor of the orbit, maxilla grafts, correction of frontal depression and mandibular reconstruction.

Adolescent↗
PubMed1994

Continuous infusion bleomycin in AIDS-related Kaposi's sarcoma.

PURPOSE: To determine the toxicity, response, and survival rate of 72-hour continuous infusion bleomycin administered to patients with AIDS-related Kaposi's sarcoma. PATIENTS AND METHODS: Seventeen patients with biopsy-proven and measurable-disease AIDS-related Kaposi's sarcoma were treated with a continuous infusion of bleomycin at a dose of 20 mg/m2/d for 3 days every 3 weeks. All patients were evaluated for toxicity, response, and survival using the National Cancer Institute common toxicity criteria, and both the Eastern Cooperative Oncology Group (ECOG) and AIDS Clinical Trials Group (ACTG) response criteria. Fourteen of 17 patients (82%) enrolled had at least two on-study poor-risk factors by ACTG staging criteria. RESULTS: A total of 59 cycles of therapy were administered. Only one cycle (2%) was complicated by an absolute neutrophil count less than 500, and there were no episodes of febrile neutropenia. Fifty-four percent of cycles were associated with fever during the infusion, and five cycles (8%) were complicated by grade 3 rash. There were no other clinically significant (> or = grade 3) toxicities. There were seven partial remissions (41%) by ECOG criteria (95% confidence interval, 18% to 64%) and 11 partial remissions (65%) by ACTG criteria (95% confidence interval, 42% to 88%). Three of five (60%) previously treated patients had a partial remission with this schedule of bleomycin. The median survival duration was 7 months, with a range of 2.5 to 25 months. CONCLUSION: This continuous infusion schedule of bleomycin is active in patients with advanced-stage AIDS-related Kaposi's sarcoma and has acceptable toxicity. This regimen should be further evaluated in patients with earlier stage Kaposi's sarcoma and as salvage therapy.

Acquired Immunodeficiency Syndrome↗
PubMed1994

[Tissue expansion in mammary reconstruction and asymmetry. Apropos of 24 prostheses].

Based on a 24 mammary expansion implants performed in 14 cases of deferred breast reconstruction and in 7 cases of asymmetry, the authors analyze their results and indications according to data reported in the recent literature data. In breast reconstruction, expansion represents a relatively simple surgical procedure allowing an increase of local tissues without any additional scars. Its indications correspond to the gap left between simple prosthesis and musculo cutaneous flaps and are based on a clinical analysis of the volume and quality of mammary tissues considering that radiotherapy constitutes more factor of morbidity than a real contra-indication. A strict selection of patients allows reduction of the complications (6% prosthesis extrusions and 6% contractures in this series) that remains quite high (30%) in the literature. Based on two main operative steps, the reconstruction needs, in the great majority of cases, several complementaries operative sequences increasing to 2.4 in their series, and to 2.6-2.8 the average number of operative steps in literature. For breast asymmetry, expansion was correlated in this series to a higher incidence of complications and especially capsular contractures, leading to a limitation of their indications to cases in which the benefit is maximal in relation to an important glandulocutaneous deficit. These indications are in which hypoplasia with superointernal malposition of the nipple areola complex where the effect of expansion is maximal in the inferointernal mammary area and tubular and tuberous breasts, in which expansion allows a widening of the base of the breast and breaks the fibrous ring at the base of the breast.

Adolescent↗
PubMed1994

[The covering of radionecrosis in plastic surgery. Apropos of a series of 20 cases].

Twenty radionecroses with various locations were operated on between 1982 and 1993 in the Plastic Surgery Department at Strasbourg. Flap covers were performed. The results and indications as a function of localization and of the size and quality of the structures involved was analyzed for these radio-induced lesions. A wide range of therapeutic option are available to the plastic surgeon who must chose the most reliable reconstruction technique after the most extensive exeresis possible. Muscle and pediculated musculo-cutaneous flaps are preferred due to their safety, their vascular, trophic and anti-infectious quality and their excellent capacity of coverage.

Adult↗
PubMed1993

A masked, randomized, dose-response study between cyclosporine A and G in the treatment of sight-threatening uveitis of noninfectious origin.

Thirty-two patients with sight-threatening uveitis and a decrease in visual acuity requiring systemic therapy were randomly assigned to either cyclosporine A or G in a dose-escalation study. Groups received from 2.5 mg/kg of body weight/day to 10 mg/kg of body weight/day of either drug along with low-dose prednisone. More patients taking cyclosporine G had improved visual acuity and a decrease in macular edema, which occurred more rapidly than in the other group, even at the lower doses tested. No difference in renal function was noted between groups at any doses tested. Four patients receiving cyclosporine G had hepatic alterations, but only one required cessation of the drug. The study indicates the potential usefulness of cyclosporine G, particularly at lower doses (4 mg/kg of body weight/day), which could lower the potential for serious renal complications.

Adult↗
PubMed1993

[Vascularized parietal bone island flap. A technical note apropos of a case of reconstruction of the palate after hemi-maxillectomy].

Closure of wide palate defects is still a very complex problem and a real challenge for cervico-facial surgeons. The authors present an original technics drifted of the one D.W. Furnas describe in 1986. It allows, in a single stage, reconstruction of palatal defects. Surgical procedure of the temporal fasciosseous island flap is presented and then, advantages and inconveniences are discussed.

Follow-Up Studies↗
PubMed1993

[Spontaneous hemorrhage of the parathyroid disclosed by an extensive cervical hematoma].

Extra capsular bleeding occupies a particular place within the evolutional complications of parathyroid tumors. Its rarity, the difficulty of the pre-operative diagnosis and its potential evolution towards airway obstruction by compression underline its singular character. A case is presented where an evolutive cervico-thoracic hematoma, evolving without functional symptoms, has led to the diagnosis of parathyroid hyperplasia. The diagnostic and therapeutic characteristics of this pathology are detailed and confronted to the similar cases found in the literature.

Aged↗
PubMed1993

[Lingual necrosis after neck irradiation].

Lingual necrosis is a rarely observed pathology. The authors report a case of a lingual necrosis in the follow up of an irradiation. Horton's disease is the first diagnosis to evoke facing a lingual necrosis. This pathology is also one of the radiotherapy's complication, irradiation accelerates atherosclerosis process. An early treatment of this arterial complication can be proposed by a good prepossession and a doppler-pulse supervision of neck vessels.

Aged↗
PubMed1993

[Reconstruction of the upper jaw. Apropos of 3 cases].

In this article, we review our personal experience in 3 patients who underwent a maxillectomy for tumor and we discuss the different reconstructive techniques available. We believe that distant pediculed flaps and free flaps give the best result for the functional and cosmetic point of view.

Aged↗
PubMed1992

[The use of Sorbsan in the treatment of the donor site of skin transplantations].

Sorbsan is a new dressing composed of alginate fibers extracted from seaweed. It is claimed to have important hydrophilic, haemostatic and biocompatible qualities. Sorbsan was used in the treatment of the donor site of split skin grafts in 52 patients operated in this department from 1988 to 1990. The patients of this series required a skin graft for various reasons as detailed below: a) skin burns in 24 cases; 2) covering of a muscle flap used in the treatment of sacral pressure sores in 15 cases; c) 13 cases of loss of substance from other various causes. Healing time averaged 16.8-13.4 and 9.3 days respectively in the three groups reported above. In 85% of cases, healing was achieved in a period variable between one and two weeks and a half, varying in accordance with patient age and general conditions. The speed of healing, particularly where thin grafts were taken, allowed multiple split skin grafts to be taken from the same donor site, facilitating the treatment of extensive skin burns. The dressing can be removed with ease with only minimal discomfort to the patient. The incidence of side effects such as itching and scar hypertrophy or pigmentation is low. We haven't noticed any allergic reaction in this series. We found the use of this dressing satisfying in the treatment of donor sites of split skin grafts, particularly in terms of patient comfort and speed or healing.

Adolescent↗
PubMed1992

Different effects of nasal and bronchial glucocorticosteroid administration on bronchial hyperresponsiveness in patients with allergic rhinitis.

Disorders of the upper respiratory tract, particularly allergic rhinitis, are commonly associated with bronchial hyperresponsiveness. The latter may be due to postnasal drip or to mediator or chemotactic factors into the lower airways that either directly alter airway reactivity or cause airway inflammation. The aim of this study was to compare the effect of an identical dose of nasal or bronchial corticosteroid administration on bronchial hyperresponsiveness in patients with allergic rhinitis. Eleven patients were studied. All of them were judged atopic on the basis of positive skin tests to common allergens. During control, spirometry, flow-volume curves, and specific airway conductance (SGaw) were measured. Bronchial challenges were then performed with increasing concentrations of carbachol, and dose-response curves were constructed. The concentration of carbachol that decreased SGaw by 35% from baseline (PD35) was determined by interpolating from the dose-response curve. Control measurements were repeated at 1-wk intervals to ensure that PD35 was stable in all the patients. Then the patients received for 2 wk, in a double-blind randomized crossover fashion, a topical administration of either an aerosol of 400 micrograms of beclamethasone dipropionate (B) into the nose (100 micrograms four times per day) or into the bronchi. During each trial period, identical sprays of placebo were used, the latter being administered into the nose when B was administered into the bronchi and vice versa. Measurements were then performed after 2 wk of intranasal administration and after 2 wk of intrabronchial administration.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Inhalation↗
PubMed1992

[Mini-forum: rhinoplasty by external approach. Collumello-trans-alar approach of open rhinoplasty: advantages].

For several years, the authors have been using a columellar transalar incision through the medial crus along the nasal septum, reaching the vault and continued laterally by a transalar cartilaginous incision. The nasal tip is thus opened like a car-hood, leaving the alar cartilage attached to the skin and exposing the triangular cartilage and the nasal septum. This approach allows septoplasty to be performed with excellent exposure. The tip is easily revised backwards allowing anomalies to be viewed directly. The advantages of this external approach compared with the classical external Rethi's approach are multiple: simplicity and rapidity of the technique, excellent access to triangular cartilages and the triangular-septum junction; possibility of always going from an endonasal approach to an external one and excellent access to the tip. Moreover, there is no long term swelling of the tip. The indications of this external approach are asymmetry of the tip, excessive tip projection, saddle nose deformities and secondary rhinoplasties. No complication has been observed in a series of 32 patients with a follow-up of 6 to 48 months. There is no disturbance of the tip position and the skin scar is imperceptible.

Bone Transplantation↗