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Biomedical subjects

E Freerksen

Publications and source records attributed to E Freerksen.

At least 19 recordsLinked to original sources
PubMed1992

Critical comments on the treatment of leprosy and other mycobacterial infections with clofazimine.

The usefulness of clofazimine (CLO, CAS 2030-63-9) in the treatment of mycobacterial infections with special emphasis on treatment of leprosy is critically discussed. Skin discolouration which decreases compliance, placenta passage, excretion in mother's milk which endanger the embryo or baby respectively, saturation kinetics in absorption and difficulties to determine free drug concentration are severe problems. The observed antagonism in the combination of CLO with other drugs, especially with dapsone, is another argument against its application in the therapy of mycobacterial infections. In Germany CLO has not been approved by the Bundesgesundheitsamt.

Clofazimine↗
PubMed1991

[Short-term chemotherapy of leprosy using the combination rifampicin + cotrimoxazole + isoniazid].

With the fixed combination RMP + SXT + INH an objective and subjective improvement was obtained within two months, even in severe LL-cases. Treatment resulted in final and relapse-free cure. In the majority of patients the typical erythematous infiltrative oedematous skin processes disappeared within the two months of treatment, in some of them (three of 21) within the six-month follow-up period. Lepromas (15 cases) disappeared in two patients within the two months of treatment. In the sixth month of the follow-up period nine patients were free from lepromas. In another six cases they subsided in the course of the following months. Reactions occurred in 13 patients, in part during treatment, in part during the follow-up period. Three of them were reversal reactions. Chemotherapy was not interrupted. When required, corticosteroids or thalidomide were given in addition. Erythema nodosum leprosum (17 cases) quickly subsided under treatment. Tolerance and compliance were excellent. The subjective minor "side effects" were not specific and cannot clearly be attributed to the medication. The major advantage of the combination RMP + INH + SXT described in this paper lies in the considerably reduced treatment duration (two to four months instead of two years), the rapid disappearance of the symptoms typical of leprosy, the high tolerance, the ease of application as fixed combination and the absence of relapses. So far the patients have been followed up for two years. Through the short treatment duration the cost of treatment is considerably reduced. The new combination allows outpatient treatment and is universally applicable. The patient can maintain his social and professional habits.

Adult↗
PubMed1990

[Chemotherapy of opportunistic infections in AIDS].

Proposal for therapy and prophylaxis of opportunistic infections in AIDS using complex combinations consisting of four substances (Rifampicin + Sulfamethoxazol + Trimethoprim + Isoniazide or Rifampicin + Sulfamethoxazol + Trimethoprim + Protionamide) in a fixed combination.

Acquired Immunodeficiency Syndrome↗
PubMed1989

New forms of multidrug therapy for the treatment of leprosy. First report for the practice on rifampicin + sulfamethoxazole-trimethoprim + protionamide and rifampicin + sulfamethoxazole-trimethoprim + isoniazid.

Since 1970, when the lifelong monotherapy with dapsone (DDS) in leprosy could be replaced by short-term combination therapy with rifampicin + isoniazid + protionamide + DDS (Isoprodian-RMP), chemotherapeutic research was faced with two problems: (1) to find alternative treatment regimens for cases of intolerance, and (2) to work out forms of therapy allowing a further reduction of the average treatment time of 2 years. The present paper describes the attempts made to find solutions to these problems. With two new combinations, alternatives have become available, and the average treatment time is shortened to 6 months. Both combinations are also effective in tuberculosis.

Drug Therapy, Combination↗
PubMed1989

Integrated complex combinations for the treatment of opportunistic infections in AIDS.

In the present paper the 'serial combinations' (components of the combination offered separately), as used in conventional combination therapy, are compared with the 'integrated complex combination' (offered as fixed combinations). So far, three combinations have been worked out on the basis of this concept (RMP + SMZ + TMP + INH; RMP + SMZ + TMP + PTH; RMP + INH + PTH + DDS). They allow successful treatment of almost all mycobacterial infections and diseases (including tuberculosis and leprosy) and a number of infections caused by gram-negative and gram-positive microorganisms and by Pneumocystis carinii.

Acquired Immunodeficiency Syndrome↗
PubMed1978

Combined therapy in leprosy. Background and findings.

This report is based on data obtained from 64 lepromatous cases. Despite many years of DDS monotherapy, the homogenates from biopsies of these patients revealed 10(4) or more bacteria. From the beginning of combination therapy with synergistic-acting substances (rifampicin + isoprodian (INH + PTH + DDS) the logarithms of the number of bacteria in the homogenates decreased, both during treatment period and during treatment-free observation period (Figs. 3--8). During the whole time biopsies were taken almost monthly. A considerable regression of the bacterial mass or even "negativity" could be observed within a relatively short time. Once started, the process of reduction of bacteria continued also after termination of therapy. To be able to evaluate a medication, therapy-free observation periods (for a minimum of 5 years) are indispensable.

Dapsone↗
PubMed1978

Subcellular distribution of [14C]5-hydroxytryptamine in the blood platelets of rabbits: effects of imipramine and and haloperidol.

Long-term (10 days) administration of imipramine [20 mg/(kg X d)] to rabbits significantly increases the Km value (4.0 micron) of 5-hydroxytryptamine uptake in their platelets compared to those of saline- (0.7 micron) or haloperidol- (0.4 micron) treated rabbits. Administration of haloperidol inhibits the 5-hydroxytryptamine uptake non-competitively, and in vitro it had an ID50 value of 22 micron. Intravenous injections of [14C]5-hydroxytryptamine were given to the animals 1 h before blood collection. After isolation of platelets, their sonicates were subjected to 30-60% continuous sucrose gradient centrifugation. The subcellular distribution of [14C]5-hydroxytryptamine indicates that imipramine treatment, in contrast to the control and haloperidol treatment, led to a shift in the exogenous 5-hydroxytryptamine peak from within the granular zone (d 1.18) to the extragranular cytoplasm (d 1.15). Compared to control values, the imipramine treatment caused 63% inhibition in the platelet Na-K-ATPase activity.

Animals↗
PubMed1977

[Research in the campaign against leprosy (author's transl)].

"Leprosy Relief through Leprosy Research" means that the results of research are made available for curing and eradicating the disease. The "Marinum Model" and the "planter test in mice" are, along with determination of serum activity in healthy test subjects, part of a complex of experiments for the assessment of the therapeutic value of an antimycobacterial substance. This replaces the "controlled studies" which, in their proper form, are scarcely possible for leprosy. With the recently developed forms of combination therapy, the duration of leprosy treatment is reduced to a few years. Because of the relationship of Mycobacterium leprae to Mycobacterium tuberculosis, certain types of combination therapy can be used in both diseases at the same time.

Animals↗
PubMed1977

Treatment of chronic salmonella carriers. Study with 40 cases of S. typhi, 19 cases of S. paratyphi b and 28 cases of S. enteritidis strains.

The present stage of our studies suggests that, provided a highly effective combined therapy is, and can be, carried out correctly, all excreters can be cured of their chronic carrier state by chemotherapy within 8-12 weeks. Although we cannot recommend a universal therapeutic regimen for all patients, a highly effective 'basic therapy' (RMP+TSP) is available for the majority of the cases, needing occasional modification, depending on the specific requirements of the individual patient as shown by the result of the serum activity determination. This method saves the patient from toxic inconveniences caused by inadequate treatment, it shortens the treatment time and makes cholecystectomy superfluous - unless it is considered necessary out of a different indication in which case it should certainly be done. We cannot share the often expressed view that Salmonella enteritidis excreters cannot be cured, a view which is found even in the most recent manuals. The same applies to the view that therapy is not necessary because it would delay cure. It is indispensable to establish a close cooperation between the public health authorities and the private physician, and we therefore wish to sincerely thank all colleagues and Public Health Officers for their collaboration.

Adolescent↗