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E Melchior

Publications and source records attributed to E Melchior.

18 recordsLinked to original sources

Determination of clofazimine in leprosy patients by high-performance liquid chromatography.

An original, simple, specific, and rapid high-performance liquid chromatography assay for the determination of clofazimine in human plasma is presented. The procedure consists of extracting the drug and the internal standard (medazepam) from 0.5 mL plasma with dichloromethane/diisopropyl ether (1:1, v/v) at pH 3.0, after precipitating the proteins with methanol. The drugs were then quantitated on a reversed-phase C8 using a mobile phase consisting of a mixture of methanol/0.25 N sodium acetate buffer at pH 3.0 (74:26, v/v). The flow-rate and wavelength were set at 1 mL/min and 286 nm, respectively. The precision, linearity, and limit of quantitation of the method were within acceptable limits. The method was considered adequate and could be applied in studies involving blood level monitoring and pharmacokinetics in leprosy patients.

Chromatography, High Pressure Liquid↗

Influence of acetylator phenotype on the haematological and biochemical effects associated with dapsone in leprosy patients.

Methaemoglobinaemia and haemolytic anaemia were the principal side-effects observed in 30 leprosy patients undergoing long-term treatment with dapsone as a single drug or as part of multidrug therapy. Hepatic, pancreatic and renal evaluations showed no relevant clinical changes. Since N-acetylation is a major metabolic pathway for dapsone, slow acetylation phenotype may be a risk factor for the development of these reactions. To confirm this hypothesis we correlated acetylator phenotype and the haematological and biochemical effects induced by dapsone. No excess proportion of slow acetylators was found. We conclude that slow acetylators are not at greater risk of developing haematological side-effects of dapsone than fast acetylators.

Blood Cell Count↗

Postpartum symptoms. Episiotomy or tear at vaginal delivery.

The influence of episiotomy was evaluated in a quasi-randomized follow-up study. In 193 primiparas with spontaneous vaginal delivery, postpartum perineal pain and insufficiency symptoms and their duration were evaluated by means of a questionnaire, 15-24 months post partum. Information about the birth and any complications was obtained from the medical records. On comparing the 85 primiparas delivered by midwives who had a low episiotomy rate (mean 21%) versus the 61 primiparas delivered by midwives with a medium episiotomy rate (mean 34%) and the 41 delivered by midwives with a high episiotomy rate (mean 70%), no differences were found regarding postpartum perineal pain and insufficiency symptoms. Postpartum perineal pain symptoms were significantly correlated to the duration of the second stage of labor, irrespective of the episiotomy rate of the midwife in charge, or of the use of episiotomy.

Adult↗

Mycobacterium terrae tenosynovitis.

A 72-year-old man was admitted with tenosynovitis of the left forearm and hand. Histopathologic examination of the excised tissue showed noncaseating granulomas. Mycobacterial culture produced Mycobacterium terrae complex. M. terrae infection of any site is rare. Analysis of four documented cases and our present case indicates that this organism causes infection in the forearm and hand after probable direct inoculation. It has not disseminated systemically from the site of local infection and may infect otherwise healthy hosts.

Aged↗

Epidemiological survey of skin diseases in schoolchildren living in the Purus Valley (Acre State, Amazonia, Brazil).

A total of 9,955 schoolchildren aged 6-16 years have been examined in a tropical region. The prevalence of dermatosis varied from 21 to 87% in the municipalities surveyed. The most common dermatoses were pediculosis (prevalence 50%), nevi (16.8%), pityriasis versicolor (13.2%), pyoderma (12.2%), pityriasis alba (9.9%), dermatophytosis (6.2%), viral dermatosis (6.2%), scabies (3.0%) and acne vulgaris (2.7%). The prevalence of angular stomatitis, miliaria rubra, candidiasis, piedra nigra, keratosis pilaris, ephelides and geographic tongue is lower but still relatively high. Females had higher rates of pediculosis capitis and males higher prevalence of pityriasis alba. The prevalence of pityriasis versicolor, pigmented nevus and scabies was similar in males and females. Folliculitis, macular pigmented nevi and especially pityriasis versicolor tended to increase with age. Leprosy is hyperendemic in the surveyed area and its rate in the schoolchildren examined was 0.08%. Population movement (urbanization), socioeconomic situation, living conditions, promiscuity, and lack of hygiene may be the cause of such high prevalence and of association of two or more skin conditions. Climatic conditions might have enhanced the prevalence of certain dermatoses (pityriasis versicolor, dermatophytosis, piedra nigra, candidiasis, miliaria rubra).

Adolescent↗

[Cross sensitivity between aminoside antibiotics (author's transl)].

The great number of topical preparation containing neomycin and their frequent use for a long period induce a lot of contact dermatitis. It is interesting to detect the importance of cross sensitivity between aminosides among the patients whose dermatitis was caused by neomycin. 15 neomycin eczematous patients were investigated. The research about cross-sensitivity concerned 6 antibiotics: streptomycin, framycetin, ribostamycin, gentamycin, kanamycin, tobramycin. Patch-tests (20 p. 100 in petrolatum) were used in order to show this cross-sensitivity. The results of these tests are nearly the same as in the other studies, as for 5 of the antibiotics; but it is the first time, to our knowledge, that a cross-sensitivity between ribostamycin and neomycin is observed. The cross-sensitivity between these two aminosides can be explained by their chemical structure. There are four rings in neomycin: the main components are neamin and neobiosamin. Only three rings are found in ribostamycin: ribostamycin is constitued of neomycin lacking neosamin of neobiosamin. Thus the structure of the 3 rings of ribostamycin is identical with the structure of 3 out of 4 rings of neomycin. The study about cross-sensitivity between aminosides suggests two conclusions: 1. The use of local antibiotics must be prescribed only when is it really necessary. 2. It seems wise to avoid all systemic aminosid antibiotics for patients who are sensitized by neomycin ointment.

Adult↗

[Analysis of inter and intrapathologist concordance and discordance in a comparative study of the Madrid and Ridley-Jopling classifications of leprosy].

Eighty-six patients of leprosy have been examined by three leprologists; they have been classified according to the Madrid classification and their lesions biopsied and sent to two pathologists for independent histopathological examination. The pathologists have not received any information regarding the cases. Firstly the "senior" pathologist (A) utilized the Madrid classification and the "junior" pathologist (B) the Ridley-Jopling classification. In a second phase, the "senior" pathologist utilized the Ridley-Jopling classification and the "junior" pathologist the Madrid classification. Both pathologists did not know their own previous histopathological diagnosis at the second phase. The analysis of concordance and discordance between the histopathological diagnosis of the two pathologists and for the same pathologist, on utilizing the two classifications, have elicited the following conclusions: 1. There has been more concordance between the two pathologists on utilizing the Madrid classification than the Ridley-Jopling classification for the lepromatous, borderline and tuberculoïd in reaction patients. 2. The comparison of the two classifications for each pathologist on "blindly" examination of the material, has shown more concordance for the "senior" pathologist than for the "junior" pathologist. 3. These observations have convoyed to the final conclusion that the Ridley-Jopling classification brings some difficulties to the pathologists with limited experience in leprology and therefore it should be utilized only by experienced pathologists. 4. This preliminary study shows the necessity of performing another one with larger number of patients, in the active phase, with larger number of pathologists, preferably from different countries, and by utilizing the same methodology of "blind" examination of the material.

Humans↗