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Biomedical subjects

G W Raborn

Publications and source records attributed to G W Raborn.

At least 19 recordsLinked to original sources
PubMed2002

Double-blind, randomized, placebo-controlled study of topical 5% acyclovir-1% hydrocortisone cream (ME-609) for treatment of UV radiation-induced herpes labialis.

Immunopathology is recognized as an important component of infectious disease manifestations, and corticosteroids have been used as an adjunct to antimicrobial therapy for a variety of conditions. Antiviral therapy of herpes labialis has been shown to result in only a small reduction in the time to healing and the duration of pain. To determine if topical application of a combination product containing 5% acyclovir and 1% hydrocortisone (ME-609) could provide benefit to herpes labialis patients, 380 immunocompetent adults with a history of herpes labialis were exposed to experimental UV radiation (UVR) to induce a recurrence. On day 2, just before the appearance of the majority of lesions ("delayed" lesions), subjects were randomized to receive active medication or vehicle control six times per day for 5 days. Overall, 120 of 380 patients developed delayed classical lesions, of whom 50 of 190 (26%) had been treated with ME-609 and 70 of 190 (37%) had received placebo (a reduction of 29% [P = 0.02]). Healing time, measured as the time to normal skin, was reduced by treatment with ME-609 (9.0 days for treated patients versus 10.1 days for the controls [P = 0.04]). There was a trend toward a reduction in the maximum lesion size in the ME-609 recipients compared to that in the controls (43 versus 60 mm(2), respectively [P = 0.07]). The treatment had no effect on lesion pain, but ME-609 treatment reduced the number of patients with moderate or severe tenderness. Compared to treatment with a placebo, treatment with the combination antiviral-immunomodulatory cream provided benefit to patients with experimental UVR-induced herpes labialis, reducing classical lesion incidence, healing time, lesion size, and lesion tenderness. ME-609 is a novel product that merits further evaluation as a treatment for cold sores.

Acyclovir↗
PubMed1999

Peroral famciclovir in the treatment of experimental ultraviolet radiation-induced herpes simplex labialis: A double-blind, dose-ranging, placebo-controlled, multicenter trial.

Three doses of famciclovir were tested for treatment of experimental ultraviolet radiation (UVR)-induced herpes labialis. Patients received 125, 250, or 500 mg of famciclovir or placebo 3 times a day for 5 days beginning 48 h after UVR exposure, a model of early episodic intervention. Of 248 patients irradiated, 102 developed lesions while on treatment. There were no significant differences between groups in the number of lesions. The mean maximal lesion size was reduced in a dose-proportional manner: 139, 105, 77, and 55 mm2 for the placebo and 125-, 250-, and 500-mg famciclovir groups, respectively (P=.040, linear regression). Median time to healing was faster in the 500-mg famciclovir group than in the placebo group, both by investigator (4 vs. 6 days, 33% reduction, P=.010) and patient assessment (3.0 vs. 5.8 days, 48% reduction, P=.008) analyses. These findings suggest that evaluation of higher drug doses for herpes labialis treatment is warranted.

2-Aminopurine↗
PubMed1998

Oral acyclovir in prevention of herpes labialis. A randomized, double-blind, multi-centered clinical trial.

OBJECTIVE: A three-center, randomized, double-blind, placebo-controlled acyclovir clinical trial was conducted among Canadian skiers over a 2-year period. STUDY DESIGN: All patients enrolled in the study reported a history of recurrent herpes labialis with a greater-than-50% chance of a sun-induced trigger. There were 239 patients enrolled, and 237 of these were included in the analysis. For a minimum of 3 days and a maximum of 7 days, each patient received 800 mg of oral acyclovir twice daily (1600 mg/day) 12 to 24 hours before exposure to the sun. A minimum of 3 hours of outdoor activity was required each day. RESULTS: No differences were detected in baseline and outcome measures among the centers, and results from all three centers were combined for further analysis. There was no difference in healing rate between the acyclovir and placebo groups for the first 4 days. Patients using acyclovir healed slightly faster on days 5 and 6, and nearly all patients in both the acyclovir and placebo groups were healed by day 7. Adverse events were evenly distributed; no withdrawals were required in either group. CONCLUSION: 800-mg oral acyclovir taken twice a day was not significantly better than a placebo either in effectiveness and prevention of recurrent herpes labialis or in adverse effects.

Acyclovir↗
PubMed1997

Herpes labialis in skiers: randomized clinical trial of acyclovir cream versus placebo.

OBJECTIVE: A randomized, double-blind trial at seven ski sites in Canada and the United States was conducted to compare the effectiveness and the patient tolerance of topically applied 5% acyclovir cream (MAC III formulation) with those of a placebo cream in the prevention of sun-induced herpes labialis lesions. STUDY DESIGN: All subjects had experienced more than three episodes of sun-induced herpes labialis during the previous year. There were 196 subjects enrolled; 5 did not receive medication, and 10 were excluded from the efficacy analysis for protocol violations. There were 191 subjects in the intent-to-treat analysis, and a separate efficacy analysis was done on 181 subjects. Log rank and Fisher exact tests were used in the analysis. RESULTS: There was no difference between the two groups at baseline with respect to any clinical or demographic factor. There was no substantial difference between the groups with respect to adverse experiences (15 for acyclovir; 13 for the placebo). The acyclovir group had significantly fewer lesions (p < 0.01) than the placebo group (21% vs. 40%) during the 4-day follow-up period. CONCLUSION: The acyclovir group was significantly better than the placebo group during the follow-up period. The safety record of the drug was satisfactory; there was no difference between acyclovir and the placebo in side effects or pain. Topically applied 5% acyclovir cream is an effective preventive step for those who are active and exposed to the sun.

Acyclovir↗
PubMed1992

Diagnostic considerations for the medically complex patient.

As advances in medical diagnostic and treatment modalities continue to increase the life expectancy of the population, the likelihood of encountering patients in dental practice with concomitant medical problems will also rise. Thus it will become increasingly important for practicing dentists to take thorough medical histories, recognize signs of systemic disorders, and work closely with their medical colleagues to ensure that safe dental care is rendered to these medically complex patients. Although acutely ill or severely compromised individuals may be best treated in a hospital setting by those with special training, all dental practitioners should possess the diagnostic and communicative skills needed to manage those who are receiving out-patient medical care.

Clinical Laboratory Techniques↗
PubMed1990

Tisseel, a two component fibrin tissue sealant system: report of a trial involving anticoagulated dental patients.

There have been attempts since the early years of this century to produce a biocompatible, biodegradable tissue glue to aid in hemostasis and lessen the need for conventional sutures. In the early 1970s, Matras et al developed a glue to anastomose the severed ends of peripheral nerves, and which was the precursor of the product tested in this trial. Since that time, the product has gained wide acceptance in Europe, with applications in microvascular anastomosis, hemostasis of soft tissue defects, bone sealing and dural sealing.

Anticoagulants↗
PubMed1989

Herpes labialis treatment with acyclovir 5% modified aqueous cream: a double-blind randomized trial.

The efficacy of 5% acyclovir in a modified aqueous cream vehicle (ACV-MAC) in the treatment of recurrent herpes labialis was tested in a randomized, double-blind clinical trial with the modified aqueous cream vehicle as a control medication. The ACV-MAC formulation has previously been shown to offer superior cutaneous absorption relative to other topical acyclovir formulations. Treatment was initiated by patients within 1 hour of prodrome in an attempt to maximize clinical impact of this virustatic drug. While the patient group receiving active drug showed a trend toward accelerated healing, no significant differences for lesion or healing characteristics could be measured between the two treatment groups. It is suggested that optimal efficacy of ACV-MAC may be predicated on prophylactic treatment, that is, "trigger"-initiated rather than prodrome-initiated treatment.

Acyclovir↗
PubMed1989

Herpes labialis treatment with acyclovir 5 per cent ointment.

Eighty patients who were culture-confirmed positive for recurrent herpes labialis were entered into a clinical trial. Sixty of these completed two episodes each in a randomized, double-blind, placebo-controlled clinical trial of 5 per cent acyclovir in a polyethylene glycol ointment base. The 5 per cent acyclovir ointment failed to show better clinical healing effects than placebo in both documented episodes. There were no serious side effects observed in either group.

Acyclovir↗
PubMed1988

Treatment of herpes labialis with acyclovir. Review of three clinical trials.

Three trials with acyclovir in the treatment of recurrent herpes labialis in the same patient population are reviewed. In the first trial, oral acyclovir capsules, five times per day for five days, were shown to be of significant benefit for some parameters of cutaneous resolution in three successive episodes. Topical formulations were evaluated in two separate trials; 5 percent acyclovir in a modified aqueous cream base exhibited favorable trends, but 5 percent acyclovir in a polyethylene base was ineffective. A high dose of oral acyclovir may offer the most effective method of control of recurrent herpes labialis.

Acyclovir↗
PubMed1987

Oral acyclovir and herpes labialis: a randomized, double-blind, placebo-controlled study.

A study of the effects of oral acyclovir (200 mg), administered five times per day for 5 days in 210 patients who cultured positive for herpes labialis, is made. A total of 149 patients were followed through three episodes each of herpes labialis while taking a placebo or acyclovir. Patients were evaluated for several clinical parameters, including the loss of lesion crust and reduction of the size of the area of the lesion between day 1 and day 5. Acyclovir showed a significant antiviral effect. Results show that oral acyclovir can favorably affect some parameters, but that higher doses or a "loading dose" could improve its efficacy.

Acyclovir↗
PubMed1986

The use of videotape in the treatment planning seminar.

Despite the drawbacks, the student evaluation of the seminar approach was positive. This reinforced the faculty's view that the seminar is a unique, interactive learning experience. The seminar provides a forum for faculty and students to integrate the various treatment planning and case management skills taught in oral diagnosis and radiology. Students must focus on the treatment plan for the "whole" patient without regard for divisional bias. Although some students criticized the seminar experience as too stressful, others believed that a certain level of stress actually aided the learning process. The faculty plans to identify the sources of this stress and eliminate them whenever possible. One guess is that most of the stress results from the students striving to do well for their peers and the attending faculty; this will be difficult to eliminate. The use of videotape as a medium for displaying the patient interview and intraoral conditions has been proven and is well supported by student evaluation. The use of live cases for the seminars adds reality to the treatment planning process and was also strongly supported by student evaluation.

Curriculum↗