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Biomedical subjects

I G Schraibman

Publications and source records attributed to I G Schraibman.

10 recordsLinked to original sources

Oxpentifylline treatment of venous ulcers of the leg.

OBJECTIVE: To determine the effect of oxpentifylline on the healing of venous ulcers of the leg. DESIGN: Double blind, randomised, prospective, placebo controlled, parallel group study. SETTING: Four outpatient clinics treating leg ulcers in England and the Republic of Ireland. PATIENTS: 80 Consecutive patients with clinical evidence of venous ulceration of the leg in whom appreciable arterial disease was excluded by the ratio of ankle to brachial systolic pressure being greater than 0.8. INTERVENTIONS: All patients received either oxpentifylline 400 mg three times a day by mouth or a matching placebo for six months (or until their reference ulcer healed if this occurred sooner) in addition to a locally standardised method of compression bandaging. MAIN OUTCOME MEASURES: The primary end point was complete healing of the reference ulcer within six months. The secondary end point was the change in the area of the ulcer over the six month observation period. RESULTS: Complete healing of the reference ulcer occurred in 23 of the 38 patients treated with oxpentifylline and in 12 of the 42 patients treated with a placebo. Life table analysis showed that the proportion of ulcers healed at six months was 64% in the group treated with oxpentifylline compared with 34% in the group treated with a placebo (log rank test chi 2 = 4.78, p = 0.03), which was significant (odds ratio = 1.81, 95% confidence interval 1.20 to 2.71). CONCLUSION: Oxpentifylline used in conjunction with compression bandaging improves the healing of venous ulcers of the leg.

Double-Blind Method

The significance of beta-haemolytic streptococci in chronic leg ulcers.

beta-Haemolytic streptococci were identified in 18.8% of bacterial isolates from 91 legs of patients with leg ulcers swabbed routinely. This previously unreported high incidence is ascribed to selective culture methods. In view of its sensitivity to simple antibiotics and its reputed proclivity for skin destruction, the beta-haemolytic streptococcus should be sought and, if found, energetically treated.

Anti-Bacterial Agents

Drug therapy in intermittent claudication: an objective assessment of the effects of three drugs on patients with intermittent claudication.

It has been suggested that, by reducing the viscosity of blood, flow through capillaries is increased with consequent improvement in the symptoms of patients with peripheral vascular disease. We examined the effects of treatment with drugs purported to reduce blood viscosity to test the validity of this claim. Measurements of viscosity and the rate of blood flow to the leg were made in a group of patients before and after treatment with three different drugs--tetranicotinoylfructose (Bradilan), oxypentifylline (Trental) and cinnarizine (Stugeron). All patients had intermittent claudication in one leg and the distribution of arteriosclerosis was similar in each patient. After treatment there was little or no change in blood viscosity and no change in the rate of flow recorded in the symptomatic legs. We did not find any objective evidence to support the use of these drugs in patients with intermittent claudication.

Aged

Impedance plethysmography: evaluation of a simplified system of electrodes for the measurement of blood flow in the lower limb.

Venous occlusion plethysmography was used to measure the flow of blood into the lower limbs of 30 normal volunteers. An impedance plethysmograph, using disposable point electrodes, was compared with a mercury in Silastic strain gauge plethysmograph in 20 subjects. The effect of changes in the configuration of the point electrodes was studied in 10 subjects. Impedance plethysmography was shown to be reproducible, and one particular configuration of point electrodes was shown to be superior to the others.

Blood Flow Velocity

Pulsatile changes of electrical impedance in the lower limb.

The ratio of the pulsatile and the mean value of the volume of blood flowing through the calves of normal subjects with each heart beat was calculated from electrical impedance changes during venous occlusion plethysmography. Measurements made concurrently by proven Doppler ultrasound techniques did not correlate with ratios derived from the impedance measurements. The pulsatile change in electrical impedance in the limbs appears to be due more to changes of resistance in the blood than to pulsatile changes in the volume of the limb.

Adolescent