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Biomedical subjects

K Chlud

Publications and source records attributed to K Chlud.

At least 19 recordsLinked to original sources
PubMed1999

[Use of topical non-steroidal anti-inflammatory drugs in aggravated and decompensated arthroses].

Pain in osteoarthritis of the big weight bearing joints is either derived from periarticular ligaments, tendons, fascias, muscles, bursae--periarthropathy as sign of decompensation or from the reactive synovitis with or without effusion. NSAIDs (ibuprofen, diclofenac, indometacin, some salicylates, etofenamate and piroxicam) have demonstrated relevant advantages of the percutaneous route over the systemic one in soft tissue rheumatism. NSAIDs, mentioned above, locally administered as cream, gel or spray, quickly penetrate through the corneal layer of the skin and the site of application, reach highly effective concentrations in subcutis, fascias, tendons, ligaments and muscles, less in joint-capsule and -fluid indicating direct penetration. The blood levels of topical NSAIDs are extremely low with no systemic side effects, especially no gastric toxicity; however, local skin irritation is observed (1 to 2%). In contrast to this, systemic (oral) NSAIDs lead primarily via high blood levels to a lower concentration--only one tenth--in periarticular soft tissues with a high incidence of side effects. In conclusion the percutaneous application of certain NSAIDs has become a well established therapeutic regimen in painful osteoarthritis and in all other inflammatory degenerative and posttraumatic alterations of soft tissue structure.

Administration, Topical↗
PubMed1998

[Results of efficacy study with diclofenac/orphenadrine infusions in patients with musculoskeletal diseases and functional disorders].

During a post-marketing surveillance study, 641 patients (age range 18 to 86 years) with painful rheumatic diseases, mostly of vertebral etiology, were given ready-for-use infusions containing a combination of the non-steroid antiphlogistic agent diclofenac (75 mg) and the muscle relaxing agent orphenadrine (30 mg) parenterally for 7 days. The goal of the study was to investigate efficacy, tolerability, and acceptance of this intravenous therapy in wide use in physicians' practices. At the end of treatment, the global evaluation resulted in a score of 1.6 on a scale of 1 (very good) to 4 (insufficient). The tolerability score was 1.3 and the acceptability score was 1.5. Only 20 patients (3.1%) had adverse effects, most of which were of gastrointestinal nature. The medication proved appropriate for use in the treatment of painful spine syndromes, inflammatory osteoarthritis, painful osteoporosis, post-operative conditions, and extra-articular rheumatism and could represent a first step towards multi-factorial therapeutic management of these diseases.

Adolescent↗
PubMed1996

Comparison of tissue and plasma levels of ibuprofen after oral and topical administration.

The penetration and absorption of ibuprofen (CAS 15687-27-1) from a topical gel and oral tablets were tested in an open study, performed in 17 patients with degenerative knee disorders requiring an operation. Patients administered the topical test preparation (ibugel, 3 x 375 mg ibuprofen daily) or the standard oral preparation (2 x 600 mg ibuprofen daily) for 3 days prior to the operation. Samples of blood, synovial fluid, muscle, fasciae and subcutis were obtained during the operation (15 h after the last administration) and analysed for ibuprofen content using a validated HPLC method. Different absorption profiles were observed for topical and oral administration. Oral administration led to higher concentrations in the plasma, synovial fluid and fasciae, while higher levels in the muscle and subcutis were found after topical administration. After topical application, the concentrations in the fasciae, muscle and subcutis were significantly higher than those in the blood plasma and synovial fluid (p < 0.05). Very low levels of ibuprofen were observed in the subcutis after oral administration. This can be explained by the different pathways. This study demonstrated that concentrations of ibuprofen in the various biological samples were still within therapeutically effective levels 15 h after topical or oral administration. By use of an oral comparison group, it has been possible to show that the concentrations in times directly under the site of topical application lie in the same order of magnitude as those found after preoral treatment. Therapy of intra-articular inflammatory and degenerative joint diseases requires oral administration of non-steroidal anti-inflammatory drugs (NSAIDs). However, based on the results of this study, topical therapy with NSAIDs can be recommended for soft tissue rheumatism and periarticular insertion tendinopathia.

Administration, Oral↗
PubMed1991

[Percutaneous therapy with non-steroidal anti-inflammatory drugs. Pharmacokinetic criteria of effectiveness].

As in the case of systemically administered drugs, there is also a requirement for reliable kinetic evidence for the clinical effectiveness of local therapeutic NSAIDs. The conditions required for this are discussed, and compared with provisions already existing in EC countries. On the basis of a comprehensive review of the literature, it is shown that among all the locally employed NSAIDs, kinetically reliable and plausible evidence of therapeutic effectiveness is, at present, available only for indomethacin, diclofenac, salicylic acid salts and ibuprofen.

Administration, Cutaneous↗
PubMed1991

[Percutaneous therapy of painful arthritis].

Pain in osteoarthrosis of the big weight bearing joints is either derived from periarticular ligaments, tendons, fasciae, muscles, bursae--peri-arthropathy as sign of decompensation--or from the reactive synovitis with or without effusion. NSAIDs systemically administered have been so far considered as first choice medication together with physical therapy. New pharmacokinetic data on the topical, percutaneous application of NSAIDs (ibuprofen, diclofenac, indomethacin, some salicylates and to a lesser degree for etofenamate and piroxicam) have demonstrated relevant advantages of the percutaneous route over the systemic one in soft tissue rheumatism. NSAIDs, mentioned above, locally administered as cream, gel or spray, quickly penetrate through the corneal layer of the skin at the site of application, reach high effective concentrations in subcutis, fasciae, tendons, ligaments and muscles, lesser in joint-capsule and -fluid indicating direct penetration. The blood levels of topical NSAIDs are extremely low with no systemic side effects, especially no gastric toxicity; however, local skin irritation is observed (1 to 2%). In contrast to this, systemic (oral) NSAIDs lead primarily via high blood levels to a much lesser concentration--only one tenth--in particular soft tissues with a high incidence of side effects. In conclusion the percutaneous application of certain NSAIDs has become a well established therapeutic regimen in painful osteoarthrosis and in all other inflammatory degenerative and posttraumatic alterations of soft tissue structures.

Administration, Topical↗
PubMed1989

[Optimizing the clinical value of polyreactive autoantibodies to double-stranded DNA].

The serological characteristic of systemic lupus erythematosus is the presence of antibodies to double stranded (ds) DNA. Raised levels of these antibodies have been found occasionally in patients with other inflammatory rheumatic diseases. Evaluating 67 patients with anti-dsDNA antibodies we searched for additionally immunological features to improve their clinical relevance for connective tissue diseases. We found out that coexistent antinuclear antibodies, antibodies to Sm, U1-nRNP, Ro and La, except in D-penicillamine induced lupus syndrome, were most specific for connective tissue diseases. Permanent antinuclear antibody negative systemic lupus erythematosus may not really exist.

Adolescent↗
PubMed1985

Comparison of naproxen and piroxicam in the treatment of rheumatoid arthritis: a double-blind, crossover study.

A double-blind, crossover study was carried out in 50 patients with rheumatoid arthritis to compare the efficacy and tolerance of single evening doses of 1000 mg naproxen and 20 mg piroxicam. After an initial wash-out period of 1 week, patients received 4-weeks' treatment with one or other of the trial drugs and were then crossed over after a 1-week wash-out period to the alternative medication for a further 4 weeks. Objective assessments of disease activity and patients' and physician's assessments of therapeutic response were made at the end of each wash-out and active treatment period, and at the end of the trial patients and physician were asked to say which of the two active treatments was preferred. Forty-nine patients completed the 10-week trial; one patient discontinued the study while on piroxicam therapy because of side-effects. While both treatments proved effective, naproxen was statistically significantly better than piroxicam for total joint pain, grip strength, duration of morning stiffness, and overall therapeutic response. Naproxen also had a more rapid and more pronounced action than did piroxicam and was selected as the preferred drug by both patients and physicians. Patients taking naproxen reported slightly fewer side-effects than did those taking piroxicam.

Adult↗
PubMed1978

[Indometacin glucosamide in the therapy of rheumatoid arthritis (author's transl)].

40 patients with classical or definite rheumatoid arthritis were included in a double blind trial to assess efficacy and side effects of indometacin (n = 20) versus glucametacin (n = 20). In a daily dose of 420 mg glucametacin proved to be equally potent to 150 mg indometacin daily in its anti-inflammatory activity but showed fewer side effects.

Arthritis, Rheumatoid↗
PubMed1977

Clinical studies of the interaction between tolmetin and glibenclamide.

Forty patients with diabetes mellitus and rheumatic disorders (rheumatoid arthritis, osteoarthritis, soft-tissue rheumatism) were included in a double-blind trial with the purpose of investigating whether the concomitant administration of tolmetin and glibenclamide leads to an interaction. No significant alterations of blood and urine glucose values could be found in comparison to placebo. Therefore it can be assumed that there is no interaction between these two substances.

Adult↗