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Biomedical subjects

M Loewenthal

Publications and source records attributed to M Loewenthal.

At least 19 recordsLinked to original sources
PubMed2004

Impact of hydroxychloroquine therapy on chronic urticaria: chronic autoimmune urticaria study and evaluation.

BACKGROUND: Chronic urticaria (CU) imposes profound impairment on quality of life. Up to 60% of idiopathic CU is associated with autoimmune phenomena, and may respond to immunomodulation. Hydroxychloroquine offers potential efficacy for CU and is relatively benign compared with most other therapeutic approaches. OBJECTIVE: The aim of the chronic autoimmune urticaria study and evaluation was to evaluate the efficacy of hydroxychloroquine in patients with chronic idiopathic urticaria. METHODS: Twenty-one patients referred to the Immunology and Allergy Unit at John Hunter Hospital, New South Wales, Australia, with idiopathic CU were randomised to receive treatment with standard urticaria therapies (corticosteroids, H2-antihistamines, H1--antihistamines, doxepin) with or without hydroxychloroquine. Markers of autoimmunity, thyroid disease and mast-cell autoreactivity (autologous serum skin-prick testing (ASPT)) were assessed. Measures of urticaria control were compared at baseline and at 12 weeks for the 18 individuals who completed the study. These included urticaria scores, medication scores and quality-of-life indices. RESULTS: The hydroxychloroquine-treated group achieved significant improvements in quality of life as assessed by the global symptom severity score and the LAMY-7 (a quality of life index designed by Lamy, 7th revision) at 12 weeks (P < 0.01 and P < 0.05, respectively). No significant treatment effect on medication requirements or urticaria score was detected, although differences between treatment groups approached statistical significance for urticaria score and medication requirements (0.05 < P < 0.10). ASPT-reactivity did not correlate to hydroxychloroquine-responsiveness. Hydroxychloroquine was well tolerated. CONCLUSION: Immunomodulation with hydroxychloroquine is safe and appears to offer some efficacy as an intervention in CU.

Adult↗
PubMed1994

Alternating nevirapine and zidovudine treatment of human immunodeficiency virus type 1-infected persons does not prolong nevirapine activity.

The potential use of an alternating treatment strategy with nevirapine and zidovudine in prolonging the antiretroviral effects of nevirapine was evaluated. Ten human immunodeficiency virus type 1 (HIV-1)-infected p24 antigen-positive persons who had not received prior antiretroviral therapy were treated for 9-13 weeks with an alternating regimen of 1 week of nevirapine (200 mg/day) and 3 weeks of zidovudine (600 mg/day). Serum p24 antigen levels declined during the first week of nevirapine treatment (median, 59%); however, subsequent courses of nevirapine were characterized by rising p24 antigen levels, while antigen levels remained stable or declined during zidovudine treatment. Serum beta 2-microglobulin levels and CD4+ cell counts exhibited similar responses. HIV-1 isolates obtained from 2 patients revealed 40- and 1000-fold reductions in nevirapine sensitivity after 8 weeks. These findings demonstrate that alternating treatment with zidovudine and nevirapine does not prolong the effectiveness of nevirapine and does not prevent the development of nevirapine resistance.

Adolescent↗
PubMed1977

Evaluating the quality of ambulatory health care: a review of emerging methods.

While hospital quality evaluation activities have progressed dramatically in recent years, there has not been a comparable development and implementation of methods for the review and evaluation of ambulatory health care. Various technical problems regarding ambulatory records and the nature of ambulatory care itself have combined to retard the evolution of review methods. These problems are discussed, as are current efforts to overcome them. We have reviewed the relevant issues and literature and have attempted to provide a conceptual framework for better understanding the measurement of ambulatory health care quality. A selective bibliography of literature relating specifically to ambulatory care quality evaluation is presented as a guide to further study.

Ambulatory Care↗
PubMed1976

Cor triatriatum.

A case of cortriatriatum, which is not included in three types of Loeffler's classification, is reported, and a complete description of the anatomy and pathology of the case is given. A successful surgical repair of this malformation is possible; therefore the importance of its recognition is emphasized. The clinical manifestations and the different aetiopathogenic theories are reviewed.

Female↗
PubMed1976

Liver function and gastric acid secretion in parkinsonian patients under prolonged treatment with L-dopa and a peripheral decarboxylase inhibitor.

Twelve patients with long-standing Parkinson's disease, treated successfully with a combination of l-dopa and an inhibitor of aromatic l-amino acid decarboxylase (Ro 4-4602), in the ratio 4:1, were screened for damage to various organ systems, in particular liver and skeleton. Among other tests, liver biopsies were obtained before and after 6 months of treatment. One patient discontinued therapy becuase of an accentuation of pre-existent liver damage, another because of psychomental manifestations. The remaining ten patients were followed for 8-15 months and longer. The liver biopsies remained practically unaltered. Elevation of alkaline phosphatase was found in 10 out of 12 subjects. In five patients this rise fluctuated around the upper limit of normal. In two patients, who discontinued the treatment, the raised alkaline phosphatase values soon returned to normal. Analysis of isozymes proved this phosphatase to be of liver origin. All other liver function tests remained unchanged, except for an increased retention of bromsulphalein in two patients. In the one patient with the initially damaged liver, all tests became normal soon after discontinuation of therapy. No changes could be found in gastric acid secretion. All other parameters studied remained within normal limits, including urinary excretion of calcium and phosphate.

Aged↗
PubMed1975

Malignant metastatic insulinoma treated with streptozotocin.

A patient with metastatic insulinoma who suffered from severe hypoglycaemic attacks was treated with 7-5 g of streptozotocin (Upjohn). Shortly after the start of treatment, the hypoglycaemic attacks ceased; fasting blood glucose levels and serum immunoreactive insulin values returned to normal upon completion of the treatment. Two years after treatment, the patient is well and active and has not had any attacks. The oral glucose tolerance test and tolbutamide stimulation test now show serum immunoreactive insulin excretion patterns similar to those seen in diabetics.

Adenoma, Islet Cell↗
PubMed1974

Gardner's syndrome: report of a family.

Two cases of Gardner's syndrome in one family are presented. The father presented all three stigmas of the syndrome, while in the daughter no osseous manifestations were found. In the first patient, the diagnosis was made only after the second abdominal operation, when a mesenteric fibrous mass was seen. In the second case, the intestinal polyposis was clinically suspected, considering the hereditary aspects of this syndrome, and the episode of bloody diarrhea presented by this patient. Both patients were treated by subtotal colectomy with ileo-rectal anastomosis. Both of them presented fibrous tumors after the abdominal operation (the father after six years and the daughter after one year). The authors stress the importance of postoperative followup for the detection of fibrous masses that may appear due to the surgical stimulus. The literature on Gardner's syndrome is reviewed and summarized.

Adolescent↗