Topic immunotherapy in alopecia areata consist in a mild contact dermatitis with help of a chemical substances, with a high potency of sensitization, such as dinytroclorbenzenul (DNCB), squaric acid dibutylester (SADBE) and diphencypronil (DPCP). Eight patients with alopecia areata, 3 with mild form and 5 with severe form was treated with DPCP in acetone solution. We have obtained a positive result in 3 cases (37.5%), one with total regrows and 2 with partial regrows and a negative result in 5 cases, 3 with partial regrows and loss of the hair in other areas and 2 cases with no response after 24 weeks. We consider this method like an alternative therapy in severe alopecia areata resistant at other treatments.

Administration, Topical↗

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Reflux nephropathy in adults.

Reflux nephropathy (RN), the main complication of the vesico-ureteral reflux (VUR), relatively frequent in adults, is often the consequence of recurrent urinary infections in the child, hood or during pregnancy. Unilateral RN has generally a benign course but the bilateral one, with important nephron destruction, leads to focal and segmental glomerulosclerosis, manifested by high levels of proteinuria. A certain degree of cicatrization and renal failure are followed by progressive impairment of the remaining renal function, even if VUR is cured. An early diagnosis, treatment of the acute bacterial infection, adequate ingestion of liquids, regulation of the intestinal transit and complete bladder voiding by miction, associated with hypotensive and antiinfectious drug therapy lead to VUR disappearance in 80% of the cases, avoiding renal failure. Surgery is indicated only in the patients with severe reflux and with congenital or obstructive anomalies, as well as in the case of recurrent infection resistant to antibiotherapy.

Adult↗

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[Research on anti-diphtheria immunization in the city of Bucharest].

Biological, sero-epidemiological and bacteriological investigations, carried out in the town of Bucharest for evaluating the present diphtheria vaccination programme showed: -- high anatoxin titers, exceeding the titer considered as protective, in the vaccinates ; -- a concentration of the level of the titers of 1--4 AU/ml, in over 62% of the subjects, which means that the protective titer was exceeded 33 to lucru: -- negative Schick reaction, in the mean 95.06%, in the subjects examined during the 1969--1975 period; -- isolation of the Bacillus diphtheriae in a proportion of 0.08%, none of the toxigenic gravis type. The authors, correlating these data, consider the present vaccination calendar too loaded both as number of inoculations and as antigen concentration per revaccination dose, and recommend reconsideration of the vaccination programme.

Antibodies, Bacterial↗

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[Testing of ventilatory function outside the laboratory Wright type peak flowmeter].

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Adolescent↗

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Conventional spectral Doppler and color Doppler ultrasound imaging. Principles, limitations, artifacts and clinical indications in hepatology.

The physical principles, limitations, errors and indications of conventional Doppler and color encoded Doppler sonography are reviewed and their applications in the investigation of liver, spleen, portal and suprahepatic portal venous circulation are analysed. The actual possibilities and advantages of Doppler imaging, both in normal conditions and in pathologic ones, such as portal hypertension, portal venous thrombosis or cavernous transformation, liver cirrhosis, hepatoma and liver transplantation are discussed.

Artifacts↗

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[The characterization of focal hepatic lesions by color-coded Doppler echography. A preliminary test].

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Adolescent↗

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Interferon therapy in the chronic aggressive viral hepatitis.

The effects of interferon (INT) therapy in the chronic aggressive hepatitis of viral origin (CAVH) are critically reviewed. The main factor which favours the progress of acute viral hepatitis to chronic forms is the persistence of viral replication in conditions of immune deficit of the host. INT has antiviral, immunomodulating and antitumoral action. The INT alpha class proved to be the most adequate for the CAVH treatment. Many recent clinical trials have demonstrated the INT alpha effectiveness in CAVH. The results of such studies are separately analysed for each hepatitis virus. The importance of various factors, i.e., dose, treatment duration, race, sex, age, histologic lesions, ALAT level, viral DNA titer, associations with adenine-arabinoside, acyclovir, corticosteroids, a.o., is discussed in relation with the rate of therapeutic response and the risk of viral infection recurrences.

Adjuvants, Immunologic↗

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Advances in the early diagnosis and therapy of primary liver cancer.

The prevalence of primary liver cancer (PLC), unlike that of the other digestive carcinomas, is constantly increasing. Epidemiologic data have revealed the risk factors for PLC. New methods of detection allow to define the cases at high risk for PLC, and an active follow-up permits the early disease detection, when the tumor can still be operated on. The diagnostic value of each method is analysed.

Age Factors↗

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Advances in the study of proteinurias. II. Quantitative and qualitative evaluation of urinary proteins.

The methods for proteinuria detection and assay are reviewed, insisting on the main factors which influence the sensitivity and specificity of the techniques currently used in clinical practice. The up-to-date classifications of proteinurias and the follow-up methods are critically discussed, with special emphasis on the intermittent proteinurias and their diagnostic and prognostic significance, as well as on the diagnostic value of microalbuminuria.

Adolescent↗

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[The cholestasis syndrome. A critical evaluation of an exploratory strategy].

The authors studied 160 cases of biliary stasis: 120 having intrahepatic cause (101 hepatic cirrhoses and 19 primitive biliary cirrhoses) and 40 extrahepatic cause (17 choledochal lithiases and 23 cancers of the pancreas head) and check up the diagnosis value of two investigation algorithms: echography, the first investigation, followed by hepatic biopsy puncture, if the intrahepatic biliary ducts are not dilated, or transhepatic cutaneous cholangiography if the intrahepatic biliary ducts are dilated in comparison with intravenous cholangiography in the first investigation. Echography has an increased diagnosis yield (96% sensitivity, 99% specificity), is cheap, noninvasive and is the first imaging exploration used in biliary stasis syndrome.

Adult↗

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[Meningitis caused by enteroviruses. Clinical and virological study of several sporadic cases in adults].

In the course of seven years (1968--1974) viral investigations were carried out in 212 casese of meningitis; predominantly Coxsackie viruses and sometimes ECHO viruses were isolated from 80 cases (37.73%). No polioviruses were isolated. Analysis of the clinical data (onset, general conidtion, evolution, complications, psychical, renal and cardiac disturbances etc.) revealed the severe aspect of these cases. The aspect and evolution of the cerebrospinal fluid showed the presence in almost 25% of the cases of an increased number of cellular elements of more than 1 000/mm3 and albumin sometimes far above normal values with a slow return (3--4 weeks). The complex therapy applied in more than half the cases demonstrates the necessity of attentive follow up of these cases of viral meningitis.

Adolescent↗

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Advances in the study of proteinurias. I. The pathogenetic mechanisms.

The proteinurias can be due to various causes and mechanisms, with different prognosis and therapy. With respect to their mechanisms of occurrence, they are classified as: of overflow or of glomerular origin, by tubular reabsorption, by increase of tubular secretion and by protein loss from the urinary ways. These causes and mechanisms are described in detail, according to the latest data in the medical literature.

Glomerular Filtration Rate↗

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Enterovirus diseases with neurological determinations in adults. Clinical and virological study.

Enteroviruses--4 polio, 30 Coxsackie and 20 echovirus strains--were isolated from 54 patients with neurologic disease. In 29 cases (53.7%) viruses were isolated from the CSF, blood clot and nerve tissue homogenates. The correlation of the complex clinical data and the localisation of the lesions in the CNS demonstrate the involvement of cranial nerves, of the long bulbar motor pyramidal and extra-pyramidal tracts, of the reticular formation, a.o. These aspects are in accordance with the localisation of the lesions especially in the brain stem and in the hypothalamus, in most of our patients. The extent and complexity of the lesions suggest a predominatly vascular dissemination.

Adult↗