Biomedical subjects

V Duran

Publications and source records attributed to V Duran.

At least 19 recordsLinked to original sources

PubMed2000

The "boom and bust phenomenon": the hopes, dreams, and broken promises of the contraceptive revolution.

The "boom and bust phenomenon" is a pattern that has emerged in the development, introduction, and delivery of a number of significant new contraceptive products in the United States. When a new contraceptive product is introduced with great promise and publicity, it usually experiences a "boom" during which sales, demand, and expectations are high. This boom is often followed by a "bust" phase during which a product does not live up to expectations, initial excitement falls off, and a drop in sales and use ensues. The boom and bust phenomenon goes to the heart of what some have referred to as the failed promise of the contraception revolution by creating obstacles to significant expansion of contraceptive choice in the United States. Case studies of oral contraceptives, intrauterine devices, and Norplant(R) are used to illustrate the boom and bust phenomenon and the effect it has had in shaping the direction of advances in contraceptive technology.

Consumer Behavior↗

PubMed2000

Access to emergency contraception.

OBJECTIVE: To evaluate access to emergency contraception among women seeking help from clinicians who registered to be listed on the Emergency Contraception Hotline (1-888-NOT-2-LATE, ie, 1-888-668-2528) and the Emergency Contraception Website (not-2-late.com). METHODS: Two college-educated investigators posing as women who had a condom break the previous night called 200 providers to seek help. RESULTS: Only 76% of attempts resulted in an appointment or telephone prescription from a hotline provider within 72 hours, 14% were failures, and 11% resulted in referrals to other providers not listed on the hotline or website. CONCLUSION: Even under ideal conditions, access to emergency contraception is currently constrained. Although emergency contraception could reduce significantly the incidence of unintended pregnancy and the consequent need for abortion, its potential will not be realized unless women have better access to clinicians who can prescribe emergency contraceptive pills.

Contraceptives, Oral, Combined↗

PubMed1996

[Systemic diseases: evaluation of important laboratory parameters in 3 cases with unusual skin changes].

A whole spectrum of various clinical and laboratory disorders in patients with skin changes, may present systemic disease manifestations. Serological parameters correlate with the progression of the disease. Authors present cases with unusual skin lesions and abnormal laboratory findings, that were presumed to be manifestations of the systemic disease progression. The first case is a report of a patient age 44, female with dermatomyositis that started suddenly from full health with generalized linear bluish dark erythematous lesion like excoriations, periocular heliotrope violaceous to dusky erythematous rash with edema in a symmetrical distribution involving periorbital skin with no pruritus, diagnosed on admission as the case of acute urticarica. In the second report, a 17-year old female was referred to us because of a spread up linear sclerodermia followed by high immunological disturbances. Our third case was a 21-year old female with a systemic lupus erythematous--Rowell syndrome, with skin lesions of erythema multiforme type with some similarities to dermatitis herpetiformis on the first examination.

Adolescent↗

PubMed1996

[Isotretinoin in dermatologic practice].

In dermatology Isotretinoin has been used for 16 years in cases of serious clinical forms of acne resistant to common therapy. This paper presents actual knowledge on pharmacokinetics of isotretinoin, mechanisms of its action, side effects, the newest clinical indications for its application in acne therapy and other possible indications in the contemporary dermatology.

Humans↗

PubMed1995

[Chronic urticaria from the aspect of autoimmune diseases].

At some time in their lives one in a five persons is affected by urticaria and/or angioedema. The cause of urticaria may never be found in up to one quarter of patients with acute urticaria and in up to 90-95% with chronic urticaria. In this study we present results of our compounded approach (clinical follow up, laboratory findings, allergological testing) to patients with chronic urticaria and autoimmune diseases that progressed into chronic urticaria or started before the onset of the chronic urticaria. Our first case was a 56 year old woman with a 10 month history of chronic urticaria, angioedema and chronic gastritis before the diagnoses of insulin dependent Diabetes mellitus and Hypothyreoidismus primarius were established. Allergological testing reveals specific clinical significant immediate reaction to Balsam Peru. After adequate substitutional therapy was advocated and with specific clinical avoidance of offended allergen, remission was obtained. The second case was a 46 year old female suffering from chronic urticaria (with clinical features of urticaria like vasculitis) associated with hypocomplementemia (particularly C4 depressed) with negative antinuclear antibodies but positive circulating immune complexes after a 2 year follow up the patient developed Systemic lupus erythematosus. The third case was a 63 year old woman who developed chronic urticaria 3 years after total thyroidectomy, with pathological finding of Thyroiditis lymphocytaria-Hashimoto; after the allergological testing, positive lymphocyte transformation test revealed allergical sensitization to Vobenol was substituted with Thyvoral, complete remission was obtained.

Autoimmune Diseases↗

PubMed1995

[Chemotaxis activity of neutrophils and monocytes in patients with psoriasis vulgaris in relation to PUVA therapy].

With regard to the existing possibility favored by many immunologists that study on neutrophil (N) and monocyte (Mo) may throw light on the pathogenetic mechanism of clinical conditions such as psoriasis, the effect of PUVA therapy on human N and Mo chemotaxis in psoriasis vulgaris (PV) was investigated. One hundred psoriatic patients with severe clinical picture participated in this study: 20 with acute exanthematic form, 16 with chronic stable form and 64 patients in acute flare of the chronic course. Eitzman's modified method introduced originally by Rebuck was employed prior to and after PUVA, to assess N and Mo chemotaxis. The obtained results have shown pronounced and significant enhancement of N and Mo migration prior to and after PUVA in all investigated groups of patients. Significant difference due to PUVA therapy was seen only in the third phase of the inflammatory response regarding all assessed patients and group A. In this phase, these patients showed significant decrease in N and Mo mobility rate after PUVA treatment in comparison to the chemotactic activity prior to PUVA. These findings suggest the study on N and Mo chemotaxis to be justified only during the third phase of the inflammatory response, when the assessment of PUVA effect is concerned.

Chemotaxis, Leukocyte↗

PubMed1995

[Chronic urticaria caused by penicillin. Results of monitoring cases of acute penicillin urticaria which developed into chronic urticaria].

Penicillin is known to cause allergic reactions with different clinical manifestations and possible immunologic mechanisms. The purpose of this study was to follow cases of established hypersensitivity to penicillin and its possible development into chronic urticaria. 35 patients with a clinical picture of acute urticaria and with or without angioedema were examined. Three kinds of tests to penicillin were performed: patch test, scarification test and PPL test. Hypersensitivity to penicillin was confirmed in 12 (34.27%) patients with positive PPL test. Seven (58.33%) out of these 12 developed the clinical picture of chronic urticaria. As food was assumed to be the hidden source of penicillin, eliminatory diet was included. In 4 (57.14%) patients there was a complete remission of the disease during the course of diet without milk and milk products (intradermal test to milk and specific IgE antibodies were negative). The gathered results show that acute urticaria caused by penicillin can get a chronic character. It is the consequence of prolonged penicillin's activity in some so called "hidden sources of penicillin".

Acute Disease↗

PubMed1994

[Phagocytic activity of polymorphonuclear cells in patients with psoriasis vulgaris from the aspect of PUVA therapy].

The authors present results of examining phagocytotic activity of polymorphonuclear (PMN) granulocytes in patients with psoriasis vulgaris from the aspect of applied PUVA-therapy. 100 patients with psoriasis vulgaris were examined and divided into three groups, 20 patients with acute exanthematous form of the disease, 16 patients with chronic stationary form of the disease, and 64 patients with acute phase of the chronic form of the disease. 50 healthy persons made up the control group. Phagocytotic activity of neutrophils was examined by opsonization test, a modified method by Brandt. Phagocytotic index was expressed as a number of ingested particles of yeast germs in 100 PMN. Polymorphonuclears of patients were examined in the autologous and control serum of healthy people. Values of immunoglobulin IgM and IgG as well as values of complement C3 were examined in all patients using the method of laser nephelometry (Behring). All mentioned parameters were determined prior to and after PUVA therapy which was conducted by apparatus: PUVA 4000 and 6001. Results of examination show that the phagocytotic activity of PMN in patients with psoriasis vulgaris is normal and that it does not depend on how skin disorders are spread, on the strength of infiltration, exudation, the length of duration and course of the disease, as well as on applied PUVA-therapy. Reduced phagocytotic activity of PMN was determined only in individual cases, that is in 5 patients not depending on the applied therapy. In one patient hypoimmunoglobulinemia IgM as a probable cause of disturbed phagocytosis was established while in the remaining 4 patients causes of reduced phagocytosis remained unknown.

Humans↗

PubMed1993

[The effect of stress and personality structure on the onset and severity of the clinical picture of psoriasis].

On a sample of 38 psoriatic patients we tried to determine the relationship between neurotic disorders (operationalized MMPI) and the number and hazardous effects of stressful events on the one hand and the severity of the clinical picture and the time of the onset of psoriasis on the other. In our sample neurotic disorders are much commoner than in the general population indicating that they might represent one of the most significant factor of etiology, complications and prevention. The last hypothesis is based on the results showing that neurotic psoriatics develop psoriasis significantly later than non-neurotics. We haven't attained a profile of a typical neurotic person because neurotic disorders are manifested through different symptoms. The average number of stressful events was found significantly higher in more severe forms of psoriasis compared to the milder forms. Finally, a remark has been made about benefits of a multidisciplinary approach to the study of psoriasis and the inclusion of psychotherapy in the treatment of psoriatic patients.

Adult↗

PubMed1993

[Phenotyping: personal contribution to research on increased susceptibility of individual HLA phenotype combinations in predisposition to contact allergies].

We determined the A and B locus antigenic phenotype structure by means of the lymphocytotoxic test (Terasaki) in 43 subjects with allergic contact dermatitis verified by the Patch test, as well as in 103 healthy subjects (control group). Statistical fashioning was carried out by counting all of the phenotypes in the group examined by using the 2 x 2 table the X2 test with -correction according to Yates. In a case of an existing difference in frequency, the relative risk (RR) (Svejgaard) was determined. When RR was greater relation with the disease exists with the antigen which was found to have a greater EF value (Bengtsson). A statistically significant increase of A1 antigen frequency and decrease of A28 antigen frequency, as well as the absence of B13 and BW41 antigens in the group examined can be considered as a contribution in clarifying the genetic component in contact allergy etiopathogenesis.

Adolescent↗

PubMed1993

[Contact allergic dermatitis caused by plants].

In order to contribute to the setting of an accurate diagnosis and prophylaxis of phytodermatitis (PD) and to better understand eczematogenic characteristics of some plants, we present results of an allergologic analysis and review the plants which most commonly cause FD in our material. A total of 15 patients presenting with FD was examined. In all the cases we used a standard technique, patch test (PT); in cases supsective of contact urticaria syndrome (CUS) we used open PT, while photo PT was used for cases suspective of photo PD. We used fresh parts of the plants and standard allergen battery for epicutaneous testing (Department of Immunology, Zagreb). Depending on the profession of the subjects, tests with the material from working places with specific batteries of tests for specific professions were applied according to the recommendations of ICDRG. Tests with parts of the plants were carried out in 8 cases and in 5 controls. A total of 38 plants was examined. Positive PT was found for sisal, willow, parsnip, carrot, celery, spinach, green tomato, broomcorn, lemon skin, pyracantha, arborvitae, yucca, ficus, juniper tree, plane tree and greenhouse grass. In cases of positive PT for willow, carrot, celery, green tomato and grass, positive PT for Peru balsam (PB) was also detected, while in positive PT for lemon skin, a positive PT on turpentine was found as well. Negative results of PT for willow, carrot, celery, parsnip, green tomato, lemon and juniper tree and positive photo PT on greenhouse grass in controls, indicate that we have detected allergic PD on the above mentioned plants.

Dermatitis, Allergic Contact↗

PubMed1992

[Skin and laboratory tests: comparison of the epicutaneous patch test with the TTL and LIF tests in the diagnosis of medicamentous allergic contact dermatitis].

We investigated 158 patients from 15 to 82 years of age with clinically evident contact dermatitis, diagnosed at the Department for Allergic Diseases Investigations-Clinic for Dermatovenerological Diseases, Medical Faculty in Novi Sad, during the period of 1 year. We performed patch-epicutaneous test, lymphocyte transformation test (TTL) and leukocyte migration inhibition test (LIF). Among the 130 (82.2%) patients suffering from contact dermatitis, with the positive patch tests to commercial or standard battery epicutaneous allergens, 26 (20%) had at least one positive patch test to the medicament. In these cases contact allergic medicamentous dermatitis (SAMD) was proved by positive clinical and allergic investigations. In only one case, patch test was negative, with booth the TTL and LIF test positive. Among the medicaments TTL and LIF tested, antibiotics were the most frequent in 9 (34.61%) cases, analgetics were found in 6 (23.08%). Professional contact allergy to medicaments has been estimated in 5 patients (19.23%). According to the obtained results and statistic findings, relationships between the two variables-TTL and patch test, and LIF and patch test, were estimated due to the contact allergy to medicaments. Both of them were low and negative without statistic significance. Patch test remains to be the irreplaceable test with regard to CAMD.

Adolescent↗

PubMed1991

[Therapy of venous ulcers using pulsating electromagnetic fields--personal results].

The authors review the results of the treatment of venous varices by a pulsating electromagnetic field (PEMF), by the use of IVEMT-2 apparatus, treated at the Department of Dermatovenereology in Novi Sad and the Institute of Medical Rehabilitation. The treatment was carried out in 18 patients--5 men and 13 women, mean age 56 years, all with venous varices of post-thrombophlebitic origin. The number of sessions within the PEMF treatment was 10 per patient, each session lasting 15 min. The results were followed by measuring the varix surface prior to and after the treatment. The number of varices prior to the therapy was 26 and after the treatment was 20. The total surface of the varices before the treatment was 55183.90 mm2, the mean surface being 2122.46 mm2. After the treatment 6 varices epithelialized, while the total surface was 36902.51 mm2. The mean surface of the varices following the treatment was 1845.13 mm2. The varix surface reduction rate following the treatment was 33.13%. Considering the number of patients, the obtained results are preliminary and they reflect the benefits of PEMF for epithelialization of venous varices.

Adult↗

PubMed1990

[Personal experience with the use of 13-cis-retinoic acid in the therapy of severe forms of acne vulgaris].

The authors present the results of the study of the use of 13-cis-retinoic acid in the therapy of patients with a severe clinical form of acne. Twenty patients with a conglobate form of acne were included in the study. The drug was dosed in the initial phase of treatment at the dose of 0.5 mg/kg. During therapy the dose was reduced to 0.2 mg/kg depending on the clinical efficiency and appearance of unwanted effects. Therapy was conducted in the total duration of 16-20 weeks so that the patients received a mean drug dose of 0.31-0.60 mg/kg. The complete withdrawal of skin changes was registered in two patients (10%) after 12 weeks of therapy, in 15 patients (75%) after 16 weeks, and in 3 patients (15%) after 20 weeks of therapy. After the stop of drug action, the favorable effect was maintained from 2-12 months which was how long the patients were followed. The most frequently evidenced unwanted effects of therapy were dryness of the lip mucous membranes and skin. All unwanted therapy effects diminished or disappeared with drug dose decrease.

Acne Vulgaris↗

PubMed1990

[Parrot's method of angiostereometry in the evaluation of the status of chronic venous disease].

The authors present the results of capillary resistance measurements (CR) in three groups of examined subjects: with postthrombophlebitic syndrome, in patients with primary varicosis and in examined subjects which comprised the control group. We started from the fact that in more severe clinical conditions within venous insufficiency there also develop severe consequent conditions with the liberation of inflammatory reaction mediators in a greater extent than in the less severe cases and the assumption that in such patients CR is also lowered in the distant parts of the body. Angiostereometry by Parrot was the used technique. A total of 200 hundred persons was investigated. The examined subjects were divided into three groups. In group I there were 80 persons, all with the postthrombophlebitic syndrome which had the CR mean value of 15.26 cmHg (20.3 kPa). In group II there were 60 patients with primary varicosis, and the mean value of their CR was 17.7 cmHg (23.6 kPa). Group III had 60 examined subjects which comprised the control group, and their CR mean value was 19.90 cmHg (26.5 kPa). The difference was statistically significant. Capillary resistometry by Parrot is a very convenient method for the follow up and evaluation of clinical conditions of many diseases, as well as the follow up of therapy results. Due to all of its advantages it is superior to all stoppage methods such as Rumpel-Leed, for example.

Capillary Resistance↗

PubMedDate not supplied

[Persistent dyschromic erythema].

INTRODUCTION: Erythema dyschromicum perstans (ashy dermatosis) is a very rare skin disease included in the group of acquired, idiopathic hypermelanosis, with development of blue-gray macules. This disease appears more frequently in dark coloured persons, especially women in the first and second life decade. CASE REPORT: A male patient, 42 years of age, was admitted to Clinic of Dermatovenereology in Novi Sad due to appearance of slightly pruriginous, brown-reddish macules on the trunk, upper and lower extremities, without affecting the skin of the face, scalp, palm soles and visible mucous membranes. Later, the color of the macules changed into blue-gray and new lesions appeared in axilla and flexor side of the big joints, with active, erythematous and thin raised borders. Laboratory findings showed no abnormalities; antinuclear antibodies were negative. Histopathological examination of the skin specimens (which were taken from two different places) showed vacuolar degeneration of the basal cell layer, numerous pigmentophages in papillary dermis and presence of lymphohistiocytic infiltrate in dermis. No history of drug intake or exposure to UV light was established. DISCUSSION: Ashy dermatosis is included in the group of hypermelanosis of unknown origin. As possible etiological factors we can mention ingestion of ammonium nitrate, environmental pollution, hypersensitivity to cobalt chloride and postinflammatory pigmentation. Clinical characteristics: occurrence of blue-gray and gray macules on the trunk, face, neck and extremities (absence on the palms, soles, visible mucous membranes, scalp and nails). In the active phase of the disease, these macules are surrounded by erythematous and thin, raised borders. The lesions are mostly permanent. Due to clinical, histopathological, immunofluorescent and electron microscopy established similarities with lichen planus, it is considered that ashy dermatosis is a variant of lichen planus. Absence of previous drug intake, exposure to UV light, absence of the antinuclear antibodies, clinical picture and histological findings confirm the diagnosis of erythema dyschromicum perstans. CONCLUSION: This case of ashy dermatosis shows that there is a need for differential diagnosis of acquired skin pigmentations, because this dermatosis must also be taken into consideration.

Adult↗

PubMedDate not supplied

[The Koebner phenomenon, a prognostic sign of PUVA therapy effectiveness in patients with psoriasis vulgaris--yes or no?].

INTRODUCTION: Former investigations of Koebner phenomenon had demonstrated its higher incidence in patients with severe generalized and/or unstable forms of psoriasis which expressed increased resistance to various treatment modalities. The aim of this study was to establish the correlation between the presence of Koebner phenomenon and the PUVA therapy effects, total number of PUVA treatments, total dose of UVA radiation and the duration of remission after PUVA therapy discontinuation. MATERIAL AND METHODS: Sixty patients with severe clinical picture of psoriasis vulgaris, treated with PUVA therapy, were included in this research. According to the presence of Koebner phenomenon they were divided into two groups, 20 patients with positive and 40 patients with negative Koebner reaction, who were the control group at the same time. RESULTS AND DISCUSSION: 95% of patients treated with PUVA, were cleared of psoriatic changes in the Koebner positive, as well as in the Koebner negative group. There were also no differences between the Koebner positive and Koebner negative group in the mean number of PUVA treatments, mean total dose and the last dose of UVA radiation, which led up to the clinical remission of psoriasis. Our results of investigation have demonstrated increased relapse of psoriasis, during the first 6 months after cessation of PUVA therapy, in the Koebner positive group, with a high statistical significance (p < 0.001), comparing with Koebner negative group in the same period. Furthermore, the tendency of relapse of Koebner positive and Koebner negative psoriatic patients was higher in Koebner positive group even in the first 3 months after PUVA therapy. CONCLUSIONS: PUVA therapy effects, total number of PUVA treatments, total dose of UVA radiation didn't depend on presence of Koebner phenomenon. However, Koebner phenomenon was a mark of high relapsing tendency of psoriasis in the first 6 months after PUVA therapy cessation.

Humans↗

PubMedDate not supplied

[Microcirculatory changes in chronic venous insufficiency].

INTRODUCTION: The venous system of lower leg can be topographically divided into two subsystems: superficial (extrafascial) and profound (subfascial). Functionally, we can divide circulation in to macrocirculation (arteries and veins) and microcirculation (arterioles, capillaries, and venules). Blood flow towards heart can be disturbed by different pathological conditions, and than chronic venous insufficiency (CVI) develops. First alterations occurs in macrocirculation, and after some period changes in microcirculation also appear. Those changes are leading to the ultimate stage in CVI--venous ulcer. RESULTS AND DISCUSSION: Previous conceptions that alterations in microcirculation in CVI are consequences of venous stasis, high pressure in capillaries and anoxic tissue are still actual. Observations that partial pressure of oxygen is higher in venous blood of lower limbs with ulceration than in limbs without ulceration lead to hypothesis that blood is passing directly from arterioles to venules over arterio-venous temperature-regulating shunts in dermis. Histological and electron-microscopic examinations certain alterations in the structure of capillaries. Raised pressure in these altered capillaries leads to exudation of plasma and fibrinogen in the interstitial space. Soluble fibrinogen is transformed to insoluble fibrin and forms fibrin cuffs. These cuffs are a barrier for normal diffusion of oxygen. Recently, it was observed that blood cells can adhere to the endothelial cells--Leukocyte trapping hypothesis. It can be explained by slower blood flow velocity and also by expression of certain endothelial and leukocyte adhesion molecules intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1). This causes congestion of white blood cells which leads to tissue damage due to secretion of inflammatory mediators.

Chronic Disease↗