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[The effect of quantum hemotherapy on the plasma hemostatic indices and fibrinolysis in patients with unstable angina].

An evaluation was done in 172 patients with progressive stenocardia. The use of intracardiac laser light irradiation of blood in combined treatment was found to improve the clinical course of the illness and to have a beneficial effect on the factors of plasma haemostasis and fibrinolysis which play a pathogenetic role in the destabilization of the ischemic heart disease course, this being manifest by a significant decrease in the activity of factor XIII, platelet factor 4, and an increase in fibrinolysis.

Angina, Unstable↗

[The use of laparostomy in treating diffuse suppurative peritonitis].

The results of surgical intervention with the use of laparostomy in 29 patients with diffuse purulent peritonitis at the terminal stage are presented. In 11 cases, laparostomy was performed during the first operation, in 18--for postoperative peritonitis. At the time of operations, laser radiation, gastrointestinal intubation were widely used.

Aged↗

[Atopic dermatitis].

For the past decades, the prevalence of atopic dermatitis is on the rise. Three phases of the disease are recognized according to the age of the patient, either in the newborn age, in infancy or after puberty. A partial enzymatic defect in delta-6 desaturase has been reported. Such metabolic anomaly would be responsible for the alterations in both the skin barrier function and in the Th2 inflammatory reactions in part mediated through IgE. Some microorganisms colonizing the skin play an important causal role in the clinical exacerbations. The influence of food allergy on atopic dermatitis remains obscure and often unconvincing. By contrast, irritant and allergic challenges from the environment exhibit an undisputable worsening effect. The prevention relies on the eviction of predisposing factors and is favourably influenced by emollients specifically designed for atopic dermatitis. A food supplementation in alpha-linoleic acid and some specific chinese herbal remedies might well be useful. The treatment relies primarily on topical applications of corticoids. Puva-therapy, UVB phototherapy and immunomodulation by cyclosporine are indicated for difficult cases.

Administration, Topical↗

An open-label study of alefacept plus ultraviolet B light as combination therapy for chronic plaque psoriasis.

BACKGROUND: Alefacept, a fully human LFA-3/IgG(1) fusion protein, is a selective biological agent approved in the United States for the treatment of chronic plaque psoriasis. In phase 3 trials, clinical improvement and prolonged off-treatment remission of psoriasis correlated with reductions in circulating memory T cells. Reductions in pathogenic epidermal T cells in psoriatic lesions also have been noted following phototherapy with ultraviolet B (UVB) light. Because alefacept and UVB target T cells in different ways, combination therapy with these two agents may lead to greater efficacy. OBJECTIVES: To determine the safety, tolerability, and efficacy trends of combination therapy with alefacept plus UVB light in patients with chronic plaque psoriasis. METHODS: In an open-label, parallel-group study conducted at two sites, one in France and one in the United States, patients with chronic plaque psoriasis who were candidates for phototherapy received 12-weekly intramuscular injections of alefacept, 15 mg. In addition, patients were randomized to one of three treatment arms: no UVB treatment, 6-week UVB treatment, and 12-week UVB treatment. UVB treatment consisted of narrowband (NB) UVB at the site in France and broadband (BB) UVB at the site in the United States. The 12-week treatment period was followed by a 12-week follow-up period. Clinic visits occurred weekly during treatment and every 2-4 weeks during follow-up. RESULTS: A total of 60 patients (n = 30/site) were enrolled in the study. Alefacept was well tolerated when administered in combination with UVB treatment and as monotherapy. There was no evidence of increased phototoxicity or photosensitivity with the combination. At each study site, alefacept/UVB provided a higher overall response rate and led to a more rapid onset of response compared with alefacept monotherapy. Of patients who achieved > or = 50% reduction from baseline Psoriasis Area Severity Index (PASI 50) at 2 weeks after the last dose of alefacept, 75-100% in the combination therapy groups maintained this response throughout follow-up in the absence of further psoriasis therapy. CONCLUSIONS: In patients with chronic plaque psoriasis, combination therapy with alefacept plus short-term (6-12 weeks) UVB treatment is well tolerated with a trend toward greater and more rapid efficacy than alefacept alone.

Adult↗

UV-light therapies in atopic dermatitis.

106 patients from Northern Norway were given phototherapy for atopic dermatitis with ultraviolet B (UVB) (group B) or in combination with ultraviolet A (UVA), designated UVAB (group AB). Of the 52 patients in group B, 44 (84%) were cured after 23 treatments whereas 51 (94%) of the 54 patients in group AB were cured after 18 treatments. This difference is statistically significant (P less than 0.01). Of the remaining 11 patients, 6 in group B and 2 in group AB improved, and only 2 in group B and 1 in group AB were unaffected, by this treatment. In group B, 30 of the 44 healed patients had relapsed 3 months after the 1st treatment, compared to 27 of 51 patients in group AB. 3 months after a 2nd treatment, 36 (69%) of the patients in group B were still in remission compared to 51 (94%) in group AB. No side-effects were observed. The results indicate that, in the area of Norway where even the summer sunlight is scarce, UVAB and, to some extent UVB light are effective treatments for atopic dermatitis.

Adolescent↗

[Photo-brine therapy in patients with psoriasis and neurodermatitis atopica].

The effectiveness of salt water baths and subsequent selective ultraviolet phototherapy (SUP) was investigated in a prospective study on 40 patients with psoriasis vulgaris and atopic dermatitis. There were two groups with 20 patients each. The first group was treated with salt water (15%) that contained synthetic Dead Seas salt called "Psorisal"; the patients in the second group had a bath in a 3% NaCl solution. After 4 weeks of daily treatment, we found that 80% of the patients in the group treated with "Psorisal" had significantly better results than the second group. The subjective feeling of being ill had decreased significantly in both groups by the end of the study. The only side effect we found was the occurrence of sunburn in few cases, but this occurred significantly less in the "Psorisal" group. Both groups generally accepted the balneophototherapy, so it can easily be employed on an outpatient basis.

Adolescent↗

[Maintenance therapy of psoriasis].

Maintenance therapy in the interval between flares is an essential part of the therapeutic approach to psoriasis. The therapeutic effectiveness of maintenance therapy results from a positive influence on the physicochemical characteristics of individual compartments of the skin, especially the stratum corneum and the epidermis. The objective is revert from a pathological milieu toward a physiological one. These effects may be supplemented by pharmacological or biochemical effects of the active substances or substance mixtures. Focal points are the use of lipophilic bases as well as keratoplastic, antiseptic and antipruriginous additives.

Administration, Oral↗

[Association between UVA1 and PUVA bath therapy and development of malignant melanoma].

After 18 months of intensive UVA1- and bath PUVA therapy for urticaria pigmentosa, a female patient developed a malignant melanoma on the right thigh. This can be taken as further indication that intense UVA1 or PUVA therapy is capable of inducing malignant melanoma, even though this risk has not been completely proven. The total dose of UVA1 was 910 J/cm2, while the total dose of PUVA was 214.4 J/cm2. It is unclear to what extent modified UVA application of long-wave UVA light (UVA1) and modified PUVA therapy (bath PUVA) have a similar risk compared to known data.

Adult↗

Comparison of narrow-band (311 nm) UVB and broad-band UVA after oral or bath-water 8-methoxypsoralen in the treatment of psoriasis.

BACKGROUND: There is a disparity between the absorption spectrum of 8-methoxypsoralen and the action spectrum for psoralen-sensitized erythema. In an action spectrum corrected for unsensitized reaction 313 and 365 nm have similar efficacies. OBJECTIVE: We evaluated the relative erythemogenic and antipsoriatic efficacy of narrow-band (311 nm) UVB with and without prior psoralen exposure. We also compared the effects of narrow-band UVB and broad-band UVA after oral and bath-water psoralen exposure. METHODS: Patients with psoriasis underwent half-side comparison studies. In one group the therapeutic efficacy of 311 nm UVB with and without oral psoralen was assessed. The second group received UVA and 311 nm UVB after oral psoralen. The third group was exposed to both radiation sources after bath-water exposure. RESULTS: The erythemogenic, pigmentogenic, and therapeutic efficacy of 311 nm was increased by oral psoralen. With systemic 8-methoxypsoralen, UVA was comparable to 311 nm UVB. After bath-water exposure, 311 nm was clearly superior to broad-band UVA. CONCLUSION: The efficacy of narrow-band 311 nm UVB can be enhanced by psoralen. Narrow-band 311 nm UVB is also effective after psoralen bath-water delivery.

Administration, Cutaneous↗