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[Current therapeutic approach in atopic eczema].

Aside from the well established modes of topical treatment, systemic treatments are also required in cases of recalcitrant and/or severe topic eczema. The following methods already introduced in clinical practice are discussed: Substitution of gamma-linoleic acid and intake of eicosapentaenoic acid respectively, UV-irradiation with suitable wavelength bands, Cyclosporin A-treatment. Finally the different therapeutic possibilities which could effect the atopic inflammatory infiltrate are pointed out.

Combined Modality Therapy↗

[Immunological disorders and correction of them in surgical patients with atherosclerosis obliterance].

Atherosclerosis obliterance and critical lower limb ischemia lead to immunodeficiency and disbalance of T- and B- components of immune system. Surgical treatment doesn't eliminate but in a number of cases aggravates immune disorders. Immunocorrection stimulates anti-infectious protection. Indications to different variants of immunocorrection are formulated.

Antibodies, Anti-Idiotypic↗

[Current problems of clinical toxicology].

Information, toxicometry, and detoxication are the most pressing problems of present-day clinical toxicology. The author discusses some aspects in the information provision of a physician specialized in toxicology, creation of a toxicological data base, and systemic analysis making use of computer software. Special attention is paid to the assessment of methods of efferent therapy of poisonings, such as hemodialysis, hemosorption, physiohemotherapy, and their combinations.

Acute Disease↗

[The principles of administering drug and non-drug treatment methods in peptic ulcer].

As the result of the study optimal schemes of the ulcer disease treatment were elaborated. They include microwave resonance therapy, immunomodulatory and antibacterial drugs with regard to localisation, depth and size of the ulcerous lesion, exacerbation rate, degree of secondary immune disorders and seeding of gastric mucosa with Helicobacter pylori. The treatment suggested allows to shorten the terms of ulcer cicatrization, reduces exacerbation rate and ensures clinico-endoscopic remission in most patients with ulcer disease.

Adjuvants, Immunologic↗

[Endovascular therapy with laser light in the combined treatment of acute pancreatitis].

Studies conducted in experiments (132 animals) and in the clinic (109 patients) revealed a close relationship between the severity of pancreatogenous endotoxicosis and red cell membrane hyperlipoperoxidation and spontaneous red cell hemolysis, which allows three degrees of blood red cell lipoperoxidation to be distinguished in the period of acute endotoxemia: mild, moderate, and severe. Inclusion of blood laser irradiation into the management of acute pancreatogenous toxemia in moderate and severe degrees of blood red cell hyperlipoperoxidation reduces authentically the peroxide damage of the red cell membranes and the marked character of hemic hypoxia. The best effect was produced with the use of LG-75-1 laser beam in an elaborated regimen in severe red cell lipoperoxidation. The content of secondary lipoperoxidation products reduces in this case by 28.5% on the average in significant correlation with normalization of some clinical and laboratory parameters.

Acute Disease↗

Treatment of vitiligo with UV-B radiation vs topical psoralen plus UV-A.

OBJECTIVE: To compare the efficacy and safety of 2 treatment modalities, topical psoralen plus UV-A (PUVA) with unsubstituted psoralen and 311-nm UV-B radiation, in patients with vitiligo. DESIGN: This intervention study was designed as a before-and-after trial with 2 arms, in which patients were consecutively included. PATIENTS: Male (n = 99) and female (n = 182) patients, who predominantly had skin type III, with extensive, generalized vitiligo of more than 3 months' duration. INTERVENTIONS: Two patient groups were investigated. The first group of patients was treated for 4 months with either topical PUVA (n = 28) or 311-nm UV-B radiation (n = 78). The second group of patients, treated twice weekly with 311-nm UV-B radiation, was followed up for 3 (n = 60), 6 (n = 27), 9 (n = 37), or 12 months (n = 51). RESULTS: Thirteen (46%) patients in the first group treated with topical PUVA showed repigmentation after 4 months. Fifty-two patients (67%) in the 311-nm UV-B treatment group showed repigmentation after 4 months. After 3 months, 5 patients (8%) in the second group showed more than 75% repigmentation of lesional skin compared with 32 patients (63%) after 12 months. As in other treatment modalities, the face showed good repigmentation, whereas hands and feet responded poorly. No adverse effects were encountered with treatment with narrowband UV-B radiation, contrary to those seen with topical PUVA treatment. The cumulative UV-B dose was very small compared with that of the topical PUVA treatment. CONCLUSIONS: According to our results, the treatment of patients with vitiligo with 311-nm UV-B radiation is as efficient as with topical PUVA and has fewer adverse effects.

Administration, Topical↗

Mycosis fungoides: electron beam therapy in England.

Since 1962, total-skin electron-beam therapy has been available in London, England, for the treatment of patients with mycosis fungoides and skin lymphomas. The 6-mev linear accelerator produces a pencil beam of electrons at 7 mev, which are scattered through a brass scatterer and decelerated by either of two carbon decelerators or a copper decelerator to produce a beam of effective energy of 2.5, 3, or 3.5 mev; these beams have an 80% isodose distribution at 5.5, 8, and 11.5 mm, respectively. The patient receives 200 rads to the anterior, posterior, and right and left lateral fields, for a total dose of between 1600 and 2600 ras in ten treatments over 5--7 weeks. Complete clearing of the disease can be predicted in all patients except those with the most advanced tumors. However, the duration of remission after electron-beam therapy is approximately 18 months and we are presently investigating the combination of psoralens and ultraviolet light therapy as maintenance treatment following lower-dose electron-beam therapy.

Humans↗