Topical treatment habits in psoriasis patients receiving adalimumab.

BACKGROUND: Biologics are used increasingly to treat moderate-to-severe psoriasis. Here the topical treatment habits (corticosteroids and vitamin D derivates) and moisturizer use of 97 Swiss patients (male 65, female 32) receiving adalimumab have been evaluated. METHODS: Using a short cross-sectional survey the pharmacist asked patients during telephone contact about their topical treatment habits and psoriasis activity. RESULTS: 47 patients with adalimumab monotherapy were still free of psoriatic lesions after a longer follow-up of 13 months of therapy; 8 of them still used topical treatment. In contrast, 38 of 50 patients with remaining lesions used topicals. More than 75% of patients indicated that the perceived efficacy of additional topical therapy was ≥5 on a visual analog scale (0-10). The use of moisturizers did not correlate with disease activity. CONCLUSION: Topical treatment use by adalimumab patients is associated with remaining disease activity. 83% of patients without residual plaques (40% of all adalimumab patients) are able to stop topical treatment completely.

The influence of the subjects' training state on the glycemic index.

OBJECTIVE: To determine the glycemic index (GI) dependence on the training state of healthy adult males. SUBJECTS AND DESIGN: Young, adult males of normal body mass index and normal glucose tolerance were tested twice with a 50 g reference glucose solution and twice with a breakfast cereal containing 50 g of available carbohydrates in a randomized order. Ten subjects were sedentary (SE), 12 were moderately trained (MT) and 12 were endurance trained (ET). Blood glucose, insulin and glucagon were measured. RESULTS: The GI differed significantly between SE and ET subjects (P=0.02, mean difference: 23 GI units, 95% CI=3-42 GI units). The GI of the MT subjects was intermediary, but did not differ significantly from the SE or ET subjects. The insulin index did not differ significantly between the groups (P=0.65). CONCLUSION: The GI of the commercially available breakfast cereal depended on the training state of the healthy males. The training state is the first reported factor influencing the GI that is subject specific rather than food specific.

Therapeutic, hemodynamic, and metabolic effects of hyperbaric oxygenation in peripheral vascular disease.

Hyperbaric oxygen therapy (HBT) consists of inhaling 100% oxygen under pressure exceeding atmospheric pressure. Patients with various degrees of peripheral vascular disease (stages II, III, and IV according to Fontaine's classification) were treated with HBT. Clinical symptoms improved in 70%. Ankle/brachial index increased by more than 0.10 in 47%. Photoplethysmographic pulse appearance has been detected in roughly one third of patients. Transcutaneous oxygen tension did not, however, improve significantly. Plasma malondialdehyde (MDA) was evaluated as a marker of lipid peroxidation, possibly influenced by hyperbaric oxygen. Surprisingly, the authors found that MDA levels decreased after HBT, probably as a result of the activation of antioxidant systems. These results show that HBT represents a useful approach in the treatment of peripheral vascular disease, since it improves clinical and hemodynamic parameters, with no potentially harmful side effects, such as enhanced lipid peroxidation, at least in the short term.

The influence of environmental pressure on retentiveness of prosthetic crowns: an experimental study.

To determine the effect of pressure variations on the retention of prosthetic crowns, 36 identical, cast metal crowns were fixed to simulated, epoxy resin crown preparations with zinc oxyphosphate cement. Eighteen specimens were placed in a hyperbaric chamber and subjected to 15 cycles of simulated immersion at 30 m and decompression, as usually carried out by scuba divers. The untreated specimens served as controls. When the force required to dislodge the crowns was measured, the treated crowns were dislodged at about one third the load that was required to dislodge the control group, indicating that a statistically significant decrease in cement strength follows pressure variations.

Hyperbaric oxygen therapy in the treatment of multiple sclerosis. A clinical and electrophysiological study in a 2 year follow-up.

15 patients with chronic progressive Multiple Sclerosis were treated with Hyperbaric Oxygen Therapy at 2.0 atmospheres absolute for a total of 20 daily exposures followed by 2 exposures every month. The treatment was carried out for a 24 months follow-up. No objective benefit resulted from Hyperbaric Oxygen Therapy at the completion of the study while a subjective improvement in bladder control was reported in the short and in the long-term follow-up by 8 and by 5 patients respectively. No significant variations in the electrophysiological results were observed after the first 20 consecutive exposures. It is concluded from this trial that a long-term Hyperbaric Oxygen Treatment cannot moderate the progression of Multiple Sclerosis. However, an improvement in the quality of life can be obtained in some patients resulting from a better control of bladder function.

[Gow-Gates block for beginners]. / Il blocco di Gow-Gates nel neofita.

The study was carried out with two groups of 49 patients to evaluate the incidence of failures and re-injections when the blockade of the mandibular nerve was carried out according to Gow-Gates by untrained young dentists. Such an incidence was compared to that of the blockade of the inferior alveolar nerve by the same dentists trained for this specific task. Both the observed failures and re-injections in the Gow-Gates blockade progressively decrease and disappear, theoretically, after 50 blockades, while they remain almost constant in the inferior alveolar nerve blockade. The induction of the blockade was more prolonged after the Gow-Gates blockade (9 minutes) compared to the inferior alveolar nerve blockade (7 minutes). The pain induced by the injection, that due to the anesthetic and that experienced during the subsequent surgery were lower after the Gow-Gates blockade.