Fluticasone in mild to moderate atopic dermatitis relapse: A randomized controlled trial.

BACKGROUND: The long-term efficacy of corticosteroids to prevent atopic dermatitis (AD) relapses has partially been addressed in children. This study compared an intermittent dosing regimen of fluticasone propionate (FP) cream 0.05% with its vehicle base in reducing the risk of relapse in children with stabilized AD. METHODS: A randomized controlled, multicentric, double-blind trial was conducted. Children (2-10 years) with mild/moderate AD (exclusion criteria: >30% affected body surface area and/or head) were enrolled into an Open-label Stabilization Phase (OSP) of up to 2 weeks on twice daily FP. Those who achieved treatment success entered the Double-blind Maintenance Phase (DMP). They were randomly allocated to receive FP or vehicle twice-weekly on consecutive days for 16 weeks. The primary study endpoint was relapse rate; time to relapse and severity of disease were also studied. Kaplan-Meier estimates were calculated. RESULTS: Fifty-four patients (29 girls) entered the OSP (23 mild AD) and 49 (26 girls) continued into the DMP. Mean age was 5.5 (SD: 2.8) and 5.1 (SD: 2.3) yrs for FP and vehicle groups, respectively. Four patients withdrew from the DMP (two in every group). Patients treated with FP twice weekly had a 2.7 fold lower risk of experiencing a relapse than patients treated with vehicle (relative risk 2.72, SD: 1.28; p=0.034). FP was also superior to vehicle for delaying time to relapse. Both treatment therapies were well tolerated. CONCLUSION: This long-term study shows that twice weekly FP provides an effective maintenance treatment to control the risk of relapse in children with AD.

Fracturas múltiples y consumo inusual de pastillas Juanola(R) de regaliz / Multiple fractures and unusual consumption of licorice pastillas Juanola(R)

El regaliz (Glycyrrhiza glabra) se ha considerado una planta medicinal desde hace miles de años, y actualmente se utiliza en multitud de preparados por su sabor, poder endulzante y efecto antiinflamatorio. No está exento de efectos secundarios, entre ellos, la hipertensión por su efecto mineralcorticoide. Además, los flavonoides presentes en el extracto de regaliz producen un aumento de la hormona paratiroidea (PTH) y de los niveles de calcio en la orina. Presentamos un caso de una mujer de 60 años con fracturas múltiples asociadas a un consumo inusual y exagerado de pastillas Juanola® (PJ®), producto a base de extracto de regaliz

Licorice (Glycyrrhiza glabra) has been considered a medicinal plant for thousands of years, and it is included in several compounds for its flavor, sweetener and anti-inflammatory properties. It is not free of side effects, including high blood pressure due to its mineralocorticoid effect. In addition, there are flavonoids in licorice extract which increase serum parathyroid hormone (PTH) and urinary calcium levels. We report a case of a 60-year-old woman with multiple bone fractures associated with an unusual and exaggerate consumption of pastillas Juanola (PJ), product based on licorice extract

Fluticasone in mild to moderate atopic dermatitis relapse: a randomized controlled trial

BACKGROUND: The long-term efficacy of corticosteroids to prevent atopic dermatitis (AD) relapses has partially been addressed in children. This study compared an intermittent dosing regimen of fluticasone propionate (FP) cream 0.05% with its vehicle base in reducing the risk of relapse in children with stabilized AD. METHODS: A randomized controlled, multicentric, double-blind trial was conducted. Children (2-10 years) with mild/moderate AD (exclusion criteria: >30% affected body surface area and/or head) were enrolled into an Open-label Stabilization Phase (OSP) of up to 2 weeks on twice daily FP. Those who achieved treatment success entered the Double-blind Maintenance Phase (DMP). They were randomly allocated to receive FP or vehicle twice-weekly on consecutive days for 16 weeks. The primary study endpoint was relapse rate; time to relapse and severity of disease were also studied. Kaplan-Meier estimates were calculated. RESULTS: Fifty-four patients (29 girls) entered the OSP (23 mild AD) and 49 (26 girls) continued into the DMP. Mean age was 5.5 (SD: 2.8) and 5.1 (SD: 2.3) yrs for FP and vehicle groups, respectively. Four patients withdrew from the DMP (two in every group). Patients treated with FP twice weekly had a 2.7 fold lower risk of experiencing a relapse than patients treated with vehicle (relative risk 2.72, SD: 1.28; p = 0.034). FP was also superior to vehicle for delaying time to relapse. Both treatment therapies were well tolerated. CONCLUSION: This long-term study shows that twice weekly FP provides an effective maintenance treatment to control the risk of relapse in children with AD

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[Consumption of medicinal herbs and medicines]. / Consumo de hierbas medicinales y medicamentos.

OBJECTIVE: Given the possibility of adverse side-effects, interactions with medicines and poisoning by contaminants among herbal medicine consumers (HM), we aimed to describe the consumption of HM by health centre users being treated with medicines. DESIGN: Cross-sectional, observational study.Setting. Thirteen health centres in the Community of Valencia. PATIENTS AND OTHER PARTICIPANTS: Users of either sex, over 14, chosen for a study of use of medicines to find differences between the sexes. MEASUREMENTS AND MAIN RESULTS: The study variables, age, gender, education, consumption of medicines and use of HM, were gathered from the clinical records, the long-treatment card and an ad hoc structured survey. 801 out of 812 users took medicines. 159 took HM (19.6%; 95% CI, 16.9-22.3); average age 55.8 (SD, 16.5); women 58.5% (95% CI, 50.8-66.1). They took 226 HM (mean of 1.42; 95% CI, 1.32-1.52). Men consumed more HM (p < 0.05). There were no differences in consumption of HM for age, educational background or number of medicines taken. 42.8% (95% CI, 35.1-50.2) of those who took HM attended for consultation over 10 times in the previous year. 96.9% (95% CI, 93.7-98.4) of HM were taken by self-medication. They were consumed: <> by 36.7% (95% CI, 30.4-43.0); stomach problems, 19.5% (95% CI, 14.3-24.6); nerves/depression, 12.8% (95% CI, 8.5-17.2); intestinal disorders, 10.6% (95% CI, 6.6-14.6); insomnia 5.8% (95% CI, 3.1-9.6). 49.1% (95% CI, 42.6-52.6) were manufactured HM. CONCLUSIONS: One of every five patients being treated with medicines is also taking HM by self-medication. The health authorities and doctors should advise of the risks to health and of the counter-indications of these products.

[Influence of patient's sex on the quality of medicine taken]. / Influencia del sexo del paciente en la calidad de los medicamentos consumidos.

OBJECTIVE: To analyse the relationship between patient's sex and quality of medicine taken by monitoring the most pertinent predictive variables. DESIGN: Observational cross-sectional study. SETTING: Thirteen Health Centres in the Community of Valencia. PARTICIPANTS: Adult users, selected by consecutive sampling. MAIN MEASUREMENTS: A semi-structured questionnaire collected the following variables: social and personal details, use of medicines for health problems, frequency of use of services, and place where prescription was issued. The quality of the medication was measured by its intrinsic value (IV). RESULTS: 412 of the 812 patients were women. Men took more medication with a high IV, and women more with an unacceptable IV. Women over 45 took more medication with a not-high IV. Multivariate analysis showed: a) women took one and a half times more medicines with a not-high IV than men, with differences not significant, and b) in the 45-64 age-group, being a woman operated as a modifier of effect, increasing prevalence of consumption of not-high IV to two and a half times more than men. This was adjusted for frequency of attendance, health problems and where the prescription was issued. CONCLUSIONS: The study helped clarify the influence of gender on the quality of medicine, by pointing to the greater likelihood of women between 45 and 64 taking lower-quality medication. In addition, it showed the effect of where the prescription was issued and of health problems on explaining this difference in consumption.

[An analysis of the information in the Medicom International Vade Mecum with respect to drugs with vitamin A]. / Análisis de la información del Vademécum Internacional Medicom respecto a los medicamentos con vitamina A.

OBJECTIVE: Determination of whether rational drug use is facilitated by the quality of the information provided by the Medicom International Vademecum on drugs containing vitamin A as active component. DESIGN: Descriptive study. SETTING: Primary, specialized and hospital health care within the national context. SUBJECTS: Total drugs containing vitamin A, included in the 1995 Medicom International Vademecum. MEASUREMENTS: Systematic analysis of the information contained in the technical note on drugs containing vitamin A included in the Medicom International Vademecum, with respect to several parameters. RESULTS: The Medicom International Vademecum lists a total of 37 drugs containing vitamin A (35 in combination). A total of 112 different indications are given; 74 are not accepted in the literature, and 29 are related to the active components present in combination with vitamin A. CONCLUSIONS: The analysis of the technical information provided by the Medicom International Vademecum on medications containing vitamin A reveals major deficiencies in the parameters investigated.