Non-interventional study to collect data for the application of lidocaine gel 2% during scaling and root planing and professional mechanical plaque removal.

OBJECTIVES: Evaluation of the safety and efficacy of a topical lidocaine gel 2% (LG) during scaling and root planing (SRP) and professional mechanical plaque removal (PMPR). MATERIALS AND METHODS: The anesthetic effects as well as unwanted effects of LG prior to or during SRP and PMPR were evaluated in an observational, non-randomized, non-interventional study design. A total of 385 treatments were recorded in 68 study centers all over Germany. Rating of the anesthetic effect of LG by treating personnel and patients using a four-item verbal rating scale (VRS), tolerability, safety (adverse effects), and need for additional local injection anesthesia (ALI). RESULTS: In SRP as well as in PMPR, application of LG allowed a sufficiently pain-free therapy in more than 90% of the patients as stated on the VRS (SRP: 97.8%, PMPR: 93.75%). Overall, ALI was needed in only 4.23% of the patients treated (SRP: 5.3%, PMPR: 2.62%). One adverse effect occurred within the observation. CONCLUSIONS: Application of LG may offer a safe and effective way to achieve pain-free therapy in periodontal patients. CLINICAL RELEVANCE: Patient compliance is key to the success of periodontal maintenance therapy. Effective and safe pain control during various kinds of periodontal therapy might increase patient compliance and therefore contribute to the long-term treatment success, among other factors. With regard to the patients observed in this study, 47% had previously received periodontal maintenance therapy and were therefore familiar with the treatment and the associated pain.

The French polidocanol study on long-term side effects: a survey covering 3,357 patient years.

BACKGROUND: AIMS Short- and mid-term side effects of sclerotherapy, in particular with polidocanol (lauromacrogol 400), have been previously described in our registry of 12,173 sessions. The objective of this follow-up registry was to evaluate the long-term incidence of adverse events with polidocanol. METHODS: The physicians involved in the initial French registry were contacted and asked to partake in the follow-up survey. Initially included patients were controlled at the latest possible date to determine whether a complication had occurred after the end of the initial survey. RESULTS: Data on 1,605 patients included in the French registry were reviewed with a maximum follow-up of 60 months, covering 3,357 patient years. Five (0.4%) adverse events were observed in patients treated with liquid polidocanol and 46 (1.1%) in patients treated with polidocanol foam. The most frequent side effects were visual disturbances (n=14), and the most severe were muscular vein thrombosis (n=8). The onset of side effects was mostly observed directly after sclerotherapy or in the 6 months after (84% in the first year). One deep vein thrombosis recurrence occurred in a patient with heterozygote Factor V Leiden after stopping anticoagulant treatment (foam sclerotherapy). CONCLUSIONS: Foam sclerotherapy is a recognized reference method in the treatment of varicose veins of all types. This study demonstrates that polidocanol is a safe sclerosing agent in the short and long term.

Microelectrode investigations of the visual system at the Department Of Clinical Neurophysiology, Freiburg i.Br.: a historical account of the first 10 years, 1951-1960.

The history of the first ten years of neurophysiological science (1951-1960) at the Department of Clinical Neurophysiology in Freiburg i.Br. (Germany) is described by some of the participants. We describe the concepts of Richard Jung for the development of an experimental neurophysiology, the technical conditions which helped to realize these ideas, and the integration of the newly emerging German neurophysiological science into the international community, through the large number of foreign visitors. A short account is given of the young scientists working at the Freiburg laboratory during this period, their main lines of research, as well as the results of their studies.

Efficacy and Safety of a Lidocaine Gel in Patients from 6 Months up to 8 Years with Acute Painful Sites in the Oral Cavity: A Randomized, Placebo-Controlled, Double-Blind, Comparative Study.

Lidocaine is a well-accepted topical anaesthetic, also used in minors to treat painful conditions on mucosal membranes. This randomized, double-blind, placebo-controlled study (registered prospectively as EudraCT number 2011-005336-25) was designed to generate efficacy and safety data for a lidocaine gel (2%) in younger children with painful conditions in the oral cavity. One hundred sixty-one children were included in two subgroups: 4-8 years, average age 6.4 years, treated with verum or placebo and 6 months-<4 years, average age 1.8 years, treated only with verum. Pain reduction was measured from the time prior to administration to 10 or 30 minutes after. In addition, adverse events and local tolerability were evaluated. In group I, pain was reduced significantly after treatment with verum compared to placebo at both time points. In group II, the individual pain rating shift showed statistically significant lower pain after treatment. Only seven out of 161 patients reported an adverse event but none were classified as being related to the study medication. The local tolerability was assessed as very good in over 97% of cases. For painful sites in the oral cavity, a 2% lidocaine gel is a meaningful tool for short-term treatment in the paediatric population.

[Comparative in vitro and in vivo studies on the permeation and penetration of ketoprofen and ibuprofen in human skin]. / Vergleichende In-vitro- und In-vivo- Studien zur Permeation und Penetration von Ketoprofen und Ibuprofen an humaner Haut.

The aim of the present in vitro and in vivo studies was to compare the permeation and penetration of a 2.5% ketoprofen (CAS 22071-15-4) gel [Phardol Schmerz-Gel (Test-D)] with the permeation and penetration of two other ketoprofen gels (Ref-I, Ref-E) and an ibuprofen (CAS 15687-27-1) gel (Ref-D) on excised human skin. Furthermore, in vivo studies were performed. The permeation studies utilizing static Franz diffusion cells allow the determination of the transdermal (systemic) transport, whereas the penetration studies in vitro (according to the Saarbrücker model) and in vivo permit setting up a concentration-depth profile. For this purpose the permeation kinetics of ketoprofen from three different gels (each containing 2.5% ketoprofen) over a period of two days were determined at heat-separated human skin of different donors. The in vitro permeability coefficients for Test-D (6.50 x 10(-7) cm x s(-1)) and Ref-I (5.72 x 10(-7) cm x s(-1)) were comparable and the transport occurred for both by a factor of 8-9 faster than with Ref-E (0.78 x 10(-7) cm x s(-1)). In parallel to the permeation studies with ketoprofen, the permeability coefficient of caffeine from an ointment was assessed using the skin biopsies of the same donors as a quality assurance. In a second part of the studies, the in vitro penetration of ketoprofen from Test-D was determined over a period of 3 h at three different skin biopsies in comparison to a commercially available 5% ibuprofen gel (Ref-D). As a main result a concentration-depth profile for ketoprofen and ibuprofen could be issued. The ketoprofen (37.7 +/- 12.1 microg/cm2) and the ibuprofen (30.1 +/- 6.0 microg/cm2) penetrate to the same order of magnitude into the upper part of the Stratum corneum, whereas ibuprofen stronger accumulates in the deeper layers (ketoprofen: 27.3 +/- 8.5 microg/cm2; ibuprofen: 73.7 +/- 31.1 microg/cm2). An additional in vivo penetration study was performed with Test-D to set up an in vitro-in vivo (IVIV) correlation. Over a period of 3 h, the amount of ketoprofen in the Stratum corneum in vivo was 78.4 +/- 19.1 microg/cm2 being comparable to the in vitro data.