Fixed duration MDT in paucibacillary leprosy (classical and modified).

We analyzed the records of 1022 patients of paucibacillary leprosy who had received either 6 doses of WHO-MDT alone (" classical" MDT, 668 patients) or had post-MDT dapsone for at least 6 months ("modified" MDT, 354 patients). The duration of posttherapy surveillance ranged from 6 months to 7 years (mean 20.4 months). We found that the incidence of unfavorable events was significantly higher with the classical regimen when patients were graded as active at the end of the fixed duration regimen, especially when patients with > 2 lesions were considered. In the patients who were graded as inactive at the end of 6 doses, there was a slight excess of unfavorable events in the modified regimen, although not statistically significant. No correlation was found between unfavorable events and the regularity of treatment or the lepromin status. Overall, the incidence of adverse events was higher in patients with multiple lesions, and more than 90% of the adverse events occurred during the first 2 years of follow up. It is felt that 6 doses of MDT is adequate in the majority of patients who have few lesions or who have become inactive at the end of the treatment period. However, caution should be exercised in those with multiple lesions or in those considered active at the end of 6 doses.

Relapses in paucibacillary leprosy after MDT--a clinical study.

A study was undertaken in a field-based project to assess the incidence and clinical profile of relapses occurring in paucibacillary leprosy patients after adequate doses of multidrug therapy (MDT). Of the 1509 paucibacillary patients who had received not less than 6 doses of MDT (WHO regimen), 85 relapsed; a relapse rate of 5.63% (17.5/1000 person years at risk). These relapses included 12 cases with features of reversal reaction. Seventy-nine percent of the patients relapsed with skin lesions. The relapse rate was higher in borderline cases and in those with more lesions, and it was lower in those who had received dapsone for at least 6 months after cessation of MDT. Seventy-four percent of the relapses were detected between 7 and 24 months of follow up. We feel that uniform clinical criteria should be formulated for the diagnosis of relapse. Individualization of therapy, rather than adhering to a fixed duration of MDT, would be likely to achieve satisfactory cure rates and fewer relapses.

Multidrug therapy in paucibacillary leprosy--a five year experience.

736 paucibacillary (PB) patients were given multidrug therapy (MDT) for at least 6 months. Overall, 44% became inactive after 6 doses, and 69% after 12 doses. However, 27% remained active at the time of analysis. It is recommended that at least 12 doses of MDT be given to PB patients irrespective of the type.

Childhood leprosy in Bombay: a clinico-epidemiological study.

During the years 1976-1985, 2138 cases of leprosy were detected in children aged 0-14 years, in L and M wards of Greater Bombay. Out of these, records of 1084 patients were available for detailed analysis. These were mainly from the deprived sections of society. Most cases were detected through surveys, though in recent years, there is an increasing trend for voluntary reporting. The relevant epidemiological and clinical findings are presented and compared with the data of other workers in this field.

[Rehabilitative treatment of patients with primary and secondary spinal cord neoplasms]. / Il trattamento riabilitativo nei pazienti affetti da neoplasie midollari primitive e secondarie.

The Authors present their studies concerning rehabilitation treatment in primary and secondary spinal cord tumors. They examine the problems inherent in this complex pathology. Rehabilitation was initiated in the acute phase of the illness with the aim of preventing secondary and tertiary damage that could jeopardize successive functional recuperation. The Authors believe that rehabilitation treatment, when used early enough, improves the day life for patients with spinal cord tumors.

Effect of prostacyclin on antigen induced immediate bronchoconstriction in asthmatic patients.

The effect of premedication with inhaled prostacyclin (PGI2) on the allergen induced immediate bronchoconstriction was investigated in 10 asthmatic patients, under single blind conditions, by means of a body plethysmograph. Statistical analysis (Dunnett's test) did not show any significant difference between PGI2 and placebo. The possible meaning of these results is discussed.

Aspects of bronchial reactivity to prostaglandins and aspirin in asthmatic patients.

The behaviour of bronchial reactivity to PGF2alpha was studied in asthmatic patients under various experimental conditions. Premedication with aminophylline, i.v., and, to a lesser extent, with DSCG afforded a partial protection, while beclomethasone dipropionate was inactive under this point of view. Diftalone, a new non-steroid anti-inflammatory agent, was well tolerated in 9 aspirin-intolerant asthmatic patients, and did not modify the bronchial response to PGF2alpha which was found to be generally lower then that of other aspirin-tolerant asthmatic patients. PGE 1-2 and DSCG prevented the bronchospasm induced by inhalation or ingestion of acetylsalicylic acid in a small group of patients. Good protection was also reached with PGE1-2 in the exercise-induced bronchospasm.

[Positive ionotropic action of glucose-1-phosphate. Clinical research during heart catheterization]. / Azione inotropa positiva del glucosio-1-fosfato. Ricerche cliniche in corso di cateterismo cardiaco

The effect of glucose-1-phosphate, administered in a single dose (5 g by slow intravenous route), on myocardial contractility was evaluated in a group of patients undergoing diagnostic cardiac catheterization. The study of the hemodynamic values observed demonstrated that glucose-1-phosphate has positive inotropic action and is able to strengthen the effect of the cardioactive glucosides.