[Patch testing in patients with leg ulcers with special regard to modern wound products]. / Epikutantestung bei Patienten mit Ulcus cruris unter besonderer Berücksichtigung moderner Wundprodukte.

BACKGROUND: Patients with leg ulcers often have contact sensitizations. Modern wound care products claim low allergic potential. OBJECT: To analyze the patch test results in leg ulcer patients with focus on modern care wound products. MATERIAL AND METHODS: 95 leg ulcer patients were tested with the standard German patch test series as well as frequently used wound care products. RESULTS: 61% of the patients had at least one positive reaction. Most frequent reactions were seen with tert-butylhydroquinone, povidone iodine, balsam of Peru, a hydrogel, fragrance mix I and II, Amerchol L101 and gentamicin. There were 14 reactions to modern wound care products with highest sensitization rates for hydrocolloids and hydrogels. Patients sensitized to wound care products had significantly more positive patch test reactions. CONCLUSION: There are sensitisations against modern wound care products, especially hydrogels. That should be considered in patch test of leg ulcer patients.

Acute effects of methylphenidate on neuropsychological parameters in adults with ADHD: possible relevance for therapy.

Recent research has demonstrated that attention-deficit/hyperactivity disorder (ADHD), one of the most common mental disorders in childhood, continues into adulthood. In adulthood, however, pharmacotherapy with psychostimulants still is an off-label treatment. Because of this we routinely administer a test dose of methylphenidate (MPH) prior to a continuous medication and measure MPH effects quantitatively and repeatedly employing a neuropsychological test battery. To probe if the acute effects of MPH are indeed helpful in predicting longer-term efficacy of MPH treatment we retrospectively analyzed the neuropsychological test results of 34 patients on continuous MPH medication. Two testing sessions had been performed without MPH (at baseline and 24 h after a single dose intake to control possible training effects), one after a single dose and one after 3-6 months of regular intake of MPH. A significant improvement of performance in tests assessing attentional, memory and executive functions after single medication was maintained on long term medication in those 23 patients available for follow-up. These results indicate that beneficial short term effects of MPH predict longer-term effects and may thus be helpful in the decision for an off-label treatment. Controlled prospective studies are now necessary.