Comparison of the clinical efficacy and tolerability of olopatadine hydrochloride 0.1% ophthalmic solution and loteprednol etabonate 0.2% ophthalmic suspension in the conjunctival allergen challenge model

BACKGROUND: Olopatadine hydrochloride 0.1% ophthalmic solution and loteprednol etabonate 0.2% ophthalmic suspension are topical antiallergic agents indicated for treatment of the signs and symptoms of allergic conjunctivitis and seasonal allergic conjunctivitis (SAC), respectively. OBJECTIVE: The purpose of this study was to compare the efficacy and tolerability of olopatadine, loteprednol, and placebo in inhibiting the early-phase allergic reaction (within 30 minutes) after conjunctival allergen challenge (CAC). METHODS: This was a single-center, randomized, double-masked, parallel-controlled CAC study. It consisted of 3 visits, with CAC performed at visit 1, confirmation and randomization at visit 2, and evaluation of the treatments at visit 3. Subjects with a history of allergic conjunctivitis were randomized to receive olopatadine, loteprednol, or placebo in a 2:2:1 ratio. Because loteprednol requires a loading period to achieve maximum efficacy, subjects assigned to this treatment received loteprednol QID bilaterally for a 14-day period; the olopatadine and placebo groups received placebo QID bilaterally during this period. At the evaluation visit, subjects received 1 drop of the assigned treatment in each eye. Fifteen minutes later, they were challenged with allergen. Subjects evaluated itching at 3, 5, and 10 minutes after challenge using a standardized 5-point scale; the investigator evaluated redness at 10, 15, and 20 minutes after challenge. Intraocular pressure (IOP) was measured at baseline and after the 14-day loading period. Nonparametric analyses were performed on the change from visit 2 to visit 3 in mean itching and redness scores for each time point, and on the change in mean IOP from visit 1 to visit 3. RESULTS: Fifty subjects (86% white; 42% male, 58% female; age range, 21-71 years) were enrolled and completed the study (20 olopatadine, 20 loteprednol, 10 placebo). The allergens to which subjects reacted were ragweed pollen (40%), cat hair or dander (30%), grass pollen (24%), and tree pollen (6%). The difference in inhibition of itching and redness was clinically significant (> or =1 unit difference) and statistically significant (P < 0.05) in favor of olopatadine compared with loteprednol at all 3 time points. The loteprednol group had a statistically significant increase in IOP after 2 weeks of treatment (P < 0.001). CONCLUSION: In the population studied, olopatadine was more efficacious than loteprednol in reducing the acute signs and symptoms of SAC during the early phase of the ocular allergic reaction and appeared to be better tolerated.     

A combination povidone-iodine 0.4%/dexamethasone 0.1% ophthalmic suspension in the treatment of adenoviral conjunctivitis

Introduction  

The objective of this pilot study was to determine the preliminary efficacy of a novel ophthalmic suspension containing povidone-iodine 0.4% and dexamethasone 0.1% in the treatment of adenoviral conjunctivitis.     

准分子激光上皮下角膜磨镶术后应用0.5％氯替泼诺混悬滴眼液的临床分析

目的:观察准分子激光上皮下角膜磨镶术(laser epithelial keratomileusis,LASEK)术后应用0.5％氯替泼诺混悬滴眼液的临床效果,包括角膜上皮下雾状混浊(Haze)、眼压增高发生情况.方法:总计接受LASEK患者176例345眼,分为试验组84例165眼,术后应用0.5％氯替泼诺混悬滴眼液患者,对照组92例180眼,术后应用0.1％氟米龙滴眼液患者,观察术后6个月时Haze发生率、6个月内眼压增高的发生率,采用x2检验进行统计学分析.结果:试验组与对照组6个月时术后Haze发生率分别为9.70％(16眼)和17.22％(31眼),两者差异有统计学意义(P＜0.05);术后6个月内眼压增高发生率分别为3.64％(6眼)和10.00％(18眼),两者差异有统计学意义(P＜0.05).结论:与0.1％氟米龙滴眼液相比,LASEK术后应用0.5％氯替泼诺混悬滴眼液引起眼压增高的发生率明显降低,可有效预防Haze发生,临床效果安全有效.     

Efficacy and safety of ketorolac tromethamine 0.5% and levocabastine 0.05%: a multicenter comparison in patients with seasonal allergic conjunctivitis

This multicenter, double-masked, randomized, parallel-group study compared the efficacy and safety of ketorolac tromethamine 0.5% ophthalmic solution with levocabastine 0.05% and ketorolac tromethamine vehicle in patients with seasonal allergic conjunctivitis. One drop of ketorolac, levocabastine, or vehicle was instilled in each eye four times daily for 6 weeks. In the majority of efficacy variables, ketorolac produced the greatest improvements, followed by levocabastine and vehicle. Ketorolac was significantly more effective (P<.05) than vehicle in reducing mean itching scores, palpebral hyperemia, bulbar hyperemia, and edema. Patients treated with ketorolac reported significant improvements (P<.05) in their ability to sleep and to concentrate on work, compared with those who received vehicle. No significant differences were noted among the treatment groups in safety or tolerability. Ketorolac tromethamine 0.5% ophthalmic solution instilled four times daily is effective and safe in reducing the signs and symptoms of seasonal allergic conjunctivitis.     

Cardiovascular effects of ophthalmic 0.5% timolol aqueous solution and 0.1% timolol hydrogel

The objective of this randomized, double-masked, cross-over study was to compare the cardiovascular effects of two glaucoma formulations, ophthalmic 0.5% timolol aqueous solution and 0.1% timolol hydrogel. Twenty-four young healthy subjects received for 2 weeks either twice daily 0.5% timolol solution or once daily 0.1% timolol hydrogel. Heart rate (HR), blood pressure, atrio-ventricular conduction (PR interval), corrected QT time (QTc) and heart rate variability (HRV) were measured in supine position and during head-up tilted position. The mean peak concentrations of timolol in plasma were significantly higher after administration of 0.5% aqueous solution than after 0.1% hydrogel. A 0.5% timolol aqueous solution decreased HR on average by 3 bpm in supine position and by 7 bpm in head-up tilted position while no significant effects were observed with 0.1% timolol hydrogel. During tilt test HR was significantly lower after administration of timolol aqueous solution than after timolol hydrogel (mean +/- SD, 77 +/- 11 bpm versus 86 +/- 13 bpm, P < 0.05). Timolol aqueous solution slightly decreased QTc during tilt (5.9 +/- 5.6 ms, P < 0.01). During tilt tests, timolol aqueous solution slightly increased atrio-ventricular conduction (7.2 ms, P = 0.02). No significant differences were found in HRV. These results indicate that in healthy volunteers, ophthalmic 0.5% timolol aqueous solution produces more pronounced cardiac beta-blocking effects than 0.1% timolol hydrogel.     

妥布霉素滴眼液和左氧氟沙星滴眼液治疗细菌性结膜炎的疗效观察

目的观察妥布霉素滴眼液和左氧氟沙星滴眼液治疗细菌性结膜炎的临床效果和安全性。方法回顾性分析2018年10月至2019年6月于该院门诊就诊的89例细菌性结膜炎患者的临床资料,所有患者依据就诊先后顺序分为对照组(43例)和研究组(46例)。对照组采用左氧氟沙星滴眼液治疗,研究组采用妥布霉素滴眼液治疗。比较两组临床疗效、细菌清除情况、眼表状况和不良反应发生情况。结果治疗后,研究组总有效率及细菌清除率高于对照组,差异均有统计学意义(P<0.05)。治疗前,两组泪膜破裂时间(BUT)、基础泪液分泌试验(SIt)结果比较,差异无统计学意义(P>0.05);治疗后,两组BUT、SIt结果均较治疗前下降,且对照组下降更为明显(P<0.05)。两组不良反应以眼部出现烧灼感、眼部瘙痒为主,组间不良反应发生率比较,差异无统计学意义(P>0.05)。结论妥布霉素滴眼液治疗细菌性结膜炎的效果优于左氧氟沙星滴眼液,更有利于细菌的清除,对眼表状态的影响较小,安全性更高。     

Two mast cell stabilizers,pemirolast potassium 0.1% and nedocromil sodium 2%, in the treatment of seasonal allergic conjunctivitis: A comparative study

This randomized, double-masked, active-control, parallel-group trial compared the mast cell stabilizers pemirolast potassium 0.1% and nedocromil sodium 2% in the treatment of seasonal allergic conjunctivitis. Pemirolast is currently indicated for four-times-daily administration, nedocromil, for twice-daily dosing. Both ophthalmic solutions were instilled bilaterally twice a day for 8 weeks. The study involved four office visits and two telephone contacts. Participants evaluated their symptoms daily in take-home diaries (itching was the primary efficacy variable) and completed questionnaires to assess comfort. Of a total enrollment of 80, 78 patients completed the study. No significant differences were found between pemirolast and nedocromil on any signs or symptoms of allergic conjunctivitis (redness, chemosis, itching, eyelid swelling). At each visit, pemirolast was rated significantly more comfortable than nedocromil. A significantly higher percentage of the pemirolast group experienced no signs or symptoms at work or school (58% vs 28%; P = .005). The number of adverse events did not differ significantly between groups. Twice-daily administration of pemirolast potassium was as efficacious and safe as twice-daily nedocromil sodium in the 8-week treatment of ragweed allergic conjunctivitis and was superior to nedocromil in comfort. Increased comfort with pemirolast may increase patient satisfaction and compliance with therapy.     

A comparative study of the action of dexamethasone sodium phosphate and dexamethasone acetate in steroid-eluting pacemaker leads

BACKGROUND: The aim of this study was to characterize acute and medium-term pacemaker lead performance with the two most commonly used glucocorticosteroids: dexamethasone sodium phosphate and dexamethasone acetate. METHODS: Forty sets of atrial and ventricular passive-fixation leads containing either dexamethasone sodium phosphate or dexamethasone acetate were implanted as dual chamber pacemakers. Randomization was equally distributed to both arms of the study. Stimulation thresholds, lead impedance, and sensing were measured on the day of implant, day 1, 1 month, 3 months, and 6 months following the implant. RESULTS: For the dexamethasone sodium phosphate arm, the atrial stimulation thresholds were 0.9 +/- 0.1 V at implant and 0.8 +/- 0.1 V at 6 months, and in the ventricle 0.5 +/- 0.1 V at implant and 0.6 +/- 0.1 V at 6 months. In the dexamethasone acetate arm, the atrial stimulation thresholds were 0.7 +/- 0.1 V at implant and at 6 months, and in the ventricle 0.5 +/- 0.1 V at implant and at 6 months. There were no significant differences between dexamethasone sodium phosphate or dexamethasone acetate leads for stimulation thresholds at any of the intervals of follow-up. P- and R-wave sensing were similarly maintained over the duration of follow-up with no significant differences between groups at any of the intervals of follow-up. Pacing lead impedance showed a trend towards lower values in the dexamethasone acetate arm, which only reached statistical significance at 3 months and beyond for ventricular leads. CONCLUSIONS: Leads containing dexamethasone sodium phosphate and dexamethasone acetate demonstrate equivalent and excellent acute and medium-term pacemaker lead performance characteristics.     

0.5%、0.75%左布比卡因与0.5%、0.75布比卡因用于较低位硬膜外阻滞麻醉的临床观察

目的比较0.5％、0．75％左布比卡因和0.5％、0．75％布比卡因用于低位硬外阻滞麻醉的效果和安全性,探讨左布比卡因用于低位硬膜外阻滞麻醉的有效性和优越性。方法选择ASAⅠ～Ⅱ级下肢手术接受硬膜外阻滞麻醉的病人76例,随机分为四组,A组（19例）用0．5％左布比卡因20ml,B组（19例）用0,5％布比卡因20ml,C组（19例）用0．75％左布比卡因20ml,D组（19例）用0．75％布比卡因20ml,手术部位为股都及其以下区域。硬外穿刺间隙为第3～4腰椎棘间隙,骶向置管3cm。注药后测定阻滞平面和起效时间,判定下肢运动阻滞程度,记录术后创口开始疼痛时间和下肢运动恢复时间,并记录可能的并发症。结果A组和C组各1例阻滞失败外,四组其余病例阻滞起效时间均〈12min（P〉0．05）;注药20min后C组和D组分别有12例和13例下肢完全不能举动,A组和B组无一例下肢完全不能举动（P〈0．01）;A组运动阻滞程度低于B组,而痛觉阻滞时间长于B组（P〈0．01）;A组和B组运动阻滞程度、痛觉阻滞时间及下肢运动恢复时间均低于C组和D组（P〈0．01）;C组痛觉阻滞时间明显长于D组,运动阻滞时间明显短于D组（P〈0．01）,而运动阻滞程度相似（P〉0．05）。感觉阻滞优良率100％。无局麻药中毒病例及特殊并发症出现。结论0．75％左布比卡因和0．750k布比卡因用于低位硬膜外阻滞麻醉的效果相似并具有一定的术后镇痛效应,0．5％左布比母因可用于肌松程度要求低的下肢手术,0．75左布比卡因适用于任何下肢手术的硬膜外阻滞麻醉。     

Evaluation of once daily tobramycin dosing in critically ill patients through Bayesian simulation

OBJECTIVE: To evaluate if once-daily dose (ODD) regimens of tobramycin attain pharmacodynamic goals using individualized pharmacokinetic monitoring of critically ill patients with creatinine clearance (Clcr) over 60 mL/min. METHODS: Fifty-one adult critically ill patients treated with intravenous tobramycin with ODD were included in the study. The effect of dosing using the proposed method was compared with a weight-based (7 mg/kg) dosing method. Pharmacokinetics parameters, peak concentration (Cpeak), minimum concentration (Cmin) and the time below the minimum inhibitory concentration (MIC) were estimated using Bayesian analysis. Pharmacodynamic parameters used to evaluate both dosing regimens were Cpeak/MIC ratio and, secondly, time below MIC (T< MIC). RESULTS: The median dose of tobramycin administrated in our hospital was too low for achieving pharmacodynamic goals. In contrast, the weight-based (7 mg/kg) method produced an adequate Cpeak/MIC ratio but an increase of the dose would not reduce the secondary pharmacodynamic index T60 mL/min achieved the Cpeak/MIC target values of 10. However in critically ill patients with Clcr>80 mL/min, T相似文献   

A successful antibiotic treatment by a new administration route: a case report of a subcutaneous administration of ceftazidime and tobramycin

When intramuscular or intravenous administrations of parenteral drugs are not possible, the use of other routes (e.g., subcutaneous route) should be considered. We report a patient with Duchenne muscular dystrophy, who was hospitalized for acute pneumonia due to antibiotic‐resistant strains of bacteria. Our patient was successfully recovered with antimicrobial therapy by subcutaneous administration of ceftazidime and tobramycin, for which no safety and efficacy data are available in humans. To the best of our knowledge, this case is the first supporting the subcutaneous administration safety and potential efficacy of both ceftazidime and tobramycin in humans.     

复方妥布霉素滴眼液与普南扑灵滴眼液在儿童斜视术后的疗效观察

目的比较复方妥布霉素滴眼液及普南扑灵滴眼液在儿童斜视术后的抗炎效果及安全性。方法征得患儿父母同意,87例（174眼）3～11岁儿童经全身麻醉或局部麻醉下行双眼斜视术矫正后,随机一眼用普南扑灵滴眼液,另一眼用复方妥布霉素滴眼液,自术后第1天开始,每天4次,持续4周,比较两种滴眼液在术后的抗炎作用及对眼内压的影响。结果两种滴眼液对术后炎症反应均有显著的抑制作用,其抗炎效果比较差异无统计学意义（P〉0.05）,复方妥布霉素滴眼液组有明显的升高眼内压作用,普南扑灵组无明显的升高眼内压作用,两者比较差异有统计学意义（P〈0.01）。结论两种滴眼液均对儿童斜视术后有较好的抗炎作用,但普南扑灵无明显的升高眼内压作用。     

Comparison between single-dose oral prednisolone and oral dexamethasone in the treatment of croup: a randomized, double-blinded clinical trial

Objective: To compare the effectiveness of three corticosteroid regimens in children with mild to moderate croup. Methods: Double‐blinded, randomized comparative trial with parallel design, conducted in the ED of a paediatric tertiary care hospital. Children aged 6 months to 6 years presenting to the ED with croup were eligible for inclusion if their Westley croup score was 2 or more. They were randomized to receive a single oral dose of either prednisolone 1 mg/kg, dexamethasone 0.15 mg/kg or dexamethasone 0.6 mg/kg. Primary outcome measures were the magnitude and rate of reduction in Westley croup score, rate of return for medical care with ongoing croup, and further treatment with steroids in the week following index presentation. Secondary outcome measures were the proportion of subjects requiring admission or salvage therapy, such as nebulized adrenaline, during index presentation. Results: A total of 99 children, aged 6–79 months, were enrolled (mean age: 1.7 years). Thirty‐four patients were randomized to receive prednisolone 1 mg/kg, 34 to receive dexamethasone 0.15 mg/kg, and 31 to receive dexamethasone 0.6 mg/kg. Baseline characteristics of the three groups were similar. The parents of 86 patients (87%) were available for follow‐up telephone interview at 1 week. There were no significant differences in primary or secondary outcome measures between the three treatment groups. Conclusions: Both prednisolone 1 mg/kg and low‐dose dexamethasone (0.15 mg/kg) were found not to differ in efficacy from the currently recommended 0.6 mg/kg dexamethasone. The use of these corticosteroid regimens in treating patients with mild to moderate croup is thus supported.     

Anti-emetic prophylaxis with oral tropisetron and/or dexamethasone

BACKGROUND: The corticosteroid dexamethasone and the serotonine3 -antagonist tropisetron are both effective drugs for the prophylaxis of post-operative nausea and vomiting (PONV) when given intravenously. The aim of this trial was to evaluate the oral use of both drugs as part of a routine oral premedication and to compare their single and combined effectiveness. MATERIALS AND METHODS: In this randomized, placebo-controlled, double-blind study, 320 inpatients with a moderate-high risk of PONV (> or = 40% according to two validated risk scores) received an oral premedication 1-2 h pre-operatively with placebo, a fixed dose of tropisetron 5 mg, dexamethasone 8 mg, or a combination of both drugs. A standardized general anaesthesia was performed, including benzodiazepine premedication, propofol, rocuronium, desflurane in air/O2, fentanyl or sufentanil followed by a continuous infusion of remifentanil. Post-operative analgesia and anti-emetic rescue medication were standardized. The main outcome measures were the severity of PONV within the first 24 h (rated by a standardized scoring algorithm). The incidence of PONV was used as the secondary outcome. RESULTS: Data from 310 patients were analyzed. The mean severity score in the placebo-, tropisetron-, dexamethasone- and the combined-groups was 1.37, 0.8, 0.8 and 0.38, respectively. The incidence of PONV of any severity was 59.2%, 37.5%, 40% and 22.8%, respectively. The reduction of the incidence and the severity of PONV were statistically significant with all three interventions. Results from additional analyses suggested that both drugs were equally effective and that there was a simple additive effect of tropisetron and dexamethasone compared with placebo. CONCLUSION: Oral tropisetron and dexamethasone were both equally effective in reducing the severity and incidence of post-operative nausea and vomiting. The latter could be reduced by approximately 35% in a population of moderate-high risk for PONV. Both drugs had an additive effect. However, even in the combination group there still remained an unacceptably high incidence of PONV of more than 20%. This highlighted the need for a multimodal anti-emetic approach in high-risk patients and the importance of treatment of PONV.     

Amitriptyline and dexamethasone combined treatment in drug-induced headache

Frequent or regular intake of antimigraine drugs, including analgesics, constitutes a common cause of chronic daily headache. Discontinuation. of symptomatic medication can produce an increase in head pain accompanied by withdrawal symptoms. We report the favourable outcome of treating a group of outpatients with the combination of amitriptyline, dexamethasone and sumatriptan. Dexamethasone (4 mg/day) was given intramuscularlv for 2 weeks, amitriptyline orally at night (50 mg/day) for at least 6 months, and sumatriptan subcutaneously to treat acute headache attacks. Eighteen out of 20 patients abstained from drug abuse. Eleven of these 18 patients showed a marked reduction in headache frequency (at least 75% in relation to the basal value), and were considered "very good responders". The other seven patients experienced at least 50%, reduction in headache frequency compared to baseline. This preliminary report suggests that drug-induced headache can be treated effectively in outpatients using dexamethasone, amitriptyline and sumatriptan in combination with significant benefit in everyday life conditions.     

Comparison of ramosetron, dexamethasone, and a combination of ramosetron and dexamethasone for the prevention of postoperative nausea and vomiting in Korean women undergoing thyroidectomy: A double-blind, randomized, controlled study

Background: Thyroidectomy is associated with a relatively high incidence of postoperative nausea and vomiting (PONV), ranging from 51% to 76%. Because these symptoms are distressing for patients, prophylactic medication to avoid or reduce PONV is recommended.Objective: The aim of the present study was to compare the efficacy of ramosetron, dexamethasone, and a combination of ramosetron and dexamethasone in preventing PONV in Korean women undergoing thyroidectomy.Methods: In this double-blind, randomized, controlled trial, consecutive adult female patients who were scheduled to undergo thyroidectomy under general anesthesia at the Kyungpook National University Hospital (Daegu, Korea) were randomly assigned to receive ramosetron 0.3 mg alone, dexamethasone 8 mg alone, or a combination of ramosetron 0.3 mg and dexamethasone 8 mg administered intravenously as a single dose immediately after induction of anesthesia. The primary end point of this study was the total PONV rate up to 24 hours postanesthesia. The secondary end points were the incidence of nausea, incidence of vomiting, severity of nausea (0 = no nausea to 10 = nausea as bad as it could be), use of rescue antiemetic drugs, and the occurrence of adverse events (AEs) determined through interview or spontaneous patient report for 24 hours postanesthesia.Results: A total of 198 female patients were approached for study inclusion, 18 of whom were excluded. Therefore, 180 Korean women (mean [SD] age, 46.5 [12.6] years; height, 159.8 [2.7] cm; weight, 53.2 [3.6] kg) were enrolled and completed the study. The total PONV rates up to 24 hours postanesthesia were 35%, 13%, and 10% in the dexamethasone, ramosetron, and combination groups, respectively. The PONV rate was significantly lower in the combination group than in the dexamethasone alone group (P = 0.006). The PONV rate was not significantly different in the combination group compared with the ramosetron alone group. The PONV rate in the dexamethasone alone group was significantly higher than that in the ramosetron alone group (P = 0.03). The severity of nausea (median [25th-75th percentiles], 0 [0-0] vs 0 [0-4]; P = 0.009) and rate of use of rescue antiemetic drugs (5% vs 27%; P = 0.006) were significantly lower in the combination group than in the dexamethasone alone group, whereas the severity of nausea (median [25th-75th percentiles], 0 [0-0] vs 0 [0-0]) and rate of use of rescue antiemetic drugs (5% vs 7%) were not significantly different between the combination and ramosetron alone groups. The severity of nausea (median [25th-75th percentiles], 0 [0-4] vs 0 [0-0]; P = 0.033) and the rate of use of rescue antiemetic drugs (27% vs 7%; P = 0.018) were significantly higher in the dexamethasone alone group than in the ramosetron alone group. The rates of AEs (headache: 15%, 20%, and 18%; dizziness: 18%, 22%, and 15%) were not significantly different in the dexamethasone alone, ramosetron alone, or combination groups, respectively.Conclusions: The combination of ramosetron and dexamethasone was more effective in reducing PONV than was dexamethasone monotherapy. However, the combination did not show additional benefits compared with ramosetron alone in preventing PONV after thyroidectomy in these Korean women.     

Chemical parameters, antimicrobial activities, and tissue toxicity of 0.1 and 0.5% sodium hypochlorite solutions.

ffe chemical parameters, antimicrobial activity, and tissue toxicity of two sodium hypochlorite (NaOCl) solutions buffered to a physiologic pH were studied. Initially, a 0.5% NaOCl solution buffered with 3 g of NaH2PO4 per liter was examined. The solution had a pH of 7.49 and an osmolality of 352 mOsmol/liter. When compared with unbuffered and NaHCO3-buffered 0.5% NaOCl solutions, the NaH2PO4-buffered solution was significantly more effective in killing Staphylococcus aureus in vitro. However, the pH of the NaH2PO4-buffered solution decreased over time with a concomitant decrease in antibacterial activity. A freshly prepared solution decontaminated human cadaveric skin colonized by S. aureus, Pseudomonas aeruginosa, or Candida albicans in vitro within 10 min of exposure, whereas a 24-h-old solution cleared the skin of organisms within 15 min. When gauze soaked with 0.5% NaOCl was applied to guinea pig skin for 2 weeks, a 15% decrease in basal cell viabilities was noted. Because of the pH instability and basal cell toxicity, a 0.1% NaOCl solution buffered with NaH2PO4-Na2HPO4 was evaluated. This solution had an osmolality of 386 mOsmol/liter and a pH of 7.4 that was stable over 1 week. A freshly prepared 0.1% NaOCl solution decontaminated skin colonized with S. aureus, C. albicans, and P. aeruginosa within 10, 20, and 30 min, respectively. A 24-h-old solution did not completely decontaminate the colonized skin but significantly reduced the number of microorganisms on the skin surface (P less than 0.001). Application of this solution of guinea pig skin for 2 weeks produced no significant effect on basal cell viabilities. These solutions may serve as alternative topical agents for use in burn therapy.     

A comparative study of the therapeutic effect of dithranol cream 0.1% and 0.25% with that of dithranol stylus 0.1% and 0.2% in the treatment of psoriasis

In Dithranol cream the oily phase is emulsified with an aqueous phase to make the preparation more convenient to apply. The cream also contains ascorbic acid as an antioxidant, which protects dithranol against atmospheric oxidation, thus increasing its stability. A stylus containing dithranol, ol. cacao, paraffin and vaselinum has been used as a comparative drug. The stylus is routinely used in this clinic. Sixty patients with stable psoriasis were pre-assigned into two treatment groups, receiving at random Dithranol cream 0.1%, 0.25% and Dithranol stylus 0.1%, 0.2%, respectively. Both groups started their treatment with the 0.1% preparation once a day for 2 weeks followed by the 0.2% or 0.25% preparations once a day for another 2 weeks. The following laboratory tests: Hb, WBC, Diff, S-ALAT, S-ASAT and S-creatinine were recorded before and after treatment. Staining of clothes was none to slight in 70% (21/30) of the patients using Dithranol stylus 0.2%, and 80% (24/30) in the patients using Dithranol cream 0.25%. The sensation of burning was none to slight in 83% (25/30) of the patients and skin discolouration was none to slight in approximately 80% (24/30) of the patients using the Dithranol stylus 0.2% and Dithranol cream 0.25% preparations. Both groups showed significant improvement in all effect-variables after 2 and 4 weeks' treatment compared to initial. The results are over all better after 4 weeks' treatment than after 2. No abnormal values due to dithranol treatment could be found in the laboratory tests.