A follow-up study of patients with recurrent urticaria and hypersensitivity to aspirin, benzoates and azo dyes

We have studied seventy-five patients with recurrent urticaria and angio-oedema of more than 4 months duration and with positive provocation tests to aspirin, azo dyes, and/or benzoates. Crossreactions between the test compounds were common. The patients were recommended to be on a diet free from salicylates, benzoates, and azo dyes. They were then followed for 6–24 months. At the follow-up, 24% were free from symptoms, 57% considered themselves much better and 19% stated that they were slightly better or unchanged. All patients had followed the diet for at least 1–3 months. Most of those who became totally free of symptoms did not continue with the diet, while most of the patients who considered themselves much better found that it was necessary to continue on the recommended diet. They usually developed symptoms as soon as they ingested something containing azo dyes or benzoates. To be able to maintain such a diet, it is important that the content of additives in food and drugs be properly declared.     

Increased chemotactic activity of neutrophil leukocytes in psoriasis

The random and active migration of neutrophil leukocytes in agarose was studied in sixty-one patients with psoriasis and in healthy controls. E. coli filtrate was used as chemoattractant. The random as well as the active migration was increased in psoriasis. The increase was most pronounced in those cases with widespread psoriasis. In twenty patients who were followed for 1–3 years, the neutrophil chemotactic activity remained essentially unchanged.     

Age changes in the two-point discrimination threshold in human oral mucosa

Fifty young and fifty elderly subjects were tested by a two-point discrimination method applying an aesthesiometer to the mucous membrane of lips, cheeks and tongue. Two changes characteristic of ageing were disclosed: (1) higher threshold values were found in the older age group concomitant with (2) a greater range of variation in these values. The importance of the perception of tactile stimuli from the structures tested is discussed in relation to adaptation to full dentures. It is suggested that signals arising from lips, cheeks and tongue assist the process of adaptation, whereas signals from the denture foundation can, on occasion, prevent adaptation.     

Debrisoquine 4-hydroxylation and sulphamethazine N-acetylation in patients with schizophrenia and major depression

Debrisoquine 4-hydroxylation and sulphamethazine N -acetylation phenotypes were determined in 115 Czech drug-free in-patients with schizophrenia ( n =64) or major depressive disorder ( n =51). These data were compared with a control group of 321 healthy volunteers from the North-East German area of Greifswald. The distribution of debrisoquine hydroxylator phenotypes was almost identical in patients and healthy controls. Thus, there were 8.7% (95% CI 5.4–12.0%) of poor metabolizers (PM) among patients while 8.7% (95% CI 3.6–13.8%) PM among the control group. The prevalences of PM amongst patients with chronic schizophrenia and major depression were 10.9% (95% CI 4.5–21.3%) and 5.9 % (95% CI 1.24–16.3%), respectively (χ² schizophrenics vs control=0.315, NS; χ² depressive patients vs control=0.450, NS). However, within the group of EM patients there was a significant ( P <0.01) shift towards higher debrisoquine metabolic ratios, reflecting a lower hydroxylation capacity in EM patients compared with EM healthy controls. The proportion of slow acetylators (SA) was 60.0% (95% CI 51.0–68.9%) in the entire group of psychiatric patients and 57.5% (95% CI 52.1–62.9%) in the control group (χ² all patients vs control=0.195, NS). Furthermore, there were no significant differences in the prevalence of the SA phenotype between controls and schizophrenics or patients with major depression. Although the results of this modest study were negative, the presence of subtle differences in the metabolic capacity between psychiatric patients and a healthy population cannot be ruled out.     

STUDIES ON PHOTOTHERAPY IN NEWBORN INFANTS

ABSTRACT: Windorfer, A., Faxelius, G. and Boréus, L. O. (Departments of Clinical Pharmacology and Paediatrics, Karolinska Hospital, Stockholm, Sweden). Studies on phototherapy in newborn infants: Influence on protein binding of bilirubin and salicylate and on activity of acetylsalicylic acid esterase. Acta Paediatr Scand 64:293, 1975.– Phototherapy of newborn infants with hyperbilirubinemia was shown to result in an increase in hematocrit values and in the activity of the erythrocyte enzyme acetylsalicylic acid esterase. The elevation of the enzyme activity also could be produced in light-treated rabbits and in vitro after illumination of blood from adult volunteers. The binding of bilirubin to serum albumin and of salicylate to plasma proteins did not alter, nor did the concentrations of albumin or total proteins in plasma. It is concluded that light does not increase the unbound fraction of bilirubin in blood.     

Transcatheter Closure of Patent Foramen Ovale in Patients with Paradoxical Embolism. Procedural and Follow-up Results after Implantation of the Starflex® Occluder Device with Conjunctive Intensified Anticoagulation Regimen

Background: Prevalence of patent foramen ovale (PFO) is higher in patients with paradoxical embolism and associated with increased risk for recurrent thromboembolic events. By percutaneous closure of PFO, surgical closure or permanent oral anticoagulation can be avoided. So far, published series included different occluder systems and various indications and regimens of postprocedural anticoagulation. The aim of the present study was to evaluate the short- and long-term results after implantation of the Starflex^® occluder in patients with PFO using an intensified anticoagulation regimen.
Methods and Results: 154 patients with PFO (94 men; age: 44 ± 13 years) and > 1 thromboembolic event were included. Other causes for embolism were excluded. PFO closure was successful in 147 patients (95.5%). All patients were treated with phenprocoumon (INR 2.5) and aspirin (100 mg/die) for 6 months. Transesophageal echocardiography (TEE) was repeated at 6 months. Mean clinical follow-up period was 26 ± 18 months.
After 6 months, five patients had a significant residual shunt, and five patients had suspected thrombus formation on the occluder. In three of these five patients, the occluder was surgically removed and foreign body reaction was noted. During follow-up, nine patients suffered from neurological events (two strokes, seven transient ischemic attacks [TIA]), though complete closure of the PFO was documented by TEE. Two patients died during follow-up; three patients had bleeding complications.
Conclusion: Percutaneous closure of PFO in symptomatic patients by Starflex^® occluder represents an effective therapy with a low incidence of periinterventional complications and recurrent thromboembolism. However, thrombus formation at the occluder system may occur in some patients despite an aggressive anticoagulation regimen.     

Acid Nonspecific Esterase in Human Langerhans Cells

Epidermal dendritic cells showing a diffuse activity of acid nonspecific esterase were observed in three cases of mycosis fungoides stage I. As these cells by their appearance and localization resemble Langerhans cells, and dermal histiocytes and macrophages react in the same manner, this is another enzyme cytochemical suggestion of a relationship between Langerhans cells and the monocyte-macrophage-system.