A randomized controlled trial of electromagnetic therapy in the primary care management of venous leg ulceration

OBJECTIVE: The aim was to establish the potential efficacy, tolerabilityand side-effect profile of electromagnetic therapy as an adjunctto conventional dressings in the treatment of venous leg ulcers. METHOD: A prospective, randomized, double blind controlled clinicaltrial was carried out in a dedicated leg ulcer clinic basedin one urban general practice. Nineteen patients with leg ulcersof confirmed venous aetiology were assessed. The main outcomemeasures were rate and scale of venous leg ulcer healing, changesin patient-reported pain levels, quality of life, degree ofmobility, side effect profile and acceptability to patientsand staff. RESULTS: Sixty-eight per cent of patients attending this dedicated clinicachieved improvements in the size of their ulcer (4, 21%, healedfully) and in reduced pain levels (P < 0.05) during the trial,despite the chronicity of ulcer histories. Patients treatedwith electromagnetic therapy at 800 Hz were found at day 50to have significantly greater healing (P < 0.05) and paincontrol (P < 0.05) than placebo therapy or treatment with600 Hz. All patients reported improved mobility at the end ofthe study. The electromagnetic therapy was well tolerated bypatients, with no differences between groups in reporting adverseevents, and proved acceptable to staff. CONCLUSION: Despite the small numbers in this pilot study, electromagnetictherapy provided significant gains in the healing of venousleg ulcers and reduction in pain. Keywords. Electromagnetic therapy, RCT, leg ulcers, primary care.     

Evidence for lectin-mediated adherence ofMoraxella catarrahlis

Summary Clinical isolates ofMoraxella catarrhalis (n=86) were evaluated for their haemagglutinating activity with different types of erythrocytes. Of all the isolates tested, 12 did not agglutinate with any of the erythrocytes, whereas 65 reacted with human erythrocytes of type A, B, and 0, and 26 with erythrocytes from rabbit, guinea pig, dog, or rat. None of the isolates agglutinated with sheep and goat erythrocytes. The agglutination titres ranged from 0 to 64. Among these isolates, 13 different agglutination patterns could be distinguished. The agglutinating activity was Ca²⁺-dependent and was inhibited by proteases, by temperatures exceeding 50°C and by the addition of D-glucosamine or D-galactosamine. The adherence capacity of theM. catarrhalis isolates to tracheal epithelium correlated with their agglutination titre and could be inhibited by the same treatments. These data provide strong evidence that adherence ofM. catarrhalis is mediated by lectins located on the bacterial surface.

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Nachweis lektin-vermittelter Adhärenz vonMoraxella catarrhalis

Zusammenfassung 86 klinische Isolate vonMoraxella catarrhalis wurden auf ihre Fähigkeit zur Agglutination mit verschiedenen Erythrozytenarten geprüft. 12 der geprüften Isolate zeigten keinerlei Agglutination mit Erythrozyten. 65 reagierten mit menschlichen Erythrozyten der Blutgruppen A, B und 0 und 26 mit Erythrozyten von Kaninchen, Meerschweinchen, Hunden oder Ratten. Keines der Isolate agglutinierte Erythrozyten von Schafen oder Ziegen. Die Agglutinationstiter lagen in einem Bereich von 0–64. Die Isolate boten 13 verschiedene Agglutinationsmuster. Die Agglutinationsfähigkeit war abhängig von Ca⁺⁺ und wurde durch Proteasen, Temperaturen über 50°C und die Zugabe von D-Glukosamin oder D-Galaktosamin gehemmt. Die Fähigkeit vonM. catarrhalis, sich an Trachealepithel anzuheften, korrelierte mit dem Agglutinationstiter und konnte durch dieselben Behandlungen gehemmt werden. Diese Daten bieten deutliche Hinweise dafür, daß die Adhärenz vonM. catarrhalis durch Lektine auf der Oberfläche der Bakterienzelle vermittelt wird.