Contact allergies induced by TTS-treatment

The efficiency of a nicotine-containing transdermal therapeutic system (TTS) was investigated in a clinical study, the purpose of which was to help 183 heavy smokers give up their addiction by systematic and continuous nicotine application and simultaneous behavioral therapy. During the treatment period, 53% of the patients complained of pruritus and 39% developed erythemas that were almost exclusively confined to those areas where the patches had been applied. However, most symptoms appeared only in slight or moderate forms. In contrast to irritative cutireactions, 6 patients developed a genuine contact allergy (type IV, delayed type reaction) which proved in 5 cases to be induced by the nicotine contained in the patches. Presumably TTS-treatment may induce contact allergies to pharmaceutic agents, as has already been described in other observations on allergies to haptens.     

The effects of adenosine and of some adenosine analogues on the concanavalin A- or acetylcholine-induced histamine release from human adenoidal mast cells

Histamine release induced by concanavalin A (Con A) or acetylcholine is enhanced by adenosine or the adenosine analogues PIA and NECA. The enhancement is not affected by preincubation with adenosine deaminase.The degree of the Con A-induced histamine release decreases with increasing incubation time. Under these conditions, the enhancing effect of adenosine on histamine release is either abolished or even reversed to inhibition.     

A longitudinal and prospective study of Epstein-Barr virus load in AIDS-related non-Hodgkin lymphoma.

BACKGROUND: Epstein-Barr virus (EBV) may be causally associated with non-Hodgkin Lymphoma (NHL) in HIV-infected patients. OBJECTIVES: To compare EBV load in whole blood in AIDS-NHL patients, HIV non-AIDS patients and non-HIV-infected persons, and to prospectively measure EBV load in whole blood in AIDS-NHL patients. STUDY DESIGN: Longitudinal and prospective study. RESULTS: We observed no statistical difference in EBV load between AIDS-NHL (3.69log(10) copies/mL [interquartile range (IQR): 2.89-4.27]) and HIV non-AIDS patients (3.08log(10) copies/mL [IQR: 1.29-3.57]) but AIDS-NHL patients had significantly higher EBV loads than HIV-negative controls (1.19log(10) copies/mL [IQR: 0.00-3.29]). We noticed an inverse correlation between CD4+ lymphocytes count and EBV load in patients with AIDS-NHL (r(2)=0.41, P=0.01). In the longitudinal study, the mean EBV load three months after NHL diagnosis decreased significantly (mean difference=-1.69log(10) copies/mL [95% confidence interval: -0.32; -3.04]; P=0.03) under chemotherapy but was still elevated in patients with relapses or no response to chemotherapy. CONCLUSION: Although EBV load seems a suboptimal marker for the diagnosis of AIDS-NHL, we observed a significant decrease of EBV load in patients treated with chemotherapy and a strong association between NHL outcome and EBV load in whole blood.     

Leflunomide therapy following penetrating keratoplasty in the rat

Background: The isoxal derivative, leflunomide (LF), is a new potent immunosuppressive which has been shown to be effective in preventing autoimmune disorders and reactions leading to organ transplantation rejection. LF is thought to antagonise cytokine activity and thereby to interfere with T-helper-cell-dependent B- and T-lymphocyte proliferation. Methods: We used LF to treat corneal allograft rejection in the rat, comparing its effect with that of cyclosporin A (CSA). Corneal buttons were grafted from Lewis/Brown Norway rats to Lewis recipients. Animals were randomly assigned to the following treatment groups: I, untreated; II, CSA (10 mg/kg i.m.); III, LF (2.5 mg/kg p.o.); IV, LF (5 mg/kg p.o.); V, LF (10 mg/kg p.o.); VI, combined therapy (LF 10 mg/kg p.o. and CSA 10 mg/kg i.m). Treatment began on the first postoperative day and was continued until rejection occurred. Results: The mean graft rejection time in the untreated allogeneic group was 12 days. A significant delay in graft rejection was observed in all treatment groups compared with group I (P<0.001). Further, the delay in graft rejection resulting from combined therapy (group VI) was statistically significant compared with all other groups (P<0.001). Conclusion: These results suggest that (a) LF when used alone is as effective as CSA in treating corneal allograft rejection in the rat, and (b) when LF and CSA are combined they are more effective than either drug alone in the prolongation of allograft survival.Presented in abstract form at the Berlin-Brandenburg Eye Congress, 4–5 December 1993. None of the authors has any proprietary or financial interests in the compound leflunomide     

The RETAIN project: dicom teleradiology over an ATM-based network

The RETAIN project (Radiological Examinations Transfer on an ATM Integrated Network) has aimed at testing videoconferencing and DICOM image transfers to get advice about difficult radiological cases over an asynchronous transfer mode (ATM)-based network, which affords a more comfortable interface than narrow-band networks and allows exchange of complete image series using the DICOM format of studies. For this purpose, an experimental ATM network was applied between six university hospitals in four different countries. An assessment of the functionalities of the system was performed by means of log-file analysis, video recording of the sessions and forms filled out by the participants at the end of each session. Questionnaires were answered by the users at the end of the project to bring out perspectives of utilisation and added value. We discussed 43 cases during 20 sessions. For technical or organisational problems, only 20 of the 36 planned sessions took place. The throughput over ATM (10.5 Mbit/s, 20 times faster than six ISDN B-channels) was adequate. Despite the experimental configuration of the network, the system was considered as satisfactory by all the physicians. In 72 % of the sessions, the expected result (answer to the question) was gained. By common consent, videoconferencing was unanimously regarded as a prominent tool in improving the interaction quality. Asynchronous transfer mode is an efficient method for fast transferring of radiologic examinations in DICOM format and for discussing them through high-quality videoconferencing. Received: 26 October 1998; Revised: 25 February 1999; Accepted: 2 April 1999     

Can the e-OAKHQOL be an alternative to measure health-related quality of life in knee osteoarthritis?

Quality of Life Research - To assess the validity of the e-OAKHQOL questionnaire and analyze whether the answers were affected by the form of administration (electronic vs. paper). Two samples of...     

Chronische Pollakisurie

Background

Persistent unexplained urological complaints and diseases are a common problem in clinical practice. Psychological components can play an important role in urological complaints. Neglect of these facts can lead to an insufficient or incorrect treatment. Therefore, apart from the specific medical diagnostics, a complete examination of mental and psychological functions before an invasive intervention is also required.

Psychosomatics in urology

Illustrated by the case of a young woman with a request for a cystectomy while suffering from a chronic pollakiuria, this paper explains the importance of good interdisciplinary collaboration for evidence-based, guideline-oriented medical treatment. The patient’s suffering and urge for removing the bladder was contrasted by a lack of medical indication for surgery and the principle of proportionality. The essay gives insight into the discipline of psychosomatic medicine, somotoform disorders found in urology and, especially, the symptoms of pollakiuria and overactive bladder.

Conclusion

The case illustrates the importance of timely and simultaneous medical and psychosocial diagnostics for the treatment outcome in patients with unspecific physical complaints. Treatment recommendations for patients with somatoform complaints in clinical practice are provided.     

Cybersecurity in PACS and Medical Imaging: an Overview

This article provides an overview on the literature published on the topic of cybersecurity for PACS (Picture Archiving and Communications Systems) and medical imaging. From a practical perspective, PACS specific security measures must be implemented together with the measures applicable to the IT infrastructure as a whole, in order to prevent incidents such as PACS systems exposed to access from the Internet. Therefore, the article first offers an overview of the physical, technical and organizational mitigation measures that are proposed in literature on cybersecurity in healthcare information technology in general, followed by an overview on publications discussing specific cybersecurity topics that apply to PACS and medical imaging and present the “building blocks” for a secure PACS environment available in the literature. These include image de-identification, transport security, the selective encryption of the DICOM (Digital Imaging and Communications in Medicine) header, encrypted DICOM files, digital signatures and watermarking techniques. The article concludes with a discussion of gaps in the body of published literature and a summary.     

Apomorphine formulation may influence subcutaneous complications from continuous subcutaneous apomorphine infusion in Parkinson’s disease

Journal of Neurology - Continuous subcutaneous (s.c.) apomorphine infusion is an effective therapy for Parkinson’s disease (PD), but a limitation is the formation of troublesome s.c. nodules....