RESUMEN
In black population, the skin-bleaching with cutaneous topical corticosteroids on a large body area is a widespread practice and is associated with numerous cutaneous complications. We report a 25-year-old Congolese woman who was admitted for weakness, arthralgias and abdominal pain. The association of a relative hyperpigmentation of the small joints of hands and feet with clinical features of hypercorticism led to suspect a chronic use of cutaneous topical steroids for skin-bleaching. On biological tests, plasma cortisol and corticotropin levels were undetectable and the short corticotropin (ACTH) stimulation test was negative, leading to the diagnosis of adrenal insufficiency complicating the chronic use of topical steroids. Clinical symptoms resolved with hydrocortisone therapy. One year later, the patient admitted a five-year continuous use of cutaneous topical steroids (betamethasone, 0.05%). Skin-bleaching through chronic use of cutaneous topical steroids, is a common practice in black women, and should be suspected in the presence of adrenal insufficiency with or without clinical features of hypercorticism, and conversely, skin-bleaching users should be tested for hypothalamo-pituitary-adrenal function.
Asunto(s)
Insuficiencia Suprarrenal/inducido químicamente , Betametasona/efectos adversos , Cosméticos/efectos adversos , Fármacos Dermatológicos/efectos adversos , Glucocorticoides/efectos adversos , Pigmentación de la Piel/efectos de los fármacos , Insuficiencia Suprarrenal/diagnóstico , Insuficiencia Suprarrenal/tratamiento farmacológico , Adulto , Antiinflamatorios/uso terapéutico , Betametasona/administración & dosificación , Femenino , Glucocorticoides/administración & dosificación , Humanos , Hidrocortisona/uso terapéutico , Factores de TiempoRESUMEN
The efficacy and safety of a new veno-active flavonoid fraction (S 5682) consisting of micronized diosmin (90%) and hesperidin (10%) have been studied in 100 patients with symptomatic capillary fragility in a double-blind, randomized, placebo-controlled trial. Treatment lasted 6 weeks and consisted of 2 daily tablets of either S 5682 or placebo. Patients were examined at weeks 0, 2, 4 and 6. Compared to placebo, capillary resistance, assessed by the negative suction cup method, was significantly higher in the S 5682 group at week 4 (219 +/- 10 mmHg versus 159 +/- 8 mmHg; p < 0.001) and week 6 (261 +/- 12 mmHg versus 163 +/- 9 mmHg; p < 0.001). This resulted in a significant improvement of symptoms of capillary fragility (spontaneous ecchymosis, epistaxis, purpura, petechiae, gingivorrhagia, metrorrhagia and conjunctival haemorrhage) in S 5682 treated patients (p < 0.001). S 5682 was well tolerated. The rate of side-effects spontaneously volunteered by the patients was similar in both groups. We, therefore, conclude that S 5682 increases to a large extent the capillary resistance in patients with abnormal capillary fragility without significant side-effects.
Asunto(s)
Fragilidad Capilar , Diosmina/uso terapéutico , Flavonoides/uso terapéutico , Hemorragia/prevención & control , Hesperidina/uso terapéutico , Anciano , Resistencia Capilar/efectos de los fármacos , Método Doble Ciego , Combinación de Medicamentos , Femenino , Humanos , MasculinoRESUMEN
Perindopril is a non-sulphydryl angiotensin converting enzyme (ACE) inhibitor which requires hydrolysis to its active metabolite, perindoprilat, to produce its effects. Ten cirrhotic patients with mild to severe disease were studied after oral administration of a single 8 mg dose of perindopril as its tert-butylamine salt. Compared with a historical control group of young healthy volunteers receiving the same single oral dose of perindopril, mean AUC values of the prodrug perindopril were double in patients with liver cirrhosis (602 +/- 294 s.d. ng ml-1 h vs 266 +/- 70 s.d. ng ml-1 h) whereas the mean AUC of perindoprilat was found to be similar (134 +/- 139 ng ml-1 h vs 120 +/- 29 ng ml-1 h). The partial metabolic clearance of perindopril to perindoprilat was much lower in the cirrhotics (26 +/- 12 ml min-1 vs 58 +/- 22 ml min-1). The maximum inhibition of plasma ACE activity measured in the cirrhotic patients (87.5 +/- 5.1%) was comparable with that previously reported with perindopril in patients with mild hepatic impairment as well as in patients with essential hypertension. We suggest that liver cirrhosis may be associated with imparied deesterification of perindopril to its active metabolite perindoprilat but that no dosage adjustment of perindopril is required in cirrhotic patients.
Asunto(s)
Inhibidores de la Enzima Convertidora de Angiotensina/farmacocinética , Indoles/farmacocinética , Cirrosis Hepática Alcohólica/metabolismo , Cirrosis Hepática/metabolismo , Adulto , Anciano , Inhibidores de la Enzima Convertidora de Angiotensina/sangre , Inhibidores de la Enzima Convertidora de Angiotensina/orina , Femenino , Humanos , Indoles/sangre , Indoles/orina , Masculino , Persona de Mediana Edad , PerindoprilRESUMEN
The specific cell-mediated and humoral immune responses of 14 children allergic to honeybee venom were studied. An 8-day rush venom immunotherapy induced an increase in T proliferative (p less than 0.04) and T suppressive (p less than 0.003) cell-specific activities. Antibody variations, an increase in specific IgG4 (p not equal to 0.05), and a decrease in specific IgE (p less than 0.01) were observed 1 year later. Initial high T suppressive cell activity prevents T proliferative cell increase during rush venom immunotherapy. High initial levels of specific IgG1 and specific IgG4 have opposing effects on the increase in T suppressive cell activity, the former being positively correlated with intensive increase (r = 0.840; p less than 0.005), the latter negatively with T suppressive cell increase (r = -0.709; p less than 0.001). These data indicate that there are interrelationships between the cell-mediated immunity and the antibody responses in honeybee allergy.
Asunto(s)
Venenos de Abeja/uso terapéutico , Adolescente , Formación de Anticuerpos , Especificidad de Anticuerpos , Venenos de Abeja/inmunología , Niño , Preescolar , Femenino , Estudios de Seguimiento , Humanos , Inmunidad Celular , Inmunoterapia , Masculino , Linfocitos T Colaboradores-Inductores/inmunología , Linfocitos T Reguladores/inmunología , Factores de TiempoRESUMEN
In sixteen autistic children high values of IgG and a high level of lymphocyte stimulation with PHA were observed. Principal component analysis showed: 1) a significant correlation between basic lymphocyte mitogenic activity and the clinical symptoms opposition and hyperactivity, 2) a significant correlation between high Ig levels, high PHA stimulation responses and the main autistic symptoms (withdrawal, inaffectivity, hypoactivity, mannerism, stereotypy and negatively echolalia), 3) a significant correlation with serotonin uptake by platelets and high immunological responses. Such correlations are strongly in favor of an immunologic component in autistic disease.
Asunto(s)
Trastorno Autístico/inmunología , Inmunoglobulinas/análisis , Serotonina/sangre , Adolescente , Trastorno Autístico/sangre , Trastorno Autístico/psicología , Plaquetas/metabolismo , Niño , Preescolar , Femenino , Humanos , Inmunoglobulina G/análisis , Inmunoglobulina M/análisis , Activación de Linfocitos , Masculino , Fitohemaglutininas/farmacologíaRESUMEN
Thirty-six cases of interstitial pneumonia in acquired immunodeficient states were treated with transfer factor (Dialysable Leukocyte Extract) and studied retrospectively. The criteria of efficacity of this treatment were: rapidity of immediate improvement, improvement after failure of other immunostimulant therapy and demonstration of a dose-related effect. The mechanism of the therapeutic action is unclear. There is no evidence in favour of "transfer" of cell mediated immunity. A non-specific mode of action (adjuvant effect, interferon synergy, proinflammatory action) seems much more likely.