A comparative study of clarithromycin modified release and amoxicillin/clavulanic acid in the treatment of acute exacerbation of chronic bronchitis.

This phase III, investigator-blind, randomized, parallel-group study compared the efficacy and tolerability of clarithromycin modified release (MR) with those of amoxicillin/clavulanic acid in 250 adult outpatients with acute exacerbationof chronic bronchitis (AECB). Patients received either clarithromycin MR 500 mg once daily or amoxicillin/clavulanic acid 500 mg/125 mg three times daily for 7 days. Primary endpoints were sponsor-defined clinical response and pathogen outcome at the end of treatment. Secondary endpoints were sponsor-defined clinical response and pathogen outcome at study end, investigator-defined clinical response at end of treatment and end of study, resolution or improvement of signs and symptoms, eradication of baseline pathogens, serologic outcome for atypical pathogens, and occurrence of reinfection and superinfection. Adverse events and compliance were also evaluated. Clinical and bacteriologic outcomes with both treatments for all endpoints were statistically equivalent, as were total adverse events, although the incidences of digestive disturbances (13% vs 4%) and discontinuations due to adverse events (8 vs 2 patients; P < or =.05) were significantly higher with amoxicillin/clavulanic acid. Ninety-five percent of patients receiving clarithromycin MR and 80% receiving amoxicillin/clavulanic acid were 100% compliant with medication (P < or =.05). Clarithromycin MR and amoxicillin/clavulanic acid are both well tolerated and effective as therapy for AECB; however, clarithromycin produced fewer side effects and discontinuations and higher compliance rates.

Body sculpture: the words become reality.

The last decade has been marked by the development of liposuction. A better knowledge of the anatomy of fat tissue, together with an improvement in different devices, has made our results more predictable. However, such areas as the chin, anterior and inner thigh, and knee have remained "difficult." This is especially true when large volumes of fat need to be removed. Blood loss has remained a problem as well. The development of ultrasound (U.S.) liposuction is a big step toward even more predictable results and to where blood loss can be negligible.

A clinicopathologic study of six cases of lipoid proteinosis.

We have reviewed the clinical and histological presentations of six cases of lipoid proteinosis. Deposits in the dermis were heterogeneous in nature and location. In the first stage of the disease's evolution, basement membrane components accumulate at the normal site of vascular, muscular, and epithelial basement membranes. Later on, lipids and amorphous material fill the superficial dermis, pushing apart the normal collagen bundles. Such deposits seem to be organized around preserved reticulin fibers. The amorphous material did not react with antibodies to collagen types I, III, IV, and V.

Partial thickness scalp grafts: clinical experience of their use in resurfacing facial defects.

Partial thickness scalp grafts provide a good cosmetic match for resurfacing small facial defects. The donor site is convenient for harvesting the graft, comfortable for the patient in the post-operative period and heals quickly with few complications. This paper outlines our experience with this procedure.

The inner arm fasciocutaneous flap.

A fasciocutaneous flap raised on the inner surface of the upper arm has been used to release 16 burn scar contractures of the anterior axillary fold. It is a relatively quick and simple procedure that adequately corrects the contracture and does not have to followed by prolonged splinting.