Comparison of dextranomer paste and saline dressings for management of decubital ulcers.

In this open-label, parallel-group study, 23 male spinal cord injury patients aged 23 to 73 years (median 54 years) with a total of 30 exudative decubital ulcers were randomly allocated to receive treatment with dextranomer paste (15 ulcers) or conventional saline dressings (15 ulcers). Treatment was applied at least once every 12 hours and continued for a maximum of 15 days, until the ulcer was clean and covered with new granulation tissue and was suitable for skin grafting. The same physician assessed ulcer status (extent of drainage, granulation, erythema, and edema and the presence or absence of necrosis and epithelialization) each time the study nurse changed the dressings. Treatment with dextranomer paste resulted in significantly greater improvement in ulcer drainage compared with saline; 73% versus 13% of the ulcers, respectively, showed > or =25% improvement in drainage from baseline to the end of the study. Both treatments were well tolerated, with no evidence of any local irritation. Dextranomer paste was more effective than saline dressings in the management of decubital ulcers in spinal cord injury patients.

Profound alterations of the lipoprotein metabolism during danazol treatment in premenopausal women.

Twelve women with pelvic endometriosis were treated with 600 mg of danazol daily for 24 weeks. The molar and fractional lecithin:cholesterol acyl transfer (LCAT) rates and the concentrations of cholesterol, phospholipids, and triglycerides were determined in plasma and in the very low-density lipoprotein, low-density lipoprotein (LDL), high-density lipoprotein (HDL), and HDL2 and HDL3 fractions before, during, and after the medication. After 2 weeks the HDL, HDL2, and HDL3 cholesterol concentrations were reduced by 49%, 73%, and 29%, respectively, while the LDL level was increased by 14%. The molar and fractional LCAT rates decreased during treatment, and these reduced LCAT rates are consistent with a reduced fractional LDL removal. Within 8 weeks after cessation of medication, all parameters had returned to the pretreatment levels.

Plasma lipoproteins during and after danazol treatment.

Twelve women with pelvic endometriosis were treated with danazol, at a dose of 200 mg three times daily, over a 24-week period. The concentrations of cholesterol and triglycerides were determined in plasma and in the lipoprotein fractions. After only 2 weeks the mean high density lipoprotein (HDL) cholesterol had already decreased by 49% and 6 weeks later the reduction was 59%. The low density lipoprotein (LDL) cholesterol concentration increased by 14% after 2 weeks and by 34% after 8 weeks. The triglycerides increased by 20% after 2 weeks. Eight weeks after cessation of treatment the lipoprotein fractions had returned to the pretreatment levels.

Coronary arteriography in 486 patients--arteriographic pathology and prognosis.

The coronary arteriographic findings and prognosis in a series of 486 non-surgically treated patients were analyzed. A semiselective injection was used. The number and causes of deaths were obtained from the census registry after a follow-up period of 7--12 years. The material comprised normal arteriograms in 26% of the patients, wall irregularities at most in 17%, obstruction of at least half the diameter in 37%, and unclassifiable arteriograms in 19%. A mean of 1.8 obstructed arteries per patient was found in the group with obstructive arterial lesions and among these patients the left anterior descending artery was most often engaged. In the same group the cardiac mortality at seven years was 20%. There were no significant differences between deceased and survivors with regard to clinical data. The arteriograms themselves offered more information about the prognosis. Normal arteries or wall irregularities at most implied excellent prognosis with regard to death in coronary heart disease. The seven-year mortality was 36% among patients with coronary artery occlusions, which is significantly higher than 14% among those with arterial stenosis. Materials from the USA and Canada have displayed a much higher mortality than our study in spite of comparable arteriographic findings.