Computed tomography of the brain, hepatotoxic drugs and high alcohol consumption in male alcoholic patients and a random sample from the general male population.

Computed tomography (CT) of the brain was performed in a random sample of a total of 195 men and 211 male alcoholic patients admitted for the first time during a period of two years from the same geographically limited area of Greater Stockholm as the sample. The same medical, social and neuroradiological methods were used for examination of the alcoholic inpatients as for the random controls. Laboratory tests were performed, including liver and pancreatic tests. Toxicological screening was performed and the consumption of hepatotoxic drugs was also investigated and the following were the types of drugs used: antiarrhythmics, antiepileptics, antiphlogistics, mixed analgesics, barbiturates, sulphonamides, benzodiazepines, clomethiazole and phenothiazine derivatives, all of which are metabolised by the liver. The group of male alcoholic inpatients and the random sample were then subdivided with respect to alcohol consumption and use of hepatotoxic drugs: Group IA, men from the random sample with low or moderate alcohol consumption and no use of hepatotoxic drugs; IB, men from the random sample with low or moderate alcohol consumption with use of hepatotoxic drugs; IIA, alcoholic inpatients with use of alcohol and no drugs; and IIB, alcoholic inpatients with use of alcohol and drugs. Group IIB was found to have a higher incidence of cortical and subcortical changes than group IA. Group IB had a higher incidence of subcortical changes than group IA, and they differed only in drug use. Groups IIB and IIA only differed in drug use, and IIB had a higher incidence of brain damage except for anterior horn index and wide cerebellar sulci indicating vermian atrophy. Significantly higher serum (S) levels of bilirubin, gamma-glutamyl transpeptidase (GGT), aspartate aminotransferase (ASAT), alanine amino-transferase (ALAT), creatine kinase (CK), lactate dehydrogenase (LD) and amylase were found in IIB. The results indicate that drug use influences the incidence of cortical and subcortical aberrations, except anterior horn index. It is concluded that the groups with alcohol abuse who used hepatotoxic drugs showed a picture of cortical changes (wide transport sulci and clear-cut or high-grade cortical changes) and also of subcortical aberrations, expressed as an increased widening of the third ventricle.

[Methodology of hygienic standardization of allergenic mixtures of stable composition (a model of combined veterinary preparations)]. / K metodologii gigienicheskogo normirovaniia allergennykh smesei postoiannogo sostava (na modeli kombinirovannykh veterinarnykh preparatov).

The article presents the experimental study results of a comparative assessment of the allergenic activity of three newly developed veterinary preparations (both their major components and complete combined forms)--rivicycline, sulphapen and geovet . No increase in sensibilization was traced, and some indicators showed a weakened sensitizing ++ action of the combined preparations in comparison with the respective doses of the constituent allergic components. The allergy inducing components were determined. The authors recommended hygienic norm of the combined veterinary preparations, as mixtures with permanent composition, by their major allergic components. The proposed technique of a comparative express-test of allergic mixtures and their components may be recommended as another approach to express hygienic norming of the allergens.

Sulphamethoxypyridazine for dermatitis herpetiformis, linear IgA disease and cicatricial pemphigoid.

One-hundred and sixty-eight cases of dermatitis herpetiformis were reviewed to compare the clinical response to and incidence of side-effects from dapsone and sulphamethoxypyridazine. Thirty-seven received sulphamethoxypyridazine (0.25-1.5 g/day) as a single agent therapy at some stage during their care and 161 had dapsone only (50-450 mg/day). Thirty of these patients received both drugs, but at different times. Both were highly effective in controlling the skin disease in 97% of patients on dapsone and 89% on sulphamethoxypyridazine. While 36 (22%) of dapsone-treated subjects had intolerable side effects warranting a change in therapy, this occurred in only five (13.5%) of those treated with sulphamethoxypyridazine. Sulphamethoxypyridazine was also effective as a single agent in three patients with linear IgA disease who had suffered adverse effects from dapsone, and in 10 out of 15 patients with oral and cutaneous lesions of cicatricial pemphigoid.

[Benign intracranial hypertension caused by sulfenazone]. / Ipertensione endocranica benigna da sulfenazone.

Case report of a iatrogenic benign intracranial hypertension in a 7 months old infant. Unlike in the child and the adult, this syndrome has a peculiar non specific clinical pattern in the infant. Having ruled out other specific acute diseases of the central nervous system, it seems reasonable not to start any treatment since the outcome of this condition is always benign.

Alveolitis associated with sulphamethoxypyridazine.

A woman developed alveolitis which appeared to be caused by sulphamethoxypyridazine and which resolved after withdrawal of the drug and six months' treatment with prednisolone.

Manifestaciones hepáticas en los pacientes de lepra / Hepatic anifestations in leprous patients

Se estudian en detalle las manifestaciones hepáticas en los pacientes de lepra, se realiza una breve revisión bibliográfica de esta afección. Se ingresó en el Servicio de Dermatología un grupo de 20 pacientes que presentaban lepra lepromatosa (LL) y lepra dimorfa (LD), a los que se les realizó un estudio específico de exámenes de laboratorio, laparoscopia y biopsia hepáticas. Se encontraron lesiones específicas e inespecíficas atribuibles a la lepra. Se recomienda que al notificar un nuevo paciente de LL o LD, se le realice un estudio sistémico completo, para detectarle en una etapa temprana estas manifestaciones hepáticas (AU)

Manifestaciones hepáticas en los pacientes de lepra / Hepatic manifestations in leprous patients

Se estudian en detalle las manifestaciones hepáticas en los pacientes de lepra, se realiza una breve revisión bibliográfica de esta afección. Se ingresó en el Servicio de Dermatología un grupo de 20 pacientes que presentaban lepra lepromatosa (LL) y lepra dimorfa (LD), a los que se les realizó un estudio específico de exámenes de laboratorio, laparoscopia y biopsia hepáticas. Se encontraron lesiones específicas e inespecíficas atribuibles a la lepra. Se recomienda que al notificar un nuevo paciente de LL o LD, se le realice un estudio sistémico completo, para detectarle en una etapa temprana estas manifestaciones hepáticas

Multiple attacks of jaundice associated with repeated sulfonamide treatment.

Four women who were treated with sulfonamides because of recurrent urinary tract infections experienced adverse liver reactions with jaundice during their third, fourth and fifth course of treatment, respectively. In spite of this, sulfonamide treatment was reinitiated some years later. Adverse liver reactions with jaundice recurred on all occasions. The clinical picture of the liver reactions was indistinguishable from that of viral hepatitis and a hepatitis-like reaction was also seen histologically. Signs of fibrosis appeared histologically after a third attack of jaundice associated with sulfonamides in one patient, but otherwise no persisting abnormalities were noted.

Adverse drug reactions during treatment of urinary tract infections.

Adverse reactions reported to the Swedish Adverse Drug Reaction Committée concerning Sulfapral (a sulphonamide combination for urinary tract infections) and nitrofurantoin were remarkably similar. The commonest hypersensitivity reactions were in skin and lung. During the 10-year period 1966-75 reactions to the sulphonamide were fewer (n=327) than those reported for nitrofurantoin (n=781), but the former appeared to carry a higher mortality rate - 4.6% of reported sulphonamide reactions were fatal as compared to only 1.0% for nitrofurantoin (P less than 0.001). The number of reactions to the sulphonamide tended to remain constant, whereas those to nitrofurantoin increased rapidly, both absolutely as well as relative to sales of the drug.