No abstract

A topical 3% foscarnet cream formulation was evaluated for its ability to treat experimental UV radiation (UVR)-induced herpes labialis in a double-blind study. Healthy adult volunteers with a history of sunlight-induced herpes labialis were randomly assigned at four centers to receive either foscarnet cream (n = 152) or a vehicle control (n = 150). Following measurement of the minimal erythematous dose (MED), the subjects' lips were exposed to 4 MEDs of UV light. Subjects applied the cream on the UVR-exposed area approximately eight times daily beginning immediately after UVR exposure and continuing for 7 days, or until all lesions had a minimum of 4 days of treatment. There were no significant differences between groups in the percentages of subjects that developed any lesion, aborted lesions (did not progress beyond a papule), immediate lesions (developed within 48 h of UVR), or delayed classic lesions (developed 48 h to 7 days after UVR). Treatment with foscarnet significantly reduced the mean lesion area (49 versus 81 mm2; P = 0.01), the maximum lesion area (80 versus 141 mm2; P = 0.01), and the time to healing (P = 0.03) of the delayed classic lesions (n = 78). There was also a trend for a decrease in the mean duration of these lesions (156 versus 191 h; P = 0.08) and the duration of pain (3.9 versus 4.3 days; P = 0.06) in foscarnet-treated subjects. There were no clinically significant adverse reactions. These data suggest that topical foscarnet can be efficacious and deserves further evaluation for the treatment of herpes labialis.

The efficacy and toxicity of foscarnet cream for the treatment of mucocutaneous herpes simplex virus lesions or lesions that were clinically unresponsive to systemic acyclovir treatment (median, 30.5 days) in AIDS patients were studied in a phase I/II, open-label, nonrandomized multicenter trial. In the study, 20 patients with advanced stages of AIDS were treated with foscarnet 1% cream five times a day for a mean duration of 34.5 days. Response of index lesions (n = 20) was judged to be completely healed (8 lesions), excellent (4 lesions), or good (1 lesion) in 65% of lesions. The median time to first negative herpes simplex virus culture of index lesion was 8 days. Among 15 patients with pain at baseline, 11 had complete resolution of pain and 2 had at least a 50% reduction. Clinical adverse events included skin ulceration (4 patients), application site reactions (3 patients), fever (3 patients), and headache (3 patients). Five (25%) patients developed new lesions due to herpes simplex virus at sites other than those being treated topically while enrolled in the study. Topical foscarnet 1% cream appears to be a safe and effective treatment for acyclovir-unresponsive mucocutaneous herpes simplex virus infection in AIDS patients.

A comparative study of a new iron carbohydrate complex, iron-poly (sorbitol-gluconic acid) complex (FerastralB) and iron-sorbitol (JectoferB) has been performed. I n all, 31 patients with iron deficiency anaemia have been treated, 23 with Ferastral and 8 with iron-sorbitol. The total doses of Ferastral have been 1 000 mg to 2 000 mg of iron given at weekly intervals in single doses of 500 mg. Iron-sorbitol was given daily in a dose of 100 mg of iron up to a total dose of 1300 mg. After single doses of 500 mg of Ferastral, levels of iron and unsaturated iron binding capacity (UIBC) in serum were estimated. The iron concentration in serum reached a maximum level 24 to 48 hours after the injection. After that a continuous decrease was observed, but after seven days still higher levels than before treatment were seen. A decrease in the UIBC was observed, and 24 to 48 hours after the injection about half of the initial capacity still remained. After further 3 to 4 days the initial value of UIBC was obtained. The renal excretion of iron varied between 7 % and 25 % in the patients treated with Ferastral in single doses of 500 mg of iron. The haemoglobin response was of the same magnitude for Ferastral and iron sorbitol. After two weeks the mean increase was 1.6 gfl00 ml for both preparations and after four weeks 3.1 g/lOO ml for Ferastral and 2.6 g/lOO ml for iron-sorbitol. No effects on liver and kidney functions during treatment with Ferastral, and no changes were observed in serum electrolytes or ECG. No general side effects were observed in the patients treated with Ferastral. In five patients discolouration at the site of injection was observed. One patient experienced an intensive pain in one buttock, which persisted for 12 hours. No pain was felt in the other buttock in which iron was injected at the same time. In the patients treated with iron-sorbitol, local discomfort was relatively common. : iron deficiency anaemiaintramuscular ironiron-poly (sorbitol-gluconic acid) complexiron in serum -UIBCurinary excretion of ironha emoglobin Key-words

The object of the study was to investigate the effect of EMLA cream when used as an anaesthetic for the debridement of ulcers and wounds. The cream was applied to a fresh, standardized wound caused by a dermatome, to an ulcer which was to be revised and for simultaneous split-skin grafting to both donor site and recipient area to be debrided. The effect on wound healing, the plasma concentrations of lidocaine and prilocaine and the analgesic effect following the application of EMLA to the ulcer and to both ulcer and donor site were studied. The study showed that EMLA cream when topically applied has a sufficient analgesic effect for revision of an open ulcer and can be used concomitantly for both revision of the ulcer and cutting of the split-skin graft. The application of EMLA cream to the fresh wound, or to the recipient area prior to cleaning, did not cause any clinical signs of a delayed healing at the applied areas compared to the control sites.