Topical levocabastine versus sodium cromoglycate in allergic conjunctivitis

The aim of this study was to evaluate the effect of levocabastine, a new H1-blocking antihistamine for topical use, in comparison with sodium cromoglycate on conjunctival symptoms of birch pollinosis. The two drugs were compared in a randomized double-blind comparative study over 5 weeks in 37 children and adolescents (6-19 years of age) with birch pollen conjunctivitis. Nasal symptoms occurred in 31 of the children and were treated with beclomethasone dipropionate nasal spray. An oral antihistamine was offered as rescue medication for eye symptoms. Initially, the patients received placebo four times a day for a 7-day run-in period. Conjunctival symptoms were recorded daily on diary cards on a 100 mm visual analogue scale. The pollen counts indicated a short but intensive birch pollen season. There was no statistically significant difference between the two treatment groups with regard to eye symptom scores before and during active treatment. However, the patients' evaluation of the efficacy of the therapy was in favour of levocabastine (P less than 0.01). Topical levocabastine, an H1-blocker, applied twice daily, seems to protect from symptoms of allergic conjunctivities as favourably as sodium cromoglycate applied four times a day. There was no difference in number or character of reported adverse reactions between the two treatment groups.     

Progestin receptor isoforms and prostaglandin dehydrogenase in the endometrium of women using a levonorgestrel-releasing intrauterine system

This study has examined endometrial tissue in 14 normal women prior to insertion of a levonorgestrel-releasing intrauterine system (LNG-IUS) and thereafter longitudinally for up to 12 months post-insertion. The specific endpoints examined by immunohistochemistry were progesterone receptor (PR) subtypes A + B, oestrogen receptor (ER) and prostaglandin dehydrogenase (PGDH). Two antiprogesterone receptor antibodies, one specific to PR(B) subtype and the other to PR subtype A + B, were employed to examine the localization of both PR isoforms. The activity of PGDH, a progesterone dependent enzyme, was also measured. ER and PR(A+B) and PR subtype B were significantly down-regulated in glands and stroma in the presence of continuous intrauterine LNG delivery. There was an apparent increase in PR(A) immunoreactivity in endometrial glands between 6 and 12 months post-insertion. Consistent with down- regulation of both isoforms of PR was reduced glandular PGDH immunostaining following LNG-IUS insertion, and PGDH activity (as measured by metabolism of excess substrate in vitro). Furthermore, PGDH activity, known to be localized in the glands, significantly increased (P < 0.05) at 12 months post-insertion, coinciding with the observed increase in glandular PR(A+B) immunoreactivity at this time. Since the LNG-IUS suppresses the PR(B) so strongly, PR(A) is likely to be the subtype that mediates long term LNG action in the endometrium. PR(B) is the more suppressed of the two subtypes, and only PR(A) rises along with PGDH activity. Alterations to normal endometrial morphology and function, e.g. perturbation of normal sex steroid receptor expression, following exposure to high concentrations of local LNG, may play a role in the aetiology of bleeding disorders associated with the LNG-IUS. Further elucidation of local uterine mediators involved in the mechanism of bleeding problems is required.      

Linkage studies of non-syndromic recessive deafness (NSRD) in a family originating from the Mirpur region of Pakistan maps DFNB1 centromeric to D13S175 [published erratum appears in Hum Mol Genet 1996 May;5(5):710]

Autosomal recessive non-syndromal hearing impairment (NSRD) is genetically heterogeneous. Five loci have been identified to date which map to chromosomes 13 (DFNB1), 11 (DFNB2), 17 (DFNB3), 7 (DFNB4) and 14 (DFBN5). We report definite linkage of NSRD to the locus DFNB1 in a single family of 27 families studied of Pakistani origin. Haplotype analysis of markers in the pericentromeric region of chromosome 13q revealed a recombination event which maps DFNB1 proximal to the marker D13S175 and in the vicinity of D13S143.      

Pain in children with cerebral palsy: a cross‐sectional multicentre European study

Aim: To determine the prevalence and associations of self‐reported and parent‐reported pain in children with cerebral palsy (CP) of all severities. Method: Cross‐sectional design using a questionnaire; analysis using ordinal regression. Children aged 8–12 years were randomly selected from population‐based registers of children with CP in eight European regions; a further region recruited 75 children from multiple sources. Outcome measures were pain in the previous week among children who could self‐report and parents’ perception of their child’s pain in the previous 4 weeks. Results: Data on pain were available from 490 children who could self‐report and parents of 806 children (those who could and could not self‐report). The estimated population prevalence of self‐reported pain in the previous week was 60% (95% CI: 54–65%) and that of parent‐reported pain in the previous 4 weeks was 73% (95% CI: 69–76%). In self‐reporting children, older children reported more pain but pain was not significantly associated with severity of impairment. In parent reports, severity of child impairment, seizures and parental unemployment were associated with more frequent and severe pain. Conclusion: Pain in children with CP is common. Clinicians should enquire about pain and consider appropriate physical, therapeutic or psychological management.     

The prognostic value of amplitude integrated EEG in neonatal sepsis and/or meningitis

Aim: To investigate the longitudinal course and prognostic value of amplitude integrated EEG (aEEG) in infants with neonatal sepsis or meningitis. Methods: Amplitude integrated EEG recordings of 22 infants with sepsis/meningitis were retrospectively evaluated. Mean gestational age was 38 weeks (range: 34–42 weeks). Thirteen infants had meningitis. Survivors were seen for neurological follow‐up. Four infants died, two were severely abnormal at 24 months. Amplitude integrated EEG background pattern, sleep wake cycling (SWC) and electrographic seizure activity (EA) were appraised. Results: All infants with continuous low voltage or flat trace on aEEG (n = 4) had an adverse outcome. Low voltage aEEGs (n = 9) had a positive LR (LR+) for an adverse outcome of 5.3 (95% CI: 1.9–14.8) at 6 h and 8.3 (95% CI: 1.3–55) at 24 h after admission. EA was more frequent in infants with adverse outcome (p < 0.01) and had a LR+ for adverse outcome of 10.6 (95% CI: 1.5–76). SWC appeared more frequent in infants with good outcome (p < 0.05). Conclusion: Low voltage background pattern, SWC and EA on aEEG are helpful to predict neurological outcome in infants with neonatal sepsis or meningitis.     

Phase II trial of continuous low -dose temozolomide for patients with recurrent malignant glioma

BACKGROUND:In this phase II trial,we investigated the efficacy of a metronomic temozolomide schedule in the treatment of recurrent malignant gliomas(MGs).METHODS:Eligible patients received daily temozolomide(50 mg/m2)continuously until progression.The primary endpoint was progression-free survival rate at 6 months in the glioblastoma cohort(N=37).In an exploratory analysis,10 additional recurrent grade III MG patients were enrolled.Correlative studies included evaluation of 76 frequent mutations in glioblastoma(iPLEX assay,Sequenom)aiming at establishing the frequency of potentially"drugable"mutations in patients entering