Timolol in Migraine Prophylaxis

SYNOPSIS
The literature on the use of beta-blocking drugs in migraine suggests that not all such agents are effective. A double-blind crossover study of timolol in migraine prophylaxis was undertaken with fourteen patients, in order to assess the value of this drug in particular, and also to elucidate further the reason for the varied response to different beta-blockers. Timolol significantly reduced the frequency of migraine attacks, and was preferred to placebo. This supports the contention that beta-blocking drugs without intrinsic sympathomimetic activity are effective in migraine prophylaxis.     

Eustachian tube function in children.

Eustachian tube function of children with bilateral serous otitis media was studied in 14 ears following myringotomy and pressure equalizing tube insertion. Cases with non-Eustachian tube pathology potentially contributing to Eustachian tube dysfunction were excluded from the study. Eustachian tube function was evaluated utilizing an impedance audiometer to document neutralization of positive and negative middle ear pressures. All cases showed persistent tubal dysfunction for up to six months. Partial incomplete neutralization of positive pressure occurred in 64 per cent, but in no case could negative pressure be partially neutralized even when "locking" was relieved with valsalva. Continuous ventilation of the middle ear for up to six months did not allow a return to normal Eustachian tube function. This is extremely effective palliation, and should be recognized as such.     

Salmonella Meningitis Treatment with Intravenous Trimethoprim

Summary: Intravenous trimethoprim and sulphadiazine were used in the successful treatment of Salmonella meningitis in a four months old child. Pharmacological data are presented which show good penetration of the blood-brain barrier by trimethoprim. This combination appears to be a useful alternative therapy for gram-negative meningitis.
Trimethoprim is a bacterial dihydrofolate reductase inhibitor which is currently administered in conjunction with Sulphamethoxazole as an oral preparation. Recently a parenteral preparation of trimethoprim (Trimethoprim Lactate Burroughs-Wellcome) has become available for restricted use. We report our experience with the USC of this drug in an infant with Salmonella meningitis.