No abstract

The aim of the present investigation was to compare the efficacy and tolerability of azelastine (CAS 58581-89-8) (1.12 mg/day) and levocabastine (CAS 79547-78-7) (0.4 mg/day) nasal spray administered twice daily to patients with seasonal allergic rhinitis. A total of 180 patients participated in a 4-week, double-blind, parallel group (n = 90 each) study. Symptom severity of nasal, ocular and other symptoms were recorded, out of which a total symptom score (TSS) was calculated. Physicians assessed symptoms at baseline and at days 7, 14, and 28, patients and physicians evaluated the efficacy and tolerability. After 4 weeks of treatment with azelastine the mean overall TSS was reduced from a baseline score of 18.7 to 4.2, after levocabastine from 17.8 to 5.9. Patients morning scores for treatment days 1 to 28 gave a mean total score of 212.4 for the azelastine group and 230.6 for the levocabastine group; the equivalent evening scores yielded a mean total score of 115.5 and 175.6 respectively. Global efficacy was judged by physicians as either 'very good' or 'good' for 90% of azelastine patients and for 74% of the levocabastine group; 92% of azelastine patients and 76% of levocabastine patients judged treatment to be either 'very good' or 'good'. No serious adverse events were reported, all adverse events were related to nasal symptoms. Both azelastine and levocabastine administered twice daily as a nasal spray provide effective and well tolerated symptomatic treatment of seasonal allergic rhinitis. Azelastine, however, was statistically superior in efficacy as well as in safety (PWei-Lachin < 0.0001, combined results).

Fungal infections of the auditory canal and middle ear are usually left unnoticed and regarded as a harmless saprophytic growth. However, these infections may become clinically significant in immunocompromised patients or patients undergoing long-term antibiotic treatment. This is demonstrated by characteristic case reports and confirmed by light and electron microscopic findings. Moreover, studies on animals with experimentally induced fungal infections have furnished evidence for the risk of the infection’s spreading to the inner ear and causing serious damage to the organ of Corti; indirect damage to these structures by mycotoxins cannot be ruled out. To avoid complications of such severity of an allegedly harmless otomycosis we consider a quick and clinically easy to perform local treatment of high-risk patients as absolutely necessary. Such a treatment using bifonazole solution or cream was carried out on a number of patients and proved to be effective and free from side effects.

SUMMARYIn this study we established a novel solid-phase immunoassay for CD21 using the time-resolved tluoresccnccof lanthanidechclates. The capture assay was able to detect concentrations ofas low as IOOpgofCD2l antigen per millil[trcor.saniple and was used for quantitative determination orCD21 in lysatcs of different cell lines as well as in patient serum specimens. CD21 was measured in lysates of tonsils and eell lines of B, T cell and myelomonoeyte lineage, and appeared to eonsist ofmonomeric aniigen under the detergent conditions used. Elevated levels of soluble CD2I were observed in serum of patients with Epstein Barr virus (EBV) infection, a disease known to be associated with polyclonal B cell activation, and in infection with ihe lymphotropie rubella virus. Significantly increased levels were also found in malignancies whieh are associated with EBV, In patients with nasopharyngeal carcinoma (NPC). a correlation with the litre of EBV-specific IgA was observed, thus supporting a possible role of soluble CD2I as a marker for disease activity in certain malignancies. Our data suggest that measurement of soluble CD21 could serve as a marker for activation of the immune system and diseases involving the B cell lymphoid system. Possible mechanisms and functions of soluble CD21 are discussed.

80 adult outpatients suffering from otitis media, sinusitis (maxillaris or frontalis) or peritonsillitis were treated with 500 mg ciprofloxacin b.i.d. (n = 40) or with 2 g penicillin V t.i.d. (n = 40). The patients were randomly allocated. Three groups of patients resulted, clinically and bacteriologically evaluable, or only clinically evaluable because the isolated strains were resistant to ciprofloxacin or penicillin V or because no strains were isolated. Ciprofloxacin was superior to penicillin V; there were fewer resistant strains (one compared to 11), and the eradication rate (57% compared to 43%) as well as the clinical efficacy (60% compared to 48%) of ciprofloxacin were better than those of penicillin V--even in a daily dose of 6.0 g. Both treatments were well tolerated; side effects were neither reported nor found.