Effect of the CURB campaign on barbiturate prescribing in Northern Ireland

Barbiturate prescribing in general practice in Northern Ireland was monitored from computer data on prescription pricing for the years 1966 to 1979, and subjected to two methods of statistical analysis.Over the last decade a very marked decline in the prescribing of barbiturate hypnotics was accompanied by progressive decreases in barbiturate anti-epileptic and combination product utilization. During the 1975 to 1977 CURB campaign there was a statistically significant greater decrease in the total quantity of barbiturate hypnotics prescribed, but the downward trend in the numbers of prescriptions written was not significantly greater than before the campaign. The main effect of CURB, therefore, was to reduce the average quantity of barbiturate per prescription. The changes in barbiturate combination product prescribing between the CURB years were consistently large, whilst anti-epileptic barbiturate prescribing decreased less significantly towards the end of the campaign.

Lack of effect of oral ribavirin in naturally occurring influenza A virus (H1N1) infection

A double-blind placebo-controlled trial of ribavirin was conducted in 97 young adult males naturally infected with influenza virus similar to A/Brazil/11/78 (H1N1). Ribavirin was given orally at a dose of 1,000 mg/day for five days beginning within 24 or 48 hr after onset of clinical influenza. The clinical signs and symptoms of influenza and quantitative viral shedding were the same in ribavirin- and placebo-treated groups. Ribavirin treatment was associated with significantly fewer fourfold or greater rises in antibody to influenza A viral antigen by the complement-fixation test, while rises in hemagglutination-inhibiting antibody titers occurred with equal frequency in both groups. The ribavirin-treated group experienced significant increases in bilirubin and in reticulocyte counts after onset of therapy.

Influence of 19-nor-deoxycorticosterone on blood pressure, saline consumption, and serum electrolytes, corticosterone, and renin activity

Young, unilaterally nephrectomized, female Sprague-Dawley rats were given daily sc injections of 19-nor-deoxycorticosterone acetate (19-nor-DOCA) in oil at a dosage of 100 micrograms/day for 21 days and twice that amount for a further 11 days. One group drank distilled water and another drank 1% NaCl solution. Comparable control groups received oil injections. Another group received DOCA at the same steroid dosage and drank saline. Both 19-nor-DOCA-treated groups rapidly became hypertensive and developed cardiac hypertrophy, as did those given DOCA and saline. Saline consumption was greater in rats receiving 19-nor-DOCA, than in those given DOCA. Rats injected with 19-nor-DOCA and given water to drink showed enhanced growth and developed thymus enlargement and displayed hypokalemia and a reduction in both serum renin activity and corticosterone concentration. Plasma sodium concentration was not affected by any form of treatment. Clearly, 19-nor-DOCA is a potent mineralocorticoid and hypertensogenic agent. Since the parent steroid is known to be present abundantly in the urine of rats with regenerating adrenal glands, although circulating amounts have not yet been ascertained in that circumstance, it may be etiologically involved in adrenal regeneration hypertension, which such rats are prone to develop.

Effect of cadmium on salt hypertension in rats

The suggestion that cadmium-induced hypertension in rats might be due to renal sodium retention, known to result from Cd treatment, was examined. Young female rats were given a regimen of intraperitoneal cadmium treatments reported to cause hypertension reliably within a month. They were sensitized to the development of salt hypertension by removal of one kidney and then given 1 percent saline solution to drink. Over a five-week period, experimental animals consistently drank more saline than controls, despite which fewer of them became hypertensive, with the result that the average systolic pressure of controls finally reached the hypertensive range, whereas the experimental group remained normotensive. Cadmium treatment had no detectable effect on growth, the hemogram, serum Na and K, or the weight of liver, kidney, heart, spleen, thymus, or adrenal glands. There was thus no evidence that cadmium caused any adverse constitutional or hemodynamic effects, but it appeared to retard the development of salt hypertension. The results do not support the suggestion that the hypertensive effects of cadmium are modulated by sodium-retaining influences on the kidney.

Blood pressure in conscious and anesthetized adrenal-enucleated Sprague-Dawley and Wistar-Furth rats

Systolic blood pressure was measured weekly in conscious and in anesthetized female Sprague-Dawley (SD) and Wistar-Furth (W/Fu) rats following adrenal enucleation, unilateral nephrectomy, and the imposition of a high salt intake. SD rats quickly developed adrenal-regeneration hypertension (ARH) which progressed rapidly, and was identifiable in both the conscious and the anesthetized state. W/Fu rats slowly developed mild ARH, which, with a single exception, was identifiable only in conscious animals; the arterial pressures were within the normotensive range under anesthesia. The depressor effect of ether was also greater in adrenal-enucleated W/Fu than in similarly prepared SD rats, and in hypertensives than in normotensives. It is concluded that blood pressure measurements taken under anesthesia may not be representative of the true resting blood pressures: this is likely to be a particularly crucial problem in identifying early hypertension under circumstances and in rat strains highly susceptible to the depressor effects of ether.

Adrenal-regeneration hypertension in Wistar-Furth rats

The susceptibility of young virgin female Wistar-Furth (W/Fu) rats to adrenal-regeneration hypertension (ARH) was evaluated by comparing the blood pressure of adrenal-enucleated, mononephroadrenalectomized, salt-loaded rats with that of similarly treated rats having one intact adrenal over a period of 5 weeks. Hypertension began to appear in animals of the first group by the 3rd week, affected all of them by the 4th week, and increased in severity during the 5th week. Control rats remained normotensive during the study. Hypertensive rats developed marked enlargement of the heart and kidney, which frequently displaced myocardial scarring and nephrosclerosis, respectively. These studies do not support the contention that W/Fu rats display heightened resistance to ARH to which, in fact, they appear to be just as susceptible as are most other strains.

Experimental hypertension and other responses to 18-hydroxy-deoxycorticosterone treatment in the rat

Young female unilaterally nephrectomized, salt-loaded, Sprague-Dawley rats were treated with 200 microgram or 1 mg 18-hydroxy-deoxycorticosterone-21-acetate (18-OH-DOCA) in oil daily, and a group of kidney-intact animals on a normal salt intake was given 2 mg/day. The hormone was not found to increase saline consumption, increase urinary potassium or kallikrein excretion, or depress serum renin activity or potassium concentration. Slight hypertension did develop at 3 weeks in salt-loaded rats on the lowest dose, but this was neither increased by higher dosage or longer treatment, nor reflected by increased heart or kidney weight. The effect of 40-mg pellet implantation of DOCA and 18-OH-DOCA was then compared in unilaterally nephrectomized, salt-loaded, female Fischer 344 rats. The former caused increased saline consumption, hypertension, hypokalemia, and heart and kidney enlargement, whereas 18-OH-DOCA did not. Thus, the hypertensogenic potency of 18-OH-DOCA is, at best, a reflection of its known, very weak, mineralocorticoid activity.

In vitro lymphocyte transformation as a herd survey method for bovine paratuberculosis

The lymphocyte-transformation (LT) test was evaluated for its potential application as a field test for bovine paratuberculosis. Using a whole blood technique, samples from 3 consecutive collection periods were subjected to 3 mycobacterial antigens and to phytohemagglutinin. The results obtained from LT were compared with conventional serologic and cultural methods. A positive LT response to johnin purified-protein derivative (PPD) or avian PPD (or both) was noted in 40% to 60% of the animals tested. The complement-fixation test yielded 4% to 6.7% positive results, the immunodiffusion test between 1.2% and 1.4%, and the direct fecal culture between 2.4% and 6%. The mean of the stimulation indices of all positively responding animals was highest with johnin PPD. Specific stimulation to mammalian PPD occurred between 2.4% and 6% of the animals. The efficacy of the LT test for determining the incidence of infection with Mycobacterium paratuberculosis is discussed.

Johne's disease and the practitioner

Mycobacterium paratuberculosis infections and the disease states resulting in cattle are defined as spectral in nature. There is a spectrum of immunological response which complicates tests based on this. It is recommended that initial diagnosis of suspicious clinical cases be confirmed by direct fecal smears and a serological test such as immunodiffusion. Herd evaluation requires the application of fecal cultures plus immunodiffusion. Control requires rigid management hygiene measures, surveillance of the herd status and post mortem confirmation of salvaged animals.

The Seattle Virus Watch. VII. Observations of adenovirus infections

The following findings were made from observations of adenovirus (AV) infections in Seattle VW families, 1965-1969, which extended the 1961-1965 New York VW studies: That infections are predominantly enteric, may be abortive or invasive and followed by persistent intermittent excretion was confirmed. That such excretion is most characteristic of types 1, 2, 3 and 5 viruses may explain why these types were usually endemic. However, since observed duration of excretion was not increased despite a longer average observation period, persistent excretion appears not to continue indefinitely and generation-to-generation transmission now seems improbable. Unilike New York, alternate cycling of types 1 and 2 viruses was not seen. Among homotypic susceptibles, infection rates for the endemic types were highest in infants (greater than 90% for types 1 and 2), decreased with age in older children but increased in parents, perhaps because of closer contact with infants. Development of serum neutralizing antibody was most frequent (about 90%) after types 1 and 2 infection; in all cases, titers decayed over time. While delayed virus spread related to persistent intermittent excretion did occur, spread closely following new or renewed (after larger than or equal to 3 months) excretion was more important. Sibling introducers were more effective spreaders than infants, and duration of excretion was more important than mode. These data indicate that homotypic immunity is 85% protective against infection. A protective effect of heterotypic immunity could not be shown. Illness (chiefly respiratory and often febrile) was associated with 49% of infections in susceptibles and with 65% when respiratory shedding occurred. The contribution of AV to all infectious illness, based on virus-positive infections only, was 5% in infants and 3% in the 2-4-year age group; for febrile illness, the corresponding contributions were about 10% and 5%. Inclusion of infections discovered only be serology (49% of all infections) would greatly increase the contribution of AV to illness.

Delayed onset and reduced severity of adrenal-compression hypertension in rats treated with digitoxin

1. Bilateral compression of adrenal glands combined with unilateral nephrectomy and followed by imposition of a high sodium chloride intake caused severe hypertension in all rats, accompanied by enlargement of the heart, kidneys and adrenal glands, atrophy of the thymus and severe nephrosclerosis. 2. Digitoxin treatment delayed the onset, reduced the incidence and ameliorated the magnitude of the hypertensive response in such rats; it also reduced the degree of cardiac hypertrophy, the severity of nephrosclerosis and completely prevented enlargement of the adrenals and kidneys or atrophy of the thymus.

Rubella vaccine in postpubertal women. Experience in Western Washington State

Nearly two thousand nonimmune, postpubertal females given rubella vaccine in western Washington state in 1970 to 1974 were followed up for acute reactions, inadvertent pregnancy onset, and (776 women) seroresponse. Low-level prevaccination immunity appears to explain most of the apparent vaccine failure (11.6%). The 27 vaccine-complicated pregnancies identified resulted in 17 apparently normal infants (nine from nonimmune mothers). The remaining ten were terminated by abortion (four in nonimmune women), but no abortus yielded rubella virus. Frequency of post-vaccination complaints (largely joint-related) varied with age (higher in those over 25 years), with vaccine (higher after HPV-77-DE-5 than after Cendehill strain virus), with stage of menstrual cycle when vaccine was given, and with method of contraception.

On the mineralocorticoid and hypertensogenic properties of 16beta-hydroxy-dehydroepiandrosterone

Dosages of either 1 or 2 mg daily of 16beta-hydroxy-dehydroepiandrosterone, given to mononephrectomized, salt-loaded female rats, had no detectable effect upon saline consumption, blood pressure, kallikrein excretion or heart and kidney weight. Its alleged mineralocorticoid properties, as judged by these criteria, were not demonstrable.

Immunoglobulin classes in genital secretions of mycoplasma-infected and normal heifers

Immunoglobulin levels were studied in the genital secretions of seven heifers which had been bred to a bull infected with Mycoplasma agalactiae var. bovis and three heifers bred to a noninfected bull. The median immunoglobulin G (IgG)/IgA ratio ratio for vaginal secretions was 0.7, for cervical secretions 21.9, and for uterine secretions 13.0. This indicated that IgA was the mahor immunoglobilin class in the most superficial portion of the reproductive tract and that IgG was the major class in secretions of the deeper tract. The response to infection was studied by comparing animals infected with mycoplasma and noninfected controls. The IgG/IgA ratios were significantly lower in infected animals than in controls, apparently due to high IgA values in infected animals. Low mycoplasmal agglutinin titers were detected in secretions of three of the infected animals, but there appeared to be no relationship between agglutinin titers and histopathological lesions or between agglutinin titers and IgG/IgA ratios in this group of animals.

Effect of deoxycorticosterone acetate and 16beta-hydroxy-dehydroepiandrosterone on blood pressure and plasma renin activity of rats

Intact female Sprague-Dawley rats were given daily injections of either 3.125 mg of deoxycorticosterone or 5.0 mg of 16beta-hydroxy-dehydroepiandrosterone, calculated from the activities reported for each to be equivalent mineralocorticoid dosages. The former caused hypertension, cardiorenal enlargement, increased urine output and depressed PRA. Treatment with 16beta-OH-DHEA had no such effect, raising questions regarding its classification as a mineralocorticoid.

Protective effect of digitoxin in adrenal-compression hypertension

Bilateral compression of the adrenal glands combined in mononephrectomy and followed by the imposition of a high NaC1 intake resulted in severe hypertension in all rats so treated. It was accompanied by enlargement of the heart, kidneys, and adrenal glands, atrophy of the thymus, and the occurrence of severe nephrosclerosis. Digitoxin treatment delayed the onset, reduced the incidence, and ameliorated the magnitude of the hypertensive response in such animals; it also reduced the degree of cardiac hypertrophy and the severity of nephrosclerosis and completely prevented enlargement of the adrenals and kidneys and atrophy of the thymus.

Detection of estrus in dairy cows by electrical measurements of vaginal mucus and by milk progesterone

Electrical resistance (ohms) of mucus were analyzed in 20 postpartum Holstein cows by use of a probe inserted into the anterior vagina every other day for 30 days. Composite milk samples were taken on the same day, and progesterone was determined by radioimmunoassay. Cows were observed twice daily for standing estrus and reproductive organs palpated weekly per rectum (rectal palpation). Fifteen cows which were cycling showed increasing progesterone 6 to 7 days after the onset of estrus with values of 8.1 to 10.0 ng progesterone/ml milk on days 10 to 17. Concentrations had declined rapidly 2 days before onset of the next estrus. Progesterone in milk was affected by cow and by day of the cycle. Electrical resistance followed a similar cyclical pattern, but variability was large and only cows differed. The correlation between milk progesterone and mucus resistance was .22. Progesterone concentrations for four cows with follicular cysts fluctuated randomly with a mean of 2.6 ng/ml. Mean resistance of vaginal mucus was 44 omega for both cycling and cystic cows, indicating that a single measurement of electrical resistance every 2nd day was unreliable in distinguishing physiological states. One cow had high progesterone in milk on days 19 to 25 and was diagnosed pregnant by rectal palpation 3 wk later. Cows were not seen in estrus 28% of the time when milk progesterone and rectal palpation indicated they were in the follicular phase of the estrous cycle and were cycling.

The Seattle Virus Watch. VI. Observations of infections with and illness due to parainfluenza, mumps and respiratory syncytial viruses and Mycoplasma pneumoniae

Seattle Virus Watch families were observed, 1965-1969, for infections with paramyxoviruses and M. pneumoniae by agent isolation and antibody assay of serial sera. Infection rates, based on serology, exceeded those in Tecumseh where families contained fewer young children. Rates per 100 person-years were 44.4 for parainfluenzavirus, 21.6 for respiratory syncytial (RS) virus and 12.3 for M. pneumoniae. Preschool children experienced the highest rates for RS and parainfluenza-viruses but, for the latter, rates were also high among older children and adults. Within invaded families infection rates generally varied inversely with age, although for M. pneumoniae the rates for adults and 6-9 year old children nearly equalled the infant rate. The introducers' identity and/or the age-specific infection rates in invaded families support the role of young schoolchildren in community spread of M. pneumoniae and, together with older children and adults, of RS virus. Young schoolchildren were less important than infants, preschoolers, and adults in spreading parainfluenza-viruses and less important than preschoolers and infants for mumps. The frequent infection of exposed older children and adults suggests that reinfection with all the agents studied is common. All agents spread significantly within families and secondary attack rates for the mostly non-immune infants indicated high infectivity of parainfluenza and mumps viruses. The basic high pathogenicity of these agents and of RS virus is indicated by the high frequency of illness among virus shedders (80-90%) and among seroconverting infants (greater than or equal 68%). The less frequent illness of older persons with serologically proven infection is consistent with diminished clinical response to reinfection. Parainfluenza-associated illnesses were relatively severe and contributed up to 9.3% to total respiratory illnesses. RS virus-related illnesses also were severe but contributed less (4-5%) to total respiratory disease. Mumps-associated illness was largely respiratory, 65% overall, 77% in infected infants and 75% above age 9. Thus, mumps virus emerges as another respiratory pathogen which is spread largely by 2-5-year old children rather than by schoolchildren with "typical" parotitis.

Excretion of Na and H2 O and hypertension after adrenal enucleation or compression

An attempt was made to analyze the participation of the several independent variables that must contribute to the reproted inability of large male adrenal-enucleate rats withintact kidneys to normally excrete sodium following a light oral sodium load. This was prompted by a desire to understand whether the phenomenon was improtant to development of adrenal-regeneration hypertension (ARH). The results indicated that sdoium retention required the presence of both kidneys as it was not evident in unilaterally nephrectomized rats. The failure of ARH to develop in rats having both kidneys argues against a cause-and-effect relationship between the two phenomena. Sex does not appear to be important to sodium retention. Various fasting periods were employed, but with none of them did rats with a single kidney exhibit sodium retention. Since the conditions necessary to elicit imparied sodium excretion are incompatible with the induction of ARH and those essential to development of ARH prevent significant sodium retention, the two must be considered as independent manifestations of distrubed glandular function.

The Seattle virus watch. V. Epidemiologic observations of rhinovirus infections, 1965-1969, in families with young children

Rhinovirus (RV) infections in Seattle Virus Watch (VW) families (1965-1969) were monitored by screening respiratory specimens in WI-38 cell cultures and by homotypic neutralization tests on sera related to family episodes revealed by RV isolation. Temporally related illness in members not proven infected was also taken to indicate infection. RV isolates (including those from the New York VW, 1961-1965) were typed within the official 90-serotype frame. Typed isolates from New York (165 with 39 serotypes) and Seattle (456 with 59 serotypes) were compared with the Tecumseh Study to test the hypothesis that some serotypes are "common," persisting because of greater infectivity. Of 32 serotypes qualifying as "common" in at least 1 study, 4 were "common" in all 3 studies and 8 in 2 studies. The 23 "common" Seattle serotypes differed from the remaining 36 serotypes in being more infective and in their more frequent association with prolonged shedding. The New York and Seattle isolates together revealed an increase over time in the proportion not typable or of of higher numbered types, consistent with progressive shift in RV antigenic character. WI-38 isolates indicated spring peaks of RV all 4 years but a fall peak only in 1967. An even larger fall peak was seen when all specimens from September-November 1968 were re-examined in fetal tonsil diploid cells. Thus, both spring and fall peaks appear to describe RV seasonality. RV infections explained 16% of all reported respiratory illness (20% of upper respiratory), but RV-associated illness in young children, especially under 2 years, was more severe and almost twice as frequent as in adults. The age of introducers and the direct relation of family size to frequency of episodes indicate that community spread depends largely on preschool children, including infants. Within families, the secondary attack rate (SAR) was highest following paternal introduction and, for all introducers, the SAR varied inversely with age (mother excepted). RV shedding was observed most often (85% of specimens) from the day before to 6 days after illness onset but prolonged shedding was common (to 21 days in 20% and 28 days in 1.4% of infections). RV infectivity, reflected by SAR among nonimmunes, was highest for infants (78%) and, for all ages, was greater with ill than with well introducers (71% versus 27%). Immunogenicity of RV was poor (Seroresponse: 48% of shedders, 32% of nonshedding contacts) but varied greatly with serotype. Illness frequencies among non-immunes were 59% for all proven infections and 35% when infection was not shown..

Bovine veneral vibriosis: cure of genital infection in females by systemic immunization

Cure of female cattle with venereal vibriosis by systemic immunization with killed Campylobacter fetus cells in incomplete Freund adjuvant was investigated. Heifers infected in the cervicovaginal area with a cloned population of C. fetus venerealis were vaccinated subcutaneously 14 and 24 days thereafter with the infecting strain in incomplete Freund adjuvant. Six of eight vaccinated heifers were free of infection 25 to 48 days postinfection. One of the cured animals had an intercurrent infection which precluded interpretation of a vaccine effect. All controls remained infected 48 to 51 days postinfection, when the experiment was terminated. In vaccinated animals, agglutination titers against whole cells of the infecting strain reached peaks varying from 1,280 to 20,480 in serum and from 20 to 5,120 in cervicovaginal mucus (CVM) within days 24 to 32 postinfection. No consistent relationship was noted between levels of whole cell antibodies in serum and those in CVM. Evidence for the occurrence of antigenic variation in the organism after vaccination was sought by comparing the agglutinability of the infecting strain and CVM isolates in serum and CVM extracts. Serum samples of most cured heifers agglutinated whole cells prepared from isolates of the respective heifers to the same extent as cells of the infecting strain. In the corresponding comparisons, those from noncured animals agglutinated isolates to lower titers. CVM extracts from one cured animals agglutinated isolates derived from the same or closely spaced CVM samples to titers comparable with those obtained with the infecting strain. In the remaining animals, CVM extracts which agglutinated the infecting strain produced lower or undetectable reactions with corresponding isolates. It is proposed that the elimination of infection is dependent upon opposing responses of host and parasite, of which the degree of antigenic alteration in the infecting strain and the rate of mobilization and the concentration of specific antibodies in the genital secretions are key factors.

Evolution of adrenal-regeneration hypertension in blinded rats

The influence of blinding upon the blood pressure and adrenal regeneration of monoephrectomized but otherwise normal and mononephrectomized adrenal-enucleate rats on a high Na intake was evaluated. Blinding had no effect on control blood pressure, or upon the incidence, course and severity of adrenal-regeneration hypertension. Similarly there was no discernible effect on the regeneration of enucleate adrenal glands. The adrenal glandsands of otherwise normal blinded rats showed some enlargement in proportion to body weight, a finding which is probably attributable to loss of body weight in several animals.

Bovine Venereal Vibriosis: Variations in Immunoglobulin Class of Antibodies in Genital Secretions and Serum

The immunoglobulin classes of antibodies to Campylobacter (Vibrio) fetus in cervicovaginal mucus (CVM) were determined by the indirect fluorescent antibody test at sequential periods, since the order of class appearance has not been established for specific secretory immune responses. In the local immune response to C. fetus immunoglobulin M (IgM) antibodies appeared first, immunoglobulin A (IgA) antibodies next, and immunoglobulin G (IgG) last. IgM antibodies were quite transient, but IgG antibodies remained longer, and those of the IgA class persisted until the end of the experimental period (up to 10 months). Since differences appear to exist between immune mechanisms at cervicovaginal and uterine sites, as well as between immune responses induced by local and systemic immunizations, the immunoglobulin classes of antibodies in uterine secretions were compared with the classes in CVM and serum. Uterine antibodies arose coincidently with uterine lesions in heifers slaughtered after short periods of infection. In convalescent animals only IgA antibodies were found in CVM, whereas the predominant class of antibodies in the uterine secretions was IgG 1 in three of four animals studied. Only IgG antibodies were detected in CVM and uterine secretions of systemically immunized animals. These findings could account for faster clearance of C. fetus from the uterus than from the cervicovaginal area in locally infected animals and for failure of colonization in systemically immunized animals, because IgG antibodies are good opsonins and IgA antibodies are not. IgA antibodies do immobilize C. fetus , however, so they could prevent recolonization of the uterus in cervicovaginal carriers.

STUDIES O F SINGLE SAMPLES AND WHOLE POPULATIONS : THE POINT BISERIAL AND ITS GENERALIZATIONS

This paper revives an old statistic, the point biserial correlation, reviews some past generalizations of it, generalizes i t further, and shows how thesecorrelations are useful for studying the characteristics of observations in single samples or whole populations. The distinctions between analysis o� variance techniques and complex point serial correlation analyses are examined in considerable detail.

Beclomethasone dipropionate aerosol in childhood asthma

Twenty-five patients with severe childhood asthma were treated with beclomethasone dipropionate. 21 of these children were receiving oral corticosteroid therapy in addition to disodium cromoglycate. Of the total treated, 21 children improved or maintained their asthma status on this treatment over an average period of 4 months, and were able to reduce and stop their regular oral corticosteroid dosage, but 4 children had to revert to their original therapy. No systemic or local toxic effects were experienced by any of the children. Beclomethasone dipropionate appears to be an effective drug in the treatment of severe childhood asthma in those patients who need corticosteroid therapy in addition to disodium cromoglycate.