Double-blind cross-over trial comparing beclomethasone dipropionate and terfenadine in perennial rhinitis

Eighteen patients with perennial rhinitis were evaluated in this double-blind cross-over trial comparing beclomethasone dipropionate (BDP) aqueous nasal spray with terfenadine tablets. Both treatments were effective in reducing symptom scores but BDP was significantly better than terfenadine in relieving running nose and sneezing (P less than 0.05). BDP also had a greater effect on reducing nasal inflammation than terfenadine. Although the clinicians and patients assessed both therapies to be equi-effective, significantly more patients preferred the BDP treatment (P less than 0.003). Overall, BDP therapy proved more beneficial than terfenadine therapy in this small group of perennial rhinitis sufferers.

Underdiagnosis of asthma in the elderly

One hundred and ninety-nine elderly men and women were assessed for their pulmonary function and their mental ability. One hundred and twenty-one patients had a PEFR less than 70% of the predicted for their age and height. Reversibility tests showed that 82 patients had 15% or more improvement in their PEFR following 200 micrograms salbutamol. However, only 6% of the patients were receiving respiratory-related medication. Further analysis showed that there was no correlation between the patients' age, sex, amounts of sputum production, wheeze, breathlessness, smoking habits, chest expansion, hospitalization, mental function and airway reversibility. 'Reversible' patients did, however, have a high incidence of cough and a low pre-test PEFR value. The predominant symptom of 'reversible' and 'non-reversible' patients was cough. The study emphasizes the importance of routinely performing lung function tests in elderly patients and the use of reversibility tests to identify reversible airways obstruction. These results suggest that in old age potentially reversible airways obstruction is often overlooked or misdiagnosed.

Is the combination inhaler of salbutamol and beclomethasone dipropionate as effective as the same agents from separate inhalers in the management of childhood asthma?

A double-blind crossover study lasting 16 weeks was carried out in children with chronic extrinsic asthma to compare the clinical effects of regular inhalations of salbutamol and beclomethasone dipropionate from a combination inhaler and regular inhalations of the same two drugs used sequentially from separate inhalers. Eighteen patients entered the study and 16 completed both 8-week treatment periods. However, there was a large amount of missing data, with only 9 complete sets of paired data; efficacy analyses were performed on data from 10 patients on separate inhaler therapy and from 14 patients on combination inhaler therapy. There were no significant differences between daily peak flow rate measurements, symptom scores, additional symptomatic bronchodilator therapy, acute exacerbations of asthma or incidence of adverse events, demonstrating that both treatments were similarly effective in controlling the patient's asthmatic symptoms. There was, however, a trend for higher peak flow values and lower symptom scores on separate inhaler therapy in this small group of asthmatic children. Although the results suggest that regular therapy using a combination inhaler is as effective as sequential administration of salbutamol and beclomethasone dipropionate from separate inhalers, it is concluded that the study should be extended to a larger group of patients to determine whether there might be any statistically significant differences between the two regimens.

Adjustment of Vietnamese refugee youths: a self-report

Structured interviews explored the problems of 41 Vietnamese refugee youths in foster homes in New York State. Refugees in this country 3 years or more and 1 1/2 years or less were compared. Self-reports indicated the youths were adapting well, and their social adjustment increases significantly over time.

Presence of sulfhydryl groups in glucagon secretion granule membranes

The effect of various sulfhydryl-binding reagents on the release of glucagon from isolated secretion granules was studied. Secretion granules isolated from toadfish islet tissue by differential centrifugation in sucrose were incubated in the test medium, the granules were centrifuged down, and the supernatant was assayed for glucagon using a RIA. When the granules were incubated in isotonic saline, 16-18% of the total glucagon in the granules was released. Whereas the addition of various dithiol-binding reagents (Cd++, Hg++, AsO2-, and dichlorophenylarsine), an oxidizing agent (oxidized glutathione), a reducing agent (reduced glutathione), and an amino group-binding reagent reagent (trinitrobenzene sulfonic acid) had no effect, the addition of Co++ to the incubation medium decreased glucagon release and the addition of the monothiol-binding reagents, p-hydroxymercuribenzoate and diphenylchloroarsine, produced a 2- to 3-fold increase in glucagon release. These results suggest that sulfhydryl groups may be present in the glucagon secretion granules and that they may be involved in glucagon release.

Behavioral correlates of social anxiety

High school students' scores on a paper-and-pencil test of social anxiety were correlated with talking, eye contact and gesturing behaviors during a 10-min vidotaped interview. Results showed that high anxious subjects talked less while listening to instruction. They also held the gaze for less total time and in bouts of shorter duration while they were talking;while they were listening, they were significantly more variable in their average bout duration. Within-group variability suggested that non-verbal behaviour should be analysed according to individual rather than group differences.