Prophylactic therapy in cyclic vomiting syndrome.

The experience with prophylactic therapy for cyclic vomiting syndrome (CVS) at Princess Margaret Hospital for Children, Perth, Western Australia was retrospectively reviewed by questionnaire. Data was collected from 31 patients, aged 2.9-21.75 years who reported a mean of nine attacks per year. Eleven patients had utilized prophylactic therapy. Parental assessment of benefit was recorded. Propranolol was the most effective agent with reported benefit in four of six cases, other antimigraine agents were deemed effective in two of seven cases. Anti-convulsants and antidepressants were not considered useful. Homeopathic and vitamin supplements were thought to be beneficial in three of six cases. Prophylaxis was less likely to be beneficial in the more severe cases of CVS, but was of benefit in those patients whose attacks were precipitated by infection or who had features consistent with migraine. Prophylactic therapy with propranolol or serotonin receptor antagonists should be considered in children with frequent or severe symptoms.

Cyclical breast pain--some observations and the difficulties in treatment.

This paper describes a retrospective study of the clinical aspects and treatment of 566 women with cyclical breast pain over a seven-year period. Figures for the effectiveness of simple treatments including some homeopathic drugs are reported. The article concludes that reassurance is the fundamental treatment. Good responses are obtained from simple and safe drugs (oil of evening primrose, vitamin B6) with minimal side-effects. The use of stronger hormone drugs such as tamoxifen and danazol was only necessary in a small proportion of patients and resulted in a higher incidence of side-effects.