Evaluation of cefixime in the treatment of bacterial maxillary sinusitis.

The efficacy and safety of cefixime, the first oral third-generation cephalosporin, were evaluated in a multicenter clinical trial involving 118 adult patients with acute sinusitis or acute exacerbations of chronic sinusitis. Patients received a single daily dose of 400 mg of cefixime for a mean duration of 10 days; 106 patients completed a course of therapy. Clinical cure and improvement were achieved in 90% of these patients (61% cured and 29% improved). Among the patients evaluated again 2 weeks after therapy, 91% had a sustained clinical cure or improvement. Sinus exudate specimens were obtained from all patients by transantral puncture before therapy. Pathogens were isolated from 76 patients (66%), the most common pathogens being Haemophilus influenzae, alpha-hemolytic streptococci, and Streptococcus pneumoniae. Eighty-six percent of pathogens were presumed eradicated. Three patients discontinued therapy because of side effects. The most frequently reported adverse effects were gastrointestinal, with 20% of patients reporting diarrhea. Cefixime was effective in the treatment of bacterial sinus infections in adults and was well tolerated.

Muscle relaxation techniques: a therapeutic tool for family physicians.

Muscle relaxation techniques are important adjunctive therapy for anxiety-related conditions. Family physicians can learn to teach the techniques so as to try helping anxious patients themselves rather than automatically referring them to a psychiatrist. The exercises are generally acceptable to patients, are easy to learn and do not require expensive equipment. They are beneficial in insomnia and tension headache, of some value in chronic anxiety states and a useful adjunct in hypertension. In this paper the evidence supporting the value of muscle relaxation therapy is briefly reviewed, methods of teaching and of practising the techniques are described in detail, and answers to some of the questions and problems that may arise are presented.

Mega-doses of behaviour therapy for treatment-resistant agoraphobics.

This was a pilot project set up to test the feasibility of effectively and inexpensively treating agoraphobic patients who had not responded to adequate trials of behaviour therapy (and other therapy) in the past. We employed a quantitatively intensive program of exposure therapy, calisthenics and muscular relaxation, and have explained the rationales for the choice of each treatment. The results were gratifying in four of the five patients, with follow-up to three years. This pilot project enabled us to set up a cost-effective treatment for all forms of agoraphobia which is as efficient as other programs described. It has also highlighted the fact that some patients exist who may do poorly on schedules of behaviour therapy which are adequate for some patients, and yet may do well if the amount of treatment is drastically increased.

The effect of procarbazine on the chromosomes of normal and malignant mouse cells.

The effects of the cancer drug methylhydrazine derivative procarbazine (PC) on the chromosomes of normal and malignant cells in the mouse strains Swiss Albino, CF1, and BDF1 have been analyzed. PC broke chromosome in the hypotetraploid Ehrlich and the diploid P388 ascites tumors. Practically all breaks seemed to be of the G2 type and, as far as could be determined, took place in the quinacrine-dark or the corresponding Giemsa-light regions. The vast majority of the broken ends had rejoined to form chromatid translocations. No increase in chromosome breaks were seen in any of the normal tissues treated in vivo: spleen, bone marrow, spermatocytes, or spermatogonia (in this tissue the cells were not counted). The chromosomes of the Ehrlich ascites tumor have been studied by means of both Q-banding and G-banding. Very few, if any, chromosomes seem to have an exact homologue or to correspond to any of the normal mouse chromosomes.