[The effectiveness comparison of various conservative treatment options of nasopharyngeal inflammation in children]. / Sravnenie effektivnosti razlichnykh variantov konservativnogo lecheniya vospaleniya glotochnoi mindaliny u detei.

The problem of hyperplasia/inflammation of the structures of the Pirogov-Waldeyer lymphoid-pharyngeal ring and related complications is one of the most frequently discussed in pediatric practice, in particular in matters of methods and expediency of conservative treatment. The article describes the effectiveness of various regiment of conservative treatment of pediatric patients with inflammation of the pharyngeal tonsil (adenoiditis) based on the results of an open comparative observational study. OBJECTIVE: To compare the effectiveness of various schemes of conservative therapy of adenoiditis in children. MATERIAL AND METHODS: 154 patients were divided into three groups: group I - standard therapy; group II - standard therapy + a specially developed homeopathic protocol; group III - a specially developed homeopathic protocol. At each of the visits (day 0th, 7th, 30th, and 90th), ENT-organs endoscopy and a 10-point visual assessment of symptoms were performed by analog score. The effectiveness of treatment (day 7th, 30th, and 90th) was evaluated by both doctors and patients. RESULTS: Analysis of the results showed that the symptoms of adenoiditis were stopped most quickly (day 7th) in patients of group I, but more pronounced and prolonged positive dynamics was noted in comparison groups II and III (only in these groups parents/legal representatives of patients rated the effectiveness as recovery in 25% and 35%, respectively). CONCLUSION: Conservative treatment of adenoiditis: has a positive effect (the severity and duration depends on the therapy regimen); avoids adenotomy, especially in patients who have taken homeopathic medications as a part of combined therapy. The use of a standardized homeopathic protocol is possible, both in combination with the use of other medications, and as monotherapy. Against the background of taking homeopathic medications, undesirable side effects may occur, which the parents of patients should be informed about in advance.

AJM300 (carotegrast methyl), an oral antagonist of α4-integrin, as induction therapy for patients with moderately active ulcerative colitis: a multicentre, randomised, double-blind, placebo-controlled, phase 3 study.

BACKGROUND: AJM300 is an oral, small-molecule α4-integrin antagonist. We assessed the efficacy and safety of AJM300 in patients with moderately active ulcerative colitis. METHODS: This multicentre, randomised, double-blind, placebo-controlled, phase 3 study consisted of two phases: a treatment phase and an open-label re-treatment phase. The study was done at 82 hospitals and clinics in Japan. Patients with a Mayo Clinic score of 6-10, endoscopic subscore of 2 or more, rectal bleeding subscore of 1 or more, and an inadequate response or intolerance to mesalazine were enrolled. Patients were randomly allocated (1:1) via a website to either AJM300 (960 mg) or placebo by the minimisation method, which was adjusted centrally by dynamic assignment against the Mayo Clinic score (≥6 to ≤7, ≥8 to ≤10 points), any use of corticosteroid, anti-TNFα antibody, or immunosuppressants during the disease-active period (yes vs no), duration of induction therapy until randomisation (<4 weeks vs ≥4 weeks) as the minimisation factors. Patients, investigators, site staff, assessors, and the sponsor were masked to treatment assignments. The study drug was administered orally, three times daily, for 8 weeks, and continued for up to 24 weeks if endoscopic remission was not achieved or rectal bleeding did not stop. The primary endpoint was the proportion of patients with a clinical response at week 8, and was analysed in the full analysis set. Clinical response was defined as a reduction in Mayo Clinic score of 30% or more and 3 or more, a reduction in rectal bleeding score of 1 or more or rectal bleeding subscore of 1 or less, and an endoscopic subscore of 1 or less at week 8. The study is registered with ClinicalTrials.gov, NCT03531892, and is closed to recruitment. FINDINGS: Between June 6, 2018, and July 22, 2020, 203 patients were randomly assigned to AJM300 (n=102) or placebo (n=101). At week 8, 46 (45%) patients in the AJM300 group and 21 (21%) patients in the placebo group had a clinical response (odds ratio 3·30, 95% CI 1·73-6·29; p=0·00028). During the 8-week treatment and 16-week extension treatment periods, adverse events occurred in 39 (39%) of 101 patients in the placebo group and 39 (38%) of 102 patients in the AJM300 group. We found no difference in the incidence of adverse events between groups or after repeated administration of AJM300. The most common adverse event was nasopharyngitis (11 [11%] of 101 patients in the placebo group and ten [10%] of 102 patients in the AJM300 group). The most common treatment-related adverse event was also nasopharyngitis (four [4%] of 101 patients in the placebo group and three [3%] of 102 patients in the AJM300 group). Most adverse events were mild-to-moderate in severity. No deaths were reported. A serious adverse event was reported in the AJM300 group (one patient with anal abscess), but this was judged to be unrelated to study drug. INTERPRETATION: AJM300 was well tolerated and induced a clinical response in patients with moderately active ulcerative colitis who had an inadequate response or intolerance to mesalazine. AJM300 could be a novel induction therapy for the treatment of patients with moderately active ulcerative colitis. FUNDING: EA Pharma and Kissei Pharmaceutical. TRANSLATION: For the Japanese translation of the abstract see Supplementary Materials section.

Are new variants of psoriasis therapy (IL-17 inhibitors) safe?

Psoriasis is a chronic, recurrent, inflammatory, and proliferative skin disease. Its etiology has not yet been fully assessed, but undoubtedly it is a multifaceted disease. The key role in its pathomechanism is played by genetic, immunologic, and environmental factors and stress. If traditional methods of psoriasis treatment (phototherapy, methotrexate, retinoids, cyclosporine A) fail, we reach for the following biopharmaceuticals - infliximab, etanercept, adalimumab, or ustekinumab. However, genetic engineering progress discovers new possibilities - the pending clinical trials involve IL-17, IL-23 antagonists, PDE4 and -3 and -1. Psoriasis etiopathogenesis mainly involves the IL-17A, IL-17F, and IL-17A/F subtypes, which affect the keratinocytes. The biological therapy molecularly oriented with the antagonists of interleukin 17 is based mainly on the influence onto the cytokine in the manner that prevents it from binding with the receptor. Three biopharmaceuticals are currently under third phase studies: two fully humanized antibodies neutralizing IL-17 - ixekizumab and secukinumab, and one human monoclonal antibody, brodalumab. The below work will be devoted to the analysis of possible undesirable symptoms, which were observed during the studies. We will try to review the latest literature concerning the most important clinical trials conducted in many centers.

Short-term increase in prevalence of nasopharyngeal carriage of macrolide-resistant Staphylococcus aureus following mass drug administration with azithromycin for trachoma control.

BACKGROUND: Mass drug administration (MDA) with azithromycin is a corner-stone of trachoma control however it may drive the emergence of antimicrobial resistance. In a cluster-randomized trial (Clinical trial gov NCT00792922), we compared the reduction in the prevalence of active trachoma in communities that received three annual rounds of MDA to that in communities that received a single treatment round. We used the framework of this trial to carry out an opportunistic study to investigate if the increased rounds of treatment resulted in increased prevalence of nasopharyngeal carriage of macrolide-resistant Staphylococcus aureus. Three cross-sectional surveys were conducted in two villages receiving three annual rounds of MDA (3 × treatment arm). Surveys were conducted immediately before the third round of MDA (CSS-1) and at one (CSS-2) and six (CSS-3) months after MDA. The final survey also included six villages that had received only one round of MDA 30 months previously (1 × treatment arm). RESULTS: In the 3 × treatment arm, a short-term increase in prevalence of S. aureus carriage was seen following MDA from 24.6% at CSS-1 to 38.6% at CSS-2 (p < 0.001). Prevalence fell to 8.8% at CSS-3 (p < 0.001). A transient increase was also seen in prevalence of carriage of azithromycin resistant (AzmR) strains from 8.9% at CSS-1 to 34.1% (p < 0.001) in CSS-2 and down to 7.3% (p = 0.417) in CSS-3. A similar trend was observed for prevalence of carriage of macrolide-inducible-clindamycin resistant (iMLSB) strains. In CSS-3, prevalence of carriage of resistant strains was higher in the 3 × treatment arm than in the 1 × treatment (AzmR 7.3% vs. 1.6%, p = 0.010; iMLSB 5.8% vs. 0.8%, p < 0.001). Macrolide resistance was attributed to the presence of msr and erm genes. CONCLUSIONS: Three annual rounds of MDA with azithromycin were associated with a short-term increase in both the prevalence of nasopharyngeal carriage of S. aureus and prevalence of carriage of AzmR and iMLSB S. aureus. TRIAL REGISTRATION: This study was ancillary to the Partnership for the Rapid Elimination of Trachoma, ClinicalTrials.gov NCT00792922 , registration date November 17, 2008.

Estudio piloto del efecto terapéutico de algunos medicamentos homeopáticos indicados en la rinofaringitis aguda / Pilot study of therapeutic effect of some homeopathic medicines indicated for acute nasopharyngitis

El presente trabajo tiene el objetivo de mostrar el efecto terapéutico de algunos medicamentos homeopáticos en la rinofaringitis aguda o resfriado común, enfermedad aguda de vías respiratorias superiores de tipo viral de baja patogenicidad (VRSBP) y gran incidencia en la actualidad, en una muestra piloto de tipo clínico, longitudinal y prospectiva, conformada por 22 pacientes captados en la Unidad Médica de la Escuela Nacional de Medicina y Homeopatía (ENMH) del Instituto Politécnico Nacional (IPN); 15 pacientes del sexo femenino y 7 del masculino, en un rango de entre 4 y 11 años de edad. La elección de los medicament s homeopáticos se realizó con base en lasemiología de los síntomas presentados, enfatizando particularmente en las modalidades, el color del moco, ataque al estado general y la exploración física.

This paper aims to show the therapeutic effect of some homeopathic medicines in acute nasopharyngitis or common cold , acute upper respiratory disease of viral type low pathogenic ( VRSBP ) and high incidence currently in a pilot sample clinical , longitudinal and prospective type , consisting of 22 patients recruited in the Medical Unit of the National School of Medicine and Homeopathy ( ENMH ) of the National Polytechnic Institute ( IPN) ; 15 female patients and 7 male , ranging between 4 and 11 years old. The choice of homeopathic medicament s was made based on thesemiotics of the symptoms presented , emphasizing particularly on the modalities , the color of mucus, malaise and physical examination.

Efficacy and Safety of Ustekinumab in Korean Patients with Moderate-to-severe Psoriasis / 대한피부과학회지

BACKGROUND: Psoriasis is a chronic, relapsing inflammatory disease that affects approximately 2~3% of the population worldwide and often requires lifelong care. Recent advances in understanding the immunogenesis of psoriasis has led to the development of biological agents that target specific immunological pathways. Ustekinumab is a human monoclonal antibody that binds to the p40 subunit common to interleukin-12 and 23, key cytokines in the pathogenesis of psoriasis. OBJECTIVE: This study aims to address the efficacy and safety of ustekinumab in Korean patients with moderate-to-severe psoriasis. METHODS: The clinical records of 32 consecutive patients treated with ustekinumab were reviewed retrospectively. Treatment effectiveness was estimated based on reported Psoriasis Area and Severity Index (PASI) 50, 75, and 90 response rates, defined as a > or =50%, > or =75%, or > or =90% reduction from baseline PASI scores, respectively. A stereotyped questionnaire was completed by the physician, and information about adverse events and quality of life was collected. RESULTS: The average baseline PASI score was 25.7. Overall 38%, 56%, and 80% patients achieved PASI 75 response rates at weeks 4, 16, and 52 respectively. Thirteen patients (41%) experienced a mild adverse event such as upper respiratory infection, pruritus, urticaria, nasopharyngitis, headache, hyperglycemia, abnormal hepatic function, or arthralgia. CONCLUSION: Ustekinumab provides an effective, safe, and well-tolerated alternative for the symptomatic treatment of Korean patients with moderate-to-severe psoriasis.

Estudio piloto del efecto terapéutico de algunos medicamentos homeopáticos indicados en la rinofaringitis aguda / Pilot study of therapeutic effect of some homeopathic medicines indicated for acute nasopharyngitis

El presente trabajo tiene el objetivo de mostrar el efecto terapéutico de algunos medicamentos homeopáticos en la rinofaringitis aguda o resfriado común, enfermedad aguda de vías respiratorias superiores de tipo viral de baja patogenicidad (VRSBP) y gran incidencia en la actualidad, en una muestra piloto de tipo clínico, longitudinal y prospectiva, conformada por 22 pacientes captados en la Unidad Médica de la Escuela Nacional de Medicina y Homeopatía (ENMH) del Instituto Politécnico Nacional (IPN); 15 pacientes del sexo femenino y 7 del masculino, en un rango de entre 4 y 11 años de edad. La elección de los medicament s homeopáticos se realizó con base en lasemiología de los síntomas presentados, enfatizando particularmente en las modalidades, el color del moco, ataque al estado general y la exploración física. (AU)

This paper aims to show the therapeutic effect of some homeopathic medicines in acute nasopharyngitis or common cold , acute upper respiratory disease of viral type low pathogenic ( VRSBP ) and high incidence currently in a pilot sample clinical , longitudinal and prospective type , consisting of 22 patients recruited in the Medical Unit of the National School of Medicine and Homeopathy ( ENMH ) of the National Polytechnic Institute ( IPN) ; 15 female patients and 7 male , ranging between 4 and 11 years old. The choice of homeopathic medicament s was made based on thesemiotics of the symptoms presented , emphasizing particularly on the modalities , the color of mucus, malaise and physical examination. (AU)

[The rehabilitative treatment of the frequently ill children presenting with chronic infectious foci in the nasopharynx].

AIM: The objective of the present study was to elucidate the influence of the combined physiotherapeutic remedial treatment on the effectiveness of rehabilitation of the frequently ill children (FIC) and children presenting with chronic infectious foci inthe nasopharynx taking into consideration their microelemental and immunological status. MATERIALS AND METHODS: A total of 80 frequently ill children and children presenting with chronic infectious foci inthe nasopharynx were available for the observation with special reference to dynamics of clinical conditions, immunological processes, and microelement composition. CONCLUSION: The combined treatment including the intake of "Asonovklyuch" mineral water enhanced the resistance of the children to the causative factors of respiratory infections and increased selenium content in their body. It is concluded that the treatment of the children presenting with chronic infectious foci inthe nasopharynx with the use of the specialized dietary product "Clinutren Junior" produces an anti-inflammatory and immunoregulatory effect and thereby promotes the correction of disorders of microelement nutrition.

One-year, multicenter, open-label, single-arm study evaluating the safety and effectiveness of etanercept for the treatment of moderate-to-severe plaque psoriasis in a Canadian population.

BACKGROUND: Although etanercept is well tolerated and effective in moderate-to-severe plaque psoriasis, data are limited in Canadian practice settings. OBJECTIVE: To assess the effectiveness and safety of etanercept in Canadian patients with moderate-to-severe plaque psoriasis (Physician Global Assessment [PGA] ≥ 3) in routine practice. METHODS: A 1-year, multicenter, open-label trial of 246 patients enrolled from March 2006 to July 2009 was conducted. Patients received etanercept 50 mg subcutaneously twice weekly for 3 months and then 50 mg once weekly for 9 months. The primary end point was the proportion of patients achieving a PGA score ≤ 2 at month 12. Secondary end points included the proportion of patients achieving PGA score ≤ 2 at months 3, 6, and 9 and change from baseline at month 12 for Patient Global Assessment (PtGA), body surface area, and Dermatology Life Quality Index (DLQI). Adverse events were reported. RESULTS: At month 12, 73.5% (95% CI 67.2-79.1) achieved a PGA score ≤ 2. The response was similar regardless of the previous response to systemic or phototherapy. The proportion of patients achieving this score improved from 2.2% (95% CI 0.3-4.2) at baseline to 73.5% (95% CI 67.2-79.1) at 12 months. At 12 months, patients with a DLQI score of 0 or ≥ 5-point improvement was 28.8% (95% CI 22.9-34.7) and 47.3% (95% CI 40.8-53.9), respectively. No new safety signals were reported. CONCLUSION: The majority of this Canadian population demonstrated a meaningful improvement in PGA and DLQI scores over 1 year.

[The experience with the application of selective polarized chromotherapy in the clinical practice].

A series of investigations have demonstrated the anti-inflammatory, bactericidal, analgesic, and vegetocorrective effects of extraocular selective polarized chromotherapy using blue and red light and the possibility to optimize autonomous regulation with the help of this technique. The results of the study confirmed the high clinical effectiveness and safety of the method being considered for the treatment of acute respiratory diseases, chronic tonsillitis, cervical dorsopathies, and vegetative dysfunction.

Association between cord blood 25-hydroxyvitamin D concentrations and respiratory tract infections in the first 6 months of age in a Korean population: a birth cohort study (COCOA) / 소아과

PURPOSE: Previous studies suggest that the concentration of 25-hydroxyvitamin D [25(OH)D] in cord blood may show an inverse association with respiratory tract infections (RTI) during childhood. The aim of the present study was to examine the influence of 25(OH)D concentrations in cord blood on infant RTI in a Korean birth cohort. METHODS: The levels of 25(OH)D in cord blood obtained from 525 Korean newborns in the prospective COhort for Childhood Origin of Asthma and allergic diseases were examined. The primary outcome variable of interest was the prevalence of RTI at 6-month follow-up, as diagnosed by pediatricians and pediatric allergy and pulmonology specialists. RTI included acute nasopharyngitis, rhinosinusitis, otitis media, croup, tracheobronchitis, bronchiolitis, and pneumonia. RESULTS: The median concentration of 25(OH)D in cord blood was 32.0 nmol/L (interquartile range, 21.4 to 53.2). One hundred and eighty neonates (34.3%) showed 25(OH)D concentrations less than 25.0 nmol/L, 292 (55.6%) showed 25(OH)D concentrations of 25.0-74.9 nmol/L, and 53 (10.1%) showed concentrations of > or =75.0 nmol/L. Adjusting for the season of birth, multivitamin intake during pregnancy, and exposure to passive smoking during pregnancy, 25(OH)D concentrations showed an inverse association with the risk of acquiring acute nasopharyngitis by 6 months of age (P for trend=0.0004). CONCLUSION: The results show that 89.9% of healthy newborns in Korea are born with vitamin D insufficiency or deficiency (55.6% and 34.3%, respectively). Cord blood vitamin D insufficiency or deficiency in healthy neonates is associated with an increased risk of acute nasopharyngitis by 6 months of age. More time spent outdoors and more intensified vitamin D supplementation for pregnant women may be needed to prevent the onset of acute nasopharyngitis in infants.

The hemostatic efficacy of Ankaferd Blood Stopper in adenoidectomy.

OBJECTIVE: To evaluate the efficacy of Ankaferd Blood Stopper (ABS) in the control of intraoperative and postoperative bleeding in adenoidectomy. METHODS: In total, 90 patients underwent traditional cold steel adenoidectomy and were then randomized to receive ABS or 0.9% physiological saline solution to obtain hemostasis. Objective data collected included time of operation and blood loss during operation. Visual analog scales (VAS) were used to record subjective data by the operating surgeon including bleeding following adenoid pack removal and ease of operation. RESULTS: In a comparison between patients in the ABS group (n = 46) and the control group (n = 44), those in the ABS group had significantly shorter operation times (9.11 ± 1.02 vs. 13.16 ± 3.96 min; p < 0.001) and less blood loss during the operation (20.19 ± 8.59 vs. 25.48 ± 12.96 ml; p ≤ 0.05) and a shorter hemostasis time (3.83 ± 0.8 vs. 5.82 ± 1.67 min; p < 0.001). Regarding hemorrhage after tampon removal, 40 patients (87%) in the ABS group and 17 patients (38.6%) in the control group did not suffer from hemorrhage (p < 0.001). Regarding ease of hemostasis, 40 patients (87%) in the ABS group experienced very easy or easy hemostasis while 26 patients in the control group did so (59.1%; p = 0.004). Patients in the ABS group returned to a regular diet earlier and had less use of analgesics at 7 days postoperatively. Use of electrocautery was less in the ABS group than in the control group (10.9 vs. 40.9%; p = 0.001). CONCLUSIONS: The side on which ABS was used showed significant differences in hemostasis time, blood loss, and ease of hemostasis. ABS appears to be safe and effective; it decreases intraoperative bleeding and reduces operating time when compared to traditional hemostasis methods after curette adenoidectomy.

Terbinafine hydrochloride oral granules versus oral griseofulvin suspension in children with tinea capitis: results of two randomized, investigator-blinded, multicenter, international, controlled trials.

BACKGROUND: Although griseofulvin is currently considered the primary antifungal agent used to treat tinea capitis in many countries, increasingly higher doses and longer durations of treatment are becoming necessary to achieve effective treatment. Alternative antifungal therapies with shorter/simpler treatment regimens may be important to develop for this indication. OBJECTIVE: To compare the efficacy and safety of a new pediatric formulation of terbinafine hydrochloride oral granules with griseofulvin oral suspension in the treatment of tinea capitis. METHOD: Children (4-12 years of age) with clinically diagnosed and potassium hydroxide microscopy-confirmed tinea capitis were randomized in two identical studies (trial 1, trial 2) to once-daily treatment with terbinafine (5-8 mg/kg; n = 1040) or griseofulvin administered per label (10-20 mg/kg; n = 509) for a period of 6 weeks followed by 4 weeks of follow-up. End-of-study complete cure (negative fungal culture and microscopy with Total Signs and Symptoms Score [TSSS] = 0), and mycologic (negative culture and microscopy) and clinical cure (TSSS = 0) were primary and secondary efficacy variables, respectively. Efficacy analysis was based on pooled data using modified intent-to-treat population (those who received at least one dose of study drug and had positive baseline fungal culture, N = 1286). Safety assessments included monitoring of the frequency and severity of adverse events (AEs). RESULTS: Rates of complete cure and mycologic cure were significantly higher for terbinafine than for griseofulvin (45.1% vs 39.2% and 61.5% vs 55.5%, respectively; P < .05). A majority (86.7%) of patients received griseofulvin, 10 to 19.9 mg/kg per day; complete cure rate was not found to be higher among patients who received griseofulvin more than 20 mg/kg per day compared with those who received less than 20 mg/kg per day. Complete cure rate was statistically significantly greater for terbinafine compared to griseofulvin in trial 1 (46.23% vs 34.01%) but not in trial 2 (43.99% vs 43.46%). On the basis of pooled data, clinical cure was higher for terbinafine than for griseofulvin, but the difference was not found to be statistically significant (P = .10). Subgroup analyses revealed that terbinafine was significantly better than griseofulvin for all cure rates--mycologic, clinical, and complete--among patients with Trichophyton tonsurans but not Microsporum canis (P < .001). For M. canis, mycologic and clinical cure rates were significantly better with griseofulvin than with terbinafine (P < .05). Approximately 50% of patients in each group reported an AE; almost all were mild or moderate in severity. Nasopharyngitis, headache, and pyrexia were most common in both groups. There were no drug-related serious AEs, no deaths, and no significant effects on weight or laboratory parameters, including liver transaminases. LIMITATIONS: In retrospect, a difference in the distribution of infecting microorganisms between the two trials was a limitation. Stringent adherence to griseofulvin doses recommended by prescribing information but smaller than those used in current clinical practice, and exclusion of adjuvant therapies such as shampoos or topical agents, which are routinely used in practice, are other limitations. CONCLUSIONS: Data from this largest pediatric trial of terbinafine to date indicate that terbinafine is efficacious and well tolerated in the treatment of tinea capitis. Terbinafine is an effective alternative to griseofulvin against T. tonsurans tinea capitis.

An unusual rhino-pharyngeal foreign body.

BACKGROUND: Foreign bodies of the upper aerodigestive tract are commonly seen in the paediatric population; however adult patients with nasal foreign bodies in particular are much less common and when sharp foreign bodies are present there is a great risk of developing complications. STUDY DESIGN: This is a case report of a 20-year-old male magician with impacted rhino-pharyngeal foreign body. He intentionally inserted two long sewing needles into the right nasal cavity during a magical act. RESULTS: The impacted foreign bodies were located in his nose/pharynx and removal was achieved per orally under general anaesthesia. Only a minimal evidence of retropharyngeal abscess was noted despite the prolonged stay of the foreign bodies. CONCLUSION: This case highlights the fact that both a deliberate and an accidental foreign body in an adult nasal cavity can get impacted as well as the significance for its early removal.

[Primary acute rheumatic fever in juveniles from an organized community]. / Pervichnaia ostraia revmaticheskaia likhoradka u iunoshei, prebyvaiushchikh v usloviiakh organizovannogo kollektiva.

A closed population of juveniles was studied to follow-up manifestations of primary rheumatic fever. In line with other unfavourable factors, the onset of the disease within the first 6 months of the observation was due to cross streptococcal infection (foci of chronic nasopharyngeal infection were detected in 68.6% examinees, rheumatism debut after acute nasopharyngeal infection was in 91.0% patients). Persistence of streptococci was established in many blood counts in immunofluorescence reaction in 88.2% patients in acute disease, in more patients with lingering rheumatic process. Clinical manifestations include, aside from arthritis and rheumocarditis, frequent thyroid and gastrointestinal lesions. It is thought valid to raise the dose and duration of administration of penicillin in patients with primary rheumatic fever as it eradicates chronic infection foci, prevents recurrences, reduces the number of patients with a lingering course of the disease, with recurrences and valvular defects of the heart.

Traitement homeopathique des rhino-pharyngites recidivantes de l'enfant / Homeopathic treatment of the recurrent rhinopharyngitis in child

Les rhino-pharyngites recidivantes de l'enfant (R.P.R.) resultent d'une inflammation du rhino-pharynx avec congestion et suppuration localisee au niveau des formations lymphoides, se repetant chaque annee, non seulement en hiver, mais egalement en d'autres saisons, surtout automne et printemps.(AU)

The human nasal mucous membrane during chronic inflammation, before and after muco-active therapy: a study using scanning electron microscopy.

Chronic inflammation seems to induce alterations in nasal mucosa morphology. The type and extent of these alterations seem to be directly correlated with the duration of the inflammation. This study was carried out to ascertain whether the administration of muco-active drugs could modify these alterations by inducing their total or partial regression. Ten healthy control subjects, and thirty patients affected with chronic rhinopharyngitis, at various levels of severity, were studied. All the forty subjects underwent biopsy of the posterior region of the medium turbinate. The bioptic samples were examined using Scanning Electron Microscopy (SEM). Patients with phlogosis underwent treatment which consisted of a single day administration of carbocysteine-sobrerol (1125 mg carbocysteine and 180 mg sobrerol day 20 days). This group underwent biopsy again and the fragments obtained were studied using the same method. Chronic inflammation, in the nasal epithelium, causes progressive degenerative phenomena, which are related to the duration and to the severity of the pathology. The response of the nasal mucosa principally results in damage to the muco- ciliary unit, loss of cilia and consistent modifications in the mucous secretion. In cases of persistent inflammation, the nasal epithelium becomes squamous. The therapy employed was able to alter the morphological signs of degeneration in the less severe cases, and to improve the overall pattern of the most severe and irreversible pathologies.