Intranasal capsaicin is efficacious in non-allergic, non-infectious perennial rhinitis. A placebo-controlled study.

BACKGROUND: Several authors described capsaicin, the pungent substance in red pepper, as an efficacious therapy for non-allergic non-infectious perennial rhinitis (NANIPER). Repeated capsaicin application induces peptide depletion and specific degeneration of the unmyelinated sensory C-fibres in the nasal mucosa. METHODS: We performed a placebo-controlled (NaCl 0.9%) study with 25 NANIPER patients. Daily record charts and visual analogue scales (VAS) were used for clinical evaluation. Nasal lavages were obtained before, during, and after treatment. RESULTS: There was a significant and long-term reduction in the VAS scores in the capsaicin group. No significant difference was found between the placebo and capsaicin treated groups for the mean group concentrations of leukotriene (LT) C4/D4/E4, prostaglandin D2 (PGD2), and tryptase. The levels of mast cell mediators, tryptase and PGD2, and leukotrienes, mediators derived from a variety of inflammatory cells, were low at baseline and comparable with levels observed in nasal lavages obtained from normals. CONCLUSION: As involvement of inflammation could not be demonstrated, it is not surprising that capsaicin has no effect on inflammatory mediators. This suggests that inflammatory cells do not play a major part in the pathogenesis of NANIPER.

Duplex sonographic findings in a popliteal vein aneurysm.

We report on a new case of popliteal vein aneurysm, a rare anomaly almost always presented by pulmonary emboli. Usually the lesion is demonstrated on phlebography. However it is possible to establish the diagnosis with duplex sonography. A short review of the literature is included.

One hundred elective resections of the left colon and rectum with unprotected manual anastomosis.

One hundred consecutive elective resections with hand suture of the left colon and rectum without a protective colostomy are reported. The absence of clinical fistulas, wound infections and abcesses indicates the safety and the feasability of this approach. There was a two per cent mortality rate. The article stresses the importance of a good suturing technique, good preparation, the judicious use of anti-anaerobic drugs, the use of plastic ring drapes and the changing of gloves, drapes and instruments before wound closure. The absence of leakage and of septic complications lowers dramatically the overall complication rate.

Wound infections in general surgery. A two-year prospective study in a private hospital.

The major and minor infection rate in 1,219 surgical wounds in which infection was a possible hazard was 4.2%. For the clean group the infection rate was 1%, for the clean-contaminated 6%, for the contaminated 15% and for the dirty class 19%. The mortality was 0.8% but there were no deaths due to infection or septicaemia. The results are classified according to the kind of surgery. They reflect a two-year prospective study in a conventional operating room without special air handling systems, in a private hospital. The series is characterized by a low antibiotic use (32% of the patients), the complete absence of anastomotic leaks and a systematic change of gloves, drapes and instruments before abdominal wound closure.

Primary closure of the perineal wound after abdomino-perineal amputation for adenocarcinoma.

This is a prospective study of primary closure of the perineum in 35 successive cases of abdomino-perineal amputation of the rectum for adenocarcinoma (January 1972 - December 1978). All operations are performed by the same surgeon in a one-team approach. In 33 patients the perineum is closed, and 32 patients are available for evaluation. In 66% of them the wound heals per primam. Very extensive and exenterative procedures do not lower the chances for success. In women the results are better than in men. They are even better after posterior vaginal wall resection and posterior exeneration (no failures). Early postoperative failures are usually due to bleeding; the late ones are caused by infection. The procedure is complicated by one death (81 years), one ureteral fistula (47 years) and one late perineal hernia which may be imputed to the method. Primary closure of the perineum appears to be a very feasible (33/35), usefull and rather safe procedure from which the patient has a lot to win and quite nothing to loose.