Headache and Chiari I malformation in the pediatric population.

There has been disagreement regarding surgical intervention in treating pediatric patients with Chiari I malformation with headache as sole complaint. Therefore, we retrospectively reviewed our experience over a 6-year period, with patients less than 5 years of age (mean = 34.8 months) with radiographically confirmed Chiari I malformation. We identified 7 patients who presented with headaches as their only complaint. The headaches varied in location and severity. All patients were treated with posterior fossa decompression and syringosubarachnoid shunt when indicated. At follow-up, all patients were noted to have rapid clinical improvement (mean = 11.6 weeks) and remain asymptomatic. Our data suggest that patients less than 5 years of age with Chiari I malformation benefit from surgical decompression when presenting with a chief complaint of headache.

Food antibodies in acute psychoses.

Antibodies to a variety of foods, and in particular cereals, were measured in serum from 100 patients with acute psychoses and 100 elective surgical patients. For 13 out of 14 foods to which non-IgE antibodies were detected the schizophrenics had slightly more antibodies than the controls. There was an association between a possible secondary mania and the presence of IgE antibodies to wheat or rye. However, neither the schizophrenia nor the mania findings can be regarded as evidence for food allergy causing psychiatric disorder, since the immunological findings in both cases may represent consequences of the illnesses or their treatment, rather than causes of the illness.

Non-allergenic haemolysins in grass pollens and housedust mites.

25 batches of pollen (six common grasses, maize, short ragweed) and two batches of housedust mite (Dermatophagoides pteronyssinus) all contained haemolysins. The haemolysins of two grass pollens and of the housedust mites were of small MW (100-200 Da) and apparently non-allergenic. Both caused inflammation when injected into human skin, at doses that could be experienced naturally. The "allergic" airways diseases may not be entirely immunologically mediated.

Angioedema responding to antiprotease treatment but without abnormalities of the complement system.

Four patients suffered from chronic or recurrent angioedema, of sudden onset in adult life, associated with visceral pain and impossible to control by dietary means. In spite of normal complement function they respond very well to tranexamic acid therapy. Antiprotease drugs need not be restricted to cases of ClsINH deficiency.

Persistent warts protected from immune attack by a blocking factor.

Severe warts of 20 years duration, highly resistant to therapy, were found to contain a soluble factor which blocked the local expression of cellular immunity, without affecting systemic immune responsiveness. This finding enabled us to propose therapy by infection, and this had a limited success.