Predisposing factors of rhinitis medicamentosa: what can influence drug discontinuation?

BACKGROUND: the primary end point of our study was to define risk factors and identify the underlying conditions that may have led to the abuse of vasoconstrictors in rhinitis medicamentosa. Moreover, we analysed factors that may influence the vasoconstrictors discontinuation. METHODOLOGY: this was a prospective case-control observational study. Cases and controls were evaluated at the baseline in order define factors that may have influenced onset of rhinitis medicamentosa. They were re-evaluated at 3 months to verify symptoms control and drug discontinuation. Finally, they underwent a phone call questionnaire after 12 months regarding drug discontinuation. A potential bias of our study is that evaluating discontinuation we included subjects treated differently according to the main diagnosis. RESULTS: patients with rhinitis medicamentosa were more frequently smokers than controls, they had higher mean HAMA scores and positive psychiatric diseases history. Additionally, we frequently detected a local inflammation at nasal cytology in patients with rhinitis medicamentosa. A significant improvement in all nasal symptoms scores was observed in cases and controls but 29.4% of cases did not discontinue the vasoconstrictors. Two major factors negatively influenced discontinuation: positive nasal cytology and pathological HAMA score. CONCLUSION: we observed that positive local inflammation, anxiety and smoking habit correlate positively with vasoconstrictors abuse. In addition, we demonstrated that anxiety and local inflammation were the most important factors impairing drug discontinuation.

[Propofol in single bolus for treatment of elevated intracranial hypertension]. / Il propofol in singolo bolo nel trattamento della ipertensione endocranica.

Eleven patients with intracranial pressure (ICP) above 20 mmHg despite hyperventilation and neurosedation were treated with a bolus of propofol (1.5 mg/kg) i.v. At baseline and 1-2-5-10-15-30-45 minutes after propofol administration we recorded the values of PIC, systolic arterial pressure (SAP) and mean arterial pressure (MAP), heart rate (HR) and cerebral perfusion pressure (CPP), calculated as MAP less PIC. In the first ten minutes after propofol we observed a statistically significant (p less than 0.05) decrease of ICP and SAP. MAP decreased in the first five minutes only. Consequently HR increased at the same time. CPP decreased in the first two minutes after administration of the drug, but without statistical evidence. We conclude that propofol, in our opinion, can be used to treat intracranial hypertension but the hemodynamic effects in hypovolemic patients must be taken into consideration.

[Preservation at -195 degrees C of trypsinized organs for primary cultures]. / Conservazione a -195,8 degrees C di organi tripsinizzati per colture primarie.

Trypsinized cells from rabbit kidney can be kept at -195, 8 degrees C indefinitely. When necessary, propagation in monolayer cultures is readily obtained as primary cultures, provided that some conditions be respected: 1) only glass culture flask must be used. Falcon plastic vessels do not allow cell attachment in this type of primary culture 2) the lag period is particularly long: it taken about 20 days before the beginning of cell multiplication 3) fetal calf serum is toxic for the cells in the 2nd and 3rd change of the culture medium, during the lag period.

[Intestinal secretory IgA and bacterial antigens in oral administration]. / IgA secretorie intestinali ed antigeni batterici somministrati per via orale.

The proposed technique for purification and concentration of secretory IgA has been applied to intestinal wash fluids obtained by clisma from 15 patients under bacterial extracts treated (COLOPTENE-DEBAT). The collected data show that the technique is suitable for routinary use and the bacterial extracts do increase the amount of IgA in the intestinal contents.

[Filaments of the "Candida albicans" in human serum (author's transl)]. / Sulla filamentizzazione di "Candida albicans" in siero umano.

A study on human serum activity on Candida albicans cells has been carried out. In smear microcultures the microcolonies morphogenesis and the thread formation in the presence of serum, as well as the reappearance of normal yeast cells after re-growth in normal nutrient agar has been assessed. The serum globulin-fraction appeared to have the greatest germ-tube inducing activity: an heat-sensitive quality that went lost after 30 minutes at 100 degrees C. The multiplying activity of the Candida cells was almost completely abolished in the presence of serum. Realying on these experimental findings the AA. suggest that a demaging factor may be present in sera, linked to the globulin protein fraction, that hinders the Candida cell-wall normal synthesis: hence follows the appearance of threads, mostly deprived of multiplying activity. A condition in some way akin to the well known filament inducing activity of penicillin on Gram-negative bacteria.