Comparison of sublingual and intramuscular administration of vitamin b12 for the treatment of vitamin b12 deficiency in children

Abstract Background: In most countries, contrary to some disadvantages, such as pain, relatively higher cost, and poor adherence to treatment, intramuscular (IM) route is still the primary treatment method for Vitamin B12 (VB12) deficiency. In recent years, because of these difficulties, new treatment methods are being sought for VB12 deficiency. Objectives: We aimed to compare sublingual (SL) and IM routes of VB12 administration in children with VB12 deficiency and to compare the efficacy of methylcobalamin and cyanocobalamin therapy in these children. Methods: This retrospective study comprised 129 patients with VB12 deficiency (serum Vitamin 12 level ≤ 200 pg/mL) aged 5-18 years. Based on the formulations of Vitamin 12, we divided the patients into three treatment groups as IM cyanocobalamin, SL cyanocobalamin, and SL methylcobalamin. Results: After Vitamin 12 therapy, serum Vitamin 12 levels increased significantly in all patients, and there was a statistically significant difference between the treatment groups (p < 0.05). Conclusions: SL cyanocobalamin and methylcobalamin were found as effective as IM cyanocobalamin for children with Vitamin 12 deficiency in correcting serum Vitamin 12 level and hematologic abnormalities.

Sublingual and oral zolpidem for insomnia disorder: a 3-month randomized trial

Objective: To evaluate the safety and efficacy of a 5 mg sublingual dose of zolpidem, compared to a 10 mg oral dose, at bedtime and "as needed" following middle-of-the-night awakenings. Methods: Participants were randomized into an oral group (oral zolpidem 10 mg and sublingual placebo at bedtime and "as-needed") and a sublingual group (oral placebo and sublingual zolpidem 5 mg at bedtime and "as-needed"). Participants underwent medical evaluation, polysomnography, the psychomotor vigilance test, and completed questionnaires. Results: Of 85 patients, 67 met the criteria for insomnia (48±10 years; 79% women) and were randomized. Of these, 46 completed 92±5 days of treatment. Mild-to-moderate adverse events were reported by 25% of the participants, including headache, sleepiness, and dizziness. Both treatments decreased middle-of-the-night awakenings by an average of -3.1±2.3 days/week and increased total sleep time by 1.5 hours. Changes in sleep quality and insomnia severity scores were also favorable and comparable between groups: variation depended on continuation of treatment. Regarding PSG findings, sleep latency decreased more in the sublingual group than the oral group (-14±42 vs. 10±29 min; p = 0.03). The psychomotor vigilance test showed minor residual effects 30 minutes after awakening, which reversed after 2 hours. Conclusions: The safety and efficacy of both zolpidem formulations are comparable. The sublingual 5 mg dose induced sleep more rapidly. Clinical trial registration: NCT01896336

Factores involucrados en la adherencia a la inmunoterapia sublingual y subcutánea en pacientes del Servicio de Alergología de una institución de salud en Medellín-Colombia / Factors involved in adherence to sublingual and subcutaneous immunotherapy in patients from the Allergy Service at a health institution in Medellin-Colombia

Introducción. Las enfermedades alérgicas en el mundo han aumentado en el último siglo, requiriendo a su vez nuevos tratamientos que permitan mejorar la calidad de vida de los pacientes; como respuesta, la inmunoterapia ha surgido como una opción terapéutica. El objetivo de este estudio fue identificar aspectos de la adherencia a la inmunoterapia sublingual (ITSL) y subcutánea (ITSC), y los motivos de abandono. Materiales y métodos. Estudio descriptivo retrospectivo de pacientes con enfermedades alérgicas (rinitis, asma o dermatitis atópica) que iniciaron inmunoterapia, por vía subcutánea o sublingual, en el Servicio de Alergología de una institución de salud de la ciudad de Medellín, Colombia. Para el análisis estadístico se utilizaron distribuciones absolutas, relativas, medidas de resumen y la prueba Chi cuadrado de independencia. Resultados. Se incluyeron 144 pacientes (ITSC=84,7%; ITSL=15,3%). El 38,9% de los pacientes fueron considerados adherentes; no se hallaron diferencias significativas en la adherencia según la vía de administración (p=0,833). La razón más importante para la selección de la vía de la inmunoterapia en ambos grupos fue la recomendación médica. De los pacientes no adherentes, el 95,5% (n=84) abandonaron el tratamiento. Las características sociodemográficas de los dos grupos de inmunoterapia fueron relativamente similares, sin diferencias significativas. Se encontró una diferencia significativa entre el servicio prestado por la institución en salud y el abandono al tratamiento, siendo mayor para el grupo tratado con ITSL (38,5%; p=0,007). Conclusión. La principal causa de abandono de la terapia fue la no autorización del tratamiento por parte de las Entidades Promotoras de Salud (53,6%).

Introduction. Allergic diseases in the world have increased in the last century, requiring novel treatments to improve the quality of life of patients. As a result, immunotherapy has emerged as a therapeutic option. The aim of this study was to identify aspects of adherence to sublingual (SLIT) and subcutaneous (SCIT) immunotherapy and reasons for non-adherence. Materials and methods. We present a retrospective study of patients with allergic diseases (rhinitis, asthma or atopic dermatitis) who initiated SCIT or SLIT at the allergology clinic in a health institution in Medellin, Colombia. Absolute and relative distributions, descriptive statistics and Chi square test were used for statistical analysis. Results. A total of 144 patients were selected (SCIT=84.7%; SLIT=15.3%). From the total of patients, 38.9% were considered adherent; no significant differences were found in adherence according to the route of administration (p=0.833). The most important reason for selecting the type of immunotherapy was medical recommendation. Of the non-adherent patients, 95.5% (n=84) discontinued the treatment. Sociodemographic characteristics of the two immunotherapy groups were relatively similar, with no significant differences. A significant difference was found between the service provided by the health institution and discontinuation of treatment, being greater for the group treated with SLIT (38.5%; p=0.007). Conclusion. The main cause of discontinuation of immunotherapy was the lack of approval for funding by the Health Promoting Agencies (53.6%).

Tratamiento con desmopresina sublingual en dos lactantes con hidranencefalia y diabetes insípida central / Treatment with sublingual desmopressin in two infants with hydranencephaly and central diabetes insipidus

La diabetes insípida central es una patología infrecuente en pediatría ocasionada por un déficit de vasopresina. Sus manifestaciones clínicas principales son poliuria y polidipsia. Las malformaciones cerebrales son una de las principales causas. La desmopresina es la droga sintética de elección para el tratamiento. Una de las vías de administración es la sublingual y su uso en lactantes es muy limitado. Se describe a dos lactantes con hidranencefalia y diabetes insípida central que fueron tratados satisfactoriamente con desmopresina sublingual.

Central diabetes insipidus is a rare disease in children caused by a deficiency of vasopressin. Its main clinical manifestations are polyuria and polydipsia. Brain malformations are one of the main causes. Desmopressin is the synthetic drug of choice for the treatment. One of the routes of administration is sublingual and its use in infants is very limited. We describe two infants with central diabetes insipidus and hydranencephaly who were successfully treated with sublingual desmopressin.

The influence of sublingual immunotherapy on quality of life in children with allergic rhinitis / 临床耳鼻咽喉头颈外科杂志

To analyze the impact of sublingual immunotherapy(SLIT)on the quality of life in children with allergic rhinitis.Fifty children with allergic rhinitis who have received sublingual immunotherapy were enrolled in this study.Quality of life was evaluated via measurement of VAS score and rhinoconjunctivitis quality of life questionnaire(RQLQ)before and after treatment.Twenty patients after treatment had complete remission,13 cases were partly alleviated and 17 cases had no response.The total effective rate was 66%.The Multi-VAS scores and Uni-VAS scores in each observation time point(at half a year,one year,two years after treatment)had statistically significant difference compared with that of pre-treatment with SLIT(<0.05).According to RQLQ scores,the quality of life,nasal symptoms,conjunctiva symptoms,non-nasal(ocular)symp-toms,behaviors and emotional responses were greatly improved in each time point compared with that of pretreatment(<0.05).Symptomatic treatment scores in each time point after treatment were significantly different and had a positive correlation with the scores of RQLQ(<0.05).SLIT can improve the nasal allergic symptoms,children's life quality and reduce the use of symptomatic treatment medicines.

Effectiveness and safety of sublingual misoprostol in medical treatment of the 1st trimester miscarriage: experience of off-label use in Korea

OBJECTIVE: This study was conducted to determine the effectiveness and safety of medical treatment with sublingual misoprostol (MS) in the 1st trimester miscarriage under the approval by Health Insurance Review and Assessment Service (HIRA) for off-label usage by the single medical center in Korea. METHODS: A retrospective cohort study was performed in one institution between April 2013 and June 2016. Ninety-one patients diagnosed with miscarriage before 14 weeks of gestation and wanted to try medical treatment were included. A detailed ultrasound scan was performed to confirm the diagnosis. Patients took 600 microgram (mcg) of MS sublingually at initial dose, and repeated the same dose 4–6 hours apart. Successful medical abortion was defined as spontaneous expulsion of gestational products (including gestational sac, embryo, fetus, and placenta). If gestational products were not expelled, surgical evacuation was performed at least 24 hours later from the initial dose. Information about side effects was obtained by medical records. RESULTS: About two-thirds of patients had a successful outcome. The median interval time from pill to expulsion was 18 hours in the successful medical treatment group. There was no serious systemic side effect or massive vaginal bleeding. Presence or absence of vaginal spotting before diagnosis of miscarriage, uterine leiomyomas, subchorionic hematoma, or distorted shape of gestational sac on ultrasound scan were not statistically different between the two groups. CONCLUSION: Medical treatment with sublingual MS can be a proper option for the 1st trimester miscarriage, especially for the patient who want to avoid surgical procedure. We can reduce the unnecessary sedation or surgical intervention in the patients with the 1st trimester miscarriage.

Treatment of drooling with sublingual atropine sulfate in children and adolescents with cerebral palsy / Tratamento da sialorreia com sulfato de atropina via sublingual em crianças e adolescentes com paralisia cerebral

ABSTRACT Atropine sulfate blocks the muscarinic receptors in the salivary glands and leads to reduced saliva production. There are no published studies about its use in children with cerebral palsy. Objective To report the effect of sublingual atropine sulfate to treat drooling in children with cerebral palsy by comparing the results of the Drooling Impact Scale in a non-controlled open clinical trial. Results Twenty-five children were assessed. The difference in the mean scores of the pre- and post-treatment scales reached statistical significance. There was a low frequency of side effects compared to studies with other anticholinergics. Conclusion The use of sublingual atropine sulfate seems to be safe and there is a reduction in the Drooling Impact Scale score, which suggests efficacy in the treatment of drooling in children and adolescents with cerebral palsy. Our results should be replicated in randomized, placebo-controlled studies with larger numbers of participants.

RESUMO O sulfato de atropina bloqueia os receptores muscarínicos nas glândulas salivares reduzindo a produção de saliva. Não há estudos publicados relativos ao seu uso para tratamento da sialorreia em crianças com paralisia cerebral. Objetivo Relatar o efeito do sulfato de atropina sublingual no tratamento da sialorreia em crianças com paralisia cerebral a partir da comparação dos resultados da Drooling Impact Scale em ensaio clínico aberto não controlado. Resultados Vinte e cinco crianças foram avaliadas. A diferença das pontuações médias nas escalas pré-tratamento e pós-tratamento atingiu significância estatística. Houve baixa frequência de efeitos colaterais em relação a outros anticolinérgicos. Conclusão O uso de sulfato de atropina sublingual parece ser seguro e está relacionado a uma redução na pontuação da Drooling Impact Scale, o que sugere eficácia no tratamento da sialorreia em crianças com paralisia cerebral. Nossos resultados devem ser replicados em estudos randomizados, placebo controlados, com maior número de participantes.

Decreased post-operative pain using a sublingual injection of dexamethasone (8 mg) in lower third molar surgery

BACKGROUND: Every patient who undergoes mandibular third molar surgery is concerned about post-operative pain. Indeed, previous researchers have used various methods to treat such pain. This study aimed to assess the effectiveness of sublingual injection of dexamethasone (8 mg) to treat post-operative pain after mandibular third molar surgery. METHOD: This was a randomized, double-blind, split-mouth, clinical trial, involving 48 healthy patients who required surgical removal of two mandibular third molars with similar bilateral positions. All operations were performed by the same experienced surgeon. The patients were randomized into a study group (8 mg dexamethasone injection) and a placebo group (normal saline injection). Both interventions were injected into the sublingual space immediately after local anesthesia, 30 min before the first incision. The study group received an 8 mg dexamethasone injection, while the placebo group received a normal saline injection. The wash period between the patients' two operations was 3 to 4 weeks. Pain was assessed by recording the number of analgesic tablets (rescue drug) consumed, as well as by noting the patients' responses to the visual analog scale (VAS) on the first, second, and third days after surgery. RESULTS: The study group differed significantly from the placebo group in terms of VAS score and analgesic consumption. CONCLUSION: Dexamethasone (8 mg), injected sublingually, significantly eased post-operative pain after surgical removal of the mandibular third molar.

Efficacy of sublingual immunotherapy in children with allergic rhinitis / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To evaluate the efficacy of sublingual immunotherapy with dermatophagoides farina drops on children with allergic rhinitis.@*METHOD@#This was retrospective study analyzing the efficacy of dermatophaguides farinae drops SLIT in 110 patients (aged 4-14 years old) with house dust mites induced allergic rhinitis (without asthma). All the patients were divided into the SLIT group (n = 60) and drug group (n = 50). Patients in SLIT group received sublingual immunotherapy combined with symptomatic medication, and patients in drug group only received symptomatic medication. We recorded and evaluated the total nasal symptom scores (TNSS), total medication scores (TMS) and visual analogue scale (VAS) of the 2 groups at three time points, before the treatment, and the treatment for 1-year and 2-year.@*RESULT@#After 1-year and 2-year treatment, compared with drug group, TMS, TNSS and VAS in SLIT group decreased significantly (P < 0.01). When compared with baseline, we got the similar result as compared with drug group. Besides, the TMS of drug group increased significantly after treatment (P < 0.01). And no significant difference was observed in TNSS and VAS. In addition, there was significant difference in the Proportion of patients withdrawing symptomatic medication in SLIT group and drug group (68.33%,16.00%, respectively; P < 0.01). There were 4 local adverse reactions occurred during the treatment and no serious adverse events occurred.@*CONCLUSION@#Sublingual immunotherapy with Dermatophagoides farinae drops showed significant clinical efficacy in children with allergic rhinitis comparing with pharmacotherapy.

Efficacy of the dust mites drops sublingual immunotherapy in pediatric allergic rhinitis / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To observe the role of the dust mites drops sublingual immunotherapy(SLIT) in pediatric allergic rhiriitis caused by dust mites and compare its efficacy between monosensitized and polysensitized children.@*METHOD@#A total of 77 pediatric allergic rhinitis patients received Dermatophagoides farina extracts sublingual immunotherapy for 2 years were enrolled as desensitization group and were allocated into monosensitized group (41 cases) and polysensitized group (36 cases) according to the number of coexisting allergens. Meanwhile another 33 allergic rhinitis children treated by pharmacotherapy during the period were collected as control group. The total symptom scores (TNSS), total medication scores (TMS) and visual analogue scale(VAS) were assessed at the beginning, six months, 1 year and 2 years of the treatment. SPSS 13. 0 software was used to analyze the data.@*RESULT@#the score of TNSS and VAS in desensitization was slightly higher than the control after six months treatment, but without difference at l year and 2 years; the score of TMS had significantly improved in desensitization compared with the corresponding points in control. All the parameters in monosensitized group were equivalent with polysensitizend group, except the score of TMS was slightly lower than the polysensitizend group at six months.@*CONCLUSION@#Dust mite drops sublingual immunotherapy is effective for the allergic rhinitis children caused by mites. And it has similar immunotherapy efficacy between monosensitized and polysensitized children.

Efficacy of sublingual immunotherapy with Dermatophagoides farina drops in monosensitized and polysensitized patients with allergic rhinitis / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To evaluate the efficacy of sublingual immunotherapy (SLIT) with standardized Dermatophagoides farina drops in monosensitized and polysensitized patients with allergic rhinitis.@*METHOD@#The clinical data of 162 patients treated with standardized Dermatophagoides farina drops were analyzed retrospectively. These patients were divided into the monoallergen sensitized group and polyallergen sensitized group according to the results of skin prick tests. The total nasal symptoms score (TNSS), the total medication score (TMS) and adverse effects (AEs) were evaluated before treatment, 2 year after SLIT treatment and 3 year after drug discontinuance. Result:After SLIT treatment for 2 years and drug discontinuance for 3 years, the TNSS (3. 14[2. 47; 3. 65], 3. 45 [2. 76; 3. 92], respectively) and TMS (0. 42[0. 36; 0. 57],0. 35[0. 26; 0. 44], respectively) in the monoallergen sensitized group were lower than that before the treatment (TNSS: 9. 00 [8. 00; 10. 00], TMS: 2. 16 [1. 88; 2. 37]), which have showed a statistically significant difference(P0. 05).@*CONCLUSION@#SLIT with standardized Dermatophagoides farina drops has a long-term efficacy in monosensitized and polysensitized patients with allergic rhinitis. Moreover, a longer SLIT treatment (>2 years) may be necessary to consolidate its efficacy.

Onset time and efficacy of sublingual immunotherapy with Dermatophagoides farinae drops in children with allergic rhinitis / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the onset time and efficacy of sublingual immunotherapy (SLIT) with Dermatophagoides farinae drops in children with house dust mites (HDM)-induced allergic rhinitis (AR).</p><p><b>METHODS</b>One hundred and forty three children with perennial moderate to severe HDM-induced AR were treated by SLIT with standardized Dermatophagoides farinae extract. One hundred children who finally completed two years treatment were divided into two groups according to the age: younger children group (aged 4-8 years, n = 52) and older children group (aged 9-14 years, n = 48). Respectively, Each children was assessed before and after 1st, 2nd, 3rd, 6th, 12th, 24th months of the treatment. Total nasal symptom score (TNSS), total medication score (TMS) and visual analogue scale (VAS) were evaluated at each visit. All clinical data were analyzed retrospectively with the SPSS 19.0 software.</p><p><b>RESULTS</b>TNSS, TMS and VAS of two groups decreased significantly after three months of the treatment compared with before (younger children group: Z value was -3.843, -3.534, -3.940, older children group: Z value was -3.938, -3.405, -3.953, all P < 0.05). TNSS and VAS of younger children group decreased significantly after two months of the treatment compared with before (6.4 ± 1.6, 5.3 ± 1.4 vs 8.6 ± 1.2, 7.9 ± 1.6, Z value was -3.843, -3.940, both P < 0.05). Five children (5%) experienced local adverse events and 2 children (2%) experienced mild systemic adverse events. No severe adverse events happened during the treatment.</p><p><b>CONCLUSIONS</b>SLIT with Dermatophagoides farinae drops is an efficient and safe treatment for children with HDM-induced AR. Its onset of action can be observed as early as 3 months after treatment.</p>

Effects of house dust mite sublingual immunotherapy in children with allergic rhinitis and asthma / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy of SLIT with Dermatophagoides farinae drops in children with allergic rhinitis and allergic asthma according to its different duration.</p><p><b>METHODS</b>The efficacy of Dermatophagoides farinae SLIT in 100 children (aged 3-14 yr) with allergic rhinitis and allergic asthma induced by house dust mites was retrospectively analyzed. All children were treated with Dermatophagoides farinae drops for 4 years and followed-up at the interval of 3 months. Total nasal symptom scores (TNSS), total rhinitis symptomatic medication scores (TRMS), daytime asthma symptom scores (DASS), nighttime asthma symptom scores (NASS), total asthma symptomatic medication scores (TAMS), visual analog scale scores (VAS) and lung function were assessed during follow-up visit. SPSS 20.0 software was used for data analysis.</p><p><b>RESULTS</b>After 2 years' SLIT, compared with 1-year duration, besides NASS (0.00[0.00;0.00], 0.00[0.00;0.00]; Z = 1.811; P > 0.05), TNSS (2.00[1.00;2.00], 0.00[0.00;0.00]; Z = 7.021, P < 0.01), TRMS (2.00[2.00;2.00], 0.00[0.00;0.00]; Z = 8.855; P < 0.01), VAS scores (3.00[2.00;4.00], 1.00[0.00;1.00]; Z = 4.494, P < 0.01), DASS (1.00[0.00;1.00]; 0.00[0.00;0.00]; Z = 4.383, P < 0.01) and TAMS (0.00[0.00;1.00], 0.00[0.00;0.00]; Z = 8.944; P < 0.01) all showed significant improvement. After 3-year duration, compared with 2-year duration, VAS scores (1.00[0.00;1.00], 0.00[0.00;0.00]; Z = 3.645, P < 0.05) in patients were significantly decreased. Other results showed no significant difference. The comparison of efficacy between 3 and 4-year duration showed no significant difference in global clinical outcomes (all P > 0.05).</p><p><b>CONCLUSIONS</b>Patients receiving 2 year' SLIT achieve more clinical benefits than those who receiving 1-year duration. The higher efficacy of 3-year duration compared with 2-year duration is supported by a significant improvement in VAS. Besides, the comparison between 3 and 4-year duration shows no significant difference in global clinical outcomes. Therefore, 3 years' duration is optimal in this study.</p>

Efficacy of sublingual immunotherapy with Dermatophagoides farinae drops on patients with allergic rhinitis of different symptom severity / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To evaluate the efficacy of sublingual immunotherapy (SLIT) with Dermatophagoides farinae drops for allergic rhinitis (AR) of different symptom severity.@*METHOD@#This retrospective analysis to receive SLIT treatment of 143 cases of patients with allergic rhinitis, according to the severity of disease symptoms divid- ed into two groups, moderate group (62 patients) and severe group (81 patients). Before SLIT and after SLIT for half year, 1 year and 1. 5-2.0 years, the TNSS, TMS and sign scores of patients with allergic rhinitis were evaluated.@*RESULT@#The TNSS, TMS and sign scores had continuously improved significantly after SLIT for half year, 1 year and 1.5-2.0 years in two groups as compared with baseline (P 0.05). Half year after SLIT treatment, in two groups for sign scores, there were significant differences (Z = 3.32, P 0.05) and TMS (Z = 0.37, P > 0.05). 1 and 1.5-2.0 years after SLIT, there were no significant differences in two groups for TNSS, TMS and sign scores (P > 0.05).@*CONCLUSION@#SLIT with Dermatophagoides farinae drops for 1.5-2.0 years is effective in the patients with allergic rhinitis of different symptom severity. And equivalent efficacy could be achieved for different symptom severity.

Study on the efficacy and safety of sublingual immunotherapy with standardized dermatophagoides farinae drops for allergic rhinitis / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To evaluate the efficacy and safety of the sublingual immunotherapy with dermatophagoides farinae drops on patients with allergic rhinitis.@*METHOD@#One hundred and twelve cases were collected from adult patients with dust-mite allergic rhinitis of our hospital who could adhere to treatment and regular follow-up. These patients were randomly allocated to receive either sublingual immunotherapy (SLIT group, n = 56) or medical treatment (Control group, n = 56). To evaluate the clinical efficacy by side effects which were registered, symptom and medication scores which were assessed and rhinoconjunctivitis quality of life questionnaire (RQLQ) which was completed in the baseline and two years after treatment.@*RESULT@#Dropouts after the 2 years' treatment were 5 of SLIT group and 4 of Control group respectively. SLIT group induced the significant reductions on both the symptom scores (7.81 ± 3.14 to 3.89 ± 2.01, P < 0.0 1) and the medication scores (2.86 ± 0.75 to 0.44 ± 0.06, P < 0.01). Meanwhile, Control group induced the reductions on both the symptom scores (8.01 ± 3.32 to 5.20 ± 2.43) and the medication scores (2.95 ± 0.80 to 1.75 ± 0.40). There were significant differences (P< 0. 01) in symptom and medication scores between the two groups after 2-year treatment. The patients in SLIT group had fewer symptoms and lower intake of medication. There were statistically significant differences in RQLQ between SLIT group [19 (15,22)] and Control group [36 (26,47)] after two years treatment (Z = -5. 21, P < 0.01). SLIT group also had significant improvement in RQLQ (Z = -6.10, P < 0.01) between before and after the treatment. There were 4 patients who showed adverse reactions in SLIT group (3 occurred in increment period, and 1 occurred in the maintenance period). The incidence of adverse reactions was 7.14%. No severe systemic side effects were registered.@*CONCLUSION@#SLIT with standardized dermatophagoides farinae drops in China is safe and effective to patients with allergic rhinitis.

Labour induction; use of sublingual misoprostol versus oxytocin in case of ruptured membranes at term

To compare the efficacy of misoprostol 50ug [sublingual] in comparison with oxytocin infusion than for induction of labour in cases of PROM [premature rupture of membrane at term]. Prospective randomized study. Mujahid Trust Hospital, Faisalabad. Duration: Conducted from Dec 2006 to April 2008. Women were randomized to receive either 50 microgram of sublingual misoprostol every 4 hours with Ringer's lactate solution or oxytocin infusion 10 lU in one litre of Lactated Ringer's solution with a sublingual placebo. Main outcome measures: The number of women delivering vaginally within 24 hours of labour induction. Fifty two women [83%] in misoprostol group and 48 [77%>] in oxytocin group delivered vaginally within 24 hours [relative risk [RR]1.1. However, the induction to vaginal delivery was significantly shorter in the misoprostol group 15+3.7 hours compared with the oxytocin group 18+4.1. The incidence of tachysystole was more than three folds higher in misoprostol than in the oxytocin group [14%] versus 4.3%] RR3.3] but this was not statistically significant. There was no significant difference in the incidence of hypertonus or hyperstimulation syndrome, mode of delivery intervention for fetal distress or neonatal outcomes between the two groups. The group of women received misoprostol for labour induction were found more successful in achieving vaginal delivery in comparatively shorter time and more acceptable to patients. Further studies on safety with large numbers of women need to be conducted before routine use

Misoprostol en dos formas de administración para la dilatación cervical en el aborto instrumentado / Misoprostol in two forms of administration for cervical dilatation in instrumented abortion

Introducción: el misoprostol es un producto extremadamente útil como fármaco abortivo, tiene un alto margen de seguridad cuando es pautado en dosis adecuadas y con una correcta supervisión médica. Objetivo: evaluar la eficacia de misoprostol, en la dilatación del cérvix en el aborto instrumentado en gestantes de hasta 9 semanas, Métodos: se realizó un estudio experimental, entre enero y diciembre de 2011, en el Hospital General Docente Iván Portuondo del municipio San Antonio de los Baños, provincia Artemisa, que compara 2 formas de administración de 400 mcg de misoprostol. El universo estuvo constituido por un total de 620 pacientes, de ellos 224 conformaron la muestra. Resultados: 113 pacientes recibieron tratamiento por vía vaginal y 111 por vía sublingual, 202 casos tuvieron una dilatación eficaz y 22 casos se comportó como no eficaz. En más de las 2/3 partes de los casos, el tiempo necesario para la interrupción fue normal, seguido por las que fue prolongado para un 16,1 por ciento y en último, las que tuvieron un tiempo quirúrgico corto, con un 11,6 por ciento. Los efectos secundarios que más se presentaron fueron la fiebre y escalofríos en el caso de la vía sublingual en más de un 50 por ciento. Conclusiones: la administración previa de 400 mcg de misoprostol en el aborto instrumentado, resulto ser más efectiva para la dilatación cervical cuando se colocó vía vaginal en contraste con la vía sublingual

Introduction: misoprostol is an extremely useful product to be used as abortive drug, it has a high margin of safety when prescribed at adequate doses and with a proper medical supervision.Objective: to evaluate the efficacy of misoprostol in the dilation of the cervix in instrumented abortion in pregnant women up to 9 weeks,Methods: it was conducted an experimental study, between January and December 2011, at Ivan Portuondo General Teaching Hospital of San Antonio de los Baños municipality, Artemisa province, which compares two forms of administration of 400 mcg of misoprostol. The universe consisted of a total of 620 patients, of which 224 formed the sample.Results: 113 patients were vaginally treated and 111 sublingually, 202 cases had an effective dilatation and 22 cases behaved ineffectively. In more than 2/3 parts of the cases, the time required for termination was normal, followed by those prolonged to 16,1 per cent and finally, those who had a short surgical time with 11,6 per cent. Side effects that occurred more frequently were fever and chills in the case of the sublingual administration over 50 per cent.Conclusions: prior administration of 400 mcg of misoprostol in instrumented abortion, proved to be more effective for cervical dilation when placed vaginally in contrast to sublingually

Fast onset of action of sublingual immunotherapy in dust mite caused allergic rhinoconjunctivitis / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate whether sublingual immunotherapy(SLIT) can take effect during the early phase in allergic rhinoconjunctivitis.@*METHOD@#Sixty subjects diagnosed as allergic rhinoconjunctivitis were enrolled and divided into the SLIT group and the control group. The daily symptom and medication scores were recorded and analyzed.@*RESULT@#After 4 weeks treatments, the daily symptoms score had significantly reduced in SLIT group(P 0.05). Whereas, the daily symptoms score and daily medication score in control group had shown changes with fluctuations. The correlation analysis had indicated that the daily medication score in the control group had a significant negative correlation with the daily symptom score (F = 554.9, P < 0.01). No serious adverse events occurred in this study.@*CONCLUSION@#SLIT could take effect in patients with allergic rhinoconjunctivitis sensitive to house dust mite as fast as the 4th week.

Long-term efficacy of sublingual immunotherapy with Dermatophagoides Farianae Drops in children with allergic asthma sensitized to dust mites / 中华儿科杂志

<p><b>OBJECTIVE</b>To observe the efficacy of sublingual immunotherapy (SLIT) in children with allergic asthma during the treatment and 1 year after the treatment.</p><p><b>METHOD</b>This is an open and retrospective study; 80 children with mild-moderate allergic asthma between 4 and 14 years of age were chosen from the Department of Respiratory Medicine, Nanjing Children's Hospital Affiliated to Nanjing Medical University from May to August, 2009. All children were sensitized to Dermatophagoides Farianae and/or Dermatophagoides Pteronyssinus and have received anti-asthma drug therapy for 3 months (baseline). Thirty-nine children in SLIT group underwent 2-year SLIT and combined with anti-asthma drug, these children were then followed up for 1 year. Forty-one children in drug group only received anti-asthma drug and were followed up for 3 years. The scores of asthma symptom, scores of asthma medication and the number of discontinuation of anti-asthma drug were compared between the SLIT group and drug group for the baseline, end of the 2nd year and 3rd year treatment. The frequency of acute attack of asthma was also compared between the two groups for 1 year before the treatment and the 3rd year treatment.</p><p><b>RESULT</b>(1) At baseline, the asthma symptom scores, the medication scores and the frequency of acute attack of asthma in 1 year before the treatment of the two groups showed no significant difference. (2) After 2-year SLIT, the daytime asthma symptom scores of SLIT group were lower than the drug group (0.18 ± 0.06,0.93 ± 0.12,Z = -4.873, P < 0.05), the night asthma symptom scores of the two groups showed no significant difference. One year after SLIT, the daytime and night asthma symptom scores of SLIT group were both lower than those of the drug group (daytime SLIT group vs. Drug group: 0.18 ± 0.06 vs. 1.46 ± 0.72,Z = -5.082, P < 0.05;night SLIT group vs. Drug group: 0.05 ± 0.04 vs. 0.66 ± 0.14,Z = -4.019, P < 0.05). (3) At the end of SLIT and 1 year after SLIT, the medication scores of SLIT group were both lower than those of the drug group (End of SLIT SLIT group vs. Drug group: 0.31 ± 0.07 vs. 0.75 ± 0.12,Z = -2.813, P < 0.05;1 year after SLIT SLIT group vs. Drug group: 0.17 ± 0.06 vs. 0.87 ± 0.17,Z = -4.106, P < 0.05), the number of discontinuation of anti-asthma drug of SLIT group were both more than the drug group (End of SLIT SLIT group vs. Drug group: 20 vs. 10,χ(2) = 6.167, P < 0.05;1 year after SLIT SLIT group vs. Drug group: 29 vs.13,χ(2) = 14.581, P < 0.05).(4) In the 3rd year, the frequency of acute attack of asthma in SLIT group was significantly lower than that of drug group (0.69 ± 1.20, 1.20 ± 1.44,Z = -1.968, P < 0.05) .</p><p><b>CONCLUSION</b>SLIT can significantly improve the symptoms of asthma, reduce the use of anti-asthma drug and reduce the frequency of the acute attack of asthma. Meanwhile, the efficacy could still maintain 1 year after the SLIT treatment.</p>