Omalizumab treats chronic rhinosinusitis with nasal polyps and asthma together-a real life study.

INTRODUCTION: Chronic rhinosinusitis with nasal polyps (CRSwNP) and asthma often coexist and thus treating both with one intervention is an attractive strategy. OBJECTIVE: To prospectively evaluate whether treatment with the monoclonal antibody against IgE Omalizumab for severe allergic asthma also effectively treats co-existent CRSwNP. METHODS: SNOT-22 and the ACQ-7 scores were recorded at 4 and 16 weeks of treatment in a cohort of patients with both CRSwNP and severe refractory allergic asthma treated with Omalizumab (n=13) according to UK guidelines for their severe asthma. SNOT-22 in a surgery only treated CRSwNP with asthma group (n=24) was compared. RESULTS: Rapid improvement was seen at 4 weeks and 16 weeks of treatment in both CRSwNP and asthma control. The improvement in CRSwNP with Omalizumab was similar to that seen in a group of patients who received upper airway surgery. CONCLUSION: Omalizumab treatment for severe allergic asthma also improves co-existent CRSwNP. Further clinical studies of current and emerging biological agents for severe asthma should include upper airway outcomes. These agents may be effective for severe CRSwNP and comparative studies with surgery are warranted.

A modification of the thiobarbituric acid reaction.

A simple modification of the thiobarbituric acid reaction, which removes nonspecific chromogenic reaction products, involves incubation at room temperature for 16-20 hr and a column chromatographic step. The chromogen-concentrating capacity of the latter step is useful for determination of low concentrations of thiobarbituric acid-reactive materials in biological preparations.

Perfect pitch.

Thirty-five subjects with perfect pitch, representing 19 families, were studied with a Perfect Pitch Questionnaire, which provided information on note-recognition capacity and musical exposure and training, as well as demographic characteristics. Perfect pitch was found to predominate in females and was detected at a very early age. The significant family incidence of the trait suggests the operation of genetic mechanisms concerning which speculations are presented.

Clorazepate use may prevent alcohol withdrawal convulsions.

Clorazepate dipotassium was administered orally for the five-day prophylactic treatment of potential, incipient and overt withdrawal signs and symptoms in 226 patients on admission to an inpatient alcohol treatment unit. Conservative estimates based on these patients' histories and on literature reports predicted that between 7 and 40 (3% to 18%) of these persons would be expected to have a withdrawal convulsion. No patients experienced convulsions. This complete absence of seizures suggests that clorazepate is effective in counteracting convulsive and other manifestations of the alcohol withdrawal syndrome.

L-tryptophan as a hypnotic in special patients.

The authors briefly review prevalence and current treatment trends of sleep disorders in the elderly, underlining the need for the development of a more suitable hypnotic for this population. The use of L-tryptophan (LT) as a physiologic hypnotic in aged responders is considered and the hypnotic effect of 1- to 4-g bedtime doses on ten male inpatients and outpatients aged 30 to 72 years is evaluated. Results suggest a dramatic and sustained relief of insomnia for 3 weeks in 30 per cent of the patients and the absence of side effects in 90 per cent of those who took the agent. The authors conclude that despite its long therapeutic history, L-tryptophan has not been more successful because only a minority of humans appear to be responsive to its hypnotic actions. They point to the need to replicate their current preliminary observations in a larger controlled geriatric population and to delineate biochemical characteristics of LT responders in order to increase LT sensitivity in some patients and convert nonresponders to responders.

Successful treatment of endogenous depression with alprazolam in a patient with recent cardiac disease: case report.

Alprazolam, a triazolobenzodiazepine, was successfully used to treat a patient with recent cardiac disease who presented with DST-positive endogenous depression. The relative absence of cardiotoxic effects warrants the consideration of this medication in cardiac patients with concurrent anxiety and/or depression.

Malondialdehyde production by erythrocytes from alcoholic and non-alcoholic subjects.

A survey of the capacity of erythrocyte suspensions to handle a standard hydrogen peroxide oxidative load was made in a population of white male hospitalized alcoholics and non-hospitalized, non-alcoholic subjects. As measured by malondialdehyde (MDA) production, the capacity to handle this oxidation load was decreased in a significant percentage of individuals with a positive family history of alcoholism and who have experienced problems with alcohol sufficient to produce cytopathological changes and to require hospitalization.

Identification of harman in the rat arcuate nucleus.

This communication describes the presence of 1-methyl-beta-carboline (harman) in the hypophysiotropic area of the hypothalamus which incorporates the arcuate nucleus. Diethyl ether extracts of borate-buffered arcuate homogenates were subjected to silica column chromatography and thin-layer chromatography (TLC). Identification of the beta-carboline was accomplished by use of fluorescent spectrometry, gas chromatography (GC), mass spectrometry (MS) and combined gas chromatography-mass spectrometry (GC-MS).