The value of Ems Mineral Salts in the treatment of rhinosinusitis in children. Prospective study on the efficacy of mineral salts versus xylometazoline in the topical nasal treatment of children.

UNLABELLED: The treatment of rhinosinusitis seen in the light of uncertain pathogenesis and variable symptoms is under discussion and ranges from the administration of antibiotics, decongestants and anti-allergic agents to no treatment. In this randomized, prospective, double-blind and controlled study the effect of a 14-day treatment (1-2 sprays into each nostril t.d.) with either isotonic Ems Mineral Salts (EMS) solution (Siemens & Co., Bad Ems, Germany) or xylometazoline solution (0.05%) was tested in children (n=66) aged 2-6 years. MAIN OUTCOMES: the degree of mucosal inflammation, nasal patency, general state of health, condition of the middle ear, auditory function as well as an assessment of complaints by the parents. With the exception of the hearing defects, all parameters showed a clear improvement in both treatment groups at the end of the observation period (p>0.001). The hearing defects showed only a trend towards improvement. At the end of the study no differences between the treatment groups could be determined. However, at the intermediate examination after the first 7 days of treatment more favourable results were seen in the group treated with EMS. No undesired medicinal effects were observed, although in 7 out of 34 cases the nasal spray was improperly used in the group treated with xylometazoline. The results of the study show that there is no difference in efficacy between an exclusive treatment by EMS solution in children aged 2-6 years and a treatment with xylometazoline, but with the distinction that with EMS the length of use was not restricted, there were not the potential side effects of nasal decongestants, and there was no contraindication in the newborn and infants.

Seroepidemiological correlations of antibodies to human herpesviruses and human immunodeficiency virus type 1 in African patients.

A seroepidemiological evaluation of the humoral immune response against human herpes viruses was carried out in patients with and without HIV infection in Tanzania to study the role of these viruses as a cofactor in AIDS. Serum specimens were obtained from 321 outpatients and 100 healthy schoolchildren of a rural population in the Kagera Region, Tanzania, and from 149 inpatients of an urban population in Dar-es-Salaam, Tanzania. The data were analysed by logistic models taking into account demographic variables. The data obtained revealed no differences in the prevalence of antibodies to human herpes viruses between the different groups. Therefore, our study under the present conditions and the observed stages of AIDS does not suggest an influence of HIV infection on human herpesvirus infection or serologic response.

PIP: In Tanzania, researchers analyzed serum data on 321 15-62 year old outpatients at a rural hospital and 100 healthy 8-14 year old schoolchildren in Kagera Region (1986), on 120 inpatients of the Muhimbili Medical Center (MMC) in Dar-es-Salaam (1988), and on 29 inpatients from Ocean Road Hospital (ORH) also in Dar-es-Salaam (1989) to determine the prevalence and titers of antibodies to various herpes viruses and their relation to HIV-1. 43% of the adults from Kagera tested positive for HIV-1 compared with 63% from MMC and 72% from ORH. None of the children were HIV-1 seropositive. Almost everyone tested positive for Epstein-Barr virus (EBV) (93-99%). All those at ORH also had antibodies for herpes virus 6 (HHV-6) while the other groups all had HHV-6 seroprevalence levels 50%. Even though there were differences in antibody prevalences and titers for some EBV antigens between HIV-1 seropositive and HIV-1 seronegative adults, they were not significant. Seroprevalences for HHV-6 and EBV also infected with HIV-1 regardless if they were symptomatic or asymptomatic were not considerably higher than those in HIV-1 seronegative patients. This remained true for all 3 adult groups irrespective of the various percentages of HHV-6 seropositive patients. These results did not demonstrate HIV-1 infection as affecting human herpes virus infections or serologic responses. Therefore these viruses appeared not to be a cofactor in AIDS.