Hypersensitivity reactions from inhalation of milk proteins.

We describe the case of a young man with IGE-mediated hypersensitivity to milk, casein, and lactoglobulin, who went into respiratory crisis every time he milked his sheep.

Nedocromil sodium and astemizole, alone or combined, in the treatment of seasonal allergic conjunctivitis. A multicentre double blind clinical trial.

Two hundred and seven patients with active symptoms of allergic conjunctivitis were studied in a four-week multicentre double blind, double dummy, clinical trial comparing efficacy and safety of nedocromil sodium eye drops with oral astemizole, placebo, and the combined active treatments. Clinical signs were evaluated by clinicians after 1, 2 and 4 weeks, while symptoms were recorded by patients on daily diary cards. Overall opinions were recorded at the end of treatment. Nedocromil sodium eye drops and astemizole, alone or combined, significantly reduced ocular symptoms when compared to placebo (diary card total symptom score and patients' opinion). In the clinicians' opinion nedocromil sodium alone or combined (but not astemizole alone) significantly decreased ocular symptoms when compared to placebo. All treatments were safe and well tolerated, drowsiness being the most frequent side effect observed in patients treated with astemizole. These results indicate the effectiveness of nedocromil sodium eye drops in the treatment of seasonal allergic conjunctivitis.

First dose and steady state pharmacokinetics of nimesulide and its 4-hydroxy metabolite in healthy volunteers.

The pharmacokinetics of nimesulide (4-nitro-2-phenoxymethane-sulfonanilide, NMS), a non-steroidal antiinflammatory drug, and of its 4-hydroxy metabolite (4-nitro-2-(4'-hydroxy-phenoxy)-methane sulfonanilide, OH-NMS) was studied after a single oral dose (200 mg) and after repeated treatments (100 mg every 12 hours for 7 days) of NMS to two groups of 12 healthy volunteers. Plasma concentrations of NMS and OH-NMS were followed for 48 hours after the single dose and up to the 12th hour on the 1st day and on the 7th day during repeated treatment. After the single dose of 200 mg peak plasma concentrations of the drug (9.85 micrograms/ml) were reached at 3.17 hours and the half-life during the elimination phase was 4.95 hours. The metabolite reached highest plasma levels (3.03 micrograms/ml) at 5.33 hours and its apparent half-life was similar to that of the parent drug (4.78 hours). NMS plasma levels on the 7th day, predicted from the results of the 1st day, were similar to the measured values. The pharmacokinetics of NMS or OH-NMS after single or repeated dose was not time or dose dependent.

Clinical study on pharmacological interaction between nimesulide and warfarin.

This article describes the pharmacological interaction between nimesulide, a recently introduced non-steroidal anti-inflammatory drug, and warfarin, an indirect anticoagulant. The aim of the study was to demonstrate if nimesulide could potentiate the activity of this anticoagulant drug, as previously shown by some authors. Ten patients, who were taking 5 mg/day of warfarin, were treated with nimesulide 100 mg twice a day, for seven days: the association of the two drugs did not alter, in a statistical way, neither prothrombin time, nor partial thromboplastin time, nor fibrinogenemia, nor bleeding time. The findings showed that, in a short-term treatment, there was no bleeding risk in combining warfarin with nimesulide.

[The nimesulide treatment of inflammation and posttraumatic pain in maxillofacial surgery. A controlled study versus flurbiprofen]. / Trattamento con nimesulide della flogosi e del dolore post-traumatico in chirurgia maxillo-facciale. Studio controllato verso flurbiprofen.

Nimesulide has been employed in maxillofacial surgery so as to assess the drug's anti-pain and anti-inflammatory properties. The study was carried out in double blind controlled form, using flurbiprofen as a reference: both medications were administered in suppository form at a fixed dose of two per day, corresponding to 400 mg/die of nimesulide and 200 mg/die of flurbiprofen. Forty adult patients were entered into the experiment and they were assigned to one or other preparation at random until two groups of twenty units each had been formed. Duration of the treatment was just a little more than six days on average and at the end it was possible to conclude that the two therapies were useful in the whole constellation of parameters considered but with some diversification: nimesulide in fact showed an ability to resolve the inflammatory process more readily and consistently than the reference, a tendency that was also confirmed statistically. Tolerability of nimesulide was perfect. There was one episode of diarrhoea with the reference.

Volume receptors in guinea pig labyrinth: relevance with respect to ADH and Na control.

We tested the hypothesis that changes in extracellular fluid volume are reflected by pressure changes within structures of the inner ear and that through neural pathways, a control mechanism exerts an influence on antidiuretic hormone (ADH) release and Na excretion. The study was performed on 35 guinea pigs. In protocol 1, 13 animals were studied before and after decompression of the inner ear by bilateral fluid withdrawal in an experimental setting of sustained isotonic expansion that kept the osmoreceptor partially activated and the intrathoracic volume receptors suppressed. A group of six sham-operated animals served as control. In protocol 2, nine animals were studied before and after a unilateral rise in their inner ear pressure during slightly hypertonic low-rate infusions that kept the osmoreceptor and thoracic volume receptors stimulated. A group of seven sham-operated guinea pigs served as controls. Decompression of the inner ear was attended by a rise in plasma ADH from 11.9 +/- 2.4 to 29.1 +/- 6.9 pg/ml, in urine osmolality (Uosmol) from 470 +/- 48 to 712 +/- 46 mosmol/kg (P less than 0.001), and a fall in urine flow rate (V) from 184 +/- 47 to 71 +/- 11 microliters/min (P less than 0.01), whereas plasma Na (PNa) and osmolality (Posmol) did not change. During inner ear hypertension, plasma ADH fell from 25.6 +/- 3.9 to 18.4 +/- 3.1, Uosmol from 829 +/- 58 to 627 +/- 43 (P less than 0.001), and V rose from 51 +/- 11 to 130 +/- 23 (P less than 0.001), whereas glomerular filtration rate, PNa, and Posmol did not change.(ABSTRACT TRUNCATED AT 250 WORDS)

Specific immunotherapy with allergoids in atopic subjects, hyporeactive to other vaccines.

Allergoids comply with the therapeutic requirement to reach high doses of the injected allergen, since the modifications of the allergens cause a loss of allergenicity, though the immunogenicity is being retained. Considering that it is possible to use a starting dose 40 times higher in comparison with retard vaccines, we thought it very expedient to treat with allergoids 18 patients allergic to parietaria, and 12 patients allergic to grass pollen, who had shown no clinical improvement after immunotherapy, lasting for at least three years with retard vaccines. The therapeutic results obtained are the following: improvement in 66% of the parietaria allergic patients after the first year, and of the 72% in the second year, of the 75% of the grass pollen allergic patients after the first year and of the 83% in the second year. They can be interpreted as due to the fact that such patients are always poorly reactive to the doses of allergens commonly present in retard vaccines. On the contrary, they do react to allergoids, both due to the high amount of allergen administered, and to the fact that polymerization brings about a stronger epitopic expression matched by a higher immunogenic activity. Moreover, the data are also indicative for a good relationship between the antibody titer of antigen-specific blocking IgG and the clinical effectiveness valued by means of symptom and medication scores.

[Pollinosis caused by Parietaria. Clinical observations in Northern Sardinia and botanical and allergic considerations on P. officinalis L. and P. judaica L. (P. diffusa Mert. and Koch)]. / La pollinosi da Parietaria. Osservazioni cliniche nel Nord Sardegna, e considerazioni botaniche e allergologiche su P. officinalis L. e P. judaica L. (= P. diffusa mert. et Koch).

Botanical and allergological relations between two Parietaria species with greater pollinosic incidence, P. officinalis and P. judaica-P. diffusa, are examined: taxonomic and morphological aspects are discussed, and a key for their determination is proposed. Results of clinical-allergological survey on pollinosic subjects in North Sardinia during several years by means of Prick or Scratch Test are now presented. Diagnostic assays have been effected with extracts found on the market while the therapy has been carried out with extracts of "allergoids" and "modified" type, as well as with extracts of P. judaica. Cross-reactivity between P. officinalis and P. judaica has been evidenced, and greater therapeutic efficacy has been observed by employing "purified" and "modified" vaccines.

[Research on a new allergenic extract adsorbed on L-tyrosine. Pharmacological and immunotherapeutic findings]. / Ricerche su un nuovo estratto allergenico adsorbito su L-tirosina. Indagini farmacologiche ed immunoterapiche.

Antigen-specific immunotherapy, whose usefulness has been widely and objectively documented in the last few years, and whose therapeutic effectiveness depends on the administration of high doses of antigen, exploits the use of retard allergenic extracts which turn out to be more tolerated, and liable to a lower occurrence of side-effects. The Authors describe the results obtained with pollinosis vaccine adsorbed on L-tyrosine and employed on 206 patients with seasonal allergic conditions. Pharmacological experiments were performed on these vaccines, to establish their general tolerability (on mice and guinea-pigs), their local tolerability and the prolonged tolerability on rats. The results of the pharmacological experiments show that the vaccine does not cause any side-effects or toxic phenomena, that the growth curve of the animals treated is superposable to that of the controls, and that the product is perfectly absorbed without irritation or phlogosis of the peripheral tissues. As far as the clinical data are concerned a high percentage of cases (56.6%) classified as "optimal" were observed, while only a low percentage (4.54%) showed results classified as "null". Concerning the occurrence and the frequency of side-effects we should like to point out that only in one of the 206 cases tested (0.48%) was there local itching. These data are particularly significant, when compared with the side effects registered during immunotherapy with the aqueous vaccines.