Comparative efficacy of terfenadine, loratadine, and astemizole in perennial allergic rhinitis.

Nonsedating H1 antihistamines such as terfenadine, loratadine, and astemizole are widely prescribed for the treatment of allergic rhinitis. The comparative efficacy of these agents has not been thoroughly studied. We studied 14 subjects in an open-label four-way crossover trial. Patients were recruited from an outpatient allergy clinic. Inclusion criteria were documented rhinitis symptoms for at least 2 years before the study and skin-test positivity in response to perennial allergens. Each subject underwent sequential 2-week trials of each of four H1 antihistamines: terfenadine, loratadine, astemizole, and chlorpheniramine. No placebo was included. Outcome measures were subjective rhinitis symptom scores, overall efficacy scores, and concomitant pseudoephedrine use. In addition, nasal-examination scores were obtained by way of physician assessment at the end of each 2-week trial, and side effects were tabulated. Nasal-examination scores for each of the four H1 antihistamines were significantly better than the baseline scores (p < 0.05). No statistically significant differences in rhinitis symptom scores, overall efficacy scores, or concomitant pseudoephedrine use were noted. We detected no clinically significant differences in efficacy among terfenadine, loratadine, astemizole, and chlorpheniramine in the treatment of perennial allergic rhinitis.

Effects of prior strength exercise on the heart rate oxygen uptake relationship during submaximal exercise.

Fourteen young males (mean age 26.7 yrs) were tested to determine if there was an alteration, in the heart rate-oxygen uptake relationship during submaximal cycle ergometer exercise following isokinetic strength training activity as has been documented following high intensity endurance activity. Results indicated that there was a significant increase rate without a concomitant increase in heart oxygen uptake during the first five minutes of submaximal cycle riding at 73% VO2max after heavy strength leg exercise, angular velocity of 30 degrees/second, when compared to no prior exercise. This alteration in the heart rate-oxygen uptake relation is not apparent by 20 minutes of the same submaximal exercise despite higher lactate values and greater ratings of perceived exertion. For individuals using heart rate as a guide to exercise intensity, the elevated heart rate at five minutes of submaximal exercise following heavy strength leg exercise does not exceed the 20 minute value which is an accurate reflection of energy cost and intensity.

Laboratory induction and clinical occurrence of combined clindamycin and erythromycin resistance in Corynebacterium acnes.

Corynebacterium acnes strains cross-resistant to clindamycin and erythromycin were observed following long-term selection or mutagenic treatment in the laboratory. Similar strains were found among clinical isolates from patients using clindamycin or erythromycin topically in the treatment of acne vulgaris. Clindamycin resistance was never observed in the absence of resistance to macrolides or other lincosaminides. It is suggested that this resistance may result from an alteration of the 50S ribosomal subunit.