Increased Prevalence of Polyneuropathy in Parkinson's Disease Patients: An Observational Study.

BACKGROUND: The independent contribution of levodopa exposure and Parkinson's disease (PD) to the risk of polyneuropathy is not established. OBJECTIVE: This study investigated whether patients with newly diagnosed PD without previous exposure to antiparkinsonian drugs have higher prevalence of polyneuropathy than the general population. METHODS: Using the UK General Practice Research Database, presence of polyneuropathy in the previous 3 years was assessed. RESULTS: Of 5089 PD patients and 19,897 controls, polyneuropathy was confirmed in 15 PD patients (0.29% ) and 24 controls (0.12% ). Polyneuropathy prevalence was 2.4-fold higher in PD patients than controls. CONCLUSIONS: In this observational study, PD patients had a higher prevalence of preexisting polyneuropathy that cannot be explained by adverse effects of antiparkinsonian drugs.

Untreated chronic rhinosinusitis: a comparison of symptoms and mediator profiles.

OBJECTIVES/HYPOTHESIS: Since the early 1990s, the knowledge of inflammatory mediators involved in chronic rhinosinusitis has increased extensively. However, until the present no data on trends in mediator levels in the natural course of the exacerbation-free interval of chronic rhinosinusitis have been published. The purpose of the study was to examine how levels of inflammatory mediators and clinical findings in chronic rhinosinusitis relate over time in the absence of acute exacerbation. STUDY DESIGN: Prospective study. METHODS: The authors investigated 12 untreated patients with chronic rhinosinusitis and repeated clinical examinations and measurements of inflammatory mediators in the nasal mucosa (messenger RNA [mRNA]of interleukin-1beta; interleukins 3, 5, 6, and 8 [IL-3, IL-5, IL-6, and IL-8]; interferon gamma; tumor necrosis factor-alpha [TNF-alpha]; monocyte chemotactic proteins 1, 3, and 4 [MCP-1, MCP-3, and MCP-4]; and granulocyte-macrophage colony-stimulating factor [GM-CSF]), as well as measurements of peptido-leukotriene [PLT] and prostaglandin E2 [PGE2]) in nasal secretion over a period of 4 weeks. RESULTS: Clinically speaking, the symptom score significantly improved over the period of 4 weeks, whereas other clinical parameters (computed tomography score, endoscopy score, rhinomanometric values, saccharine transport time, ciliary beat frequency, and olfaction) varied insignificantly. Regarding proinflammatory and inflammatory mediators, only mRNA of IL-1beta, IL-6, IL-8, MCP-1, and TNF-alpha were detected in relevant amounts in nasal mucosa, and their levels decreased only insignificantly over the 4-week period. In nasal secretion, a slight decrease of PGE2 and PLT levels was observed over the same time period. CONCLUSION: Subjective symptoms may show a spontaneous improvement of approximately 25% in patients with so-called "stable" chronic rhinosinusitis over a 4-week period, whereas objective clinical parameters vary insignificantly. Messenger RNA of IL-1beta, IL-6, IL-8, MCP-1, and TNF-alpha, as well as PLT and PGE2 levels, are detectable and appear to play a role in the persistence of inflammation in chronic rhinosinusitis. Their levels decrease only insignificantly over time, even in the absence of acute exacerbation of disease, possibly rendering the mucosa more prone to recurrent acute episodes.

Surveillance study of Sinupret in comparison with data of the Mainz birth registry.

In about 80% of all pregnant women medical drugs are used during pregnancy. Phytomedicines play an important role in self- and prescribed medication. Since the thalidomide tragedy teratogenic effects of medicamentous treatment are well known. Only a few investigations and studies on the tolerability and safety of plant-based medicines in pregnancy have been published. From 1992-1997 a nationwide retrospective surveillance study of 762 pregnant women (786 newborns) was conducted to evaluate the safety of the herbal combination preparation Sinupret during pregnancy. Standardized questionnaires were used for retrospective and systematic examination of all pregnancies. All cases were treated with Sinupret for at least 24 hours. The data of the population-based Mainz birth registry were used for comparison, interpretation and evaluation of the Sinupret study. For infants with birth defects and/or clinically abnormal pregnancies single-case-analyses were performed. The study collective was representative for Germany. 13 single-case-analyses were performed. In three cases the pregnancy ended with an abortion and in one case with an intrauterine death of the fetus. Nine newborns (1.1%) were diagnosed with major malformations. The critical evaluation of the collective and the individual cases yielded no evidence of possible teratogenic and/or embryotoxic effects of the phytomedicine in 11 out of 13 cases. In the remaining two cases a causal relationship is theoretically possible but very unlikely. On the whole the study underlines the value of the pediatric epidemiologic research in malformations of the Mainz birth register for the monitoring, assessment and evaluation of pharmaceutical studies on drug safety during pregnancy.