Abnormal intraocular pressure control in systemic hypertension and diabetic mellitus.

Retinal vein obstruction is a common complication of the retinopathy seen in patients with chronic hypertension. Previous studies have shown an abnormal control of intraocular pressure in response to changes of posture in patients with retinal vein obstruction. This paper describes the results of the investigation of the intraocular pressure response in 57 normotensive healthy adults and in 95 hypertensive patients, with a short study of 14 diabetic patients. Both hypertensive and diabetic groups showed abnormal responses. The possible significance of these findings as the expression of a fundamental anomaly by patients who develop either hypertension or diabetes is discussed.

Effects of pseudoephedrine and triprolidine, alone and in combination, on symptoms of the common cold.

A total of 466 healthy adults from four different regions of England entered a double-blind, randomised trial to test the effectiveness of an antihistamine (triprolidine) and a decongestant (pseudoephedrine), alone or in combination, in relieving symptoms of the common cold. During the study 199 subjects reported a total of 243 colds. Subjects recorded the severity of 12 symptoms during treatment and noted separately the severity of a further seven symptoms that represented unwanted effects of treatment or served as an index of suggestibility. They were then asked about their overall improvement in symptoms during treatment and whether they thought they had taken placebo. Sneezing, nasal obstruction, and overall response to treatment were significantly improved (p <0.01) with psuedoephedrine or pseudoephedrine and triprolidine compared with placebo.

Dose-response study of the nasal decongestant and cardiovascular effects of pseudoephedrine.

1 The effects of different doses of orally administered pseudoephedrine on nasal airway resistance (NAR) were studied in a group of eighteen healthy subjects using double-blind conditions with drugs administered in a series of cross-over experiments according to a Latin-square design. 2 Challenge with 1% histamine diphosphate to one nostril 1 h after administration of the drugs produced increases in NAR. 3 The effects of pre-treatment with both placebo and increasing doses of pseudoephedrine on this histamine-induced increase in NAR were examined. Pseudoephedrine 60 mg, 120 mg and 180 mg significantly (P less than 0.05) reduced the effect of histamine on NAR compared with the placebo, and the protective effects of these doses did not differ significantly from each other. Pseudoephedrine 15 mg and 30 mg did not differ from placebo in their effects on NAR. 4 Small, but statistically significant increases in pulse and systolic blood pressure occurred after pseudoephedrine 120 mg and 180 mg, but not after pseudoephedrine 60 mg, 30 mg or 15 mg. No significant effects were produced by any of the doses of pseudephedrine with regard to diastolic blood pressure. Similarly no dose of pseudoephedrine altered mood or produced any excess of unwanted effects compared with placebo. 5 We conclude that pseudoephedrine 60 mg is the optimal single adult dose since this achieves maximal nasal decongestion without cardiovascular or other unwanted effects.

Comparison of antibody responses and virus shedding following administration of trivalent oral poliomyelitis vaccines prepared either in monkey or human diploid cell substrates.

Nineteen (22.9%) of 83 sera collected before vaccination from adult volunteers aged 21-64 years were without neutralizing antibody to poliomyelitis at levels of 0.15 i.u./ml for types I and II and 0.1 i.u./ml for type III. Some correlations were found between the history of previous vaccination and the presence of antibody but these were not well defined. Vaccination with a single dose of trivalent oral polio vaccine elicited fourfold or greater antibody responses to one or more poliomyelitis types in 53 (63.9%) volunteers, the percentage antibody resposnes being inversely related to the titre of antibody present before vaccination. Types I, II or III poliomyelitis virus were recovered from 76.8% of faecal samples collected 1 week after vaccination. The percentage recovery progressively declined thereafter until virus was recovered from 10.5% of samples collected 6 weeks after vaccination. Type for type, the titres and percentages of antibody responses and virus shedding in faeces were similar following trivalent oral poliomyelitis vaccines whether prepared in monkey or human diploid cell substrates. Some change in reproductive capacity temperature (r.c.t./40) marker was found in faecal isolates from volunteers vaccinated with monkey kidney and human diploid grown vaccines but no change in 'd' marker was found.

Antibody responses to vaccination with WRL 105 strain live influenza vaccine in previously vaccinated and unvaccinated volunteers.

Intranasal vaccination with a single 0.5 ml dose of 10(7.0) EID 50 WRL 105 strain live influenza vaccine elicited four-fold or greater increases in circulating homotypic haemagglutinating inhibiting (HAI) antibody in 60 (64.5%) of 93 volunteers, or in 58 (74.4%) of 78 volunteers with HAI antibody titres before vaccination of less than or equal to 1/20. In comparison, in a group of volunteers vaccinated 9 months previously re-vaccination elicited antibody responses in only 4 (6.9%) of 58 volunteers, or in 3 (14.3%) of 21 volunteers with antibody titres before vaccination of less than or equal to 1/20. Titres of vaccine-induced antibody and antibody resulting from earlier natural infection appeared to fall slowly and at equivalent rates over a 9 month period.

WRL 105 strain live attenuated influenza vaccine; comparison of one and two dose schedules.

Haemagglutinating inhibiting antibody (HAI) responses were determined and clinical reactions recorded in 162 adult volunteers who received either 1 or 2 intranasal doses of 10(7-0) EID50 WRL 105 strain live influenza vaccine or placebo. After administration of a single dose of vaccine significant antibody responses were obtained in 69 (70%) of 98 volunteers with initial antibody titres of less than or equal to 1/20. Of the 70 volunteers who received a second dose of vaccine, 62 provided a further post-vaccination sample of serum, and only 3 (4-8%), who had not responded to the first dose of vaccine, produced a significant antibody response. Local, upper respiratory and constitutional symptoms were recorded more frequently after the administration of a first dose of vaccine than after placebo or a second dose of vaccine. The symptoms were of a minor nature except in one volunteer who, after the first dose of vaccine, developed influenzal symptoms followed by bronchitis.

A clinical trial of WRL 105 strain live attenuated influenza vaccine comparing four methods of intranasal vaccination.

A single intranasal dose of 10(7-0) EID50 recombinant WRL 105 strain live attenuated influenza vaccine was administered intranasally to 193 volunteers either as nose drops or by one of three spray devices which produced sprays of differing physical characteristics. In volunteers with homologous haemagglutinating inhibiting antibody titres of less than or equal to 20 before vaccination, seroconversion rates varied widely from 80% following the administration of drops to 71%, 57% and 28% with the three spray devices. In the week following vaccination 16 (22%) of 74 volunteers who were found to show a fourfold or greater antibody response to took analgesics to control symptoms in comparison with 4 (7%) of 58 volunteers who exhibited no serological response to vaccination (P less than 0-05). However, neither the occurrence of upper respiratory nor systemic symptoms were significantly different in these two groups and the degree of attenuation of the recombinant WRL 105 strain appears to be acceptable for future use.

A clinical trial of WRL 105 strain live attenuated influenza vaccine comparing four methods of intranasal vaccination.

A single intranasal dose of 10(7.0)EID50 recombinant WRL 105 strain live attenuated influenza vaccine was administered intranasally to 193 volunteers either as nose drops or by one of three spray devices which produced sprays of differing physical characteristics. In volunteers with homologous hemagglutinating inhibiting antibody titres of less than or equal to 20 before vaccination, seroconversion rates varied widely from 80% following the administration of drops to 71%, 57% and 28% with each of the spray devices. In the week following vaccination 16 (22%) of 74 volunteers who were found to show a fourfold or greater antibody response took analgesics to control symptoms in comparison with 4 (7%) of 58 volunteers who exhibited no serological response to vaccination (p less than 0.05). However, neither of the occurrence of upper respiratory nor systemic symptoms were significantly different in these two groups and the level of attenuation of the recombinant WRL 105 strain appears to be acceptable for future use.

The effect of co-trimoxazole on antitoxin response to tetanus toxoid.

The effect of a 4-day course of co-trimoxazole (Septrin) on antitoxin response to tetanus vaccine was assessed in a double-blind study involving 22 healthy adults. The tetanus antitoxin levels were measured by in vivo and in vitro methods for up to 8 weeks after the first of two injections of tetanus vaccine, given 4 weeks apart. No sigificant difference was observed in the level of tetanus antitoxin produced in subjects who received co-trimoxazole (Septrin) in recommended therapeutic dosage during the first 4 days of the trial from that in subjects who received placebo tablets. The results indicate that a 4-day course of co-trimoxazole (Septrin) does not affect antibody production.