Significant Reduction In Symptom Scores Research Articles

T1307 Treatment of Diarrhea-Predominant Irritable Bowel Syndrome with mesalazine and/or Saccharomyces Boulardii

Context - Irritable bowel syndrome (IBS) is a functional bowel disease characterized by abdominal pain and altered in- testinal habits. The pathophysiology of IBS remains unclear. Recent studies have demonstrated that some IBS patients, especially in diarrhea-predominant IBS (IBS-D), display persistent signs of minor mucosal inflammation and a modified intestinal microflora. The mesalazine has known intestinal anti-inflammatory properties. Saccharomyces boulardii is a probiotic used for a long time in treatment of diarrhea, including infectious diarrhea. Objective - Evaluate the effects of mesalazine alone, combined therapy of me- salazine with liophylised Saccharomyces boulardii or alone on symptoms of IBS-D patients. Methods - Based on Rome III criteria, 53 IBS-D patients (18 year or more) were included. To exclude organic diseases all patients underwent colonoscopy, stool culture, serum anti-endomisium antibody, lactose tolerance test and ova and parasite exam. Patients were divided in three groups: mesalazine group (MG) - 20 patients received mesalazine 800 mg t.i.d. for 30 days; mesalazine and Saccharomyces boulardii group (MSbG) - 21 patients received mesalazine 800 mg t.i.d. and Saccharomyces boulardii 200 mg t.i.d. for 30 days and; Saccharomyces boulardii group (SbG) - 12 patients received Sb 200 mg t.i.d. for 30 days. Drugs that might have any effect on intestinal motility or secretion were not allowed. Symptom evaluations at baseline and after treatment were performed by means of a 4-point likert scale including: stool frequency, stool form and consistency (Bristol scale), abdominal pain and distension. Paired t test and Kruskal-Wallis test were used for statistical analyses. Results - Compared to baseline, there were statistically significant reduction of symptom score after 30 th day therapy in all three groups: MG (P<0.0001); MSbG (P<0.0001) and in SbG (P = 0.003). There were statistically significant differ - ences in the symptom score at 30 th day therapy of the MG, MSbG and SbG groups (P = 0.03). There were no statistical differences between MSbG and MG symptom score at 30th day therapy (P = 0.9). Conclusions - The use of mesalazine alone, Saccharomyces boulardii alone or combined treatment with mesalasine and Saccaromyces boulardii improved IBS-D symptoms. The improvement of the symptom score was greater with mesalazine alone or combined with Sb as compared with Sb treatment alone. These preliminary results suggest that mezalazine may be useful in treatment of IBS-d patients, and warrant further larger studies. HEADINGS - Irritable bowel syndrome. Diarrhea. Mesalamine. Saccharomyces boulardii.

Clinical Efficacy and Safety of Sublingual Immunotherapy With Tree Pollen Extract in Children

Valovirta E, Jacobsen L, Ljørring C, Koivikko A, Savolainen J. Allergy. 2006;61:1177–1183 PURPOSE OF THE STUDY. To investigate the clinical efficacy, safety, and dose-response relationship of sublingual immunotherapy (SLIT) in children suffering from rhinoconjunctivitis with or without asthma. STUDY POPULATION. Eighty-eight children (aged 5–15 years) in Finland with a history of tree-pollen–induced allergic rhinoconjunctivitis with or without seasonal asthma. Skin-prick test, specific immunoglobulin E, and conjunctival provocation test were used to confirm allergy to tree pollen. METHODS. Randomized, double-blind, placebo-controlled dose-response study using a glycerinated mixture of pollen from birch, hazel, and alder trees. Three groups receiving SLIT 5 days per week for up to 18 months were given an accumulated weekly dose of 24 000 U (dose group 1), an accumulated weekly dose of 200 000 U (dose group 2), or placebo. RESULTS. In the birch-pollen season, dose group 2 showed a significant reduction in both symptom (P = .01) and medication (P = .04) scores compared with those in the placebo group, but dose group 1 showed only a significant reduction of symptom scores (P = .03). No serious adverse events were reported. Oral local reactions were the most common adverse effect, ranging from 25% of patients in the placebo group to 50% in group 2. CONCLUSIONS. SLIT with tree-pollen extract provided dose-dependent benefits in tree-pollen–allergic children in terms of significantly reduced symptoms and medication use. The treatment was well tolerated. REVIEWER COMMENTS. The use of allergen-specific immunotherapy by the sublingual route, SLIT, has been increasing in clinical practice in Europe. SLIT is especially attractive for use in children, because it is a noninjection form of immunotherapy. This study showed a modest reduction (∼40%) in both symptom and medication scores. This is an interesting disease-modifying therapy that will need more studies to characterize efficacy and safety and to compare the results to that of subcutaneous immunotherapy before wider use can be recommended.

Surgical outcome and long‐term follow up after laparoscopic rectosigmoid resection in women with deep infiltrating endometriosis

The aim of this study was to assess the long-term outcome of treating severely symptomatic women with deep infiltrating intestinal endometriosis by laparoscopic segmental rectosigmoid resection. Detailed intraoperative and postoperative records and questionnaires (preoperatively, 1 month postoperatively and every 6 months for 3 years) were collected from 22 women. The estimated blood loss during surgery was 290 +/- 162 ml (range 180-600), and average hospital stay was 8 days (range 6-19). One woman required blood transfusion after surgery. Two cases were converted to laparotomy. One woman had early dehiscence of the anastomosis. Six months after surgery, there was a significant reduction of symptom scores (greater than 50% for most types of pain) related to intestinal localisation of endometriosis (P < 0.05). Score improvements were maintained during the whole period of follow up. Noncyclic pelvic pain scores showed significant reductions (P < 0.05) after 6 and 12 months, but there was a high recurrence rate later. Dysmenorrhoea and dyspareunia improved in 18/21 and 14/18 women with preoperative symptoms, respectively. Constipation, diarrhoea and rectal bleeding improved in all affected women for the whole period of follow up. Laparoscopic segmental rectosigmoid resection seems safe and effective in women with deep infiltrating colorectal endometriosis resulting in significant reductions in painful and dysfunctional symptoms associated with deep bowel involvement.

Extracts from The Cochrane Library: Allergen injection immunotherapy for seasonal allergic rhinitis (review)

The “Cochrane Corner” is a quarterly section in the journal that highlights systematic reviews relevant to otolaryngology–head and neck surgery, with invited commentary to highlight implications for clinical decision making. This installment features a Cochrane Review entitled “Allergen injection immunotherapy for seasonal allergic rhinitis,” which shows a low risk of adverse events plus a significant reduction in symptom scores and medication use.

A double blind randomised placebo controlled pilot study of oral co-trimoxazole in advanced fibrotic lung disease

Background: In 1996, clinical improvement with oral co-trimoxazole was noted in a patient with biopsy proven advanced fibrotic lung disease who was awaiting a lung transplant. Subsequently, 14 patients with end stage fibrotic lung disease also responded to oral co-trimoxazole. This prompted a double blind randomised placebo controlled pilot study in patients with advanced stages of idiopathic interstitial pneumonias (IIP) to objectively measure benefit. Patients: Twenty patients (aged 49–84 years; 11 males) with progressive fibrotic lung disease who had differing subtype diagnosis from CT scans of progressive fibrotic IIP, and showed oxygen desaturation on exertion were selected. Method: A detailed assessment of arterial gases, lung function, and progressive shuttle-walking tests combined with oxygen saturation monitoring. Quality of life data was recorded. Randomisation was to co-trimoxazole or identical placebo for 3 months followed by 6 weeks of pulmonary rehabilitation before decoding. Placebo patients received active treatment upon decoding with continued follow up of all patients. Main outcome measures: Primary 1. Shuttle walking test. Secondary 2. FVC and quality of life. Results: Active treatment showed a significant improvement in shuttle walking test from 255 to 355 m ( p = 0.002 ) (95% CI 200–450) with reduced oxygen desaturations during exercise ( p = 0.003 ). FVC improved on treatment (+21%) from median 1.9 to 2.3 L ( p = 0.05 ) (95% CI 1.3–3.0) but TLC and DLCO were not significantly changed although stable at 12 months. The MRC 5 Point Dyspnoea Score showed improvement ( p = 0.05 ) at 3 months for the active group which was maintained at 12 months. The SGHRQ showed a significant reduction in symptom scores at 12 months ( p = 0.05 ). The placebo group showed no significant change in any parameters, but demonstrated identical improvement following oral co-trimoxazole. Serum vascular endothelial growth factor (VEGF) was reduced 50% in the active group at 3 months, but just failed to reach statistical significance. ‘Out of study’ HRCT scans in 12 patients showed significant reduction in ground glass changes ( p = 0.05 ) after 12 months of continuous co-trimoxazole treatment. Conclusion: The findings of the pilot study show significant improvements in objective and subjective parameters which fulfil the ATS/ERS (2000) criteria of ‘a favourable response to treatment’.

Allergen injection immunotherapy for seasonal allergic rhinitis

Allergic rhinitis is the most common of the allergic diseases. Despite improved understanding of the pathophysiology of allergic rhinitis and advances in its pharmacological treatment, its prevalence has increased worldwide. For patients whose symptoms remain uncontrolled despite medical treatment, allergen injection immunotherapy is advised. An allergen-based treatment may reduce symptoms, the need for medication and modify the natural course of this disease. To evaluate the efficacy and safety of subcutaneous specific allergen immunotherapy, compared with placebo, for reducing symptoms and medication requirements in seasonal allergic rhinitis patients. We searched the Cochrane Ear, Nose and Throat Disorders Group Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, Issue 1 2006), MEDLINE (1950 to 2006), EMBASE (1974 to 2006), Pre-MEDLINE, KOREAMED, INDMED, LILACS, PAKMEDINET, Scisearch, mRCT and the National Research Register. The date of the last search was February 2006. All studies identified by the searches were assessed to identify randomised controlled trials involving participants with symptoms of seasonal allergic rhinitis and proven allergen sensitivity, treated with subcutaneous allergen specific immunotherapy or corresponding placebo. Two independent authors identified all studies reporting double-blind, placebo controlled randomised trials of specific immunotherapy in patients with seasonal allergic rhinitis due to tree, grass or weed pollens. Two authors independently performed quality assessment of studies. Data from identified studies were abstracted onto a standard extraction sheet and subsequently entered into RevMan 4.2.8. Analysis was performed using the Standardised Mean Difference (SMD) method and a random-effects model; P values < 0.05 were considered statistically significant. The primary outcome measures were symptom scores, medication use, quality of life and adverse events. We retrieved 1111 publications of which 51 satisfied our inclusion criteria. In total there were 2871 participants (1645 active, 1226 placebo), each receiving on average 18 injections. Duration of immunotherapy varied from three days to three years. Symptom score data from 15 trials were suitable for meta-analysis and showed an overall reduction in the immunotherapy group (SMD -0.73 (95% CI -0.97 to -0.50, P < 0.00001)). Medication score data from 13 trials showed an overall reduction in the immunotherapy group (SMD of -0.57 (95% CI -0.82 to -0.33, p<0.00001)). Clinical interpretation of the effect size is difficult. Adrenaline was given in 0.13% (19 of 14085 injections) of those on active treatment and in 0.01% (1 of 8278 injections) of the placebo group for treatment of adverse events. There were no fatalities. This review has shown that specific allergen injection immunotherapy in suitably selected patients with seasonal allergic rhinitis results in a significant reduction in symptom scores and medication use. Injection immunotherapy has a known and relatively low risk of severe adverse events. We found no long-term consequences from adverse events.

Clinical efficacy and safety of sublingual immunotherapy with tree pollen extract in children

Subcutaneous immunotherapy has been the principal approach of immunotherapy in the treatment of allergic diseases. Several clinical studies with birch, alder or hazel pollen extract conducted as subcutaneous immunotherapy have been published suggesting a well-tolerated and clinically effective treatment. Only a few clinical studies of sublingual immunotherapy (SLIT) with these allergens have been published. This study investigated the clinical efficacy, safety and dose-response relationship of SLIT in children suffering from rhinoconjunctivitis with/without asthma. Eighty-eight children (5-15 years) with a history of tree pollen-induced allergic rhinoconjunctivitis with/without seasonal asthma for >or=2 years were included. Allergy to tree pollen was confirmed by positive skin-prick test, positive specific IgE and positive conjunctival provocation test. The extract used was a glycerinated mixture of Betula verrucosa, Corylus avellana and Alnus glutinosa 100,000 SQ-U/ml. Children were randomized into three groups receiving SLIT 5 days a week for up to 18 months; dose group 1: accumulated weekly dose of 24,000 SQ-U; dose group 2: accumulated weekly dose of 200,000 SQ-U; and placebo. In the birch pollen season, dose group 2 showed a significant reduction of symptom (P = 0.01) and medication scores (P = 0.04) compared with placebo. Dose group 1 showed a significant reduction of symptom scores (P = 0.03). There were no statistical differences between dose groups 1 and 2. All children tolerated the treatment well. SLIT with tree pollen extract provided dose-dependent benefits in tree pollen-allergic children in terms of significantly reduced symptoms and medication use. The treatment was well tolerated.

Clinical evaluation of the Chinese herbal medicine formula STA‐1 in the treatment of allergic asthma

Although some formulae of traditional Chinese medicines (TCM) have been used for antiasthma treatment, few of them have had sufficient discussion on their efficacy, safety and mechanisms. In this study, the availability of the TCM formula STA-1 for the treatment of allergic asthma was investigated by conducting a double-blind, placebo-controlled and randomized trial. One hundred and twenty patients between the ages of 5 to 20 years with mild-to-moderate asthma were included. These patients were treated with either STA-1 or placebo in a dose of 80 g/kg/day and were administered twice daily for 6 months. The main outcome measures were a daily diary record of symptoms, supplementary bronchodilator and glucocorticoid treatment, changes of pulmonary function (forced expiratory volume in 1 s), changes of total and Dermatophagoides pteronyssinus (DP)-specific IgE and side effects. The results showed a statistically significant reduction of symptom scores, systemic steroid dose, total IgE and specific IgE in the STA-1 group. Furthermore, STA-1 also improved the pulmonary lung function FEV(1) compared with the placebo group and only minimal side effects were shown. These results suggested that STA-1 is available for the treatment of mild-to-moderate chronic asthma.

Systemic Omega-6 Essential Fatty Acid Treatment and PGE1Tear Content in Sjögren’s Syndrome Patients

To determine the effect of oral omega-6 essential fatty acids on PGE(1) tear content and signs and symptoms of ocular discomfort in patients with Sjögren's syndrome (SS). This randomized, double-masked, controlled, clinical trial involved 40 patients with primary SS, divided into two groups: group 1: 20 patients (18 women, 2 men; mean age, 36.9 +/- 7.9 years [SD]) treated for 1 month with linoleic acid (LA; 112 mg), and gamma-linolenic acid (GLA; 15 mg) administered twice daily; group 2: 20 patients (19 women, 1 man; mean age, 36.3 +/- 5.5 years) treated twice daily with placebo. Patients underwent three examinations: at baseline (T0), after 1 month of treatment (T1), and 15 days after suspension of treatment (T2). At each examination, the following tests were performed: tear sampling (2 microL) from the inferior meniscus, tear break-up time (BUT), fluorescein stain of the ocular surface, and tear basal secretion. A symptom score was also obtained at each examination. PGE1 was evaluated by enzyme immunoassay. The primary efficacy variable was PGE1 content of tears. The tear PGE1 levels were significantly increased in group 1 at T1 versus T0 (PGE1 level: T0, 44 +/- 5.4 ng/mL; T1, 58.3 +/- 5.5 ng/mL; P < 0.01 versus T0 and group 2 at T1). At examination T2, a statistically significant reduction of PGE1 levels toward baseline was observed (45.7 +/- 5.2 ng/mL; P < 0.01 versus T1). A statistically significant reduction of symptom score was observed in group 1 at examination T1 (P < 0.01 versus T0 and group 2 score). At examination T2, the symptom score was significantly higher than T1 but remained lower than T0. The corneal fluorescein stain in group 1 showed a statistically significant improvement at examination T1 versus T0 and group 2 (P < 0.01). This improvement was also present at T2 (P < 0.02). No statistically significant differences were found for the other tests. No statistically significant changes were observed in the patients in group 2 at all examination time points. Omega-6 administration increases the PGE1 levels in tears of patients with SS and improves ocular surface signs and symptoms of ocular discomfort.

Role of Leukotriene Inhibitors in the Postoperative Management of Nasal Polyps

This was a prospective double blind comparative study on 40 patients. It compared the effects of the leukotriene receptor antagonist montelukast and beclomethasone nasal spray on the post-operative course of patients with sinonasal polyps. All patients underwent endoscopic sphenoethmoidectomy and were randomized post-operatively into two groups. Group I: 20 patients (9 females and 11 males) age 17 to 67 (32.4 ± 9.5 years), receiving 10 mg montelukast orally daily and Group II: 20 patients (6 females and 14 males) age 17 years to 57 years (33.5 ± 11.9 years), receiving 400 ug beclomethasone local sprays daily. All patients were followed up for 1 year and a symptom score was recorded throughout this period. There was a significant reduction in symptom scores in both groups throughout the study period. In the montelukast group improvement was more marked in itching, post-nasal discharge and headache. The control of sneezing and rhinorrhea was comparable in both groups with a marginal advantage of montelukast. Steroids had a more marked effect on smell disturbances and obstruction. There was no difference in the recurrence rate or in the need for rescue medications between both groups. Both drugs seem to have a complementary action and further studies are needed to determine which patients should receive which treatment.

Efficacy and tolerability of short-term specific immunotherapy with pollen allergoids adjuvanted by monophosphoryl lipid A (MPL®) for children and adolescents

BackgroundSpecific immunotherapy (SIT) with pollen allergoids formulated with the Th1-inducing adjuvant 3-deacylated monophosphoryl lipid A (MPL? adjuvant, Corixa) has shown good efficacy and tolerability in the treatment of pollen allergies in adults. The aim of this study was to evaluate this treatment in children and adolescents aged 6-17 years old who were sensitive to grass/rye or tree pollens MethodsAn open, multicenter study was performed using 90 children and adolescents. The patients received four subcutaneous injections of grass/rye (n = 64) or tree pollen allergoids (n = 26) adsorbed to L-tyrosine and containing MPL? adjuvant. Efficacy was measured by symptom and medication scoring, skin prick test reactivity and IgG/IgE antibody responses. Tolerability was monitored by recording adverse events ResultsBoth grass/rye and tree pollen treatment groups showed significant reductions in symptom scores and anti-allergic medication use compared with the previous pollen seasons (p < 0.01 in all cases). After therapy, skin prick test reactivity was significantly reduced in both groups and pollen-specific IgG was significantly increased in both groups whereas little change was apparent in pollen-specific IgE. Overall tolerability was similar to results obtained in previous studies in adults ConclusionShort-term SIT using four injections of grass/rye or tree pollen allergoids adsorbed to L-tyrosine and with MPL? adjuvant was shown to be effective with good tolerability. The treatment compared favorably with previous studies in adults

Intranasal heparin reduces eosinophil recruitment after nasal allergen challenge in patients with allergic rhinitis

Background: Recently, several studies have shown that heparin possesses various anti-inflammatory and antiallergic properties. It has been proposed that heparin might play an important role in limiting the inflammatory events associated with asthma and allergic rhinitis by neutralizing inflammatory mediators, such as eosinophil cationic protein and major basic protein, and by limiting eosinophil recruitment. Objective: To test the hypothesis that heparin can limit the extent and magnitude of eosinophilic inflammation, we examined the effect of inhaled intranasal heparin on nasal response to allergen challenge in 10 patients with allergic rhinitis. Methods: The capacity of heparin to reduce nasal response was studied by evaluating symptom score, eosinophil cationic protein concentration, and eosinophil counts in nasal lavage fluids 10, 60, and 360 minutes after allergen challenge. Results: Pretreatment with intranasal heparin produced a significant reduction in symptom score 10 minutes after allergen challenge and reduced the eosinophil influx at each time point after antigen challenge, statistical significance being reached 60 and 360 minutes after allergen challenge. Similarly, the amount of eosinophil cationic protein in the nasal wash was reduced at each time point; this reached statistical significance 360 minutes after allergic challenge. Conclusion: Heparin was shown to provide protection with respect to nasal allergen challenge. The mechanism by which heparin produces its protective activity seems to be related to the neutralization of eosinophil cationic protein as well as to the reduction of eosinophil recruitment. (J Allergy Clin Immunol 2001;108:703-8.)

Changes in quality of life after hormonal treatment of endometriosis

To assess whether hormonal treatment of endometriosis improves quality of life for women with endometriosis. In a prospective, randomized, double-blind, double-dummy study on 48 women with verified endometriosis, the pain pattern and quality of life were registered before, during and after treatment with nafarelin or medroxyprogesterone acetate. The distribution of the studied parameters were tested by means of a Skewness test. ANOVA analysis was used for normally distributed variables and Friedman's analysis and Mann-Whitney U-test for non normally distributed variables. There was a difference between the 30 women who participated all through the study and the 18 who dropped out. It was noticeable that anxiety-depression and sleep disturbances were significantly more common among the drop outs. There was a significant reduction in symptom score during the study, without any significant difference between the treatment groups. The sleep disturbances and anxiety-depression score improved significantly from before treatment to the end of the follow-up, but the anxiety-depression score increased during the nafarelin treatment period. There was a statistically significant improvement of paid working life in the nafarelin treated group. All the other psycho-social parameters as well as emotional balance improved during the study period without difference between groups. When hormonal treatment is planned it is very important to take into consideration previous psychosocial experiences of the patient. Factors of importance for quality of life such as sleep disturbances and anxiety-depression improved significantly after treatment with nafarelin or medroxyprogesterone acetate.

Monitoring allergen immunotherapy of pollen‐allergic patients: the ratio of allergen‐specific IgG4 to IgG1 correlates with clinical outcome

Although allergen immunotherapy has been established as a treatment of type I allergy back in 1911, until now the underlying mechanisms have not been fully understood, nor are there any parameters which would allow one to monitor an ongoing treatment or to assess therapeutic success in the meantime. We wanted to define allergen-specific parameters that change due to treatment in correlation with the clinical outcome. We conducted a controlled study with grass pollen-allergic children and compared allergen-specific antibody titres before and 1 year after the onset of immunotherapy in contrast with untreated allergic and healthy children. Two recombinant forms of the major allergen group V of Phleum pratense (Phl p 5) served as model allergens. No change in IgE levels and no significant reduction of skin prick test (SPT) reactivity were seen. On the other hand, a significant reduction of symptom scores in the treated group and a significant rise in allergen-specific IgG1, IgG2 and IgG4 due to the treatment could be observed, but in neither case could we establish a correlation between the increasing amounts of the single antibody classes and the reduction of symptom scores. But most interestingly, when comparing the ratio of IgG4 to IgG1 with the symptom scores, we found significant correlations. Nevertheless, treated allergic patients still differ considerably from healthy controls as nonatopics have hardly any measurable allergen-specific IgG antibodies and no IgE antibodies at all. The ratio of IgG4 to IgG1 can serve as a valuable parameter that allows us to assess the success of immunotherapy already 1 year after the onset. The increase of specific IgG1 in relation to IgG4 during treatment reflects a possible influence of this subclass on the induction of tolerance towards allergens.

Botulinum toxin versus pneumatic dilatation in the treatment of achalasia: a randomised trial

BackgroundIntrasphincteric injection of botulinum toxin is a new treatment option for achalasia.AimsTo compare the immediate and long term efficacy of botulinum toxin with that of pneumatic dilatation.MethodsSymptomatic patients with achalasia...

THE EFFECTS OF DIETARY SUPPLEMENTATION WITH n-3 POLYUNSATURATED FATTY ACIDS (n-3 PUFA) ON ATOPIC DERMATITIS

In a multi-center placebo controlled cross over trial, We compared the efficacy of continuous n-3 PUFA enriched food “Ipaole” supplementation (daily intake dose; ALA: 60mg/kg, EPA: 30mg/kg, DHA: 18mg/kg) for atopic dermatitis to that of a isonergic placebo containing olive oil for 4 weeks.A total of 37 patients with atopic dermatitis, aged 12.8+4.9 years, from 6 investigative centers (male: 17, female: 20; severe: 22, moderate: 15) were employed.The patients were randomly divided into two groups: A group consists of 20 patients receiving Ipaole preceding placebo; B group 17 patients receiving placebo preceding Ipaole.Of the 37 patients who started the trial 2 from A group and 2 from B group dropped out.During Ipaole supplementation a statistically significant improvement was observed in the overall severity and grade of inflammation, and in the percentage of the body surface involved by ezema (p<0.01).But during placebo administration no significant reduction of symptom score was shown. During Ipaole supplementation the treatment score also significantly decreased (p<0.1) but does not significantly reduced during placebo intake.During Ipaole supplementation a statistically significant rise of EPA, EPA/AA and DHA of serum phospholipids was observed (p<0.001, p<0.01), but not observed during placebo intake.Bleeding time prolonged slightly in some patients, but any clinical sign of bleeding was not observed.These results suggest that the supplementation of n-3 PUFA enriched food is useful in the treatment of some patients with atopic dermatitis.

Transrectal hyperthermia in the management of men with prostatism: an algorithm for therapy.

Transrectal hyperthermia has been proposed as a potential treatment for benign prostatic hyperplasia (BPH). This report presents our initial experience in an ongoing clinical trial to evaluate the safety and efficacy of transrectal thermal therapy (TRTT) for symptomatic BPH. To date, 24 patients (mean age 60.6 years) have undergone TRTT. In all cases the initial investigations included pre-operative symptom score analysis, synchronous video/pressure/flow urodynamic studies and transrectal measurement of both the size of the prostate and the distance between the applicator and the prostatic urethra (AU). Twenty-one patients completed the study (mean follow-up 6.7 months). There was a significant reduction in symptom score (> 50%) in 14 patients and the peak urinary flow rate (Qmax) increased from 5.9 to 12.4 ml/s at 1 month, 12.7 ml/s at 3 months and 13.2 ml/s at 6 months. In 12 patients the decrease in symptom score and the increase in flow rate exceeded 50%. Five of the 6 patients who failed to respond to treatment had prostate volumes > 85 g; 4 had voiding detrusor pressures < 40 cm H2O and 5 had an AU distance > 2.5 cm. These preliminary results suggest that TRTT may be a potential therapeutic alternative in patients with mild to moderate symptoms of prostatism. However, patients with either lower detrusor pressures (< 40 cm H2O) or very large prostates are unlikely to show a beneficial response. We suggest that large prostates may preclude effective temperature distribution and therefore mitigate the potential therapeutic benefit.