Leo H. Cummins

Hypoglycemia and convulsions in children following alcohol ingestion

Summary Two instances of hypoglycemia followingingestion of alcohol have been reported. Both children had convulsions, and one of them died. Possible etiological mechanisms are briefly reviewed. When a child becomes comatose or convulses after ingesting an alcohol-containing substance, hypoglycemia may be present. Blood should be drawn for glucose determination, and 50 per cent glucose should be injected through the same needle.

Efficacy of azelastine in perennial allergic rhinitis: Clinical and rhinomanometric evaluation

Azelastine is a chemically novel medication that has been demonstrated to be clinically effective for asthma and seasonal allergic rhinitis. In a 10-week, multicenter, double-blind, placebo-controlled, crossover study, the efficacy and safety of azelastine, 1 mg and 2 mg twice daily, were evaluated in 192 patients with symptoms of perennial allergic rhinitis. Patients maintained daily symptom and adverse-experience diaries and were evaluated every 2 weeks by the investigators. Pseudoephedrine, 30 mg, was provided as backup medication. Amelioration of most individual symptoms and a decrease in the total symptom scores were observed with both dosages of azelastine; greater improvement with 2 mg twice daily than with 1 mg twice daily, was observed. Nasal congestion, as a symptom and as reflected by rhinomanometric assessment, was the least improved parameter. Backup decongestant medication decreased during treatment with azelastine and increased during the placebo regimen. There were no major adverse effects.

Comparison of Clinical Effects and Pharmacokinetics of Once- Daily Uniphyl and Twice-Daily Theo-Dur in Asthmatic Patients

A pharmacokinetic study using theophylline syrup in adult asthmatic patients demonstrated a mean apparent volume of distribution of 0.38 liters/kg, mean elimination rate constant of 0.10 hours-1, and variable rates of clearance of theophylline (total body clearance of 0.38 to 0.96 ml/kg per minute). Subsequently, the asthmatic patients were compared using a cross-over design after maintenance Uniphyl (once daily at 8 a.m. or at 8 p.m.) and Theo-Dur (twice daily at 8 a.m. and 8 p.m.). Total daily maintenance theophylline dosage, calculated from the pharmacokinetic data, was identical in all three cross-over phases. At the end of each phase, plasma theophylline levels were measured every two hours and spirometric determinations were made every four hours (excluding 4 a.m.) for 24 hours. The following results were observed: highest peak and mean plasma theophylline concentration and area under the concentration-time curves with evening Uniphyl (p less than 0.05); prolonged time-to-peak theophylline concentration after nocturnal compared with daytime dosing; diurnal variation in pulmonary function and plasma theophylline concentrations; no significant differences between the three maintenance treatments in asthmatic symptoms or spirometric results.

Immediate adverse reactions to acetaminophen in children: Evaluation of histamine release and spirometry

and a !ys!ne analogue (MK-521): disposition in man. Br J Clin Pharmacol 1982;14:357-62. 10. Hitchens M, Hand EL, Mulcahy WS. Radioimmunoassay for angiotensin converting enzyme inhibitors. Ligand Q 1981; 4:43. 11. Ferguson RK, Vlasses PH, Swanson BN, et al. Effects of enalapril, a new converting enzyme inhibitor, in hypertension. Clin Pharmacol Ther 1982;32:48-53. 12. Dickstein K, Till AE, Aarsland T, et al. The pharmacokinetics of enalapril in hospitalized patients with congestive heart failure. Br J Clin pharmacol 1987;23:403-10. 13. Biol!az J, Schelling JL, Des Combes J, et al. Enalapril maleate and a lysine analogue (MK-521) in normal volunteers: relationship between plasma drug levels and the renin angiotensin system. Br J Clin Pharmacol 1982;14:363-8. 14. Till AE, Gomez H J, Hichens M, et al. Pharmacokinetics of repeated single oral doses of enalapril maleate (MK-421) in normal volunteers. Biopharm Drug Dispos 1984;5:372-80. 15. Schwartz JB, Addison AT, Abernethy DR, et al. Altered pharmacokinetics and pharmacodynamics of enalapril in patients with congestive heart failure versus patients with hypertension [Abstract]. J Am Coil Cardiol 1985;5:544. 16. Shaddy RE, Teitel DF, Brett C. Short-term hemodynamic effects of eaptopril in infants with congestive heart failure. Am J Dis Child 1988;142:100-5. 17. Bengur AR, Beekman RH, Rocchini AP, et al. Hemodynamic effects of eaptopril in children with congestive or restrictive cardiomyopathy [Abstract]. J Am Coil Cardiol 1988; 11 (suppl A):28A. 18. Artman M, Graham TP. Guidelines for vasodilator therapy of congestive heart failure in infants and children. Am Heart J 1987;113:994-1005.

189. Factors of importance in determining the prevalence of indoor molds

The concentration of molds isolated in 68 homes of allergic patients in southern California using the Andersen volumetric sampler varied from a minimum of 36 to a maximum of 5,984 isolate/M3 air sampled. The most frequently isolated included Cladosporium, Penicillium species. Alternaria, Sterile (Non-sporulating) Mycelium, Epicoccum, Aspergillus species, Aureobasidium and Dreschlera. Statistically significant higher mold isolates were associated with high shade and high levels of organic debris near the home and poor landscaping and landscape maintenance. Low concentrations of mold isolates were associated with the presence of a central electrostatic filtration system and good compliance with dust controls. The viable mold spore levels were lower in homes where the electrostatic filtration unit was operated continuously rather than intermittently. No statistically significant correlations could be made between indoor mold isolates and any of the following: number and age of the occupants, age and size of home, month of survey or the presence of indoor plants.