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Sulfathiazole in the treatment of sinusitis
SELECTED
Analysis Infections.
Serum Sickness and Anaphylaxis: With Horse Serum for Various 93 and
313,
101
~\HSTRACTY
of Cases of 6,211 Patients Iiojis
F. G.:
Am.
J. Dis.
Treated Child.
64:
1942.
Most of the patients dealt with in this study were seen by the author at Willard Parker Hospital in New York (‘ity between 19% and 1932. The mortality from serum anapl~ylauis in the series was 1 in 1 ,242. This is much greater than Park’s frequently quoted figure of 1 in 50,(1011 which appears to have been deri\-et1 from a study of the literature. \‘arious factors influence tire incitlence of serum sickness and anaphylasis, iueluding the kind of serum? its methotl of preparation, the quantity, the horse producing it, the race of the l’atient (Kegroes less susceptible than whites), the The most important factors are the kirrcl route of admi~listlatio~~, ant1 the patient. of ncrum, the metlrod of l)rel)aring it, the repetition of injections and the patient. When the reaction to the intratlrrmal sensitivity lest n-as positive, the incidence of serum sickness following inoculation of diphtheria antitoxin was four times, of anaph?-laxis, thirty-iive times, and of death, eleven times greater than Tf the reaction to the conjunetix-al when the reaction to the test xts negative. test was positive, the incidence of serum sickness was five times and of anaphylasis, one hundred seventy-three times greater. Secondary injections increase{1 the incidence of serum sickness by 50 per cent while the anaphylaxis rate was tw-enty-three times greater than after the primar?; injections. This figure of twenty-three is derived from fourteenfold increase Iv-here the intramuscular route was used and a sixt>--twofold increase when the intravenous route was used. Reven types of serum rash are described, including ant1 symptoms. The five deaths reported each followed the two instances in which an autopsy was performed, of anaphylnxis. Thermal
reactions
n-crc
found
to be depencl~nt
Round Table Discussion on Allergy.
J. Petliat.
twenty-four a secondary the findings
on the 21:
horw
different signs injection. In were typical
producing
the
serum.
113, 194L’.
This
discussion by Doctors Walzer, Rackemann, Donnally, Pratt, Ratner, and Tuft brings out both general principals in which the discussants are agreed as well as points upon which each feels more emphasis should be placed. While perennial treatment of pollinosis appears to be accepted as the most satisfactory type of treatment, a difference of opinion develops in the matter of treating an individual with positive tests but a negative clinical history. The part played 1)) foods, especially corn, cherries, chocolate, and alcohol, in aggravating pollinosis is discussed. It is suggested that determination of the level of an individual’s constitutional reaction may provide a short cut in treatment. The concept of an allergenically denatured diet is presented. The value of ipecac used as an emetic in ohstructiv-e asthma is l~rought out. In addition, serum allergy, history taking, and numerous other subjects are discussed.
Rhinology UNDER
Sulfathiazole 794, Xarks maxillary
THE DIRECTIOS
in the Treatment
and Ophthalmology
OF FRESCII
of Sinusitis.
Ii.
IIANSFX~, Xarks,
M.I)., R. I?.:
ST. LOUIS Arch.
Otolaryng.
35:
1942. presents sinusitis
a review in which
of the literature sulfanilamido
and a report and sulfathiazole
of ten cases of chronic were employed. He
found that sulfathiazole jelly, 20 or 50 per cent, was an effective therapeutic agent when injected into the maxillary slllus in which there n-as evitleuce of Ialrrollic* maxillary sinusitis. 9 suspension of snlfathiazolo seemed to l)e more efF’r~c:t ivc than sodium sulfathiazole when usetl c~lini~aily. The average duration of syrnl>toms among the ten patients was tcu months, and the ax-erage time required fol, resolution was about three or four weeks. This suggests that a trial wit11 sulf:lt,hiazole is indicated in the treatment of chronic maxill:~ry sinusitis before surgical treatment is advised.
Experimental Hypersensitivity of Mucous Tract. Frank, I., Blahd, M., and Howell. Frank, Blahd, and Howell sitivity of mucous membranes the mucous membranes can he membranes. They noted that without injury to the mucous and other mucous membranes.
Vasomotor
Rhinitis
Membranes Ii.
hf.:
of the Upper
Arch.
Otolaryng.
Respiratory 35:
918,
1942.
report their observations on experimental hyperse~lof the upper respiratory tract. They found that sensitized via many portals. including other mucous foreign suljstances introduced into the nasal sinus, membrane. sensitized distant areas, such XP the skin
in the Tropics.
Jaffe,
Ludwig:
Arch.
Otolaryng.
35:
li,
l!)G.
Jaffe reports his observations on vasomotor rhinitis in the tropics. He fount1 t,hat the condition is quite common in this climate. There was a great deal of dust, especially in the cities, and it was felt that this was a factor in the cause of the trouble. l\‘o atmospheric studies were mado in regard to pollens or mol(l spores. No skin tests or allergic management were instituted. The patients were treated by cauterization of the mucous membrane with a concentrated solution of triehloracetic acid. The author warns against unnecessary operations. He suggests methods of conservative therapy which he 11:~s found to l)e satisfactory.
Prevention and
of Death in Status Asthmaticus:
Kurtin,
il.:
Arch.
Otolaryng.
35:
ill,
Value of Bronchoscopy.
lkww,
T,.,
1942.
Bases and Kurtin emphasize the value of I~ronchosco~~y in the 1)revention of They rc‘port that six of the seven patients who (lied death in status asthmaticus. of status asthmaticus at the Mount Sinai Hosl,itsl and on whom autopsy was performed in the past fifteen years died from lplocking of the tt;rchr:nl~ronchi:il airThey reviewed the literature on deatlr way by excessive outpouring of secretion. in asthma and pointed out the frequent?bvith which it was noted that obstruction Thc~v give 2. c:is(’ report of the tracheobronchial tree with secretion was present. of an instance in which bronchoscopic aspiration was a lift-saving procedure. They conclude in saying that the most iml)ortarrt factor in causing death in status asthmaticus is obstruction of the tr;lcllt!ol,roncl~i:~l t,ree 11y \-iscitl secretion. Thev point out that this material ran 1~ rernored 11~ suction through a l~ronchoscope. They strongly advise the use of this procrdurr in those caxs of stafus asth?nalicw.s in which other measures have proved unsuccessful.
Presence Chicago
and Action Laryng.
of Lysozyme & Otol.
Sot.,
Oct.
in the Nasal Mucus. 6, 10~1.
(Arch.
Brorruer, (‘. E. (1.: Tr. Otolaryng. 35: 825, 1912.)
Bronner reports his observations on the plcsence and action of lysozyn~? in the nasal mucosa. He states that in addition to the mechanical action of the ciliatetl epithelium and the drainage, lysozyme can be considered a factor in the mechanism of local tissue resistance. He found that lysozyme disappeared or decreased
Analysis Infections.
Serum Sickness and Anaphylaxis: With Horse Serum for Various 93 and
313,
101
~\HSTRACTY
of Cases of 6,211 Patients Iiojis
F. G.:
Am.
J. Dis.
Treated Child.
64:
1942.
Most of the patients dealt with in this study were seen by the author at Willard Parker Hospital in New York (‘ity between 19% and 1932. The mortality from serum anapl~ylauis in the series was 1 in 1 ,242. This is much greater than Park’s frequently quoted figure of 1 in 50,(1011 which appears to have been deri\-et1 from a study of the literature. \‘arious factors influence tire incitlence of serum sickness and anaphylasis, iueluding the kind of serum? its methotl of preparation, the quantity, the horse producing it, the race of the l’atient (Kegroes less susceptible than whites), the The most important factors are the kirrcl route of admi~listlatio~~, ant1 the patient. of ncrum, the metlrod of l)rel)aring it, the repetition of injections and the patient. When the reaction to the intratlrrmal sensitivity lest n-as positive, the incidence of serum sickness following inoculation of diphtheria antitoxin was four times, of anaph?-laxis, thirty-iive times, and of death, eleven times greater than Tf the reaction to the conjunetix-al when the reaction to the test xts negative. test was positive, the incidence of serum sickness was five times and of anaphylasis, one hundred seventy-three times greater. Secondary injections increase{1 the incidence of serum sickness by 50 per cent while the anaphylaxis rate was tw-enty-three times greater than after the primar?; injections. This figure of twenty-three is derived from fourteenfold increase Iv-here the intramuscular route was used and a sixt>--twofold increase when the intravenous route was used. Reven types of serum rash are described, including ant1 symptoms. The five deaths reported each followed the two instances in which an autopsy was performed, of anaphylnxis. Thermal
reactions
n-crc
found
to be depencl~nt
Round Table Discussion on Allergy.
J. Petliat.
twenty-four a secondary the findings
on the 21:
horw
different signs injection. In were typical
producing
the
serum.
113, 194L’.
This
discussion by Doctors Walzer, Rackemann, Donnally, Pratt, Ratner, and Tuft brings out both general principals in which the discussants are agreed as well as points upon which each feels more emphasis should be placed. While perennial treatment of pollinosis appears to be accepted as the most satisfactory type of treatment, a difference of opinion develops in the matter of treating an individual with positive tests but a negative clinical history. The part played 1)) foods, especially corn, cherries, chocolate, and alcohol, in aggravating pollinosis is discussed. It is suggested that determination of the level of an individual’s constitutional reaction may provide a short cut in treatment. The concept of an allergenically denatured diet is presented. The value of ipecac used as an emetic in ohstructiv-e asthma is l~rought out. In addition, serum allergy, history taking, and numerous other subjects are discussed.
Rhinology UNDER
Sulfathiazole 794, Xarks maxillary
THE DIRECTIOS
in the Treatment
and Ophthalmology
OF FRESCII
of Sinusitis.
Ii.
IIANSFX~, Xarks,
M.I)., R. I?.:
ST. LOUIS Arch.
Otolaryng.
35:
1942. presents sinusitis
a review in which
of the literature sulfanilamido
and a report and sulfathiazole
of ten cases of chronic were employed. He
found that sulfathiazole jelly, 20 or 50 per cent, was an effective therapeutic agent when injected into the maxillary slllus in which there n-as evitleuce of Ialrrollic* maxillary sinusitis. 9 suspension of snlfathiazolo seemed to l)e more efF’r~c:t ivc than sodium sulfathiazole when usetl c~lini~aily. The average duration of syrnl>toms among the ten patients was tcu months, and the ax-erage time required fol, resolution was about three or four weeks. This suggests that a trial wit11 sulf:lt,hiazole is indicated in the treatment of chronic maxill:~ry sinusitis before surgical treatment is advised.
Experimental Hypersensitivity of Mucous Tract. Frank, I., Blahd, M., and Howell. Frank, Blahd, and Howell sitivity of mucous membranes the mucous membranes can he membranes. They noted that without injury to the mucous and other mucous membranes.
Vasomotor
Rhinitis
Membranes Ii.
hf.:
of the Upper
Arch.
Otolaryng.
Respiratory 35:
918,
1942.
report their observations on experimental hyperse~lof the upper respiratory tract. They found that sensitized via many portals. including other mucous foreign suljstances introduced into the nasal sinus, membrane. sensitized distant areas, such XP the skin
in the Tropics.
Jaffe,
Ludwig:
Arch.
Otolaryng.
35:
li,
l!)G.
Jaffe reports his observations on vasomotor rhinitis in the tropics. He fount1 t,hat the condition is quite common in this climate. There was a great deal of dust, especially in the cities, and it was felt that this was a factor in the cause of the trouble. l\‘o atmospheric studies were mado in regard to pollens or mol(l spores. No skin tests or allergic management were instituted. The patients were treated by cauterization of the mucous membrane with a concentrated solution of triehloracetic acid. The author warns against unnecessary operations. He suggests methods of conservative therapy which he 11:~s found to l)e satisfactory.
Prevention and
of Death in Status Asthmaticus:
Kurtin,
il.:
Arch.
Otolaryng.
35:
ill,
Value of Bronchoscopy.
lkww,
T,.,
1942.
Bases and Kurtin emphasize the value of I~ronchosco~~y in the 1)revention of They rc‘port that six of the seven patients who (lied death in status asthmaticus. of status asthmaticus at the Mount Sinai Hosl,itsl and on whom autopsy was performed in the past fifteen years died from lplocking of the tt;rchr:nl~ronchi:il airThey reviewed the literature on deatlr way by excessive outpouring of secretion. in asthma and pointed out the frequent?bvith which it was noted that obstruction Thc~v give 2. c:is(’ report of the tracheobronchial tree with secretion was present. of an instance in which bronchoscopic aspiration was a lift-saving procedure. They conclude in saying that the most iml)ortarrt factor in causing death in status asthmaticus is obstruction of the tr;lcllt!ol,roncl~i:~l t,ree 11y \-iscitl secretion. Thev point out that this material ran 1~ rernored 11~ suction through a l~ronchoscope. They strongly advise the use of this procrdurr in those caxs of stafus asth?nalicw.s in which other measures have proved unsuccessful.
Presence Chicago
and Action Laryng.
of Lysozyme & Otol.
Sot.,
Oct.
in the Nasal Mucus. 6, 10~1.
(Arch.
Brorruer, (‘. E. (1.: Tr. Otolaryng. 35: 825, 1912.)
Bronner reports his observations on the plcsence and action of lysozyn~? in the nasal mucosa. He states that in addition to the mechanical action of the ciliatetl epithelium and the drainage, lysozyme can be considered a factor in the mechanism of local tissue resistance. He found that lysozyme disappeared or decreased