The skin tests were safe, and the immediate reaction to skin tests successfully diagnosed allergy to beta-lactam antibiotics in children reporting reactions suggestive of immediate HS. In contrast, most accelerated and delayed reactions were diagnosed by OC. Thus, our results suggest that the diagnostic and predictive values of skin tests for nonimmediate HS to beta-lactams in children are low. (ABSTRACT TRU

As in adults, NMBA, then latex were responsible for most anaphylactic reactions during anesthesia. Our results confirm that skin tests with anesthetic agents are feasible and safe in children and improve the safety of subsequent anesthetic procedures.

The efficacy of Broncho-Vaxom®/Imocur® (OM-85 BV), an orally administered lyophilized bacterial extract, for recurrent respiratory and ear, nose and throat (ENT) infections was evaluated in 116 children aged 6 months to 19 years by comparing its activity in 61 children with that of a placebo in 55 children. The study was randomized, double-blind, and comprised a 90-day treatment period followed by a 90-day follow-up period without test drugs. Over the 180 days, 39.5% of patients taking OM-85 BV remained free from infection compared with 16.5% on placebo (p < 0.01). 44% on OM-85 BV did not need antibiotics compared with 23.5% on placebo (p < 0.05). These differences were even greater in the subgroup of children aged 6 years and less (34 vs. 3.5% for the absence of infections, p < O.Ol and 37 vs. 10% for the need of antibiotics, p < 0.05). Tolerance to OM-85 BV was excellent, and laboratory investigations showed no abnormalities attributable to this product. This work confirms that the immunomodulator OM-85 BV is an effective immunotherapy for recurrent respiratory and ENT infections in children

The effect of whole lung irradiation on lung function was investigated in 48 children treated for Wilm's tumour with pulmonary metastases. Lung function tests were performed before irradiation and were repeated annually for as long as possible, the length of follow-up varying from two to 17 years. A reduction in both lung volume and in dynamic compliance was clearly observed. In some patients these changes occurred in the early post-irradiation months, but in most the decrease observed progressed over longer periods of time. Static pressure volume curves, bloodgases, and carbon monoxide transfer were normal. These findings make it unlikely that postirradiation pulmonary fibrosis was involved. Another explanation for the decreased lung volume and dynamic compliance might be failure of alveolar multiplication. Muscular injury is unlikely as the patients were able to produce normal transthoracic pressures. A failure of chest wall growth is also possible and would explain the progressive restrictive impairment but not the early lung function changes. It is suggested that the early effects detected in some patients were the result of lung injury and that later effects resulted from impaired chest wall growth.Although the effects of pulmonary irradiation on lung function have been extensively investigated in adults, reports on the effects on respiratory function of whole lung irradiation are relatively few and there have been no reports of detailed, repeated lung function tests after this type of irradiation.In contrast to adults, young children are in a period of rapid lung and skeletal growth and the effect of pulmonary irradiation might be a failure of alveolar development resulting from impaired cellular proliferation, thus decreasing the number of alveoli. The aim of this study was to detect the shortand long-term pulmonary function changes in young children who received whole lung irradiation at doses which were therapeutically efficient but close to tolerance and we have tried to characterise the physiopathological mechanisms of the changes observed. Actinomycin D which enhances the effects of irradiation, was administered consecutively.1

A total of 107 children of both sexes between 2 and 6 years of age with pollen-induced seasonal allergic rhinitis (SAR) were entered in a multicentre study of double-blind parallel group design in which the effects of 5 mg cetirizine, given as drops from a solution containing 10 mg/ml once daily each evening for two weeks, were compared with those of identical placebo. Sneezing, rhinorrhea, nasal obstruction and nasal and ocular pruritus were the symptoms evaluated by means of symptom scores by investigators and, on daily record cards, by parents. Investigators also made a global evaluation at the end of treatment. Cetirizine was more active than placebo for each symptom evaluated both by parents and investigators. There were significant by more (p = 0.002) days during which symptoms were absent or mild, in the cetirizine than in the placebo group. When the maximum symptom scores rated by investigators at each visit were compared, the difference in favour of cetirizine at the end of treatment was statistically significant (p = 0.04). Global evaluation by investigators of changes in symptoms at the end of the study showed an improvement in both groups which was significantly greater with cetirizine, providing excellent or good improvement in 34/54 patients compared with 25/53 patients on placebo (p = 0.039). Tolerance was good. Three patients on cetirizine and none on placebo experienced mild somnolence.

Summary Lymphoblast transformation tests were carried out in the presence of α‐lactalbumin and β‐lactoglobulin. In patients with cow's milk protein intestinal intolerance in seventeen of forty‐five (37·8%) the lymphoblast transformation tests were positive. Sensitization in the first month of life seemed to favour lymphoblast transformation. In control children in only four of forty‐three (9·5%) the lymphoblast transformation tests were positive, the difference from intolerant patients being significant 0·01 < P < 0·001. Lymphoblast transformation tests were negative in the seven children with active coeliac disease. Although a negative test does not exclude cow's milk protein intolerance, lymphoblast transformation tests can be considered a useful aid in diagnosis because of its specificity.

Summary In a one-year follow-up study, 444 blood histamine determinations were performed in 163 patients with solid malignant tumours. Compared with normal subjects, blood histamine levels were significantly lower in patients with unresected primary tumours (30.7 + 19.9 ngml -), metastases (34.1 + 17.1 ngml -), or both (24.5+12.8ngml-1). By contrast, after successful tumour resection, histamine blood levels were nearly normal (52.1 + 18.4 ng ml -, versus 59.6 + 22.6 in control patients). Stability of the histamine blood levels was associated with stability of the disease. A progressive decrease in histamine blood levels preceded clinical relapse or detection of metastasis. In patients with consecutive histamine blood levels which were < 15 ng ml-1, survival did not exceed 2 months.In patients with gastrointestinal tumours, blood histamine levels provided information additional to that derived from serum CEA determination. In patients with non-gastrointestinal tumours, the blood histamine level may be of more value than CEA as a marker of disease progression.Numerous clinical surveys have shown that the atopic population has a decreased risk of malignancy and that a decreased prevalence of immediate hypersensitivity has been observed in cancer populations (

In comparison with those in normal (+/+) mice, tissue histamine levels were lower in athymic (nu/nu) female mice and higher in athymic male mice. The sexual difference was less marked or absent in nu/nu mice. These results show (a) that endocrine factors are involved in the distribution of tissue histamine, and (b) that the thymus cannot be considered as the main source of tissue histamine in pathogen-free mice.