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Proceedings of the British Thoracic Society Thorax 1983;38:700-719 Thorax: first published as 10.1136/thx.38.9.700 on 1 September 1983. Downloaded from Proceedings of the British Thoracic Society The 1983 Summer Meeting of the British Thoracic Society was held on 27-29 June in the University of Cambridge BTS smoking withdrawal study: fators assodated with four there was continuing "active" disease at the time of giving up smoking death. The average follow-up in this supplementary series is six years and to date there has been only one simple IA CAMPBELL for BTS Research Committee In the British tumour (neurilemmoma). Thoracic Society's smoking withdrawal study 9-7% of 1550 patients successfully gave up smoking. Reasons for wanting to stop smoking, apart from improvement in Treatment of pneumothorax by simple aspiration health, were expense (30%), dislike of addiction (20%) and "dirty habit" (18%). Concern about weight gain was AAD HAMILTON, GJ ARCHER All the patients admitted to expressed by 41% of men and 59% of women. Men were Stepping Hill Hospital with an uncomplicated more successful than women and success in both sexes pneumothorax requiring treatment during the 12 months increased with age. Men with ischaemic heart disease did up to January 1983 were admitted to the study. These best (21% success). Married or single men were more patients, numbering 10, were treated by simple aspiration likely to give up smoking than divorced or separated men. of air using a plastic cannula used for intravenous insertion. Patients whose "most important other person" was a non- In seven patients the procedure was successful. Of these, smoker did better than if such a person smoked. Women there has so far been only one recurrence, in a patient who who thought they were addicted were less likely to suc- had had four previous pneumothoraces. One other elderly ceed. Confidence in ability to stop smoking for a year was patient developed a small ipsilateral pleural effusion which related to successful outcome in men. Mean weight gain in has been assumed to be neoplastic. None of the other those who were successful was 5-9 kg. Socideconomic pneumothoraces has so far recurred. Of the patients who group, cigarette consumption, concern about weight gain had unsuccessful aspiration, all had severe coexisting lung copyright. and health concern were not related to outcome. Of the disease and only one had successful re-expansion after successes, 50% rated will power as important, and 15% insertion of an intercostal tube. In this small series there mentioned illness, 13% their families and 7% their doctor. were only two patients with so-called benign spontaneous Only 1 % mentioned expense. Failure was most commonly pneumothorax; all the others had presumed causative fac- attributed to lack of will power (28%), relief of tension by tors. It is concluded that simple aspiration by means of an cigarettes (24%), and addiction (16%). Other smokers in intravenous cannula warrants further investigation. the family and pressure at home were more important in women than men. http://thorax.bmj.com/ Tuberculous lymphadenitis: results of nine-month and eighteen-month regimens after eighteen months Pulmonary sarcoidosis: a personal survey over 20 years CR McGAVIN for the Research Committee of the BTS This RN JOHNSTON Three hundred and thirty-eight patients multicentre study compares nine versus 18 months' with pulmonary sarcoidosis under the care of one physician chemotherapy for lymph node tuberculosis. The drug have been reviewed. Seventy-six were diagnosed between regimens comprise rifampicin and isoniazid supplemented 1956 and 1963 or earlier and a minimum follow-up of 20 initially by ethambutol for eight weeks. One hundred and years is reported (average 22*5 years). All except six (8%) fifty-two patients had entered the study by June 1982. on October 2, 2021 by guest. Protected have been traced (92% follow-up). Fifty-five patients have Thirty-two were withdrawn, mostly because of drug errors no respiratory disability after at least 20 years but 10 have and non-attendance. One hundred and twenty patients, x-ray evidence of minimal pulmonary fibrosis and three of equally divided between long-course and short-course more extensive fibrosis. Respiratory function tests at the chemotherapy, have now been observed for 18 months. end of the survey in 42 patients show that only 12 (29%) Seventy-four per cent were Asian (mean age 33 years) and had a transfer factor less than 80% of predicted. Fourteen 22% were European (mean age 50 years). In the first nine patients received prednisolone for progressive or relapsing months after the start of therapy fresh nodes appeared in disease. None of these patients died from sarcoidosis but 12%, existing nodes enlarged in 11%, and 8% required 16 died from other causes and eight (10%) developed var- further surgical procedures. In the second nine months ious forms of malignant disease. Among 263 patients seen after the start of therapy existing nodes enlarged in 6% and subsequent to 1963 this good prognosis continues, with fresh nodes appeared in 3% of the short-course group, but pulmonary fibrosis in a further four patients. Two patients there were no such events in the long-course group. No have died from progressive sarcoidosis and postmortem microbiological relapse has been recorded to date, but findings are available in a further two patients, and in these follow-up continues. 700 Proceedings of the British Thoracic Society 701 Thorax: first published as 10.1136/thx.38.9.700 on 1 September 1983. Downloaded from Controlled trial of six months' chemotherapy in pulmonary Thus the six-month regimen was superior to the 12-month tuberculosis regimen and for both regimens the results were as good for nomads as for the settled residents. JH ANGEL, AR SOMNER, KM CITRON for the BTS Research Committee Two six-month regimens of isoniazid and Anfthistamines in seasonal aflergic rhinitis: a double-blind rifampicin, supplemented for the first two months by strep- study of demastine and tomycin and pyrazinamide (SHRZ6) or by ethambutol and ketotifen pyrazinamide (EHRZ6), were compared with a nine- AD BLAINEY, S OLLUER, C GOULD, RJ DAVIES Antihistamines month regimen of isoniazid and rifampicin, supplemented are widely used in the treatment of allergic rhinitis and are for the first two months by ethambutol (EHR9). All 444 considered effective. It has recently been shown that patients who completed chemotherapy had negative ketotifen is a powerful antihistamine (Phillips et al. Br J sputum cultures by the end of treatment, but the rate of Clin Pharmacol 1983, in press), though it is claimed that it sputum conversion was significantly more rapid with the may also have additional "antiallergic" properties. We two pyrazinamide-containing regimens. Adverse reactions have conducted a double-blind placebo-controlled com- were not a serious problem. Hepatitis occurred in 4% of parison of ketotifen with clemastine, an established antihis- the, patients who received pyrazinamide (SHRZ6 and tamine, in adults with seasonal allergic rhinitis to deter- EHRZ6) and in 4% of patients in the regimen without mine whether ketotifen provides any advantage over pyrazinamide (EHR9). Three hundred and seventy-six clemastine. Forty-eight patients with seasonal allergic patients have been followed up for three years from the rhinitis due to grass pollen entered the study; 16 received end of chemotherapy. Relapses have occurred in one of ketotifen and 16 clemastine (both at a dose of 1 mg twice 121 SHRZ6 patients, three of 126 EHRZ6 patients, and daily). Sixteen received identical placebo tablets. Symp- two of 129 EHR9 patients. These observations reinforce toms of rhinorrhoea, sneezing, and nasal blockage were our earlier conclusion that six months' chemotherapy with recorded on visual-analogue scales and diary cards at these pyrazinamide-containing regimens is as effective as three-weekly intervals throughout the summer, and dose- the currently recommended nine months' regimen and has response curves for the increase in nasal resistance in the advantage of being shorter and cheaper while being response to increasing doses of histamine were produced equally well tolerated. on each occasion. Symptom scores and the nasal response to histamine initially increased in all three groups but after more than six weeks of therapy both symptoms and the nasal response to histamine were significantly reduced in Controlled trial of short-course and standard-duration the ketotifen-treated group in comparison with placebo. copyright. chemotherapy for pulmonary tuberculosis in the Algerian The clemastine-treated patients showed a significant Sahara: Algerian worldng group and Medical Research reduction in the nasal response to histamine but no Council collaborative study improvement in symptoms. We conclude that ketotifen is effective in the treatment of seasonal allergic rhinitis in JANET J DARBYSHIRE (presenter) A six-month daily oral adults. This may be the result of its potent antihistaminic regimen of isoniazid and rifampicin supplemented by activity or the drug may have additional properties. pyrazinamide and ethambutol for the first two months has been compared with a 12-month daily oral regimen of http://thorax.bmj.com/ isoniazid and ethambutol, supplemented by streptomycin for the first month, in an area of the Algerian Sahara where Isosorbide dinstrate and isoxsuprine in exercise-induced a substantial proportion of the population is nomadic. The asthma study was conducted under conditions approaching those achievable in the routine treatment services and, in particu- WM TULLETT, KR PATEL The effects of saline, isosorbide, lar, the nomads were allowed to continue their nomadic isoxsuprine, salbutamol, and sodium cromoglycate (SCG) way of life. A total of 601 patients all with a positive were compared in seven patients with exercise-induced sputum smear in the local laboratory were admitted to the asthma (EIA). The protective effect of isoxsuprine and study, 28% being nomads. Confirmation of the diagnosis isosorbide as measured by FEV, after eight minutes of on October 2, 2021 by guest.
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