Mortality associated with oral contraceptive use. Medical profession needs to examine facts.
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Biomedical subjects
Publications and source records attributed to M J Radcliffe.
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Every doctor in clinical practice is familiar with the patient who presents with multiple 'soft' symptoms. Where organic pathology cannot be demonstrated, there is a tendency to apply psychiatric labels. Indeed, it has been suggested that the risk of psychiatric disorder increases linearly with the number of presented symptoms. In psychiatric practice, the mere absence of an organic cause of disease is often regarded as adequate reason to invoke a psychological mechanism. However, this action precludes the possibility of any other diagnosis, and thus constricts therapeutic management to the psychiatric realm. Such psychologization of illness is commonplace, overworked and infrequently challenged. This highlights the longstanding controversy over multiple allergy and the role of psychiatric disorder.
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In a double-blind placebo-controlled crossover study, 36 adults with perennial allergic rhinitis were treated with daily subcutaneous injections of inhalant allergens, the doses of which had been predetermined by intradermal testing. The dose chosen for each allergen was the maximum intradermally tolerated dose (MITD) of that allergen, defined as 0.05 ml of the strongest concentration in a 1:5 dilution series which did not produce a positive wheal. Of the 27 who expressed a preference, 21 (78%) preferred the active preparation and six (22%) the placebo (p = 0.006). Significant symptom relief was apparent on an analysis of total rhinitis symptom scores (p = 0.006), nasal blockage (p = 0.02), nasal discharge (p = 0.006), postnasal drip (p = 0.02) and anosmia (p = 0.02). These results support the validity of allergen-specific low-dose immunotherapy using the MITD.