Natürliche Familienplanung

The symptothermal method (STM) is the most effective method of natural family planning, if two parameters to determine the beginning as well as the end of the fertile phase are used (double-check). The main parameters observed by women are BBT and cervical mucus changes. The method-effectiveness is 0.3–0.5 pregnancies per 100 women years, if there is no unprotected intercourse in the self-detected fertile phase. The use-effectiveness is about 2 in Germany. These results are derived from large European databases. In developed countries, the STM replaces the old calendar and temperature methods and the Billings method.     

Zur Eliminationskinetik des Digoxin vor und während Spironolactonbehandlung

Zusammenfassung Im Tierversuch konnte unter hohen Spironolactondosen eine Beschleunigung der Digoxinelimination nachgewiesen werden, die auf eine vermehrte Metabolisierung des Digoxins nach Induktion mikrosomaler Leberenzyme zurückgeführt wurde. Deshalb wurde bei 8 Patienten die Eliminationskinetik des Digoxins vor Spironolactonbehandlung untersucht, wobei morgens nüchtern 0,1 mg³H-Digoxin intravenös als einmalige Dosis verabreicht wurde. Zur Messung der Digoxinkonzentration wurden venöse Blutproben zu bestimmten Zitpunkten bis zu 120 h entnommen, der Urin fraktioniert 5 Tage lang gesammelt. Zusätzlich wurde während der gesamten Versuchsperiode die im Stuhl ausgeschiedene Digoxinmenge bestimmt. Während der Messung der Digoxinelimination wurden gleichzeitig nicht-invasive Parameter des mikrosomalen Leberenzymsystems wie Antipyrinhalbwertszeit, Antipyrinclearance, Gamma-Glutamyl-transpeptidase im Blut und d-Glucarsäureausscheidung im 24 h-Urin gemessen. Danach wurde jedem Patienten 15 Tage lang eine therapeutische Erhaltungsdosis von 150 mg Spironolacton täglich verabreicht. 10 Tage nach Beginn der Spironolactonbehandlung wurde die oben beschriebene Untersuchung der Digoxinelimination zusammen mit den Parametern des mikrosomalen Leberenzymsystems wiederholt.Aufgrund der errechneten pharmakokinetischen Parameter ließen sich unter Spironolactonbehandlung keine Änderungen der globalen Eliminationskonstante respektive der Halbwertszeit des Digoxins nachweisen. Ebenso blieb das Verteilungsvolumen, die renale und metabolische Clearance unbeeinflußt, die Digoxinausscheidung im Faeces war während beiden Versuchsperioden nicht signifikant verschieden und betrug für die gemessene Zeitperiode etwa 15% der verabreichten Dosis. Außerdem zeigten die Parameter des mikrosomalen Enzymsystems der Leber keinerlei Änderungen vor und unter Spironolactonbehandlung. Aufgrund dieser Ergebnisse konnte unter den klinisch üblichen Spironolactondosen keine Veränderung der Digoxinelimination nachgewiesen und eine Enzyminduktion sicher ausgeschlossen werden. Deshalb sind die in der Literatur berichteten Änderungen der Digoxinausscheidung auf eine zu hohe Dosierung im Tierversuch zurückzuführen und haben für den Menschen keine therapeutische Bedeutung.Herrn Prof. Dr. E. Bauereisen zum 65. Geburtstag in Dankbarkeit gewidmet     

Antibody- and complement-mediated lysis of HIV-infected cells and inhibition of viral replication

HIV-1-positive antisera were tested for their ability to lyse HIV-1-infected cells in the presence of active complement. Cytolytic effects caused by sera derived from infected humans were slower than those observed with sera from immunised chimpanzees. Lytic but also negative sera were found among HIV-1-infected asymptomatic men as well as among clinical AIDS cases. Human antisera that lysed infected cells reacted similarly irrespective of whether the complement was heterologous or autologous. Analysis of complement-mediated lysis using defined antisera against recombinant HIV-1 env or core antigens suggested that gp160/gp120 and p24 can act as target antigens for an antibody- and complement-mediated cytolysis of infected cells. Complement alone reduced the spread of HIV-1 infection in CD4+ cells and the ability of HIV-1 and HIV-2 to form plaques in CD4-transfected HeLa cells. Co-operative effects of specific antibodies and complement were the most effective in inhibiting HIV infections.     

Home chaos: sociodemographic, parenting, interactional, and child correlates.

We conducted 2 studies to (a) establish the usefulness of the construct of home chaos, (b) investigate its correlates, and (c) determine the validity of the Confusion, Hubbub, and Order Scale (CHAOS) used to measure the construct in each study. Study 1 relied on a sample of European American preschoolers and their mothers and Study 2 on a sample of African American school-age children and their caregivers. Home chaos was associated with less effective parental discipline; elevated behavior problems, limited attentional focusing, and reduced ability to understand and respond to social cues in children; and reduced accuracy and efficiency in a cooperative parent-child interactional task, after controlling for potential confounds. It is concluded that (a) home chaos is not a proxy for adverse social or psychological circumstances but a useful construct in its own right; (b) home chaos is associated with multiple detrimental correlates in parents and children; and (c) the CHAOS scale provides an adequate and economical measure of home confusion and disorganization that should prove useful in clinical research with diverse populations.     

RECOMBINATION FRACTIONS IN THE HLA SYSTEM BASED ON THE DATA SET ‘PROVINCES FRANÇAISES’: INDICATIONS OF HAPLOTYPE-SPECIFIC RECOMBINATION RATES

In the large genetic survey ‘Provinces Françaises’ the recombination fractions in the HLA system have been estimated by a family analysis programme (FAP). A total of 1332 families were analysed and in general the findings were in agreement with recombination fractions reported previously. The maternal recombination rates were on average 1.8 times higher than the corresponding ones for males. The comparison of the recombination fractions with the corresponding physical distances suggests the existence of hot spots of recombination. The analysis did not show deviations from expected values for HLA-A and B alleles on HLA-A/B recombinant haplotypes. However, analysis of HLA-B/DR recombinant haplotypes showed a skewed distribution of B and DR alleles. The significance of the findings is difficult to evaluate as all results are estimated numbers and frequencies but a manual analysis of the recombinant families confirmed the observations. HLA-B/DR recombinant haplotypes carried often HLA-DR3 and DR11 whereas DR2 and DR7 were more rarely present on recombinant haplotypes. DR4 had an increased incidence on BF/DR recombinant haplotypes but not on A/B or B/BF recombinant haplotypes. Some of the haplotypes with the strongest linkage disequilibria as A1, B8, DR3 and A3, B7, DR2 seem to be less frequently involved in recombinations than other haplotypes. Variations of recombination rates depending on certain alleles or haplotypes might partially explain the conservation of some haplotypes or part of haplotypes in Caucasoids.     

Ciprofloxacin in the treatment of acute exacerbations of chronic bronchitis

Eighty hospital patients with acute purulent exacerbations of chronic bronchitis associated withHaemophilus influenzae, Streptococcus pneumoniae, Branhamella catarrhalis orPseudomonas aeruginosa were treated with ciprofloxacin. The patients were divided into four groups of 20 patients each and administered either 500 mg, 750 mg (two different batches of tablets) or 1000 mg twice daily for ten days. Most of the patients withHaemophilus influenzae andBranhamella catarrhalis infections were treated successfully but the results in patients withStreptococcus pneumoniae andPseudomonas aeruginosa infections were less satisfactory. Although the ciprofloxacin MICs for the latter organisms were relatively low, mean serum and sputum concentrations measured on the first day of treatment did not exceed 2–3 mg/l and 1–2.3 mg/l respectively. The overall clinical results for all dosage regimes were only fair, mainly due to failure to eradicateStreptococcus pneumoniae andPseudomonas aeruginosa. Adverse effects (nausea, stomach pain or hallucinations) were seen in eight patients, causing treatment to be discobtinued in five. It is concluded that ciprofloxacin is only of limited use in the treatment of respiratory tract infections unlessStreptococcus pneumoniae is absent.     

Effect of Topical Indomethacin on Allergen-Induced Dual Skin Reactions

Twelve asthmatics with dual bronchial and skin reactions after allergen challenge received topical treatment with a 5%-indomethacin cream half an hour before and up to 7h after intradermal allergen and histamine injections. The erythema during the first 20 min of the wheal and flare reaction (WFR) was not affected, neither were the diameters of wheals and flares. 40 to 60 min after injection we observed a marked reduction of the erythema in histamine-and allergen-tested skin areas of 10 Patients. This effect lasted up to the 5th h alter injection of high allergen doses. During the hilly developed late cutaneous reactions (LCR) no effect 0f indomethacin on the erythema was observed, the edema of LCR was only insignificantly reduced. These results suggest that the erythema in LCR between the 1st and 4th is caused, at least in part, by local formation of prostaglandins.