Protein, lactose and fat concentration of breast milk of mothers of term and premature neonates

The protein, lactose and fat concentrations in the milk of seven mothers giving birth at term and six mothers giving birth prematurely were determined. Samples were obtained during the first 31 days of lactation. The protein, lactose and fat concentrations of preterm milk were found to be similar to those of fullterm milk over this period. For both term and preterm groups, protein concentration decreased with increasing age, while lactose concentration increased. Fat concentration did not show a consistent pattern of change in the preterm group, but tended to increase with advancing age in the term group.     

THE CYCLING OF COMBINATION ANTIRHEUMATIC DRUG THERAPY IN RHEUMATOID ARTHRITIS

In this open pilot study a combination of hydroxychioroquine,prednisolone and alternating months of treatment with sulphasalazineor oral weekly pulse methotrexate has been investigated in 16patients with rheumatoid arthritis (RA) refractory to a totalof 67 disease suppressive medications. Results at 3 months indicatedsignificant improvements in visual analogue score for pain,joint count, Ritchie index, scale of disability related to activitiesof daily living, ESR, rheumatoid factor and C-reactive protein.This degree of improvement, however, was not maintained 6 and12 months after commencement of treatment. Pain score, Ritchieindex and ESR were the only parameters demonstrating significantimprovement at 12 months. Therapy was terminated in eight patients,half due to lack of efficacy and half because of side effects. KEY WORDS: Arthritis, Treatment, Methotrexate, Sulphasalazine, Antimalarials, Corticosteroids     

Prothrombin complex concentrates reduce blood loss in murine coagulopathy induced by warfarin,but not in that induced by dabigatran etexilate

Summary. Background: Both established oral anticoagulants such as warfarin and newer agents such as dabigatran etexilate (DE) effectively prevent thromboembolic disease, but may provoke bleeding. Limited clinical data exist linking oral anticoagulant reversal and bleeding tendency, as opposed to surrogate laboratory markers. Objective: To quantify bleeding in warfarin‐anticoagulated and DE‐anticoagulated mice by tail transection with or without pretreatment with potential reversal agents: prothrombin complex concentrate (PCC); activated PCC (APCC); recombinant factor VIIa (rFVIIa); or murine fresh‐frozen plasma (FFP). Methods: CD1 mice were given warfarin or DE by gavage, and the effects on in vitro coagulation assays, volume of blood loss and the bleeding time following tail transection injury were evaluated with different reversal agents. Results: PCC (14.3 IU kg^?1), but not rFVIIa (3 mg kg^?1) or FFP (12 mL kg^?1), normalized blood loss and bleeding time in mice with warfarin‐induced elevations of mean prothrombin time at two intensities (prothrombin time ratios of either 4.3 or 24). Neither separate nor combined PCC and/or rFVIIa treatment nor APCC (100 U kg^?1) treatment significantly reduced blood loss in mice anticoagulated with 60 mg kg^?1 DE 75 min prior to tail transection. Both combined PCC plus rFVIIa treatment and APCC treatment significantly reduced bleeding time in the DE‐treated mice. Conclusions: Our data suggest that PCC treatment prevents excess bleeding much more effectively in warfarin‐induced coagulopathy than in DE‐induced coagulopathy.     

Effect of continued rt-PA administration on the residual stenosis after initially successful recanalization in acute myocardial infarction - a quantitative coronary angiography study of a randomized trial

Quantitative angiography was performed in 68 out of 123 patientstreated with intravenous rt-PA for acute myocardial infarction.At 90 min angiography, the median minimal cross-sectional areawas 1.11 mm² and the median percentage area stenosis was 80%.A percentage area stenosis greater than 70% was seen in 78%of the patients. Patients with a patent infarct related artery at the first angiogramwere randomized to receive subsequent infusions either of rt-PA+ heparin or placebo + heparin. There was a persistent trendof improvement in minimal lumen diameter and percentage diameterstenosis of the residual stenosis in the infarct related arteryin both treatment groups when re-examined 6–24 hours laterand at the time of hospital discharge. A reduction in ‘plaquearea’, the area between the detected and the referencecontours of the infarct related segment, was more frequentlyseen in patients receiving a second infusion of rt-PA than inpatients with no prolonged thrombolytic therapy (83% versus57%, P<0.025, chi square).