Modification of hemorheologic parameters by beta-receptor blockers with special reference to propranolol and talinolol

There are no systematic and complex investigations regarding the hemorheologic action of the betablockers propranolol and talinolol. The results on the other ones are contradictory. On the basis of a critical survey of the literature, in-vitro-experiments and studies in animals (rats) and humans may conclude that there are no remarkable deteriorations of rheological parameters in the therapeutic dose range. This is valid for diseases only where the haemodynamic regulation doesn't prevail.     

Symptomatic reversible duodenal compression due to iatrogenic retroperitoneal hematoma

Selective serotonin reuptake inhibitors are frequently employed to treat depression. However, although rarely, coagulation abnormalities have been described following the use of these compounds, and these effects appear to be enhanced by simultaneous use of nonsteroidal anti-inflammatory drugs. We describe a case of reversible symptomatic duodenal compression caused by a retroperitoneal hematoma after ingestion of sertraline and nimesulide.     

Near-total reduction in verapamil bioavailability by rifampin. Electrocardiographic correlates

We evaluated the significance of the interaction between rifampin and verapamil in six volunteers who received single doses of verapamil, 10 mg intravenously (IV), then 120 mg orally two days later. Subjects were then given rifampin, 600 mg orally every day for 15 days. After 13 and 15 days of rifampin therapy, the IV and oral doses of verapamil were repeated. Electrocardiograms (ECG) were done and serum verapamil and norverapamil concentrations measured before and for 12 h after each dose. For IV verapamil, there was a small decrease in area under the serum concentration-time curve and an increase in clearance after rifampin therapy (p less than 0.05). There were no changes in elimination half-life, volume of distribution, or AUC for percentage of change in P-R interval-time curve (AUCPR). For oral verapamil, there were marked decreases in peak concentration, AUC, oral bioavailability (all p less than 0.005), and AUCPR (p less than 0.001) after rifampin treatment. There were no changes in time to peak concentration or elimination half-life. For oral verapamil, significant P-R interval prolongation occurred only before treatment with rifampin. The decrease in oral bioavailability and the abolition of ECG response confirm that a highly significant drug interaction exists between rifampin and verapamil given orally but not intravenously.     

Hereditary prolidase deficiency in 2 sisters with therapy-resistant leg ulcers

Two sisters with hereditary prolidase deficiency are presented. Recurrent and painful leg ulcers are the predominant feature.     

Different accessory function for TH1 cells of bone marrow derived macrophages cultured in granulocyte macrophage colony stimulating factor or macrophage colony stimulating factor.

The ability of macrophages to stimulate immune responses is heterogeneous and may have influence on the type of the developing immune response. Therefore, in an attempt to define different functional states of mouse macrophages, we made use of the two macrophage growth factors: macrophage colony stimulating factor (M-CSF) and granulocyte macrophage colony stimulating factor (GM-CSF). Generation of macrophages from freshly isolated bone marrow cells in the presence of GM-CSF results in a population expressing profound antigen presenting function for mouse TH1 cells, resulting in strong lymphokine production and proliferation of the T cells. Furthermore, high amounts of a novel soluble cytokine active on mouse TH1 cells are generated during the interaction of TH1 cells with macrophages elicited with GM-CSF. In contrast, macrophages grown from bone marrow cells for at least 14 days in the presence of M-CSF express only minimal antigen-presenting function for TH1 cells. Treatment of such macrophages for 24 h with either IFN-gamma or GM-CSF allows the distinction between two further functional states. Those treated with IFN-gamma efficiently presented antigen towards TH1 cells. The T cells produced large amounts of lymphokines and proliferate well. However, synthesis of the novel soluble cytokine (active on TH1 cells) was not detectable. The generation of this mediator requires a short-term treatment with GM-CSF of macrophages developed in the presence of M-CSF prior to their interaction with TH1 cells.     

Weight of the thyroid gland in the Brandenburg district before introduction of iodized salt

The first prospective investigation of thyroid weights of over 20 years old adults in the GDR is presented. The material is based on autopsy findings from the Brandenburg area before using salt with iodine. Judging by the results this area appears as an endemiological one. Relationships to iodine content of drinking water, comparisons with autopsy statistics of other countries, and the role of regional epidemiological differences are pointed out. The importance of the investigation for patients care and the possibility of controlling the effect of using salt with iodine is underlined. The examination of relations between thyroid weight and anthropometric data showed no additional results.     

Anemia vs iron deficiency: increased risk of preterm delivery in a prospective study.

Using criteria from the Centers for Disease Control, anemia and iron-deficiency anemia (anemia with serum ferritin concentrations less than 12 micrograms/L) were assessed in greater than 800 inner-city gravidas at entry to prenatal care. Iron-deficiency anemia was associated with significantly lower energy and iron intakes early in pregnancy and a lower mean corpuscular volume. The odds of low birth weight were tripled and of preterm delivery more than doubled with iron deficiency, but were not increased with anemia from other causes. When vaginal bleeding at or before entry to care accompanied anemia, the odds of a preterm delivery were increased fivefold for iron-deficiency anemia and doubled for other anemias. Inadequate pregnancy weight gain was more prevalent among those with iron-deficiency anemia and in those with anemias of other etiologies. The prevalence of iron-deficiency anemia (3.5%), however, was lower than anticipated for an inner-city, minority population in whom most anemias had been attributed clinically to iron deficiency.     

Cell mediated immunity (CMI) and post transplant viral infections — Role of a functional immune assay to titrate immunosuppression

Cell mediated immunity (CMI) was assessed by the ImmuKnow assay in 12 patients after kidney transplantation, who presented with viral infection. Treatment included lowering of immunosuppression in all cases and antiviral treatment if indicated. The assay was repeated during the follow up. The ImmuKnow assay at time of presentation of viral infections was 56.8 ± 58.2 (range 3–178; median 22) ATP ng/ml. With the clearance of viral infection and lowering of immunosuppression, the assay showed an increase in the level of CMI at 194.5 ± 118.9 (range 53–409; median 150) ATP ng/ml. There was viral clearance or stabilization in all cases and there was no incidence of allograft rejection. The ImmuKnow assay of CMI can be used to titrate initial immunosuppression reduction and its subsequent increase, in patients with viral infection after transplantation.