Deep venous thrombosis of the arm: etiology, diagnosis and treatment

Thrombosis of the upper extremity is frequently (30-52%) related to the use of an indwelling venous catheter, but it can also occur in healthy individuals after exercise. In the past it was considered a relatively benign thrombotic event, which was treated conservatively, sometimes even without anticoagulant therapy. Recent studies have shown that complications of deep venous thrombosis of the upper extremity occur frequently: pulmonary embolism (8-36%), recurrence thrombosis after cessation of anticoagulant treatment (2-15%) and post-thrombotic syndrome (up to 50%). Therefore when thrombosis of the upper extremity is clinically suspected, it should be objectively diagnosed by compression echography followed if negative by phlebography, with anticoagulant treatment directly afterward, preferably with low-molecular heparin and then acenocoumarol or phenprocoumon.     

Hospital infections in general surgery wards

In 1997 the hospital infections programme was accepted by the National Association for Infectious Diseases (Polskie Towarzystwo Zakazeń Szpitalnych--PTZSz). About 100 hospitals from Poland participated in the surveillence system introducing nosocomial infection registration cards in their units. The results of the research were sent to the PTZSz. The results from general surgery departments in 1998 were analysed. This year 79 general surgery units took part in nosocomial infection programme of PTZSz, sending from 1 to 2259 questionnaires. The analysis included 48,964 nosocomial infection registration cards. Nosocomial infection developed in 1,031 cases in the general surgery departments what accounted for 2.11% of all treated patient in that period. Surgical site infections were the most often place of nosocomial infections (37.1%), next skin and soft tissue infections (20.1%), and finally respiratory tract infections (17.6%). The average duration of hospitalization in general surgery departments was 10.2 days. In case of nosocomial infection occurrence the time of treatment was extended three times. The most frequent aetiological pathogenes of nosocomial infections were as follows: Escherichia coli and Staphylococcus aureus.     

Horizontal appendicular dysmetria in four patients with a typical Wallenberg's syndrome

During the acute stage of a Wallenberg's syndrome ipsilateral appendicular dysmetria is frequently seen. The dysmetria is more apparent in the ipsilateral upper extremity. These patients also have a peculiar type of dysmetric eye movements that are characterized by hypermetric saccades toward the side of the lesion and hypometric saccades to the opposite side. We examined four patients with acute Wallenberg's syndrome and found horizontal dysmetria of the affected extremity. Hypermetric arm and hand movements were present to the side of the lesion and hypometric movements toward the opposite side. This type of dysmetria is probably related to the same patophysiological mechanism that underlies dysmetric eye movements in the Wallenberg's syndrome. The dysmetria tends to disappear with time although it continues to be present in some patients six months after the ischemic damage.     

CCR5 and beta-chemokines in HIV-1 infected children

The duration from initial infection with HIV-1 to CD4 lymphocyte depletion and progression to AIDS varies among infected individuals. Despite treatment with highly active antiretroviral therapy (HAART), patients still show different stages of disease progression. We examined the role of beta-chemokines and its receptor, CCR5 in HIV-1 infected children in order to define determinants of HIV progression among treated individuals. Population was divided in two groups: Group 1--Long Term Non Progressors (LTNP) includes 10 patients with B1-B2 CDC disease classification and with a less aggressive therapy (only 2 in HAART); Group 2--Rapid Progressors (RP) includes 9 patients with C3 disease classification. All the patients had a CCR5 wild type (wt) genotype indicating that they do not have the 32 base-pair deletion associated with slower progression. There was an increased production of MIP 1-beta in 8/10 LTNP but only in 4/9 Progressors (Paired t-test/Wilcoxon Sign test, p-value < 0.05). The change in the levels of MIP-1 beta after PHA stimulation was statistically significant in both groups. The levels of RANTES increased in LTNP and RP and the change of the levels after mitogen stimulation was statistically significant for both groups included. The production of RANTES and MIP-1 beta in response to stimulation between both groups was not statistically significant. The production of MIP-1 alpha was variable in both groups and the difference in the levels after mitogen stimulation between the groups was not statistically significant. These results suggest that beta-chemokines do not play an important role in HIV-1 progression in children undergoing HAART.     

Anti-inflammatory activity of Agave intermixta Trel. and Cissus sicyoides L., species used in the Caribbean traditional medicine

Agave intermixta Trel. and Cissus sicyoides L. are two tropical plants originating from the Dominican Republic. Aqueous extracts from these species are used in traditional medicine. In contrast, biological activity and toxicity of these plants are not yet evaluated systematically. The aim of the present work is to investigate a potential anti-inflammatory activity, and to elucidate the toxicity of the extracts. No lethal effects were produced after oral administration of the extracts. The values of the medium lethal doses after intraperitoneal administration were quite high for both species, although A. intermixta seems to be rather more toxic than C. sicyoides. The anti-inflammatory effects have been investigated in two experimental in vivo models. The carrageenan-induced rat paw oedema was chosen as a model for general inflammation, and the mice ear oedema test using tetradecanoylphorbol acetate as inflammatory agent as a model of topical inflammation. Dry extracts from decoctions of A. intermixta leaves and C. sicyoides stems were administered in doses of 300 and 500 mg/kg (p.o.) in the general model, and in doses of 3 and 5 mg/mouse ear for both plants in the topical model. In the general anti-inflammation assay, the oral administration of both extracts produced a significant anti-inflammatory effect, most pronounced for A. intermixta than for C. sicyoides. In the topical model, the administration of both extracts produced similar inhibitions of the oedema, with a reduction of approximately 50% in comparison with the control group. In homogenated tissue samples from the inflamed areas, a distinct decrease in the level of myeloperoxidase enzyme was noted.     

Synthesis of new N-(4-pyridyl)-1-aminopyrazoles and their muscarinic and adrenergic properties

The synthesis of new N-(4-pyridyl)-1-aminopyrazoles is described. Their binding properties were tested for muscarinic and other neurotransmitter receptors, together with their acetylcholinesterase inhibitory activity. The series derived from 3,5-dimethyl-1H-pyrazole showed moderate activities in both muscarinic and adrenergic receptor binding tests.     

Uptake and intracellular activity of ofloxacin isomers in human phagocytic and non-phagocytic cells

The penetration and intracellular activity of ofloxacin and its isomers (levofloxacin and D-ofloxacin) into human polymorphonuclear leucocytes (PMN), human peritoneal macrophages (PMphi) and tissue cultured epithelial cells (McCoy) were evaluated. The cellular to extracellular concentration (C/E) values of the three fluoroquinolones were higher than 3.6 and 2.6 in PMN and PMphi, respectively. The C/E ratios in McCoy cells were lower than those in PMN, but still higher than 2.0. The uptake of ofloxacin and its isomers was rapid, non-saturable and reversible. All quinolones (extracellular concentrations: 2, 5 and 10 mg/l) produced a significant reduction of viable intraphagocytic Staphylococcus aureus in phagocytic cells. We concluded that ofloxacin and its isomers reach high intracellular concentrations in phagocytic and non phagocytic cells while remaining active in the former.     

Variables modulating stress and coping that discriminate drug consumers from low or nondrug consumers

The present study assesses how certain stress and coping variables relate to drug use. A total of 124 subjects (85 men, 39 women) took part. They were divided into two groups: consumers and low or nonconsumers. Results indicate that consumers show significantly lower scores in self-control than low or nonconsumers. This research is of interest because it analyzes the relationship among assertiveness, self-control, self-efficacy, and drug use. We consider it worthwhile to take these variables into account when planning prevention programs.     

Thrombophlebitis of the lateral sinus. A more frequent complication than expected

At present, the frequency of intracranial complications of middle ear infections has decreased sharply as a result of the use of more effective antibiotics. We report two cases of lateral sinus thrombosis, in a 2-year-old male and a 14-year-old male respectively, after middle ear infection that progressed to mastoiditis with osteitis. The severity of these complications underlines the importance of clinical awareness and early diagnosis by angiographic magnetic resonance imaging so that suitable treatment can be begun.