Prostaglandins and angioplasty. An experimental study in canine arteries

To prevent platelet aggregation following percutaneous transluminal angioplasty (PTA), cyclooxygenase inhibitors such as acetylsalicylic acid (ASA) and indomethacin are recommended. However, ASA blocks both the proaggregating effects of thromboxane (TXA2) and the antiaggregating and vasodilating effects of prostacyclin (PGI2). The authors measured the contractile response of dilated canine carotid arteries in situ and in vitro using an isometric force transducer. Following PTA, contraction of the arterial wall was significantly reduced (p less than 0.01). By blocking cyclooxygenase with indomethacin (3 micrograms/ml), contraction was greatly improved (p less than 0.001). These results suggest that PTA may result in marked release of prostacyclin by the damaged arterial wall, which could account for the decreased responsiveness of the artery to exogenous norepinephrine.     

Disproportionate steatorrhoea in alcohol-induced calcific pancreatitis

The pancreatograms, as assessed by endoscopic retrograde cholangiopancreatography, of 51 patients with alcohol-induced calcific pancreatitis (AICP), were compared after division of the patients into three groups according to their insufficiency patterns. The first group, consisting of 18 patients, was labelled as having 'disproportionate steatorrhoea' characterized either by overt steatorrhoea and mild or no diabetes or by mild steatorrhoea and a normal glucose tolerance test result. The second group of 15 patients had severe diabetes associated with overt, mild or no steatorrhoea and constituted the 'insufficiency' group. The third group consisted of 18 patients with little or no pancreatic insufficiency. Twelve of the 18 patients with disproportionate steatorrhoea had a proximal complete or incomplete obstruction of their main pancreatic ducts, compared with 3 out of 15 in the insufficiency group and 4 out of 18 in the group with little or no pancreatic insufficiency. In this study an increased incidence of complete or incomplete obstruction (P less than 0,002) was found in the patients with disproportionate steatorrhoea compared with the other two groups. This suggests that obstruction to pancreatic flow may account for the dominant clinical presentation of steatorrhoea in some patients with AICP.     

Pedigree analysis and epidemiological features of idiopathic congenital talipes equinovarus in the United Kingdom: a case-control study

Background  

Congenital talipes equinovarus (CTEV) is a common developmental disorder of the foot, affecting between 1 and 4.5 per 1000 live births. The aetiology is not well elucidated. While both genetic and environmental factors are implicated, no specific genes have been identified and little is known about environmental risk factors.     

A comparison of enrichment media for the isolation of salmonellae from seagull cloacal swabs.

The relative efficiency of three selective enrichment broths (Muller-Kauffmann tetrathionate. Rappaport''s and selenite F) was investigated for the isolation of salmonellae from seagull cloacal swabs. Pre-enrichment in buffered peptone water was employed throughout the study, which involved the examination of 560 gulls, sixty (10.7%) of which were found to be carrying salmonellae. Rappaport''s broth as modified by Vassiliadis for incubation at 43 degrees C (Vassiliadis et al. 1976) yielded the highest number of positive swabs (57) and the widest range of serotypes. It was significantly more efficient that either selenite F or tetrathionate broth, although the results obtained with Rappaport''s broth incubated at 37 and 43 degrees C did not differ significantly (P greater than 0.5). Eleven serotypes were isolated during the study, the most prevalent being Salmonella virchow.     

Pancreatic enzyme replacement therapy

The relative efficacy of three commercial pancreatic enzyme supplements in improving fat absorption was studied using the [¹⁴C]triolein breath test in 12 patients with chronic pancreatitis. Two of the supplements were enteric coated. The one nonenteric coated product was studied twice: with and without ranitidine coadministration. Doses complied with the manufacturers recommendations. Baseline studies included pentagastrinstimulated gastric acids, 72-hr fecal fat excretion, and [¹⁴C]triolein absorption while not on supplementation. Acid outputs were variable (BAO: 0.3–4.1 meq/hr; MAO: 3.5–34.6 meq/hr). Three patients had mild steatorrhea (i.e., <10 g/day) and the remaining severe fat malabsorption (56.9±41.5 g/day). Although fat absorption was significantly improved by all three supplements, the nonenteric coated preparation was most effective (P< 0.001). However, laboratory analysis demonstrated that lipase content was four times greater, ie, 17,000 IU/4 tablets. Pretreatment with ranitidine failed to further improve the absorption in patients given nonenteric supplements but was effective in those found to have high or normal acid outputs (P<0.001). Our results suggest that the recommended dosage of enteric coated preparations is insufficient for adult patients with severe chronic pancreatitis. Secondly, the marked variability of acid secretion in such patients possibly accounts for the variability of results obtained by others on the usefulness of coadministration of antacids and H₂ antagonists. Routine measurement of gastric acid secretion status may help optimize the choice and form of pancreatic enzyme supplementation.     

An evaluation of commercially available dehydrated Rappaport-Vassiliadis medium for the isolation of salmonellae from poultry

A total of 745 samples of chicken giblets was cultured to determine the relative efficiency of a commercially available Rappaport-Vassiliadis medium (RV-Oxoid). Experiments to determine the optimum inoculation ratio showed that 1:100 was superior to the other ratios tested. Comparison of RV-Oxoid with standard RV and RV-medium prepared using soya peptone (RV-soya) showed that after 24 h RV-soya was significantly better than RV-Oxoid (P less than 0.05), although there was no significant difference between standard RV and RV-Oxoid. Furthermore, when the duration of incubation was extended to 48 h there was no significant difference between the three media (P greater than 0.25). We conclude that RV-Oxoid is a satisfactory product for the isolation of salmonellae from poultry, providing that it is inoculated at a ratio of 1:100 and is incubated for 48 h. Its use can therefore be recommended to laboratories who wish to use a dehydrated medium.