Brain lesions in newborns exposed to high-dose magnesium sulfate during preterm labor.

High-dosage, tocolytic magnesium sulfate (MgSO4) administered to pregnant women during preterm labor can be toxic, and sometimes lethal, for their newborns (Cochrane Database of Systematic Reviews (relative mortality risk 2.82, 95% confidence interval 1.2-6.6)). Based on the results of the Magnesium and Neurologic Endpoints Trial and the work of many others, a unifying triangular concept is proposed to account for the increased prevalence of brain lesions, with their likely resultant mortality, in neonates and infants exposed to high-dose MgSO4 in the context of preterm labor. We review the evidence that: (1) elevated circulating levels of serum ionized magnesium occurring in mothers, and therefore in their babies, at the time of delivery are associated with subsequent neonatal intraventricular hemorrhage (IVH); (2) neonatal IVH is strongly associated with lenticulostriate vasculopathy (LSV), an unusual mineralizing lesion involving the thalami and basal ganglia of the neonate; and, (3) exposure to 50 g or more of tocolytic MgSO4 during preterm labor is associated with the development of LSV.     

Bildgebung der Nasennebenhöhlen (NNH) in der heutigen Zeit

CT is accepted as the gold standard for pathological-anatomical evaluation of paranasal sinus disease, CT is especially considered an obligatory part of planning surgical procedures. Indications for paranasal sinus CT include trauma, malignant disease, and chronic sinusitis, which accounts for the major part of examinations. Due to the benign character of the disease and the relatively moderate age of the patients involved, the radiation dose of paranasal sinus CT plays an important role. The use of a low-dose spiral CT technique and the reformation of coronal images out of the axial CT data instead of an additional direct coronal scan allow the effective dose of paranasal sinus CT to be reduced to the order of a chest radiogram. MRI is the preferred imaging modality in malignant disease or complications of inflammatory sinus disease that extend beyond the limits of the paranasal sinuses. The clinical value of other imaging modalities, including plain film radiography, ultrasound, or scintigraphy, is limited to special indications.     

Gastroduodenal tolerability of indomethacin and acetaminophen. A comparative endoscopic study in healthy subjects

The effect of a 5- and 10-day treatment with indometacin and acemetacin (Rantudil) on the gastroduodenal mucosa was endoscopically evaluated in 16 healthy volunteers. In a randomised double-blind cross-over fashion the volunteers received 50 mg t.i.d. indometacin as well as 60 mg t.i.d. acemetacin. Acemetacin evoked after 5 and 10 days significantly less gastroduodenal lesions than indometacin. Possible reasons for this apparently better tolerability of acemetacin in man are discussed.     

Gelastic epilepsy and precocious puberty in hamartoma of the hypothalamus]

Four cases of hypothalamic hamartoma leading to gelastic epilepsy, precocious puberty and behavioural disorders are reported. Cerebral neuroradiologic examinations revealed a tumor-like mass attached to the hypothalamus in the region of the mamillary bodies in all cases. Precocious puberty developed in the two girls at 4 and 13 months but in neither of the two boys, who both suffered behaviour disturbances in the form of aggressive outbursts. A total resection of the tumors of both boys led to histologic confirmation of hamartoma. One boy was free of seizures upon follow-up, whereas seizure frequency in the other boy was reduced, while his aggressivity increased. The cases are discussed in context of current therapeutic conceptions of gelastic epilepsy and central precocious puberty.     

An evaluation of thermal dilution for obtaining serial measurements of cardiac output

The thermal dilution method offers a number of advantages in the measurement of cardiac output particularly when measurements at frequent intervals over prolonged periods are required. The sources of error in the quantification of thermal indicator input and other factors pertinent to the applicability of this method to serial measurements in an automated clinical environment are discussed.     

Detection of antibodies to HTLV-III in commercially available immunoglobulin preparations

Summary Samples of 96 polyvalent and virus-specific immunoglobulin batches commercially available in West-Germany were tested by enzyme-linked immunoassay and immunoblot for the presence of anti-HTLV-III antibodies. 37% of the polyvalent and 87% of the virus-specific batches were positive. It was concluded that these preparations are still safe and because of their reportedly low titer neutralizing antibodies possibly beneficial in certain cases, such as newborns of HTLV-III positive mothers or after accidental exposure to infectious material in clinics or laboratories.Abbreviations AIDS acquired immunodeficiency syndrome - ARC AIDS-related complex - CMV cytomegalovirus - ELISA enzyme-linked immuno adsorbent assay - HTLV-III human T-cell lymphotropic virus, type III     

Seroepidemiology of HTLV-III (LAV) in the Federal Republic of Germany

Summary In 1984 10,281 sera were collected in the FRG and examined for antibodies to HTLV-III (LAV) with an enzyme-linked immunosorbent assay and confirmative tests. Of the German AIDS patients 81% have antibodies. Individuals belonging to AIDS risk groups, homosexuals, haemophiliacs and i.v. drug abusers, have antibody frequencies between 25%–72%. The detection of HTLV-III antibodies in blood donours indicates that the virus is being transmitted by blood transfusions.Abbreviations AIDS acquired immunodeficiency syndrome - LAS lymphadenopathy syndrome - ARC AIDS related complex - LAV lymphadenopathy associated virus - HTLV-III human T-lymphotropic virus type III - HBV hepatitis B virus     

Differential effects of misoprostol and ranitidine on the pharmacokinetics of diclofenac and gastrointestinal symptoms

1. The effects of oral misoprostol (800 microg day(-1)) and ranitidine (300 mg day(-1)) on the pharmacokinetics of diclofenac (100 mg) were assessed in a three-way randomized crossover study in 18 healthy male subjects. 2. Subjects were studied over three 8 day periods, during which they received twice-daily placebo, misoprostol, or ranitidine. A single dose of diclofenac was given orally on days 1 and 8, and plasma diclofenac concentrations were measured by h.p.l.c. over 24 h. 3. Misoprostol caused a non-significant 19% increase in the mean Cmax value of diclofenac on both days 1 and 8. After 8 days of dosing with misoprostol there was a significant (P = 0.04) 20% decrease in the AUC of diclofenac. 4. Ranitidine had no statistically significant effects on the pharmacokinetics of diclofenac. 5. Co-administration of misoprostol and diclofenac was associated with a higher frequency and severity of gastrointestinal symptoms and frequency of bowel opening, and a decrease in faecal consistency when compared with either placebo or ranitidine plus diclofenac (P < 0.01).