Counterelectrophoresis in the Diagnosis of Amebiasis

One hundred eighty-one collected sera were tested for amebic serologic reactivity, using the counterelectrophoresis technic (CEP) and compared to the results of the agar gel diffusion (AGD) and the latex agglutination (LA) methods. Of 23 sera from patients with proven amebic liver abscess, 22 (96%) were positive immediately after CEP for one hour and all were positive within 24 hours. Of eight sera from patients with intestinal amebiasis, five were positive immediately and seven within 24 hours. Of 150 sera from patients with nonamebic illnesses, there were no positives with any method used. The CEP and AGD were in agreement on all sera tested.     

Xamoterol in the Treatment of Orthostatic Hypotension Associated with Multiple System Atrophy (Shy-Drager Syndrome)

The effect of xamoterol on the orthostatic hypotension associatedwith Shy-Drager syndrome was investigated in three patients.Intra-arterial blood pressure was measured during a controlperiod and during treatment with xamoterol, both in a cardiovascularinvestigation laboratory and for 24 h of unrestricted activityusing portable apparatus. Xamoterol lessened the total number of symptomatic episodesof orthostatic hypotension by 67 per cent. Average untreated24-h intra-arterial blood pressure was 132/78 mmHg; during treatmentwith xamoterol it rose to 138/90 mmHg. However episodes of severehypertension (defined as a systolic intra-arterial blood pressureabove 200mmHg) were more frequent with xamoterol. Although xamoterol attenuated orthostatic hypotension, carefulmonitoring of ambulatory blood pressure may be necessary, particularlyat the start of treatment, because of the development of severesupine hypertension. Intravenous test doses of xamoterol didnot predict either the attenuation of orthostatic hypotensionor the development of supine hypertension in all patients.     

Beta-adrenergic blockade in acute myocardial infarction: a haemodynamic and radionuclide study

While long term beta-adrenergic blockade, introduced in theconvalescent stage of myocardial infarction, may reduce subsequentmortality, the value of early beta-blockade in the acute phaseis less certain. Therefore, the influence of beta-blockade onleft ventricular performance and eventual infarct size was assessedin 61 consecutive patients with acute myocardial infarction.Metoprolol (15 mg i. v. followed by 200 mg day^-1 orally) orplacebo was administered in a double-blind, randomised fashionwith a median delay of 5.9 hours from onset of symptoms. After15 days of double blind therapy all patients were started onopen treatment with metoprolol. All patients underwent haemodynamicmonitoring for 24 hours and serial radionuclide ventriculographyand thallium 201 scintigraphy.In the first hour metoprolol produceda decrease in cardiac output (1.3 l min^-1; P<0.001) due toa reduction in heart rate (15 min^-1; P<0-001) and a decreasein left ventricular stroke work index (10.7 g m m²; P<0.001)due to a reduction in mean arterial pressure (10 mmHg; P<0.001).There was then a gradual attenuation in these changes. Whilemetoprolol produced an increase in pulmonary capillary wedgepressure and in both end-diastolic and end-systolic volumes(P<0.05), these changes were confined to patients with abaseline pulmonary capillary wedge pressure below the medianof 13 mm Hg mercury. There was no significant change in strokevolume or in ejection fraction in response to metoprolol. Therewas no significant difference between the groups in left ventricularperformance, as assessed by radionuclide ventriculography, orin scintigraphic infarct size, either at the end of the 15 daysdouble-blind treatment or after 3 months open treatment withmetoprolol.Thus, early intervention with metoprolol in acutemyocardial infarction appeared to reduce myocardial oxygen consumptionwith no adverse haemodynamic effect. However, metoprolol failedto preserve left ventricular function, or to reduce apparentinfarct size. These data suggest that the modest reduction inmortality reported in the acute phase studies of beta-blockadein myocardial infarction, is unlikely to be due to infarct reduction.It is more likely to be due to a secondary prevention or toan antiarrhythmic effect.     

The Effect of the Food Intake on the Morning Value of the Citric Acid Concentration of the Blood.

The intake of food in the morning immediately after awakening causes an increase in the Ci-value of the blood serum, measured by Thunberg's enzymatic method. In a series of 10 subjects the lowest increase was 5 %, the highest 32 %, and the mean value 20.6 %. When the method is used for diagnostic purposes in liver diseases, blood samples should be taken on an empty stomach and under so similar conditions as possible.