A mild form of captopril-induced pemphigus

We describe a mild form of drug-induced pemphigus in a woman with essential arterial hypertension treated with captopril. Complete recovery was observed three weeks after the therapy had been discontinued.     

Cervical lymphadenopathy in the dental patient: a review of clinical approach.

Lymph node enlargement may be an incidental finding on examination, or may be associated with a patient complaint. It is likely that over half of all patients examined each day may have enlarged lymph nodes in the head and neck region. There are no written guidelines specifying when further evaluation of lymphadenopathy is necessary. With such a high frequency of occurrence, oral health care providers need to be able to determine when lymphadenopathy should be investigated further. Although most cervical lymphadenopathy is the result of a benign infectious etiology, clinicians should search for a precipitating cause and examine other nodal locations to exclude generalized lymphadenopathy. Lymph nodes larger than 1 cm in diameter are generally considered abnormal. Malignancy should be considered when palpable lymph nodes are identified in the supraclavicular region, or when nodes are rock hard, rubbery, or fixed in consistency. Patients with unexplained localized cervical lymphadenopathy presenting with a benign clinical picture should be observed for a 2- to 4-week period. Generalized lymphadenopathy should prompt further clinical investigation. This article reviews common causes of lymphadenopathy, and presents a methodical clinical approach to a patient with cervical lymphadenopathy.     

The use of ofloxacin in cystic fibrosis patients]

The new quinolones represent the latest possibility of specific oral antibiotic treatment of infections caused by gram-negative bacteria. Among the new quinolones, ciprofloxacin and ofloxacin are characterized by strong in vitro activity against most Pseudomonas species strains, favourable kinetic in body fluids, good tolerability and the possibility of oral administration. For these reasons they appear to be ideal antibiotics for long-term home therapy of chronic obstructive pulmonary disease in cystic fibrosis (CF). The efficacy of ciprofloxacin has been recently assessed. In this study, actual effectiveness of ofloxacin in long-term home antibiotic treatment of patients affected by CF was evaluated. The study was a no-blind cross-over study, designed to compare ofloxacin treatment with conventional oral antibiotic therapy. Young adult patients, who needed long-term antibiotic therapy and whom sputum culture were positive for sensitive strains, were randomly assigned to 2 groups. One group received ofloxacin, the other group was given a non-quinolone oral antibiotic, selected according to sputum culture sensitivity. Oral antibiotics were administered for 20 days, then a break of 10 days was allowed during which patients received nebulized aminoglucosides, usually tobramycin. After 3 months, therapies were rotated: the first group received a non-quinolone oral antibiotic and the second group received ofloxacin for another 3 months. The clinical score (according to Huang et al., see table I) and the lung function (FVC, FEV1, pulsed SaO2) were assessed in all the patients at the beginning and at the end of each three months period of oral antibiotic therapy.(ABSTRACT TRUNCATED AT 250 WORDS)     

Cystic meningiomas. Report of seven cases

Seven patients with cystic meningioma are reported. The computerized tomography appearance of these meningiomas may mimic that of a glial or metastatic tumor with cystic or necrotic changes, and lead to an incorrect presumptive diagnosis. Radiological evaluation and recognition are important for the surgical removal of these potentially curable neoplasms.     

Nature of the genetic determinant controlling encapsulation in Staphylococcus aureus Smith.

Two strains of Staphylococcus aureus, Smith and M, were studied for the elimination of encapsulation. For S. aureus M, encapsulation was stable. For S. aureus Smith, spontaneous loss of encapsulation was 1.3% and increased markedly in medium containing surface-active agents. In the presence of sodium dodecyl sulfate, unencapsulated cells had a considerable selective advantage. Attempts to demonstrate covalently closed circular plasmid deoxyribonucleic acid were unsuccessful. In cultures of unencapsulated cells, encapsulated cells were observed occasionally. These data argue against a plasmid location for the determinants controlling encapsulation in this organism in spite of a high spontaneous loss of this character.     

Development of a bacteriophage-typing set for Staphylococcus epidermidis.

Six phages isolated from lysogenic cultures of Staphylococcus epidermidis were used to type cultures in our collection classified previously as "untypable" with our original typing set of 13 phages, new clinical isolates from Missouri, and clinical isolates from Connecticut, Georgia, Pennsylvania, and Virginia. Typability with the new set of 6 phages and with our 13 original phages was compared. For 203 cultures, 81 (39.9%) cultures were typable with the set of 6 phages and 73 (36.0%) cultures were typable with the set of 13 phages. When the two typing sets were combined, the percentage of typability for 425 cultures increased to 49.9%. compared with 35.7% with the original set of 13 phages. For 109 cultures from outstate, the percentage of typability was 56.9%, whereas that for 316 cultures from Missouri was 47.5%. When only cultures in biotype 1 were considered, the percentage of typability for 268 cultures with the combined set increased to 58.2%, compared with 39.5% with the original set of 13 phages. Analysis of individual reactions for all 425 cultures typed in our laboratory indicated that 11 of the 19 phages in the combined set accounted for the majority of the reactions, and a provisional set containing these 11 phages is proposed.