HL-A Antigens in Leprosy

HL—A phenotype frequencies were studied in 30 patients with leprosy and in 149 healthy controls. Leprosy patients had a significantly higher frequency of HL—A14. In addition, a majority of the HL—A14 patients gave a negative response to leproma antigen using the Mitsuda test.     

Hookworm Anemia: Iron Metabolism and Erythrokinetics

Iron metabolism, balance of red cell production and destruction and ironabsorption from hemoglobin were determined in 11 patients with heavy hookworm infection and severe anemia.

The plasma iron, total iron binding capacity, bone marrow hemosiderinand plasma Fe⁵⁹ clearance are in agreement with the idea that the anemia associated with hookworm infection is of the iron deficiency type.

The rate of red cell production measured by the E/M ratio, absolute reticulocyte count and plasma iron turnover showed an increase to about twicenormal, while the rate of destruction estimated by the T erythrocytesurvival showed a destruction about 5 times normal. This unbalance betweenproduction and destruction could explain the severity of the anemia.

The increase of fecal urobilinogen output to twice normal was interpretedas due to the metabolism of the hemoglobin lost into the intestine rather than toan increase of hemolysis.

The estimation of fecal blood loss in the patients whose red cells weretagged with Cr⁵¹ and Fe⁵⁹, showed that the radioactivity counted with Fe⁵⁹was only about 63 per cent of the radioactivity counted with Cr⁵¹. This difference was interpreted as due to iron absorption from the hemoglobin lostinto the intestine.

The mean daily fecal excretion of iron reaches 4.7 mg. Since the ironmetabolism in these patients is in equilibrium, we have concluded that theiron loss is replaced by the iron from food; this is in addition to the 3 mg.hemoglobin iron which is reabsorbed from the blood lost into the gut.

Submitted on January 9, 1961 Accepted on April 2, 1961     

CONTRIBUTION TO THE PATHOGENESIS OF HEMOPHILIA

The causes of the delayed coagulation of hemophilic blood seem to become cleareras time advances. On one side we have the investigations of the school of Minot,indicating a deficit in the globulin fraction; and on the other side are the works ofthose who maintain that there exists an excess of anticoagulant substances. Wesupport the latter theory, although in our opinion the two theories do not contradict each other, since it might be possible that this anticoagulant substancewould act on the globulin fraction diminishing its coagulant power. This substancecould be identified with the anticephalin fraction of Tocantins.

With the idea that this substance might be less stable than the coagulant fractions (fibrinogen, prothrombin, and thromboplastin) we have tried to render itinactive by keeping the blood in a refrigerator for a certain length of time. Inactivity was obtained in some of our experiments. We know that the stability ofthis substance varies from one patient to the other, but we have not been able tofix the cause of these variations.

In conclusion, we consider that other means of neutralizing the action of thisanticoagulant substance should be investigated. This inactivity once obtained, weshould have advanced far in solving the intricate problem of hemophilia.

     

Coexisting Preexcitation Syndrome and Intermittent Heart Block Presenting as Neonatal Seizures

An infant presented with neonatal syncope and seizures. An ECG showed a preexcitation pattern, most compatible with Wolff-Parkinson-White (WPW) syndrome. Rhythm monitoring during an event demonstrated prolonged periods of complete AV block with no ventricular escape mechanism. We postulated that ventricular asystole was initiated by mechanical or autonomic influences on the accessory pathway and sustained by electrophysiologic interactions between the accessory pathway and the junctional escape focus. This is the first case report of a newborn having coexisting congenital AV block and WPW syndrome.     

Disposition of Nifurtimox and Metabolite Activity Against Trypanosoma cruzi using Rat Isolated Perfused Liver

Abstract— Nifurtimox disposition was investigated using the rat isolated perfused-liver method after administration of 25 μg mL^?1 nifurtimox, and its disappearance was monitored by analysing the perfusate sample at various times. Biliary excretion was also measured. The drug concentration profile underwent a biexponential decline over the 2-h study period, with a terminal half-life of 62·76 ± 17·56 min. Nifurtimox is a high clearance compound (15·23±5·53 mL min^?1). The extraction ratio was 0·621 ±0·159. Biliary excretion accounted for 0·05% of the dose, the remainder consisting of highly polar metabolites. By 2 h, a minimal fraction of unchanged nifurtimox was recovered from the perfusate. Nifurtimox activity against Trypanosoma cruzi (clone CA-1) during the perfusion was also determined. Epimastigotes isolated from continuous culture were exposed to the samples of perfusate at different perfusion times in a microtitre plate. After an incubation time of 72 h at 27°C, the parasite number in each well was counted under a microscope. From 0 to 75 min after the perfusion, the anti-trypanosomal activity decreased, but an increase in activity was observed at the later times. These findings show that active metabolites are formed during the perfusion.     

Effects of Trecadrine,a β3-Adrenergic Agonist,on Intestinal Absorption of d-Galactose and Disaccharidase Activities in Three Physiopathological Models

Impairments in intestinal absorptive and digestive processes have been described in several pathophysiological situations, such as in drug-induced diabetes, obesity and hypercholesterolaemia. Furthermore, there is evidence for the occurrence of β₃-adrenoceptors in multiple regions of the gastrointestinal tract, but there are no data concerning their possible involvement on jejunal and ileal digestive and absorptive functions. In this work, we have measured the modifications of selective intestinal absorption and disaccharidase activities in alloxan-induced diabetic and in diet-induced obese and hypercholesterolaemic Wistar rats. The action of a β₃-adrenergic agonist (Trecadrine) with hypoglycaemic and lipolytic properties on those gastrointestinal functions has been studied. Increases in the galactose uptake by intestinal rings and in both sucrase and maltase activities were found in diabetic rats. The results obtained after Trecadrine administration to diabetic rats led to an improvement of the altered values. On the other hand, our data show a decrease in sugar absorption and in disaccharidase activities in both obese and hypercholesterolaemic groups, probably related to the low carbohydrate and high fat content of these diets. An amelioration in sucrase activity was observed after treatment with Trecadrine. Finally, Trecadrine administration to control animals significantly inhibited galactose intestinal absorption, which was independently confirmed by additional in-vitro studies. Overall, these results could be attributed not only to an improvement in the pathophysiological condition (diabetes, obesity and hypercholesterolaemia), but also to a direct effect of the β₃-adrenergic agonist on the intestinal absorption processes.     

Unusual Placement of a Pacemaker Pocket

Because of infection and extensive radiation injury to the skin of the chest wall, a dual chamber pacemaker was implanted deep to the clavicle. The wound has been stable and comfortable for 1 year and pacemaker programming has been unimpaired.     

SUSTAINED REDUCTION IN URINARY CALCIUM DURING LONG-TERM TREATMENT WITH SLOW RELEASE NEUTRAL POTASSIUM PHOSPHATE IN ABSORPTIVE HYPERCALCIURIA

Purpose

We tested whether UroPhos^§-K a new slow release neutral form of potassium phosphate (155 mg. phosphate, 8 mEq. potassium per tablet) in a dose of 4 tablets twice daily absorptive hypercalciuria, a major cause of nephrolithiasis characterized by excessive intestinal calcium absorption accompanied in some patients by excessive bone loss.

Materials and Methods

A total of 25 patients with absorptive hypercalciuria were studied in a 4-year, prospective, open trial with UroPhos-K at yearly intervals during a 4-day inpatient physiological study with a constant metabolic diet containing 400 mg. calcium, 100 mEq. sodium and 800 mg. phosphate daily.

Results

Treatment with UroPhos-K caused a sustained, marked reduction in urinary calcium (264 to 181 mg. daily). Fractional⁴⁷ calcium absorption decreased modestly (74.0 to 64.6%) commensurate with a reduction in serum 1,25-dihydroxyvitamin D (42 to 34 pg./ml.). Intact parathyroid hormone increased within the normal range (30 to 42 pg./ml.). Bone mineral density was stable at the lumbar spine, femoral neck and distal third of the radius.

Conclusions

UroPhos-K may provide a long-term alternative for hypercalciuric patients in whom thiazide therapy fails.     

Sources of information about diet and health in a Mediterranean country: Comparison with other European member states

Background: A Pan-European survey was carried out to assessthe main sources of information about healthy diet in the Europeanpopulation and to assess whether these sources differ betweena Mediterranean country and other European populations. Methods:This study belongs to a Pan-European survey on Attitudes toFood, Nutrition and Health. A multistage sampling procedurewas used. Each subject was asked about the main sources of informationon healthy eating. The survey was completed between October1995 and February 1996 in the 15 member states of the EuropeanUnion. The questionnaire was completed by 14,331 persons, approximately1,000 from each member state. Data were quota controlled bysociodemographic factors and all results were weighted for thepurpose of maintaining national representativeness. The participantswere asked to indicate which sources they used more often outof a list with 22 options. They were allowed to select a maximumof two sources. Results: The source of information ‘televisionprogrammes or radio’ was more prevalent in the rest ofthe member states of the European Union (30.9%) than in Spain(25.7%). ‘Health professionals’ were mentioned withsimilar frequency as a source of information in Spain and inthe rest of the European Union. Conclusions: Our results confirmthat mass media play an important role in transferring messagesabout healthy eating to the general public. Increasing the circulationof newspapers in Spain, where a low level of newspapers readingexists, would probably improve the knowledge of the generalpublic.