Localized Kaposi''s sarcoma in a patient with pemphigus vulgaris

We report the case of a patient with a 13-year history of pemphigus vulgaris (PV) treated with immunosuppressive agents, prednisone and mycophenolate mofetil who had developed lesions of Kaposi's sarcoma (KS) on a sole plaque of PV that had been previously treated with intralesional injections of steroids. The lesions were surgically removed and polymerase chain reaction (PCR) demonstrated human herpesvirus-8 (HHV-8) DNA. There were neither recurrences nor later dissemination of KS following gradual decrease of the immunosuppressive therapy. We suggest that the treatment with intralesional steroids may have influenced the local reactivation of a latent infection of the virus, determining the appearance of this localized KS.     

Flerobuterol: a potential antidepressant drug related to β-adrenergic agonists. Experimental profile in mice

The potential antidepressant effect of flerobuterol (dl-(fluoro-2 phenyl)-1 t-butylamino-2 ethanol), a new drug related to beta-adrenoceptor agonists, was evaluated and compared with imipramine and salbutamol using classical psychopharmacological tests in mice. Like imipramine and salbutamol, flerobuterol (0.5-32 mg kg-1, ip) fully prevented apomorphine (16 mg kg-1, sc)- and partly reversed reserpine- and oxotremorine-induced hypothermia. At higher doses (16-32 mg kg-1), flerobuterol enhanced the toxic effects of yohimbine. Unlike imipramine, flerobuterol and salbutamol did not reduce immobility duration in the behavioural despair test. Salbutamol and flerobuterol decreased locomotor activity. Flerobuterol did not induce mydriasis, did not prevent oxotremorine-induced tremors or salivary and lacrimal gland secretion and did not reduce reserpine-induced palpebral ptosis. Propranolol (8 mg kg-1, ip) but not alpha-methyl-paratyrosine (75 mg kg-1, ip) prevented the flerobuterol-induced antagonism of apomorphine-induced hypothermia. Our results suggest that flerobuterol demonstrates potential antidepressant activity, which could be related to beta-adrenoceptor activation in mice.     

Adding Bupivacaine to High-potassium Cardioplegia Improves Function and Reduces Cellular Damage of Rat Isolated Hearts after Prolonged, Cold Storage

Background: Bupivacaine retards myocardial acidosis during ischemia. The authors measured function of rat isolated hearts after prolonged storage to determine whether bupivacaine improves cardiac protection compared with standard cardioplegia alone.

Methods: After measuring cardiac function on a Langendorff apparatus, hearts were perfused with cardioplegia alone (controls), cardioplegia containing 500 [mu]m bupivacaine, or cardioplegia containing 2 mm lidocaine; were stored at 4[degrees]C for 12 h; and were then reperfused. Heart rate and left ventricular developed pressures were measured for 60 min. Maximum positive rate of change in ventricular pressure, oxygen consumption, and lactate dehydrogenase release were also measured.

Results: All bupivacaine-treated, four of five lidocaine-treated, and no control hearts beat throughout the 60-min recovery period. Mean values of heart rate, left ventricular developed pressure, maximum positive rate of change in ventricular pressure, rate-pressure product, and efficiency in bupivacaine-treated hearts exceeded those of the control group (P < 0.001 at 60 min for all). Mean values of the lidocaine group were intermediate. Oxygen consumption of the control group exceeded the other groups early in recovery, but not at later times. Lactate dehydrogenase release from the bupivacaine group was less than that from the control group (P < 0.001) but did not differ from baseline.     

Medical removals of the Multiload IUD

In a follow-up evaluation of 3721 Multiload IUD users, the removal rate for medical reasons other than bleeding/pain was only 2.6 per 100 women at three years. Most of these removals were for reasons that appeared to be unrelated to IUD use. The removal rate for pelvic inflammatory disease was 0.3 per 100 woman years. Women were followed up for up to three years after removal of their IUDs. Among women with PID at least 70% of those who desired pregnancy subsequently became pregnant, a rate similar to that of women who had their IUDs electively removed to become pregnant. The study provides further data on the safety of intrauterine contraception.

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Resumen Durante el seguimiento de 3721 usuarias del DIU Multiload, la tasa de remociones por otras razones médicas que sangrado/dolor, fué de 2.6 por 100 mujeres en tres años. La mayoría de estas remociones fueron hechas por razones que parecen no estar relacionadas con el uso del DIU. La tasa de remociones por enfermedad inflamatoria pelviana fué de 0.3 por 100 años-mujer. Las mujeres tuvieron seguimiento hasta tres años después de la remoción de sus DIU. Entre las mujeres con enfermedad inflamatoria pelviana, al menos 70% de las que desearon un embarazo lo consiguieron; una tasa similar a la de mujeres que eligieron la remoción del DIU para quedar embarazadas. El estudio proporciona más información sobre la inocuidad de la anticoncepción intrauterina.

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Résumé Lors d'une évaluation de suivi effectuée sur 3721 utilisatrices de DIU Multiload, le taux de retrait pour des raisons médicales autres que des pertes sanguines/douleurs n'a atteint que 2,6 pour cent des femmes après trois ans. La plupart de ces retraits ont été pratiqués pour des raisons qui ne semblaient pas liées à l'utilisation du DIU. Le taux de retrait pour cause d'inflammation pelvienne s'est élevé à 0,3 pour cent femmes-an. Les femmes ont été suivies pendant des périodes allant jusqu'à trois ans après le retrait du DIU. Parmi les patientes qui avaient contracté une inflammation pelvienne, 70% au moins de celles qui souhaitaient une grossesse sont par la suite devenues enceintes; taux semblable à celui des femmes qui avaient choisi de ne plus porter leur DIU précisément pour avoir un enfant. Cette étude fournit des données supplémentaires sur la sécurité qu'apporte la contraception intrautérine.

     

Contraception for women exposedin utero to diethylstilbestrol

Although the effects ofin utero exposure to diethylstilbestrol (DES) have been extensively documented, there is an absence of information on the suitability of different contraceptives for use by DES-exposed women. This paper briefly describes some of the effects associated with DES exposure. Use of various contraceptive methods by DES-exposed women are considered in light of these effects.

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Resumen Aunque los efectos de la exposición a dietilestilbestrol (DES) en útero ha sido documentada extensivamente, hay falta de información sobre la conveniencia de diferentes anticonceptivos para uso en mujeres expuestas a DES. Este trabajo describe brevemente algunos de los efectos asociados con la exposición a DES. Se considera el uso de distintos métodos anticonceptivos para mujeres expuestas a DES en vista a esos efectos.

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Résumé Bien que les effets de l'exposition de l'utérus au diéthylstilboestrol (DES) fassent l'objet d'une documentation importante, on manque d'information sur les différents contraceptifs que peuvent utiliser les femmes exposées au DES. Cet article décrit brièvement certains des effets associés à l'exposition au DES et examine, en considération de ces effets, l'utilisation de diverses méthodes de contraception par les femmes qui y sont exposées.

     

Benign intracranial hypertension and recombinant growth hormone therapy in Australia and New Zealand

Benign intracranial hypertension (BIH) is reported in three children from Australia and one from New Zealand, who were being treated with recombinant human growth hormone (rhGH). Three males and one female, aged between 10.5 and 14.2 y, developed intracranial hypertension within 2 weeks to 3 months of starting treatment. A national database, OZGROW, has been prospectively collecting data on all 3332 children treated with rhGH in Australia and New Zealand from January 1986 to 1996. The incidence of BIH in children treated with growth hormone (GH) is small, 1.2 per 1000 cases overall, but appears to be greater with biochemical GHD (<10IUml ^-1), i.e. 6.5/1000 (3 in 465 cases), relative risk 18.4, 95% confidence interval 1.9-176.1, than in all other children on the database. The incidence in patients with Turner's syndrome was 2.3/1000 (1 in 428 cases). No cases in patients with partial GHD (10–20 IUml ^-1) or chronic renal failure were identified. Possible causative mechanisms are discussed. The authors'practice is now to start GH replacement at less than the usual recommended dose of 14IUm-² week^-1 in those children considered to be at high risk of developing BIH. Ophthalmological evaluation is recommended for children before and during the first few months following commencement of rhGH therapy and is mandatory in the event of peripheral or facial oedema, persistent headaches, vomiting or visual symptoms. The absence of papilledema does not exclude the diagnosis.