Studies on Several Genetic Hematologic Characteristics of the Mexican Population: IV. The Finding of a Fast Hemoglobin Component (Hemoglobin Mexico) in an Indian Family

The clinical, genetic and electrophoretic characteristics of what is verylikely a new hemoglobin variant, hemoglobin Mexico, are presented. It isclinically silent, transmitted by an autosomal co-dominant gene, and inalkaline pH moves faster than hemoglobin A.

Submitted on January 9, 1963 Accepted on April 21, 1963     

Embolic Accident Following Heparin Therapy for a Left Ventricular Clot Diagnosed by TEE:

There are few data available on the incidence of embolic events inpatients with systemic anticoagulation. We describe a 40-year-old woman in congestive heart failure who was shown by transesophageal echocardiography to have an apical thrombus in the left ventricle without concomitant aneurysm. The patient was started on heparin immediately after the diagnosis was established. Twelve hours later she developed an embolic cerebrovascular accident. We believe that heparin dislodged the thrombus as occurs occasionally with thrombolytic agents used in the treatment of acute myocardial infarction.
transesophageal echocardiography, paradoxical embolization with heparin treatment, left ventricular thrombus     

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.     

Cost-effectiveness of ambulatory surgery in Cali, Colombia

To compare the cost and effectiveness of a system of simplifiedambulatory surgery against traditional in-patient surgery, westudied a surgical procedure commonly performed in both settings- non-recurrent elective inguinal herniorrhaphy. We comparedthe 17 operations performed in an ‘intermediate healthunit’ (IHU) or outpatient hospital in Cali, against the15 performed in a traditional secondary hospital from mid-Januarythrough mid-April, 1989. Pre-surgical characteristics of thepatients were similar. After the operation, the IHU patientshad few complications, were more satisfied, and resumed theirusual activities sooner than the hospital patients (34 versus52 days, respectively). The average cost per procedure was US$39.12in the IHU as compared to US$148.76 in the hospital-a four-folddifference. Intermediate health units seem to offer importantadvantages for uncomplicated surgery in both cost and outcome.