Enzymatic method for phenylketonuria screening using phenylalanine dehydrogenase.

An enzymatic method using phenylalanine dehydrogenase (PheDH;EC 1.4.1.-) for the determination of phenylalanine in blood-spot specimens has been developed for the Cobas Bio centrifugal analyser. Method accuracy was established by correlation of results from blood spots with phenylalanine values obtained by quantitative aminoacid analysis on simultaneously collected plasma specimens. The phenylalanine dehydrogenase method demonstrated linearity to 2500 mumol/L and had recoveries of 89.4 +/- 4.6% (mean +/- SEM). The between-run precision using blood-spot specimens was 9.8% at 285 mumol/L. In the context of a routine newborn screening program, the enzymatic method was found to have a lower false-positive rate (1% vs 3%) when evaluated against the classical fluorimetric Autoanalyser method.     

Phaeohyphomycotic cutaneous disease caused by Pleurophoma in a cardiac transplant patient

A 56-y-old female cardiac transplant patient treated with cyclosporine and prednisone noted the onset of three nontender red nodules on the legs and arms after gardening. Biopsy of all lesions revealed inflammatory cells and hyphal elements in the dermis. The dematiaceous fungus cultured from biopsy tissue was a pycnidial-forming organism of the genus Pleurophoma. The lesions responded to the topical application of miconazole.     

Comparative clinical trial of fenticonazole ovule (600 mg) versus clotrimazole vaginal tablet (500 mg) in the treatment of symptomatic vaginal candidiasis

A multi-centre, randomized, single-blind, parallel-group clinical trial was undertaken in 50 patients (26 fenticonazole, 24 clotrimazole) with symptomatic vaginal candidiasis to compare the antifungal efficacy and tolerability of single-dose intra-vaginal treatment with a fenticonazole ovule (600 mg) or a clotrimazole vaginal tablet (500 mg). Assessment was by laboratory mycological investigation and symptomatic assessments for a period of 3 weeks from the day of treatment. Of the 50 patients, 43 (23 fenticonazole, 20 clotrimazole) returned for assessment 1 week after drug administration and 32 (17 fenticonazole, 15 clotrimazole) were re-assessed 3 weeks after drug administration. Both treatments resulted in very similar and highly significant improvements in symptoms, associated with disappearance of detectable Candida in approximately 70% of patients. There were no significant differences between treatments and no appreciable incidence of relapse during the 3-week period of observation. At the end of this period, 10 (59%) of 17 fenticonazole patients were totally disease-free, as compared with 10 (67%) of 15 patients after clotrimazole treatment. The cure rate observed was somewhat less than that previously seen when intra-vaginal cream formulations of the same two drugs were given on a multiple-dose basis. Both drugs were very well tolerated, with no reports of appreciable local or systemic adverse reactions to either drug.