Unusual case of anuria due to African bee stings.

We describe a case of multiple African bee stings in which the exceptionally high dose suggests a direct effect of hymenoptera venom on the renal tubules. The case does not follow the previously reported pattern of hypovolemic or anaphylactic shock, hemolysis and/or rhabdomyolysis, despite the potentially lethal amount of venom injected.

Effect of oral administration of bacterial extracts on the bactericidal capacity of polymorphonuclear leucocytes in children with recurrent respiratory infections.

The effect of orally administered bacterial extracts given intermittently over 16 weeks on the bactericidal capacity of polymorphonuclear leucocytes (PMNs) in children with recurrent respiratory infections was investigated using a luminol-amplified chemiluminescence assay. Chemiluminescence of PMNs stimulated with zymosan or N-formyl-methionyl-leucyl-phenylalanine (fMLP) before and after treatment with bacterial extracts or intramuscular benzanthine penicillin was evaluated. Chemiluminescence induced by opsonized zymosan increased significantly (P less than 0.05) after treatment with bacterial extracts, whereas no significant changes were observed in the fMLP-stimulated PMNs. Long-acting penicillin treatment did not significantly affect zymosan- or fMLP-stimulated chemiluminescence. The data suggest that orally administered bacterial extracts can increase the opsonic capacity of serum and thus the bactericidal capacity of PMNs in subjects with recurrent respiratory infections.

The assessment of quality of life as a measure of gold salts treatment efficacy in rheumatoid arthritis.

BACKGROUND: In the evaluation of functional status of patients with rheumatoid arthritis (RA) the health related quality of life is currently considered important because of its approach to various components of life, such as social, psychological, and physical aspects. We used the Stanford Health Assessment Questionnaire (HAQ) to assess the improvement of functional status in patients with RA treated with gold salts. METHODS: In a prospective investigation 91 patients with RA in anatomical stage I, II, or III, 66 females and 25 males, with a mean age of 53.17 years, were evaluated during medical treatment in a 1-year follow-up. The treatment consisted in sodium aureothiosulphate, plus corticosteroids and NSAID. The assessments were done during ambulatory visits, at baseline and after 6 and 12 months of treatment, by HAQ as well as by other parameters such as Ritchie Index, visual analog scale (VAS), and morning stiffness. A group of 19 RA patients included by the same criteria and treated only by corticosteroids and NSAID was used as control for the first 6 months of the study. RESULTS: HAQ scores and other parameters were significantly lower (p=0.0001) at the 6th and 12th month measurements when compared with baseline. In the control group only a significant difference in the VAS score was detected. CONCLUSIONS: All the parameters measured in our study were useful in detecting clinical improvement in RA patients treated with sodium aureothiosulphate plus corticosteroids and NSAIDs, but the HAQ provides a more global assessment of the patient's status.

Effects of beta 2-agonists during cardiopulmonary exercise test in COPD patients.

The aim of this study was to evaluate endocrine-metabolic, respiratory and cardiovascular effects of two beta 2-sympathomimetic selective agents, such as broxaterol and salbutamol, before and during cardiopulmonary exercise test (CPX). Twelve in-patients with chronic obstructive pulmonary disease (COPD) (with partially reversible airways obstruction) were included. Broxaterol (400 micrograms) and salbutamol (400 micrograms) were administered i.v., according to a double-blind, cross-over study. Before treatment and within 60 min after the administration of each agent, the patients underwent incremental CPX by bicycle ergometer to the maximum tolerable threshold. At these times the following variables were assessed: minute ventilation (VE), oxygen consumption (VO2), carbon dioxide production (VCO2), VE/VO2 ratio and O2 pulse, glycaemia, insulinaemia, plasma norepinephrine (NE) and epinephrine (E), arterial oxygen and carbon dioxide tension (PaO2 and PaCO2), plasma lactates, heart rate (HR), systolic (SBP) and diastolic (DBP) blood pressure. Spirometry was performed before and after the administration of each beta 2-adrenoceptor agonist. CPX brought about a significant increase in VE, VO2, VCO2, and O2 pulse. Broxaterol or salbutamol administration did not significantly modify the increases caused by CPX. At rest, 60 min after treatment, both bronchodilators caused a significant rise in glycaemia. A significant reduction of PaO2 (after broxaterol) and PaCO2 (after salbutamol) was observed at rest. In contrast, both agents caused no modification to potassium and insulin levels.(ABSTRACT TRUNCATED AT 250 WORDS)

[Sodium gold thiosulfate therapy: an open, viewed, multicenter trial in rheumatoid arthritis patients followed for two years]. / Terapia con tiosolfato di sodio e oro: studio osservazionale, aperto, multicentrico in pazienti con artrite reumatoide seguiti per due anni.

OBJECTIVE: To evaluate if parenteral gold-therapy with Sodium gold thiosulfate is effective and safe for the treatment of rheumatoid arthritis we began an open, multicenter trial. METHODS: 126 rheumatoid arthritis patients were treated with Sodium gold thiosulfate for two years. Efficacy, quality of life, progression of joint damage, inflammatory parameters and side effects were evaluated. RESULTS: Gold salts reduced joint inflammation and improved subjective and objective symptoms, quality of life and activity of illness within 6 months. Side effects appeared in 13,8% of all cases and regressed, promptly, when gold therapy stopped. The poor efficacy caused the interruption and the change from the gold therapy to others disease-modifying anti-rheumatic drugs (DMRDs) in 17,8 % of the patients. CONCLUSIONS: The follow-up showed Sodium gold thiosulfate was effective in Rheumatoid Arthritis and the survival in therapy was of 77,8% to one year and of 68,4% to two years.

[Treatment of histamine-dependent allergic dermatoses with a 120-mg terfenadine tablet once a day]. / Trattamento delle dermatosi allergiche istamino-dipendenti con terfenadina compresse 120 mg in monosomministrazione giornaliera.

Terfenadine, an anti-H1-selective antihistaminic drug has been used in an experimental clinical study. The effectiveness and tolerance of the compound in the treatment of pruritic dermatitis such as urticaria, atopic dermatitis and topical dermatitis, have been evaluated. Terfenadine, administered in 120 mg tablets in a single daily dose in 30 patients demonstrated a fully satisfactory therapeutic activity and reliability of use.

Ineffectiveness of intravenous beta 2-agonists on improving exercise tolerance in patients with reversible chronic airway obstruction.

The effects on exercise tolerance after acute administration of beta 2-agonists were investigated in 11 patients with partly reversible chronic airway obstruction after 400 micrograms of salbutamol (S) given intravenously (i.v.) and after 400 micrograms i.v. of a new selective beta 2-agonist, broxaterol (B), by a cardiopulmonary incremental exercise test. At rest, while VE increased in respect to basal conditions (C) after S (from 13.3 +/- 2.2 to 14.4 +/- 2.8 l/min; p < 0.05) and after B (from 13.6 +/- 3.1 to 15.5 +/- 3.6 l/min; p < 0.05), VO2, VCO2 and VO2/HR showed no substantial variations. A small, not significant reduction of PaO2 was observed both after S (from 82.7 +/- 11.7 to 79.1 +/- 16.7 mm Hg) and B (from 81.6 +/- 10.5 to 78.0 +/- 11.0 mm Hg). The maximum workload increased neither after S (from 67.5 +/- 39.1 to 66.6 +/- 37.0 W) nor after B (from 65.7 +/- 39.3 to 60.0 +/- 35.8 W). At peak of exercise, VO2, VCO2 and VO2/HR did not change after S and B as compared with C, whereas VE remained higher after both beta 2-agonists throughout the effort. VO2 at ventilatory anaerobic threshold (AT) was significantly greater either after S (from 744 +/- 378 to 815 +/- 302 ml/min; p < 0.05) and after B (from 756 +/- 290 to 842 +/- 292 ml/min; p < 0.05). The PaO2 increase shown by these patients during effort was greater after beta 2-agonists administration, delta PaO2 from rest to peak of exercise amounting to 14.9 +/- 14.3 vs. 7.8 +/- 8.2 mm Hg after S and to 17.8 +/- 15.1 vs. 8.8 +/- 10.9 mm Hg after B, in respect to relative baseline (p < 0.05). We conclude that beta 2-agonists, when given acutely, do not improve exercise tolerance in patients with reversible chronic airflow obstruction, although these drugs can induce a small increment of ventilatory AT. In addition, arterial blood gases do not deteriorate at rest and are better preserved during exercise after beta 2-agonists.

[Pharmacokinetics of broxaterol in asthmatic children]. / Farmacocinetica del broxaterolo in bambini affetti da asma.

Pharmacological profile of broxaterol, a new beta adrenergic compound, was investigated in 12 asthmatic children (6 male and 6 female with age 8-13 years). This study was performed from November to May, and venous blood was collected after 30, 45, 120, 180, 240 minutes from administration of 0.5 mg broxaterol; the urine was collected every 4 hours drug intake (0-4, 4-8, 8-12 hours). Drug absorption proved very fast: T max was 0.9 hours and Cmax was 2.05 micrograms/ml. T 1/2 was 2.3 hours. The urine concentration of broxaterol in the urine 0-4 and 4-8 hours after administration, was 6.11 and 2.3% (as drug percentage), after 8 hours no broxaterol was evaluated in the urine. Pharmacological profile of broxaterol in asthmatic children and adults is comparable.