Effect of aspirin on blood pressure in hypertensive patients taking enalapril or losartan.

The ability of angiotensin converting enzyme (ACE) inhibitors to lower blood pressure may in part be due to the formation of vasodilatory prostaglandins. Inhibition of prostaglandin synthesis with aspirin may therefore theoretically attenuate the antihypertensive effect of ACE inhibitors. This trial studied the interaction between aspirin (ASA) and enalapril, an ACE inhibitor, and ASA and losartan, an angiotensin subtype 1 receptor antagonist. Seventeen essential hypertensive patients were studied, maintained on a stable dose of either enalapril (n = 7) or losartan (n = 10) monotherapy for > or =12 weeks before and throughout the study. Each patient received a 2-week course of placebo, 81 mg/day ASA, and 325 mg/day ASA, each treatment separated by a 2-week washout period. Blood pressure (BP) and serum thromboxane B2 (TXB2) samples were obtained at the end of each treatment period. Placebo was compared with each dose of ASA for each group. In both the enalapril and losartan groups, mean, systolic, and diastolic BP were unchanged with the addition of ASA. Concentrations of TXB2 were suppressed to <10% in both groups with ASA. This study demonstrates that 81 to 325 mg/day ASA exerts no significant effect on BP in essential hypertensives taking enalapril or losartan.

Hypertension in renal failure.

Hypertension is a common component of the morbidity associated with renal failure. The mechanisms that contribute to high blood pressure are reviewed in this section. Also covered are therapies to reduce hypertension, the treatment goals of those therapies, and the outcomes of antihypertensive therapy on kidney function in patients with renal failure. Various antihypertensive agents are specifically addressed, and a treatment paradigm is presented for combination antihypertensive drug therapy, which is usually necessary in the antihypertensive therapy of patients with renal failure.

Metastatic prostate cancer to the spine and a PSA of 5666: a case report.

Prostate cancer is the most commonly diagnosed cancer and the second most common cause of cancer death among American men. To our knowledge, the highest reported prostate specific antigen (PSA) level on initial presentation is 3280 ng/mL. In this case report, we discuss a 46-year-old African-American man with back pain of 1-month's duration. A magnetic resonance imaging study of the lumbar spine revealed numerous osseous metastatic lesions, and the PSA level was found to be 5666 ng/mL. He was treated with oral narcotics and a Duragesic patch to achieve analgesia and bicalutamide (Casodex) and leuprolide acetate (Lupron) therapy for androgen blockade. Later in his course, he required chemotherapy due to hormone-refractory prostate cancer. The patient has done well as shown at his latest follow-up at 48 months. The objective of this report is to discuss the first patient with metastatic prostate cancer to the spine with PSA level greater than 3,500 ng/mL.

Comparison of swab transport media for recovery of Listeria monocytogenes from environmental samples.

Environmental monitoring is recognized as an important strategy for controlling Listeria monocytogenes in food processing facilities. Samples are taken by swabbing environmental surfaces, and the swabs are immersed in a medium for transport to the laboratory. In this study, buffered peptone water (BPW), Dey-Engley neutralizing broth (DE), neutralizing buffer (NB), Letheen broth (LE), and newly described MCC buffer (MCC) were evaluated as transport media for recovery of sanitizer-stressed L. monocytogenes from inoculated swabs. After storage at 4°C, the media performed similarly, but at 25°C relative recovery efficiency from the inoculated sponges was DE > LE > BPW > MCC > NB. Recoveries from stainless steel surfaces followed similar trends. MCC, DE, and NB were compared for L. monocytogenes recovery in the presence of Escherichia coli, Enterococcus faecalis, Lactobacillus plantarum, Pseudomonas fluorescens, and Listeria innocua. After 4°C storage, all population levels changed little; after 25°C storage, DE allowed the best growth of L. monocytogenes regardless of other species present. MCC, DE, and NB performed similarly for recovery of L. monocytogenes from an artificial milk biofilm and for recovery of Listeria spp. from swabs obtained from a meat processing facility. Transport medium formulation, time and temperature of swab storage, and coexistence of other species affect recovery of sanitizer-stressed L. monocytogenes from environmental swabs. The study confirms the need to maintain 4°C storage conditions during swab transport.

Purification and Characterization of Liposan, a Bioemulsifier from Candida lipolytica.

The inducible water-soluble bioemulsifier liposan (M. C. Cirigliano and G. M. Carman, Appl. Environ. Microbiol. 48:747-750, 1984) was purified from the yeast Candida lipolytica. The purification procedure included repeated solvent extractions of a concentrated culture filtrate and Affi-Gel concanavalin A affinity chromatography. The procedure yielded a preparation containing a major band (M(r) = 27,600) which stained for protein and carbohydrate upon polyacrylamide gel electrophoresis in the presence of sodium dodecyl sulfate. Liposan is composed of approximately 83% carbohydrate and 17% protein. Acid and enzymatic digestions of the emulsifier revealed that the carbohydrate portion is a heteropolysaccharide consisting of glucose, galactose, galactosamine, and galacturonic acid. Liposan effected and stabilized oil-in-water emulsions with a variety of commercial vegetable oils. Emulsification and stabilization properties of liposan were compared to those of a number of commercial emulsifiers and stabilizers.

Isolation of a bioemulsifier from Candida lipolytica.

The yeast Candida lipolytica produced an inducible extracellular emulsification activity when it was grown with a number of water-immiscible carbon substrates. Negligible emulsification activity was produced by this yeast when it was grown with glucose as the carbon substrate. In hexadecane-supplemented cultures, emulsification activity was first detected after 36 h of growth, with maximum production after 130 h. A water-soluble emulsification activity was partially purified by repeated solvent extractions of the culture filtrate. This emulsifier, which we named liposan, was primarily composed of carbohydrate. Maximum emulsification activity was obtained when the ratio of hexadecane to liposan was 50:1. Maximum emulsification activity was obtained from pH 2 to 5. Liposan was heat stable to temperatures up to 70 degrees C, with a 60% loss in activity after heating for 1 h at 100 degrees C. Liposan effected stable oil-in-water emulsions with a variety of hydrocarbons.

Binding and uptake of native and glycosylated albumin-gold complexes in perfused rat lungs.

We have examined, by electron microscopy, the effect of glycosylation on binding, uptake, and transport of albumin-gold complexes in capillaries of isolated perfused rat lungs. Lungs were perfused for 2 min at 4 degrees with native and glycosylated albumin-coated gold particles. After the excess probe was washed out for 5 min the lungs were fixed immediately or perfused for 30 and 60 min at 37 degrees with a isoosmotic buffer before fixation. The localization and density of the probes over different microvascular endothelial compartments were determined by electron microscopy. We found that both native and glycosylated albumin were bound to the surface of the pulmonary microvascular endothelium, preferentially over the stomatal diaphragms of luminal smooth-walled vesicles. In both BSA and glycosylated BSA perfusions at 37 degrees, most of the probe was internalized and accumulated in lysosomes and only a few gold particles were observed in the extravascular compartment even after 60 min perfusion. However, binding, internalization, and transport of the protein-gold complexes was enhanced by nonenzymatic glycosylation of albumin.

Medical therapies for inflammatory bowel disease.

Inflammatory bowel disease is a spectrum of disorders whose etiology and pathogenesis are unclear. No therapy is standard; many modalities exist for management. New drugs, improved formulations of existing drugs, combination therapy and biologic agents offer more effective relief and maintain disease remission.

Head louse infestations: epidemiologic survey and treatment evaluation in Argentinian schoolchildren.

BACKGROUND: Our aim was to demonstrate that the treatment of individual cases is effective, but not sufficient, to control endemic Pediculus capitis, and that eradication of the epidemiologic school focus may lower significantly the prevalence of infestation. Statistical data on the degree of infestation relating to socio-economic and cultural variables were also updated. Therapeutic effects and educational impact were evaluated. METHODS: An educational and motivational program was designed for pupils, parents, and teachers: 326 children and 15 adults were subjected to clinical and parasitologic evaluation. The recorded parameters included the age, sex, hair style and length, presence of other dermatologic diseases, degree of infestation, clinical remission, parasitologic remission, dwelling type and features, need to share a bed with co-dwellers, availability of home tap water supply, level of family income, and periodic medical controls. The entire population received treatment with neutral shampoo and rinsing cream containing 1% permethrin. Exclusion criteria were the presence of acute scalp inflammation and a history of pyrethrin and/or pyrethroid sensitivity. Statistical analysis was performed as required on data expressed as frequencies, percentages, means, and standard deviations by chi-square and Fisher exact tests. RESULTS: The overall infestation prevalence rate was 81.5%, the highest values corresponding to children from 6 to 11 years of age, with a slight predominance in males (55.4% vs. 44.6%). A significantly greater rate of clinical remission was observed in subjects enjoying home tap water supplies (p < 0.01). CONCLUSIONS: The model of research plus action adopted allows the following conclusions to be drawn: (i) individual and isolated treatments for pediculosis are useful, but will not by themselves allow for the epidemiologic control of this parasitosis; (ii) massive, complete, and simultaneous treatments lead to a significant decrease in infestation prevalence; (iii) educational measures tending to foster collective awareness enable greater epidemiologic surveillance to be achieved; (iv) careful inspection of the entire scalp is essential with the use of a powerful light source and lenses with high magnification, as the parasite has no predilection for any given area; (iv) socio-economic and cultural conditions are not relevant for infestation, although a good home tap water supply is essential for treatment.

Farmacodermias en pacientes H.I.V / Farmacodermal in H.I.V patients

La incidencia de reacciones adversas a drogas en pacientes HIV positivos es elevada. Las drogas más frecuentemente involucradas so: sulfonamidas y amoxilina-cluvanato. Diferentes tipos de reacciones son vistas, entre ellas:eritema polimorfo y la necrólisis epidérmica tóxica, que pueden llegar a comprometer la vida del paciente.Los mecanismos que provocan estas reacciones son desconocidos,sin embargo las las evidencias sugieren que la afectación podría deberse a la capacidad disminuida para la detoxificación de metabolitos intermediarios de las drogas con capacidad reactiva. Otras reacciones menos severas sondescriptas como erupciones máculo-pápuloerimatosas generalizadas asociadas a la administración de trimetoprima-sulfametoxazol;hiperpigmentación de uñas asociada a zidovudina y menos frecuentemente,erupción exantemática severa en aproximadamente el 1 por ciento de los pacientes que reciben zidovudina.La observación de de dos pacientes con eritema polimorfo como reacción adversa al cotrimoxazol y amnoxilina-clovanato y otros pacientes con otras reacciones a diferentes drogas motivan esta publicación