Conserving large populations of lions - the argument for fences has holes.

Packer et al. reported that fenced lion populations attain densities closer to carrying capacity than unfenced populations. However, fenced populations are often maintained above carrying capacity, and most are small. Many more lions are conserved per dollar invested in unfenced ecosystems, which avoid the ecological and economic costs of fencing.

Efficacy, tolerability, and safety of lanthanum carbonate in hyperphosphatemia: a 6-month, randomized, comparative trial versus calcium carbonate.

BACKGROUND/AIMS: Hyperphosphatemia is an important clinical consequence of renal failure, and its multiple adverse systemic effects are associated with significantly increased risks of morbidity and mortality in dialysis patients. Existing oral phosphate binders have not permitted control of serum phosphate within currently accepted guidelines. This study compares lanthanum carbonate with calcium carbonate for control of serum phosphate in hemodialysis patients. METHODS: In this European multicentre study, 800 patients were randomised to receive either lanthanum or calcium carbonate and the dose titrated over 5 weeks to achieve control of serum phosphate. Serum levels of phosphate, calcium and parathryoid hormone were followed over the following 20 weeks. RESULTS: Around 65% of patients in each group achieved phosphate control, but in the calcium carbonate group this was at the expense of significant hypercalcemia (20.2% of patients vs. 0.4%). Consequently, calcium x phosphate product tended to be better controlled in the lanthanum group. CONCLUSION: This 6-month study demonstrates that serum phosphate control with lanthanum carbonate (750-3,000 mg/day) is similar to that seen with calcium carbonate (1,500-9,000 mg/day), but with a significantly reduced incidence of hypercalcemia. Lanthanum carbonate is well tolerated and may be more effective in reducing calcium x phosphate product than calcium carbonate.

Oxaprozin versus aspirin in rheumatoid arthritis: a double-blind trial.

A parallel double-blind trial was carried out over a 3-month period in 40 patients suffering from active rheumatoid arthritis to compare the anti-inflammatory effectiveness and side-effects of treatment with oxaprozin and aspirin. The results showed that 1200 mg oxaprozin daily had similar anti-inflammatory properties to those of 3.9 g aspirin daily in rheumatoid arthritis. Better results were produced with 1200 mg oxaproxin daily than with a 600 mg dosage level, suggesting that there is a close dose-response relationship. The incidence of side-effects was similar with both drugs. Gastrointestinal intolerance was more frequent and severe in the aspirin group, whereas rash and headache were noted more often in patients receiving oxaprozin.

Thrombotic thrombocytopenic purpura: a rare but potential life-threatening complication following ticlopidine administration.

Thrombotic thrombocytopenic purpura (TTP) is a known, although rare, complication of ticlopidine treatment. It typically appears within the first days or weeks after initiation of therapy. We describe a case of TTP in a 75-year-old patient, due to ticlopidine, occurring three weeks after coronary stent implantation. The patient responded favourably to fresh frozen plasma exchanges. We are reporting this case to emphasize that prognosis depends on prompt diagnosis and early treatment, implying careful biochemical monitoring.

Bovine graft and polytetrafluorethylene prosthesis as an access to circulation for haemodyalisis.

In this article results are compared of the bovine graft and the Goretex graft as a shunt from an artery to a vein in view of the access to the circulation for haemodialysis. Drawing conclusions would seem premature as yet, but there seems to be some indication that the Goretex graft stays open more easily. In our opinion the Goretex graft is easier to handle during the operation. We want to point out once again that, in all probability, our ample experience with the Goretex graft plays a role in the evaluation of the outcome.

HLA-B27, arthritis and Yersinia enterocolitica infection.

Over a 3 1/2-yr period 25 cases of Yersinia enterocolitica arthritis were observed. This is a frequency of about 1% of the new patients seen at our Rheumatology Clinic. The histocompatibility antigen HLA-B27 was found in 14 of the 25 patients with Yersinia arthritis (56%). There was no difference in duration of disease, joint symptoms or laboratory data between the HLA-B27 positive or negative group. Six cases had a disease course longer than 1 yr. Four of them had a disease onset before the age of 16 yr and all cases had knee joint involvement. Our findings are discussed in relation to reports from other centers.