Proposed amendment to the "Guide to Professional Conduct".
Explore the source record for details and available documents.
Biomedical subjects
Publications and source records attributed to C Piper.
Explore the source record for details and available documents.
Tuberculosis of the gallbladder is a rare disease, which mostly is diagnosed by histological examination after cholecystectomy. Less than 60 cases are published. Four different manifestations are described by Weitz: The gallbladder infection by miliary tuberculosis in children or in adults, the disseminated abdominal tuberculosis including the biliary tract or the isolated infection of the gallbladder. Our case report outlines the progress of an isolated tuberculosis of the gallbladder wall in a patient with chronic renal failure. The uremic immunological anergy may have favoured the infection.
Explore the source record for details and available documents.
Eleven patients with terminal renal insufficiency requiring dialysis were treated with 3 X 2 g cefotaxime in an open study lasting five days when the clinical findings strongly indicated a serious bacterial infection. The effect of the administration of the high-dose antibiotic on the coagulation system (Quick test, partial thromboplastin time, thrombin time, antithrombin III and platelets) and on brain function (EEG) was investigated. The serum levels showed that the serum concentrations were not abnormally high in cases of terminal renal insufficiency requiring dialysis. In contrast to previous investigations in other beta-lactam antibiotics, no changes in the coagulation system or EEG occurred. On the basis of these findings, no reduction in the dose appears necessary for cefotaxime, if therapy does not exceed five days.
In the present study, 28 hemophiliacs substituted continuously and 5 hemophiliacs who had received almost no blood products were investigated. Cells of OKT 3+, OKT 4+, and OKT 8+ subsets were counted. Percoll separated fractions of peripheral blood mononuclear cells were examined by morphological criteria and were tested for NK cell activity. We found that the NK cell activity of both groups of hemophiliacs was decreased on testing Ficoll separated cells or low density Percoll separated cells. Normal NK cell activity was found in medium density cells of hemophiliacs. Two possible explanations are discussed: first, the NK cell activity may be suppressed in hemophiliacs and secondly, there may be a block in maturation of NK cell activity. It is unlikely that chronic substitution by blood products counts for these alterations. The possible role of chronic infections is discussed.
Recurrent pulmonary oedema occurred in a 62-year-old woman after repeated intake of hydrochlorothiazide-triamterene tablets. Eight similar reports in the medical literature suggested it to be a rare case of intolerance to hydrochlorothiazide. The lymphocyte transformation test proved an allergic genesis: there was significant stimulation of patient lymphocytes by active agent/metabolite serum of hydrochlorothiazide but not triamterene.
The predominant test system uses a near-diploid L5178Y mouse lymphoma cell line and is based on the quantitation of forward mutations occurring at the heterozygous thymidine kinase (TK) locus (TK+/- leads to TK-/-). (Other markers, such as ouabain- or methothrexate-resistance and alanine independence, in other L5178Y mouse lymphoma cells were also examined, but our criteria for the acceptability of data or the paucity of data considerably reduced the value of these mutagenesis test systems to this study.) The biochemical basis for the L5178Y/TK+/- assay depends on the ability of TK-competent cells to phosphorylate 5-bromo-2'-deoxyuridine or trifluorothymidine. The phosphorylated product or its metabolites kill these cells, thus, medium containing 5-bromo-2'-deoxyuridine or trifluorothymidine is capable of selecting for cells that are lacking the TK enzyme (TK-/-). TK-/- cells eventually give rise to a bimodal distribution of colony sizes. The relative proportion of small and large colonies appears to be characteristic of the mutagen, its dose, and the length of the expression period. A total of 108 references were reviewed and 48 chemical agents were evaluated. Of these, in vivo carcinogenicity data existed for 44 and covered a wide variety of chemical classes (43 compounds) and a complex mixture. In this system, 39 agents were positive, 1 was negative, and 4 yielded inconclusive results. The 44 test substances evaluated were insufficient to single out agents or agent classes for which the assay was particularly well suited; however, with the exception of thymidine analogs, the system seems to be versatile. The correlation of the TK locus assay results with the carcinogenicity data revealed that 2 agents were definite false positives (sodium azide and methotrexate) and 1 agent was a definite false negative (1,1-dimethylhydrazine). Further evaluation suggested that 4-acetylaminofluorene and diphenylnitrosamine were questionable false positives, while benzo[e]pyrene was a questionable false negative. (The term questionable was used to imply uncertainties concerning the mutagenicity and/or carcinogenicity data). Thus, the assay is of value in the battery approach to mutagenicity/carcinogenicity screening.
Pharmacodynamics and Pharmacokinetics of Bemetizide Compared with Hydrochlorothiazide/Controlled clinical study of acute effects Bemetizide in doses of 1, 5, 10, 20, 50 mg versus 25 mg of hydrochlorothiazide were examined in a placebo-controlled randomized single-dose study under standardized conditions in normal male volunteers. The diuretic effects of bemetizide and hydrochlorothiazide were qualitatively equal, though after higher doses bemetizide showed greater maximal, statistically significant effects on the excretion of sodium, chloride and urine volume (relative efficacy). A trend to increased elimination of potassium was detectable. Diuresis of calcium and magnesium and pH of urine were unchanged. The effects of the reference dosis of hydrochlorothiazide were constantly lower than those of higher doses of bemetizide conferring to the 24-h aliquot and the fractioned samples. The action of both substances began within 1 to 2 h after oral application exceeding 24 h. Kinetics of effects and pharmacokinetics were closely correlated. The evidence of dose-dependent kinetics for bemetizide supports the assumption, that it is absorbed incompletely in higher doses. Because of the lack of a parenteral preparation it is not possible to provide reliable information on the maximal potency of bemetizide.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
We studied 7300 singleton births in the highlands and 4881 in coastal Papua New Guinea in order to examine the separate contribution of anaemia or malaria to low birthweight. The highland sample was selected from a non-malarious area (Goroka) and the coastal sample from an area with perennial malaria transmission (Madang). There was an approximately three-fold increased risk of low birthweight (< 2500 g) in live-births in Madang compared to Goroka. The prevalence of anaemia in the two areas was strikingly different, with 29.2% of Goroka and 89.0% of Madang women anaemic. There was a trend towards increased low birthweight with decreasing haemoglobin levels in both areas, but this was significant only for Madang. It was assumed that for a given haemoglobin level the increased low birth weight percentage in Madang compared to Goroka was due to malaria exposure, and on this basis relative risk values were estimated for the effect of malaria exposure on low birthweight. Using this approach separate estimates for anaemia and malaria population-attributable risk for low birth weight in Madang were calculated. These indicated that up to 40% of low birthweight babies born in malarious areas may be attributable to malaria and less than 10% attributable to severe anaemia (Hb < 7.0 g dl-1). The magnitude of the malaria effect estimated in this analysis places a high priority on malaria control in pregnancy as a strategy for improving birthweight and child survival.