RESUMEN

Modern diagnostic tools like fiberoptic nasal endoscopy and CT imaging of the sinuses are very sensitive in helping clinicians diagnose sinus disease; we may now reevaluate the symptoms and signs most useful in making a clinical diagnosis of rhinosinusitis. Two major systems of classification and diagnostic criteria relating headaches and sinus disease have achieved currency-that of the International Headache Society (IHS) (1988) and the more recent task force recommendations of the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) (1997). This report compares and contrasts the different starting points, certain assumptions, and conflicting conclusions of these two classification systems and recommends a cooperative alliance of the IHS and AAO-HNS when these diagnostic criteria are revised.

Asunto(s)

RESUMEN

The variable clinical features of migraine and some relationships of migraine with other headache disorders have been reviewed. Although these views generally are shared by most headache specialists, some respected headache investigators reject the concept of a spectrum of migraine and conclude that the continuum model is an artifact.

Asunto(s)

Asunto(s)

RESUMEN

Aspartame, a popular dietetic sweetener, may provoke headache in some susceptible individuals. Herein, we describe three cases of young women with migraine who reported their headaches could be provoked by chewing sugarless gum containing aspartame.

Asunto(s)

RESUMEN

Forty consecutive headache patients self-administered sumatriptan for migraine, diagnosed by the criteria of the International Headache Society (IHS). Eighty percent reported excellent response. Thirty-three percent had recurrence of headache within four to twelve hours, while 67% had no recurrence. Fifty-five percent of the patients reported mild side effects, but only 8% stopped therapy because of adverse reactions. No serious cardiovascular events occurred. Recommendations for safe use of sumatriptan are suggested.

Asunto(s)

Asunto(s)

Asunto(s)

RESUMEN

Dihydroergotamine (DHE) has been used for the treatment of acute migraine headache for almost 50 years. Previous studies have emphasized use in emergency room, inpatient, or office settings. Twenty-nine patients with migraine headache who had failed to obtain relief with conventional therapy were trained to self-administer intramuscular DHE. The patients administered 0.5mg DHE and 100mg trimethobenzamide at the onset of their headache and an additional 0.5mg DHE if satisfactory headache relief was not obtained. Twenty patients were successfully contacted and interviewed. Forty-five percent of the patients had at least 50% relief of headache and continued to use the protocol. Eighty-two percent of patients who initially had at least 50% headache relief continued to use the drug, whereas none of the patients who initially had less than 10% relief continued the protocol. Sixty-one percent of patients whose headaches precluded continuation of activity had at least 50% response to initial treatment, whereas only 29% whose headaches were less severe had this response. Initial response to therapy was predictive of continued use of the treatment protocol and patients who described more severe headache had a higher response to the initial treatment. Thus, home administration of I.M. DHE offers an additional treatment regimen for patients with migraine headache.

Asunto(s)

Asunto(s)

Asunto(s)

RESUMEN

The metabolism of oral glucurolactone to serum D-glucarate by the hepatic cytochrome P450 enzyme system was no different in 20 untreated Parkinson's disease (PD) patients as compared with 20 age- and sex-matched controls. There was no evidence for a deficit in hepatic enzymes in PD.

Asunto(s)

RESUMEN

An unusual neuralgia of the great auricular nerve resulting from a skin incision to insert a cardiac pacemaker is described. The anatomy and presumed pathophysiology are discussed.

Asunto(s)

Asunto(s)

RESUMEN

A sensitive and specific spectrophotometric assay was developed to determine levels of D-glucarate in human serum. This assay makes use of the Escherichia coli glucarate catabolic enzymes D-glucarate dehydrase, alpha-keto-beta-deoxy-D-glucarate aldolase, and tartronate semialdehyde (TSA) reductase, to convert D-glucarate to equimolar quantities of pyruvate and TSA. In a one-tube reaction that included NADH, lactate dehydrogenase, and the three E. coli enzymes, 1 mumol of D-glucarate was quantitatively converted to 1 mumol each of D-glycerate and L-lactate with concomitant utilization of 2 mumol of NADH. Using this method, D-glucarate in serum was measured, along with quantitative recovery of authentic D-glucarate from duplicate serum samples to which it had been added. Glucarate is a major serum organic acid, approximating blood pyruvate levels previously determined by others.

Asunto(s)

Asunto(s)

Asunto(s)

RESUMEN

Mannitol (Mtl), not previously reported as an intracellular component of bacteria, although it has been found as an extracellular end product of anaerobic carbohydrate metabolism, accumulated within strains of all 10 staphylococcal species tested after aerobic incubation of washed cell suspensions in phosphate-buffered 1% glucose for 2 h. Phenol extracts of the cells, before and after incubation, were analyzed for Mtl content by periodate utilization and paper chromatography and for Mtl 1-phosphate content, with Mtl 1-phosphate dehydrogenase. In Staphylococcus aureus Towler, the content of Mtl increased from a 0-h value of less than 2.4 to 16 mumol/g (dry weight) after incubation, and the level of Mtl 1-phosphate increased from a 0-h value of 1 to 8 mumol/g. The identification of Mtl was confirmed as the per-O-acetyl ester by gas-liquid chromatography and as the per-O-methyl ether by mass spectrometry. Also tested were 5 additional S. aureus strains and 32 coagulase-negative staphylococcal strains. All strains accumulated Mtl, even those strains that could not utilize exogenous Mtl during aerobic growth, usually in the range 4 to 25 mumol/g. Furthermore, three strains accumulated very high Mtl levels. Bacteria from several other genera were tested, and some were found to accumulate low to moderate levels of Mtl under similar incubation conditions. The metabolic conversion of glucose to intracellular Mtl, probably via Mtl 1-phosphate, is a common feature of staphylococci and also occurs in some other bacteria.

Asunto(s)

RESUMEN

Carotenoid pigments were demonstrated in arthrospores of the dermatophyte Trichophyton mentagrophytes but were absent from hyphae and microconidia of this fungus. Incubation at higher temperatures (39 degrees C) allowed arthrosporulation to occur, but essentially no carotenoid was detected in such arthrospores. The carotenoid formation in arthrosporulating T. mentagrophytes did not appear to be either induced or stimulated by light illumination. Mature arthrospores contained the carotenoids phytoene, phytofluene, zeta-carotene, neurosporene, lycopene, and gamma-carotene and a few minor unidentified carotenoids. These carotenoids were localized within intracellular granules consisting of osmiophilic matrices and complex membranous elements. This is the first demonstration of carotenoid pigments in dermatophytic fungi.

Asunto(s)

Asunto(s)

RESUMEN

The effects of several physical and chemical agents on the survival of Trichophyton mentagrophytes arthrospores were investigated. Although arthrospores of this dermatophyte were highly resistant to chilling and freezing, they were extremely susceptible to moderate heat (above 50 degrees C) and desiccation. This high susceptibility could be significantly reduced when they were dried in the presence of exogenous proteins. These arthrospores were markedly susceptible to glutaraldehyde. They appeared to be significantly more resistant than their hyphal counterparts to common antimycotics such as clotrimazole, griseofulvin, miconazole nitrate, and nystatin. Clinical and epidemiological implications of these observations are discussed.

Asunto(s)