Asunto(s)
Fluorometría/normas , Quinidina/sangre , Fluorometría/métodos , Humanos , Enfermedades Renales/sangre , ToluenoRESUMEN
CPK MB isoenzymes were qualitatively identified using an electrophoresis method in 166 patients with acute cardiovascular disease during a six month period. Forty-three had total CPK activity in the normal or borderline range (0--75 U/Liter at the time the MB isoenzyme was first identified. Fifteen of these patients were diagnosed as having had a new acute myocardinal infarction (Group I) and another 15 as having had an old myocardial infarction (Group II). Diagnosis was based on electrocardiographic changes or autopsy findings. The remaining 13 patients were classified as "ischemic heart disease" (Group III) in the absence of strict electrocardiographic criteria or autopsy evidence of myocardial infarction. Nine of the 15 patients in Group I subsequently had elevations of their total CPK activity above 75 U/L. In contrast the total CPK activity of only one patient from Group II and Group III subsequently exceeded 75 U/liter. All 43 patients had evidence of cardiovascular disease. Our findings suggest that the detection of MB isoenzyme in the presence of a normal total CPK activity is a significant laboratory finding and is indicative of cardiac myofiber injury.
Asunto(s)
Enfermedad Coronaria/enzimología , Creatina Quinasa/sangre , Isoenzimas/sangre , Infarto del Miocardio/enzimología , Enfermedad Aguda , Adulto , Anciano , Pruebas Enzimáticas Clínicas , Electrocardiografía , Femenino , Humanos , L-Lactato Deshidrogenasa/sangre , Masculino , Persona de Mediana Edad , Infarto del Miocardio/diagnósticoRESUMEN
We describe a method for determination of serum acetaminophen concentrations in serum by reversed phase high-pressure liquid chromatography. The homolog N-propionyl-p-aminophenol was used as an internal standard. The procedure, which requires only a single extraction with diethyl ether, can be optimized to be linear over the ranges of 10 to 100 or 1 to 20 mg/liter. Within-run CV was 1.2%; between-run CV was 4.4% and 4.9% at two different concentrations. Many commonly used drugs were tested and found not to interfere. The procedure is simple and rapid enough for use on an emergency basis in cases of overdosage, and can be optimized for measurement of either therapeutic or toxic concentrations.
Asunto(s)
Acetaminofén/sangre , Cromatografía Líquida de Alta Presión/métodos , Humanos , Microquímica , Espectrofotometría UltravioletaRESUMEN
Patients who had enterococci isolated from wounds or tissues were identified from laboratory records. The charts of patients with pure cultures of enterococci were reviewed to determine the degree of clinically significant infection. We found that the frequency of infections in patients with pure cultures of enterococci was not significantly different from the frequency of infections in a control series of patients with negative cultures, but that it was significantly different from the frequency of infections in a series of patients with pure cultures of Staphylococcus aureus. Our conclusion that enterococci are not by themselves significant pathogens in wound or tissue infections is supported by a few experimental studies of other authors.
Asunto(s)
Infecciones/microbiología , Streptococcus/aislamiento & purificación , Infección de Heridas/microbiología , Humanos , Staphylococcus aureus , Streptococcus/patogenicidadRESUMEN
Forty-eight patients with blood cultures positive for Staphylococcus aureus were classified according to clinical criteria in three groups: "definite", "possible", and "doubtful" septicemia. Using traditional blood culture sets with two bottles (thioglycollate and tryptic soy broths), we found that patients with "definite" septicemia always showed more than one positive bottle per day if more than one set was drawn, that the mean detection time was 1.7 days, and that 95% of the first positive bottles and 92% of all positive bottles grew within two days of incubation. Patients with "doubtful" septicemia were more often (88%) positive in one bottle only, the mean detection time for all bottles was 3.7 days, and only 35% of the first positive bottles and 33% of all positive bottles yielded growth within two days. "Possible" cases took a position between these two extremes but tended more towards the "doubtful" cases. The implications of these findings for the interpretation of blood cultures with S. aureus are discussed.
Asunto(s)
Sangre/microbiología , Sepsis/diagnóstico , Infecciones Estafilocócicas/diagnóstico , Humanos , Sepsis/microbiología , Infecciones Estafilocócicas/microbiología , Staphylococcus aureusRESUMEN
Brand name and gereric prescriptions for 12 drugs were surveyed at 33 pharmacies in the Rochester, New York, area to determine how frequently generic prescriptions were filled with a product other than the major brand, and at a savings to the consumer. Generic prescriptions for ampicillin, erythromycin, propoxyphene, and dioctyl sodium sulfosuccinate were often filled at prices lower than comparable brand name prescriptions. Occasional, but often substantial, savings were obtained for papaverine, pentaerythritol tetranitrate, and conjugated estrogens. No savings were obtained for penicillin V, chlorpheniramine, diphenylhydantoin, sulfisoxazole, or methenamine mandelate. The pharmacists included in the survey identified correctly a mean of 18.5 out of 22 drugs as to whether products other than the major brand were available. A sample of physicians identified correctly a mean of 14.1 drugs. Pharmacists who were better informed as to which drugs were available generically were more likely to stock alternative products and more likely to charge lower prices on generic prescriptions than on brand name prescriptions.