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A prospective, randomized controlled study was carried out in 24 Italian urology wards in 675 patients undergoing transurethral prostatic resection, utilizing three different chemoprophylactic treatments with either amoxycillin (AMX), co-trimoxazole (CTX) or fosfomycin trometamol salt (FT) in order to prevent postoperative urinary tract infections. FT significantly lowered the incidence of both postoperative bacteriuria and symptomatic infections in comparison to AMX and CTX. Transient side effects, mild or moderate, were observed in 6.6% of cases. Similar safety and protective results were obtained in 233 patients undergoing different transurethral instrumentations who were chemoprophylactically treated with FT.

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This controlled multicenter study on 407 evaluable patients demonstrates the equal efficacy of two short-term antimi crobial prophylactic regimens in urological surgery involving a single dose of a long-acting cephalosporin, ceftriaxone, in comparison with a multiple dose of cefotaxime. Fifty-three of the 196 patients (27%) on the cefotaxime regimen and 47 of the 211 patients (22.3%) who received ceftriaxone showed postoperative infectious complications. There were no differences in these results.

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This multicenter, prospective and randomized study on 355 patients demonstrates the equal efficacy of two short-term antimicrobial prophylactic regimens in gynecologic and obstetrical surgery involving a single dose of a long-acting cephalosporin, ceftriaxone, in comparison with a multiple cefotaxime dose. Among the cefotaxime and ceftriaxone groups which underwent abdominal hysteroctomy, 15 of 112 (13.4%) and 20 of 97 (20.6%) patients developed infections respectively. Four vaginal hysterectomy patients out of 20 (20%) on cefotaxime regimen and 4 of 25 (16%) who received ceftriaxone, became infected (febrile morbidity, wound infections, bacteriuria and infectious complications at a non-surgical site). Also among the cefotaxime and ceftriaxone groups of emergency or elective cesarean sections the differences on the incidence of infections are not statistically significant.

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The authors investigated the activity of a combination of DDP 80 mg/m2 i.v. followed by VP16 50 mg/m2 on days 2-5 in bronchogenic carcinoma. Twenty-seven patients entered the study (10 small cell carcinoma, 9 squamous cell, 2 adenocarcinomas and 6 histologically undefined). Six patients evidenced partial response (22.3%); one patient (small cell) had complete remission. The toxicity of the regimen was scarce and well-tolerated by patients with an incidence of 88.8% alopecia, and 77.7% nausea and/or vomiting.

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In order to evaluate comparatively the methods so for available for the identification of beta-haemolytic streptococci, the following tests were carried out on 120 strains recently isolated from clinical materials: bacitracin-test, precipitation and coagglutination methods. The results obtained indicated a poor reliability of the bacitracin test, even if only restricted to the identification of the group A streptococci, as opposed to the good reliability of coagglutination and precipitation methods, which allow the identification either of group A or groups B, C and G, the latter well know to the often involved in infectious diseases. Evidences so far obtained point to the coagglutination method as the most suitable for routine diagnostic and furthermore stress the rapidity and the facility of its use.

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Serum antibodies specific for the bacteria isolated from the urines of 41 patients with chronic pyelonephritis and 14 with asymptomatic bacteriuria were assayed. Even though it is clear that infections which involve the kidney evoke higher antibody responses than do purely bladder infections, it is difficult to establish a cut-off level for distinguishing the two by this method. There is a greater probability that there will be an upper urinary tract infection without an antibody response than that there will be a good antibody response in cases with lower tract infections. In our case list, 49% of the patients with chronic pyelonephritis had titers equal to or greater than 1:400, and another 44% had titers between 1:50 and 1:100. Therefore it appears that the magnitude of the antibody response depends not only on the location of the infection but also on other factors, such as the intrinsic immunogenicity of the different bacterial strains and the properties of the immunological system of the patient.

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Autorhythmometry of blood pressure is a technique easy to be performed and well accepted by hypertensive patients. A simple inspection of data self-collected 5 times a day for many days constitute a sufficiently reliable automonitoring of blood pressure both in basal conditions and in relation to the efficacy of some dietary and/or pharmacological treatment. Several examples are reported to show that more sophisticated statistical manipulation of the data collected may give rise to a better understanding of some clinical and physiological aspects. Both analysis of variance, performed on individual subsets of data averaged at each sampling hour, and single cosinor, performed on longitudinal time series, may be used to detect and quantify a circadian rhythm as a systematic daily variation, averaging towards zero the noise superimposed to the actual time series. Serial section analysis of the data, along all the experimental span, is useful to detect a) the reproducibility of the rhythm b) the variation of its parameters induced by changes in the experimental conditions c) the long-term trend. In the first subject the influence on the circadian rhythm of the pulse rate, temperature and blood pressure, due to a 4 h advancing shift in the rest-activity synchronizer, is well documented. In the first hypertensive patient a circadian rhythm is demonstrated also in blood pressure during two non-consecutive months. No difference is detected in both mesor and amplitude of blood pressure and a full resynchronization of the acrophase is achieved when a 1 h delaying shift in the rest activity synchronizer is imposed. In the second patient a well reproducible rhythm of systolic blood pressure and a low noise/signal ratio is documented by the serial section display. In the third patient the 'lability' of hypertention seems mainly due to salt sensitivity, as documented by the significant lowering of the mesor in the second experimental span, when a lowering of only 30 mEq/day in salt intake is imposed. The serial section better documents the salt-sensitivity of this patient, during a span when loading and depressing of salt intake is imposed. In the last patient the prompt effect of therapy in lowering blood pressure within normal range is well documented by serial section with 3 day interval. A possible effect of masking the circadian rhythm of blood pressure, due to therapy, is inferred by the serial section display with an interval of the same length (33 days) as the subspan without therapy. The possibility of prevention in the hypertensive disease is discussed, with the aim of autorhythmometry and statistical methods employed in this paper.

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A long-term study was done by means of interative fluorangiography on microvascular retinal permeability versus the blood pressure control carried out in 11 patients with a diastolic blood pressure of greater than or equal to 130 mm Hg and with retinal exudates, haemorrhages and oedema. No matter what the original disease was (i.e., essential, renovascular, endocrine hypertension or chronic nephropathy with terminal renal failure) the increased permeability appeared to be critically connected with the blood pressure level. Our results confirm that hypertension per se might be the cause of vascular permeability changes.

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