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Introduction: This study describes a nosocomial outbreak of influenza in high-risk-hematological patients, and the usefulness of epidemiological measures and zanamivir administration for its control., Methods: Fifteen patients who had been in contact with a patient with influenza A were included in the study. Viral culture of nasopharyngeal exudate was performed and the epidemiological data, risk factors and clinical outcome were evaluated. The efficacy of early therapy and preventive use of zanamivir was also assessed., Results: Seven out of 15 patients (46.6%) developed symptoms and in 5 of these 7 cases (71.4%), influenza A virus was isolated. Eight patients did not develop symptoms and viral culture was sterile. All symptomatic patients were isolated, and treatment with inhaled zanamivir (10 mg/12 h, 5 days) was initiated as soon as possible; only one patient developed respiratory failure; the remaining cases had self-limited upper respiratory tract symptoms. There was no associated mortality. Zanamivir prophylaxis was used in three non-symptomatic patients considered to be at high risk. Tolerance to zanamivir was excellent. No new cases were observed after initiation of the preventive measures and use of zanamivir., Conclusion: The attack rate in a nosocomial influenza outbreak can be very high in immunocompromised patients. Prompt initiation of preventive measures, early treatment and prophylaxis with zanamivir may help to limit the extension of these outbreaks.

The aim of this study was to analyze by echocardiogram, the action of two Na+/H+ exchange, inhibitors, HOE 642 (HOE) and BIIB 723 (BIIB) on left ventricular (LV) mass and LV systolic function. We studied 16 spontaneously hypertensive rats (SHR), 8 treated with HOE 30 mg/kg/day, 8 with 30 mg/kg/day of BIIB during 30 days and 4 SHR as controls during those 30 days. Results are expressed as mean values +/- SEM. The systolic blood pressure and the echocardiograpic parameters examined did not evidence changes during that period in the controls rats. Even though HOE determined a slight decrease in blood pressure (HOE C: 184 +/- 1.75 mm Hg; HOE 30d: 176.20 +/- 2.60 mm Hg - p < 0.01) which was not detected with BIIB, both drugs provoked an increase of peak systolic stress (HOE C: 166 +/- 29 kdynes/cm2; HOE 30d: 204 +/- 34 kdynes/cm2, p < 0.04; BIIB C: 164 +/- 25.90 kdynes/ cm2; BIIB 30d: 234 +/- 29.30 kdynes/cm2, p < 0.02). HOE and BIIB reduced LV mass after 30 days of administration (HOE C: 612.50 +/- 50 mg; 30d: 452 +/- 37 mg, p < 0.01. BIIB C: 544 +/- 16mg; 30d: 374 +/- 25 mg, p < 0.01). LV endocardial shortening was similar independently of the NHE inhibitors used (HOE C: 62.30 +/- 2.75%; 30d: 65.50 +/- 2.40%, ns. BIIB C: 63.20 +/- 2,39%; 30d 67,20 +/- 1.62%, ns). These data demonstrate that long-treatment with HOE or BIIB produced similar LV mass regression without changes in endocardial fractional shortening in spite of the increase of peak systolic stress. This finding could represent an increased inotropism previously depressed by the development of hypertrophy.

Previous studies have shown that acute inhibition of nitric oxide (NO) synthesis improves sodium and water excretion and increases blood pressure in cirrhotic rats with ascites, thus suggesting that NO is an important factor contributing to the arterial hypotension and sodium retention of liver cirrhosis. In the present work we have analyzed the renal effects derived from the chronic oral treatment (10 days) with aminoguanidine (AG, 100 mg/kg/day), a preferential inhibitor of inducible NO synthase (iNOS), or Nw-Nitro-L-Arginine Methyl Ester (L-NAME, 0.5 mg/kg/day), a nonselective inhibitor of NOS, in an experimental model of liver cirrhosis with ascites (carbon tetrachloride inhalation). Untreated cirrhotic rats showed lower mean arterial pressure (MAP), diuresis, natriuresis and glomerular filtration rate (GFR) and similar renal blood flow (RBF) compared with the untreated control rats. Chronic administration of AG did not modify significantly any parameter in cirrhotic and control animals. Conversely, long-term L-NAME administration to cirrhotic rats normalized MAP and significantly increased water and sodium excretion, whereas in control animals these parameters were not significantly modified. These results show that chronic NO synthesis inhibition with L-NAME, but not with aminoguanidine, improves renal perfusion pressure and increases the lower sodium and water excretion of cirrhotic rats with ascites. Thus, an enhanced production of NO is an important factor contributing to the renal sodium and water retention characteristic of liver cirrhosis.

Diabetic polyneuropathy is a complication, that affects most patients with longstanding diabetes mellitus, deteriorating their quality of life. In the last few years, new therapeutic approaches have been developed that can improve symptoms and neurologic function, and which may prevent and in some cases stop nerve damage, and even, promote nerve fiber regeneration. These treatments are supported by several investigations in animals and humans: a) thigh glycemic control (insulin), b) aldose reductase inhibition (tolrestat), c) prevention of protein glycation (amino-guanidine), d) improvement of nerve ischemia (vaso-dilators, gamma-linolenic acid), and e) administration of neurotrophic factors (gangliosides). Most evidence support the usefulness for glycemic control. Early treatment is suggested, because marked nerve fiber loss is present in advanced neuropathy.

The usefulness of two alpha-2 adrenergic agonists (clonidine and guanfacine) and their comparative effectiveness were evaluated regarding the control of the opiates abstinence syndrome and the secondary effects, including development of cardiovascular abnormalities, in 88 parenteral heroin abusers admitted to two hospital units for the treatment of addiction. The patients were treated in a random, double blind fashion, with clonidine or guanfacine. In the study dosages, both drugs proved to be useful to control the abstinence syndrome. Nearly 70% of those treated with any of the two agonists were able to complete the treatment. When both drugs were compared, a higher degree of restlessness (p less than 0.01) was found among those treated with clonidine, although there were no differences in any other evaluated parameters to compare the degree of abstinence in each drug. The most commonly found side effects were orthostatism, lassitude, mental torpor and oral xerosis. These were independent of the drug used. There were no differences between both drugs regarding heart rate or blood pressure, although both parameters were significantly modified with the doses used in the study.

Thirty six patients with active duodenal ulcers were studied in this double blind work. 19 received placebo and 17 Cimetidine: 1 gr./day. The endoscopic control after 21 days, showed healing in 81,2% of the cases treated with Cimetidine and in 22,2% of those with placebo. After 42 days of continous treatment with Cimetidine the healing of duodenal ulcers was 82,3% against 50% with placebo; the difference being highly statestically significant; p less than 0.01. The symptoms improved with Cimetidine revealing less diurnal and nocturnal pain complete disappearance of nausea and vomit and a significant decreased ingestion of alkali tablets.