[Effects of Casimiroa edulis (Rutacea) on blood pressure and heart rate in albino rats]

Aqueous extracts of Casimiroa edulis leaves injected intravenously to 20 normal Sprague-Dawley rats produced a rapid and transitory increase in blood pressure. The amplitude of the blood pressure rise was dose dependent. The increase was statistically significant (p < or = 0.01) at a concentration of 220 mOsm/l, and was associated with a significant heart rate decrease (p < or = 0.01) probably secondary to barorreceptor stimuli. The application of 130 mOsm/l of the extract did not produce a significant increase in blood pressure, which was followed by a rapid pressure normalization. The slight increase in cardiac rate during the pressure lift was probably due to sympathetic stimuli.

[Droxicam-induced hepatitis. Description of 3 new cases and review of the literature]

Three new cases of cholestatic hepatitis caused by droxicam are described, along with a revision of the other eight cases published to date. Itching, asthenia, and jaundice were the most common symptoms. Average age was 62.8 years (range: 45-82 years), and the median time of exposition was 22.7 days (range: 5-50 days). Biochemistry of the liver showed primarily cholestasis and in 4/11 cases hypereosinophilia. Two patients presented elevated levels of cholesterol and triglycerides which disappeared within the month. Clinical manifestations persisted in one patient for eight weeks after the cessation of treatment. The three patients presented in the present series presented alteration in the biochemistry of the liver two months after initiation. Liver biopsy in three patients showed centrozonal cholestasis associated with portal inflammatory activity and presence of granulomas consistent with toxic hepatitis.

[Treatment of residual choledochal calculi in patients with Kehr's T drainage: role and results of endoscopic sphincterotomy]

The results of sphincterotomy in the treatment of residual gallstones after cholecystectomy in a series of 62 patients, bearers of a T tube are reported. The mean time after surgery was 26.4 +/- 19.2 days. The procedure was technically successful in 59/62 (95.1%). Stones were passed spontaneously or were retrieved in 55/62 patients (88.7%). In four patients gallstones persisted in spite of sphincterotomy. All were operated with favorable results. Complications were observed in 4 patients (6.4%), without mortality. Sphincterotomy is a safe and relatively efficient technique in the treatment of cholecystectomized patients with residual gallstones and a T tube drainage.

[Right ventricle with double outlet associated to total anomalous pulmonary venous drainage to innominate vein]

The clinical findings of 2 patients are studied with an association of malformations not previously reported: double outlet right ventricle and total anomalous pulmonary venous connection to the innominate vein. The following features are worth while to be underlined: 1. Both patients showed a discordance between viscero-atrial situs and direction of the apex; 2. In both cases, particularly in case 2, there existed a very unusual spacial relationship between ventricles, the right ventricle being superior with respect to the left ventricular cavity; 3. From the embryological viewpoint, this ventricular arrangement is supposed to be due to an arrest of the development of the heart in the straight tube stage, there being, however, an upwards expansion of the atrioventricular canal and common atrium; 4. An accurate diagnosis of the common or divided nature of the atrioventricular valves has been impossible in these cases; 5. These combination of lesions constitutes a challenge to cardiologists and surgeons as far as the surgical indication is concerned. In that sense, the simple anastomosis of the common pulmonary vein to the left atrium, although is not a radical cure, may be a feasible and beneficial procedure.