[Rabies vaccine inactivated with ethylenimine. Duration of the immunity in dogs]

The duration-of-immunity afforded by the ethylenimine inactivated rabies vaccine produced in BHK cells with the PV strain, was studied in dogs. One hundred per cent of the dogs became serologically positive 7 days after vaccination; the same percentage was still positive 3 years after vaccination with one dose of the vaccine. A good correlation was observed between the antibody profiles as determined by the titers obtained with the mouse neutralization and fluorescent field inhibition techniques. The correlation was not as good when the number of international units per ml was determined by both tests. The best correspondence between serological response and resistance to challenge was observed when the antibodies were determined by the number of international units per ml, using the neutralization test in mice. All the dogs challenged 12 and 25 months after vaccination resisted challenge; 89% (8/9) were protected 36 months after vaccination. Inactivated vaccines can be as effective to control rabies as those prepared with modified live virus; moreover, the inactivated vaccines are more stable and safer than the latter.

Estrogen action in the male

Estrogen administration induces a migration of eosinophil leukocytes to ductus deferens.

Bromocriptine in the treatment of hyperolactinemic amenorrhea

Thirty women with secondary amenorrhea and hyperprolactinemia were studied; galactorrhea was present in 25 of them, and 18 were infertile. Serum prolactin (PRL) levels were high in all cases, between 26 and 120 ng/ml. All women were treated with bromocriptine in increasing doses from 2.5 to 5.0 or 7.5 mg daily, according to the response obtained, for 4 months. In 27 patients a PRL determination was performed during treatment; values returned to normal (up to 20 ng/ml) in 23 women and remained high in 4. Galactorrhea disappeared in 21 of 25 women. Ovulatory menses were re-established in 17 patients (56.6%). Seven women became pregnant (38.8%), one of them after bromocriptine and clomiphene were given simultaneously in the same cycle. According to our results and a literature review the following conclusions may be drawn: (1) bromocriptine is a useful therapeutic tool for re-establishing menstruation and inducing ovulation in patients with the hyperprolactinemic-amenorrhea syndrome; (2) the association of bromocriptine and clomiphene could be the next step in the treatment of patients who fail to ovulate with bromocriptine alone.

Diffusion of beta-lactam antibiotics and fosfomycin to interstitial tissue fluid in rabbits

The ability of seven antibiotics (carbenicillin, cloxacillin, ampicillin, cephalothin, cephaloridine, cefoxitin and fosfomycin) to enter interstitial tissue fluid was evaluated. Using rabbits with implanted subcutaneous chambers, antibiotics were given intramuscularly as a single dose of 15 mg/kg, and antibiotic levels in serum and interstitial fluid of the chambers were determined at variously scheduled times after injection. The results indicated that antibiotic concentrations in the two compartments did not run parallel. The pharmacokinetic analysis showed that, in general, antibiotic diffusion from blood to interstitial fluid increased with the concentration gradient and the serum half-life, and there was an inverse relationship to pKa, protein binding and molecular weight of the antibiotic.

[Protracted diarrhea. Etiopathogenia and management (author's transl)]

For the purpose of twelve cases on protracted diarrhea, the etiopathogenia from this illness is reviewed and the tolerance and inconvenients of treatment with intravenous feeding is assessed, being the authors addicted of employing antibiotics, cholestyramine, diets free of disaccharides and fundamental diets; in such a manner that parenteral nutrition for its inconvenients and complications should only be used in case of failing the rest of therapeutic methods.

Dynamics of estrogen binding by uterine cells in vivo

The dynamics of the in vivo binding and release of tritiated estradiol in different uterine cell types are described. The very early binding of estrogens by the cytosol-nuclear and the eosinophil receptor systems is in accordance with the hypothesis that some estrogenic effects are mediated by these receptor systems.

Effect of propranolol on various parameters of estrogen stimulation in the rat uterus

Pretreatment with propranolol does not modify the estrogen-induced uterine eosinophilia, the water imbibition effect, nor the increase in uterine RNA and protein content. This confirms the independence of these parameters from the estrogen-induced early increase in uterine cAMP, since, when observed, the latter is suppressed by propranolol pretreatment.

Treatment of typhoid fever with fosfomycin alone and associated to chloramphenicol or ampicillin

Treatment with fosfomycin alone and associated to subtherapeutic doses of chloramphenicol or of ampicillin, has been tried on 50 patients with typhoid fever and on four carriers of S. typhi in the Hospital del Rey. 15 patients were treated with fosfomycin alone, 22 with fosfomycin plus chloramphenicol and 13 with fosfomycin plus ampicillin. The treatment lasted 15-20 days. The results have been evaluated clinically and bacteriologically, haemo- and coprocultures being carried out. The sensitivity of the isolated germs has been studied, including MIC and the synergism in vitro between fosfomycin-chloramphenicol and fosfomycin-ampicillin. Fosfomycin, chloramphenicol and ampicillin determinations have been carried out on the blood. The cures obtained were 67, 82 and 92% respectively with fosfomycin, fosfomycin-chloramphenicol and fosfomycin-ampicillin. We believe that this antibiotic can be useful in the treatment of typhoid fever, associating it to chloramphenicol or ampicillin, due to the synergism existing between them and given the results we have obtained.

A study of the levels of fosfomycin in the cerebrospinal fluid in adult meningitis

In order to determine the liquor concentration of fosfomycin, we chose 27 patients who were suffering from meningitis with different etiology. According to route, type of administration and doses employed, we classified the patients into five groups. Blood samples were taken from the patients 1 h after concluding the administration of the antibiotic and 2 h after the CSF sample. The concentration of fosfomycin in the serum and the CSF were then determined in the laboratory. In order to evaluate the results we divided our cases into three groups according to the state of their meningeal inflammation. In the first group of patients with active meningitis, we obtained an average concentration of fosfomycin in the serum of 65.20 mug/ml and in the CSF of 10.88 mug/ml. In the second group of patients with meningitis in the remission stage, the concentration of fosfomycin in the serum was 83.58 mug/ml and in the CSF it was 9.63 mug/ml. In the third group of patients with their meningitis cured, the concentration of fosfomycin in the serum was 66.45 mug/ml and in the CSF it was 4.95 mug/ml. On the basis of the concentrations obtained and with regard to the sensitivity in vitro, we concluded that fosfomycin can be useful in the treatment of meningitis caused by Pneumococcus, Staphylococcus, E. coli and other gram-negative bacilli.

Antibiotherapy of Serratia marcescens septicemia in children

The clinical and bacteriological response of 38 treatments performed on 24 children (11 of them neonates) carrying out separate treatments with carbenicillin (2 treatments), gentamicin [4], fosfomycin [6], and associated treatments with gentamicin plus carbenicillin [6], fosfomycin plus gentamicin [18] and fosfomycin plus carbenicillin [2] are considered. The clinical cure was obtained in 21 children (87.5%). The most effective treatment was fosfomycin plus gentamicin; both antibiotics showed synergism in vitro on isolated Serratia strains. A dosage of 75 mg/kg fosfomycin enables serum levels of about 32 mug/ml during 4-5 h, being this level higher to the MIC of all isolated strains of S. marcescens.

Fosfomycin in pneumococcal meningitis

A study has been made of 12 patients with pneumococcal meningitis with ages ranging from 12 months to 59 years. In all cases pneumococcus was isolated in the cerebrospinal fluid (CSF). Seventeen pneumococci were studied for their sensitivity to fosfomycin, ampicillin and gentamicin, including their MIC. All were sensitive to fosfomycin and ampicillin and 7 to gentamicin. On the other hand there has also been made a study of the interaction between fosfomycin plus ampicillin and fosfomycin plus gentamicin. The concentration of antibiotics in plasma and CSF had been determined. The association of fosfomycin to penicillin or ampicillin was also studied in some cases, depending on whether the patient was younger or older than 2 years, and in other cases, the association of fosfomycin with gentamicin. The concentrations of antibiotics in the CSF varied according to the stage of evolution of the meningitis. As regards clinical results, 10 cures and 2 failures have been obtained. The pneumococcus was eradicated from the CSF in all cases, including the two failures, in the control carried out 2-3 days after beginning of treatment, the rest of the analytical data of the CSF became normal within 5 and 17 days treatment.

Bacteriological evaluation of fosfomycin in clinical studies

Since fosfomycin has behaved in vitro as a broad-spectrum antibiotic, an attempt has been made to evaluate this behaviour in controlled clinical study carried out at different Spanish hospitals. A total of 959 patients were treated for some of the following infectious clinical processes: gonococcal urethritis, typhoid fever, enterocolitis, acute and chronic urinary tract infections, osteomyelitis, chronic otorrhoea, septicaemia, meningitis, peritonitis, surgical and suppurative infections, bronchitis, pneumonia, pharyngoamygdalitis, burns, endometritis, ocular infection, whooping cough and nasal carriers of S. aureus. The results obtained as a function of the microorganism isolated in these clinical processes in percentage of clinical and bacteriological success have been 96% of the S. aureus infections, 95% of the Streptococcus sp. including S. pneumoniae, 90% of the N. gonorrhoeae infections, 94% of the E. coli infections including enteropathogenic E. coli, 90% of the S. marcescens infections, 76% of the Proteus sp. infections, 72% of the Klebsiella-Enterobacter infections, 66% of P. aeruginosa infections and 78% of the S. typhi infections.

Fosfomycin: Laboratory studies

Fosfomycin, a nontoxic broad-spectrum antibiotic, different in structure from all previously described antibiotics, acts selectively by inhibiting cell wall formation. It was overlooked during many years of screening because of antagonism by culture medium ingredients and frequent occurrence of resistant mutants. It is effective in many because the neutralizing substances are not present and resistant mutants of most species are avirulent. Fosfomycin has favorable pharmacologic characteristics. It is not cross resistant, does not show antagonism, and has been used successfully in combinations. An insoluble calcium salt is used in oral formulation and a sodium salt for parenteral administration. Overall success rates of 86% were reported with 1,000 patients in Spain and 79% in Japan.

Fosfomycin in puerperal infections and its elimination in lochia

31 patients suffering from puerperal endometritis, 16 of whom with other concomitant infections (sepsis, infection of episiotomy, pyelonephritis) were treated with fosfomycin. 86% of the germs isolated were sensitive to fosfomycin. The results obtained have been excellent in 26 patients (84%) and null in 5 (16%). Fosfomycin showed to be an antibiotic of wide-spectrum, and it acted very rapidly, since apirexia of the patients was achieved after 2-3 days of treatment. The antibiotic had perfect tolerance. No disagreeable secondary effects nor changes in the haematological data were observed. We have also carried out a study on the elimination in lochia of fosfomycin in a group of 21 patients with normal birth and puerperium. The concentrations of the antibiotic in lochia, although variable, are sufficient to achieve the desired bactericide action.

[Urinary excretion of 11-deoxy-17-ketosteroids during the normal menstrual cycle (author's transl)]

Urinary excretion of 11-deoxy-17-ketosteroids was studied in 20 to 22 women with normal menstrual cycles on the 7, 10, 14 and 20th days of their cycles. The fraction studied showed a significant cyclic variation with a type of pattern for Androsterone and Aetiocholanolone and another one for the Dehydroepiandrosterone. The possibity of one metabolic path for the former metabolites and a different one for the latter, plus its close conection with the functional changes of the ovary, were arrived at.

Daily variations of FSH, LH and testosterone response to intravenous luteinizing hormone-releasing factor (LRF) in normal men

The responses of FSH, LH and testosterone to acute stimulation with synthetic LRF were studied in 6 healthy, fertile men aged 33.4 plus or minus 1.6 yr (X plus or minus SE). Fifty mug of LRF were given, iv at 0600 h, 1200 h, 1800 h and 0000 h, at 1-week intervals, to all 6 volunteers simultaneously. Blood samples were collected by venipuncture before (-5 and 0 min) and 8, 16, 32, 64 and 128 min after LRF injection. Plasma levels of FSH, LH and testosterone were determined by double antibody radioimmunoassay techniques. The responses of FSH and LH to LRF injection showed a clear difference at the times studied. Maximal values were obtained at 0600 h and 1800 h while the response at noon was not significant for LH and absent for FSH. Testosterone secretion showed a clear-cut response to LRF in all the subjects. At three of the four studied times (0600 h, 1800 h, 000 h) plasma testosterone was already increased at 8 min reaching its maximum at 16 min and persisted high until the end of the study. The noon response reached its maximum at the end of the test period. The daily variations of FSH and LH responses to acute LRF stimulation should be taken into consideration in clinical practive and the increment in testosterone secretion makes this test a useful indicator for androgenic testicular reserve.