Lactose tolerance in lambs with rotavirus diarrhoea

It has been suggested that lactose malabsorption is an important factor in producing the diarrhoea of acute rotavirus infection. Accordingly, the lactose tolerance of gnotobiotic newborn lambs, infected with lamb rotavirus, has been investigated by clinical studies and tissue enzyme assays. Although lactase activity is low in affected areas of the small intestine, rotavirus infected lambs are not lactose intolerant as assessed by the measurement of reducing substances in the faeces, or by the clinical effects and blood glucose levels after a 5.8 mmol (2 g)/kg lactose load on the second day post-infection. Lactose intolerance could be demonstrated by using extremely high (29.2 mmol (10 g)/kg) doses of lactose, three or four times the normal dietary lactose intake. These experiments suggest that lactose-containing feeds (such as maternal milk) are not necessarily contraindicated in patients or animals with rotavirus diarrhoea.

[Bacteroides fragilis. Maternal-placental and foetal contamination (author's transl)]

In order to study the maternal-placental and foetal contamination, cytologic study and aerobic-anaerobic cultures were performed on 1 000 placentae of infants who were referred to the Intensive Care Unit. Bacteroides were isolated from 30 specimens, and on smears, Gram negative bacteria were found on 11 of these cases. Only in 2 infants Bacteroides were isolated from blood, gastric aspirate and meconium; 20 infants were said to be infected on clinical and biological bases; eight were normal. Bacteroides infection is usually benign; the symptoms are not specific; the diagnosis is often delayed and the treatment uneasy. Nowadays, Carbenicillin, Ticarcilin, Cefoxin or Metronidazole are advised, according to the sensibility of the organism.

[Clostridium perfringens infection and necrotising enterocolitis]

During a four year period (1974--1977) 21 infants died as a result of severe necrotising enterocolitis (N.E.C.). In 9 cases, Clostridium perfringens was isolated. When this organism is recovered either from the placenta or from the first meconium and or when the signs of the disease appear within a few days of birth, materno-fetal transmission of the infection may be suspected. The infection occurs most frequently in neonates in whom the gastrointestinal tract was already colonized by Clostridium.

[Hepato-pulmonary Nocardia infections (report of one case) (author's transl)]

Actinomycosis due to Nocardia asteroides is a mainly pulmonary disease; the metastases are due to migration of the germ in the blood from the primary lung focus. The case reported here concerned a patient whose initial symptoms were mainly hepatic, suggesting an amoebic abscess of the liver. The pulmonary lesions appeared only secondarily with presence in the sputum of the nocardia which was responsible. Prolonged treatment with trimethoprime sulfamethazole led to complete and lasting cure of the lesions, confirmed radiographically and by a liver scan.

Hypothalamic-pituitary-gonadal dysfunction in men using cimetidine

We studied the effect of cimetidine therapy (1200 mg per day by mouth for nine weeks) on the hypothalamic-pituitary-gonadal axis of seven men. There was a 43 per cent mean reduction in sperm count after therapy. The luteinizing hormone response to luteinizing hormone releasing factor was also reduced, and a statistically significnat rise in plasma testosterone occurred, although it was less than that before therapy. Gonadotropin responses to provocative clomiphene stimulation were inadequate when compared with those of controls. Cimetidine did not affect the responses of thyroid-stimulating hormone, prolactin, growth hormone and thyroxine to thyrotropin releasing factor. Caution is advisable in administration of cimetidine for prolonged periods to young men.

Pathogenesis of diarrhoea caused by astrovirus infections in lambs

Experimental infection of 2-day-old gnotobiotic lambs with lamb astrovirus produced mild diarrhoea after an incubation period of about 48 hours. No other clinical symptoms developed. Infection was studied by immunofluorescent and histological examination of tissues from the lambs. Astroviruses infected only mature villus epithelial cells and subepithelial macrophages in the small intestine, where they produced partial villus atrophy. Infected enterocytes were replaced with cuboidal cells from the crypts, and the lesion gradually healed by 5 days after infection. No serological relationship was detected by immunofluorescence between lamb astrovirus antigen in gut sections and antisera to either calf or human astrovirus.

[Severe complications following intermittent administration of rifampicin]

In the last two years the authors have noted the cases of five patients with pulmonary tuberculosis to which intermittent treatment with Rifampicin was administered (twice weekly, 600-900 mg/day), in association with Ethambutol. Between 2 and 6 months after the treatment was started, 24-72 hours after the last administration of Rifampicin acute renal failure developed in all five cases. Two of the patients also had signs of liver failure (increased serum transaminase, lowered pseudo-cholinesterase, increased BSP retention), and in one of them there was also a hematological syndrome consisting in hemolytic anemia and thrombocytopenia. Four of the patients benefited from application of diuretics, hydroelectrolytic re-equilibration and/or hemodialysis. One of the subjects died 12 hours after being hospitalized, with acute pulmonary oedema, refractory to treatment. From the histopathological viewpoint glomerular lesions were found in the kidney (non-uniform thickening of the basal membranes by PAS-positive deposits). In two of the patients various immunological tests have been carried out (Coombs test, lymphocyte-migration inhibition, serum and urine immunelectrophoresis) that, by their alterations, provide some elements indicating the immunological origin of the phenomena.

[Distinction between beta-lactamases of immunotypes 1 or 2 using a new beta-lactam antbiotic (author's transl)]

The resistance of Gram negative bacteria to ampicillin and carbenicillin is often associated with the presence of plasmidic transferable beta-lactamase (class III of Richmond and Sykes). Using immunological and physico-chemical tests, two sub-classes have been identified. The sensitivity of Escherichia coli K12 with plasmid P111 (immunotype 1) or plasmid P453 (immunotype 2) determined by means of the minimal inhibitory concentrations, contrasts significantly with a new beta-lactam antibiotic, X-587. Study of the kinetic constants (Km, Vmax) of the beta-lactamases confirms and explains this difference. Thus we have a simple and rapid method for differentiation of these 2 types of enzymes.