Short Form (SF-36) Health Survey measures are associated with decreased adherence among urban African Americans with severe, poorly controlled hypertension.

The objective of this study was to determine whether an association exists between Short Form (SF-36) Health Survey measures and nonadherence among urban African Americans with poorly controlled hypertension. A total of 158 African Americans were admitted to an urban academic hospital for severe, uncontrolled hypertension. The main outcome measure was self-reported nonadherence to antihypertensive medications using a validated instrument.

Physicians' perceptions and knowledge of drug costs: results of a survey.

The objective of this survey was to determine physicians' opinions of the importance of drug costs, sources of drug cost information used, preferences for mechanisms to lower drug costs, and to assess knowledge of the relative cost of common drugs. A questionnaire containing opinion statements and five categories of drugs to be ranked from least to most expensive was sent to 598 physicians at our tertiary-care, university-affiliated teaching hospital. In all, 398 (66.

Tuberculin testing in a tertiary hospital: product variability.

Nine percent of 2,721 hospital employees, previously tuberculin negative, were PPD positive when tested with 5 TU of PPD (Aplisol, Parke-Davis). Seventy percent of the positive reactions were found to be erroneous on retesting with Tubersol (Connaught). The excessive potency of Aplisol led to excessive expenditures of time and money investigating a nonexistent outbreak.

Empiric antibiotic therapy of abdominal sepsis and serious perioperative infections.

This article discusses empiric therapy for several serious infections in surgical patients. The accepted antibiotic treatment for purulent peritonitis, the empiric treatment of postsurgical wound infection, and the empiric treatment of postsurgical pneumonia are discussed. The cost of the various regimens is listed.

Multicenter trial of fleroxacin versus ceftriaxone in the treatment of uncomplicated gonorrhea.

In a multicenter, randomized, open, comparative trial, patients with uncomplicated gonorrhea were treated with 400 mg of oral fleroxacin or 250 mg of intramuscular ceftriaxone. A total of 458 men and 447 women were enrolled. Of these, 312 men (68%) and 245 women (55%) were evaluable for efficacy.

Vancomycin is not an essential component of the initial empiric treatment regimen for febrile neutropenic patients receiving ceftazidime: a randomized prospective study.

The use of vancomycin as part of the initial antibiotic therapy of febrile neutropenic patients has become a controversial issue. Some studies support its incorporation in the initial regimen, and others suggest that vancomycin can be added later. We examined this issue in a prospective, randomized trial.

Trimethoprim-sulfamethoxazole anaphylactoid reactions in patients with AIDS: case reports and literature review.

Adverse effects are common in patients with acquired immunodeficiency syndrome (AIDS) who receive trimethoprim-sulfamethoxazole (TMP-SMX). Two patients experienced a rare anaphylactoid syndrome. Within hours of receiving a double-strength TMP-SMX tablet, a 28-year-old human immunodeficiency virus (HIV)-positive man developed fever, hypotension, and bilateral pulmonary infiltrates.

Staphylococcal pericarditis. An atypical presentation.

Purulent pericarditis is typically an acute and often catastrophic illness. The case presented herein has unusual manifestations of pericarditis caused by Staphylococcus aureus. The clinical course was indolent and prolonged, and unlike the usual case, no primary source could be found.

Procoagulant synthesis by exudate and bone marrow-derived murine macrophages.

Murine exudate macrophages elicited by different stimuli and bone marrow-derived macrophages were studied for their capacity to synthesize factor VII and tissue factor in a basal state and on stimulation with endotoxin (LPS). Cells elicited by different stimuli varied in their production of both factors. Thioglycollate-elicited cells generally made more, but not significantly more, tissue factor in response to endotoxin than cells elicited with periodate or streptococci.

Treatment of uncomplicated gonorrhea with single-dose imipenem-cilastatin.

Single 500-mg intramuscular doses of imipenem-cilastatin cured 116 (95%) of 122 men and 9 of 9 women with uncomplicated gonorrhea due to beta-lactamase-negative Neisseria gonorrhoeae. Most co-existing Chlamydia trachomatis infections persisted. Imipenem-cilastatin is effective for uncomplicated gonorrhea in men but has no advantages over other available regimens.

Strongyloides meningitis.

Acute pyogenic meningitis occurred in a 46-year-old woman receiving long-term steroid therapy. Cultures for bacteria and fungi were negative, and the meningitis failed to respond to broad spectrum antibiotics. Abundant Strongyloides stercoralis larvae were found in the patient's feces a sputum, and a filariform larva was found in a hanging drop preparation from centrifuged cerebrospinal fluid.

Pyoderma gangrenosum in a kindred. Precipitation by surgery or mild physical trauma.

Five cases of pyoderma gangrenosum occurring in a kindred are presented. Three of the cases occurred after abdominal surgery and tended to be confused with postoperative wound infections. Two cases occurred after superficial injury to the leg and were also thought to represent a peculiar form of cellulitis.

Lymphocyte collaboration is not required for the induction of murine macrophage procoagulant by endotoxin.

The putative requirement for lymphocytes as instructor cells in the induction of macrophage procoagulant (PCA) by endotoxin (LPS) was tested on elicited mouse peritoneal macrophages and on bone marrow-derived macrophages. Percoll purification of thioglycollate macrophages to at least 99.8 percent failed to diminish PCA induction by LPS.

Histoplasmosis presenting as a neck mass.

A unilateral neck mass is an unusual clinical presentation for histoplasmosis. A patient with a large, unilateral neck mass caused by Histoplasma capsulatum is presented to alert readers to such a possibility and to illustrate some of the difficulties in diagnosing and managing the disease.

Macrophage factor X activator formation: metabolic requirements for synthesis of components.

The in vitro production of factor VII-like material and of tissue factor activity by murine thioglycollate exudate macrophages was measured by amidolytic assays. Tissue factor activity was inducible by endotoxin, and its induction was inhibited by 1 microgram/mL of actinomycin D, 10 micrograms/mL of cycloheximide, and 0.2 micrograms/mL of tunicamycin.

Macrophage procoagulants.

Monocytes and macrophages can be induced to produce tissue factor. Recent data suggest that macrophages make other products involved in the extrinsic coagulation pathway. These include vitamin K-dependent factors, factor X activators and a prothrombinase.

The endotoxin-induced procoagulant of mouse exudate macrophages: a factor-X activator.

The properties of mouse macrophage procoagulant induced by endotoxin in vitro were studied by the acceleration of clotting and by chromogenic assays using as substrates human plasma and bovine components, which are not activated by mouse tissue factor. Maximal macrophage procoagulant activity occurred when activated cells were lysed in culture supernatant fluids, suggesting the interaction of cellular and supernatant factors. This procoagulant was clearly able to activate bovine factor X.

Early results of a comparative trial of ceftazidime versus cephalothin, carbenicillin and gentamicin in the treatment of febrile granulocytopenic patients.

Ceftazidime was compared with a combination of cephalothin, carbenicillin and gentamicin as empirical therapy for fever in granulocytopenic patients. Forty-eight patients were studied in this randomized trial. In the 44 evaluable cases, favourable clinical responses were seen in 9/21 ceftazidime-treated cases and 13/23 patients treated with the combination.

Endotoxin fails to induce procoagulant in C3H/HeJ exudate macrophages.

Monocytes and macrophages from a variety of animal species produce procoagulants upon stimulation with endotoxin in vitro. While C3H/HeJ mice and their cells have exhibited refractoriness to known effects of phenol-water extracted endotoxin, two recent reports indicate that the cells of these mice produce procoagulants in a normal manner in response to endotoxin. This study compares the responsiveness of cells of C3H/HeJ and C3H/HeN mice to phenol-water extracted endotoxin and to disrupted gram-negative cell walls.

Comparative efficacy of piperacillin and penicillin G in treatment of gonococcal urethritis.

The comparative efficacy of 2 g of piperacillin and 4.8 X 10(6) U of penicillin G in the treatment of uncomplicated gonococcal urethritis was assessed in a randomized prospective study. Sixty-five evaluable patients received piperacillin, and 55 received penicillin G.