Colombian patients with New World cutaneous leishmaniasis were treated with a combination of a topical formulation (15% paromomycin sulfate/5% methylbenzethonium chloride, twice a day) and parenteral meglumine antimonate (20 mg of antimony [Sb]/kg.d]). Cohort 1 received topical therapy for 10 days and Sb for 7 days; 18 (90%) of the 20 patients were cured (follow-up, 12 months). Other clinical data suggested that neither the topical formulation alone nor the 7-day regimen of Sb alone would have cured many patients. In a subsequent cohort, which received topical therapy for 10 days and Sb for 3 days, the cure rate was 42% (eight of 19 patients). In Colombian cohorts (historical controls) treated with Sb alone for 10-15 days, the cure rate was 31%-36%. Side effects in cohort 1 patients consisted of local reactions to the topical formulation: burning and pruritus in 25% of patients and vesicle formation in 15% of patients. This is the first report that a regimen partially composed of topical antimicrobial agents can be highly effective for treatment of New World cutaneous leishmaniasis.
Requirement for TPN was associated with more leaks, complications and mortality. Leakage was presumably responsible for almost half of deaths. Hyperlipidaemia and female gender were associated with lower rates of complications. These findings warrant a better understanding of metabolic status on perioperative outcome after left colectomy.
Recordings of transmural potential difference (PD) in the stomach have well established that the mucosal surface of this organ is negative in relation to the serosal surface (Rehm, 1946;Revelstad, Owen, and Magath, 1952). On the other hand, it had been noted that the oesophagus has a positive transmural potential difference (Helm, Schlegel, Code, and Summerskill, 1965). The potential difference transition zone from negative to positive values was shown to represent the mucosal transition from acid-bearing to columnar and from columnar to oesophageal mucosa (Meckeler and Ingelfinger, 1967). Utilizing an improved method of recording transmural potential difference (Hernandez and Beck, 1968), we reexamined the characteristics of the potential difference transition zone in normal individuals and in patients suffering from hiatus hernia. In addition, we explored the variations in potential difference which occur over lesions where the mucosal integrity of the oesophagus was destroyed by ulcerations.
METHODS
RECORDING OF POTENTIAL DIFFERENCE SIMULTANEOUSLYWITH OESOPHAGEAL PRESSURE MEASUREMENTS ('PULL-THROUGH METHOD') Oesophageal pressure and potential difference were measured by a technique previously described and evaluated (Hernandez and Beck, 1968), and measurements of pressure changes were based on the method of Winans and Harris (1967). The main features of the combined method are depicted in Figure 1.For both the pressure and the potential difference recording, Ringer's solution (Na+ = 147 m-equiv/l; K+ = 4 m-equiv/l; Ca++ 4.5 m-equiv/l and Cl-= 156 m-equiv/1 was infused at a rate of 0-382 ml/min. The 50 ml plastic syringes were filled through a three-way plastic stopcock (SC) and placed into a Harvard pump2 (HP) which slowly advanced the plungers. Three of the
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