for the HypoCAT study investigators* Hyponatremia in cirrhosis is associated with significant morbidity and mortality and complicates ascites management. Vasopressin receptor antagonists improve serum sodium concentration by increasing renal solute-free water excretion, but their effects on the management of ascites have not been assessed. Our aim was to investigate the effects of satavaptan, a highly selective vasopressin V 2 receptor antagonist, on ascites management and serum sodium in hyponatremic patients with cirrhosis. A total of 110 patients with cirrhosis, ascites, and hyponatremia (serum sodium <130 mmol/L) were included in a multicenter, double-blind, randomized, controlled study comparing three fixed doses of satavaptan (5 T he development of ascites in cirrhosis is the result of an abnormal regulation of the extracellular fluid volume that causes a positive fluid balance due to a persistently increased renal sodium and water reabsorption. Several lines of evidence indicate that this renal dysfunction is related to impairment in circulatory function characterized by splanchnic arterial vasodilation, secondary to sinusoidal portal hypertension. This causes a reduction in the effective arterial blood volume and a subsequent homeostatic activation of vasoconstrictor and sodium-retaining and water-retaining systems, including the renin-angiotensin-aldosterone system, the sympathetic nervous system, and vasopressin, which are responsible for sodium and water retention. 1,2 According to this pathogenesis, the pharmacological approach to treatment of ascites has been based on the administration of spironolactone, a drug that antagonizes the effect of aldosterone, which reduces the increased extracellular fluid volume by increasing renal sodium and water excretion. 3 However, a significant proportion of patients with ascites either do not respond to spironolactone or require the administration of high doses of the drug, which increases the risk of From the

Background: Tigecycline, an expanded broad-spectrum glycylcycline, exhibits in vitro activity against many common pathogens associated with community-acquired pneumonia (CAP), as well as penetration into lung tissues that suggests effectiveness in hospitalized CAP patients. The aim of the present study was to compare the efficacy and safety of intravenous (IV) tigecycline with IV levofloxacin in hospitalized adults with CAP.

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