Controlled trial of 3-day quinine-clindamycin treatment versus 7-day quinine treatment for adult travelers with uncomplicated falciparum malaria imported from the tropics.

We conducted a randomized, double-blind, placebo-controlled trial to compare a 3-day quinine-clindamycin regimen (group QC) with a 7-day quinine regimen (group Q) for the treatment of uncomplicated Plasmodium falciparum malaria in travelers returning from the tropics. A total of 55 and 53 patients in groups Q and QC were analyzed, respectively. Adverse effects were similar in both groups, although two patients in group Q had severe adverse reactions, leading to the cessation of treatment. The 28-day cure rate for the evaluated patients (per-protocol analysis) was 100% for group QC, whereas it was 96.3% for group Q (P = 0.5). The 28-day cure rate in the intention-to-treat analysis was 96.2% for group QC, whereas it was 94.6% for group Q (P = 1). There were no significant differences between the two regimens with regard to parasite and fever clearance times. Our study shows that the 3-day quinine-clindamycin regimen is well tolerated and compares favorably with a 7-day quinine treatment. This short-term regimen had previously been evaluated only in areas of endemicity. According to our results, the 3-day quinine-clindamycin regimen may be an alternative for the treatment of imported uncomplicated P. falciparum malaria in travelers returning from the tropics.

1,4-Dimethoxy-9(10H)-acridinone derivatives. Synthesis, DNA binding studies and trypanocidal activity.

New acridinonic derivatives, which are hydroxy- and methoxy-substituted in positions 1, 4, and 1,4 were prepared with a view to obtain antiparasitic drugs. These compounds were tested against Trypanosoma cruzi strains and their capability of interacalation into DNA was determined. Nucleus substitutions, DNA binding, and trypanocidal activities have been correlated.

Studies on pancreatic stones. II. Citrate secretion in the canine pancreatic juice.

In a previous study, we found that pancreatic stones could be dissolved in vitro by a citrate solution. We then decided to look for the possible secretion of citrate into the pancreatic juice, and to find a means of increasing it. Pancreatic juice secretion was collected in Thomas fistula dogs submitted to four protocols: basal conditions, secretin stimulation (0.5 and 2.0 U . kg-1 . h-1), caerulein boluses (25 and 100 ng . kg-1) superimposed on 0.5 U . kg-1 . h-1 secretion and intraduodenal citrate infusion (1.05 mmol . kg-1 . h-1). Under basal conditions mean citrate output per 15 min was 0.11 +/- 0.02 mumol. During secretin and caerulein stimulation, citrate output paralleled that of protein, and a linear regression was calculated: Ycitrate = -0.013 + 0.019 Xprotein (mumol/mg). Intraduodenal citrate infusion induced a sharp increase in citrate output which reached 11.5 mumol/15 min, but only 0.12% of the infused citrate amount was secreted into pancreatic juice during 1 h.

[Thiamine deficiency in chronic alcoholics. Value of pre- and postoperative treatment]. / Carence en thiamine chez les éthyliques chroniques. Intérêt du traitement pré et post opératoire.

Thiamine deficiency in the chronic alcoholic would appear to have a triple origin: inadequate intake, absorption and utilisation. Its consequences are well known: peripheral neuropathy, WERNICKE and KORSAKOFF type encephalopathies and cardiac problems (with asystole at the extreme). The active principle of thiamine, TPP or cocarboxylase, is involved as a coenzyme of pyruvate decarboxylase and of alphaketoglutarate decarboxylase in the ocidative decarboxylation reactions of the Krebs cycle. TPP is involved as a coenzyme of transketolase in the transketolisation reactions of the pentose pathway. The stimation of transketolase demonstrates a deficiency in thiamine. Fourteen patients suffering from surgical ENT malignancies were involved in the present study. Seven patients received vitamin B therapy before and after the operation. The results showed a significant decrease in thiamine deficiency. Seven were used as controls and did not receive vitamin B therapy. Transketolase estimations showed and increase in the deficiency. Thiamine deficiency exists in the chronic alcoholic and may be corrected by the administration of B vitamins.