Molecular, biochemical, and sensorial characterization of cocoa (Theobroma cacao L.) beans: A methodological pathway for the identification of new regional materials with outstanding profiles.

Cocoa is an economically important product in Colombia. On-farm germplasm evaluations enable the selection of superior genotypes for propagation and distribution across the country. This study examined 12 cocoa samples from Antioquia along with five reference materials, employing 96 single nucleotide polymorphism (SNP) markers. Furthermore, these genetic findings were correlated with physical, chemical, and sensory attributes. Primary coordinate analysis revealed that the majority of samples were hybrids derived from five original germplasm pools, including Criollo, Amelonado, and three Upper Amazon Forastero cocoas. The integral profile of the 12 selected materials was classified into Modern Criollo (Rodriguez-Medina et al., 2019) [3], Forasteros (Rodriguez-Medina et al., 2019) [3], and Trinitarios (Borja Fajardo et al., 2022) [6]. Three key factors were identified to best account for the sample classification: type of variety, functional properties, and quality.

RID: Evaluation of the Possible Inhibiting Effect of the Proinflammatory Signaling Induced by TNF-α through NF-κß and AP-1 in Two Cell Lines of Breast Cancer.

Receptor internalization and degradation (RID), is a transmembrane protein coded within the E3 region expression cassette of adenoviruses. RID downregulates the cell surface expression of epidermal growth factor receptor (EGFR), tumor necrosis factor receptor (TNFR), and apoptosis antigen 1 (FAS), causing a reduction of the effects of their respective ligands. In addition, RID inhibits apoptosis by decreasing the secretion of TNF-related apoptosis-inducing ligand (TRAIL) by normal tissue cells. In this article, we report that RID inhibited chemokine expression in human breast cancer cell line MDA-MB-231 but showed no effect in cell line MCF7. These dissimilar results may be due to the different molecular and functional properties of both cell lines. Therefore, it is necessary to replicate this study in other breast cancer cell models.

Correction to: Long-term safety and clinical performance of kyphoplasty and SpineJack® procedures in the treatment of osteoporotic vertebral compression fractures: a pilot, monocentric, investigator-initiated study.

The author list was incomplete. The complete list of authors is the following: D. Noriega, F. Rodrίguez-Monsalve, R. Ramajo, I.Sánchez-Lite, B. Toribio, F. Ardura. The corresponding author regrets sincerely this error. The original article got update.

Long-term safety and clinical performance of kyphoplasty and SpineJack® procedures in the treatment of osteoporotic vertebral compression fractures: a pilot, monocentric, investigator-initiated study.

This pilot monocenter study in 30 patients with painful osteoporotic vertebral compression fractures compared two vertebral augmentation procedures. Over a 3-year post-surgery follow-up, pain/disability/quality of life remained significantly improved with both balloon kyphoplasty and SpineJack® techniques, but the latter allowed better vertebral body height restoration/kyphosis correction. INTRODUCTION: Patient follow-up rarely exceed 2 years in trials comparing vertebral augmentation procedures for the treatment of painful osteoporotic vertebral compression fractures (VCFs). This pilot, investigator-initiated, prospective study aimed to compare long-term results of SpineJack® (SJ) and balloon kyphoplasty (BKP). Preliminary results showed that SJ resulted in a better restoration of vertebral heights and angles, maintained over 12 months. METHODS: Thirty patients were randomized to SJ (n = 15) or BKP (n = 15). Clinical endpoints were analgesic consumption, back pain intensity (visual analog scale (VAS)), the Oswestry Disability Index (ODI), and quality of life (EQ-VAS score). They were recorded preoperatively, at 5 days (except EQ-VAS), 1, 3, 6, 12, and 36 months post-surgery. Spine X-rays were taken 48 h prior to the procedure and 5 days, 6, 12, and 36 months after. RESULTS: Clinical improvements were observed with both procedures over the 3-year period without significant inter-group differences, but the final mean EQ-5Dindex score was significantly in favor of the SJ group (0.93 ± 0.11 vs 0.81 ± 0.09; p = 0.007). Vertebral height restoration/kyphotic correction was still evident at 36 months with a greater mean correction of anterior (10 ± 13% vs 2 ± 8% for BKP, p = 0.007) and central height (10 ± 11% vs 3 ± 7% for BKP, p = 0.034) and a larger correction of the vertebral body angle (- 5.0° ± 5.1° vs 0.4° ± 3.4°; p = 0.003) for SJ group. CONCLUSIONS: In this study, both techniques displayed very good long-term clinical efficiency and safety in patients with osteoporotic VCFs. Over the 3-year follow-up, vertebral body height restoration/kyphosis correction was better with the SpineJack® procedure.

Actualización en caracterización molecular de levaduras de interés industrial / Update on molecular characterization for yeast of industrial interest

Las levaduras, además de ser un modelo de la investigación biomédica, tienen diversas aplicaciones en la industria alimentaria, en agricultura y la producción de etanol combustible. Dado que la calidad y la cantidad del producto dependen de la dinámica y la frecuencia de los microorganismos presentes en la fermentación, el uso de herramientas de caracterización molecular se ha incrementado y popularizado en las industrias que emplean levaduras. Estas técnicas se basan en la amplificación o análisis por enzimas de restricción de una porción del ADN genómico de levadura y se clasifican de acuerdo a su capacidad de resolución taxonómica para discriminar a nivel inter o intra-específica. La primera parte de la revisión incluye pruebas interespecíficas tales como, análisis de restricción o RFLP para las regiones ITS2, ITS1-5.8, D1 / D2 de los genes 26S ribosomal DNA. La segunda parte incluye, pruebas de uso común para caracterización nivel de cepa, tales como: la amplificación aleatoria del ADN polimórfico (RAPD), análisis cromosómico por electroforesis en gel de campo pulsado (PFGE), análisis de restricción del ADN mitocondrial (ADNmt- RFLP) análisis por mini / micro satélites y la huella genética de ADN por amplificación de regiones interdelta de los transposones Ty. Esta revisión describe y discute los detalles técnicos de los métodos más utilizados para la caracterización molecular de las levaduras y algunos ejemplos de sus aplicaciones en el contexto industrial.

Yeasts, besides being a model of biomedical research, have various applications in the food industry, in agriculture and the production of ethanol fuel. Since the quality and quantity of the product depend on the dynamics and frequency of microorganisms present in the fermentation, the use of molecular characterization tools has been increased and popularized in the industries that use yeast. These techniques are based on amplification or analysis by restriction enzyme of a portion of yeast genomic DNA and are classified according their ability of taxonomic resolution to discriminate at inter- or intra-specific level. The first part of this review includes interspecific tests such as, restriction analysis or RFLP for the ITS2 regions, ITS1-5.8, D1 / D2 of ribosomal DNA 26S genes. The second part includes, tests commonly used for characterization at strain level, such as random amplified DNA polymorphism (RAPD), Chromosome analysis by pulsed gel field electrophoresis (PFGE), restriction analysis of mitochondrial DNA (ADNmt- RFLP), analysis of the mini / micro satellites and DNA fingerprinting by amplifying interdelta regions of Ty transposons. This review describes and discuses technical details of the most commonly used methods for molecular characterization of yeast and some examples of their applications in the industrial context.

Síndrome diarreico por rotavirus en niños menores de 5 años inmunizados y no de la ciudad de Maracaibo, estado Zulia, Venezuela / Diarrheic syndrome due to rotavirus in immunized and non-immunized children under 5, in the city of Maracaibo, state of Zulia, Venezuela

La diarrea aguda es la causa más común de morbi-mortalidad infantil, donde el Rotavirus es uno de los principales agentes involucrados en las diarreas severas en niños menores de 5 años. El presente estudio tiene como objetivo determinar la presencia de rotavirus en una población infantil con cuadros diarreicos, vacunados y no vacunados que acuden a observación pediátrica del Hospital de Niños y Hospital Universitario de Maracaibo, estado Zulia en el período de Abril 2011 hasta Abril 2012, para ello se recolectaron 100 muestras de heces y para el diagnóstico se utilizó la técnica de Aglutinación Directa en partículas de Látex. Resultaron positivos un 43,6% (24/55) de niños no vacunados y 33,3% (10/30) de niños vacunados afectando principalmente a los menores de 1 año con predominio del sexo masculino con un 65,9% sobre el sexo femenino con 40%, la diarrea por el agente viral estudiado representó casi la mitad de las hospitalizaciones por gastroenteritis, encontrándose una diferencia estadística significativa de p= 0.027 en el numero de evacuaciones del cuarto día, entre niños no vacunados (5) y vacunados (3). Los resultados de esta investigación muestran la circulación de rotavirus en niños vacunados y no vacunados, es por ello importante considerar que el presente reporte tiene como fin último alertar a la comunidad médica a considerar en todo niño con gastroenteritis la posibilidad de que se trate de un cuadro por RV.

Acute diarrhea is the most common cause of morbidity and mortality in infants, where rotavirus is one of the main agents involved in severe diarrhea for children under five years. The present study aims to determine the presence of rotavirus in a vaccinated and unvaccinated pediatric population with acute diarrhea that came to the Children’s Hospital and the University Hospital of Maracaibo, State of Zulia, for observation from April 2011 to April 2012. One-hundred stool samples were collected and direct agglutination of latex particles was used for diagnosis. 43.6% of the unvaccinated children were positive (24/55) as were 33.3% (10/30) of the vaccinated children. Principally, children under 1 year were affected, predominantly males with 65.9% and females with 40%. Diarrhea due to the viral agent under study accounted for nearly half the hospitalizations for gastroenteritis. A statistically significant difference of p = 0.027 was found between the number of evacuations on the fourth day in unvaccinated (5) and vaccinated (3) children. Results of this research show rotavirus circulating in vaccinated and unvaccinated children. Therefore, the purpose of this report is to alert the medical community to consider that every child with gastroenteritis could possibly have RV.

Subgenotype diversity of hepatitis B virus American genotype F in Amerindians from Venezuela and the general population of Colombia.

The objective of this study was the evaluation of the genetic diversity found in HBV circulating among Venezuelan Amerindians and the general population in Colombia. Phylogenetic analysis of the S region in 194 isolates showed that genotype F is highly predominant in Colombia and Venezuela. This might be related to the genetic background of the population. F3 is the main subgenotype which circulates in both countries. Phylogenetic analysis of 61 complete genome sequences of HBV American genotypes confirms the presence of two genotypes F and H, and 4 F subgenotypes. In Venezuela, subgenotypes F1, F2, and F3 circulate in East and West Amerindians, while only F3 was found among South Amerindians. Japreira community derived from Yucpa Amerindians around 150 years ago. However, several Japreira HBV sequences were forming a clade that can be classified as subgenotype 2b, differing from Yucpa sequences that belong mainly to subgenotype F3. The apparent absence of correlation between the phylogenetic groupings of HBV isolates with the ethnical origin in aboriginal populations might be suggesting a recent origin of HBV American subgenotypes, or a genetic drift effect.

Groove pancreatitis: MRI and pathologic findings.

OBJECTIVE: Our purpose is to describe the MRI findings with pathologic correlation, in five patients with groove pancreatitis, a specific form of chronic pancreatitis affecting the groove between the pancreatic head, the common bile duct and duodenum. MATERIALS AND METHODS: Five patients with pathologically proven (four cases) and clinical and MRI findings (follow-up) consistent with the diagnosis of groove pancreatitis (one case) were reviewed. Three patients underwent cephalic pancreatoduodenectomy (Whipple procedure) due to severe duodenal stenosis; MRI findings were correlated with the histological findings. RESULTS: In all patients a mass was seen affecting the groove between the pancreatic head and the duodenum. Precontrast images demonstrated hypointense tissue relative to pancreatic parenchyma on T1-weighted images and iso to slightly hyperintense tissue on STIR and T2-weighted images. Postcontrast dynamic Gd-DTPA images, showed peripheral mass enhancement on immediate postgadolinium images and progressive and centripetal mass enhancement on delayed images with good delineation of multiple cysts. Histologically, fibro-inflammatory tissue was demonstrated in the groove and the duodenal wall with obliterative concentric scarring of the distal common bile duct. CONCLUSIONS: MRI findings are demonstrative of the pathologic features characteristic of this entity: the fibrous tissue in the pancreaticoduodenal groove, the duodenal wall inflammation and the groove and/or duodenal wall cyst formation.

Cyclospora cayetanensis infections among diarrheal patients from Venezuela.

The prevalence and importance of Cyclospora cayetanensis as an enteropathogen among 71 patients (22-45 years old) with acquired immunodeficiency syndrome (AIDS) and 132 children with diarrhea (0-12 years old) from Venezuela was assessed retrospectively. Two to three stool samples from each patient attending our parasitology laboratory for parasitologic and medical assistance were examined. For identification of the coccidium, modified Ziehl-Neelsen carbolfuchsin staining of formalin-ether stool concentrates was used, and for other intestinal parasites, iron-hematoxylin-stained smears and formalin-ether concentrates were examined. Cyclospora oocysts were found in seven (9.8%) of 71 AIDS patients and seven (5.3%) of 132 children with diarrhea. Other pathogenic parasites were present in most of the patients (9 of 14, 64.3%) shedding oocysts. Cyclosporiasis predominated in children 2-5 years of age with respect to those < or = one year of age (P < 0.05). The findings suggest that C. cayetanensis is common in diarrheal patients from Venezuela. However, the role of the parasite as the causal agent of diarrhea in these patients is uncertain.

Seroepidemiology of toxoplasmosis in amerindians from western Venezuela.

A survey of 447 Amerindians aged 1-69 years (mean age, 18.6 +/- 15.8 years) in 3 mountain and 1 lowland communities from Venezuela were studied to determine the seroprevalence of Toxoplasma gondii, the environmental risk factors for the infection, and how the process of acculturation may affect the transmission rate. Serum samples were tested for immunoglobulin G antibodies by a commercial indirect hemagglutination test. The overall prevalence of infection was 49.7% (222 of 447) and ranged 38.2-62.4%. A higher antibody rate was found in the lowland setting as compared with those from the mountain area (P < 0.001). The geometric mean titer in the overall population was 280.3. No age-antibody association was detected in the mountain communities, although a gradual increase in positivity with increasing age (P < 0.01) was observed in the lowland setting, reaching a peak of 83.3% in the oldest group. The results suggest that transmission by infective cat feces may play a predominant role in the spread of infection in this population. This study demonstrates the environmental Toxoplasma infection pressure in this sylvatic population and how transmission rate is facilitated by environmental changes produced by acculturation.

[Seroepidemiology of Herpes simplex virus type 2 in the Amerindian Yukpa population of Zulia state, Venezuela]. / Seroepidemiología del virus Herpes simplex 2 en una población indígena Yukpa. Estado Zulia. Venezuela.

BACKGROUND: Yukpa aborigines start early in life their sexual activity and promiscuity with native and foreign individuals is common among women. This behavior allows the installation and propagation of Herpes simplex virus type 2 (HSV-2). AIM: To determine the presence of antibodies to HSV-2 in a Yukpa Amerindian community at Zulia State, Venezuela. SUBJECTS AND METHODS: We studied 96 natives, between 13 and 49 years old (62.3% of the whole population, 100% of individuals in fertile age). Control population consisted of 76 individuals, with similar sex and age range distribution, of the urban population from Maracaibo, Zulia State, Venezuela. HSV-2 serologic status was determined by an indirect fluorescent antibody test. RESULTS: Antibodies to HSV-2 were detected in 53.1% of Yukpa population and 21.1% of urban population. Aboriginal women aged 21 to 40 years old had a prevalence of antibodies against HSV-2 of 66.7%. Among pregnant native women, the prevalence of antibodies against HSV-2 was 54.6%. CONCLUSIONS: There is a high prevalence of antibodies against HSV-2 among Yukpa natives in Venezuela.

[Serum levels of soluble CD30 molecule in hepatitis B virus infection]. / Niveles séricos de la molécula CD30 soluble en la infección por el virus de hepatitis B.

BACKGROUND: The release of CD30 molecule in the soluble form (sCD30) is considered a feature of Th2 activation and proliferation of the cellular phenotype Th2. AIM: To analyze the immunoregulatory role of sCD30 in the evolution of hepatitis B virus (HBV) infection. PATIENTS AND METHODS: Three study groups were formed: 15 patients with acute infection by HBV who remitted toward the resolution of the infection; 15 patients who evolved to the carrier state and 15 subjects without clinical history of infection by this or other viruses. The determination of serological markers for the HBV was done by the Microparticles Enzymatic Immunoanalysis techniques (MEIA). The method of double antibody by ELISA was used For sCD30 determination. RESULTS: A significant sCD30 increase (p < 0.05) was observed in patients with acute infection, during the acute phase (135.7 +/- 36.7). These values decreased to 16.2 +/- 2.5 during the convalescent phase. Patients that evolved to the carrier state, did not experience a rise in sCD30 values (40.2 +/- 6.7, 38 +/- 9.2 and 36.1 +/- 8.3 during the acute phase, at 120 and 240 days respectively). The value in the control group was 34.8 +/- 6.7. CONCLUSIONS: The group that evolved towards remission experienced a higher activation of the Th2 cellular phenotype, promoting humoral immune response. An inactivity of sCD30 values was observed in the group that evolved to the carrier state.

[Effect of climatic factors on the epidemiology of rotavirus infection in children under 5 years of age in the city of Maracaibo, Venezuela]. / Influencia de los factores climatológicos en la epidemiología de la infección por rotavirus en los niños menores de 5 años de la ciudad de Maracaibo, Venezuela.

Diarrhea is one of the most common problem of public health worldwide, specially in developing countries. In Venezuela, this affection must be weekly reported when it occurs in children under five years of age. During June 1993 to May 1995, 379 stool specimens were obtained from children under five years of age with diarrhea admitted in Hospital de Niños of Maracaibo, Venezuela. Control group was conformed by 93 asymptomatic children. The rotavirus RNA was extracted with phenol-chloroform and precipitated with ethanol. Finally, polyacrylamide-gel-electrophoresis (PAGE), followed by silver staining was employed for rotavirus detection. Our results showed 62 (16.4%) positive cases for rotavirus in symptomatic children and 9 (9.7%) in control group. The highest incidence was showed in the infants under one year of age (21.5%). The electrophoretic analysis revealed only one long electropherotype pattern in studied samples. It was observed a close relationship between the increase of rotavirus cases and the increase of the pluviometric index and a decrease of mean temperature observed during the period of study. Both variables determine the increase or decrease of viral infection in our region. This result shows the importance of the climatic factors in the rotavirus epidemiology.

High incidence of hepatitis C virus infection in hemodialysis patients in units with high prevalence.

The prevalence of hepatitis C virus (HCV) infection was evaluated in 227 hemodialysis patients from four units in Caracas, Venezuela, by using different second- and third-generation enzyme immunoassays (EIAs) and immunoblot assays. HCV antibodies were detected in 162 patients (71%) by the recombinant-based second-generation assays (Abbott and Ortho) and in 161 patients by the synthetic peptide-based EIA (UBI). Of the 162 HCV antibody-positive serum samples, 161 were confirmed to be positive by RIBA 3. HCV RNA was detected in 49 of 68 (72%) of the seropositive patients and in 5 of 21 (24%) of the seronegative ones. HCV RNA was not always correlated with an increase in alanine aminotransferase (ALT) levels. Among 20 patients positive for HCV RNA and for HCV antibodies (without any hepatitis B virus [HBV] marker), only 10 had elevated ALT levels. The possible interference of HBV for HCV replication was evaluated. No significant difference was found between the presence of HCV RNA and the presence of any HBV serological markers. The possible routes of transmission of HCV in hemodialysis patients are multiple, and some of them are still controversial. Of the HCV-positive patients, 30% received a blood transfusion, significantly more than the 15% found for the HCV-negative group. However, blood transfusions alone could not account for the high incidence observed in this group of patients (38% from 1994 to 1995). In conclusion, about one-quarter of the apparently non-HCV-infected patients were probably seroconverting, ALT may not be a useful indicator of HCV infection in hemodialysis patients, and nosocomial transmission of HCV may play a role in the spread of HCV in this group.

Characterization of the antibody reactivity to synthetic peptides from different parts of the hepatitis C virus genome.

Infection by hepatitis C virus (HCV)*, the aetiologic agent responsible for the majority of non-A-non-B posttransfusion hepatitis, is detected by assaying for antibodies against structural and nonstructural recombinant proteins or synthetic peptides. The aim of this study was to characterize the antibody reactivity of selected sera against antigenic peptides spanning immunodominant regions of the core, NS4 and NS5 HCV proteins. Reactivity to synthetic peptides was determined by enzyme immunoassay (EIA) for 11 selected sera from blood donors (good responders), for 27 selected sera from hemodialysis patients (poor responders), all positive for HCV antibodies (tested by different second and third-generation assays), and for 7 negative sera. Some peptides from the core and the NS4 region were widely recognized by the tested sera. Sera not reactive with core, NS4, or NS5 region by some immunoblot assays exhibited reactivity against peptides from these proteins. Autoimmune reactivity associated with HCV infection was evaluated by using a synthetic peptide derived from the GOR peptide; 8/11 HCV-positive sera were found reactive against this peptide. No correlation was found between reactivity to any of the peptides tested and the presence of HCV RNA in the serum or with HCV genotype. The EIA reactivity of peptides from the core region suggested a multideterminant antigenic structure, where reactivity of each epitope may be differentially affected by neighboring amino acids depending on individual sera. This situation was particularly evidenced in selected sera from poor responder specimens where a more restricted antibody response to core peptides was observed. Reactivity of sera from HCV-infected patients with synthetic peptides from the core, NS4, and NS5 regions indicated the presence of multiple linear epitopes (particularly in the core region) that may be used in a mixture for immunodiagnosis; however, the length and exact position of the synthetic peptides must be chosen carefully.

[High prevalence of hepatitis B and C markers in an indigent community in Caracas, Venezuela]. / Alta prevalencia de marcadores de hepatitis B y C en una comunidad de indigentes de Caracas, Venezuela.

Hepatitis B and C serological markers were evaluated in indigent patients living in a workhouse in Caracas, Venezuela. Three out of 146 specimens were reactive for HBsAg (2.1%) and 41 for anti-HBc (28%). Eight sera were reactive for antibodies against HCV, and 7 were confirmed by immunoblot assays (4.8%). Four out of these 7 HCV-positive sera were also HCV-RNA positive. The prevalence for viral hepatitis markers was significantly higher than that found in blood donor population in Caracas. The probable risk factors associated with this high prevalence of blood-borne viral hepatitis were: promiscuity, transfusion, drug addiction, alcoholism and history of reclusion. This high prevalence of hepatitis B and C compels the precaution for medical and paramedical staff attending this kind of patients.

Epidemiology of hepatitis C virus in western Venezuela: lack of specific antibody in Indian communities.

Hepatitis C virus (HCV) is transmitted mainly by the parenteral route after percutaneous exposure to virus-infected products or body fluids. Thus, HCV shares with hepatitis B and D (HBV, HDV) viruses this common transmission route. The prevalence of antibody against HCV (anti-HCV) was studied in 1155 serum samples from individuals at risk of infection by bloodborne or sexually transmitted agents, as well as from others lacking such risk factors, from the city of Maracaibo, Venezuela. Anti-HCV and serological markers of infection by HBV and HDV were also studied in further 550 samples taken from Bari Indians living in different communities in the Perijá mountains, State of Zulia, Venezuela. The results obtained showed that recipients of blood or blood products are at increased risk of HCV infection in Maracaibo, whereas sexual transmission plays only a minor role if any. Both HBV and HDV infections were highly prevalent among Bari Indians (64.4% positive for anti-HBc; 11.1% of HBsAg carriers; 15.3% positive for anti-HDV among HBsAg carriers). No anti-HCV positive samples were, however, detected among them, thus suggesting either that HCV has not still reached this population or that HBV and HDV are transmitted by routes unshared by HCV. Anti-HCV was also absent among samples from mentally retarded patients from Maracaibo, thus confirming similar findings from other countries and supporting the existence of specific transmission mechanisms for HBV and HDV which are not working for HCV.

The neurologic effects of thiopental therapy after cardiac arrest.

We studied the effect of thiopental loading during resuscitation of 53 patients following cardiopulmonary arrest and compared the outcome with that found in 54 patients treated conventionally in the 30 previous months. Thiopental therapy (10 mg/kg i.v.) was begun within 30 min of the arrest once hemodynamic stability had been established. Thiopental infusion (20 mg/kg over 6 h) was followed by phenobarbital sodium (125 mg every 12 h), tolerance to the initial dose having been assessed. The in-hospital mortality rate for both groups was similar. In patients with ischemic heart disease, the mortality rate within the first 6 h was significantly higher in the thiopental group (p less than 0.05), although for the remaining patients there were more survivors among the thiopental treated patients (p less than 0.05). Excluding the patients who died within the first 6 h, 61% of the patients in the thiopental group survived cardiac arrest with normal cerebral performance, whereas only 37% in the standard treatment group showed normal functional outcome (p less than 0.03). These results suggest a favorable neurologic effect of thiopental loading during resuscitation of patients without ischemic heart disease. In patients with ischemic heart disease, an initial hemodynamic deterioration may contribute to minimising the beneficial effect of barbiturate therapy.

Myocardial depression in septic shock caused by meningococcal infection.

Comparative hemodynamic measurements recorded in 19 cases of septic shock associated with Neisseria meningitidis bacteremia and in 20 shock cases associated with bacteremia due to other Gram-negative bacilli showed a significantly higher incidence of early myocardial depression in the cases with meningococcal infection. Echocardiographic, ECG, and serum enzyme (CK-MB isoenzyme) studies closely correlated with impaired myocardial contractility and development of cardiogenic shock in patients with meningococcal bacteremia. Autopsy of the heart from three patients who succumbed to shock confirmed the presence of myocarditis with intracellular Gram-negative diplococci. Our observations suggest that the onset of cardiac dysfunction precedes clinical manifestations of shock.