Neisseria meningitidis sepsis as a complication of labor. A case report.

Bacteremia in the obstetric patient is an uncommon event. The occurrence of sepsis is even more rare. We report a case of maternal sepsis complicating labor and delivery in which the blood culture isolate was Neisseria meningitidis.

Use of the subcutaneous heparin pump during pregnancy.

Six patients requiring anticoagulation during pregnancy were managed with a continuous-infusion subcutaneous heparin pump. There were no cases of recurrent thrombosis; however, five of the six patients had major or minor bleeding complications despite therapeutic partial thromboplastin time levels.

Effect of danazol on vocal pitch: a case study.

Acoustic analysis was used to measure fundamental frequency (vocal pitch in cycles per second) in a woman before, during, and after danazol therapy for endometriosis. A moderate lowering of fundamental frequency occurred within the three months of therapy and progressively lowered throughout the 5.5-month course. There was some action toward pretreatment levels, but 12 months after therapy, lowering of fundamental frequency persisted. The acceptability of this side effect and the need for further research are discussed.

Effect of free fatty acid concentration on furosemide binding to human serum albumin.

The effect of varying concentrations of sodium oleate on the binding of furosemide to human serum albumin was investigated using continuous ultrafiltration. The furosemide fraction free was 1.37% in the absence of sodium oleate increasing to 3.52% in the presence of 2 mEq/l of sodium oleate. Furosemide bound to two types of binding sites on the albumin molecule. It was found that the numbers of binding sites of each type were constant with the addition of free fatty acid (FFA); however, the decrease in the affinity constants for each site was directly proportional to the increase in FFA over the range of 0-2 mEq/l added sodium oleate. Sodium palmitate and linoleic acid were tested individually to determine the effect of interaction, the fraction free increasing to 2.59 and 1.96% in the presence of 2 mEq/l of sodium palmitate and linoleic acid, respectively.

Effect of sodium oleate on salicylic acid binding to human serum albumin.

The pharmacological activity of salicylates is related to the non-protein-bound fraction of drug in the plasma. Free fatty acids have been shown to displace bound drug and to increase the serum levels of salicylates. Continuous ultrafiltration was used to measure unbound salicylic acid at 37 degrees. A nonlinear analysis of the ultrafiltration data using whole number values for the number of binding sites indicates that sodium oleate displaces the salicylic acid competitively at both binding sites. Increased concentrations of fatty acids due to disease or the infusion of fatty acid emulsions perhaps may produce toxic levels of salicylic acid.

Solubility and ionization characteristics of phenytoin.

The solubility of phenytoin was determined in pH 7.4 and 5.4 phosphate buffers at five temperatures; in hydroalcoholic solutions, 0--4% methanol; and in pH 4.8--8.4 buffer solutions. From the temperature data, the enthalpy and entropy of solution of this nonideal system were calculated and were similar at both pH values. The data obtained from the buffer solutions were used to calculate the apparent dissociation constant, pKa', of phenytoin as 8.06. A GLC method with on-column methylation was used to quantitate phenytoin with 5-(p-methyl-phenyl)-5-phenylhydantoin as an internal standard. The assay uses chloroform of extraction of the drug from aqueous solutions. The ratio of peak heights was adjusted for weights of aqueous and organic layers, and results were calculated in micrograms per gram of sample and mole fraction of phenytoin. Although hydroalcoholic solutions enhanced drug solubility, there is a potentially significant disadvantage in using alcohol for clinical studies.

Solution thermodynamics of alkyl p-aminobenzoates.

Equilibrium solubilities of the first four homologous alkyl p-aminobenzoate esters were determined in methanol, ethanol, and 1-propanol at 25, 33, and 40 degrees; the esters and the alcohols comprise separate homologous series. The solution process of a solute may be considered to be the summation of two sequential steps, melting and mixing, and the magnitude of solubility depends upon temperature and the extent of interactions between solute and solvent molecules. Quantitative solute concentrations, obtained from spectrophotometric analysis, were converted to mole fractions. Statistical analysis of the logarithmic mole fraction solubilities of the aminobenzoates, which were linear with respect to both reciprocal absolute temperature and the logarithm of absolute temperature, generated enthalpies and entropies of solution, respectively. The heats of fusion and the melting points of these aminobenzoates were determined to calculate their ideal solubilities. Excess free energies and partial molal free energies of each solution were calculated from the activity coefficients of the solutes; the thermodynamic elements for these systems are discussed.