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Objective: To evaluate the efficacy and safety profile of one 30-mg nimodipine oral tablet taken three times per day (one tablet with breakfast, one with lunch, and one with dinner) or one 150-mg cinnarizine verum oral capsule taken once each day with dinner for 12 weeks., Study Design: Comparative in a double-blind, multinational pilot study., Setting: Tertiary referral center., Patients: A total of 221 patients met the study criteria; of that total, 181 adult patients completed the study, including 135 women and 46 men whose ages ranged from 20 to 80 years., Interventions: Two calcium antagonists were used to treat vertigo (nimodipine, 89 patients; cinnarizine, 92 patients), and all patients were maintained on the same dosage regimen until they completed 12 weeks of treatment. Patients were evaluated at 2-and 4-week intervals; an additional evaluation was made at Week 14 to determine vertigo recurrence in the posttreatment period., Main Outcome Measures: The response was evaluated by using the vertigo severity index, a count of vertigo episodes in a given time period. Each episode is weighted according to its intensity., Results: Nimodipine treatment decreased the incidence of moderate vertigo episodes by 78.8% and decreased severe vertigo episodes by 85.0%. Cinnarizine treatment decreased the incidence of moderate vertigo episodes by 65.8% and decreased severe vertigo episodes by 89.8%. Nimodipine and cinnarizine exhibited similar safety profiles. Only two patients withdrew from the study because of adverse events possibly related to the study drug. One patient withdrew from the cinnarizine group because of headache, and one patient withdrew from the nimodipine group because of lipothymia., Conclusion: These data confirm the marked efficacy of both nimodipine and cinnarizine in the treatment of vestibular vertigo.

Background: Respiratory pathogens are becoming increasingly resistant to antimicrobials. A new group of drugs, called respiratory quinolones have been synthesized to overcome this problem., Aim: To study the in vitro susceptibility of respiratory pathogens to old and new antimicrobials., Materials and Methods: Forty five strains of S pneumoniae, 44 strains of H influenzae, 21 strains of M catarrhalis, 10 strains of methicillin susceptible S aureus and 20 strains of methicillin resistant S aureus were studied. All were isolated from community acquired respiratory infections during 1999. Minimal inhibitory concentrations of moxifloxacin, amoxicillin, amoxicillin/clavulanic acid, clarithromycin, azithromycin, ciprofloxacin and levofloxacin were determined using the Etest method. Beta-lactamase production by H influenzae and M catarrhalis was also studied., Results: S pneumoniae strains were 100% susceptible to quinolones and cotrimoxazole, 2% were resistant to macrolides, 11% were resistant to amoxicillin/clavulanic acid and 47% were resistant to cefuroxime. H influenzae was 100% susceptible to quinolones, azithromycin and amoxicillin/clavulanic acid. There was a 53% resistance to cotrimoxazole, 21% to amoxicillin, 9% to clarithromycin and 7% to cefuroxime. M catarrahalis was 100% susceptible to quinolones and 100% resistant to amoxicillin, 5% resistant to macrolides, 14% resistant to amoxicillin/clavulanic acid, 20% to cefuroxime and 30% to cotrimoxazole. Methicillin susceptible S aureus was susceptible to all antimicrobials and methicillin resistant S aureus was resistant to all., Conclusions: Maxifloxacin and the new respiratory quinolones can be useful in the treatment of respiratory infections.

This study was designed to evaluate efficacy and tolerability of two different doses of aprotinin in patients receiving aspirin before undergoing coronary artery bypass grafting. Forty-two patients were randomized to receive either placebo (group I), or aprotinin in doses of 4,000,000 KIU (group II) or 6,000,000 KIU (group III). Drug efficacy was determined by measuring postoperative blood loss and transfusion of blood products. Both doses were effective in reducing blood loss and transfusion requirements. Blood loss through thoracotomy drainage was 450 +/- 224, 182 +/- 144, 142 +/- 98 ml, respectively, for control and treatment groups II and III (p = 0.0001). The numbers of patients with blood transfusions were seven (50%), two (17%) and two (17%) for group I and treatment groups II and III, respectively (p = 0.10). Tolerability was excellent and complications few and reversible. In conclusion, high and medium doses of aprotinin were well tolerated and reduced bleeding and transfusion requirements in patients submitted to coronary bypass surgery under the effects of aspirin.

Background: There is no consensus about the ideal antimicrobial agent and duration of treatment for urinary tract infection in women., Aim: To assess the efficacy of a five days course of ciprofloxacin for the treatment of urinary tract infection in women., Patients and Methods: Women with urinary tract infection were treated with ciprofloxacin (Baycip, Bayer) 250 mg bid during 5 days. Patients were evaluated three to four days after treatment start, two to seven days and one month after treatment end., Results: Of 101 eligible women, 96 aged 18 to 65 years old, coming from three major Chilean cities, participated in the study and 80 completed the follow up period. There was a 95% clinical success, 2.5% partial improvement and 2.5% treatment failure. The causal microorganism was erradicated in 90% of cases, in 1.2% treatment failed and in 8.7% a re-infection occurred. Adverse effects attributable to the drug were observed in 12 patients (headache in 3, gastrointestinal disturbances in 8, somnolence in 1 and irritability in 1)., Conclusions: Ciprofloxacin is an useful antimicrobial for the treatment of lower urinary tract infection in women.

Background: Acarbose, an alpha glucosidase inhibitor is a drug used in the treatment of non insulin dependent diabetes mellitus, that interferes with the intestinal absorption of monosaccharides., Aim: To study the effect of acarbose in non insulin dependent diabetic patients that had an inadequate metabolic control with diet and sulphonylureas., Patients and Methods: Diabetic patients received acarbose, 150 mg/day during four weeks and this dose was increased to 300 mg/day during 3 months. Afterwards, patients were followed for a period of 12 weeks without acarbose. Fasting and post-prandial blood glucose and glycosilated hemoglobin were measured sequentially during the study., Results: Eighty five patients were recruited for the study but 64 complied with the treatment protocol. The age of these patients was 56 +/- 8.8 years old, their diabetes duration was 7.8 +/- 8.8 years and their body mass index was 27.6 +/- 3.6 kg/m2. During acarbose treatment, glycosilated hemoglobin decreased from 8.36 +/- 1.33 to 7.71+ 1.7% (p < 0.001), fasting blood glucose decreased from 173 +/- 48 to 159 +/- 59 mg/dl (p < 0.03) and post-prandial blood glucose decreased from 254 +/- 80 to 241 +/- 80 mg/dl (NS). After discontinuing acarbose glycosilated hemoglobin and blood glucose levels returned to basal levels. Body weight and blood pressure did not change during the treatment period. Fifty nine patients had gastrointestinal symptoms (meteorism, flatulence and abdominal distention) that were mild in 59% and moderate in 39%. Episodes of hypoglycemia were not observed., Conclusions: Acarbose, associated to sulphonylureas is an effective drug to reduce blood glucose and glycosilated hemoglobin levels in patients with non insulin dependent diabetes.

In a previous study we observed that 6% of adult and 18% of children contacts of H. influenzae infected patients became carriers of the bacillus. We studied 1296 adults involved in children care, 398 from day care centers and 898 from hospitals in Santiago. A pharyngeal sample was cultured in chocolate agar plus bacitracin (300 mg/ml) and incubated at 37 degrees C in a 5-10% CO2 atmosphere for 18-24 h. Isolates of H influenzae were biotypified and serogrouped according to international recommendations. We observed that 2.4% of subjects were H influenzae carriers. Thirty carriers were treated with 2 doses of enoxacin, 440 mg. All became free of H influenzae at a 30-day follow-up.