Dextran sulfate is poorly absorbed after oral administration

Article Abstract:

The human immunodeficiency virus (HIV) selectively infects and destroys cells involved in the immune response. When dextran sulfate, a drug that inhibits coagulation, is placed in laboratory cell cultures, it prevents cells from being infected with HIV. In addition, it enhances the action of zidovudine, currently the only approved treatment for HIV infections. Although the drug has not yet been approved by the Federal Drug Administration, patients are allowed to purchase the drug from Japan and are taking the tablets orally. To see if dextran sulfate is absorbed effectively after oral administration, the bioavailability of the drug was compared in six healthy volunteers receiving a single 1,800 milligram oral dose of dextran and a single intravenous (IV) dose, 225 mg or 300 mg. Since dextran sulfate is an anticoagulant, the activated partial thromboplastin time (APTT; an index of blood clotting time), which is prolonged after IV administration, was measured to determine the absorption. Tests measured the binding ability of dextran and its effects on lipid activity, which is known to be altered after IV dextran administration. The three different tests indicated that less that one percent of dextran sulfate was absorbed after oral administration. Only 0.5 percent was recovered in the urine, the APTT was unchanged and the lipolytic activity was two times higher (maximum is 11). After IV administration, on the other hand, 25 to 29 percent was recovered in the urine, APTT increased 3.5 to 9.2 times and the lipolytic activity was 185 to 248 times higher than the baseline values. Therefore dextran sulfate is poorly absorbed after oral administration. (Consumer Summary produced by Reliance Medical Information, Inc.)

Drug therapy, AIDS (Disease)

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Plasmodium malariae infection in an asymptomatic 74-year-old Greek woman with splenomegaly

Article Abstract:

A 74-year-old Greek woman illustrates the necessity of screening people for malaria in areas where the disease is thought to have been eliminated. She had had malaria at the age of 3 but had recovered without treatment. At the age of 72, a routine physical exam revealed that she had an enlarged spleen. She was diagnosed with lymphoma and treated with methotrexate. The drug triggered headaches and fever, which stopped when the drug was discontinued. Repeated blood tests were negative for malaria, but the polymerase chain reaction revealed low levels of Plasmodium malariae in her blood. She had probably been infected for 40-70 years with no symptoms of malaria.

Case studies, Diseases, Malaria, Greeks

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Sporadic urban leptospirosis

Article Abstract:

Inner city residents exposed to rat urine may be at risk for infections with Leptospira (L.) interrogans. A genetic laboratory test called the polymerase chain reaction (PCR) test seems to be useful in identifying patients with L. interrogans infections and the sources of that infection. PCR tests were performed on three patients with known L. interrogans infections and on rats found in their neighborhood alleys. PCR tests detected L. interrogans in all three patients and in 19 of 21 rats tested.

Health aspects, Diagnosis, Polymerase chain reaction, Metropolitan areas, Leptospirosis

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