Archives of Internal Medicine

doi: 10.1001/archinte.1986.00360240005001pmid: N/A

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doi: 10.1001/archinte.1986.00360240023002pmid: N/A

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Soffer, Alfred

doi: 10.1001/archinte.1986.00360240035003pmid: N/A

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. Abstract On July 1, 1976, I assumed the responsibility of editorial stewardship for the Archives. Chief editors of the specialty journals of the American Medical Association serve a maximum of ten years. Therefore, in keeping with the policy established by the American Medical Association, effective Dec 1, 1986, all manuscripts submitted to the Archives should be mailed to the new Editor of the Archives, James E. Dalen, MD. Dr Dalen is a distinguished investigator, teacher, and clinician. Raised in Seattle, he received his bachelor of science degree from Washington State University, Pullman. He obtained a master's degree in psychology from the University of Michigan, Ann Arbor, before attending the University of Washington Medical School, Seattle. He concluded postgraduate studies in internal medicine and cardiology in Boston and began his teaching career at Harvard Medical School and the Peter Bent Brigham Hospital, Boston, in 1967. In 1974, he was named associate professor

Fisher, Marc;Levine, Peter H.;Weiner, Bonnie H.

doi: 10.1001/archinte.1986.00360240036004pmid: N/A

Abstract The negative effects of certain dietary constituents on long-term health are increasingly evident to the medical and lay communities. For example, the adverse effect of excessive intake of saturated fats on atherosclerosis and the effects of high dietary sodium levels on hypertension are reasonably well accepted. Thus, most dietary prescriptions relate to reducing the intake of specific components. It is distinctly unusual to find evidence that additional quantities of a common foodstuff may have a favorable impact on the development of disease, but recently, the potential beneficial effects of increased fish consumption, especially supplementation which provides the oils of cold salt water species, has become apparent. The initial enthusiasm concerning the potential benefits of fish consumption came from epidemiologic studies of Eskimos, which demonstrated reduced cardiac mortality and perhaps reduced underlying atherosclerosis.1 Diminished rates of symptomatic coronary artery disease (CAD) have also been observed in other populations who consume References 1. Editorial: Eskimo diets and diseases. Lancet 1983;2:1139-1141. 2. Kromhout D, Bosschieter EB, de Lezenne Coulander C: The inverse relation between fish consumption and 20-year mortality from coronary heart disease. N Engl J Med 1985;312:1205-1209.Crossref 3. Hirai A, Hamazaki T, Terano T, et al: Eicosapentaenoic acid and platelet function in Japanese. Lancet 1980;2:1132-1133.Crossref 4. Hay CRM, Durber AP, Saynor R: Effect of fish oil on platelet kinetics in patients with ischemic heart disease. Lancet 1981;1:1269-1272. 5. Lee TH, Hoover RL, Williams JD, et al: Effects of dietary enrichment with eicosapentaenoic and docosahexaenoic acids on in vitro neutrophil and monocyte leukotriene generation and neutrophil function. N Engl J Med 1985;312:1217-1224.Crossref 6. Fisher M, Upchurch KS, Levine PH, et al: Effects of dietary fish oil supplementation on polymorphonuclear leukocyte inflammatory potential. Inflammation , in press. 7. Bradlow BA, Chetty N, van der Westhuyzen J, et al: The effects of a mixed diet on platelet function, fatty acids and serum lipids. Thromb Res 1983;29:561-568.Crossref 8. Singer P, Wirth M, Berger I, et al: Influence on serum lipids, lipoproteins and blood pressure of mackerel and herring diet in patients with type IV and V hyperlipoproteinemia. Atherosclerosis 1985;56:111-118.Crossref 9. Phillipson BE, Rothrock DW, Connor WE, et al: Reduction of plasma lipids, lipoproteins and apoproteins by dietary fish oils in patients with hypertriglyceridemia. N Engl J Med 1985;312: 1210-1216.Crossref 10. Weiner BH, Ockene IS, Levine PH, et al: Cod liver oil supplementation inhibits coronary atherosclerosis in swine. J Am Coll Cardiol 1986;7:57. 11. Krenner JM, Michalek AV, Linniger L, et al: Effects of manipulation of dietary fatty acids on clinical manifestations of rheumatoid arthritis. Lancet 1985;1:184-187.Crossref 12. Kelley VI, Gerretti A, Izui S, et al: A fish oil diet rich in eicosapentaenoic acid reduces cyclooxygenase metabolites and suppresses lupus in MRLI-1pr mice. J Immunol 1985;123:1914-1919.

Sheagren, John N.

doi: 10.1001/archinte.1986.00360240037005pmid: N/A

Abstract Newer blood culture techniques, such as lysis-centrifugation and lysis-filtration, increase the sensitivity of methods for detecting microorganisms in the blood by permitting rapid removal of the microbes from microbicidal serum factors and antibiotics. These techniques also maximize cultural conditions for isolate recovery. A lysis-centrifugation (LC) blood culture tube has been developed, and represents a practical blood culture system which improves recovery. However, contamination of cultures with the LC system is significantly greater than with conventional broth systems.1 According to the study reported in the present issue of the Archives by Walker et al,2 the cost at the Mayo Clinic of technician time and materials is equivalent to the cost of a conventional blood culture system with routine subcultures. Walker et al focus on the clinical impact of enhanced detection of Staphylococcus aureus by the LC blood culture system compared with a conventional broth system. The bottom line is that the References 1. Henry NK, McLimans CA, Wright AJ, et al: Microbiological and clinical evaluation of the isolator lysis-centrifugation blood culture tube. J Clin Microbiol 1983;17:864-869. 2. Walker RC, Henry NK, Washington JA II, et al: Lysis-centrifugation blood culture technique. Arch Intern Med 1986;146: 2341-2343.Crossref 3. Sheagren JN: Staphylococcus aureus: The persistent pathogen. N Engl J Med 1984;310:1368-1373, 1437-1442.Crossref 4. Jarvis WR, White JW, Munn VP, et al: Nosocomial infection surveillance, 1983. MMWR 1985;33:9SS-21SS. 5. Henry NK, Grewell DM, Van Grevenhof PE, et al: Comparison of lysis-centrifugation with a biphasic blood culture medium for the recovery of aerobic and facultatively anaerobic bacteria. J Clin Microbiol 1984;20:413-416. 6. Sheagren JN: Controversies in the management of sepsis and septic shock: Empiric antimicrobial therapy , in Sibbald WJ, Sprung DL (eds): New Horizons Conference on Sepsis and Septic Shock . Fullerton, Calif, Society of Critical Care Medicine, 1986, pp 257-274.

Bell, William R.;Anderson, Kenneth C.;Noe, Dennis A.;Silver, Bruce A.

doi: 10.1001/archinte.1986.00360240039006pmid: N/A

Abstract • The interaction between the histamine H-2 receptor antagonist, cimetidine, and warfarin sodium was prospectively studied in 14 patients who were previously anticoagulated for five years. The patients received warfarin and cimetidine concomitantly for a minimum of ten days. Seven of the patients experienced increases in plasma warfarin concentrations. This correspondingly resulted in abnormal prolongation of their prothrombin times. In these patients the elevation in the steady-state warfarin concentration demonstrates that coadministration of cimetidine significantly reduces the plasma clearance rate of warfarin. The serum and urine metabolite levels of warfarin were not qualitatively different in the absence in contrast to the presence of cimetidine. It is apparent that cimetidine can act as an inhibitory influence on the catabolic degradation of warfarin. (Arch Intern Med 1986;146:2325-2328) References 1. Finkelstein W, Isselbacher KJ: Cimetidine. N Engl J Med 1978;299: 992-996.Crossref 2. Chang HK, Morrison SL: Bone marrow suppression associated with cimetidine. Ann Intern Med 1979;91:580-581.Crossref 3. Posnett DN, Stein RS, Graber SE, et al: Cimetidine-induced neutropenia. Arch Intern Med 1979;139:584-586.Crossref 4. Gillford LM, Aeugle ME, Myerson RM, et al: Cimetidine postmarket outpatient surveillance program. JAMA 1980;243:1532-1535.Crossref 5. Weddington WW, Muelling AE, Moosa HH, et al: Cimetidine masquerading as delirium tremens. JAMA 1981;245:1058-1059.Crossref 6. Volkin RL, Shadduck RK, Winkelstein A, et al: Potentiation of carmustine-cranial irradiation-induced myelosuppression by cimetidine. Arch Intern Med 1982;142:2435.Crossref 7. Treston JW: Cimetidine: II. Adverse reactions and patterns of use. Ann Intern Med 1982;97:728-734.Crossref 8. Rudnick MR, Bastl CP, Elfenbein IB, et al: Cimetidine-induced acute renal failure. Ann Intern Med 1982;96:180-182.Crossref 9. Watson AJ, Dalbow MH, Stachura I, et al: Immunologic studies in cimetidine-induced nephropathy and polymyositis. N Engl J Med 1983;308: 142-145.Crossref 10. Flind AC: Cimetidine and oral anticoagulants. Lancet 1978;2:1054.Crossref 11. Silver BA, Bell WR: Cimetidine potentiation of the hypoprothrombinemic effect of warfarin. Ann Intern Med 1979;90:348-349.Crossref 12. Breckenridge AM, Challiner M, Mossman S, et al: Cimetidine increases the action of warfarin in man. Br J Clin Pharmacol 1979;8:392-393.Crossref 13. Serlin MJ, Sibeon RG, Mossman S, et al: Cimetidine: Interaction with oral anticoagulants in man. Lancet 1979;1:317-319.Crossref 14. Dacie JV, Lewis SM: Practical Hematology , ed 4. New York, Grune & Stratton, 1968, p 270. 15. Miale JB: Laboratory Medicine: Hematology , ed 2. St Louis, CV Mosby Co, 1972, p 1280. 16. O'Reilly RA, Aggeler PM, Hoag MS, et al: Studies on the coumarin anticoagulant drugs: The assay of warfarin and its biologic application. Thromb Haemost 1962;8:82-95. 17. O'Reilly RA, Aggeler PM, Leong LS: Studies on the coumarin anticoagulant drugs: The pharmacodynamics of warfarin in man. J Clin Invest 1963;42:1542-1551.Crossref 18. Bjornsson TD, Blaschke TF, Meffin PJ: High-pressure liquid chromatographic analysis of drugs in biological fluids: I. Warfarin. J Pharm Sci 1977;66:142-144.Crossref 19. Tasker RAR, Nakatsu K: Rapid reliable and sensitive assay for warfarin using normal phase high-performance liquid chromatography. J Chromatogr 1982;228:346-349.Crossref 20. Randolph WC, Osborne VL, Walkenstein SS, et al: High-pressure liquid chromatographic analysis of cimetidine, a histamine H2-receptor antagonist, in blood and urine. J Pharm Sci 1977;66:1148-1150.Crossref 21. Snedecor GW, Cochran WG: Statistical Methods , ed 6. Iowa City, Iowa State University Press, 1976. 22. Gibaldi M, Perrier D: Pharmacokinetics , ed 2. New York, Marcel Dekker Inc, 1982, pp 321-322. 23. Nagashima R, O'Reilly RA, Levy G: Kinetics of pharmacologic effects in man: The anticoagulant action of warfarin. Clin Pharmacol Ther 1969;10: 1022-1035. 24. Campbell MA, Plachetka JR, Jackson JE, et al: Cimetidine decreases theophylline clearance. Ann Intern Med 1981;95:68-69.Crossref 25. Reitberg DP, Bernhard H, Schentag JJ: Alteration of theophylline clearance and half-life by cimetidine in normal volunteers. Ann Intern Med 1981;95:582-585.Crossref 26. Desmond PV, Patwardhan RV, Schenker S, et al: Cimetidine impairs elimination of chlordiazepoxide (Librium) in man. Ann Intern Med 1980;93: 266-268.Crossref 27. Feely J, Wilkinson GR, Wood AJJ: Reduction of liver blood flow and propranolol metabolism by cimetidine. N Engl J Med 1981;304:692-695.Crossref 28. Reimann IW, Klotz U, Frolich JC: Effects of cimetidine and ranitidine on steady-state propranolol kinetics and dynamics. Clin Pharmacol Ther 1982;32:749-757.Crossref 29. Knapp AB, Maguire W, Keren G, et al: The cimetidine-lidocaine interaction. Ann Intern Med 1983;98:174-177.Crossref 30. Klotz U, Anttila V-J, Reimann I: Cimetidine/diazepam interaction. Lancet 1979;2:699.Crossref 31. Wilkinson CF, Hetnarski K, Hicks LJ: Substituted imidazoles as inhibitors of microsomal oxidation and insecticide synergists. Pesticide Biochem Physiol 1973;4:299-312.Crossref 32. Puurunen J, Pelkonen 0: Cimetidine inhibits microsomal drug metabolism in the rat. Eur J Pharmacol 1979;55:335-336.Crossref 33. Gibaldi M, Koup JR: Pharmacokinetic concepts: Drug binding, apparent volume of distribution, and clearance. Eur J Clin Pharmacol 1981;20:299-305.Crossref 34. Yacobi A, Udall JA, Levy G: Serum protein binding as a determinant of warfarin body clearance and anticoagulant effect. Clin Pharmacol Ther 1975;19:552-558. 35. Mackihan JJ: Pharmacokinetic consequences of drug displacement from blood and tissue proteins. Clin Pharmacokinet 1984;9( (suppl 1) ):32-41.Crossref

doi: 10.1001/archinte.1986.00360240042007pmid: N/A

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. Abstract —In the article entitled "Prevention of Amphotericin B—Induced Rigors by Dantrolene" published in the August 1986 Archives (1986;146: 1587-1588), an error appeared on page 1587, column 1, line 18, column 2, lines 5, 6, 15, and 20, and on page 1588, column 1, line 5. The word was incorrectly rendered as "acetaminophen B"; the correct word should have been "acetaminophen."

Bernstein, Jack M.;Gorse, Geoffrey J.;Linzmayer, M. Ines;Pegram, P. Samuel;Levin, Robert D.;Brummett, Robert E.;Markowitz, Norman;Saravolatz, Louis D.;Lorber, Richard R.

doi: 10.1001/archinte.1986.00360240043008pmid: N/A

Abstract • We prospectively compared the efficacy and safety of netilmicin sulfate or tobramycin sulfate in conjunction with piperacillin sodium in 118 immunocompromised patients with presumed severe infections. The two treatment regimens were equally efficacious. Nephrotoxicity occurred in a similar proportion in patients treated with netilmicin and tobramycin 17% vs 11%). Ototoxicity occurred in four (9.5%) of 42 netilmicin and piperacillin and in 12 (22%) of 54 tobramycin and piperacillin—treated patients. Of those evaluated with posttherapy audiograms, three of four netilmicin and piperacillin—treated patients had auditory thresholds return to baseline compared with one of nine tobramycin and piperacillin—treated patients. The number of ≥15-dB increases in auditory threshold as a proportion of total ≥15-dB changes (increases and decreases) was significantly lower in netilmicin and piperacillin— vs tobramycin and piperacillin—treated patients (18 of 78 vs 67 of 115). We conclude that aminoglycoside-associated ototoxicity was less severe and more often reversible with netilmicin than References 1. Bodey GP: Antibiotics in patients with neutropenia. Arch Intern Med 1984;144:1845-1851.Crossref 2. Klastersky J: Treatment of severe infections in patients with cancer: The role of new acyl-penicillins. Arch Intern Med 1982;142:1984-1987.Crossref 3. Love LJ, Schimpff SC, Hahn DM, et al: Randomized trial of empiric antibiotic therapy with ticarcillin in combination with gentamicin, amikacin or netilmicin in febrile patients with granulocytopenia and cancer. Am J Med 1979;66:603-610.Crossref 4. Hewitt WL: Gentamicin: Toxicity in perspective. Postgrad Med J 1974;50( (suppl 7) ):55-59. 5. Keys TF, Kurtz SB, Jones JD, et al: Renal toxicity during therapy with gentamicin or tobramycin. Mayo Clin Proc 1981;56:556-559. 6. Moore RD, Smith CR, Lietman PS: Risk factors for the development of auditory toxicity in patients receiving aminoglycosides. J Infect Dis 1984; 149:23-30.Crossref 7. Plaut ME, Schentag JJ, Jusko WJ: Aminoglycoside nephrotoxicity: Comparative assessment in critically ill patients. J Med 1979;10:257-266. 8. Schentag JJ, Plaut ME, Cerra FB: Comparative nephrotoxicity of gentamicin and tobramycin: Pharmacokinetic and clinical studies in 201 patients. Antimicrob Agents Chemother 1981;19:859-866.Crossref 9. Smith TR, Smith CR: Risk factors for aminoglycoside nephrotoxicity , in Whelton A, Neu HC (eds): The Aminoglycosides, Microbiology, Clinical Use, and Toxicology . New York, Marcel Dekker Inc, 1982, pp 401-415. 10. Eliopoulos GM, Moellering RC Jr: A critical comparison of the newer aminoglycosidic aminocyclitol antibiotics , in Remington JS, Swartz MN (eds): Current Clinical Topics in Infectious Diseases , ed 4. New York, McGraw-Hill International Book Co, 1983, pp 378-402. 11. Tablan OC, Reyes MP, Rintelmann WF, et al: Renal and auditory toxicity of high dose: Prolonged therapy with gentamicin and tobramycin in Pseudomonas endocarditis. J Infect Dis 1984;149:257-263.Crossref 12. Sarubbi FA, Hull JH: Amikacin serum concentrations: Prediction of levels and dosage guidelines. Ann Intern Med 1978;89(part 1):612-618.Crossref 13. Lerner AM, Cone LA, Jansen W, et al: Randomized, controlled trial of the comparative efficacy, auditory toxicity, and nephrotoxicity of tobramycin and netilmicin. Lancet 1983;1:1123-1126.Crossref 14. Bendush CL: Ototoxicity: Clinical considerations and comparative information , in Whelton A, Neu HC (eds). The Aminoglycosides: Microbiology, Clinical Use, and Toxicology . New York, Marcel Dekker Inc, 1982, pp 453-486. 15. Smith CR, Lipsky JJ, Laskin OL, et al: Double-blind comparison of the nephrotoxicity and auditory toxicity of gentamicin and tobramycin. N Engl J Med 1980;302:1106-1109.Crossref 16. Bender JF, Fortner CL, Schimpff SC, et al: Comparative auditory toxicity of aminoglycoside antibiotics in leukopenic patients. Am J Hosp Pharm 1979;36:1083-1087.

Jacob, Rolf G.;Shapiro, Alvin P.;Reeves, Richard A.;Johnsen, Anna Margareta;McDonald, Robert H.;Coburn, P. Christopher

doi: 10.1001/archinte.1986.00360240049009pmid: N/A

Abstract • We compared the effects of relaxation therapy in hypertensive patients taking placebo, a β-blocker (atenolol, 100 mg/d), or a diuretic (chlorthalidone, 50 mg/d), and we also compared the effects of relaxation therapy with the effects of the latter two drugs alone. Blood pressures were measured not only in the relaxation therapists' office and at a hypertension clinic, but also in the patient's environment by means of 24-hour ambulatory blood pressure recordings. The effect of relaxation therapy, while statistically significant, was modest. There was no generalization of effect to ambulatory blood pressure. Atenolol was significantly more effective than relaxation in reducing both systolic and diastolic pressure. Chlorthalidone was significantly more effective than relaxation in reducing systolic but not diastolic pressure in the hypertension clinic only. The long-term effects of relaxation were independent of concomitant drug use, but within the actual relaxation sessions blood pressure dropped further during chlorthalidone than during References 1. WHO/ISH Mild Hypertension Liaison Committee: Trials of the treatment of mild hypertension. Lancet 1982;1:149-156. 2. Curb JD, Borhani NO, Blaszkowski TP, et al: Long-term surveillance for adverse effects of antihypertensive drugs. JAMA 1985;253:3263-3268.Crossref 3. Patel C, Marmot MG, Carruthers M, et al: Trial of relaxation in reducing coronary risk: Four-year follow-up. Br Med J 1985;290:1103-1106.Crossref 4. Cottier C, Shapiro K, Julius S: Treatment of mild hypertension with progressive muscle relaxation. Arch Intern Med 1984;144:1954-1958.Crossref 5. The Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure: The 1984 report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure. Arch Intern Med 1984;144:1045-1057.Crossref 6. English EH, Baker TB: Relaxation training and cardiovascular response to experimental stressors. Health Psychology 1983;2:239-259.Crossref 7. Lake CR, Ziegler MG, Coleman MD, et al: Hydrochlorothiazide-induced sympathetic hyperactivity in hypertensive patients. Clin Pharmacol Ther 1979;26:428-432. 8. Harshfield GA, Pickering G, Laragh JH: A validation study of the Del Mar Avionics Ambulatory blood pressure system. Ambulatory Electrocardiography 1979;1:7-12. 9. Haber E, Koerner T, Page LB, et al: Application of a radioimmunoassay for angiotensin I to the physiologic measurements of plasma renin activity in normal human subjects. Clin Endocrinol 1969;2:1349-1355.Crossref 10. Bernstein DA, Borkovec TC: Progressive Relaxation Training: A Manual for the Helping Profession. Chicago , Illinois Research Press, 1973. 11. Luthe W: Autogenic Therapy . New York, Grune & Stratton, 1969. 12. Jacob RG, Beidel DC, Shapiro AP: The relaxation word of the day: A simple technique to measure adherence to relaxation. J Behav Assessment 1984;6:159-165.Crossref 13. Ruppert D, Carrol RJ: Trimmed least squares estimation in the linear model. J Am Statistical Assoc 1980;75:828-838.Crossref 14. Gould BA, Mann S, Davies AB, et al: Does placebo lower blood-pressure? Lancet 1981;2:1377-1381.Crossref 15. Luborski L, Crits-Christoph MS, Brady JP: Behavioral versus pharmacological treatments for essential hypertension: A needed comparison. Psychosom Med 1982;44:203-213.Crossref 16. McMahon FG: Management of Essential Hypertension: The New Low-Dose Era , ed 2. London, Futura Publishing Co Inc, 1984, pp 75-155. 17. Messerli FH, DeCarvalho JGR, Christie B, et al: Systematic hemodynamic effects of biofeedback in borderline hypertension. Clin Sci 1979;57: 437-439. 18. Jacob RG, Chesney MA: Stress management of cardiovascular reactivity. Behav Med Update 1984;6:23-27. 19. Taylor CB, Agras WS, Schneider JA, et al: Adherence to instructions to practice relaxation exercises. J Consult Clin Psychol 1983;51:952-953.Crossref 20. Jacob RG, Kraemer HC, Agras WS: Relaxation therapy in the treatment of hypertension. Arch Gen Psychiatry 1977;34:1417-1427.Crossref

Walker, Randall C.;Henry, Nancy K.;Washington, John A.;Thompson, Rodney L.

doi: 10.1001/archinte.1986.00360240055010pmid: N/A

Abstract • To determine the clinical impact of enhanced detection of Staphylococcus aureus by a lysis-centrifugation (LC) blood culture system, consecutive cases of S aureus bacteremia during a seven-month period were reviewed. Of 77 clinically significant cases, the LC system detected 70 cases (91%) while a conventional broth system detected 67 cases (87%). Of 60 cases detected by both systems, the LC system was positive earlier than the broth system by one or more days in 34 cases (57%) and later in none. It also detected more (12 vs four of 13) patients with persistent bacteremia who were receiving antimicrobial treatment. Forty-three patients (56%) did not receive appropriate antimicrobial therapy until cultures were reported positive. Enhanced detection of S aureus bacteremia is a clinically important advantage of the LC blood culture technique. (Arch Intern Med 1986;146:2341-2343) References 1. Henry NK, McLimans CA, Wright AJ, et al: Microbiological and clinical evaluation of the Isolator lysis-centrifugation blood culture tube. J Clin Microbiol 1983;17:864-869. 2. Henry NK, Grewell CM, Van Grevenof PE, et al: Comparison of lysis-centrifugation with a biphasic blood culture medium for recovery of aerobic and facultatively anaerobic bacteria. J Clin Microbiol 1984;20:413-416. 3. Bille J, Stockman L, Roberts GD, et al: Evaluation of a lysis-centrifugation system for recovery of yeasts and filamentous fungi from blood. J Clin Microbiol 1983;18:469-471. 4. Libman H, Arbeit RD: Complications associated with Staphylococcus aureus bacteremia. Arch Intern Med 1984;144:541-545.Crossref 5. Sheagren JM: Staphylococcus aureus: The persistent pathogen. N Engl J Med 1984;310:1368-1373, 1437-1442.Crossref 6. Whimbey E, Wong B, Kiehn TE, et al: Clinical correlations of serial quantitative blood cultures determined by lysis-centrifugation in patients with persistent septicemia. J Clin Microbiol 1984;19:766-771. 7. Washington JA II, Ilstrup DM: Blood cultures: Issues and controversies. Rev Infect Dis , in press. 8. Gill VJ, Park CH, Stock F, et al: Use of lysis-centrifugation (Isolator) and radiometric (BACTEC) blood culture specimens for the detection of mycobacteremia. J Clin Microbiol 1985;22:543-546.