RESUMEN
BACKGROUND: The number of patients with Guillain-Barré syndrome (GBS) who have been observed in Curaçao, the Netherlands Antilles, may be increasing. METHODS: Clinical and serologic data were obtained from records of patients admitted between 1987 and 1999 and fulfilling National Institute of Neurological and Communicative Disorders and Stroke criteria for GBS. When possible, serum and stool samples were collected. The results were compared with a large Dutch epidemiologic study. RESULTS: The authors identified 49 patients, an overall crude incidence rate (IR) in Curaçao of 2.53/100,000 inhabitants (95% CI 1.87 to 3.35) (Dutch study 1.18, rate ratio (RR) of 2.14, p < 0.001). The IR in Curaçao increased from 1.62 in 1987 to 1991 to 3.10 in 1992 to 1999, RR 5.22 (95% CI 2.48 to 10.2, p = 0.02). The IR showed a curvilinear shape within a year. In comparison with the Dutch group, patients from Curaçao had a more severe course of the disease, with a mortality rate of 23% (3.4% in the Dutch group, p < 0.001), a higher percentage of preceding gastroenteritis (p < 0.001), and less sensory involvement (p < 0.001). In 8 of 10 serum samples, evidence was found for a recent infection with Campylobacter jejuni. CONCLUSIONS: The authors found a steady increase in incidence of GBS over the years in association with a more pronounced seasonal preponderance and a more severe course. The clinical characteristics suggest a role for C jejuni.
Asunto(s)
Infecciones por Campylobacter/mortalidad , Campylobacter jejuni , Gastroenteritis/mortalidad , Síndrome de Guillain-Barré/mortalidad , Femenino , Gastroenteritis/microbiología , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Antillas Holandesas/epidemiología , Estaciones del AñoRESUMEN
OBJECTIVE: To confirm an observed increase in the occurrence of Guillain-Barre syndrome (GBS) in patients in Curacao. DESIGN AND METHODS: Between 1987 and 1999, medical records of all patients who fulfilled the National Institute of Neurological Communicative Disorders and Stroke (NINCDS) criteria for GBS were reviewed. RESULTS: Forty-nine patients were diagnosed as GBS resulting in an incidence rate (IR) of 2.53/100,000 inhabitants (95 percent CI 1.87-3.35). From 1987 to 1991, the IR remained stable, whereas from 1992 to 1999, there was a linear increase in the IR. There was a high IR in the colder months and a low IR in the warmer months. Patients showed a low percentage of sensory involvement (17 percent, generally 65 percent), rapid progression of the disease (83 percent, generally 30 percent), high percentage of artificial respiration (31 percent, generally 17 percent) and high mortality rate (23 percent, generally 3-5 percent). Fifty-five percent of the patients reported a preceding gastroenteritis (GE); 9/10 serum samples showed evidence of a recent Campylobacter jejuni infection. CONCLUSIONS: This is the first report of an increase in IR of GBS over a longer period, associated with low percentage of sensory involvement, a more severe course and a high mortality rate. The characteristics suggest a role for C jejuni. Prospective research is needed to show whether the increase in GBS is due to an overall increase in IR of C. jejuni infections on the island.(Au)
Asunto(s)
Humanos , Polirradiculoneuropatía/epidemiología , Polirradiculoneuropatía/diagnóstico , Estudios de Cohortes , Estudios Prospectivos , Infecciones por Campylobacter/sangre , Antillas Holandesas/epidemiologíaRESUMEN
We carried out an epidemiological study on the prevalence and annual incidence of myasthenia gravis on tropical islands Curaçao and Aruba in the period 1980-1995. Twenty-one patients (seven men and 14 women) were identified. The point prevalence increased from 29 per million in 1980 to about 70 per million in 1990-1995; the annual incidence over the total period was 4.7 per million. The female:male ratio was 2:1; purely ocular cases (2/21) comprised 9.5% and thymomas (4/21), 19%. These data are in accordance with most other epidemiological studies in non-tropical areas. No other studies on myasthenia gravis in tropical areas have been reported.
Asunto(s)
Miastenia Gravis/epidemiología , Adolescente , Adulto , Edad de Inicio , Anciano , Niño , Estudios Epidemiológicos , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Factores Sexuales , Clima Tropical , Indias OccidentalesRESUMEN
Human neurocysticercosis is an important parasitic disease in developing countries. Most epidemiological studies on the disease have used antibody-based assays that allow the detection of transmission 'hot spots' and the identification of the main risk factors for transmission. However, such assays have low predictive value in the detection of active cases of neurocysticercosis. The screening potential of the most commonly used antibody-detection technique, the electroimmunotransfer blot assay (EITB), has now been compared with an antigen-capture assay, in an endemic region of Mexico. The subjects were 68 patients with late-onset epilepsy, 35 cases of taeniasis and a randomly selected, control group of 133 individuals from the same region. Parasite-specific antibodies and antigens were more common among the epileptics and taeniasis cases than among the controls. The antigens appeared to be associated with late-onset epilepsy and the antibodies with the presence of subcutaneous nodules. The sensitivities of both tests, to detect epilepsy or taeniasis, were low, but the specificity and the positive predictive value of the antigen-capture assay was high when used with the epileptics. As late-onset epilepsy and neurocysticercosis seem to be associated in endemic regions, antigen-capture assays are probably the most reliable method of detecting active cases of neurocysticercosis in epidemiological studies.
Asunto(s)
Anticuerpos Antihelmínticos/análisis , Antígenos Helmínticos/análisis , Enfermedades Endémicas , Epilepsia/inmunología , Neurocisticercosis/inmunología , Adulto , Animales , Estudios de Casos y Controles , Epilepsia/parasitología , Heces/parasitología , Humanos , México/epidemiología , Neurocisticercosis/complicaciones , Neurocisticercosis/epidemiología , Factores de Riesgo , Taenia/inmunología , Teniasis/complicaciones , Teniasis/epidemiología , Teniasis/inmunologíaRESUMEN
Using antiestrogen labelled with iodine-131 we proved the useful as diagnostic and therapeutic tools to identified hormone dependent cancers in breast with very encorageous results in 7 cases of human cancer. The method was simple and safe and similar methods for scanning of prostate tumors dependent are in current research in our laboratory and will be object of other communications.
Asunto(s)
Neoplasias de la Mama/tratamiento farmacológico , Antagonistas de Estrógenos , Neoplasias Hormono-Dependientes/tratamiento farmacológico , Adulto , Neoplasias de la Mama/química , Neoplasias de la Mama/diagnóstico , Antagonistas de Estrógenos/uso terapéutico , Femenino , Humanos , Radioisótopos de Yodo , Persona de Mediana Edad , Neoplasias Hormono-Dependientes/química , Neoplasias Hormono-Dependientes/diagnósticoRESUMEN
The severe Duchenne type of muscular dystrophy is inherited as an X-linked recessive trait. Approximately two thirds of healthy female heterozygous carriers have a high serum creatine kinase (SCK). A suspected carrier with a normal SCK level therefore, presents an important problem in genetic counselling. Based on Bayesian methods, Emery and Hollyway derived a formula which is applicable when the sporadic case is either the son or brother of a consultant and which also includes information on SCK levels in the consultant and in normal daughters and sisters. The present paper describes the results obtained with use of this formula in 27 families with at least a propositus with Duchenne muscular dystrophy.
Asunto(s)
Creatina Quinasa/sangre , Heterocigoto , Distrofias Musculares/genética , Adolescente , Adulto , Animales , Gatos , Niño , Preescolar , Femenino , Genes Recesivos , Ligamiento Genético , Humanos , Masculino , Distrofias Musculares/enzimología , Linaje , Probabilidad , Cromosoma XRESUMEN
La distrofia muscular progresiva tipo Duchenne es una enfermedad hereditaria ligada al cromosoma X. Aproximadamente dos terceras partes de mujeres heterocigotas (portadoras) del gen, presentan niveles sericos altos de creatinfosfocinasa (CPK). Una portadora probable con un nivel serico normal de CPK, representa un serio problema en asesoramiento genetico. Basados en metodos bayesianos, Emery y Holloway derivaron una formula la cual es aplicable cuando el caso esporadico corresponde a un hermano o hijo de la consultante e incluye informacion sobre los niveles sericos de CPK de la consultante, de las hijas de la consultante y de sus hermanas. En el presente trabajo se describen los resultados obtenidos con el uso de esta formula en 27 familias con al menos un propositus con distrofia muscular progresiva tipo Duchenne