RESUMO
Membranous glomerulonephritis and the nephrotic syndrome concurrent with the Miller-Fisher variant of the Landry-Guillain-Barre-Strohl syndrome (LGBS), acute post-infective polyneuritis, is reported in a 49-year-old man. The onset of heavy proteinuria coincided with the development of the neurological disturbance. While immunosuppressive therapy appeared to hasten improvement in the neurological disease, no such improvement occurred in the glomerulopathy (AU)
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Glomerulonefrite Membranosa/etiologia , Síndrome Nefrótica/etiologia , Neuritos/etiologia , Glomerulonefrite Membranosa/patologia , Glomerulonefrite Membranosa/fisiopatologia , Síndrome Nefrótica/patologia , Síndrome Nefrótica/fisiopatologia , Neuritos/patologia , Neuritos/fisiopatologia , BarbadosRESUMO
A review of patients diagnosed as having multiple sclerosis (MS) at the Queen Elizabeth Hospital since 1961 has been carried out. Thirty-eight of 45 cases fulfilled the agreed criteria for diagnosis. There has been an eight-fold increase in the incidence of multiple sclerosis seen at the QEH over the last 25 years, and particularly the last decade (22 or 58 percent in the last six years). The gender ratio (1.9:1), age of onset (31 ñ 6.8), the clinical spectrum and course of patients in this series are almost identical to the well-known clinical spectrum of MS. Eight patients were expatraiates - residents and tourists. One of these was made dramatically worse by the heat, perhaps equivalent to the "hot bath test". Of the 30 West Indian patients, 14 had lived overseas for one year or more and two had spent short vacations abroad, but nine had never left Barbados. The greatly increased rate of diagnosis of MS may reflect increased risk through travel - emigration and return, study travel, holiday travel and tourism - as well as improved referral diagnostic practices. Local physicians, therefore, need to be more aware of the possibility of MS in the Caribbean, and its protean forms. A continiung and significant further increase in new cases is predicted (AU)
Assuntos
Humanos , Masculino , Feminino , Adulto , Esclerose Múltipla/epidemiologia , Barbados/epidemiologiaRESUMO
The first five years' experience of a small, Caribbean, hospital-based haemodialysis unit is reviewed with particular reference to the aetiology of end-stage renal failure (ESRF), complications of therapy, causes of death and the factors influencing rehabilitation. Malignant hypertension evolved as an important cause of ESRF, accounting for 42 percent of cases among Black Barbadians on the dialysis programme (AU)
Assuntos
Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Diálise Renal , Diálise Renal/efeitos adversos , Insuficiência Renal Crônica/etiologia , Insuficiência Renal Crônica/mortalidade , Insuficiência Renal Crônica/terapia , Nefroesclerose/complicações , BarbadosAssuntos
Adulto , Pessoa de Meia-Idade , Humanos , Masculino , Feminino , Diálise Renal , Insuficiência Renal Crônica/terapia , Barbados , Diálise Renal/economiaRESUMO
Seventeen hospital outpatients with extrinsic bronchial asthma were treated with 1 mg ketotifen for sixteen weeks. The evaluation of overall efficacy was based on five clinical examinations on each patient, including lung function studies, frequency of symptoms and decrease in concomitant drug utilization. The tolerance of the drug and periodic assessment of adverse reactions were also evaluated. Both peak flow and FEV1 showed a progressive increase over four months of treatment with ketotifen. Peak flow increased from an initial value of 225ñ89 1/min. (mean ñ SD) to 303 ñ 122 1/min. Only the values at the fourth month were statistically significant (p<0.01). FEV1 increased progressively from 1.25 ñ 0.45 litres. Again only the values at the fourth month were significant (p<0.025). There was no increase in FVC or FEV1/FVC, even at the fourth month. A number of subjects appeared to have great difficulty grasping the techniques required to perform pulmonary function tests. There were four subjects whose performance was consistently unsatisfactory (wider inter test variation) and well below the others even when clinically asymptomatic; these subjects' values were consistently less than 200 1/min. (peak flow) and 1 l/sec FEV1). The results of re-analysis excluding these subjects were as follow: Both peak flow and FEV1 showed higher values and the differences at the fourth month were greater, reaching a level of p<0.005 for peak flow and p<0.01 for FEV1. Ketotifen was beneficial in reducing the frequency of attacks in 14 out of 17 patients. It was very effective in two patients (not a single attack after starting the trial); nine patients did not have any attacks after 12 weeks. No concomitant medication was used by two patients, while seven have considerably reduced the doses of concomitant medication. One patient showed no response. Tolerance was good in all patients, the only side effect being mild daytime sedation in twelve patients. Cessation of therapy was not warranted in any patient because of this side effect. These results suggest that improvement with ketotifen is most marked after three months of therapy (AU)