RESUMO
INTRODUCTION: Strachan's disease is a condition which mainly affects the nervous system. It is characterized by optic, auditory and peripheral neuropathies and lesions of the skin and mucous membranes. In 1955 Miller Fisher gave it this name, since the clinical condition described by Henry Strachan in Jamaica during the nineteenth century was similar to that seen in Canadian prisoners-of-war in Japanese concentration camps during the Second World War. DEVELOPMENT: Since there are similarities between these clinical disorders and the major neuropathic epidemic seen recently in Cuba, we have reviewed and compared the endemic and epidemic conditions of similar characteristics seen in Cuba during the nineteenth and twentieth centuries. We also make a detailed review of a similar condition described in 1898-1900 by Doctors Madan, López and Santos Fernández, during the last Cuban War of Independence. This seems to be one of the earliest descriptions of the disorder. We also consider the so-called Strachan's syndrome or disease, and descriptions from the same period of tobacco-alcohol amblyopia and beriberi. These conditions seem to have been very similar to the so-called optical and peripheral forms of the current Cuban epidemic. It is concluded that the clinical characteristics of the recent Cuban neuropathic epidemic, at least in the optical form, were seen to be endemic during the nineteenth century. In many cases this was considered to be alcoholic amblyopia or some other obscure neuropathy which became epidemic during periods of severe economic depression. CONCLUSION: Madan gave a full description of the disorder at the same time as Strachan did. In 1898 he also suggested its true cause and died trying to relieve it. We therefore consider that Strachan's syndrome should be renamed the Strachan-Madan syndrome.
Assuntos
Surtos de Doenças , Neurite Óptica/epidemiologia , Terminologia como Assunto , Ambliopia/epidemiologia , Ambliopia/etiologia , Ambliopia/história , Beriberi/epidemiologia , Clima , Cuba/epidemiologia , História do Século XIX , História do Século XX , Humanos , Incidência , Distúrbios Nutricionais/complicações , Distúrbios Nutricionais/história , Neurite Óptica/etiologia , Neurite Óptica/história , Transtornos Relacionados ao Uso de Substâncias/complicações , Transtornos Relacionados ao Uso de Substâncias/história , SíndromeRESUMO
The 1991 to 1994 epidemic of neuropathy in Cuba has been one of the more devastating in recent history, affecting more than 50,000 people throughout the entire country with clinical manifestations of optic and peripheral neuropathy. Although the causes are not entirely clear, it seems that a combination of acute nutritional deficiency and the toxic effects of tobacco and possibly other unidentified toxic substances is involved. The epidemic coincided with the acute worsening of the economic situation on the island following political changes in Eastern European countries and a tightening of the US economic embargo. This paper reviews reports of a strikingly similar epidemic known as the "Amblyopia of the Blockade," which occurred in Cuba almost a century ago when the island was undergoing a US naval blockade during the Cuban-Spanish-American war. It discusses the parallelism with the recent epidemic as well as the implications of this historical evidence to clarify further the ultimate causes of these epidemics.
Assuntos
Ambliopia/história , Surtos de Doenças , Doenças do Sistema Nervoso Periférico/epidemiologia , Ambliopia/etiologia , Cuba/epidemiologia , Surtos de Doenças/história , Contaminação de Alimentos , História do Século XIX , Humanos , Estado Nutricional , Doenças do Sistema Nervoso Periférico/etiologia , Saúde Pública , Fumar/efeitos adversos , Fatores de Tempo , GuerraRESUMO
Artigo de atualizaçäo em Oftalmologia, pela sua importância clínica (distúrbio de uma das funçöes mais características da visäo - sua acuidade - prevenível e recuperável, mas irreversível passada a fase crítica do desenvolvimento de competências neuronais), experimental (base de entendimento dos processos visuais) e epidemiológica (prevalência populacional de uns 4%, relativamente alta), resultando em extensa multidisciplinariedade nas possíveis abordagens