The incidence of primary malignant bone tumors in Suriname

In a retrospective research the incidence of primary malignant bone tumors in Suriname is recorded. In the period 1978 up to and including 1987 there were 15 patients with primary malignant bone tumors, 9 men and 6 women. The incidence is 0.4 per 100.000 per year and for men and women 0.5 and 0.3 respectively. It may be concluded that with the occurrence of 1 to 2 cases per year, these primary bone tumors are rare in Suriname......(AU)

Fatal malformations in Jamaica

Babies with major malformations were identified during the Jamaica Perinatal Morbidity and Mortality Survey. They were found in 96 (8.6 percent) of 1112 perinatal and neonatal deaths coming to necropsy and in 28 (2.6 percent) of 1085 not so examined. The central nervous system was most commonly affected, followed by the renal, gastrointestinal, and cardiovascular systems in decreasing order of frequency. Many infants had abnormalities in more than one system and 10 malformations syndromes/sequences were identified. Although at the present time, major malformations make only a small contribution to perinatal and neonatal mortality in Jamaica, their importance will increase when deaths from other causes, such as birth asphyxia, decline. The type of malformation currently fatal in a particular population is relevant when planning diagnostic and surgical services for neonates and infants. It is also important to any discussions about provision of prenatal diagnostic services. (AU)

Deformities of bone and joint in St. Vincent - abstract

This retrospective study assesses the types and incidence of bone deformities seen by a single surgeon from 1964 to 1983, in the island os St. Vincent, with a population of 107,000. The data were obtained from the clinical and operation records, the private library of clinical photographs, and x-ray films. The deformities were congenital (57 percent), post-traum (12.4 percent), infective (6.5 percent), neoplastic (0.8 percent), degenerative (15.3 percent), deficiency (0.2 percent) and idiopathic (7.8 percent). Many congenital deformities were not diagnosed in infancy and were acknowledged only in later childhood and hence were untreated. A notable example was congenital dislocation of the hip. Others, such as talipes equino-varus, though acknowledged, were either not treated or improperly treated. There was a surprising number of preventable acquired deformities. Many were the result of neglect or gross mismanagement of cases of trauma; while others were due to failure to diagnose and hence manage certain conditions such a Perthes' disease and adolescent coxa vora. The prognosis of many of these deformities could be improved by careful routine examination of the newborn infant by midwives and family and hospital practioners, by educating mothers to take their infants to the family doctor on suspicion of any abnormality, by the recruiting of poperly trained doctors for the districts and hospitals, and by the provision of orthopaedic sugeons preferably at the local level or even on a regional bais (AU)

Techniques for the measurement of human body composition

In many disorders of nutrition, and of water and electrolyte balance, body weight may be an unreliable index of the clinical state, since it may fail to reflect the change in body composition which is physiologically more important. Some techniques by which body composition can be measured in the living subject have been briefly reviewed: recent developments in the field have included some methods of great expense and complexity, and some which are very cheap and simple. An attempt has been made to suggest which methods are most appropriate for specific applications, and to indicate the assumptions which are implicit in these methods (AU)

Haemoglobin SC disease in Jamaica

A skeletal survey was carried out on 84 cases of haemoglobin SC disease. The radiological features noted were increased translucency of bone, abnormal trabecular pattern, medullary expansion, wide vascular channels in phalanges, and radiological evidence of infarction, both medullary and cortical. The frequency of bone lesions thus demonstrated increased with age. The most characteristic lesions in this region were those of vascular necrosis; contributing factors such as the high haemoglobin level characteristic of the condition are discussed. An interesting feature was the lack of correlation betweeen clinical severity and degree of radiological change. (AU)

Sickle cell beta thalassaemia in Jamaica

An analysis of the radiological appearances in a skeletal survey of 48 patients in Jamaica with sickle cell beta thalassaemia is presented. The appearances are similar to those in homozygous sickle cell disease and SC disease and a confident distinction between the conditions on radiological grounds alone is likely. (AU)

Bone histological changes occurring after haemodialysis treatment for chronic renal failure

The changes that occurred in the histological appearances of iliac crest biopsies after haemodialysis for chronic renal failure in 16 patients are described. In the majority there is loss of bone and an increase in resorptive activity that resembles that seen in "disues" osteoporosis. The amount of osteoid present increases in most of the patients and other defects of calcification also make their appearance during the period of dialysis. None of the changes is peculiar to patients treated in this way. The findings are discussed in the light of hypotheses advanced on the condition of "dialysis bone disease".(AU)

The metabolic effects of phoshate on bone - abstract

The therapeutic role of phosphate solutions in the management of hypercalcemic states has been well established, but the mechanism by which phosphate lowers the serum calcium is unclear. The two major possibilities are that phosphate produces its effect by inhibiting bone resorption or stimulating bone formation. Total urinary hydroxyproline (OHPr) is an index of collagen metabolism and rises when there is excessive bone resorption. The effect of the phosphate on urinary OHPr excreation in patients with such metabolic bone diseases as Paget's disease, secondary hyperparathyroidism, osteogenesis imperfecta and osteoporosis was studied, and in all these conditions, oral phosphate supplementation reduced urinary OHPr and a cessation of phosphate was immediately followed by a rise in urinary OHPr levels. In further studies on dogs the effect of phosphate supplementation on collagen synthesis in vivo was estimated by measuring the incorporation of labelled proline into bone collagen. The results show that phosphate supplementation increased the rate of collagen synthesis but resorption was little influenced. It is proposed that phosphate lowers the serum calcium by promoting collagen synthesis and stimulating new bone formation (AU)

Radiological changes associated with leg ulcers in the tropics

The radiological changes associated with four distinct types of leg ulceration common in the tropics are reviewed. Only mild changes occurred in the tropical phagedenic group, but more marked radiological abnormalities occurred in the three chronic groups. The frequency and pattern of the periosteal reaction is the most useful guide to radiological differentiation of these groups. (AU)

The metabolism of iron-dextran given as a total-dose infusion to iron deficient Jamaican subjects

The movements of iron-dextran, following a total dose infusion of up to 2550 mg. iron in six severely iron deficient patients, have been studied using a Fe tagged complex. The preparation is removed from the plasma in 8-10 days. Fifty per cent of the iron was incorporated into haemoglobin in 3-4 weeks and the iron stores replenished rapidly. Using organ scanning, the liver was confirmed as the site of primary plasma clearance, but accumulations of iron were detected in the spleen and bone marrow. Only minute quantities of radioactivity appeared in the urine. No untoward effects on iron metabolism have been detected, but reduction of the serum iron and total binding capacity to low levels 6 weeks post infusion is of interest. An attempt has been made to interpret the findings to elucidate the ferrokinetics of this method of treatment.(Summary)

Observations on the etiology of tibia vara

Twenty-eight cases of the infantile and three cases of the adolescent type of tibia vara occurring in West Indian Negroes are reported. The condition is characterised by failure of growth of the postero-medial part of the upper tibial epiphysis. The deformity produced is acute varus at the upper tibia with medial torsion and eventually flexion of the diaphysis on the epiphysis. These deformities are considered to be due to a vicious circle set up by considerable alteration of the lines of force on the medial portion of the upper tibial epiphysial line (Summary)

The bone changes in sickle cell anaemia and its genetic variants

The bone changes are described in fifty-one cases of sickle cell anaemia, nineteen cases of sickle cell haemoglobin C disease and two cases of sickle cell thalassaemia. Avascular necrosis of the head of the femur has been found in all three types of sickle cell disease. These responded to treatment. The changes found in six cases of Perthes' disease in the negro compared with the changes in avascular necrosis of the head of the femur in sickle cell disease. Hyperplastic bone changes are seen only in true sickle cell anaemia and not in the variants. Secondary osteomyelitis appears to be fairly common in sickle cell anaemia. Organisms of the salmonella group have often been found in these cases (Summary)