Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 12 de 12
Filtrar
Mais filtros










Filtros aplicados
Base de dados
Intervalo de ano de publicação
1.
In. United Medical and Dental Schools of Guy's & St. Thomas' Hospitals; King's College School of Medicine & Dentistry of King's College, London; University of the West Indies. Center for Caribbean Medicine. Research day and poster display. s.l, s.n, Jun. 30, 1997. p.1.
Não convencional em Inglês | MedCarib | ID: med-832

RESUMO

Bone marrow necrosis, is the most common cause of the painful crises in the sickle cell disease, is a recurrent cause of morbidity. In Jamaica, these events increase in incidence in late teenage, are most common in young adults and decrease progressively in frequency and severity after the age of 30 years. Precipitating events include cold exposure, exertion, infections, and stress but skin cooling is the commonest factor in Jamaica. Risk factors include pregnancy, especially the last trimester and immediate post partum period and a high haemoglobin level. The MRC Laboratories [Jamaica] undertakes the management of over 5000 patients islandwide and treats 4-12 painful crises daily. Crises admitted to the day care centre are deemed of sufficient severity to require narcotic analgesia and patients are given rehydration and their response to analgesia monitored during the day. After assessment at 4pm. they are given the option of hospital admission or discharge home with similar analgesia in oral form. Over 90 percent elect to return home. It is estimated that the South East London Health Authority spent 1.9 million pounds on the inpatient management of the painful crises last year, four times the entire budget of the MRC Laboratories [Jamaica] which supervises the outpatient clinical care and research programmes among a much larger population. It is proposed that the Jamaican model of outpatient care for the painful crises may provide a more acceptable and less socially disruptive therapeutic approach and would free resources which could be used to improve other aspects of patient care in sickle cell disease. Its applicability should be explored in the United Kingdom.[AU]


Assuntos
Humanos , Anemia Falciforme/mortalidade , Necrose , Medula Óssea , Jamaica , Fatores Desencadeantes , Fatores de Risco , Dor
2.
J Wildl Dis ; 30(4): 497-505, Oct. 1994.
Artigo em Inglês | MedCarib | ID: med-4736

RESUMO

A field of study was conducted on Antigua, West Indies to determine the feasibility of delivering an oral rabies vaccine or population control agent to free-ranging mongooses (Herpestes javanicua). Two biomarkers (tetracycline hydrochloride [THCL] and Dupoint Oil Blue A dye) and two bait types (Dupont polymer fish meal and polyurethane foam) were used to bait three study sites. Four hundred polymer baits containing both biomarkers were distributed at 36 central point bait stations (11 baits/station) on an 80 ha study site (5 baits/ha); 69 percent of the mongoose population consumed one or more baits. Two thousand baits containing THCL and 400 baits containing DuPont dye were distributed on two additional 100 ha study sites (24 baits/ha). Polymer fish meal baits were used on the first site and polyurethane baits on the second site. Based on the presence of biomarkers in bone or soft tissue, 96 to 97 percent of the mongooses at both sites consumed at least one bait. We conclude that oral baiting of mongooses is a feasible method for delivery of vaccines for the control of rabies in this species (AU)


Assuntos
Feminino , Masculino , 21003 , Vacina Antirrábica/administração & dosagem , Vacinação/veterinária , Herpestidae , Tecido Adiposo/química , Administração Oral , Antraquinonas/administração & dosagem , Antraquinonas/análise , Biomarcadores , Medula Óssea/química , Corantes/administração & dosagem , Corantes/análise , Mandíbula , Polímeros , Poliuretanos , Cauda , Tetraciclina/administração & dosagem , Tetraciclina/análise
3.
Baillieres Clin Haematol ; 6(1): 93-115, Mar. 1993.
Artigo em Inglês | MedCarib | ID: med-8474

RESUMO

Evidence from structural studies of DNA suggest that the sickle cell mutation has arisen on at least three separate occasions in Africa and as a fourth independent mutation in the Eastern Province of Saudi Arabia or India. The pathophysiology of sickle cell disease is essentially similar in these different areas although the frequency and severity of complications may vary between areas. Generally, the chronic haemolysis and resulting anaemia is well tolerated, although serious morbidity and occasionally mortality may be associated with the aplastic crisis or cholelithiasis. Exacerbation of anaemia below steady state levels occurs with chronic glomerular damage and renal failure, especially in older patients. Most of the morbidity of the disease arises from bone marrow necrosis in the painful crisis or from vaso-occlusive manifestation. Changes in the splenic circulation results in life-threatening episodes of acute splenic sequestration, the chronic morbidity of hypersplenism, and splenic dysfunction renders children prone to pneumococcal septicaemia. Chronic organ damage contributes to chronic leg ulceration in adolescence and progressive renal,pulmonary,and occasionally cardiovascular impairment in later life. The clinical spectrum of homozygous sickle cell disease varies widely between patients. Factors contributing to this variability include alpha-thalassaemia,persistence of high HbF levels, haematology, social circumstances, and geographical and climatic variation. Many of the causes of mortality may be prevented or more effectively treated,leading to increased survival and an increased quality of life in affected subjects (AU)


Assuntos
Humanos , Masculino , Feminino , Anemia Falciforme/complicações , Globinas/genética , Anemia Falciforme/genética , Anemia Falciforme/metabolismo , Anemia Falciforme/patologia , Medula Óssea/patologia , Transtornos Cerebrovasculares/etiologia , Oftalmopatias , Nefropatias/etiologia , Úlcera da Perna/etiologia , Pneumopatias/etiologia , Necrose , Esplenopatias/etiologia
4.
West Indian med. j ; 40(Suppl. 2): 111, July 1991.
Artigo em Inglês | MedCarib | ID: med-5195

RESUMO

The pharmacokinetics of injected sodium bicarbonate and radioactive tracers were studied from various intraosseous (IO) sites and a peripheral intravenous (IV) site. Anaesthetised piglets (12-23kg) were catheterised with peripheral 22-gauge IV catheters and 18-gauge bone marrow needles in the medial malleolar, tibial, femoral and humeral IO sites. Standardised aliquots of NaHCO3, (1meq/kg) and Tc-99m DTPA (600 micro-curies) were injected at randomly selected sites. The initial time and maximal level of CO2 rise after NaHCO3 injected were monitored using an end tidal CO2 monitor. The initial time to reach, and proportion of injected tracer in the central circulation were determined using radioactivity counter measure of carotid blood samples drawn at 1.5 second intervals for 1 minute and at 2, 5, 10, 20, 30, and 40, minutes. The following kinetics were determined: SAS analysis by ANOVA. KINETICS - DTPA time to carotid (sec); Tracer amount/Total dose (percentage total dose; Initial CO2 rise (sec);Maximal CO2 rise (mmHg);- IV - 12.8, .032, 12.8 9.6 respectively; HUMERUS - 12.0, .048, 12.0, 8.4 respectively; FEMUR - 13.5, .035, 12.6, 8.1 respectively; ANKLE - 18.6, .037, 13.6, 7.3 respectively; TIBIA - 17.3, .033, 12.9, 12.9 respectively. There was no statistically significant difference (p>.05) in the following: 1) Time of initial expired CO2 rise, 2) Maximal expired CO2 rise, 3) Time of tracer to reach the central circulation from IO and IV sites. Our study suggests: (1) IO and IV sites are similarly rapid means of injection delivery to the central circulation, (2) adjustments in dosages of medication may not be required to achieve the same IO effects as IV injection (AU)


Assuntos
Humanos , Infusões Intravenosas , Infusões Intraósseas , Farmacocinética , Bicarbonato de Sódio , Traçadores Radioativos , Medula Óssea
5.
West Indian med. j ; 40(Suppl. 1): 37, April 1991.
Artigo em Inglês | MedCarib | ID: med-5573

RESUMO

Transferrin receptors are used by rapidly dividing tissues such as bone marrow for the extraction of iron necessary for their metabolic requirements. As cells in the erythropoietic series mature, transferrin receptors are cleaved from the cell surface and may be measured free in the plasma. Serum transferrin receptors (STR) levels are therfore believed to reflect the extent of erythropoiesis and are elevated in anaemias associated with iron deficiency, haemolysis and thalassaemia and decreased in aplastic anaemia. Levels have been measured in stored sera from 182 children with homozygous sickle-cell (SS) disease and 42 controls with a normal haemoglobin (AA) genotype age 8 years (ñ 3 months) in a cohort study from birth. Levels is SS children (mean, SD: 38.3, 12.7) greatly exceeded those in AA controls (6.7, 1.9) (test = 32.1, p0.001) and were negatively correlated with total haemoglobin and foetal haemoglobin levels in both sexes but not with reticulocyte counts. The serum transferrin receptor level may be a useful indicator of the degree of eryreticulocyte counts. The serum transferrin receptor level may be a useful indicator of the degree of erythropoietic expansion in SS disease, and requires further study to determine its clinical value (AU)


Assuntos
Humanos , Criança , Anemia Falciforme , Receptores da Transferrina , Medula Óssea/metabolismo , Porfiria Eritropoética/sangue , Hemoglobina Fetal
6.
Int Symp Princess Takamatsu Cancer Res Fund;15: 77-90, 1984.
em Inglês | MedCarib | ID: med-10543

RESUMO

We had shown previously that the prevalence of human T-cell leukemia/lymphoma virus type I (HTLV-I) antibody positivity is high in Jamaican non-Hodgkin's lymphoma (NHL) patients and that virus-positive patients have the clinical features and poor prognosis of adult T-cell leukemia/lymphoma (ATL). 62 percent of 45 NHL patients diagnosed consecutively between 2/1/82 and 1/31/84 and studied prospectively were HTLV-I-antibody positive. Skin involvement (38 percent), hypercalecemia (44 percent), and leukemia (40 percent) were unusually prevalent and there was a strong association (p < 0.05) with HTLV-I-antibody positivity. 52 percent of the patients had bone marrow infiltration, and 74 percent of these patients were HTLV-I-antibody positive (p=.06). Lymphadenopathy (96 percent), hepatomegaly (60 percent), and splenomegaly (25 percent) were detected with about the same frequency as in other series of NHL patients with advanced disease, and 61-88 percent of these patients were HTLV-I-antibody positive. Patients were classified into those with "typical ATL" (NHL associated with 2 of the 4 features) i) hypercalecemia; ii) histologically proven skin infiltration; iii) leukemia; and iv) bone marrow infiltration, providing that the morphology of infiltrating of leukemic cells was characteristic of ATL; those "consistent with ATL" (NHL associated with 1 of these 4 features); and "non-ATL" (NHL without any of these 4 additional features). Thirty-two (71 percent) of the NHL patients were ATL patients, i.e. had features typical of or consistent with ATL, and 78 percent of these were HTLV-I-antibody positive. HTLV-I provirus was detected in tumour cells of all HTLV-I-antibody positive patients tested. Three (23 percent) of the non-ATL patients were HTLV-I-antibody positive. There was no correlation between histopathological features and the clinical classification of HTLV-I-antibody positivity. Median survival of ATL and non-ATL patients was 16 and 53 weeks. Although the disease was unusually fulminant, 34 percent of the ATL patients had a subacute or chronic course. Skin involvement and leukemia were prominent in these patients. Hypercalecemia was the chief prognostic determinant. Median < 0.05). Hypercalecemia caused 10 deaths, infections 12, and death was due to tumour progression in 4 patients. Infections were usually due to pyogenic organisms and only 2 patients had systemic opportunistic infections. Six (27 percent) of 22 chronic lymphocytic leukemia (CLL) patients were HTLV-I-antibody positive. (AU)


Assuntos
Humanos , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Masculino , Feminino , Anticorpos Antivirais/análise , Deltaretrovirus/imunologia , Leucemia/etiologia , Linfoma/etiologia , Medula Óssea/patologia , Hipercalcemia/etiologia , Leucemia Linfoide/etiologia , Linfoma/classificação , Linfoma/patologia , Prognóstico , Dermatopatias/etiologia
7.
Lancet ; 2(8247): 595-7, Sept. 19, 1981.
Artigo em Inglês | MedCarib | ID: med-14386

RESUMO

Since 1952, 112 childen with sickle cell anaemia (SCA) in Jamaica have had an aplastic crisis. Outbreaks occurred in 1956, 1960, 1965-67, 1971-73, and 1979-80. Most cases occurred in children under 10 years of age, and an aplastic crisis in a patient over the age of 15 years is rare. There were 38 cases in 1970-80 and stored serum specimens from 28 of these were available for virus studies. Evidence for infection with a parvovirus-like agent was found in 24 of these 28 cases. Viral antigen was detected in 2 patients, both of whom demonstated seroconversion. Serconversion during 1980 was detected in a further 7, increasing amounts of antibody during the convalescent period were found in 5, antibody was found in 2 of 4 patients from whom only an acute phase specimen was available and the remaining 10 were antibody positive in the only convalescent phase sample available for testing. Antibody was found in 4 of 94 controls with the SS genotype (in retrospect 2 of these may have had an aplastic crisis) and in 17 percent of 48 controls with a normal haemoglobin (AA) genotype. The results accord with the possibility that the parvovirus-like agent is the principal cause of aplastic crisis in SCA (Summary)


Assuntos
Humanos , Lactente , Pré-Escolar , Criança , Anemia Falciforme/complicações , Surtos de Doenças , Parvoviridae , Viroses/complicações , Fatores Etários , Anemia Falciforme/patologia , Medula Óssea/patologia , Hemoglobinas/análise , Jamaica , Reticulócitos/patologia
8.
J Laryngol Otol ; LXXX1X(4): 453-5, Apr. 1975.
Artigo em Inglês | MedCarib | ID: med-13870

RESUMO

The dimensions of the internal auditory canal were compared in patients with SS disease and with or without abnormal audiograms to investigate the role of auditory nerve compression by expansion of the petrous, temporal bone in hearing loss. There was no correlation between abnormal audiograms and narrowing of the internal auditory canals and it was concluded that this mechanism was not responsible for the hearing loss in SS disease (AU)


Assuntos
Humanos , Anemia Falciforme/complicações , Transtornos da Audição/etiologia , Anemia Falciforme/patologia , Limiar Auditivo , Medula Óssea/citologia , Meato Acústico Externo/patologia , Transtornos da Audição/patologia , Hemólise , Orelha Interna/inervação , Orelha Interna/patologia , Síndromes de Compressão Nervosa/etiologia , Síndromes de Compressão Nervosa/patologia , Osso Temporal/patologia
9.
Br J Haematol ; 28(4): 505-13, Dec. 1974.
Artigo em Inglês | MedCarib | ID: med-15892

RESUMO

Globin synthesis was studied in three Jamaican Negro families with 18 heterozygotes and 5 homozygotes for beta-thalassemia. Synthesis of the beta chain of Hb A in the peripheral blood of heterozygotes was equal to that of the alpha-chain in 10 patients and was decreased in the remainder. In one patient with Hb C beta-thalassemia the beta/alpha ratio was normal. These findings were similar to those in American Negroes, but differed from those in Caucasian with beta-thalassemia trait, in each of whom the beta/alpha ratio was decreased. Globin synthesis was balanced in the bone marrows of Negro and Caucasian heterozygotes. Despite the milder clinical disease in Negro homozygotes as compared to Caucasian patients, the beta/alpha ratios were similar in both groups. The presence of alpha-thalassemia combined with beta-thalassemia in Negro heterozygotes is not a likely explanation for the high incidence of balanced globin synthesis ratios. The expression of relative beta to alpha chain synthesis in Negro heterozygotes appears to be modified by a factor which is not linked to the delta-chain locus. The nature of this factor is not known at present.(Summary)


Assuntos
Humanos , Adulto , Pessoa de Meia-Idade , Idoso , Masculino , Feminino , Globinas/biossíntese , Talassemia/metabolismo , Medula Óssea/metabolismo , Hemoglobina C/análise , Heterozigoto , Homozigoto , Talassemia/genética , Talassemia/fisiopatologia , Fragmentos de Imunoglobulinas/biossíntese , Jamaica , América do Norte/etnologia , Linhagem
10.
West Indian med. j ; 22(4): 184, Dec. 1973.
Artigo em Inglês | MedCarib | ID: med-6223

RESUMO

Neutrophils which are the first type of cells observed in the course of an inflammatory response to injury, are severely depleted in bone-marrow cells of animals after injection of antigens and insoluble thrombin, both of which provoke an inflammatory response. Increased RNA synthesis in neutrophils on phagocytosis of solid particles has also been reported. Since inhibitors of RNA synthesis in vivo can prevent the mobilisation of lymphocytes but not of neutrophils to the damaged area, and the arrival of lymphocytes is dependent on prior presence of neutrophils, it is possible that RNA synthesized in neutrophils controls the mobilisation of lymhocytes in the inflammatory response. Consistent with this hypothesis is the finding that neutrophils disintegrate after phagocytosis thus RNA so released could be taken up by lymphocytes. A study was therefore conducted on the effect of various chemotactic and phagocytosis - promoting factors on H3-uridine incorporation into RNA by rat bone-marrow cells. These cells have a high concentration of neutrophils. Chemotactic factors, anti-genantibody complexes, fibrin and fibrinogen had little effect on H3-uridine incorporation into RNA. A delipidized bovine plasma fraction, which has fibrinolytic activity, stimulated the incorporation of H3-uridine into these cells. A study of phagocytosis-promoting globulin led to the purification of a post-heparin lipoprotein lipase enzyme which stimulated RNA synthesis in bone marrow cells and also in peritoneal neutrophils. The results suggest that this enzyme increases RNA synthesis in neutrophils by affecting the plasma membrane. This could be an important reaction in the control of the inflammatory response(AU)


Assuntos
Ratos , Medula Óssea , RNA , Fatores Quimiotáticos , Fagocitose , Uridina
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...