Parálisis periódica tirotóxica hipopotasémica / Thyrotoxic hypokalemic periodic paralysis

Parálisis periódica tirotóxica hipopotasémica (PPHT) es una complicación rara asociada con hipertiroidismo, especialmente entre los caucásicos. Es más común en la población asiática. La PPHT se caracteriza por episodios de debilidad muscular e hipocalemia. Las características clínicas del hipertiroidismo en pacientes con PPHT pueden ser sutiles. Presentamos el caso de un hombre de 24 años de edad que se presentó con debilidad ascendente de extremidades inferiores después de consumir alcohol. El paciente fue diagnosticado con la enfermedad de Graves y con Parálisis periódica hipopotasémica tirotóxica. Se inició el tratamiento con cloruro de potasio, metimazol y propranolol y fue dado de alta del hospital en condición estable para seguimiento ambulatorio.

Thyrotoxic hypokalemic periodic paralisis (THPP) is a rare complication associated with hyperthyroidism, especially among Caucasians. It is most common in the Asian population. The THPP is characterized by episodes of muscle weakness and hypokalemia. Clinical features of hyperthyroidism in patients with THPP may be subtle. We report a case of a 24-year-old man who presented with ascending lower extremity weakness after drinking. The patient was diagnosed with Graves disease and thyrotoxic hypokalemic periodic paralysis. Treatment with potassium chloride, methimazole and propranolol was initiated and he was discharged from hospital in stable condition for ambulatory follow-up.

Development of an enzyme-linked immunosorbent assay for detection of IgM antibodies to Babesia bigemina in cattle.

A crude antigenic preparation of Babesia bigemina was used to develop an ELISA for the detection of IgM antibodies. Optimal dilutions of the antigen, using positive and negative reference sera, were determined by checkerboard titrations. Negative sera from cattle imported from tick-free areas, serum samples collected from infected B. bigemina cattle were used to validate the test. The specificity was 94% and sensitivity of the Elisa 87.5%. Sera from 385 cattle deriving from areas free from tick-borne diseases, which were submitted to a preimmunization process, were screened by this technique. The Elisa detected seroconversion on the 14th day post-inoculation in animals either infested with Boophilus microplus ticks (infected with B. bigemina), or inoculated with B. bigemina infected blood. Antibody titers decreased after day 33; however, all animals remained positive until the end of the experiment (124 days). The ELISA described may prove to be an appropriate serological test for the detection of IgM antibodies against B. bigemina.

Dominican concepts of health and illness.

It is essential that primary health care providers be familiar with the cultural surroundings from which a person emerges. The Dominican immigrants, like all immigrants, bring with them a whole value and belief system concerning health, illness, and disease prevention. Through a better understanding of that belief system, the primary health care provider can offer a more meaningful interaction with the Dominican immigrant population.