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Trop Geogr Med ; 30(1): 5-21, Mar. 1978.
Artigo em Inglês | MedCarib | ID: med-12673


The West Indies, and associated parts of the Caribbean area, are extremely diverse and afford interesting examples for the study of geographical medicine. Short accounts are given of some conditions whose aetiologies have been relatively recently clarified, including vomiting sickness of Jamaica, veno-occlusive disease of Jamaica, blackfat pulmonary fibrosis of Guyana, and epidemic acute glomerulonephritis of Trinidad. The aetiology of tropical sprue, which is common in Puerto Rico and absent from Jamaica remains to be explained although a hypothesis has been put forward. Further work is needed to establish the geographical distribution of idiopathic cardiomegaly and the spinal neuropathies and associated syndromes of retrebublar neuritis and sensorineural deafness before their aetiologies can be understood (AU)

Humanos , Criança , Adulto , Medicina Tropical , Doenças Ósseas/epidemiologia , Glomerulonefrite/epidemiologia , Cardiomegalia/epidemiologia , Hipoglicinas/envenenamento , Fabaceae/envenenamento , Doenças do Sistema Nervoso/epidemiologia , Intoxicação por Plantas/epidemiologia , Fibrose Pulmonar/etiologia , Tabagismo , Espru Tropical/epidemiologia , Infecções Estreptocócicas/epidemiologia , Streptococcus pyogenes , Síndrome , Guiana , Jamaica , Porto Rico , Trinidad e Tobago , Índias Ocidentais
Q J Med ; 40(160): 457-70, Oct. 1971.
Artigo em Inglês | MedCarib | ID: med-12998


In Guyana, a large number of patients have been diagnosed as having a diffuse pulmonary fibrosis of unknown aetiology, characterized by typical radiological appearances, dyspnoea, cough, weight loss, and eventually pulmonary heart disease. Investigation of 56 patients showed that all had smoked a tobaco known as 'blackfat' or 'black tobacco'. In a community survey 20.4 per cent of the population aged 55 years and over smoked this tobbaco. 19.6 per cent of the blackfat smokers but no non-blackfat smokers showed definite radiological evidence of pulmonary fibrosis. Smokers with, but not those without fibrosis, had severe airway obstruction. Immunological studies made it unlikely that an extrinsic allergic aveolitis had caused the radiological changes. Three post-mortem open-lung specimens were obtained and in each case the histology showed a diffuse interstitial fibrosis and vasculitis associated with large deposits of lipid surrounded by black amorphous material. Blackfat is a tobacco leaf to which mineral oil and vaseline is added for flavouring and as humectants. The presence of oil in the tobacco, and the post-mortem findings of oil in the lungs, indicate that the diffuse pulmonary fibrosis can be more accurately described as a lipoid pneumonia caused by the inhalation of mineral oils when blackfat is smoked. The potential health hazards of many tobacco additives, particularly oils, employed by the tobacco industry should be recognized. A similar type of disease as that found in Guyana may be present in other parts of the world where blackfat, or related tobacco, are smoked.(Summary)

Humanos , Adulto , Pessoa de Meia-Idade , Idoso , Masculino , Feminino , Pneumonia Lipoide/etiologia , Tabaco , Tabagismo , Fatores Etários , Doenças dos Trabalhadores Agrícolas , Peso Corporal , Bronquite/etiologia , Cianose , Eletrocardiografia , Guiana , Pulmão/patologia , Pulmão/diagnóstico por imagem , Mastigação , Testes de Precipitina , Fibrose Pulmonar , Testes de Função Respiratória , Espirometria , Pneumonia Lipoide/epidemiologia
West Indian med. j ; 18(2): 119, June 1969.
Artigo em Inglês | MedCarib | ID: med-6426


Over the past year epidemiological, immunopathological and morbid anatomical studies have been in progress in an attempt to define the aetiology of an obscure form of diffues pulmonary fibrosis in Guyana. Dr. H. M. S. G. Beadnell of Lusignan hospital has kept a record of all cases of pulmonary fibrosis referred to him. 14 of these patients were interviewed and examined. All were Indian aged 49-75 years, and 9 were women. The onset had been insidious, there being progressive dyspnoea, dry cough and weight loss. Common findings were central cyanosis, basal crepitations and signs of right ventricular hypertropy. Chest X-ray showed diffuse fibrotic changes and areas of consolidation. Lung function showed severe obstructive airways disease in most, and restrictive lung disease in a few. Patients were questioned about previous occupations, dust exposure and smoking habits. This revealed that all smoked blackfat tobacco smoking was determined during a population survey of two local communities. Only eleven blackfat tobacco smokers were found, all Indian women, and three of these had typical pulmonary fibrosis. 16 people known to smoke blackfat tobacco were examined; 12 had evidence of respiratory disease and 5 had radiographic appearances of pulmonary fibrosis. Further epidemiological studies undertaken more recently lend support to these findings(AU)

Humanos , Feminino , Fibrose Pulmonar/etiologia , Tabagismo , Cianose , Hipertrofia Ventricular Direita , Guiana
Lancet ; 2(562): 259-60, Aug. 1968.
Artigo em Inglês | MedCarib | ID: med-13090


The clinical features and epidemiology of diffuse pulmonary fibrosis in Guyana have been investigated. The condition is limited to East Indians and is characterised by progressive dyspnoea leading to pulmonary heart-disease and congestive heart-failure. 19 hospital patients studied, and 7 others radiographically confirmed, had all smoked "blackfat" tobacco, a variety which is not widely used.(Summary)

Humanos , Adulto , Pessoa de Meia-Idade , Idoso , Masculino , Feminino , Fibrose Pulmonar/epidemiologia , Tabagismo , Tabaco , Peso Corporal , Dispneia/etiologia , Guiana , Insuficiência Cardíaca/etiologia , Fibrose Pulmonar/etiologia , Fibrose Pulmonar/diagnóstico por imagem , Doença Cardiopulmonar/etiologia , Testes de Função Respiratória
Br J Dis Chest ; 61(3): 159-62, July 1967.
Artigo em Inglês | MedCarib | ID: med-8769


The clinical radiological and pathological features of desquamative interstitial pneumonia in a 55-year old Jamaican male negro are described. Although the patient presented with progressive effort dyspnoea there were minimal abnormal chest signs but marked derangement of the respiratory function tests. The most severe radiological changes were demonstrated in the middle zones of the lung fields, and a follow-up chest film 2 months later showed slight involvement of the lower zones as well. The microscopic appearance was typical of the condition except that the vascular changes overshadowed the other abnormalities present. Although there was an excellent subjective response to steroid therapy, lung function tests repeated 2 months after the onset of the disease showed no significant change. (Summary)

Humanos , Pessoa de Meia-Idade , Masculino , Fibrose Pulmonar , Seguimentos , Fibrose Pulmonar/tratamento farmacológico , Fibrose Pulmonar/patologia , Fibrose Pulmonar/diagnóstico por imagem , Testes de Função Respiratória , Esteroides/uso terapêutico , América do Norte
West Indian med. j ; 14(1): 18-21, Mar. 1965.
Artigo em Inglês | MedCarib | ID: med-10734


Another case of diffuse progessive interstitial fibrosis of the lung is described in a child. The diagnosis was made by lung biopsy and treatment with steroids instituted because of the extreme dyspnoea. There appeared to be considerable symptomatic inprovement but no significant changes occurred in the radiological appearance (AU)

Humanos , Criança , Fibrose Pulmonar/diagnóstico , Fibrose Pulmonar/tratamento farmacológico
West Indian med. j ; 13(2): 73-6, June 1964.
Artigo em Inglês | MedCarib | ID: med-10628


Four cases of lung fibrosis are described in Jamaicans. The cases are of interest because the fibrosis differed in origin. Each terminated with failure of a hypertrophied right heart, the duration of failure being relatively short before death (AU)

Humanos , Adulto , Pessoa de Meia-Idade , Masculino , Feminino , Doença Cardiopulmonar/etiologia , Fibrose Pulmonar/complicações , Fibrose Pulmonar/etiologia , Insuficiência Respiratória/etiologia