RESUMO
OBJECTIVES: Haemophilus influenzae vaccine was introduced in the United Arab Emirates in 1999. Our objective was to describe the pattern of meningitis in a health district in the decade before the introduction of the vaccine and compare it with the data from elsewhere. METHODS: For this retrospective study we included 128 meningitis cases reported from 1990 to 1999. Information on the cases was abstracted from the case notification forms and clinical and laboratory data from the hospital case notes. RESULTS: H. influenzae was the most common cause of bacterial meningitis (n=59, 46.1%) followed by Streptococcus pneumoniae (n=20, 15.6%). Meningitis was a disease primarily of infants and children and the median age was 15 months. One fifth of the patients (n=27) had neurological sequelae of which 33.3% had seizures and 25.9% developed deafness. 18.9% (10 out of 53) of H. influenzae isolates were resistant to ampicillin compared with 5.9% (3 out of 51) to chloramphenicol. 78.9% (15 out of 19) of S. pneumoniae isolates were susceptible to penicillin. CONCLUSIONS: The epidemiology of meningitis in our health district is similar to the epidemiology of meningitis during the pre-vaccine era in other countries.
Assuntos
Meningite por Haemophilus/epidemiologia , Meningite Pneumocócica/epidemiologia , Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Vacinas Anti-Haemophilus/uso terapêutico , Haemophilus influenzae/isolamento & purificação , Humanos , Lactente , Masculino , Meningites Bacterianas/epidemiologia , Meningite por Haemophilus/prevenção & controle , Pessoa de Meia-Idade , Estudos Retrospectivos , Emirados Árabes Unidos/epidemiologiaRESUMO
The information returned to the hospital clinician after a necropsy was investigated in a series of 1000 patients. It was found that specific clinical queries were answered in 83% of cases, that the necropsy corrected the major clinical diagnosis in 36% of cases, and that 29% of cases were used for undergraduate or postgraduate teaching. The results demonstrate the continuing value of the necropsy as an investigative and educative procedure.
Assuntos
Autopsia , Educação Médica , Estudos de Avaliação como Assunto , Hospitais de Ensino , Humanos , Prontuários MédicosRESUMO
The thyroids of primary thyrotoxicosis patients prepared for partial thyroidectomy with propranolol contained much more lymphoid infiltrate than those prepared with carbimazole. No relation was found between the extent of lymphoid infiltrate in the thyroid and the development of postoperative hypothyroidism either between or within the two drug treatment groups. This study has shown that the extent of thyroid infiltrate should not be used as the major factor in predicting hypothyroidism after subtotal thyroidectomy for primary thyrotoxicosis.
Assuntos
Hipertireoidismo/patologia , Tecido Linfoide/patologia , Glândula Tireoide/patologia , Autoanticorpos/análise , Carbimazol/uso terapêutico , Citoplasma/imunologia , Feminino , Humanos , Hipertireoidismo/tratamento farmacológico , Hipertireoidismo/imunologia , Hipertireoidismo/cirurgia , Hipotireoidismo/etiologia , Cuidados Pré-Operatórios , Propranolol/uso terapêutico , Tireoglobulina/imunologia , Tireoidectomia/efeitos adversos , Tireoidite/patologiaAssuntos
Autopsia , Educação de Graduação em Medicina , Patologia/educação , Televisão , Cor , EscóciaRESUMO
The specimen of thyroid resected at partial thyroidectomy from 103 patients with primary thyrotoxicosis was studied with histometric and organ culture techniques. Twenty-seven patients had been prepared for operation with propranolol and seventy-six with carbimazole: all received Lugol's iodine for 10 days before operation. The resected specimen and deduced total thyroid weight was greater in the patients prepared with carbimazole. There was no absolute qualitative histopathological difference in the appearance of the glands of the two groups of patients, but histometry showed that the volume percentage of colloid and total gland colloid weight was significantly greater in the patients prepared with carbimazole: the volume percentage of epithelial cells and the total gland epithelial cell weight was similar in the two groups. The iodide concentrating capacity per g wet weight thyroid tissue or per unit volume of colloid did not differ significantly between the two groups. However, the iodide concentration capacity per unit volume of epithelial cells was significantly higher in the carbimazole prepared patients than in those prepared with propranolol.