Acute rheumatism in Jamaican children

One hundred consecutive admissions between 1952-1960 to the University College Hospital of the West Indies of children with acute rheumatism are analysed. The condition is severe with a mortality rate of 21 per cent and cardiac morbidity rate of 24 per cent. Early diagnosis and bed rest combined with maintenance penicillin to prevent recurrence are most important aspects of treatment. The introduction of maintenance benzathine penicillin by monthly injections in 1957 has resulted in an improvement in the results (AU)

Some effects of the administration of Crotalaria fulva extract by mouth

Pilot experiments to assess changes in R.N.A. and glycogen levels in the livers of rats fed aqueous extracts of Crotalaria fulva are described. (AU)

Fatal case of laryngeal papilloma

Clinical and pathological features of a case of papilloma of the larnyx in a child are described. The incidence of these tumours in Jamaican children appears to be the same as in children in other parts of the world. The aetiology is unknown. (AU)

Acute rheumatism in Jamaican children - abstract

One hundred consecutive admissions between 1952-1960 to the University College Hospital of the West Indies of children with acute rheumatism are analysed. The condition is severe with mortality rate of 21 percent and cardiac morbidity rate of 24 percent. Early diagnosis and bed rest combined with maintenance penicillin to prevent recurrence are the most important aspects of treatment. The introduction of maintenance benzathine penicillin by monthly injections in 1957 has resulted in an improvement in the results (AU)

Rupture of the uterus during labour

Five cases of ruptured uterus have occurred among 7,591 deliveries at the University College Hospital of the West Indies. These have been described, and the causes, diagnosis and management of ruptured uterus have been discussed (AU)

Acute rheumatic fever in Jamaican children

Forty-four cases of acute rheumatic fever in children admitted to the University College Hospital over four years are reviewed. The disease is not uncommon in Jamaica and its symptomatology in general is similar to that found in temperate climates. Chorea was rare in the series reported while nodules and erythema marginatum were not seen. The disease affects slightly younger age groups than in temperate climates and is severe with a high mortality and high incidence of cardiac complications.(Summary)

Further observations of the liver, pancreas and kidney in malnourished infants and children: the relation of certain histopathological changes in the pancreas and those in liver and kidney

Data on the association of fatty change in the liver and the histopathology of the pancreas and kidney are presented in 51 malnourished and 41 non-malnourished children as well as in 22 infants dying in the perinatal period. Pancreatic pathology was observed in malnourished infants and children, and in contrast with Davies' observation in Uganda, it was present also in marasmic children, of which some did and others did not have a fatty change in the liver. In children suffering from miscellaneous and non-nutritional conditions there was a high degree of association between pancreatic changes and severe (histological grading, ++ - +++, or chemically over 10 per cent fat) fatty change in the liver, there being no histopathological changes in the pancreas in children of this group with a fatty change of less than 10 per cent fat (histological grading +) in the liver, with 3 exceptions (Tables IV and V). The fat vacuoles in the parenchymal cells in the liver were in the former (i.e. ++ - +++) group large and occupied most of the cells; in the latter (i.e. +) group they were frequently small, and apparently of recent origin in many instances. A fatty change similar in aspect to the one depicted by Silvera and Jelliffe was noted in 5 infants who died in the perinatal period, but we do not agree with these authors that it represents a histological manifestation of foetal malnutrition. It is in our opinion a non-specific phenomenon observed in neonates as well as in older individuals. Routine histology demonstrated certain histopathological changes in the kidneys in the older children which were absent in the perinatal group. None of the changes could, however, be correlated with the nutritional disorders since they were seen with similar frequency in the control series. (Summary)

Further observations on the liver, pancreas and kidney in malnourished infants and children. II. The gross composition of the liver

(1) Measurements have been made of the fat and nitrogen content of the liver in 31 infants less than 3 years old dlying of malnutrition, and in 20 control infants of the same age-group dying of infections and other diseases. The malnourished group contains 16 cases diagnosed as kwashiorkor, 9 cases diagnosed as marasmus, and 6 cases of severe (2) In the malnourished group enlargement of the liver was often noted on clinical examination. This impression was confirmed at autopsy: the liver weights were much higher than normal, whether expressed in relation to age or to body weight. The increase in weight was caused by fatty infiltration. (3) Fatty liver was most common in the cases of kwashiorkor, but occurred sporadically in all the other groups. In the malnourished cases as a whole the amount of liver fat tended to be greatest in those which showed the least evidence of growth failure, as judged by weight and height. (4) By comparison with a normal or ideal standard, the total amount of liver protein in the malnourished infant was reduced by nearly 40 percent. There was no significant difference in total liver protein between the cases of kwashiorkor and of marasmus. The greatest increase in liver fat was found in the cases with the least severe depletion of liver protein. This suggests that there is no causal connection between the 2 pathological processes - decrease in liver protein and increase in liver fat. (5) There was a significant association between oedema and fatty liver. These are two main diagnostic criteria of kwashiorkor in Jamaica. (6) In the discussion 2 points are considered: the significance of the associations that have been found, and the nature of the distinction between kwashiorkor and marasmus (AU)

Further observations on the liver, pancreas and kidney in malnourished infants and children: the relation of certain histopathological change in liver, pancreas and kidney

(1) Data on the association of fatty change in the liver and histopathology of the pancreas and kidney are presented in 51 malnourished and 41 non-malnourished children as well as in 22 infants dying in the perinatal period. (2) Pancreatic pathology was observed in malnourished infants and children, and in contrast with Davies' observation in Uganda, it was present also in marasmic children, of which some did and others did not have a fatty change of liver. (3) In children suffering from miscellaneous and non-nutritional condiitons there was a high degree of association between pancreatic changes severe (histological grading, ++-+++. or chemically over 10 percent fat; fatty change in the liver, there being no histopathological changes in the pancreas in children with a fatty change of less than 10 per cent. fat (histological grading +) in the liver, with 3 exceptions (in tables). The fat vacuoles in the parenchymal cells in the liver were in the former (i.e.+) group they were frequently small, and apparently in many instances of recent origin. (4) A fatty change similar in aspect to the one depicted by Silvera and Jeliffe was noted in 4 infants who died in the perinatal period, but we do not agree with these authors that it represents a histological manifestation of foetal malnutrition. It is in our opinion a non-specific phenomenon observed in neonates as well as in older individuals. (5) Routine histology demonstrated certain histopathological changes in the kidneys in the older children which were absent in the perinatal group. None of the changes could, however, be correlated with the nutritional disorders since they were seen with similar frequency in the control series (AU)

Data about malignant neoplasms and about the incidence of cirrhosis of the liver in Jamaica

Data are presented of malignant neoplasms encountered in autopsies of patients of the University College Hospital, Jamaica, B.W.I. over a two year period. The low incidence of primary liver cell carcinoma is stressed; in connection with this figures on the incidence of cirrhosis of the liver are presented. They show a lower incidence for this disease (3.2 percent) than is reported for most tropical countries (Summary)

Data about malignant neoplasms and the incidence of cirrhosis of the liver in Jamaica

Data on malignant neoplasms encountered in autopsies performed on patients of the University College Hospital of the West Indies in a two year period are presented. The low incidence of primary liver cell carcinoma is stressed. In connection with this, figures on the incidence of cirrhosis of the liver are presented, showing a lower incidence for this disease (3.2 percent) than that reported from most tropical areas. (AU)