Gene/Protein Disease Symptom Drug Enzyme Compound
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8 Zimbabwean children are discussed in whom the nephrotic syndrome (NS) was a manifestation of membranous glomerulonephritis (GN) which was associated in every case with hepatitis B antigenaemia. This marks the first occasion that such an association has been reported in African children, although it has been thoroughly documented in children in Europe, the Far East and America. Microhaematuria, hypertension and mild to moderate renal insufficiency were frequent early associated findings, and every child exhibited hypocomplementaemia and a markedly diminished immunoglobulin G (IgG) level. The disease followed a benign course in the majority, and only 1 child died in renal failure.
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PMID:Association of hepatitis B (HBs) antigenaemia and membranous glomerulonephritis in Zimbabwean children. 638 36

During the last decade, tremendous changes have occurred in health status and patterns of health care in Singapore. These changes have presented great opportunities for the Department of Social Medicine and Public Health to conduct research into a wide variety of topics of vital interest to community health. Subjects studied include health problems of urbanization, especially those related to industrial health, highrise living, and traffic accidents; health consequences of changing lifestyles particularly those related to smoking and alcohol; the changing epidemiology of communicable and noncommunicable diseases, particularly those related to smoking and alcohol; the changing epidemiology of communicable and noncommunicable diseases, particularly those relating to hypertension, cancer, tuberculosis and venereal diseases; new aspects of health care delivery especially those pertaining to the aged; Chinese medicines and primary health care; health education techniques and priorities, with special respect to teachers, mothers, and workers, and road users; and medical problems and social changes, including the erosion of the extended family system and the wider practice of abortion. The enormous coverage of research activities carried out by the department is seen in the publication figures by staff and postgraduate students of our department (1970, 5; 1971, 6; 1972, 7; 1973, 23; 1974, 24; 1975, 29; 1976, 28; 1977, 18; 1978, 14; 1979, 23). It is obvious therefore that in this short paper we can only hope to select some research projects for discussion. Among ongoing major projects which did not receive mention in the text of this paper are the Study of Occupational Health Hazards of Firemen, the Prospective Cohort Study on the relationship of Hepatitis B Carrier Status and the development of Hepatoma, a study of transplacental passage of lead and problems of Child Rearing in Highrise Apartments.
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PMID:Changing patterns of community health university research in Singapore during 1970-1979. 744 75

Despite of advances in 1-year survival rates of renal allografts, no comparable achievements have been made in long-term graft survival. To identify risk factors for chronic progressive renal allograft dysfunction we conducted a retrospective study in 639 patients transplanted between 1983 and 1990. Graft function was assessed by the slope of individual 1/creatinine regression lines and chronic progressive graft dysfunction was defined as a slope of the 1/creatinine line of > 0.1 dl/mg/year, indicating a loss of glomerular filtration rate of > 10 ml/min/year regardless of the initial serum creatinine value. A number of possible risk factors were determined and analysed by linear regression analysis. One hundred and six patients (16.6%) showed chronic progressive graft dysfunction. No correlation was found between the rate of functional deterioration and the age and gender of the donor or the recipient, the blood group, the prevalence of hepatitis B or C, the number of blood transfusions, the total ischaemia time, or the number of kidneys from female donors grafted into male recipients. Chronic progressive graft dysfunction was associated with the number of HLA-B/DR mismatches (P = 0.04) and with a first acute rejection episode later than 60 days after transplantation (P < 0.001). Chronic progressive graft dysfunction also occurred in the absence of an acute rejection episode. Significantly (P < 0.001) more patients with chronic progressive graft dysfunction were hypertensive not only 12 months after transplantation, but also at the time of transplantation, indicating that hypertension may not only be secondary to deteriorating graft function, but that hypertension per se leads to graft damage and initiates chronic progressive graft dysfunction. All efforts should be made to control blood pressure adequately to improve long-term survival of renal allografts.
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PMID:Pre-transplant hypertension: a major risk factor for chronic progressive renal allograft dysfunction? 747 10

Orthotopic liver transplantation is now routinely performed as a cure of numerous untreatable paediatric liver diseases. Evaluation of post-transplant quality of life is subjective and very difficult. It has to take into account the pre-transplant quality of life and the emotional stress to the family. Transplantation saves life in 65%-90% of the patients. Several diseases may, however, recur after transplantation, such as hepatitis B, C or NANB, or tumours. Some metabolic diseases may also progress in other organs. Extra-hepatic manifestations or sequelae may persist after transplantation. Complications of transplantation include renal function impairment, hypertension, viral and opportunistic diseases. Of particular concern is the post-transplant lymphoproliferative syndrome. Liver transplantation is able to restore growth. Children are less frequently admitted to hospital after transplantation, take fewer medications, return to school, are less dependent and interact more normally with their peers. Quality of life may not reach perfection, and depends also on the way our society accepts these imperfections.
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PMID:Quality of life after orthotopic liver transplantation in children. An overview of physical, psychological and social outcome. 775 11

Rapidly progressive glomerulonephritis (RPGN) is rarely associated with macroscopic polyarteritis nodosa (PAN), as seen in this series of 7 out of 235 patients. The clinical symptoms of PAN were as follows: myalgias 6; fever 1; arthralgias and mononeuropathy multiplex 5; cutaneous vasculitis 3; arterial hypertension 4, 3 of which were malignant. The mean proteinuria was 2.7 g/24 h; creatininemia 458 microM/l; microscopic hematuria was present in 4 of the 7 patients; only 1 patient was anuric. Markers of hepatitis B virus were absent in all cases. Arteriography revealed microaneurysms and renal infarcts in 6 patients and distal arterial stenosis in one. Renal biopsies from all 7 patients demonstrated extracapillary glomerulonephritis, which was associated with tubulointerstitial fibrosis in one. Necrotizing vasculitis lesions were associated in 5 cases. Immunofluorescence was positive in 5 cases. The association of RPGN and PAN exists and may be underestimated due to the lack of systematic angiographic examinations during RPGN and renal biopsies in PAN patients with renal involvement.
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PMID:[Rapidly progressive glomerulonephritis in macroscopic periarteritis nodosa. 7 cases]. 790 9

Although hepatic transplantation is now a well-accepted treatment modality for end-stage liver diseases there are little detailed data on the clinical profile of patients who survive beyond 1 year following transplantation. The aim of this study was to develop a cross-sectional profile on 53 adults who have survived beyond 2 years following liver transplantation. These patients have been followed for a mean of 43.5 months (range 24-84) since the time of transplant. Nineteen patients had persisting liver enzyme abnormalities, 11 due to chronic viral hepatitis (seven hepatitis C virus, three hepatitis B virus), four due to biliary disease. Two had post severe rejection, one steatosis secondary to obesity while in one the aetiology was unclear. Nineteen (36%) of patients required anti-hypertensive medications. The median doses of Prednisone, Cyclosporin and Imuran were 7.5, 300 and 50 mg daily, respectively. The mean serum creatinine was 117 +/- 27 mumol/L. However 22 (41%) had an elevated serum creatinine (> 120 mumol/L) but in only seven was the serum creatinine > 150 mumol/L. Fourteen (26%) of patients were obese (body mass index > 30) whilst 46% had a higher than recommended serum cholesterol (mean level 5.6 +/- 1.5 mumol/L). There has only been one case of internal malignancy (lymphoma) although 19 patients attend regular dermatological review for skin cancer surveillance. Forty-eight patients had a Karnofsky Score > 80. In conclusion, the vast majority of these patients have excellent clinical function but some caution is required with respect to renal function, hypertension, obesity and mild hypercholesterolaemia.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:A follow up of 53 adult patients alive beyond 2 years following liver transplantation. 828 Aug 46

Liver transplantation poses enormous and complex medical problems. Of the infective complications, bacterial infections are the commonest overall, but the single commonest is cytomegalovirus and the most deadly are the fungal infections. Therapeutic options and possibilities for prophylaxis are improving. Rejection, both acute and chronic, is the other major cause of mortality, and the balance between immunosuppression and infection is difficult. Cyclosporin treatment contributes to renal impairment, hypertension, and multitudinous potential neurological problems. The risk of long-term neoplasia is unclear. Relatively more minor is the potential for osteoporosis and metabolic complications, such as diabetes and hyperlipidaemia. Hepatitis B disease has a sizable risk of recurrence, but the most recent prophylaxis regimes have improved relapse rates. Having survived the physical problems following transplantation, most of which occur in the first 6 months, there are considerable psychosocial adjustments to be made particularly in the case of children where growth and development may have been delayed. Despite all these difficulties, liver transplantation is an expanding and optimistic area with enormous potential.
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PMID:Medical complications of liver transplantation. 833 63

Clinical data and renal biopsy study of 186 adult patients found to have nephropathy and seen at the Security Forces Hospital, Riyadh, over a 5-year period (1989 to 1994) were reviewed. Primary glomerular disease accounted for more than three fourths of all patients (79%), and the most common histological lesion was focal segmental glomerulosclerosis (40.8%) associated with a high incidence of hypertension (86.7%), nephrotic syndrome (61.7%), hematuria (48.8%), and renal impairment (33.3%). Mesangioproliferative glomerulonephritis was the second most common lesion (21.1%), followed by membreous glomerulonephritis (13.6%), immunoglobulin A nephropathy (IgAN) (13.6%), membranoproliferative glomerulonephritis (9.5%), and minimal change disease (1.4%). Although not as common as in most other developed countries, IgAN is being increasingly recognized in Saudis. Lupus nephritis remained the commonest cause of secondary glomerulonephritis (48.5%), whereas amyloidosis was conspicuously absent. There is no evidence, at least in this series, that chronic infection such as hepatitis B virus infection has a major role in the development of glomerulonephritis.
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PMID:Pattern of glomerular disease in Saudi Arabia. 865 Dec 43

The complications of drug abuse encompass a spectrum of glomerular, interstitial, and vascular diseases. They comprise the heroin-associated nephropathy seen in African-American intravenous drug addicts, which, however, has given way in the 1990s to HIV-associated nephropathy. Infections with methicillin-resistant Staphylococcus aureus may cause acute glomerulonephritis by releasing bacterial superantigens. Hepatitis C has supplanted hepatitis B and may give rise to membranoproliferative glomerulonephritis and cryoglobulinemia. Addicts who inject drugs subcutaneously ('skin popping') may develop amyloidosis. Cocaine causes rhabdomyolysis, severe hypertension, occasionally renal failure in the absence of rhabdomyolysis, and may hasten progression to uremia in patients with underlying renal insufficiency. 'Ecstasy', an amphetamine-like recreational drug, has caused acute renal failure, electrolyte disturbances, and malignant hypertension. In Belgium and some other European countries, women taking Chinese herbs in a slimming regimen have developed a severe and irreversible interstitial fibrosis that is assuming epidemic proportions.
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PMID:Drugs of abuse and renal disease. 874 32

Our purpose in conducting this descriptive study was to assess the health-related concerns and experiences of a sample of employed perimenopausal women in Alexandria, Egypt. In addition, we explored their help-seeking behavior and their perception of symptoms. We interviewed two hundred working women ages 40-60 years, 42% of whom were nurses, using a semistructured interview form as well as Koos's list of symptoms. The commonly mentioned concerns, in order of frequency, were chronic headaches, chronic fatigue, transportation and phone communication problems, financial problems, job dissatisfaction, backaches, hypertension, kidney disease and gall bladder disease, gastritis/indigestion, menstrual disturbances, arthritis, AIDS, and hepatitis B. With respect to the problems experienced by the women in the past 6 months, there was a high self-reported prevalence of headaches, fatigue, transportation and communication problems, backaches, job dissatisfaction, dissatisfaction with health insurance, financial problems, menstrual disturbances, gastritis/indigestion, gall bladder disease, anxiety, disturbed sleep, and hypertension. Women attempted to manage their problems mainly by taking over-the-counter drugs and self-prescribing (75.5%), doing nothing or using traditional remedies (56.5%), and going to a doctor or health insurance office (40%). Symptoms perceived by the majority of the women as not needing medical attention included loss of appetite, persistent backache, bleeding gums, chronic fatigue, persistent headaches, and loss of weight. The influence of education and occupation on women's perceptions and practices is discussed.
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PMID:Health-related concerns and experiences of employed perimenopausal women in Alexandria, Egypt. 885 19


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