Eosinophilic meningitis due to Angiostrongylus cantonensis.

Angiostrongylus cantonensis is a nematode parasite that inhabits the pulmonary arteries and heart of rodents. It is one of the causative agents of fatal eosinophilic meningoencephalitis in man. We present five cases of eosinophilic meningitis presumably due to infection with Angiostrongylus cantonensis . All the five patients gave history of ingestion of monitor lizard within ten days of onset of symptoms.

Large pericardial effusion: the differentiation of tuberculous from chronic idiopathic effusion.

AIMS: Tuberculosis is a common cause of pericardial effusion in many parts of the world often presenting with tamponade. Its recognition is important but not always easy. This study was to prospectively compare the features of tuberculous with chronic idiopathic pericardial effusion. METHODOLOGY: We studied 47 patients with large pericardial effusions or tamponade. All had pericardiocentesis and chest CT studies. Twenty-eight had tuberculous and 19 viral or idiopathic effusion. Pericardial biopsy was done in 26/28 and tuberculin skin test in 23/28 with tuberculosis and all received specific treatment. RESULTS: Patients with idiopathic effusion were older with thinner pericardium. Tamponade was frequent in both groups (64%). Fever (p<0.001) and pericardial rub (p<0.002) were more with tuberculosis. The skin test measured 17 +/- 3.2 mm. On echocardiography pericardial deposits and strands in the pericardial space were more with tuberculosis. The fluid was similar in quantity and quality. Only and all 28 with tuberculosis had enlarged mediastinal lymph glands on CT measuring 19.5 +/- 8.3 mm. On follow up of 16 +/- 10.2 months glands disappeared in 81% and regressed in 19%. Lymphadenopathy was not seen in any patient with viral/idiopathic pericarditis. All patients in both groups were well at follow up. CONCLUSIONS: Tamponade is frequent with large tuberculous and chronic idiopathic effusions. The quantity and quality of the effusion were similar. Fever and pericardial rub were more frequent with tuberculosis as also deposits and strands on echocardiography and patients had a strongly positive skin test. Mediastinal lymph gland enlargement on chest CT was found only and in all with tuberculous effusion.

Sexual and physical growth in Kerala boys.

One hundred and fifty males in the age group 10-17 years were studied longitudinally for 2 years to determine their physical and pubertal development. The velocity of linear growth, weight gain and pubertal growth velocities were determined. The relation between peak height velocity and genital stages and between genital stages and pubic hair was determined. It is concluded from this study that 86 percent of normal males reach peak height velocity while in G4 and only 5% will not have achieved peak height velocity by the time G5 is reached.

Primary pulmonary hypertension

Os autores apresentam resultados de uma serie de 91 pacientes com hipertensao pulmonar primaria observada em area tropical.Havia predominancia de doentes do sexo masculino, ao contrario do constatado em regioes nao tropicais. Praticamente, todos os pacientes apresentavam dispneia de esforco. Alteracoes eletrocardiograficas com aumento de voltagem de onda R em V1 tinham forte correlacao positiva com o nivel de pressao arterial pulmonar. Alteracoes da conducao de estimulo eletrico eram pouco frequentes. Era destacada em 90% dos casos o aumento de tamanho das arterias pulmonares, apreciado sob o aspecto radiologico.Pressao arterial pulmonar sistolica superior a 90 mmHg foi registrada em cerca de 70% dos doentes, sendo que em cerca de 49% ela superava o nivel sistemico. De um total de 58 pacientes seguidos, 34 morreram dentro de um periodo medio de 20 meses.Nao se podem determinar as razoes para o maior grau de severidade observado nesta serie, sendo possivel a participacao de um fator etnico