ABSTRACT
Plasma and plasma substitutes are used in the treatment of various conditions such as haemorrhage and shock. This article examines the role of crystalloids, artificial colloids, human plasma, human albumin, and plasma protein fraction, in the treatment of such patients, with particular reference to peripheral health facilities in developing countries.It is concluded that 0.9% saline, together with 5-6% dextrose, is of particular importance in this situation since it is easy to produce locally, is stable at high temperatures, and has a low cost/benefit ratio. The second priority is to ensure the availability of a limited quantity of one or more colloid plasma substitutes. In the field of plasma, fresh frozen or fresh liquid plasma is most useful for the treatment of various haemostatic derangements and follow-up treatment of severe burns, since it contains the widest spectrum of therapeutically useful components and can be produced locally with an acceptable degree of difficulty.The treatment of severe diarrhoea with special alkaline electrolyte solutions and oral rehydration solutions is also outlined.
Subject(s)
Developing Countries , Plasma Substitutes , Plasma , Burns/therapy , Colloids , Costs and Cost Analysis , Dextrans/therapeutic use , Diarrhea/therapy , Gelatin/therapeutic use , Hemorrhage/therapy , Humans , Hydroxyethyl Starch Derivatives/therapeutic useABSTRACT
The 5407 autopsies performed during an 8-year period formed the basis of the study; 2444 were infants and children, while 2963 were adults. The histogram of the spleen weight distribution has a fairly smooth contour with a positive skew towards the heavier spleens. The mean adult spleen weight was 271 g, and this was heavier than that of subjects in temperate climates, but comparable to the mean spleen weight of other localities in a holoendemic belt of malaria. The most frequent diagnosis at autopsy were diseases of the respiratory system, infective and parasitic diseases of which malaria is the most common, diseases of the digestive system and neoplasms. In those subjects with spleens weighing more than 500 g, neoplasms, diseases of the haematopoietic system and infectious and parasitic diseases were the most prominent. The role of environmental stimuli in a tropical environment in the hyperplasia of the reticuloendothelial system is discussed. The findings would prove useful in the differential diagnosis of large spleens found in this locality.
Subject(s)
Spleen/pathology , Splenic Diseases/pathology , Adolescent , Adult , Aged , Child , Child, Preschool , Female , Hodgkin Disease/pathology , Humans , Infant , Malaria/pathology , Male , Middle Aged , Nigeria , Organ SizeSubject(s)
Blood Banks/organization & administration , Blood Transfusion , Developing Countries , ABO Blood-Group System , Africa , Blood Donors , Blood Grouping and Crossmatching , Blood Transfusion/instrumentation , Communicable Diseases/diagnosis , Erythroblastosis, Fetal/epidemiology , Erythroblastosis, Fetal/therapy , Female , Hematologic Diseases/diagnosis , Humans , Infant, Newborn , Isoantibodies/analysis , Plasma , Plasma Substitutes , Pregnancy , Rh-Hr Blood-Group System , Rural Population , Tropical ClimateABSTRACT
Twenty-two patients with lymphocytosis and sometimes accompanied by splenomegaly selected from our difficult diagnostic cases over the past two years are presented. The clinical and laboratory features pointed to one of the following: chronic lymphatic leukaemia without lymphadenopathy, lymphosarcoma or other lymphoreticular tumour, tropical splenomegaly syndrome with a lymphatic leukaemoid reaction. The precise diagnosis was usually made by haemotological laboratory tests - viz. (a) Lymphocytes transformation test (LTT) (b) Serum/Plasma IgM estimation. It was found that: (1) There was markedly raised IgM in the responders i.e. patients with Tropical Splenomegaly Syndrome (TSS) whose spleens regressed following treatment with antimalarials, contrasting the normal levels of IgM in the non-responders to antimalarial therapy. (2) The PHA - Lymphocytes Transformation in the TSS was normal while that of Chronic Lymphatic Leukaemia (CLL) was abnormally low. These combined tests (LTT & IgM) are recommended as investigations for leukaemoid reactions involving lymphocytes.
Subject(s)
Immunoglobulin M/analysis , Leukemia, Lymphoid/diagnosis , Lymphocyte Activation , Lymphoma/diagnosis , Splenomegaly/diagnosis , Diagnosis, Differential , Female , Humans , Leukemia, Lymphoid/immunology , Lymphoma/immunology , Male , Splenomegaly/immunology , SyndromeABSTRACT
The results of Anti (D) immunoglobulin (RhoGAM) therapy in 25 Rh-negative women after delivery of Rh-positive babies are presented. None of the patients studied showed evidence of Rh-isoimmunization while two of 51 unprotected patients subsequently had antibodies detected in their serum. The incidence of Rh-negative patients is low in this environment. Because of the potential risk of isoimmunization, RhoGAM prophylaxis is advocated.
Subject(s)
Erythroblastosis, Fetal/prevention & control , Rh-Hr Blood-Group System , Adult , Antibodies , Female , Humans , PregnancyABSTRACT
After the remission of symptoms and reduction in spleen size while on proguanil therapy four patients with the tropical splenomegaly syndrome defaulted from treatment. The withdrawal of proguanil caused a recrudescence of original symptoms, splenomegaly, and a return of the initially raised serum IgM. Complete return to normal values was again effected with proguanil therapy.The role of the spleen in the tropical splenomegaly syndrome in the production of the raised serum IgM is discussed. These patients should be educated as to the nature of their disease and the importance of continued medical treatment.
Subject(s)
Proguanil/therapeutic use , Splenomegaly/drug therapy , Adult , Anthropometry , Female , Humans , Hypergammaglobulinemia/complications , Immunoglobulin A/analysis , Immunoglobulin G/analysis , Immunoglobulin M/analysis , Liver/pathology , Lymphocyte Activation , Lymphocytosis , Malaria/drug therapy , Middle Aged , Prognosis , Recurrence , Spleen/pathology , Splenomegaly/complications , Splenomegaly/diagnosis , Splenomegaly/pathology , SyndromeSubject(s)
Arboviruses/pathogenicity , Hippocampus/pathology , Anemia/etiology , Animals , Blood Cell Count , Brain/microbiology , Heart/microbiology , Hematocrit , Hyperplasia/etiology , Inclusion Bodies, Viral , Injections, Intraperitoneal , Injections, Spinal , Kidney/microbiology , Liver/microbiology , Lung/microbiology , Lymphocytes , Mice , Neutrophils , Nigeria , Spleen/microbiology , Spleen/pathologyABSTRACT
A survey for neutralizing antibodies to Congo virus was carried out in Nigeria. Of a total sample population of 250, comprising 141 males and 109 females, 9 males and 15 females had antibody levels >/= 1.5 log neutralization index. In the age group 0-10 years 4 of 84 males and 14 of 79 females had antibody levels >/= 1.5 log neutralization index. There was no evidence of nonspecific antiviral activity in the sera tested.
