HLA class II distribution in Congolese with hyperthyroidism: preliminary results.

OBJECTIVE: Incidence of the hyperthyroidism is continuously increasing, whereas our knowledge concerning the facilitating or etiologic factors of this increase are still partial. To evaluate some of these unknown factors, we started this preliminary study, in order to identify HLA genes in hyperthyroid Congolese, and to determine their susceptibilty in the appearance and development of hyperthyroidism at the Hospital Clinic of Kinshasa. MATERIALS AND METHODS: Nine Congolese women with hyperthyroidism, and thirteen healthy controls (3 women and 10 men) were examined and compared for HLA-DR and HLA-DQ genes analyses, from August 2000 to August 2002. DRB1 and DQB1 alleles were identified, using the Polymerase Chain Reaction (PCR) and immobilized sequence-specific oligonucleotide (SSO HLA-DRB1 and DQB1 test) probes assays. RESULTS: In the group with hyperthyroidism, three alleles (HLA-DR1, HLA-DR2, HLA-DR3) and an allele group (HLA-DR11,13,14) were found for DRB1 locus, while only one allele (HLA-DQB1*0602) was identified for DQB1 locus; allele group HLA-DR11,13,14 was the most frequent (allele frequency=0.50), followed by HLA-DR3 allele (allele frequency=0.222); 6 haplotypes were observed, with predominance of haplotype DR3/DR11,13,14 (genotype frequency=0.333), followed by haplotype DR11,13,14/DR11,13,14-DQB1*0602 (genotype frequency=0.222). In the group of healthy controls, three alleles (HLA-DR2, HLA-DR3, HLA-DR4) and an allele group (HLA-DR11,13,14) were identified for DRB1; HLA-DR2 allele was predominant (allele frequency=0.615), followed by allele group HLA-DR11,13,14 (allele frequency=0.231); a statistic significant difference was observed between the frequencies of DR2 allele and allele group DR11,13,14 in the healthy controls compared to those of hyperthyroid patients (p=0.02); 6 haplotypes were also detected in this group, the most frequent haplotype being HLA-DR2/DR2-DQB1*0602 (genotype frequency=0.540 versus 0.333 in the hyperthyroid group) (p=0.048). HLA-DQB1*0602 was dominant in the healthy controls group (allele frequency=0.890), versus HLA-DQB1*0302 (allele frequency=0.110). CONCLUSIONS: HLA-DR2, HLA-DQB1*0602 and DR2/DR2-DQB1*0.602 would play a protective role against the hyperthyroidism, while DR3 allele, allele group DR11,13,14 and haplotype HLA-DR3/DR11,13,14 would predispose to this disease or to Graves' exophtalmopathy. A large and profound study is needed to confirm our preliminary results.

Calcium entry blockade or beta-blockade in long-term management of hypertension in blacks.

The long-term efficacy of nitrendipine and acebutolol was assessed during a 40-week double-blind randomized trial in 60 hypertensive blacks. Nitrendipine (mean dose 32 mg/day) and acebutolol (414 mg/day) were administered in monotherapy in increasing dosage and mefruside was added in patients not controlled by monotherapy. The recumbent and standing blood pressures were reduced (P less than 0.01 or less) during monotherapy with nitrendipine and acebutolol, but the magnitude of blood pressure reduction was greater (P less than 0.05 or less) during nitrendipine dosing. Pulse rate decreased (P less than 0.01) during acebutolol whereas nitrendipine induced a nonsignificant increase. Both treatments induced no changes in serum electrolytes, creatinine, urea, uric acid, lipids, plasma renin activity, and plasma and urinary aldosterone. The overall incidence of side effects was similar with both treatments but four patients discontinued nitrendipine because of headache. The addition of mefruside to nitrendipine or acebutolol produced a further fall of blood pressure in patients not controlled with monotherapy. Monotherapy with nitrendipine or acebutolol offers an effective, safe first-line antihypertensive treatment in blacks entered in this study; with the described dosages and therapeutic schedule, nitrendipine was somewhat more effective than acebutolol.

Epidemiological study of blood pressure and hypertension in a sample of urban Bantu of Zaïre.

Blood pressure and anthropometric characteristics were studied in a 10% random sample (n = 675) of Bantu, aged greater than or equal to 10 years and living in an urban quarter of Kinshasa, Zaïre. The prevalence and awareness of hypertension as well as the therapeutic situation in adult participants aged greater than or equal to 20 years were also evaluated. Systolic and diastolic blood pressure tended to be higher in males than in females. In adults greater than or equal to 20 years, systolic and diastolic pressure were positively and independently correlated with both age and body weight. In youths (10-19 years old), systolic pressure was associated with age and body weight, while in girls diastolic pressure was related to age only. Using WHO criteria, the overall prevalence of definite hypertension in adults was 9.9% (13.6% in males and 6.8% in females). The prevalence of borderline hypertension was 7% (8.4% in males and 5.6% in females). Of the participants studied with definite and borderline hypertension (n = 49), 69% were not aware of their blood pressure elevation; 31% were aware, but only 13% were treated and 3% were controlled. It is concluded that hypertension is not uncommon in these urban Bantu and that programmes for screening and educating the population should be developed and implemented.

Relative potency of a beta-blocking and a calcium entry blocking agent as antihypertensive drugs in black patients.

The short-term efficacy of nitrendipine (N) as a first stage antihypertensive drug in black patients has been assessed and compared with acebutolol (A) in a double-blind study. Forty patients were randomized and after a 4 week run-in period on placebo, the active treatment was administered for 6 weeks starting with 20 mg N or 200 mg A once daily. The dose was increased up to 60 mg N or 600 mg A as needed. Nitrendipine appeared to be more efficient than acebutolol in reducing blood pressure and the N-induced fall in blood pressure was achieved after 2 weeks. After 2 and 6 weeks on N, the recumbent blood pressure was decreased by 13% and 12% for the systolic and by 14% and 11% for the diastolic pressure. The concurrent decreases in the A group averaged 4% and 5% for the systolic and 5% and 10% for the diastolic pressure after 2 and 6 weeks. Pulse rate and plasma renin activity in the N group were slightly increased and body weight was decreased at the end of the active treatment period.

[Automated recording of precision profiles for the radioimmunological determination of T4 using a pocket calculator of the HP-41 CV type]. / Obtention automatisée des profils de précision des dosages radioimmunologiques de T4 à l'aide d'une calculatrice de poche de type HP-41 CV.

Precision profiles as useful tool for assurance of assay quality in 10 independent T4RIAs have been automatically obtained using a small programmable pocket calculator HP-41 CV. For each T4 assay batch, the within-assay coefficient of variation varied from 7 to 11% in the hormone concentration range of 2 to 20 micrograms/dl. The difference in coefficient of variation for all the 10 successive assay batches of T4, never exceeded 1% in the same hormone concentrations regions. All the above findings demonstrate that the precision profile can be used as a powerful tool for assessing the assay quality and consistency of overall random error between successive assay batches.

Fever origins in the tropics.

The causes of fever were attempted to identify in a prospective study on 300 adult in- and outpatients with fever at Kinshasa Teaching Hospital, Zaire. Infection was by far the primary cause of fever (87%). Tuberculosis occurred in 15% of the inpatients. Malaria was the most frequent febrile disease: one fever in two was malaria. Connective tissue diseases and neoplasms were rare.