National survey of the prevalence and risk factors of glaucoma in St. Lucia, West Indies. Part I. Prevalence findings.

Although blacks appear to be at higher risk for blindness from glaucoma, there is little information available on the epidemiology of this disease in this population. Using a cluster sampling technique with systematic allocation of clusters, the authors conducted a national survey of black individuals 30 years of age and older, in St. Lucia. A total of 1679 individuals underwent a screening examination that included visual acuity, intraocular pressure (IOP) measurement, and cup/disc (C/D) evaluation. Every third person had a screening field on the Humphrey field analyzer. Individuals with either elevated IOP, abnormal C/D ratio, or an abnormal screening visual field were referred for a definitive examination and threshold visual fields. A total of 520 people were referred. Identified by stringent criteria for the diagnosis of glaucoma, which required reliable threshold visual fields abnormal by the mirror image method, 147 individuals had glaucoma for a prevalence of 8.8% in the 30 years of age and older population.

Prednisone when used as treatment for rejection correlates with poor outcome.

Since January 1974, 195 of 202 (95%) renal transplants have been performed on blacks at the Howard University Hospital Transplant Center. Hypertension is the most common cause of end-stage renal disease (ESRD) at this center (57%). The immunosuppressive regimens utilized were divided into four eras. The first era (1974-1980) consisted of the prophylactic administration of prednisone, Imuran (AZA), and Minnesota antilymphocyte globulin (MAG) with high prednisone dosage used to treat rejection. One-year, two-year, and five-year patient survival rates were 59% 54%, and 41%, respectively. Graft survival rates for the same period were 53%, 47%, and 36%. In the second era (1980-1983), the same immunoprophylaxis was used but only MAG was used to reverse rejection. One-year and two-year patient survival rates were 90% and 84%. Graft survival rates for the same period were 72% and 64%. When era 1 is compared with era 2, statistically significant improvement in patient survival is evident (P less than 0.005). Graft survival rates are statistically significant for one-year graft survival (P less than 0.05). In the third era (1983-1986), cyclosporine was the principal immunosuppressive agent used along with prednisone. Rejection in this era was treated by adjusting the cyclosporine dose to keep the level between 100 ng to 150 ng per mL and in addition to high prednisone. One-year patient survival and graft survival rates were 83% and 55%, respectively. The fourth era began April 1986 and was initiated because of previous bad experiences with high doses of prednisone to treat rejection in era 1.(ABSTRACT TRUNCATED AT 250 WORDS)

Effects of toluene exposure on the spontaneous cortical activity in rats.

Effects of toluene on the electroencephalogram (EEG) and its power spectra were measured during a 2-hr exposure in a dynamic inhalational chamber in rats. Rats were exposed to one of six graded concentrations (110.6, 162.5, 432, 676, 1558, 2730 ppm) of toluene on different days. It was found that the duration of waking (W) was increased with a decrease in duration of rapid eye movement (REM) sleep even at 110.6 ppm. Duration of nonrapid eye movement (NREM) sleep was decreased with an increase of W and a decrease of REM sleep at 162.5 ppm. Dose-related effects were noted in higher concentrations. The power of delta frequency band was increased with a decrease of theta frequency band power at hr 1 of exposure to 676 ppm during REM sleep recorded from the visual cortex. The power of theta frequency band was also decreased at hr 2 of exposure at 432 ppm. During W and NREM sleep power spectra were not changed significantly. Results indicate that the changes of EEG are a sensitive measure of the effects of toluene on the central nervous system (CNS).