ABSTRACT
The goal of "Health for All" has not changed since it was orginally promoted in 1977, but the strategy for reaching this goal has been revised dramatically. Primary health care, through preventive measures, simple lifestyle improvements, human resource development, and health education, is now promoted as a means to attain "Health for All" by the year 2000. The authors report the results of a health care project in Kenya's western province.
ABSTRACT
We studied the distribution of HLA-D--related (DRw) antigens in 40 patients with juvenile diabetes mellitus (JDM) and 79 matched controls. We found that DRw2 was significantly decreased in the JDM group, suggesting a protective effect of the antigen and that the decrease observed in B7 was secondary. HLA-DRw3 and HLA-DRw4 were increased in the diabetic group, and, as with B8/B15, these two antigen predisposed to the disease additively. The susceptibility for JDM was found to be more strongly related to HLA-DRw3 that to B8. On the other hand, B15 rather than DRw4 showed the stronger association with JDM. Moreover, we found that this second diabetogenic gene is associated primarily with B15 and only secondarily with Cw3, which is in linkage disequilibrium with B15. This study further emphasizes the immunogenetic heterogeneity of JDM.
Subject(s)
Diabetes Mellitus, Type 1/immunology , HLA Antigens/analysis , Diabetes Mellitus, Type 1/genetics , Genetic Linkage , HLA Antigens/genetics , Humans , Reference ValuesSubject(s)
Adrenal Gland Neoplasms/complications , Virilism/etiology , 17-Ketosteroids/blood , Dexamethasone , Female , Humans , Infant , Virilism/drug therapySubject(s)
Education, Nursing, Continuing , Pediatric Nursing/education , Child, Hospitalized , Humans , KenyaSubject(s)
Adrenal Hyperplasia, Congenital/blood , Carbon Isotopes , Hydrocortisone/blood , Protein Binding , Tritium , Adolescent , Adult , Anemia, Hypochromic/blood , Asthma/blood , Child , Child, Preschool , Clinical Trials as Topic , Craniocerebral Trauma/blood , Dwarfism/blood , Epilepsy, Absence/blood , Exchange Transfusion, Whole Blood , Female , Humans , Infant , Infant, Newborn , Liver Cirrhosis/blood , Male , Methods , Rickets/blood , Transcortin , Umbilical Cord/blood supplySubject(s)
Abnormalities, Drug-Induced , Sweetening Agents/adverse effects , Female , Humans , Infant, Newborn , PregnancySubject(s)
Growth Hormone/blood , Growth , Insulin , Arginine/pharmacology , Child , Deficiency Diseases/blood , Endocrine System Diseases/blood , Fasting , Growth Disorders/blood , Humans , Hypoglycemia/chemically induced , Hypothyroidism/blood , Insulin/pharmacology , Radioimmunoassay , Stimulation, Chemical , Turner Syndrome/blood , Vasopressins/pharmacologySubject(s)
Cyclophosphamide/therapeutic use , Nephrotic Syndrome/drug therapy , Alopecia/chemically induced , Biopsy , Blood Cell Count , Child , Child, Preschool , Cyclophosphamide/adverse effects , Female , Humans , Male , Nephrotic Syndrome/diagnosis , Prednisone/therapeutic use , Proteinuria/drug therapy , Steroids/therapeutic useSubject(s)
Down Syndrome , Hypothyroidism , Puberty, Precocious , Autoimmune Diseases , Child , Female , Humans , Ovarian CystsSubject(s)
Edema/complications , Femoral Vein , Nephrotic Syndrome/complications , Punctures/adverse effects , Thrombosis/etiology , Female , Humans , Infant , MaleABSTRACT
Toxic epidermal necrolysis is a condition that may occur in all age groups and resembles skin scalding. It presents as a generalized, markedly tender erythema and rapidly progresses to bullous desquamation of the superficial epidermal layers and systemic toxicity.The condition was first described in 1956. A review of the recent literature suggests that the incidence of the syndrome is increasing or it is being recognized more frequently. Its etiology has not been established, but it may represent unusual hypersensitivity to drug, bacterial, viral or immunization factors. The mortality rate in reported cases is approximately 30% and young children and debilitated adults are at greatest risk.Recently, two children with this condition were successfully treated at the Montreal Children's Hospital, using protective isolation, intensive nursing care, intravenous antibiotics and hydrocortisone hemisuccinate. Early use of corticosteroids may inhibit the progression of epidermal necrolysis and improve the prognosis.
