RESUMO
Hepatocellular carcinoma is the third most common malignancy in Kenyan males occurring with a peak incidence at 40 years of age. A worldwide correlation has been noted between the incidence of hepatocellular carcinoma and prevalence of hepatitis B virus. Liver biopsies with histological diagnosis of hepatocellular carcinoma (HCC), cirrhosis and the normals were reviewed by the authors. They were then stained for hepatitis B surface antigen (HBsAg) and hepatitis e core antigen (HBcAg). Only 2.5% of normal livers were positive for HBsAg compared with 33% of HCC and 25% of cirrhosis respectively. Hepatitis core antigen was not demonstrated in normal liver biopsies but it was present in 11.5% of HCC and 14% of cirrhosis. Background cirrhosis was noted in 52% of biopsies showing HCC. It is clear that a causal association exists between hepatitis B virus (HBV) and both liver cirrhosis and hepatocellular carcinoma. Higher antigen markers, up to 80% have been reported in South East Asia and India. This difference may be due to the type of biopsy examined (needle biopsy vs open biopsy) but the possibility that other factors such as aflatoxin and non A/non B hepatitis viruses play a more significant role in the causation of liver disease in Kenya than has previously been assumed should be explored.
Assuntos
Carcinoma Hepatocelular/complicações , Hepatite B/complicações , Cirrose Hepática/complicações , Neoplasias Hepáticas/complicações , Adulto , Aflatoxinas/efeitos adversos , Sudeste Asiático/epidemiologia , Biópsia/métodos , Carcinoma Hepatocelular/epidemiologia , Carcinoma Hepatocelular/patologia , Estudos de Casos e Controles , Causalidade , Comorbidade , Feminino , Hepatite B/epidemiologia , Hepatite B/patologia , Antígenos do Núcleo do Vírus da Hepatite B/análise , Antígenos de Superfície da Hepatite B/análise , Hepatite E/complicações , Humanos , Incidência , Índia/epidemiologia , Quênia/epidemiologia , Cirrose Hepática/epidemiologia , Cirrose Hepática/patologia , Neoplasias Hepáticas/epidemiologia , Neoplasias Hepáticas/patologia , Masculino , Pessoa de Meia-Idade , PrevalênciaRESUMO
Small-intestinal function was studied in 10 patients with visceral leishmaniasis. Vitamin-A absorption was impaired in 7 and d-xylose in 1. In 5 of the 10 patients Leishmania were demonstrated in biopsy specimens of intestinal mucosa. Parasitised macrophages were present in villous tips and less commonly in the lamina propria and submucosa; a moderate inflammatory infiltrate was composed of lymphocytes and plasma cells. 2 patients had partial villous atrophy. There was no correlation between intensity of parasitisation and severity of malabsorption. After treatment with sodium stibogluconate there was a significant improvement in absorption of vitamin A and d-xylose, and biopsy specimens became normal. In 1 patient visceral leishmaniasis was thought to be the cause of chronic diarrhoea.
Assuntos
Jejuno/fisiopatologia , Leishmaniose Visceral/fisiopatologia , Adolescente , Adulto , Gluconato de Antimônio e Sódio/uso terapêutico , Biópsia , Criança , Feminino , Humanos , Absorção Intestinal , Mucosa Intestinal/patologia , Jejuno/patologia , Leishmaniose Visceral/tratamento farmacológico , Leishmaniose Visceral/patologia , Masculino , Pessoa de Meia-Idade , Vitamina A/metabolismo , Xilose/metabolismoAssuntos
Endoscopia , Gastroenteropatias/diagnóstico , Adolescente , Adulto , Idoso , Dispepsia/diagnóstico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Úlcera/diagnósticoRESUMO
A clinical, radiological, histological, and geographical study of carcinoma of the esophagus in Kenya is reported. It was found that this cancer is diagnosed more often in males than in females, with a ration of 8:1 (Kenya Cancer Registry). The most common age in males and females is 50 to 59 years. The regions of the esophagus most commonly involved are the middle and lower thirds, in almost equal proportions. An unexplained tendency for the tumor to be poorly differentiated towards the lower third is noted. In addition a review on the possible etiological factors is presented.
