RESUMO
We studied the incidence and mortality of stroke in northern Israel to determine possible reasons for the differences previously found in mortality from this condition between the sex and ethnic groups in Israel as a whole. We identified 1,149 cases of stroke during 1984. While the age-standardized incidence was higher in men, the case-fatality rate was twice as high in women. After controlling for ethnic origin, we found that incidence was higher only in men of Western origin, while the female rates were higher in women of Asian and North African extraction. The case-fatality rate was substantially higher in women in all ethnic groups. These differences, especially in relation to the case-fatality rate, have important implications for health services in relation to both possible preventive action and to management of the acute disease phase.
Assuntos
Transtornos Cerebrovasculares/epidemiologia , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Transtornos Cerebrovasculares/etnologia , Transtornos Cerebrovasculares/mortalidade , Feminino , Humanos , Israel , Masculino , Pessoa de Meia-Idade , Fatores SexuaisRESUMO
A case is described of accidental intrathecal administration of vincristine, with detailed clinical observations over a 17-day period. The clinical picture resembled that seen with toxicity from intravenously administered vincristine, but was rapidly progressive and resulted in death. The onset was characterised by opisthotonos, followed by ascending paralysis and finally bulbar and cerebral involvement. The specific changes in the brain at autopsy were masked by those due to prolonged artificial respiration prior to death. The accidental drug administration occurred owing to procedural errors, which can be avoided by strict attention to rules.
Assuntos
Doenças do Sistema Nervoso Central/induzido quimicamente , Vincristina/intoxicação , Encéfalo/patologia , Pré-Escolar , Feminino , Cefaleia/induzido quimicamente , Humanos , Injeções Espinhais , Leucemia Linfoide/terapia , Transtornos dos Movimentos/induzido quimicamente , Paralisia Respiratória/induzido quimicamenteRESUMO
The case of a 47-year-old white female patient has been described with malignant melanoma that started as a node on her right ankle twelve years ago and regressed spontaneously. During the last two years of her life, dissemination of the melanoma appeared in the form of subcutaneous nodes, which regressed spontaneously in successive crops. In the course of her disease there was evidence of distant metastases to the brain. Spontaneous regression seems to have been enhanced by immunotherapy, when most of the metastases had regressed, including those in the brain.
Assuntos
Melanoma/terapia , Regressão Neoplásica Espontânea , Vacina BCG/uso terapêutico , Neoplasias Encefálicas , Feminino , Humanos , Melanoma/patologia , Pessoa de Meia-Idade , Metástase Neoplásica , Neoplasias Cutâneas/patologia , Neoplasias Cutâneas/terapiaRESUMO
The "sudden death" of a 23-year-old Ashkenazy Jew, suffering from "familial dysautonomia" was probably caused by an arrhythmia accompanying a myocardial infarction. Such a report is unique. Diffuse coronary atherosclerosis and direct myocardial "catecholamine cardiomyopathy" seem responsible for the myocardial damage. However, diversion of the endocardial blood flow toward dpicardium and a "coronary steal" phenomenon, both the result of a sudden catecholamine discharge, could aggravate the ischemic injury.
