Cyclosporine-related posterior reversible encephalopathy syndrome after heart transplantation: should we withdraw or reduce cyclosporine?: case reports.

Cyclosporine (CsA) related encephalopathy has not been well documented after heart transplantation. We report 2 cases of posterior reversible encephalopathy syndrome (PRES). The first case was a 68-year-old woman who underwent heart transplantation and received immunosuppression with mycophenolate mofetil, prednisone, and CsA. On day 14, she developed arterial hypertension, headache, visual disturbances, and generalized seizures. Fluid-attenuated inversion recovery magnetic resonance imaging (MRI) of the brain showed diffuse and bilateral high signals in the frontal posterior and the occipital areas. The second case was a 19-year-old man with a heart transplant receiving immunosuppression with prednisone and CsA. On day 44, he developed acute headache and generalized seizures. T2-weighted MRI of the brain showed diffuse high signals in the cerebellum, right lenticular and occipital areas. In both cases blood CsA concentration was therapeutic. Both cases recovered but in the first case neurologic findings were reversed only after CsA withdrawal.

Epidemiology of burns in Kuwait.

A prospective study of 765 burns cases treated as inpatients at the Burns Unit, IBN Sina Hospital and the Plastic Surgery Unit, Mubarak Al Kabeer Hospital from January 1984 to December 1986 is presented. Hot water scalds were the commonest type of injury. Most of the burns occurred at home but coinciding with standard working hours. Children up to 5 years old were commonly affected, but most of the fatal burns were among adults. The overall mortality rate was 7.2 per cent with a male to female ratio of 1.1:1. Our survival rate from burn injuries is improving due to advances in treatment, but prevention remains the best cure. We consider our epidemiological survey to be important as the basis for a preventive programme in Kuwait's extremely heterogeneous society.