Assuntos
Cegueira/prevenção & controle , Tracoma/prevenção & controle , Adulto , Cegueira/etiologia , Criança , Promoção da Saúde , Humanos , HigieneRESUMO
The causes of bilateral blindness (best visual acuity less than 3/60) in 1371 people in the Central African Republic seen between 1985 and 1989 who attended eye clinics in 10 out of the 16 prefectures across the country are given. The main causes of bilateral blindness were cataract (51%), glaucoma (12.7%), and onchocerciasis (8.1%). In 710 patients with unilateral blindness the main causes were cataract (38%), glaucoma (10%), iritis (7.5%), and trauma (6.3%). Bilateral blindness in children was rarely seen. The causes of visual impairment (vision between 6/18 and 3/60) in 424 patients were cataract, including aphakia (38%), maculopathy (14%), and onchocerciasis (7%).
Assuntos
Cegueira/etiologia , Catarata/complicações , Glaucoma/complicações , Oncocercose Ocular/complicações , Adolescente , Adulto , República Centro-Africana , Criança , Pré-Escolar , Traumatismos Oculares/complicações , Feminino , Humanos , Lactente , Recém-Nascido , Irite/complicações , Degeneração Macular/complicações , Masculino , Transtornos da Visão/etiologiaRESUMO
Eighteen nodules from patients with rheumatoid disease were studied histologically and immunohistochemically. A continuum of microscopic changes was observed with varying degrees of fibrinoid necrosis, mononuclear cell infiltration and healing by fibrous scarring. In two cases there was focal evidence of arteritis. Fibrin was plentiful in the necrotic areas of nodules. Small amounts of immunoglobulin were identified in plasma cells and as irregular extracellular deposits in and around areas of necrosis. In a single small vein abnormal IgG was detected. Mononuclear cells surrounding areas of necrosis stained strongly with antisera to ferritin and a cytoplasmic macrophage antigen, stained variably with muramidase (lysozyme) and negatively with alpha-1 antitrypsin antibodies. Perls' stain for ferric iron was almost entirely negative and ultrastructural x-ray microanalysis indicated that the cytoplasm of these cells were entirely free of iron. These findings confirm the chronic inflammatory nature of rheumatoid nodules but provide no support for the view that they originate in areas of vasculitis. A relative lack of cytoplasmic antiprotease along with a strong expression of ferritin appears to be a characteristic feature of macrophages in rheumatoid tissue.
Assuntos
Nódulo Reumatoide/metabolismo , Adulto , Idoso , Proteínas Sanguíneas/metabolismo , Microanálise por Sonda Eletrônica , Feminino , Ferritinas/análise , Fibrina/análise , Histocitoquímica , Humanos , Imunoquímica , Imunoglobulinas/metabolismo , Ferro/metabolismo , Masculino , Microscopia Eletrônica , Pessoa de Meia-Idade , Monócitos/metabolismo , Muramidase/análise , Nódulo Reumatoide/patologiaAssuntos
Auditoria Médica/métodos , Saúde da População Rural , Benin , Infecção Hospitalar/prevenção & controle , Hidratação/métodos , Gastroenterite/terapia , Registros Hospitalares/normas , Hospitais Gerais , Humanos , Registros Médicos Orientados a Problemas/normas , Cooperação do Paciente , Infecção da Ferida Cirúrgica/prevenção & controleRESUMO
Seventeen patients with early rheumatoid synovitis underwent synovial biopsy to assess the interrelationship between both ferritin (the intracellular iron storage protein) and Perls' positive iron (ferric iron in loose combination with protein), on the activity and course of rheumatoid disease. The amount of ferritin was associated to a significant degree with the activity of the disease at the time of biopsy, but showed no relation to the way the disease progressed over the following year. In contrast, the amount of Perls' iron bore no relation to the activity of the disease at biopsy, but its presence was associated with persistent disease. It is argued that this association is direct, that ferritin production may fail in a population of synovial macrophages, and that Perls' ferric iron may either be reduced to the ferrous form and promote the formation of toxic free radical species, or stimulate collagenase and prostaglandin release from synovial macrophages.
Assuntos
Artrite Reumatoide/metabolismo , Compostos Férricos/análise , Ferritinas/análise , Ferro/análise , Membrana Sinovial/análise , Biópsia , Compostos Férricos/farmacologia , Ferritinas/farmacologia , Humanos , Coloração e Rotulagem , Membrana Sinovial/patologia , Sinovite/metabolismo , Sinovite/patologiaRESUMO
A 10-year review of procedures undertaken in the operating theatres of a rural mission hospital in West Africa showed a total of 13819 procedures. Of these, one-third were general surgical, one-third were minor procedures, and one-third were obstetric, gynaecological or orthopaedic. This review is a record of the surgical procedures undertaken in a "typical" rural hospital in the Third World. It also indicates that a doctor contemplating a period of overseas service in such a hospital should have basic training in general surgery, obstetrics, gynaecology and trauma.
Assuntos
Cirurgia Geral/normas , Missões Religiosas , África Ocidental , Hospitais , Humanos , Medicina , Saúde da População Rural , Especialização , Procedimentos Cirúrgicos Operatórios/estatística & dados numéricosRESUMO
Analysis of answers to a questionnaire on the use of computers in general practice showed that 19 per cent of patients in two practices in Staffordshire would be worried if their general practitioner used a computer to store medical records. Twenty-seven per cent of patients would be unwilling to speak frankly about personal matters to their general practitioner if he or she used a computer and 7 per cent said that they would change to another doctor. Fifteen per cent stated that their general practitioner already had information about them that they would not want to be included in a computerized record of their medical history.
