Human streptocerciasis has been found in the Accra district (Ghana), in southern Ivory Coast, and in Upper Volta in migrants. During a survey in the forest part of the Volta Region (Eastern Ghana), 119 cases were discovered in ten villages between 6 degrees 50' N., and 7 degrees 50' N., indicating local transmission of the parasite. The parasitic load has always been low. In the area, the presence of T. streptocerca cannot modify the results of a direct diagnosis of onchocerciasis based on the emergence of microfilariae from skin snips in distilled water or normal saline solution. The parasite has not been found in surveys undertaken north of the 8 degrees N., neither in Ghana, nor in Togo or Ivory Coast. The presence of T. streptocerca in villages located on the Togolese border confirm that this filaria exists in Togo too, although no mention is made in the literature.

Animals↗

PubMedDate not supplied

[On a case of Zinsser-Engman-Cole syndrome].

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Child↗

PubMedDate not supplied

[An attempt to normalize the methodology of clinico parasitologic surveys of onchocerciasis in West-Africa (author's transl)].

In order to be able to compare in time and space the results of onchocerciasis surveys in West Africa, the authors suggest to standardize the methodology of these surveys. The following points are defined : criteria to choose the villages, selection of population specimen, registration of socio-demographic data, clinical examination, assessment of visual acuity, parasitological examination founded on two quantitative bloodless cutaneous biopsies, definition of epidemiologic indices, adjustement of these indices to a standard population, synthesis of results by age-group and sex on the one hand by the presentation of frequency distribution of cutaneous microfilarial densities, on the other hand by calculation of geometric means of these densities.

Africa, Western↗

PubMedDate not supplied

[Epidemiological, clinical and biological characters of savanna and forest onchocerciasis in west Africa.--Critical review and new data (author's tranls)].

Recent findings in Ivory Coast provide an opportunity to review possible factors influencing epidemiological differencies between forest and savanna patterns of onchocerciasis. Environmental factors, host factors, entomological and parasitological factors are taken into consideration. This provides evidence of two strains of parasite, associated with differences in pathogenicity, in biochemical structure, and with different species of the vector complex S. damnosum. The distribution of the severe pattern of the disease covers the area where the savanna vectors S. damnosum s.s. and S. sirbanum prevail, and extends as far as the southern limit of their range. In this respect, the terminology now in use appears to be justified by the geographical extent of the different patterns of the disease.

Africa, Western↗

PubMedDate not supplied

[Parasitological diagnosis of onchocerciasis. A critical review of present methods (author's transl)].

The different methods used for the parasitological diagnosis of onchocerciasis are compared to test their reliability, sensitivity and practicability under field conditions in the Sudan-Savanna area. Two skin snips taken from both iliac crests with a sclerocorneal punch give the best results during large scale field surveys. The incubation of biopsies in normal saline solution is the most sensitive technique and the results may be further improved by filtration on millipore filter-paper and collagenase digestion. However, counting microfilariae emerged after 30 minutes in distilled water is the easiest method and gives a reasonably good reliability for comparison of the results in space and time. The lack of sensitivity can be compensated for by incubation of the negative specimen during 24 hours in saline solution.

Biopsy↗

PubMedDate not supplied

[The different types of human onchocerciasis in west Africa (author's transl)].

This study reports the clinical, ophtalmological and parasitological examination for onchocerciasis in 4 882 people, living in 23 villages located in 8 different areas of west Africa. The disease is hyperendemic in the whole sample and no major differences occur when comparing the indices of Onchocerca volvulus infection. However, all the complications (eye, skin and lymph node lesions) are less common in the four forest clusters than in to the four savanna clusters. The disease seems to be relatively well tolerated in areas where transmission of Onchocerca volvulus is carried out by Simulium species other than S. damnosum s.s. and S. sirbanum. The striking epidemiological differences of onchocerciasis is probably associated with several vector-parasite complexes, which may indicate the existence of different strains of O. volvulus.

Africa, Western↗

PubMedDate not supplied

Synovium and epithelia: barriers between self and non-self?

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Animals↗

PubMedDate not supplied

[Air pouch model in the rat for evaluating articular phlogogenic capacity of ceramics].

We used the joint air pouch model in rats to study the inflammation induced by three types of calcium phosphate biomaterial: 10 mg of synthetic hydroxyapatite (HA), a sintered ceramic made of hydrooxyapatite and phosphate tricalcium (BCP), and calcium phosphate in the form of a fibre extracted from a vitro-ceramic material (VPC). Histological examination was made after 48 hours. The most intense inflammatory reaction was observed with BCP: the thickness of the superficial stratified layer of synoviocyte-like cells doubled, interstitial fibrosis occurred and neovascularization with polymorphous inflammatory infiltration was seen. HA led to the same, though less intense, type of reaction. Discrete, variable, localized inflammation was seen with VPC and was limited to the areas where the calcium phosphate fibres rolled. Despite good bone tissue tolerance, intraarticularly, these biomaterials can lead to synovial inflammation. This phlogogenic action varies greatly depending on the microcrystals injected. The factors which might affect the joint inflammatory reaction, including the size and surface of the microcrystals, the crystallinity, pH and physical treatments (heat, compaction) should be further evaluated with precision.

Animals↗

PubMedDate not supplied

Antiperinuclear factor of the IgA isotype in active rheumatoid arthritis.

OBJECTIVE: For rheumatoid arthritis (RA), antiperinuclear factor (APF) is as efficient a marker as rheumatoid factor (RF). However, the prevalence and significance of APF of the IgA isotype in active RA, as well as its correlation with RF-IgA, have not been determined. Our goal was to obtain information on these points. METHODS: APF-IgA were screened in 80 sera from patients with active RA, prospectively and consecutively selected over an 8-month period. Sera from 22 patients with Sjögren's syndrome and 50 with lupus were also studied retrospectively for APF-IgG and IgA. RESULTS: APF-IgA were found at a 1:10 dilution or above in 31 RA sera (39%), which were all positive for APF-IgG as well at higher titers. In the 64 sera positive for APF no correlations were found between APF-IgA and IgA or immune complexes-IgA, latex, the Rose-Waaler test and RF-IgA. Conversely, an association of APF-IgA was found with both APF-IgG (p < 0.0001) and anti-stratum corneum of rat esophagus (ASC)-IgG (p < 0.0001). APF-IgA, though correlated with the presence of secondary sicca syndrome in RA (p = 0.0023), was not more frequent (5/22) in primary Sjögren's sera. CONCLUSIONS: RF-IgA and APF-IgA are not correlated. Despite its localization in the mucosae, the target antigen for APF elicit fewer IgA antibodies in RA than does the RF target.

Adult↗

PubMedDate not supplied

Pancytopenia and severe cytopenia induced by low-dose methotrexate. Eight case-reports and a review of one hundred cases from the literature (with twenty-four deaths)

Severe adverse effects of low-dose methotrexate (less than 20 mg per week) are believed to be rare. We report eight cases of severe tricytopenia or pancytopenia seen in two medical departments of the same hospital in patients receiving low-dose methotrexate. Three patients had been under methotrexate for less than one month. Of the six patients with joint disease, five had rheumatoid arthritis and one psoriatic arthritis. A review of the literature found 92 previously reported cases of severe tricytopenia or pancytopenia induced by low-dose methotrexate. Of the total of 100 cases, 24 were fatal and 25 occurred within one month of treatment initiation. Potential risk factors were identifiable retrospectively in at least 50% of cases but were not all predictable or present at treatment initiation. In 30% of cases, no explanation for the hematologic complication was found, and in an additional 20% missing data precluded definite conclusions. The role of the risk factors incriminated in the literature is discussed. Although infrequent, cytopenia is a severe complication of methotrexate therapy that warrants a number of precautions, including periodic creatinine clearance and serum albumin determinations. Furthermore, the weekly dosing schedule should be printed on methotrexate boxes.

Adult↗

PubMedDate not supplied

Osteitis condensans of the clavicle: does fibrocartilage play a role? A report of two cases with spontaneous clinical and roentgenographic resolution.

Two cases of osteitis condensans of the medial clavicle with an unusual course toward spontaneous resolution of clinical and roentgenographic manifestations are reported. The relevant literature is reviewed. A pathogenic hypothesis for condensing osteitis of the clavicle, ilium, and pubis is suggested. At all these sites, the sclerosis occurs in bone overlaid by fibrocartilage. In contrast, joint aspects spared by the sclerosis are covered with hyaline cartilage. We report data documenting this fact at the sternoclavicular joint.

Adult↗

PubMedDate not supplied

Impact of using stored cells for immunofluorescence detection of antiperinuclear factor on sensitivity of the method for the diagnosis of rheumatoid arthritis.

Antiperinuclear factor is as sensitive as (0.75 to 0.80) and more specific than (0.94 to 0.97) rheumatoid factor for the diagnosis of rheumatoid arthritis. Although three groups found similar performance characteristics using the assay technique described by Youinou, lower sensitivities have also been reported. To clarify these discrepancies, we investigated each parameter of the assay, including storage time of the oral mucosa cells used as the substrate. Even when the slides were frozen, titers fell by one dilution within the first week and by two dilutions within two weeks after sampling. This decline seemed related to storage rather than to freezing: slides kept at 4 degrees C yielded an apparent three-dilution fall in titers after one week and were unevaluable after longer storage times. Successive freeze-thaw cycles did not influence results when the assay was done on the day the cells were sampled and fixed. Titers in sera stored at -25 degrees C remained unchanged or decreased by no more than one dilution during the first 18 months but declined thereafter. These data emphasize the need for performing the assay on the same day or, at the latest, on the day after fixation of the slides. That this precaution was taken should be specified in the "Methods" section of articles on antiperinuclear factor detection.

Antibodies, Antinuclear↗

PubMedDate not supplied

[From disease to health: the individual, society, environment and culture].

With the onset of science-based medicine in the mid-19th century, environmental factors were almost totally discarded as health determinants. This was a complete rupture with the medical thinking which had prevailed since the time of Hippocrates. Yet, for the vast majority of mankind, harmony with environmental reality remains the most important determinant of good or ill health. This scission explains to a great extent the differences between traditional and Western medicine, which are based on entirely different concepts and on distinct paradigms. Environment as a health determinant--in its broadest definition to include both physical and social environments--is again being considered of importance as a result of better understanding of causality factors, and because of the influence of disciplines such as ecology and epidemiology. Here we show that human societies can develop different methods of adjusting to their environments, some of which would increase the risks of disease and others which can be considered as resistance factors of a social nature. Societies and individuals alike are not equal in relation to health risks.

Cultural Characteristics↗