A questionnaire study of Jamaican patients with homozygous sickle cell (SS) disease indicated a 42% prevalence of priapism, with a median age at onset of 21 years. Two predominantly different patterns of priapism were recorded: short "stuttering" episodes lasting less than three hours, with normal consequent sexual function, and severe prolonged attacks (generally more than 24 hours) commonly followed by impotence. Stuttering episodes were frequently a prodrome to a major attack. Over one fourth of those who had suffered priapism had some degree of impotence. Hematologic analysis indicated that priapism was significantly associated with low hemoglobin F levels and high platelet counts. Patients with severe attacks of priapism had lower hemoglobin F levels and reticulocyte count, and a higher mean corpuscular volume, than patients with only stuttering episodes. Priapism and impotence contribute to the morbidity of SS disease more frequently than previously recognized.

Adolescent↗

PubMed1979

Our dirty hospitals.

Explore the source record for details and available documents.

Cross Infection↗

PubMed1979

Immune deposit nephritis and single-component cryoglobulinemia associated with chronic lymphocytic leukemia. Evidence for a role of circulating IgG-anti-IgG immune complexes in the pathogenesis of the renal lesion.

2 patients developed the nephrotic syndrome several years after diagnoses of chronic lymphocytic leukemia. In both cases light microscopy showed membranoproliferative glomerulonephritis. Electron microscopy and immunofluorescent staining revealed electron-dense deposits and deposition of immunoglobulins and C3. Both patients had single-component IgG cryoglobulinemia. The eluted glomerular-bound protein contained IgG only. IgG in patients' sera, cryoglobulins, and kidney eluate had kappa light chains only. Immune complexes were detected in the sera and in the cryoglobulins by the Clq binding test. Immunoadsorption studies revealed anti-IgG antibodies in the patients' sera, cryoglobulin, and kidney eluate. Direct immunofluorescent studies using the patients' sera, cryoglobulins, and kidney eluate on frozen sections of patients' kidneys were positive, providing additional evidence for the immune complex nature of the glomerulonephritis. The immunohistochemical studies of our patients are suggestive of the presence of circulating IgG-anti-IgG immune complexes and their possible involvement in the pathogenesis of the glomerulonephritis and the nephrotic syndrome in these 2 cases.

Antigen-Antibody Complex↗

PubMed1979

Results of the national surveillance for Guillain-Barré syndrome.

The preliminary results of the national surveillance for Guillain-Barré syndrome(GBS) are reported. In the first 6 months of 1978, 327 cases of GBS were reported to the Center for Disease Control (CDC). A statistically significant difference was observed between sex-specific attack rates, and a direct correlation also was observed between advancing age and increasing risk of GBS.

Age Factors↗

PubMed1978

Clinical experience with Wyeth Laboratories HDCS rabies vaccine at the Center for Disease Control.

Explore the source record for details and available documents.

Adult↗

PubMedDate not supplied

Alternative lipids to usual omega 6 PUFAS: gamma-linolenic acid, alpha-linolenic acid, stearidonic acid, EPA, etc.

The intravenous administration of parenteral fat emulsions is widely used in total parenteral nutrition (TPN) to supply essential fatty acids and concentrated energy in a relatively small volume of isotonic solution. They contain very high amounts of linoleic acid and usually about 8% of alpha-linolenic acid calculated in the fat phase (10 or 20% of the total emulsion). Most of the time one emulsion is given as the sole source of fat, giving direct venous entry to a fatty acid composition substantially different from that encountered in a normal diet. Since the latter greatly influences the fatty acid composition of phospholipids which are critical determinants of membrane structural properties influencing a variety of membrane functions (Fig. 1) (enzyme activity, membrane transport, receptor function) and functional precursors of intracellular and intercellular mediators (diacylglycerols, prostaglandins, leukotrienes, hydroxy fatty acids), do we provide the right fatty acid at the right place and the right time for efficient cell cell interaction? In other words, given the three roles of fatty acids--energetic, structural, functional--are we using the best strategy to avoid imbalances between the three roles?

Animals↗

PubMedDate not supplied

Neuropathology of the brain and spinal cord in human West Nile virus infection.

OBJECTIVE: To describe the histopathology of the brain and spinal cord in human West Nile virus (WNV) infection. MATERIALS AND METHODS: Single case report, including premortem clinical and laboratory findings, and autopsy. RESULTS: An 83-year-old female presented with acute confusion, high fevers, dysarthria and generalized subjective weakness, with decreased deep tendon reflexes and weakness on physical examination. Electromyography showed evidence of a sensorimotor axonal polyneuropathy of the right-sided extremities. She became ventilator-dependent and died after a 2-week ICU stay, following withdrawal of life support. WNV infection was confirmed premortem by detection of IgM antibodies from serum and CSF and postmortem by RT-PCR from brain tissue. Examination of the brain parenchyma showed scattered microglial aggregates accompanied by perivascular chronic inflammation. The leptomeninges showed focal lymphocytic infiltrates. Examination of the spinal cord showed lymphocytic infiltrates in nerve roots and within the cord proper, with focal microglial nodules and neuronophagia in the ventral horns. Special stains were negative for a demyelinating process. General autopsy revealed only emphysema and atelectasis. CONCLUSIONS: The findings in this case suggest direct viral infection of the spinal cord and nerve roots as the mechanism of the flaccid paralysis often observed in patients infected with WNV. Findings are reviewed in comparison with other reports of neuropathologic findings in human WNV infection.

Aged↗