Nomogram for kanamycin dosage.
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Biomedical subjects
Publications and source records attributed to S B Lucas.
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1. Sodium amylobarbitone (3.54 mg/kg) was given by intravenous injection to seven healthy men and nine healthy women who were not receiving other drugs. Serum amylobarbitone and urine hydroxyamylobarbitone concentrations were measured by gas-liquid chromatography. There was no significant difference between the groups either in the serum amylobarbitone concentration/time curves or in the urinary excretion of hydroxyamylobarbitone.2. The serum amylobarbitone concentration decayed over 48 h as a double exponential function of time; the first exponential component had a mean half-time of 0.6 h (males 0.56 +/- 0.06 h, females 0.62 +/- 0.08 h, +/- S.E.) and the second exponential component had a mean half time of 21 h (males 22.7 +/- 1.6 h, females 20.0 +/- 1.0 h, +/- S.E.).3. The urinary excretion of hydroxyamylobarbitone over 48 h accounted for 34% of the dose (males 33.8 +/- 3.2%, females 35.2 +/- 3.0%, +/- S.E.). One male and two female subjects excreted hydroxyamylobarbitone partly as a conjugate which was readily hydrolysed in acid.4. An elimination constant (k(el)) derived from the serum concentration/time curve by the application of a two compartment model was approximately proportional to beta (h(-1)), the rate constant of the second exponential component. There was a positive correlation (r=0.78, P<0.001) between beta and the mean rate of urinary excretion of hydroxyamylobarbitone during the 24 to 48 h period.
OBJECTIVES: To review the epidemiologic, clinical, and pathological characteristics and the public health implications of human immunodeficiency virus (HIV)-associated tuberculosis in sub-Saharan Africa. DATA SOURCES: Published medical literature (English and French) and proceedings of international and African conferences on the acquired immunodeficiency syndrome (AIDS). STUDY SELECTION: Selection by the authors of articles most pertinent to HIV infection and tuberculosis in Africa and internationally. DATA EXTRACTION: Direct reporting of quantitative data (eg, HIV seroprevalence levels) and of qualitative descriptions and conclusions from selected literature. DATA SYNTHESIS: High rates (20% to 67%) of HIV infection in patients with tuberculosis have been reported from East, West, Central, and Southern Africa. An increase in tuberculosis cases has been reported at the same time as the emergence of AIDS in several countries. Autopsies in Abidjan, Ivory Coast (Côte d'Ivoire), have shown tuberculosis as the most frequent opportunistic infection in patients dying of AIDS. Clinical differences in patients with tuberculosis who were HIV-positive and HIV-negative are reviewed, the most important being a greatly increased mortality rate in HIV-associated disease. Access to HIV testing is required for firm diagnosis, for clinical care and counseling, and for public health surveillance. CONCLUSIONS: The epidemiology of tuberculosis has been profoundly influenced by the epidemic of HIV infection in sub-Saharan Africa. Greatly increased human and material resources are required for this neglected problem in international health.
Epigastric pain is a common complaint throughout Africa, mostly in the form of non-ulcer dyspepsia. It has recently been suggested that Helicobacter (= Campylobacter) pylori, a bacterium that colonizes the gastric mucosa and causes type B gastritis, may be the cause of this epigastric pain. This paper reports the endoscopic, histological and bacteriological findings in 57 patients presenting with epigastric pain to the University of Maiduguri teaching hospital during one year, together with a review of the African literature. Of 57 patients, 49 had non-ulcer dyspepsia, 7 peptic ulceration and 1 carcinoma of the stomach. 93% of the patients had histological gastritis, and of these 87% were colonized with H. pylori. The bacterium was cultured from 13 patients. This high prevalence of gastritis and H. pylori has been found throughout Africa. The figures support a causative role for H. pylori in histological gastritis. At present the evidence in support of a causative role in non-ulcer dyspepsia is not strong enough to be able to recommend the routine use of anti-H. pylori therapy in patients with epigastric pain.
Non-ulcer dyspepsia is common in Africa, yet there are few data on its possible cause. In this study 40 patients with strictly defined non-ulcer dyspepsia were matched with 40 asymptomatic volunteers. Both groups were questioned concerning their intake of alcohol, cola nut, non-steroidal anti-inflammatory drugs, and smoking. They then underwent upper gastrointestinal endoscopy with mucosal biopsy of the gastric mucosa: these biopsies were examined for gastritis and Helicobacter pylori. Ingestion of cola nut was the only statistically significant difference between the two groups. A high prevalence of gastritis and H. pylori infection was found in both groups, suggesting that these factors are not important in the aetiology of non-ulcer dyspepsia in northern Nigeria.
Leishmaniasis is rarely encountered in southern Africa. Two cases were diagnosed by histopathology in northern Malawi in one year. One was an 18 months old child with negative human immunodeficiency virus 1 (HIV-1) serology and widespread skin lesions; the other an HIV-1 positive adult with 2 skin lesions. The Leishmania species responsible could not be identified, but the infection may be more prevalent in this region than previously thought.
Gastric Helicobacter pylori infection is common throughout the tropics yet does not always correlate with the incidence of serious upper gastrointestinal pathology. In a consecutive series of 213 patients examined by gastroscopy for dyspepsia in northern Nigeria, 176 (92%) of 193 with acceptable biopsies had gastritis. Only 16 (8%) had a histologically normal gastric mucosa. H. pylori was present in 161 of 192 patients (84%); 31/41 (75%) with chronic gastritis and 130/135 (96%) with active gastritis. Serious pathology, ulcer and gastric cancer were present in only 29 (14%).
Mycobacterium ulcerans disease starts as a painless, subcutaneous nodule, excision of which prevents the development of large Buruli ulcers. An outreach programme was set up in Ghana to promote nodule recognition and excision. The programme was cost-effective and shifted the pattern of disease presentation. This could from a model for other countries.
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