Pachydermoperiostosis in a 13 year-old boy presenting as an acromegaly-like syndrome

A thirteen year-old boy with progressive enlargement of the joints and distal extremities, clubbing, coarse facial features and hyperhidrosis was investigated. His endocrine profile was normal. Radiological studies demonstrated bilateral symmetrical periosteal new bone formation with acroosteolysis. After extensive investigation to exclude systemic and endocrine causes, a diagnosis of pachydermoperiostosis was made. Awareness of this condition helps to differentiate this syndrome from pulmonary osteoarthropathy and acromegaly.

Effect of experimental lead toxicity on cardiovascular function in calves

The effect of lead was studied on cardiovascular function in calves given oral doses of 5 mg lead acetate/kg body weight daily till the appearance of clinical signs of toxicity. Arterial blood pressure and electrocardiogram were recorded before (day 0) and on days 30 and 60 of lead administration. There was a significant increase in arterial blood pressure in lead-intoxicated calves on day 30 (124.8 +/- 1.0 mm Hg) with the peak values noted on day 60 (150.8 +/- 4.3 mm Hg). ECG in lead 11 showed marked increases in P wave duration and amplitude and duration of P-R interval. Duration of Q-T interval was decreased and T wave was inverted after 30 days of continuous lead exposure. Histopathological examination showed degeneration of cardiac musculature, mononuclear cell infiltration and swelling of Purkinjee fibers in calves sacrificed after the onset of irreversible signs of lead toxicity.

An evaluation of cardiac function in malnourished children by non-invasive methods

Forty-six malnourished children between 3-48 mo with varying grades of malnutrition (PEM) were evaluated for left ventricular function by echocardiography. None of these children had any pre-existing cardiac disease, chronic illness or significant anemia. Children with Grades III and IV PEM had significantly smaller cardiac chamber size and ventricular wall thickness as compared to normally nourished children. Cardiac output as well as other indices of left ventricular function (percentage fractional shortening, mean rate of circumferential fibre shortening and ejection fraction) were also significantly decreased in severe PEM. The atrophic PEM heart does appear to show left ventricular dysfunction in moderately severe malnutrition.