Migration and health. A study of Latin American refugees, their exile in Sweden and repatriation

OBJECTIVE

To analyse and elucidate the migration process in order to identify psycho-social themes which might act as stressors with influence on health.

DESIGN

Qualitative in-depth interviews with eleven strategically selected Latin American refugees.

SETTING

Latin American refugees living in Lund, a university town, and those who were repatriated to Santiago, Chile.

PARTICIPANTS

11 Latin Americans of whom 4 were repatriated to Chile.

RESULTS

The migration process was divided into four courses of events: cultural background and everyday life; organized violence; the exile; the repatriation. "Themes" such as cultural and working identity and high control were extracted from the dialogues as central buffering factors against microbiological or physicochemical disease agents harboured by the individual.

CONCLUSIONS

During the exile the cultural barrier, social degradation, guilt, social passivity, and ideological alienation cause a changed identity and low control which increase the vulnerability to psychological distress and physical disease.

Inadequate production of progesterone in women with systemic lupus erythematosus

We have performed a longitudinal study of the hypothalamic-pituitary-ovary axis and adrenal function during the menstrual cycle in 26 women with inactive or quiescent systemic lupus erythematosus (SLE) and in 21 healthy women as controls. In all women studied, the menstrual cycle was proved to be ovulatory by ultrasound imaging and detection of an appropriately elevated value of peak serum progesterone. Blood samples were obtained for hormonal assay on several days of the menstrual cycle studied. Patients with SLE had lower peak and day-7 postovulation serum progesterone concentrations which were both significantly lower than those found in controls, whereas no major differences were observed for any of the other hormones analysed. Although the significance of the inadequate production of progesterone we have observed in SLE women with inactive disease is not clear, our data seem to indicate that a relative deficiency of progesterone might be considered among the potential predisposing factors for development of SLE in women.

Ocular findings associated with congenital X-linked ichthyosis

Ichthyosis is frequently associated with ocular and extraocular signs. We present a case of X-linked ichthyosis associated with alterations of the anterior and posterior segments. A penetrating keratoplasty was done, and because of the patient's corneal alterations, we did a histopathologic study of the button by light and transmission electron microscopy.

Specific inactivation of the fourth complement component. II. In vitro studies

The fourth complement component (C4) inactivator obtained from nurse shark serum was used to inactivate C4 in fresh sera of various mammalian species. These hemolytically inactive sera, which contained the remaining eight complement components in unaltered form, were used (i) as a source of the first complement component (C1) for the generation of sensitized sheep erythrocytes (EA)-C1 and (ii) as a homologous reagent for the measurement of C4 activity with EA-C1 or EA in fresh, normal serum of guinea pigs, humans, dogs, and pigs.

Specific inactivation of the fourth complement component. I. In vivo studies

Intravascular injection of guinea pigs with the fourth complement component (C4) inactivator from shark serum resulted in severe serum C4 depletion that lasted for several hours. Active and direct passive Arthus reactions did not develop or were extremely mild in such C4 inactivator-treated animals as judged by gross and histological observation. In consideration of the specificity of the C4 inactivator, its independence of cofactors, and its failure to generate biologically active materials in the process of C4 inactivation, it is concluded that complement-dependent immune injury can be suppressed or avoided by interruption of the complement cascade at a single early step. The depression of the Arthus reaction beyond the time of C4 recovery prompted quantitative speculations concerning (i) the in vivo rate of C5a generation under conditions of limited C4 supply and (ii) the "saturation" of immune complexes. This view is supported by in vitro demonstration of functional inactivation or "saturation" of immune precipitates by repeated incubation with fresh guinea pig complement. It seems therefore conceivable that even temporary complement inactivation may have a profound beneficial effect on complement-dependent immune injuries.