[The so-called nutritional neuropathies in Senegal]

Neurological and electrophysiological parameters as outcome measurements for peripheral arterial occlusive disease

BACKGROUND

Ischemic monomelic neuropathy is not an uncommon complication of peripheral arterial occlusive disease (PAOD). However, many investigators have used revascularization, limb salvage, and complete wound healing rates instead of neurologic and electrophysiological parameters as outcome measurements of PAOD. The aim of the study is to investigate the neurologic and electrophysiological parameters associated with PAOD and to find the ideal tools for assessing PAOD.

METHODS

A total of 38 PAOD patients (68.5 ± 8.1 years old, male:female = 32:6) with a total of 76 lower limbs were enrolled in the study. Primary outcomes were neurological symptoms scores (NSSs) and neurological impairment scores (NISs) for the lower extremities. Secondary outcomes were taken from nerve conduction studies (NCSs) and included the following: sensory nerve action potential (SNAP) amplitudes of the sural, superficial peroneal, and medial plantar nerves and the compound muscle action potential (CMAP) amplitudes of the posterior tibial and common peroneal nerves.

RESULTS

Female patients with old age, hypertension, low body weights, low body mass indices (BMIs), decreased ankle-brachial indices (ABIs), and poorer Fontaine classifications exhibited worse NSSs and NISs indices. Patients with old age, diabetes mellitus, hypertension, histories of social alcohol consumption, low body weights, low BMIs, and poorer Fontaine classifications exhibited decreased SNAP and CMAP amplitudes in the sensory and motor NCSs. Decreased ABI was associated with decreased SNAP amplitudes in the sensory NCSs.

CONCLUSIONS

Neurologic and electrophysiological parameters can be good tools for the assessment of PAOD. NSSs and NISs are particularly good candidates for outcome measures of PAOD.

Why are so many food plants cyanogenic?

A disproportionately large number of the most important human food plants is cyanogenic. The accumulated research of numerous people working in several different disciplines now allows a tenable explanation for this observation. Cyanogenesis by plants is not only a surprisingly effective chemical defence against casual herbivores, but it is also easily overcome by careful pre-ingestion food processing, this latter skill being almost exclusive to humans. Moreover, humans have the physiological ability to detoxify cyanide satisfactorily, given an adequate protein diet. It appears that early in the domestication of crop plants the cyanogenic species would have been relatively free of pests and competitive herbivores, as well as having good nutritional qualities, and thus ideal candidates for cultivation by the first farmers.

HTLV-1 and tropical spastic paraparesis. 1. Clinical features, pathology and epidemiology

The clinical profile of tropical spastic paraparesis (TSP), described in scattered tropical and subtropical territories over the past 30 years, has been more clearly defined since the discovery of its direct association with human T lymphotropic virus type 1 (HTLV-1). A chronic disease of adults, commoner in women, it usually presents as a progressive spastic paraparesis with sphincter disturbance, sometimes with backache and lower limb sensory disorder. Most cases are chair-bound within 10 years. Histology reveals a chronic lymphocytic meningomyelopathy, predominantly in the spinal cord, together with long tract demyelination and hyalinoid thickening of the media and adventitia of small blood vessels. Geographical areas of high prevalence of TSP are known in the Caribbean, South America, South Africa, southern Japan, the Seychelles and probably in India, and it is sparsely endemic elsewhere. The virus appears to exist within lymphocytes for long periods. Vertical transmission occurs postnatally, and sexual and transfusion infection are also recognized, but much remains to be clarified regarding its pathogenesis and epidemiology.

Ear disease in a group general practice. A review of world communities

This five-year survey of ear disease in a London population of 10,000 is considered to be a valid description of the incidence of ear disease presenting in a general practice community, since all patients were examined and diagnosed either by the author or by the district hospital Ear, Nose and Throat Department. The results agreed generally with the findings of the National Morbidity Surveys, but a more comprehensive range of ear disease is described. There is general agreement, between this and other surveys in the United Kingdom and the United States, that the most common ear diseases presenting in general practice populations are acute suppurative otitis media and impacted wax, followed by presbyacusis, secretory otitis media, chronic suppurative otitis media, vertigo and traumatic deafness due to noise, blast or head injury. However, the incidence of these and other diseases differs greatly in many countries throughout the world and some aetiological factors are suggested. The evidence in this paper points to the continuing need for the investigation of the incidence and aetiology of some ear diseases in many parts of the world.

Non-traumatic paraplegia in northern Tanzania

A retrospective study of all 100 cases of non-traumatic (medical) paraplegia admitted to a large hospital in northern Tanzania over an eight-year period was undertaken; 15 of the patients were examined. Patients' ages ranged from 2 to 80 years (mean 31), and 67 were male. Seventy-one lived under 85 km (53 miles) from the hospital, and the average period from onset of symptoms of paraplegia to admission to the referral hospital was ten weeks. Tuberculosis was the most frequent cause of paraplegia (54%), followed by neoplasia (13%) and schistosomiasis, (6%). No cases of nutritional myelopathy were diagnosed. In 12 cases a diagnosis could not be established. The average period spent in hospital was 11 weeks, and 35 patients made a good recovery and were ambulant at discharge.