The significance and trend of hypertension related deaths in urban Sierra Leonean Africans

This study tried to show the contributory role of ions (cations and anions) to great contrast in the goitre prevalence between Bassa and Jos Local Government Areas, both of Plateau State, Nigeria. In pursuance of this, the concentration of cations (Ca++, Fe++, K+, Mg++, Na+, & Zn++) and anions (C1-, F, I-, & NO-3) in soil and drinking water in the two LGAs were determined and their results compared and correlated with the goitre prevalence of these areas. It was observed that both Bassa and Jos LGAs have very low but similar amounts of iodide ions in their soils. Besides, Bassa LGA contained more ions in both soil and drinking water than Jos LGA. In conclusion, the results appear to suggest that the higher ion contents of both soil and drinking water in Bassa LGA exacerbated the coexisting low iodide condition of the LGA, thus resulting in the higher goitre prevalence found in the LGA.     

Clonidine therapy for comorbid attention deficit hyperactivity disorder and conduct disorder: preliminary findings in a children's inpatient unit

This retrospective study examined the clinical course of 18 prepubertal boys (aged 6 to 12) who had dual diagnoses of attention deficit hyperactivity disorder and conduct disorder and who received clonidine on an inpatient basis after failed trials of conventional drug therapy, consisting predominantly of psychostimulants. The effects of clonidine were assessed during inpatient treatment and after discharge at intervals of 1 to 2 months. Eleven (61%) of the children had marked improvement as measured by clinical impression. Transient sedation lasting 2 to 3 days occurred after initial administration or dosage increase; otherwise, clonidine was well tolerated. Our findings suggest that clonidine may prove to be an alternative treatment of comorbid attention deficit hyperactivity disorder and conduct disorder.     

Low total serum cholesterol and intracerebral hemorrhagic stroke: is the association confined to elderly men? The Kaiser Permanente Medical Care Program

BACKGROUND AND PURPOSE: Epidemiological studies indicate a higher incidence of intracerebral (but not subarachnoid) hemorrhagic stroke among persons with low total serum cholesterol levels. This report further examines the prospective relationship of total serum cholesterol with subsequent intracerebral hemorrhage in a large, well-defined population. METHODS: The cohort included 61756 enrollees in a health plan from the San Francisco-Oakland metropolitan area (46% men, 63% white), aged 40 to 89 years and free of cardiovascular disease at baseline. Sixteen-year incidence of combined nonfatal and fatal intracerebral hemorrhagic stroke (International Classification of Diseases [ICD], 8th revision, code 431, or ICD, 9th revision, codes 431 and 432) was investigated in relation to serum cholesterol measured in multiphasic health checkups made in 1977 through 1985. Intracerebral hemorrhagic events were ascertained using hospital discharge records and as underlying cause of death by the California Mortality Linkage Information System. RESULTS: From 1978 through 1993 (average of 10.7 years), there were 386 events (201 in men, 29% fatal; 185 in women, 42% fatal). By multivariate proportional hazards life-table regression analysis, serum cholesterol level below the sex-specific 10th percentile (< 4.62 mmol/L [178 mg/dL] in men), compared with higher cholesterol level, was associated with a significantly increased risk of intracerebral hemorrhage in men aged 65 years or older (relative risk, 2.7; 95% confidence interval, 1.4 to 5.0). An excess risk was also observed among elderly women at the lowest cholesterol range, but a chance finding could not be ruled out. No relationship was seen among men or women aged 40 to 64, and no statistical interaction of low serum cholesterol with hypertension was found in either sex. CONCLUSIONS: In these data, the association between low serum cholesterol level and intracerebral hemorrhage was confined to elderly men.     

Giardiasis. Issues in diagnosis and management

Giardia lamblia is a frequent cause of diarrhea throughout the United States and the world. Advances in basic biology indicate that different strains of Giardia exist, that mammals can be infected with G. lamblia-type organisms, and that secretory IgA is important to host protection. Although water remains the most common mode of transmission of Giardia, there has been an increase in the number of person-to-person cases, especially related to children in day care, as well as an increase in food-borne cases. New antigen detection assays have improved the ability to diagnose Giardia in the stool and make it unlikely that duodenal sampling will be necessary. Metronidazole has become the drug of choice for most cases of giardiasis because of its efficacy, favorable tolerance, and availability. For pregnant women who require treatment, a non-absorbable aminoglycoside, paromomycin, may be tried first and metronidazole used if initial treatment fails.     

One-year prevalence of psychiatric disorder in Ontarians 15 to 64 years of age

OBJECTIVE: To present the one-year prevalence of 14 psychiatric disorders in a community sample of Ontarians aged 15 to 64 years. METHOD: Data on psychiatric disorders were collected on 9953 respondents using the University of Michigan revision of the Composite International Diagnostic Interview (UM-CIDI). DSM-III-R criteria were used to define the psychiatric disorders. RESULTS: Almost 1 in 5 Ontarians (18.6%) had one or more of the disorders measured in the survey. Among 15-to 24-year-olds, 1 in 4 was affected. The distribution of individual disorders varied by sex and age. CONCLUSION: Because of the immense burden of suffering associated with psychiatric disorders, clinical and research efforts in this area should receive high priority within the health budget.