Ethical issues in ageing.

Population ageing, in both the developed and developing world, has put increasing demands on health resources; this has brought to the fore various ethical issues related to ageing. This paper examines moral issues that confront people as they grow old as well as those who are involved with them. The concepts of autonomy, dignity, justice and intergenerational solidarity are explored.

Leishmaniasis in Malta and the Mediterranean basin.

Leishmaniasis is a public-health problem in most countries bordering the Mediterranean littoral. In Malta, where the disease has been recognized for many years, Phlebotomus perniciosus is the established vector and dogs act as reservoir hosts. Visceral leishmaniasis (VL) was the only form of the disease recorded in Malta until the early 1980s, when cutaneous leishmaniasis (CL) was recognized.

The prognostic value of blood glucose in diabetic patients with acute myocardial infarction.

The aim of the study was to investigate prospectively the prognostic value of blood glucose on admission in diabetic and non-diabetic patients with an acute myocardial infarction. Three hundred and thirty-three diabetic and 565 non-diabetic patients were admitted with acute myocardial infarction during the study period of 3.5 years.

Absence of circadian variation in the onset of acute myocardial infarction in diabetic subjects.

Objectives: To investigate the circadian pattern of acute myocardial infarction in non-insulin-dependent diabetic patients and to compare it with that of controls.

Background: Previous studies have shown that there is a circadian variation in the incidence of acute myocardial infarction, but there are few data on diabetic subjects.

Methods: A hospital based prospective case-control study.

A computerized health screening and follow-up system in diabetes mellitus.

A computerized population health problem targeting program for diabetes mellitus and other common non-communicable disease was tested at St Luke's Hospital, Malta. The program utilizes a patient questionnaire by dialogue with a computer lasting about 20 min. The system evaluates and targets health problems that are followed up through the database.

Factors that influence outcome in diabetic subjects with myocardial infarction.

Objective: To compare the outcome of acute myocardial infarction in NIDDM patients and nondiabetic control subjects. The relation of glycemic control, duration of diabetes, and major diabetic complications to the outcome of acute myocardial infarction in diabetic subjects was investigated.

Research Design And Methods: This was a prospective, hospital-based, case-control study.

Glucose metabolism and beta receptor function in atopic asthmatics.

Severe asthma and diabetes have been reported not to co-exist in the same patient. Various studies have attributed this to the possible association of asthma with hyperinsulinism, increased responsiveness to insulin or to beta-blockade. Previous studies have not addressed all these possible mechanisms in the same patient.

Lipoproteins and apolipoproteins in young nonobese Arab women with NIDDM treated with insulin.

The effects of insulin on the lipid values of nonobese non-insulin-dependent diabetic (NIDDM) Arab women requiring insulin was investigated to find whether these patients have the same coronary artery risk factor related to lipid levels. In this study, 55 NIDDM women on insulin therapy (mean age 28 +/- 8.1 yr and duration of disease 5 +/- 1.

Cardiovascular and pulmonary complications of epidemic typhus.

A case of typhus fever associated with cardiac and pulmonary complications is reported. The patient was a 24-year-old Egyptian female with characteristic clinical presentation of rickettsial infection, though no rash was present throughout the course of the disease. We could not find a report of such complications in the English medical literature.

Plasma dopamine beta-hydroxylase: rapid diagnostic test for recurrent hereditary polyserositis.

The diagnosis of recurrent hereditary polyserositis (RHP; also known as familial Mediterranean fever) remains one of exclusion since there has been no specific diagnostic laboratory test. A previous study suggested that the disorder is related to abnormal catecholamine metabolism. Plasma dopamine beta-hydroxylase (DBH) activity was assayed spectrophotometrically in 91 RHP patients and 162 controls.

Arachnia propionica pneumonia in hairy cell leukaemia.

Pulmonary infection caused by Arachnia propionica in a patient with hairy cell leukaemia is described. The organism is highly sensitive to penicillin but the patient succumbed to his illness despite treatment with penicillin and various other antibiotics. Various types of opportunist infections are common in patients with hairy cell leukaemia but we believe this to be the first report of infection by Arachnia propionica in such a patient.

Scleroedema diabeticorum: a minor but often unrecognized complication of diabetes mellitus.

The association of specific dermatological complications with diabetes mellitus is well recognized. Of 100 hospital-based patients with diabetes mellitus (age 48 years +/- 2SE), 14% had scleroedema diabeticorum. The affected subjects had a higher prevalence of retinopathy (p less than 0.

Excess body fat distribution and glucose homeostasis in obese Arab women.

The relationship of body fat distribution to glucose intolerance and non-insulin-dependent diabetes mellitus in Arab women was studied in 102 obese non-diabetic and 40 obese women with diabetes. The obese women underwent a glucose tolerance test. Linear regression analysis revealed a significant correlation between the waist/hip ratio and the plasma glucose concentration at 120 min.

Human brucellosis in Kuwait: a prospective study of 400 cases.

The clinical pattern of 400 cases of brucellosis in Kuwait is presented. The disease was acute in 77 per cent, sub-acute in 12.5 per cent and chronic in 10.

Some demographic and therapeutic features of diabetes mellitus in Kuwait.

A survey of all consecutive visits to all diabetic clinics in Kuwait over a period of 4 months yielded 1,266 male and 1,838 female Kuwaiti patients. Their age structure analysis revealed percent frequencies of 1.25, 15.

Familial Mediterranean fever (recurrent hereditary polyserositis) in Arabs--a study of 175 patients and review of the literature.

Recurrent hereditary polyserositis (RHP) or familial Mediterranean fever (FMF) is a chronic inherited illness of obscure aetiology. The disease is characterised by paroxysmal attacks of fever, peritonitis, pleuritis or arthritis, and predominantly affects Sephardic Jews, Arabs, Turks and Armenians. In this study, we report our 11-year experience of 175 Arab patients with this disease.

A case of ocular toxicity to ethambutol--an idiosyncratic reaction?

Optic neuritis, a well known adverse effect of ethambutol, is related to the dose and duration of the therapy. The patient described here developed rapidly progressive deterioration of vision after only 3 days of treatment with ethambutol. Such a case has not been reported before and it is suspected that this was an idiosyncratic reaction.

Takayasu's disease in Arabs.

Four cases of Takayasu's disease in female Arabs are reported. All patients had classical features of the disease. Typing for HLA phenotype showed that all patients had HLA A2, A9, BW35 and DR7 antigens, suggesting an immunogenetic basis for the disease.

Metaraminol provocative test: a specific diagnostic test for familial Mediterranean fever.

The diagnosis of familial Mediterranean fever has been one of exclusion. In a placebo-controlled, double-blind, cross-over study a challenge with a 10 mg dose of metaraminol infusion was followed within 48 h by a typical disease-like attack in all of 21 patients with familial Mediterranean fever but in none of 21 control subjects. The induced attacks were milder and of shorter duration than the spontaneous ones.

Diabetes mellitus in Kuwait. Incidence in the first 29 years of life.

The annual incidence of diabetes mellitus among Kuwaiti subjects 0-29 years of age during 1980-1981 was found to be 22.09 per 100,000. There was a very low incidence in the 0-14 and 0-19 year age groups (3.

Spontaneous haemothorax in Osler-Weber-Rendu disease.

A case of hereditary haemorrhagic telangiectasia (Osler-Weber-Rendu disease) is described who presented with severe, central chest pain mimicking acute myocardial infarction, a presentation which has not been described before. He was found to have developed spontaneous haemothorax which is a very rare complication of this disease.