Effects of caffeine on tobacco withdrawal.

Smoking cessation increases caffeine blood levels, and this has been hypothesized to cause some of the symptoms of tobacco withdrawal (e.g., anxiety and insomnia).

Specificity and effects of host resistance on the African tick Rhipicephalus zambeziensis (Acarina: Ixodidae).

Repeated infestations of the rabbit with adult Rhipicephalus zambeziensis ticks resulted in a ten-fold reduction in engorgement weight of adult ticks and a significant decline in engorgement weight of nymphs. There was no evidence of cross-resistance against the South African bont tick, Amblyomma hebraeum. Immunization of rabbits with crude extracts of whole-tick protein significantly influenced engorgement weights and oviposition rates of adult R.

Is MRCP (U.K.) a redundant qualification for graduates of D.M. (Internal Medicine), University of the West Indies?

M.R.C.

Helicobacter pylori.

Since 1983, rapid advances in the knowledge of Helicobacter pylori have given new insights into the pathogenesis of upper gastrointestinal diseases. Several methods are now available for the diagnosis of the infection. Antimicrobial therapy has emerged as a new and effective treatment for peptic ulcer disease in a proportion, as yet to be determined, of patients in the Caribbean.

Inactivation of strongyloides stercoralis filariform larvae in vitro by six Jamaican plant extracts and three commercial anthelmintics.

In vitro bioassay of (a) aqueous methanol extracts (AME) of the green leaves of mimosa (Mimosa pudica), love weed (Cuscuta americana), vervine (Stachytarpheta jamaicensis), chicken weed (Salvia serotina) and breadfruit (Artocarpus altilis); (b) methanol-water fraction (MWF) of breadfruit leaves, and (c) commercially available drugs albendazole, thiabendazole and levamisole were assayed for nematode inactivating potential, using filariform larvae of Strongyloides stercoralis. Test larvae were obtained from a 10-day-old charcoal coproculture. Bioassays were conducted in Locke's solution, using 100 larvae in each of three replicates.

Colonoscopy in Jamaica--a 12-year experience.

Four hundred and nine colonoscopic examinations were performed in 335 patients over a 12-year period in Jamaica. The main indications were suspected polyps (34%) rectal bleeding (22%) and suspected carcinoma (11%). Total colonoscopy was performed in 33% of cases.

An assessment of the doctorate of medicine (internal medicine), University of the West Indies.

The outcome is described of 48 entrants to a postgraduate degree course (DM) in Internal Medicine established at the University of the West Indies in 1974. Contact by postal questionnaire was established in 96% of 26 graduates and 82% of 22 non-graduates. 22 of 25 DM graduate responders have remained in the Caribbean, working in six Caribbean territories.

Endoscopic sclerotherapy of bleeding oesophageal varices in Jamaica.

The results of oesophageal sclerotherapy (OS) in 18 patients with recurrent bleeding varices are compared with 15 patients treated medically. The total transfusion requirement pre-sclerotherapy was 112 units of blood (mean 6/patient) which decreased to 46 units (mean 2.5) after sclerotherapy treatment was started (p = 0.

Success of didactic gastroenterology teaching for postgraduate medical residents.

Although the Doctor of Medicine programme in Internal Medicine at the U.W.I.

Endoscopic and gastric acid studies in homozygous sickle cell disease and upper abdominal pain.

Upper endoscopic and gastric acid output studies were done in 51 patients with homozygous sickle cell (SS) disease and recurrent epigastric pain. Twenty (39%) had abnormalities in the upper gastrointestinal tract including 18 (35%) with peptic ulcers. Mean basal and maximum acid output were similar in patients with and without duodenal ulcer (DU).

Gall stones in Jamaican children with homozygous sickle cell disease.

Gall stones were detected by ultrasonography in 30 of 226 (13%) children with homozygous sickle cell disease aged 5-13 years participating in a cohort study from birth. Children with gall stones had significantly lower total haemoglobin and fetal haemoglobin and higher bilirubin concentrations, but further analysis showed that the apparent effects of haemoglobin and fetal haemoglobin concentration were secondary to their relationship with bilirubin concentrations. Abdominal pain crises were significantly associated with gall stones but both factors appeared to reflect an increased clinical severity and were probably not causally related.

Therapeutic ultrasound for refractory glaucoma: a three-center study.

We present the results of therapeutic ultrasound for refractory glaucoma in a three-center study over 1 year. One hundred fifty-eight eyes were treated, with a mean follow-up of 8.0 months.

Arteriomesenteric duodenal occlusion associated with strongyloidiasis.

Arteriomesenteric occlusion of the distal duodenum may occur in clinical conditions which result in narrowing of the angle between the aorta and superior mesenteric artery. Two patients with arteriomesenteric duodenal occlusion associated with Strongyloides stercoralis infection are described. In one patient the mechanism of occlusion appeared to be significant weight loss and associated visceroptosis, while in the other patient increased diameter of superior mesenteric vessels was the major factor.

Ulcerative colitis in sickle cell disease.

Four patients with homozygous sickle cell disease and severe proctocolitis are described. The current prevalence is three patients per 1,000 attending a sickle cell clinic. The reasons for the apparent predisposition of sickle cell disease to proctocolitis could not be determined but was revealed by the large follow-up clinic.

Early loss of central visual acuity in glaucoma.

Central visual acuity is usually maintained until late in the course of glaucoma. Ten patients (5 men, 5 women) between the ages of 25 and 79 were found to have decreased visual acuity associated with central or centrocaecal scotomas early in their course. Five patients had chronic open-angle glucoma, three and pigmentary glaucoma, one and juvenile glaucoma, and one had Axenfeld's syndrome.

Jamaican vomiting sickness: a study of two adult cases.

An acute illness (Jamaican vomiting sickness) which affected two adults after eating unripe ackee fruit was investigated. Analyses of serum and urine samples were performed to compare the patterns of organic acidaemia and aciduria with those reported from childhood cases. The main conclusion from the comparison is that the toxic ackee constitutent, hypoglycin, produces essentially the same metabolic effects in adults as in children.

Prevalence of liver abnormality in early syphilis.

Hepatic structure and function of 22 unselected patients with early syphilis was assessed. In 20 (91%) routine hepatic tests or bromsulphalein retention showed mild non-specific abnormalities. Minor changes in hepatic structure were present in 12 (55%), in three of whom intrahepatic spirochaetes were found.

Long-term results of valve implants in filtering surgery for eyes with neovascular glaucoma.

Filtration surgery was performed with a pressure-sensitive, unidirectional valve implant in 79 eyes with neovascular glaucoma. The device consisted of an open Supramid tube (outside diameter 0.58 mm) sealed to a Silastic tube with a slit valve.