Translation into Portuguese and assessment of the reliability of a scale for the diagnosis of diabetic distal polyneuropathy

The aim of this study was to translate into Portuguese and to assess the reliability of an instrument for the diagnosis of diabetic distal polyneuropathy (DPN). The process for translation and adaptation into Portuguese of the Neuropathy Symptom Score (NSS) and the Neuropathy Disability Score (NDS) was performed following internationally standardized procedures. The instruments were applied by 2 raters in 57 consecutive subjects. Spearman correlation was used to evaluate the reliability and Cronbachs' alpha to evaluate the internal consistency of the items. Both, ECN and ESN, showed a good reliability (r= 0.77, p< 0.0001 and r= 0.76, p< 0.0001, respectively). ESN showed a good internal consistency (alpha= 0.74). The diagnosis of DPN, defined as the combination of the two scores (ECN+ESN) also showed a good reliability (r= 0.63, p< 0.0001). The Portuguese versions of the ESN and the ECN seem to be adequate for the diagnosis of DPN in this population.     

Neuroferritinopathy: missense mutation in FTL causing early-onset bilateral pallidal involvement

The authors identified a missense mutation in the FTL gene (474G>A; A96T) in a 19-year-old man with parkinsonism, ataxia, corticospinal signs, mild nonprogressive cognitive deficit, and episodic psychosis. This mutation was also present in his asymptomatic mother and younger brother, who had abnormally low levels of ferritin in the serum. The patient and his mother displayed bilateral involvement of the pallidum.     

Left atrial extension of a Wilms' tumor

Isolated involvement of the left heart chambers by metastases of malignant tumors is extremely rare. We report a case of an 8-year-old child, with a left atrial metastasis of a Wilms' tumor detected in a control nuclear magnetic resonance 1 year after left inferior lobectomy for metastatic extension of the kidney tumor, which was diagnosed 4 years earlier. The metastasis was excised en bloc with a disc of the posterior left atrial wall.     

Prevalence and incidence of, and risk factors for, HIV-1 infection among factory workers in Ethiopia, 1997-2001

The study was conducted to determine the prevalence, incidence, and risk factors for HIV infection among factory workers at two sites in Ethiopia. During February 1997-December 2001, a structured questionnaire was used for obtaining information on sociodemographics, sexual behaviour, and reported sexually transmitted infections (STIs) from a cohort of 1679 individuals. Serum samples were screened for antibodies against HIV, Treponema pallidum haemaglutination (TPHA), and herpes simplex virus type 2 (HSV-2). The overall baseline prevalence of HIV was 9.4%-8.5% among males and 12.4% among females. For both the sexes, the factors independently associated with an increased risk of HIV infection were widowhood and having had antibodies against TPHA and HSV-2. The risk factors specific for males were being orthodox Christian, having had a higher lifetime number of sexual partners, and genital discharge in the past five years. The risk factors for females, included low income, one or more rape(s) over lifetime, and casual sex in the last year. The overall incidence of HIV infection was 0.4 per 100 person-years. The highest rate of incidence was observed among young women aged less than 30 years (1 per 100 person-years). The study confirmed that high-risk sexual behaviour and STIs play major roles in the spread of HIV infection in the Ethiopians of both the sexes, but the factors, such as rape and low economic status, make women more vulnerable than men.     

Extranodal B-cell lymphoma of the uvea: a case report

CASE REPORT: Ocular involvement by non-Hodgkin's lymphoma is a rare condition that can result from a primary intraocular lymphoma of the retina or an intraocular manifestation of systemic lymphoma. Uveal involvement is seldom the initial manifestation of extranodal lymphoma. We describe an 80-year-old patient with a blind and painful left eye and a history of recurrent uveitis. After ultrasound evaluation, the eye was enucleated and histopathologic examination revealed a malignant B-cell lymphoma of the uveal tract. The patient has been followed for 8 years after surgery, but she has had no further systemic manifestations of lymphoma and has not required subsequent treatment. COMMENTS: Primary extranodal lymphoma can be easily mistaken for recurrent uveitis or primary intraocular lymphoma of the retina and central nervous system; it is a differential diagnosis to be considered in cases of recurrent uveitis-like symptoms evolving to blind painful eye.     

Monitoring cause-specific adult mortality in developing countries: a comparison of data sources for Addis Ababa and its implications for policy and research

Hospital statistics of causes of death for developing countries may be biased when the utilization of hospital services is low or selective. Using Addis Ababa, Ethiopia as an example, we argue that hospital data can be useful for demonstrating general cause-specific mortality patterns. In addition, a comparison of hospital statistics with data from a surveillance of burials allows for the identification of weaknesses in health services provision. We find a low level of hospital services utilization during terminal illness. Despite similarities in the cause of death structure in the different data sources, hospital statistics under-estimate the prevalence of infectious diseases. In addition, we identify an important gender bias in the utilization of health services in the direction of males being significantly more likely to die in medical facilities than females.