Urgent problems of diagnosis and treatment of reflux esophagitis

The authors analyse the results of diagnosis and surgical treatment of various forms of reflux esophagitis in 426 patients. The disease was caused by hiatal hernia in 60.4% of patients, by various operations on the cardia in 22%, and by gastric and duodenal ulcer in 8.2% of patients. Various diagnostic methods are evaluated, among which intraesophageal pH measurement and esophagofibroscopy are particularly important. The indications for operative treatment are formulated. Operations were carried out on 349 patients, complications occurred in 15%. The lethality was 0.6%. Nissen's fundoplication is the operation of choice.     

Does malnutrition predispose to diarrhoea during childhood? Evidence from a longitudinal study in Matlab, Bangladesh

It is posited that diarrhoeal illness during one period has influence on diarrhoeal illness in a subsequent period. This relationship may potentially mask the association between malnutrition and subsequent diarrhoea. To test this, we analysed data on cross-sectional anthropometry in combination with data on diarrhoeal morbidity collected longitudinally in a community-based study of 1262 children (aged 6-60 months) during March-December, 1976, in Matlab, Bangladesh. The results confirmed the posited relationship between diarrhoeal morbidities in two consecutive periods and showed that the risks of diarrhoeal attack and longer diarrhoeal illness increased more than threefold during the 2 months following diarrhoeal illness during the preceding 2 months (previous diarrhoea). Children with no previous diarrhoea indicated a positive association between malnutrition and subsequent diarrhoea, but the pattern found among children with previous diarrhoea was not understandable. Logistic regression analyses performed separately for younger and older children showed that controlling for effects of previous diarrhoea, maternal illiteracy and household poverty, severe malnutrition as assessed by weight-for-age was found to be strongly associated with the risk of longer diarrhoeal illness in a 2-month interval in the age group 24-60 months; in the same age group the association with the risk of diarrhoeal attack was significant at the 10 per cent level. No such association for malnutrition, however, was found in the age group 6-23 months.     

Coexistence of AIDS and lupus nephritis: a case report

We report the first case of membranous lupus nephritis occurring in a child with congenital AIDS. Hypocomplementemia, elevated titers of anti-nuclear antibody and antibody to double-stranded DNA supported the diagnosis of associated systemic lupus erythematosus (SLE). The pathogenetic implications of this coexistence of AIDS and SLE are discussed.     

Correction of hypercholesterolemia and dyslipoproteinemia by plasmapheresis in patients with stenocardia resistant to drug therapy

Plasmapheresis was used to correct blood lipid composition in patients with angina at rest and angina of effort (functional classes 3-4). In addition to a drop in total cholesterol and triglycerides, cholesterol in low and very-low-density lipoproteins fell abruptly, while high-density-lipoprotein cholesterol, on the contrary, increased considerably. Clinical improvement of the patients was also recorded.