Hyponatremia in visceral leishmaniasis

There are few reports linking hyponatremia and visceral leishmaniasis (kala-azar). This is a study of 55 consecutive kala-azar patients and 20 normal individuals as a control group. Hyponatremia and serum hypo-osmolality were detected in 100% of kala-azar patients. High first morning urine osmolality (750.0 ± 52.0 vs. 894.5 ± 30.0mOsm/kg H2O, p Existem poucos relatos relacionando hiponatremia com a leshmaniose visceral (calazar). Este é um estudo de 55 pacientes portadores de calazar e um grupo controle de 20 indivíduos normais. Hiponatremia e hipo-osmolalidade sérica foram detectados em 100% dos pacientes portadores de calazar. A presença de alta osmolalidade da primeira urina da manhã (750,0 ± 52,0 vs. 894,5 ± 30 mOsm/Kg H2O, p < 0,05) e da urina de 24h (426,0 ± 167,0 vs. 514,6 ± 132,0 mOsm/Kg H2O, p < 0,05), demonstraram a presença de persistente secreção de hormônio antidiurético. A concentração de sódio urinário foi elevada (82,3 ± 44,2 vs. 110,3 ± 34,7 mEq/L, p < 0,05). Hipouricemia ocorreu em 61,8% dos pacientes e aumento da fração de excreção urinária de ácido úrico foi detectada em 74,5% dos casos. Aumento da velocidade de filtração glomerular estava presente em 25,4% dos pacientes. Não havia evidência clínica de depleção de volume extracelular. Valores normais de ADH plasmático foram observados nos pacientes com calazar. Não foi detectada disfunção renal ou endócrina. É provável, que a maioria dos pacientes com calazar apresente uma síndrome de secreção inapropriada de hormônio antidiurético

The West Indian Medical Journal and the Non-communicable Diseases (NCDs) The Next 60 years

The West Indian Medical Journal (WIMJ) deserves hearty congratulations on 60 years of uninterrupted publication and for having maintained its status as the flagship medical scientific publication in the Caribbean. The Editorial for the first issue of the journal identified its remit as being a “reference journal of the diseases of the Caribbean” – a remit which it can proudly say has been discharged faithfully. The pattern of diseases in the Caribbean has changed over the years so it is gratifying to see that this anniversary issue is being dedicated to non-communicable diseases (NCDs), the major public health challenge of our time. NCDs (primarily cardiovascular disease, cancer, diabetes and chronic respiratory disease) have tremendous consequences for both personal and population health. They have assumed a prominent role in Caribbean thinking and practice because they impact on many and varied aspects of regional development. While there are other important chronic NCDs, as well as chronic communicable diseases, these four diseases account for the greatest share of mortality and disability globally, and especially so in the Caribbean. In addition, they share common risk factors