Pattern of biochemical and immune recovery in protein calorie malnutrition

Thirty-two Black children with protein calorie malnutrition were studied with a view to assessing the duration of derangement of biochemical and immunological factors. It was shown that the majority of biochemical parameters were back to normal within 20 days, while the return to normal of the immunological indlces was more protracted. Reference is made to the patients who died, and to the factors contributing to their deaths.S. Afr. Med. J., 48, 1375 (1974)

Reflex sympathetic dystrophy: the significance of differing plasma catecholamine concentrations in affected and unaffected limbs

In 26 patients with features of reflex sympathetic dystrophy, venous blood was collected from painful and unaffected limbs. Levels of plasma adrenaline, noradrenaline and its intracellular metabolite, 3, 4-dihydroxyphenylethyleneglycol (DHPG), were measured by combined gas chromatography/mass spectrometry. Plasma DHPG was lower on the painful side. Concentration of plasma noradrenaline was also lower on the painful side in patients with widespread allodynia, and in those with hyperhidrosis in the affected hand or foot. These findings do not support the widely held view that autonomic disturbances in reflex sympathetic dystrophy are due to sympathetic overactivity. Rather, they suggest that sweating and changes in peripheral blood flow result from supersensitivity to sympathetic neurotransmitters. After injury, supersensitivity to noradrenaline may also contribute to spontaneous pain and allodynia by disrupting efferent sympathetic modulation of sensation. This would explain why pain and allodynia are relieved by sympathetic blockade, and why noradrenaline rekindles pain in sympathectomized skin