Urinary schistosomiasis: a report of four cases and a review.

Urinary schistosomiasis is a common cause of hematuria in tropical regions, where it most often affects teenage boys. Children presenting with hematuria in the developed world are usually considered to have bacterial cystitis or a structural lesion and are investigated and treated accordingly. The authors report on a family recently returned to Canada from Nigeria in which all four children had urinary schistosomiasis. Nocturnal enuresis was the presenting symptom in the index case; this patient also had hematuria and dysuria. Nocturia occurred in a second child, and the other two children were asymptomatic. All four were cured by a single dose of praziquantel, a new schistosomicide. The life cycle of the causative organism, the clinical manifestations of schistosomiasis, the host response and treatment with praziquantel are reviewed.     

Pregnancy in diabetic women: outcome with a program aimed at normoglycemia before meals.

A program designed to achieve normal plasma glucose concentrations before meals was tested in 83 insulin-dependent diabetic women during 110 pregnancies. The women rigidly controlled their carbohydrate intake but not their total energy intake, and twice daily they injected a combination of short-acting (Toronto) and intermediate-acting (NPH or Lente) insulin. Obstetric care was highly individualized and was aimed at avoiding or minimizing the impact of complications, such as hypertension, on the fetus and ensuring fetal lung maturity before delivery. The mean plasma glucose levels before meals (+/- standard error of the mean) were 136 +/- 9, 117 +/- 5 and 101 +/- 2 mg/dl during the first, second and third trimesters respectively. Obstetric complications included hypertensive disease of pregnancy (in 30.0%) and hydramnios (in 16.4%). The mean gestational age (+/- standard deviation [SD]) was 38.1 +/- 1.8 weeks, the cesarean section rate 45.4% and the mean stay in hospital for diabetes control before delivery (+/- SD) 15.7 +/- 9.6 days. The perinatal mortality rate was 0.9%. Neonatal problems included congenital anomalies in 3.6%, somatomegaly in 24.6%, hypoglycemia in 26.5%, hypocalcemia in 17.3% and hyperbilirubinemia in 39.4%. There were nine cases (8.2%) of the respiratory distress syndrome, four (3.6%) of which were severe. These findings lend support to the importance of a policy aimed at achieving normoglycemia and fetal lung maturity before delivery, goals that are attainable without lengthy antenatal hospitalization.     

Free and protein-bound glutathione in normal and cataractous human lenses

Protein-bound glutathione was identified and measured in normal and cataractous human lenses. In a major group of cataracto us lenses the bound glutathione concentration was higher than normal. Study of normal lenses showed that their glutathione content is age-dependent, decreasing steadily from about 3.5mumol/g of lens at age 20 years to about 1.8mumol/g of lens at age 65 years. Cataract brings further decreases.