Parasitism of a capybara (Hydrochoerus hydrochaeris) by Amblyomma nodosum Neumann, 1899 and Amblyomma humerale Koch, 1844 in an Amazon forest area, Rondônia, Brazil / [Parasitismo por Amblyomma nodosum Neumann, 1899 e Amblyomma humerale Koch, 1844 em capivara (Hydrochoerus hydrochaeris) em área de Floresta Amazônica, Rondônia, Brasil]

Dois carrapatos adultos, sendo um Amblyomma nodosum e um Amblyomma humerale foram encontrados parasitando ativamente uma capivara (Hydrochoerus hydrochaeris) proveniente da região central do estado de Rondônia, Brasil, na zona rural do município de Ji-Paraná, localizado na Amazônia ocidental. Poucos trabalhos científicos relatam a presença de A. humerale em capivaras. Assim, esta é a primeira vez que A. nodosum é relatado parasitando essa espécie animal. Por não se tratar de um hospedeiro animal conhecido para A. nodosum ou comum para A. humerale, esses achados podem sugerir uma nova relação entre hospedeiros para eles. Portanto, são necessários mais estudos acerca da ecologia desses parasitas, principalmente por serem potenciais transmissores de patógenos de importância em medicina veterinária e saúde pública.(AU)

Amuchina 10% solution, safe antiseptic for preventing infections of exit-site of Tenckhoff catheters, in the pediatric population of a dialysis program.

Although, decreasing in incidence with the disconnection systems, the first complication is still peritonitis in patients with chronic renal failure and the second is infection of Tenckhoff catheter exit-site. All efforts made to diminish the frequency of exit-site infection lower the possibility of peritonitis. The pediatric population is well-known to have a major risk of infectious complications, and making easy and safe the care of the exit-site will prevent the peritonitis that follows. The aim of the study was to evaluate the efficacy of the Amuchina 10% solution vs. pH neutral soap in children with chronic renal failure, on preventing exit-site infection. There were 60 patients who were assigned randomly to one of two groups. One group used Amuchina 10% solution for the daily cleaning of the exit-site, and the other used pH neutral soap, with 14 months of follow-up. Before the study they have to be free of infection for at least 30 days. All were taught by the same nurse how to clean their exit-site. Groups were almost identical in years, sex, and time on dialysis. We had nine infections in the soap group and none in the Amuchina 10% solution group, with an OR: 17 (p = 0.004). From these nine infections, the bacteria isolated were: 4 (13%) were caused by Pseudomona aeruginosa, 1 (3.3%) by Staphylococcus aureus, coagulase-positive staphylococci in 2 (6.6%) and Serratia marcensens in 1 (3.3%). In conclusion, Amuchina 10% solution is effective in preventing infection on the exit-site, without any secondary topical reaction.

Evaluation of a balanced fresh paste diet for maintenance of captive neotropical rattlesnakes used for venom production.

OBJECTIVE: To evaluate efficacy of a balanced fresh paste diet for maintenance of captive neotropical rattlesnakes used for venom production. DESIGN: Controlled clinical trial. ANIMALS: 40 healthy neotropical rattlesnakes. PROCEDURE: Rattlesnakes were force-fed once per week (10% of body weight) for 19 weeks; 20 control snakes received dead mice, whereas 20 test snakes received a balanced fresh paste diet. Ecdysis rates were calculated, and body weight was recorded weekly. After 19 weeks, venom was extracted and analyzed. RESULTS: Sickness or deaths were not observed; weight loss during ecdysis and weight gain overall were similar between groups. Snakes fed the balanced fresh paste diet had similar ecdysis frequency, venom potency, and protein concentration in venom as did snakes fed mice. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that a balanced fresh paste diet has sufficient nutritional value to avoid weight loss and death and does not adversely affect venom quality in captive neotropical rattlesnakes.

Foreign matter salpingitis 3 years after typhlitis.

This case suggests that typhlitis may cause delayed abdominal pathology. A history of this condition should be considered in the work-up of any patient with gastrointestinal or genitourinary pathology.

Duchenne muscular dystrophy and concomitant metastatic alveolar rhabdomyosarcoma.

The authors report the concomitant occurrence of Duchenne muscular dystrophy (DMD) and alveolar rhabdomyosarcoma (RMS). A 4-year-old boy presented with symptoms involving his neuromuscular system that affected primarily his left hip and leg. Duchenne muscular dystrophy was diagnosed. Seven months later, metastatic alveolar RMS in the ipsilateral pelvis was documented. The diagnosis of one major disorder affecting striated muscle (DMD) may have prevented the early detection of another (RMS).

Mental health in senior citizens in the metropolitan zone of Guadalajara.

Using Goldberg's General Health Questionnaire (GHQ) to identify potential cases of mental disorders, we screened 246 randomly selected persons among the 116,616 people older than 65 in the metropolitan zone of Guadalajara; 86 subjects (35%) qualified as "cases"; this figure is much higher than that reported (20.8%) in the adult population in a previous study. Among the cases, 69% were female, 66% were widowed, and 50% were divorced; 44% had not finished gradeschool, 42% had no scholastic education, 54% were unemployed, and 40% worked at home. Factors associated with anxiety and severe depression, sleep disorders, psychosomatic symptoms, and problems in interpersonal relations were studied.

Rapid autologous marrow recovery and eradication of infectious mononucleosis despite severe immunosuppression following second transplantation for aplastic anemia.

A patient with aplastic anemia failed to respond to immunosuppressive therapy and first marrow transplantation (BMT). Recovery of autologous hematopoiesis was rapid following a second stem cell transplant with a non-myeloablative preparatory regimen. The autologous immune response to infectious mononucleosis (IM) 4 weeks post-transplant was normal despite recent and ongoing severe immunosuppression.

Ki-1+ large-cell anaplastic lymphoma after Ewing sarcoma.

PURPOSE: A large cell anaplastic lymphoma that developed after treatment of a Ewing sarcoma (ES) is described. PATIENT: An 11-year-old girl with a pelvic ES developed a large cell, Ki-1+, anaplastic lymphoma in the same anatomic location 10 months after multimodal therapy. RESULTS: ES recurred in the primary site 16 months after allogeneic marrow transplantation and 3.5 years after initial diagnosis, but the patient remains in remission from her lymphoma. CONCLUSION: The occurrence of lymphoma and ES in a short time interval in the same patient is very unusual. Whether etiologic factors other than chemoradiotherapy, including genetic disposition, play a role remains to be elucidated.

Pre-B acute lymphoblastic leukemia in a 3-year-old boy with pre-acute myelogenous leukemia myelodysplastic syndrome: cytogenetic evidence of common early progenitor cell ontogeny.

PURPOSE: Myelodysplastic syndromes in children commonly evolve into acute leukemia, usually acute myelogenous leukemia (AML) and rarely acute lymphoblastic leukemia (ALL). The lineage of the leukemia can be predicted based on characteristic morphologic and cytogenetic findings of the marrow and peripheral blood. PATIENT AND METHODS: A 3-year-old boy had refractory anemia with excess blasts and abnormalities suggestive of pre-AML with highly unusual cytogenetic changes. ALL of pre-B phenotype developed. RESULTS: Leukoerythroblastic anemia, pseudo Pelger-Huet neutrophils, and dysmyelopoietic hyperplasia of the marrow suggested likely early progression to AML. Complex cytogenetic abnormalities (monosomy 17 and 20, ring chromosome 11 with deletion of bands q23, and a derivative dicentric chromosome 12) were present in both the myelodysplastic marrow and the subsequent ALL. CONCLUSION: This case presents cytogenetic evidence of common early progenitor cell ontogeny of both malignancies (refractory anemia with excess blasts and ALL).

Successful allogeneic bone marrow transplantation for agnogenic myeloid metaplasia in a 3-year-old boy.

PURPOSE: Agnogenic myeloid metaplasia (AMM) is a myeloproliferative disorder characterized by marrow fibrosis, extramedullary hematopoiesis, splenomegaly, and leukoerythroblastosis with abnormalities of red blood cell morphology. This is rarely encountered in children. No conventional curative therapy is known; however, allogeneic bone marrow transplantation (BMT) may eradicate the underlying stem cell abnormality with subsequent normal hematopoiesis. RESULTS: We report a 3-year-old Arab boy who had AMM and who had normal marrow hematopoiesis and markedly reduced fibrosis after high-dose chemotherapy and matched sibling BMT. CONCLUSIONS: Allogeneic BMT offers a potential cure for patients with agnogenic myeloid metaplasia. A preparatory regimen containing busulfan and cyclophosphamide appears promising for patients with the disease.

Fanconi anemia in brothers initially diagnosed with VACTERL association with hydrocephalus, and subsequently with Baller-Gerold syndrome.

Two brothers with presumed Baller-Gerold syndrome, one of whom was previously diagnosed with the association of vertebral, cardiac, renal, limb anomalies, anal atresia, tracheo-esophageal fistula (VACTERL) association with hydrocephalus, were evaluated for chromosome breakage because of severe thrombo cytopenia in one of them. Spontaneous and clastogen-induced breakage was markedly increased in both patients as compared to control individuals. Clinical manifestations and chromosome breakage, consistent with Fanconi anemia, in patients with a prior diagnosis of either Baller-Gerold syndrome, reported earlier in one other patient [Farrell et al., 1994: Am J Med Genet 50:98-99], or with VACTERL association with hydrocephalus, recently reported in 3 patients [Toriello et al., 1991: Proc Greenwood Genet Center 11:142; Porteus et al., 1992: Am J Med Genet 43:1032-1034], underline the clinical heterogeneity of Fanconi anemia and raise the question of whether these syndromes are distinct disorders or phenotypic variations of the same disease.

Chemotherapy combined with surgery in successful treatment of hepatoblastoma.

Four patients presented with large intra-abdominal masses. Three patients were diagnosed as having hepatoblastomas of the right hepatic lobe, one of the left lobe. Initially these tumors were unresectable, and after biopsy each patient was treated with a standardized chemotherapy protocol. All tumors decreased remarkably in size and were resected successfully. Postoperative chemotherapy was then instituted and, as of this date, three of the children appear to be disease free; the fourth had a pulmonary metastatic lesion completely resected. Contrary to the dismal past history of patients with initially unresectable hepatoblastomas, treatment with preoperative chemotherapy, surgery and postoperative chemotherapy has had most rewarding results.

Positive monospot tests preceding the diagnosis of acute monocytic leukemia in two adolescents.

The early detection and treatment of two cases of acute monocytic leukemia (AMoL) was hampered by the presence of positive slide tests for infectious mononucleosis (IM). This assumes great importance with the recent development of specific therapy, effective for certain subtypes of nonlymphocytic leukemia.