Arbovirus studies in Angola: Serological survey for antibodies to arboviruses.

A serological survey was made comprising 4,590 human sera collected in 16 areas of Angola, in order to determine the distribution of arboviruses. The results obtained with the hemagglutination inhibition (HI) test have shown that the activity of the arboviruses is more prevalent in northern Angola, where a larger number of sera reacted in the HI test against group A and B arboviruses (7% and 32..6%, respectively). Several sera with HI reactions against Bunyamwera, group C, and Rift Valley fever viruses were also found.

Bilateral carotid endarterectomy combined with myocardial revascularization during the same surgical act.

The best surgical approach for the treatment of patients with severe cerebral artery disease and simultaneous serious coronary artery disease still remains controversial. In this report we present a case of a 72-year-old female patient admitted to the hospital with unstable angina. Triple coronary artery obstructive disease and severe bilateral carotid artery stenosis were diagnosed. A combined, simultaneous surgical procedure was performed. After total circulatory by-pass with a membrane oxygenator, the patient's body temperature was lowered to 32 degrees C. During the cool-down period, three proximal anastomoses of segments of autologous saphenous veins were performed in the ascending aorta. Immediately afterwards, bilateral carotid endarterectomy was performed, followed by three distal anastomoses to coronary arteries. The patient showed a satisfactory post-operative outcome. It was concluded that the combination of moderate hypothermia, hemodilution with appropriate hemodynamic control, as used in this patient, was an effective method of cerebral protection. The simultaneous approach of carotid endarterectomy and coronary artery by-pass surgery should be seen as a safe option for the treatment of this type of patient.

Squamous cell carcinoma of the cervix metastatic to the spleen--case report.

Squamous cell carcinoma of the cervix metastatic to the spleen is an uncommon occurrence which has only been reported in small numbers in autopsy series. We present a case of a 47-year-old patient with a Stage IIb carcinoma of the cervix, treated with radiotherapy in 1990. Four years after completion of primary treatment she presented with a voluminous left hypochondrium and epigastrium mass. An exploratory laparotomy was performed and a splenic cyst 19 cm in diameter was found. The pathological examination revealed metastatic squamous cell carcinoma of the cervix in the spleen. Peritoneal washings were positive for malignant cells, due to incidental rupture of the cyst capsule. The patient received six courses of chemotherapy with a palliative intent and is alive, without further evidence of disease, 15 months posttreatment. To our knowledge this is the only case reported in the literature of squamous cell carcinoma of the uterine cervix metastatic to the spleen, diagnosed clinically as the only site of distant spread.

Total inversion of the left lung circulation: morphologic and functional analyses.

BACKGROUND: An experimental model for total inversion of left lung circulation was developed. With this model, the authors demonstrate that it is possible to reverse the pulmonary circulation and preserve the normal function and morphology of the lung. METHODS: Eight dogs had their left pulmonary circulation reversed. The blood from the pulmonary artery trunk was diverted to the pulmonary veins, and returned from the pulmonary artery into the left atrium. In order to monitor the flow through the reversed system, color Doppler echocardiography was performed on the ninth postoperative day. The dogs were reoperated after 15 days for re-evaluation. Blood gas analyses from the aorta and the pulmonary artery were used to study the functional status of the lung in both operations. The morphology was studied by comparing biopsies of the lung performed before and after reversal of flow. RESULTS: Blood gas analysis showed no significant difference between the samples of from the aorta and pulmonary artery. Color Doppler echocardiography was a reliable method for the study of the inverted circulation. The histological study showed no differences in the morphology of the lung after the reversed circulation. CONCLUSIONS: Left pulmonary circulation was fully reversed. Pulmonary function and morphology remained normal.