Endemic Trypanosoma cruzi infection in Indian populations of the Gran Chaco territory of South America: performance of diagnostic assays and epidemiological features.

The relative specificities and sensitivities of several serological assays for the diagnosis of Trypanosoma cruzi infection were estimated in Indian populations of Argentina and Paraguay. The results obtained with the assays, which proved to be most reliable, were used to study the distribution of the parasite in these populations. Serological evidence of T. cruzi infection was demonstrated in 256 (37.7%) of 679 Indians living in relatively small and isolated communities in the Salta province of northern Argentina and in western Paraguay, regions that are part of the tropical territory called Gran Chaco. In contrast, none of the 94 Indians examined in south-western Argentina was positive. Infection in the Gran Chaco Indians increased with age and clustered in families. Marked differences in seroprevalence were observed between the 16 Indian communities examined in Gran Chaco. These differences seem to be associated both with the risk of transmission from the sylvatic reservoirs of the parasite and with the frequency with which vector-spraying campaigns have been implemented.

James B. Connolly, First modern Olympic champion. The Georgia Connection, Circa 1896.

As the centennial Olympic Games come to Atlanta in 1996, and the sailing venue to Savannah, it is only fitting that the first modern Olympic champion had some connection to the state of Georgia, the city of Savannah, and the art of sailing. James Brendan Connolly was not only a terrific athlete, but a noted writer and adventurer. Moreover, he was the type of man who impressed even the President of the United States with his sterling qualities. The latter serve as a shining example a century after his initial Olympic exploits.

Seroprevalence of human immunodeficiency virus in admitted trauma patients at a southeastern metropolitan/rural trauma center.

Human Immunodeficiency Virus (HIV) seropositivity was prospectively evaluated for trauma patients admitted to Memorial Medical Center between September 1989 and August 1990. Epidemiologic data, HIV risk factors, and opportunity for body fluid exposure were compiled for 520 admitted trauma patients 15 years of age or older who met inclusion criteria. Serum samples were obtained from initial laboratory tests. Patient identifiers were removed, and matching blinded numbers were placed on patient serum and data forms. Centers for Disease Control laboratories tested for HIV with the enzyme-linked immunosorbent assay method. The Epi-Info (Version 5.01, 1990) software package was used for statistical analysis of epidemiologic data. Results showed HIV seropositivity of admitted trauma patients to be 0.96 per cent (5/520). HIV seroprevalence among young black males from our urban area who were injured during violent aggression was 3.5 per cent. Management of 80 per cent of patients resulted in opportunity for body fluid exposure. Illicit drug use was reported by 15 per cent; 7.5 per cent gave a history of transfusion since 1977; 3 per cent identified high risk sexual partners; three patients reported homosexual activity. Two patients denied risk factors, but were HIV-seropositive. The results indicate that HIV exposure is a potential hazard to health care workers and that HIV risk factors alone are not reliable in identifying the HIV-positive patient.

Tropical pyomyositis.

Although rare, tropical pyomyositis can result from staphylococcal bacteremia and should be considered in the different diagnosis of fever associated with extremity pain. The diagnosis is readily made with a CT scan. Treatment is primarily medical with surgery reserved for refractory abscesses.

Efficacy of bufexamac cream versus betamethasone valerate cream in contact dermatitis: a double-blind trial.

A double-blind controlled study was carried out in 72 patients with atopic or contact dermatitis, who were randomly allocated to receive treatment with either 5% bufexamac, 0.1% betamethasone valerate or placebo creams. Patients applied the cream twice daily for 2 weeks. Assessments of the degree of severity of inflammation, induration, lichenification, crusts, scaling, and pruritus were made before and after treatment. The results showed that both active preparations were equally effective in improving the skin condition in the majority of the patients. In younger patients, however, the improvement with betamethasone valerate appeared to be somewhat better than that with bufexamac, particularly in relation to pruritus.

Deposits of immunoglobulins and complement C3 in clinically normal skin of patients with lupus erythematosus.

Deposits of immunoglobulins and/or complement C3 were found in two-thirds of biopsies from clinically normal skin of 64 patients with systemic lupus erythematosus, as judged by well defined criteria. The incidence of deposits in clinically normal skin was identical in patients with and without clinical skin lesions. IgM was found more frequently in the deposits (88%) than was IgG (36%) but equally frequently in involved and uninvolved skin, whereas C3 was found more often in patients with skin lesions (59% in involved skin, 36% in uninvolved skin) than in patients without skin lesions (14%). The occurrence of IgG and IgA was less frequent than that of C3 but the distribution was similar to that of C3. In normal skin of 20 patients with chronic discoid LE, deposits were found in one. Deposits were found in the skin of one-third of patients with nuclear antibodies in their sera and symptoms compatible with SLE but with a score of symptoms too low to meet the criteria.