Isolation and isoenzyme characterization of Leishmania (Viannia) braziliensis from a case of human cutaneous leishmaniasis in northeast centre of the state of São Paulo

The diagnosis of human cutaneous leishmaniasis in small towns is sometimes made without the species identification of the Leishmania, even in areas without previous epidemiological surveys. Here we report the isolation of a Leishmania strain from a patient of Rincão, state of São Paulo, that was identified by isoenzyme characterization as L. (Viannia) braziliensis. Sand fly collections were made in the area where the patient live in order to investigate the likely vector species.

Isolation and isoenzyme characterization of Leishmania (Viannia) braziliensis from a case of human cutaneous leishmaniasis in northeast centre of the state of São Paulo.

The diagnosis of human cutaneous leishmaniasis in small towns is sometimes made without the species identification of the Leishmania, even in areas without previous epidemiological surveys. Here we report the isolation of a Leishmania strain from a patient of Rincão, state of São Paulo, that was identified by isoenzyme characterization as L. (Viannia) braziliensis. Sand fly collections were made in the area where the patient live in order to investigate the likely vector species.

Morphometric study of the stromal vascularization in peritoneal endometriosis.

To evaluate the stromal vascularization of different appearances of peritoneal endometriosis, biopsies were taken from peritoneal areas with endometriosis in a series of 135 infertile women and classified as typical (black), red, or white lesions. The number of capillaries per mm2 of stroma, their mean surface area, and the ratio of capillaries/stroma surface area, and the mitotic activity were analyzed in typical, red, and white lesions. Significant differences were found between the different subgroups. The higher vascularization and mitotic activity observed in red lesions suggested the hypothesis that such lesions are very active and probably the first stage of early implantation of endometrial glands and stroma. The poor vascularization and the absence of mitosis observed in white lesions suggested that these lesions are much less active than red lesions and are a quiescent stage of the disease. Our study proves that the "activity" of peritoneal endometriosis is related to the vascularity. This concept must be considered in the further discussion of American Fertility Society Endometriosis Classification. Typical, red and white lesions are three different stages of the peritoneal disease and their relative relation to infertility is also probably different.

Prediction of individual response to controlled ovarian hyperstimulation by means of a clomiphene citrate challenge test.

A clomiphene citrate (CC) challenge test was carried out in 114 patients to evaluate the capacity of this test to predict the patient's individual response to controlled ovarian hyperstimulation (COH) performed with a gonadotropin-releasing hormone agonist and human menopausal gonadotrophins (hMG) for in vitro fertilization. The sum of follicle-stimulating hormone measured before and after CC intake, is the parameter that correlated best with subsequent response to COH. The upper limit of the reference value for this parameter, established by considering the CC challenge test performed on 26 patients who became pregnant, was 26.03 mIU/mL. Twenty patients who presented a CC challenge test result above the reference value were compared with patients with a normal test result. For these 20 patients, COH required more hMG and was cancelled in 25% of the cases (instead of 1% in the control group). The number of follicles aspirated, oocytes retrieved, and embryos obtained were on average six times lower than in patients with a CC challenge test result within the reference value, and no pregnancy was obtained. We concluded that CC challenge test provides a reliable individual prognosis for the ovarian response to COH.

[The new modular field medical units of the Army Health Service]. / Les nouvelles formations sanitaires de campagne modulaires du service de santé des armées.

Wishing to adapt itself to foreseeable conditions of modern combat army medical service had to imagine, for battle time, new sanitary units using shelters. They have two main characteristics: modular structure and quick deployment. From a first realization, part of a broad and ambitious program, characteristics and tactical using rules are defined. Such medical units could be easily used for non military purposes: i.e. to face disaster situations or modern technological risks.

[The hospital policy of the Military Health Service]. / La politique hospitalière du Service de Santé des Armées.

After having pointed out what nowadays the military hospital area represents and what its missions consist in, the authors shed the light on the trends they want the Medical Corps organization to develop and follow in order to meet its needs within the field of its allowed means. As a conclusion, they bring out the fact that, in the future, doctors will have to assume responsibilities if they want to remain "deciders", as far as hospital management is concerned.

[A comparative mechanical study of types of external fixator (author's transl)]. / Etude mécanique comparative de fixateurs externes. Le modèle du Service de Santé des Armées.

The authors have designed and original type of external fixator which can be used in the forces in case of armed conflict. Study has been directed towards a simple, strong and inexpensive apparatus which can be applied in emergency circumstances. Secondarily it can be replaced by another apparatus to allow compression, distraction or better reduction of a fracture without removal of the pins. The fixator should be applied as close as possible to bone and there should be three pins in each fragment, one close to the fracture, one distant and one intermediate. The best methods for the insertion of the pins have been tested.

[Fistulography. Results of 126 examinations (author's transl)]. / La fistulographie. A propos de 126 examens.

The authors describe the results obtained in a series of 126 patients examined by fistulography. This investigation should be conducted systematically after operative treatment of any type of fistula. The procedure involves perfusion of a water-soluble iodized contrast medium at low pressure, using a balloon sound to ensure that there are no leaks. The results supply the general or orthopedic surgeon with the information necessary for deciding the operative procedure to be used.

[Pseudotumoral rheumatoid coxitis (author's transl)]. / La coxite rhumatoïde à forme pseudo-tumorale.

Two cases of rheumatoid coxitis of the macrogeodic type are reported. In one case, there was a very large anfractuous cavity in the socket and head, complicated by a pathological fracture of the socket, which raised the suspicion of a malignant tumor. The authors review the characteristics of these macrogeodic forms of rheumatoid arthritis, about forty cases having been reported in the published literature.

[Fatigue fractures of the metatarsal bones]. / Les fractures de métatarsiens

The authors report 145 cases of fatigue fractures including 125 of the metartarsals. They compare this distribution that reported by others, in particular in German work. After study of the different types of clinical picture the authors emphasize the importance of repeated and high quality radiological examinations. They describe the four stages of radiological evolution. Each of the images taken out of its context is misleading. They may lead to the diagnosis being missed and thus should be well known.