Management of myiasis: current status and future prospects.

The management of myiasis in livestock has been an example of the success of modern chemical approaches for parasite control, yet in some cases remains extremely intractable, requiring the development of novel strategies. In addition, the growing and urgent need to develop integrated strategies that enhance the sustainability of livestock production systems drives the search for new techniques [see Int. J. Parasitol. 29 (1999) 7].The following summary represents a synthesis of a symposium presented at the 19th International Conference of the World Association for the Advancement of Veterinary Parasitology, New Orleans,USA, 10­14 August 2003. The coverage began with a review of the need for more subtle economic analysis of the impact of myiasis based on the use of the sterile insect technique (SIT) for control of bovine hypodermosis in North America. This was followed by a review of the status of chemical control with particular emphasis on the macrocyclic lactones. The outcome of the use of these compounds in a regulated control program for eradication of bovine hypodermosis in EU was surveyed. Similarly, the success of the screwworm eradication program, using the sterile insect technique has shown how effective this approach can be given the appropriate target. Several aspects of the development of newer approaches were surveyed in discussion of newer chemical control products, development of vaccines, use of host genetics, use of predictive simulation modelling and trapping for monitoring and control and the development of new diagnostic approaches for occult infestations. Finally, use of the latest molecular tools for identification of larvae causing myiasis and their use for the identification of species coming from different and distant geographical areas to colonize regions where they have been eradicated was reviewed.

Doaçäo de órgäos: opiniäo e conhecimento de médicos intensivistas da cidade de Curitiba / Organ donation: opinion and knowledge of intensive care unit physicians in the city of Curitiba

Com o objetivo de avaliar as opiniöes e conhecimentos de médicos intensivistas sobre doaçäo de órgäos, todos os intensivistas dos 13 hospitais de Curitiba com unidade de terapia intensiva de adulto participaram do estudo. De 81 intensivistas entrevistados, 75 (92,6 por cento) responderam o questionário. Todos responderam que säo favoráveis à doaçäo de órgäos, 74 (98,7 por cento) doariam seus próprios órgäos e 72 (96 por cento) autorizariam a doaçäo de órgäos de um membro da sua família. Sessenta e três (84 por cento) intensivistas näo conheciam ou näo souberam explicar a legislaçäo atual sobre doaçäo de órgäos. Quarenta e um (54,7 por cento) responderam errado ou näo sabiam os critérios médicos e legais para doaçäo de órgäos. Cinco (6,7 por cento) desconheciam a necessidade do doador ter morte encefálica, três (4 por cento) acreditavam que o doador deveria ter morte cardíaca para ser doador e 44 (58,7 por cento) näo souberam explicar o que é morte encefálica. A maioria desconhecia a sobrevida atual dos pacientes submetidos a transplante dos vários órgäos. Conclui-se deste estudo que quase todos os médicos intensivistas de Curitiba säo favoráveis a doaçäo de órgäos e estäo dispostos a participar ativamente na obtençäo de consentimento de familiares para doaçäo. O conhecimento básico sobre a legislaçäo brasileira e os vários aspectos médicos do transplante de órgäos é insatisfatório.

[Organ donation: opinion and knowledge of intensive care unit physicians in the city of Curitiba]. / Doação de órgãos: opinião e conhecimento de médicos intensivistas da cidade de Curitiba.

Our objective is to determine the opinions and knowledge of intensive care unit physicians toward organ donation. All physicians working in all 13 hospitals of Curitiba with intensive care unit for adults participated of the study. Of a total of 81 physicians, 75 (92.6%) answered the questionnaire. All physicians were favorable to organ donation, 74 (97.7%) were willing to donate their own organ and 72 (96%) to donate the organs of their relatives. Sixty-three (84%) did not know the present law on organ donation. Forty-one (54.7%) did not know the medical and legal criteria for organ donation. Five (6.7%) did not know that the patient had to have brain death in order to donate an organ, 3 (4%) thought that the patient had to have heart death in order to donate an organ, and 44 (58.7%) did not know how to explain brain death. Most physicians did not know the patient survival after transplantation of several organs. It is concluded that almost all intensive care unit physicians in Curitiba are favorable to organ donation and are willing to participate actively in obtaining consent of family members for donation. The basic knowledge of Brazilian law and several medical subjects on organ transplantation is unsatisfactory.

[Vascular thrombosis and oral contraceptives]. / Thromboses vasculaires et contraceptifs oraux.

In reference to four particular cases where a venous thrombosis associated with the use of oral contraceptives, the authors review the various factors of this problem. The importance of the concomitant use of tobacco as well as risk factors such as hyperlipidemia and hypertension, are especially stressed. These four cases, almost of an experimental nature, permit to correlate precisely the interaction between estro-progestative medications and the occurrence of venous thromboses.

[An enzootic with pseudo-tumoral manifestations in Vipera lebetina in captivity]. / Une enzootie à manifestations pseudo-tumorales chez des vipères lébétines en captivité.

The authors report the clinical and epizootic evolution of an epizooty, characterized by pseudo-tumours, observed on some vipers (Vipera lebetina) maintained in captivity at the "institut Pasteur de Tunis". The disease was characterized by 2.3 cm size nodules, scattered under the skin or into splanchnic cavities. These ones, spherical and well capsuled, were formed by a mass of clear rounded cells (histiocytes or monocytes), the necrotic central area of which contained innumerable bacteria. Several reviewed works show that this appearance of chronic abcess is a common and univocal reaction to various pathogenic factors, such as bacteria and parasites. As to etiology, the authors have doubt about the pathological role of the germs which they have identified (Salmonella and other anterobacteria) because these latter belong to the normal microbial flora of snakes and are, in the present case, probably occasional infective agents only.

[Human trichinosis. A recent epidemic in Vientiane (Laos) (apropos of 32 cases)]. / Trichinose humaine. Une épidémie récente è Vientiane (Laos) (a propos de 32 cas).

Fifty patients were hospitalised at Vientiane during May and June 1975. Infection was caused by consumption of pork meat (som-mou, lap mou and lap leuat). After an incubation period of 8 to 11 days intermittent diarrhoea followed by constant fever and orbital oedema occurred. Several days later diffuse myalgias occurred. Three patients presented neurological symptoms: left hemiplegia flexible paraplegia and limb paresis; these symptoms regressed spontaneously. 87% of the clinically suspected cases had specific serum antibodies (IFI, ID, IE). Hyperleucocytosis and hypereosinophilia were a constant factor. Anti-AH antibodies were detected by the Widal test. The histopathology characteristic of myositis was seen in the 12 muscle biopsies. Also observed was the precystic state of the larvae which is in agreement with the early timing of the samples which were obtained during the 3rd and 4rd week of infection.