Tonsillectomy for this 35-year-old patient?

Is tonsillectomy an appropriate treatment modality for this adult patient's refractory group A ß-hemolytic streptococcal pharyngitis, in light of her history of recurrent infections?

In vitro chemotaxis of Brugia pahangi infective larvae to the sera and hemolymph of mammals and lower animals.

The jird (Mongolian gerbil) is a highly susceptible experimental host for the lymphatic filarial nematode, Brugia pahangi. The chemotactic activity of serum from this host for B. pahangi infective larvae was compared in vitro to that of sera or hemolymph of a wide variety of other organisms including mammals, reptiles, fishes and invertebrates. The range of the Chemotactic Index (CI) was from 96.0 for the jird to 56.2 for a snail. An average of CI of saline control was 4.5. Significant chemotactic activity was present in many organisms, especially mammals, but was not closely related to either the phylogenetic position of the organism and to its known susceptibility as definitive host for B. pahangi. Migratory response was diminished in a consistent way by serial dilution of sera of humans, jirds and fetal bovine serum. Pre-incubation of larvae in fetal bovine serum inhibited migration, especially towards the sera of humans. Inhibition could be reversed by rinsing larvae in saline, longer rinse periods resulting in greater recovery of CI. These results are the first to suggest the activity of the specific amphid chemoreceptors in the chemotaxis of the infective larvae of B. pahangi.

Mucormycosis in immunochallenged patients.

Mucorales species are deadly opportunistic fungi with a rapidly invasive nature. A rare disease, mucormycosis is most commonly reported in patients with diabetes mellitus, because the favorable carbohydrate-rich environment allows the Mucorales fungi to flourish, especially in the setting of ketoacidosis. However, case reports over the past 20 years show that a growing number of cases of mucormycosis are occurring during treatment following bone marrow transplants (BMT) and hematological malignancies (HM) such as leukemia and lymphoma. This is due to the prolonged treatment of these patients with steroids and immunosuppressive agents. Liposomal amphotericin B treatment and posaconazole are two pharmacologic agents that seem to be effective against mucormycosis, but the inherently rapid onset and course of the disease, in conjunction with the difficulty in correctly identifying it, hinder prompt institution of appropriate antifungal therapy. This review of the literature discusses the clinical presentation, diagnosis, and treatment of mucormycosis among the BMT and HM populations.

The Dominican Republic and the Marlboro Brand: A cigarette smoking survey and status report

A survey of cigarette smoking in Santo Domingo was conducted among residents of 499 households in two neighborhoods. Residentes over 14 years old were classified as current smokers (34.6 percent), former smokers (11.3 percent), and never smokers (54.1 percent). Most of the 200 current smokers interviewed (83 percent) had started smoking by age 20, but over half (59 percent) were relatively ligh smokers, consuming 10 cigarettes per day. Remarkably for Latin America, smoking was nearly as common among women (32.9 percent) as among men (36.3 percent). Over 90 percent of the interview subjects disapproved of smoking by adults, the practice being considered undesirable by most because of its effects on health. Most of the adolescents interviewed viewed smoking as a mark of maturity (82.3 percent) and as "in" among their friends (53.7 percent). Even though few respondents understood the specific nature of health threats posed by smoking, health was the single most important factor motivating cessation. Most of the current smokers (78.0 percent) wanted to quit, and over two-thirds (67.5 percent) reported making at least one serious attempt to do so. Tobacco industry figures show that between 1962 and 1988 the total apparent cigarette consumption of the Dominican Republic rose 3.7-fold. Most of that increase was the result of promotion by Philip Morris, which now dominates the Dominican market. At present cigarettes are heavily advertised without health warnings and are sold to minors without significant restrictions. Such activities should be of particular concern in this and other developing countries with high fertility rates and young populations

The Dominican Republic and the Marlboro Brand: A cigarette smoking survey and status report

A survey of cigarette smoking in Santo Domingo was conducted among residents of 499 households in two neighborhoods. Residentes over 14 years old were classified as current smokers (34.6 percent), former smokers (11.3 percent), and never smokers (54.1 percent). Most of the 200 current smokers interviewed (83 percent) had started smoking by age 20, but over half (59 percent) were relatively ligh smokers, consuming 10 cigarettes per day. Remarkably for Latin America, smoking was nearly as common among women (32.9 percent) as among men (36.3 percent). Over 90 percent of the interview subjects disapproved of smoking by adults, the practice being considered undesirable by most because of its effects on health. Most of the adolescents interviewed viewed smoking as a mark of maturity (82.3 percent) and as "in" among their friends (53.7 percent). Even though few respondents understood the specific nature of health threats posed by smoking, health was the single most important factor motivating cessation. Most of the current smokers (78.0 percent) wanted to quit, and over two-thirds (67.5 percent) reported making at least one serious attempt to do so. Tobacco industry figures show that between 1962 and 1988 the total apparent cigarette consumption of the Dominican Republic rose 3.7-fold. Most of that increase was the result of promotion by Philip Morris, which now dominates the Dominican market. At present cigarettes are heavily advertised without health warnings and are sold to minors without significant restrictions. Such activities should be of particular concern in this and other developing countries with high fertility rates and young populations