Muscle hernias of the leg: Review of literature and report of twelve cases

Twelve patients with muscle hernias of the leg are presented. Three had large, solitary hernias of the tibialis anticus muscle, all due to direct trauma and two of which had symptoms severe enough to justify surgical repair which was successfully accomplished by fascial transplant. Nine patients had multiple small hernias which developed spontaneously with possible congenital weakness as a predisposing factor in some.The literature dealing with muscle hernias is comparatively scant. An incomplete review reveals 163 cases of muscle hernias of the leg reported, including the twelve in the present report.     

Domestic dog health worsens with socio-economic deprivation of their home communities

Dogs play an important role in infectious disease transmission as reservoir hosts of many zoonotic and wildlife pathogens. Nevertheless, unlike wildlife species involved in the life cycle of pathogens, whose health status might be a direct reflection of their fitness and competitive abilities, dog health condition could be sensitive to socio-economic factors impacting the well-being of their owners. Here, we compare several dog health indicators in three rural communities of Panama with different degrees of socio-economic deprivation. From a total of 78 individuals, we collected blood and fecal samples, and assessed their body condition. With the blood samples, we performed routine hematologic evaluation (complete blood counts) and measured cytokine levels (Interferon-γ and Interleukin-10) through enzyme-linked immunosorbent assays. With the fecal samples we diagnosed helminthiases. Dogs were also serologically tested for exposure to Trypanosoma cruzi and canine distemper virus, and molecular tests were done to assess T. cruzi infection status. We found significant differences between dog health measurements, pathogen prevalence, parasite richness, and economic status of the human communities where the dogs lived. We found dogs that were less healthy, more likely to be infected with zoonotic pathogens, and more likely to be seropositive to canine distemper virus in the communities with lower economic status. This study concludes that isolated communities of lower economic status in Panama may have less healthy dogs that could become major reservoirs in the transmission of diseases to humans and sympatric wildlife.     

Abstracts from the XIIth Scientific Meeting of the Argentine Society of Arterial Hypertension

Epidemiologic Survillance of Cardiovascular Disease Mollar G, Cavalieri L, Galarza C, Waisman G, Beratarrechea A, Petrlik E, Langlois E, Soriano F, Marchetti M, and Gonzalez B de Quirós F Programas Médicos de Plan de Salud del Hospital Italiano de Buenos Aires

To enhance efficacy of health care, surveillance activities are required, especially with chronic prevalent diseases. Epidemiologic surveillance allows US to quantify and qualify health problems, settle priorities, identify high risk groups, manage and monitor health care systems, detect frequency changes in events, and assess performance of prevention and disease management programs. We have developed a surveillance system that identifies and reports daily on patients having cardiovascular disease (CVD) who are uncontrolled.

Objective: To evaluate the accomplishment of blood pressure (BP) measurement in people with CVD belonging to a health care system included in an epidemiological surveillance list.

Design: Cohort study between 1/1/2004 and 9/1/2004.

Methods: Patients 60 years old or older identified by surveillance system during the first term of 2004, were followed up. Patients were identified as having CVD through electronic medical record using international classification for primary attention (ICPA).

Patients are reported by the software system when presenting any of the following criteria: no blood pressure record during the past 6 months, blood pressure above 140/90 in the last record, and if diabetic A1C above 7.5%.

The connection with the appointment system allowed us to detect previously the patient’s attendance and, 15 min before his or her medical appointment, send the patient to be examined by the executors of a chronic disease program, according to the JNC VII guidelines.

The BP measurement is a common intervention to most chronic diseases because it increases cardiovascular risk, hence it is considered a process indicator of the surveillance system.

Results: Of the 24,411 patients having CVD, 5506 (26%) were listed during the first term, mean age was 74 years and 65% were female. By the end of 2004, 4660 (85%) patients had blood pressure recorded with an average values of 136.76 mmHg for systolic and 77.51 for diastolic blood pressure. Blood pressure was assessed three times in average.

Conclusion: Surveillance system allowed identifying of and intervening in a high proportion of patients.