Dynamic changes of cerebrospinal fluid in upright and recumbent shunted experimental animals.

The effect of positional change on intracranial CSF pressure, valve flow rates and atrial pressures were studied in 40 experimental dogs. The flow rate with a 30 to 60 mm H2O Holter valve changed from the recumbent to the head-up position: during the first minute it increased 2 1/2 times and then progressively decreased to become stabilized 20-30 min later at a value slightly lower than the head-up value. At the same time pressure dropped rapidly to -23 mm H2O and then slowly, during 30 min to -120 mm H2O. In dogs without a shunt the pressure drop was initially similar to that of shunted dogs but recovered to almost the initial positive pressure in 30 min. The flow rate from a reservoir to the atrium through a shunt system when changing to the head-up position showed a siphon effect. Atrial pressure does not change with positioning. The findings were similar with cisternal-peritoneal shunts. Flow rate, therefore, increase in the head-up position. Negative intracranial CSF pressure was due to a siphon effect through the shunt system.     

Hospital control and multidrug-resistant pulmonary tuberculosis in female patients, Lima, Peru

We examined the prevalence of tuberculosis (TB), rate of multidrug-resistant (MDR) TB, and characteristics of TB on a female general medicine ward in Peru. Of 250 patients, 40 (16%) were positive by sputum culture and 27 (11%) by smear, and 8 (3%) had MDRTB. Thirteen (33%) of 40 culture-positive patients had not been suspected of having TB on admission. Six (46%) of 13 patients whose TB was unsuspected on admission had MDRTB, compared with 2 (7%) of 27 suspected cases (p = 0.009). Five (63%) of 8 MDRTB patients were smear positive and therefore highly infective. In developing countries, hospital control, a simple method of reducing the spread of MDRTB, is neglected.     

Prevalence of Schistosoma intercalatum and S. haematobium Infection among Primary Schoolchildren in Capital Areas of Democratic Republic Of S?o Tomé and Príncipe,West Africa

Background

A parasitological survey of Schistosoma haematobium and S. intercalatum infection among primary schoolchildren in capital area of Democratic Republic of São Tomé and Príncipe (DRSTP) was undertaken.

Methods

Subjects with positive infection were confirmed by the detection of S. haematobium ova in the urine or S. intercalatum ova in the stool by using centrifugation concentration or merthiolate-iodine-formalin concentration method. Totally, 252 urine and stool samples, respectively, were obtained from apparently healthy schoolchildren, of which 121 from boys (9.8 ± 1.4 yr) and 131 from girls (9.7 ± 1.3 yr).

Results

None of participating schoolchildren were found having S. haematobium ova in the urinary specimen. While, among 4 primary schools studied, only schoolchildren from Saint Marçal were detected with S. intercalatum ova in the fecal specimen, making the overall prevalence of S. intercalatum infection among schoolchildren was 2.4% (6/252) and girls had insignificantly higher prevalence (3.1%, 4/131) than that (1.7%, 2/121) in boys (χ² = 0.5, P = 0.5).

Conclusion

Water control and sanitation as well as snails eliminated by molluscicides are urgently needed to reduce S. intercalatum infection in DRSTP inhabitants.