DIAGNOSIS AND TREATMENT OF A NATURAL INFECTION WITH (CHAGAS DISEASE) IN A SYMPTOMATIC DE BRAZZA'S MONKEY () IN ALABAMA.

, the causative agent of Chagas disease, is a zoonotic, vector-borne, protozoan hemoflagellate with a wide host range. An 11-yr-old, captive-bred male De Brazza's monkey () presented with weight loss despite normal appetite. Examination revealed hypoglycemia, nonregenerative anemia, and many trypanosomes on a blood smear.

An adolescent female with a testosterone-secreting ovarian teratoma: a case report.

Ovarian neoplasms constitute 1% of childhood tumors. The majority of them are teratomas and usually are asymptomatic or present with paraneoplastic syndromes. Our case is a 16-year-old female who presented with chronic abdominal pain, virilization and oligomenorrhea and found to have a complex cystic mass of the left ovary, more likely cystic teratoma on abdomen and pelvis CT.

Managers' perceptions of the value and impact of HAZWOPER worker health and safety training.

Background: Worker training is a core component of the OSHA Hazardous Waste Operations and Emergency Response (HAZWOPER) standard, but few studies have considered what motivates managers to provide HAZWOPER training to employees or what they value in that training.

Methods: In 2012, four university-based programs conducted an exploratory survey of managers who sent employees to HAZWOPER courses. Results from 109 respondents were analyzed.

Retrospective long-term comparison of naturopathic fasting therapy and weight reduction diet in overweight patients.

In a follow-up study overweight and obese patients fasting according to Buchinger (modified) and a control group treated by a weight reduction diet in the context of an inpatient naturopathic complex treatment were compared using a questionnaire developed for a standardized phone interview 6.8 ± 1.1 years after inpatient treatment.

Sigmoid volvulus in 16-year-old boy with an associated anomalous congenital band.

Sigmoid volvulus, a condition generally seen in debilitated elderly patients, is extremely rare in the pediatric age group. Frequent predisposing conditions that accompany pediatric sigmoid volvulus include intestinal malrotation, omphalomesenteric abnormalities, Hirschsprung's disease, imperforate anus and chronic constipation. A 16-year-old previously healthy African American male presented with a 12 hour history of sudden onset abdominal pain and intractable vomiting.

Quality improvement and patient care checklists in intrahospital transfers involving pediatric surgery patients.

Background: Intrahospital transfers are necessary but hazardous aspects of pediatric surgical care. Plan-Do-Study-Act processes identify risks during hospitalization and improve care systems and patient safety.

Methods: A multidisciplinary team developed a checklist that documented patient data and handoffs for all intrahospital transfers involving pediatric surgical inpatients.

How medical alumni now see their junior clerkships in surgery.

The purpose of this study is to determine the effectiveness and value of the junior medical student surgical clerkship for physicians now in practice. Questionnaires were sent to all Mercer University School of Medicine alumni (1986-2007) using a five-point Likert scale. One hundred and fifty-seven responses were received from 873 recipients (18%), 71 per cent training in nonsurgical specialties.

[Unusual course of a Guillain-Barré syndrome in connection with an RS-Virus infection in a 10 months old infant].

Guillain Barré syndrome (GBS; Synonyma: Polyneuritis, Polyradikulitis) is an acute, inflammatory, demyelinating disease of the peripheral nerve system. Clinical hallmarks are symmetric muscle paralysis, areflexia and pronounced autonomic disturbances. Respiratory failure and cardiovascular instability are the main reasons for intensive care support in patients with GBS.

Valproic acid-induced pancreatitis: 16 new cases and a review of the literature.

Background: Acute pancreatitis is rarely seen in children, and, in contrast to cases in adults, it is often drug induced. One possible medication is the antiepileptic drug valproic acid (VPA), which is commonly prescribed for generalized and focal epilepsy, migraine, neuropathic pain, and bipolar disorder. The common side effects associated with VPA are typically benign, but less common but more serious adverse effects may occur.

Valproic acid-induced hepatopathy: nine new fatalities in Germany from 1994 to 2003.

Purpose: Valproic acid (VPA) is an antiepileptic drug (AED) commonly used for generalized and focal epilepsies. We provide an update on hepatotoxic side effects in Germany between 1994 and 2003.

Methods: We mailed a questionnaire to all members of the German Section of the International League Against Epilepsy, asking for VPA-induced side effects, especially severe side effects such as hepatopathy.

Benign familial neonatal convulsions: always benign?

Background: Benign familial neonatal convulsions (BFNC) is a rare autosomal dominant seizure disorder usually described to be characterized by a benign course, spontaneous remission and normal psychomotor development. The latter statement had come under consideration when a few case reports of families with less than favorable outcomes were published.

Methods: Since 1998 a total of 112 families suspected to have BFNC have been referred to our lab for genetic testing.

Swenson revisited: a one-stage, transanal pull-through procedure for Hirschsprung's disease.

Background: Hirschsprung's disease is a common cause of neonatal intestinal obstruction. A variety of operations have been used to treat this neurogenic form of bowel obstruction. This report describes an experience with a 1-stage abdominal and transanal pull-through operation in 15 patients with rectosigmoid disease.

Perineal reconstruction of female conjoined twins.

Background/purpose: Conjoined twins are some of the most challenging patients faced by surgeons. Pygopagus and ischiopagus twins present particular gastrointestinal and genitourinary reconstructive challenges. This study reviews the authors' experience with the perineal reconstruction of these types of conjoined twins.

The influence of trainee characteristics on the effectiveness of health and safety training for hazardous waste site operations work.

A 10-year retrospective analysis was done using training records for 869 trainees who had attended a 40-hour course for hazardous waste site work. The course is intended for professional site workers, but had been attended by a demographically diverse audience. Analysis of test, demographic, and course data revealed some spurious effects but also indicated that trainees were not disadvantaged in their learning gains based on their own background or that of the class overall.

Testing as a measure of worker health and safety training: perspectives from a hazardous materials program.

Background: Health and safety training for hazardous materials workers is among OSHA's major policies. A large and growing workforce in this area, and the resulting risks for these workers and the public, make quality training critical. Measuring trainees' individual knowledge following training is a common but controversial practice.

The role of antibodies in acute vascular rejection of pig-to-baboon cardiac transplants.

Long-term success in xenotransplantation is currently hampered by acute vascular rejection. The inciting cause of acute vascular rejection is not yet known; however, a variety of observations suggest that the humoral immune response of the recipient against the donor may be involved in the pathogenesis of this process. Using a pig-to-baboon heterotopic cardiac transplant model, we examined the role of antibodies in the development of acute vascular rejection.

Worker health and safety training: assessing impact among responders.

A mail survey was conducted among emergency responders who received training at the New Jersey/New York Hazardous Materials Worker Training Center. Responses indicate that technical topics are extremely important (i.e.

Humoral responses to pig-to-baboon cardiac transplantation: implications for the pathogenesis and treatment of acute vascular rejection and for accommodation.

Organs transplanted between phylogenetically-disparate species, such as from the pig into the primate, are subject to hyperacute and acute vascular rejection. Hyperacute rejection of a porcine organ by a primate is thought to be initiated by the binding of xenoreactive natural antibodies to Galalpha1-3Gal expressed on the endothelial lining of blood vessels in the xenograft. The factor(s) which initiates acute vascular rejection is uncertain; however, there is some evidence implicating xenoreactive antibodies.

Medical surveillance practices of blue collar and white collar hazardous waste workers.

Given the occupational risks of hazardous waste workers, this study was conducted to explore possible differences in medical surveillance practices among blue and white collar workers. Demographic and medical surveillance data were collected from 636 white collar and 206 blue collar trainees, enrolled in health and safety training courses. Overall, 4.

Strategies for evaluating the effectiveness of training programs.

This chapter has provided examples of practical and theoretical considerations that should be made when developing evaluation activities concomitant to training. Evaluation choices have been described based on considerations and experiences from others in the training field, sound rationale for program and policy research, and realistic constraints and demands of training. The discussion has presented some of the basic technical issues associated with the collection and analysis of trainee, program, and test data.

Infectious diseases and field water supply and sanitation among migrant farm workers.

An audit for fecal-related symptoms was performed on clinic patient charts of 936 migrant farm workers without access to water and sanitation facilities in the work fields and on an urban poor population of 8,968 patients. Migrants displayed a clinic utilization rate for diarrhea 20 times higher than that of the urban poor; similar findings for other enteric disease symptoms were documented. The data suggest that a water and sanitation standard mandating facilities in the work field for farm workers would reduce the incidence of fecal-related disease.

A need for community education in development: the Mit Abu El Kom case.

A quasi-experimental study was performed in Mit Abu El Kom Village, Egypt, where one-quarter of the 500 village households had been provided with new housing and indoor water and sanitation facilities and where, prior to this provision, water and sanitation facilities were inadequate or nonexistent among all households. No community health education had taken place among relocatees (subjects) or nonrelocatees (controls) in conjunction with the provision of water and sanitation facilities. This study investigated if subjects' access and exposure to facilities had alone been sufficient to significantly alter their relevant knowledge, attitudes and practices as compared to controls.