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Two multiple ovulation and embryo transfer (MOET) programs with fresh, frozen and vitrified red deer embryos were carried out during the reproductive season of 2005 and 2006 in a local breeding farm in Argentina. Multiparous (n=10 and 9, respectively) weaned hinds were used as donors for each year. The estrous synchronization treatment of donors and recipients consisted of inserting an ovine intravaginal sponge containing medroxiprogesterone acetate (MAP) for 12 days. Superovulation was conducted with a total dose of 180 mg of NIH-FSH-P1 (Folltropin-V, Bioniche, Belleville, Ontario, Canada), given i.m. in eight decreasing doses every 12h (40, 40; 27, 27; 15, 15; 8, 8 mg), from days 10 to 13. Donor females were mated with one stag of proven fertility. The recovery rate was 84.1% (122/145), obtaining 45.1% (55/122) of transferable embryos, 24.6% (30/122) of degenerated embryos and 30.3% (37/122) of unfertilized oocytes. Pregnancy rates after transfer of fresh, OPS vitrified/warmed and ethylene glycol (EG) frozen/thawed embryos were 64.3% (18/28), 53.3% (8/15) and 70.0% (7/10), respectively. Vitrification and freezing with ethylene glycol procedures constitute an interesting alternative for red deer embryo cryopreservation.

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An interspecific embryo transfer program was conducted for genetic improvement and increasing the number of offspring from a flock of mouflon sheep in Argentina. The female donor mouflons were divided into three groups, G1 (n=5), G2 (n=4) and G3 (n=5). The total NIH-FSH-P1 dose given to each donor on the superovulatory treatment was 260, 200 and 160 mg for G1, G2 and G3, respectively. The mouflons in G3 were maidens, while the others were multiparous. Domestic Corriedale ewes (n=60) were synchronized and used as recipients. The embryo recovery and transfer was performed by a surgical method. Mouflons (n=13) responded to the superovulatory treatment with an average of 9.1+/-2.8 ovulations. A low incidence of early luteal regression was found (1 out of 14 donors). Embryo recovery rates were 60, 31 and 76% in groups G1, G2 and G3, respectively. The percentage of transferable embryos obtained in G1 and in G2 exceeded 80%. None of the embryos obtained from G3 were of transferable quality. In G1, 25 transferable embryos were recovered and transferred to 13 recipients, resulting in a pregnancy rate of 76.9% (10/13). In G2, 10 embryos were transferred to 5 recipients, resulting in a 60% pregnancy rate (3/5). Lambing rate was 60% (15/25) and 30% (3/10) for G1 and G2, respectively. Thirteen lambs were born to the 14 donors following natural service after the embryo recoveries. This study demonstrates that the application of IET technology would have great reproductive impact, especially when the donor mouflon hinds are selected according to age and reproductive history.

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The incidence of cervical cancer increases with age among USA Hispanics and women living in Latin America starting in the fourth decade of life. We conducted a study of women > or = 40 living at the USA-Mexico border to determine the prevalence and risk factors for human papillomavirus (HPV) infection detected by polymerase chain reaction. In all, 9.2% of participants tested HPV positive. Compared with women aged 50-59, odds ratios of 8.82 and 6.67 were observed for women > or = 60 and 40-49, respectively. Among women aged 40-49, both oncogenic and non-oncogenic HPV infections were detected; however, women > or = 60 were positive for predominantly oncogenic genotypes. HPV risk significantly increased with > or = 2 lifetime sexual partners in adjusted models. These data suggest that the prevalence of HPV infection may have a second peak among post-menopausal Hispanic women.

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Few studies have reported on sexually transmitted infections at the US-Mexico border, so the prevalence of Chlamydia trachomatis in this population remains uncertain. This binational project investigated the prevalence of, and risk factors for, C. trachomatis among women along the Arizona, US-Sonora, Mexico border. Women who self-referred for routine gynaecological care were invited to complete an interviewer-administered questionnaire and to undergo a Pap smear, C. trachomatis test, and HPV test. In 2270 women, C. trachomatis prevalence overall was 8.2% as measured by hybrid capture and 2.6% by enzyme immunoassay. Infection was associated with young age, a history of new sexual partner(s) in the previous three months, HPV infection, and proximity of clinic to the international border. Antibiotic use in the previous 30 days was associated with decreased odds of infection. Women in Arizona-Sonora border communities are at increased risk for C. trachomatis infection compared to women attending clinics in non-border locations.

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In a newborn infant with galactose-1-phosphate uridyltransferase deficiency and encephalopathy, brain magnetic resonance imaging revealed cytotoxic edema in white matter. Using in vivo proton magnetic resonance spectroscopy, we detected approximately 8 mmol galactitol per kilogram of brain tissue, an amount potentially relevant to the pathogenesis of brain edema.

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A geographical sample in a rural area of eastern Guatemala revealed widespread, premature and heavy losses of permanent teeth. Social and environmental influences that affect tooth loss include inadequate diet, refined sugar, poor oral hygiene, absence of fluoride, lack of preventive education and insufficiency of dental care services. Land hunger and family poverty are of paramount importance. Gender-based cultural differences are apparent in tooth extraction rates, and use of dentures. No one escapes visitations of severe orofacial pain that cast a blight upon the quality of rural life. Periodontal disease drives the poorest of the poor to spend disproportionately large sums on pharmaceutical pain-killers and destructive traditional medicines. Lay 'tooth-pullers' visit remote rural homes to extract teeth. Only full edentulism can bring patients permanent somatic and financial relief. Community dental health is conspicuously neglected in official policies and plans for rural development.

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Rapid industrialization has transformed the agricultural economy of Puerto Rico, creating employment opportunities and raising standards of living. Success, however, is marred by widespread pollution that outstrips the infrastructural capacity necessary for the preservation of environmental quality and of human health. The result today is a landfill crisis, a heritage of toxic dumps, and an advancing tide of pollution. Rivers and reservoirs are nearly ubiquitously affected and groundwaters, long thought to be naturally protected, show evidence of increasing contamination. Limestone aquifers are at particular risk. Public awareness and inter-sectoral political leadership are urgently needed to reverse the trend towards environmental deterioration.

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The medical records of 306 British soldiers in whom a clinical diagnosis of cutaneous leishmaniasis had been made following a tour of duty in Belize were analysed. Parasitological confirmation of the diagnosis was established in 187 cases; leishmania were cultured in 117 cases and Leishman-Donovan bodies were identified histologically in a further 70 cases. Leishmania braziliensis braziliensis was identified in 78 cases and Leishmania mexicana mexicana in a further 29 cases. Seventy-one per cent of patients had a single lesion which, in most cases, occurred on the exposed extremities. The mean diameter of the ulcers was 14.4 mm. Treatment with sodium stibogluconate was effective. Two regimens were used, consisting of either 600-800 mg daily given initially for 10 days, or 600 mg b.d. given initially for 14 days. Of those allocated to the lower dose regimen 48.5% were cured after the initial 10-day course, and ultimately the ulcers of 93% of patients healed following more prolonged treatment at this dose. Of those allocated to the higher dose regimen 63.9% were cured after the initial 14-day course and ultimately the ulcers of all patients healed after more prolonged treatment at this dose. A transient leucopenia and a rise in liver enzymes were noted during treatment, and these changes were dose-dependent. No cases of mucocutaneous leishmaniasis were encountered.

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The medical records of 306 British soldiers in whom a clinical diagnosis of cutaneous leishmaniasis had been made following a tour of duty in Belize were analysed. Parasitological confirmation of the diagnosis was established in 187 cases; leishmania were cultured in 117 cases and leishman-Donovan bodies were identified in 78 cases and Leishmania mexicana mexicana in a further 29 cases. Leishmania braziliensis was indentified in 78 cases and Leishmania mexicana mexicana in a further 29 cases. Seventy-one per cent of patients had a single lesion which, in most cases, occurred on the exposed extremities. The mean diameter of the ulcers was 14.4 mm. Treatment with sodium stobogluconate was effective. Two regimens were used, consisting of either 600-800 mg daily given initially for 10 days, or 600 mg b.d. given initially for 14 days. Of those allocated to the lower dose regimen 48.5 percent were cured after the initial 10-day course, and ultimately the ulcers of 93 percent of patients healed following more prolonged treatment at this dose. Of those allocated to the higher dose regiment 63.9 percent were cured after the initial 14-day course and ultimately the ulcers of all patients healed after more prolonged treatement at this dose. A transient leucopenia and a rise in liver enzymes were noted during treatment, and these changes were dose-dependent. No cases of mucocutaneous leishmaniasis were encountered (AU)

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The biomechanics of the reconstructed flexor retinacular pulley system are poorly defined. We used a mathematical theoretical model, confirmed by a cadaver model, and a clinical radiographic model to evaluate a variety of different joint and pulley combinations. We examined twenty-four sets of radiographs of 12 fingers in 9 patients for whom excursion was measured and predicted by the mathematical model. The 30 pulley combinations evaluated in the in vitro cadaver model showed statistical correlation with the biomechanical mathematical model. Recommendations of clinical application on the basis of this information include the following: (1) Two pulleys should be placed, one proximal and one distal to each joint. (2) These two pulleys should be balanced about the joint axis both in distance from the axis and in pulley height. (3) They should be positioned at the edge of the flare of the metaphysis. (4) The three individual joints can be balanced, one to another, by maintaining minimal bowstringing at all three joints. In this way, the relative excursion at the joint and torque at the joint will be maintained in a physiological ratio as close to normal as possible.

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A porous Dacron (Phoenix Bioengineering, Bridgeport, PA) tendon is described for collateral ligament reconstruction and augumentation with proximal interphalangeal joint implant arthroplasty. Eight cases with a minimum follow-up of 15 months are reviewed. Diagnoses include posttraumatic arthritis and osteoarthritis, as well as rheumatoid arthritis. The porous Dacron tendon is constructed as a collagen-like weave. It has been useful in patients who have insufficient local tissue to achieve lateral proximal interphalangeal joint stability. In selected cases, it can obviate the need for a tendon graft and provide an alternative to arthrodesis.

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An 8-month-old white female infant with Pneumocystis carinii pneumonia had a normal blastogenic response to mitogens but no response to a variety of antigens, as well as a poor response to allogeneic cells in one-way mixed lymphocyte culture assays. The patient's mononuclear cells had defective class I (HLA-A, -B, -C) and absent class II (HLA-D) antigen expression on their surface, thus establishing the diagnosis of HLA-deficient severe combined immune deficiency (bare lymphocyte syndrome). Family HLA typing, in vitro stimulation of patient mononuclear cells, and sequence-specific oligonucleotide probe hybridization allowed the patients HLA phenotype to be determined. An unrelated bone marrow donor whose phenotype matched at all but a single A locus was found. The patient was conditioned with busulfan and cyclophosphamide, followed by infusion of T-cell-depleted bone marrow cells. The patient has been infection free with a successful marrow graft documented by HLA typing and chromosomal analysis. Sequence-specific oligonucleotide probe hybridization allows determination of the HLA phenotype in patients with HLA-deficient severe combined immune deficiency which, in turn, makes marrow transplantation an option for the reconstitution of these patients' immune system.

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The spatial pattern of reported tuberculosis incidence in Puerto Rico is characterized by numerous high-low gradients among continguous municipios. Tuberculin testing of some 1500 subjects along one such gradient reveals that there is no difference in sensitivity and suggests that the gradients are artifacts of reporting. Correlative associations with tuberculin conversion were generally weak, except for age-dependency. Collected personal histories demonstrated that the web of familial and intergenerational relationships is a major force in perpetuating the disease. Concealment of infection, denial and poor compliance in chemotherapy regimens compound the difficulties of case-discovery and case-control. Interviews in a sample of twelve health centers confirmed that, without the presence of trained and assigned tuberculosis nurses, the health care providers' 'index of suspicion' for tuberculosis is generally low. Absence of a tuberculosis clinic virtually dictates serious under-reporting of incidence in that municipio. Despite the success of Puerto Rico's control program over past decades, a reservoir of tuberculosis persists. The level of endemicity is relatively low but unsatisfactory in the context of public health aspirations.

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It is demonstrated that the reported rates of tuberculosis in Puerto Rico comprise a direct, positive measurement of location, infrastructure and numbers of personnel in the health care system. The disease map does not reflect true geographic prevalence, but it is a measurable artifact of the health care system. Areas of high and low reporting and zones of minimum patient contact, are identified in the interests of program management.

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