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The parasite that causes simian malaria in the Brazilian Amazon, Plasmodium brasilianum, is infective to man. In this region, where humans live within and in close proximity to the forest, it was suspected that this parasite could be the cause of a zoonosis. A study was performed in the areas surrounding two hydroelectric plants in the Amazon, Balbina and Samuel, aiming at determining the zoonotic potential of this parasite. P. brasilianum was detected in, respectively, 15.8% and 9.9% of 126 and 252 primates belonging to seven and eight species examined from Balbina and Samuel. The highest malaria infection rates were found among the red-howler monkey Alouatta seniculus straminea (32.3%), the bearded-saki Chiropotes satanas chiropotes (50%) and the spider-monkey Ateles paniscus paniscus (2[1+]) from Balbina and in the squirrel-monkey Saimiri ustus (21%) and the black-faced-spider-monkey Ateles paniscus chamek (28.6%) from Samuel.

In Brazil simian malaria is widely spread, being frequent in the Amazon region (10% of primates infected) and even more in the forested coastal mountains of the Southeastern and Southern regions (35% and 18% infected, respectively), but absent in the semi-arid Northeast. Only two species of plasmodia have been found: the quartan-like Plasmodium brasilianum and the tertian-like P. simium, but the possible presence of other species is not excluded. P. brasilianum is found in all enzootic foci, but P. simium was detected only on the coast of the Southeastern and Southern regions, between paralles 20 degrees S and 30 degrees S. Nearly all hosts are monkeys (family Cebidae, 28 species harbouring plasmodia out of 46 examined), and very rarely marmosets or tamarins (family Callitrichidae, 1 especies out of 16). P. brasilianum was present in all infected species, P. simium in only two. The natural vector in the Southeastern and Southern regions was found to be Anopheles cruzi, but has not been conclusively identified in the Amazon. One natural, accidental human infection due to P. simium was observed. There is no evidence of the relation of simian to human malaria in the Southeastern and Southern regions, where human malaria was eradicated in spite of the high rates of monkeys infected, but in the Amazon recent serological studies by other workers, revealing high positivity for P. brasilianum/P. malariae antibodies in local indians, would suggest that among them malaria might possibly be regarded as a zoonosis.

The use of an Immunoassay for the detection of Plasmodium falciparum and P. vivax circumsporozoite (CS) antigens in anophelines has recently incriminated other malaria vectors besides Anopheles darlingi in the Brazilian Amazon. In this study we analyzed 12,336 field-collected anophelines from endemic areas in Rondonia for plasmodial infection. Sixty-one specimens from 6 species were positive: 47 An. darlingi, 5 An. triannulatus, 4 An. albitarsis, 2 An. braziliensis, 2 An. strodei, and 1 An. oswaldoi. As concerns the species, 41 anopheles harbored P. falciparum and 20 were infected with P. vivax. An. darlingi was the most important local vector, as it was the one most frequently found infected and the only one clearly related to areas where malaria transmission was being recorded.

Chemical burns are frequently encountered by the hand surgeon. Although operative therapy is not usually necessary, prompt accurate diagnosis, appropriate care, and close follow-up are required. Generalized treatment principles as well as specific therapies are discussed.

It is hypothesized that Asian monkeys were the original hosts of Trypanosoma conorhini because they have been found naturally infected, the vector among rats is a tropicopolitan triatomine bug that belongs to a complex of Asian species, and primates were shown to be more susceptible than rats.

As a preparatory stage for a study aiming at identifying the species and subspecies of local Leishmania in naturally infected sandflies through immunoradiometric assay with monoclonal antibodies, we tried to obtain experimental infections of phlebotomines with well characterized stocks of parasites, in order to test the effectiveness of the method.

This study has provided baseline data of a quantitative neurophysiological appraisal of normal breast sensibility using our current understanding of cutaneous mechanoreceptive function. Test variables, including pressure, low- and high-frequency vibration, static and moving two-point discrimination, temperature, nipple erectibility, and pain, were evaluated in 11 normal volunteers using different coordinates over the nipple, areola, and body of the breast. Definite patterns were established so that the breast could be subdivided into distinct cutaneous areas with differing mechanoreceptive characteristics. The future aim is to broaden the scope of this study with preoperative evaluations in our clinical patients so that appropriate recommendations for future reconstructive breast procedures can be made.

Free jejunal transfer is a useful alternative for the reconstruction of defects of the pharynx and cervical esophagus. We describe 17 patients who received free jejunal grafts between 1980 and 1984 at the Eastern Virginia Medical School. The rationale and indications for the procedure are discussed. We emphasize certain technical considerations and improvements.

In view of recent studies incriminating several species of anophelines, besides Anopheles darlingi, as malaria vectors in the Brazilian Amazon, we performed an anopheline survey in four localities--Ariquemes, Cujubim, Machadinho and Itapoã do Oeste--in Rondônia, the most malarious State in the Country. Twenty species were found. An. darlingi was, by far, the dominant species and the only one whose density coincided with that of malaria. On human baits it was more numerous in the immediate vicinity of houses than indoors where, however, it was almost the only species encountered. On both situations it fed mostly at sunset and during the first half of the night. It was less numerous far from houses and scarce inside the forest. Other species (An. triannulatus, An. evansae, An. albitarsis, An. strodei) appeared in appreciable numbers only in Ariquemes, both in areas with and without malaria. The remaining species were scanty. An. darlingi was confirmed as the primary local vector.

By staining females of Anopheles cruzi with fluorescent coloured powders in a forest in the State of Santa Catarina, we showed that they move from canopy to ground and vice-versa to feed. This suggests that in areas where this mosquito is a vector of human and simian malarias sporadic infections of man with monkey plasmodia might be expected.

In an endemic area of cutaneous leishmaniasis in Rio de Janeiro State where a mule had been found infected, a systematic search among equines was performed, resulting in the detection of Leishmania parasites in skin lesions of 30.8% of the animals, which included horses and mules. The eventual role of equines in the epidemiology of the human disease is being investigated.

During an outbreak of cutaneous leishmaniasis in a locality (Las Rosas, Cojedes State, Venezuela) previously non-endemic, 12.9% of humans, 7% of dogs and 21.4% of donkeys (Equus asinus) had lesions with parasites. The agent in the three hosts was identified as Leishmania braziliensis, subspecies braziliensis at least in man and donkey. The probable vector was Lutzomyia panamensis. No infection was found in a small sample of wild mammals examined. The outbreak was apparently linked with the importation of donkeys with ulcers, from endemic areas. The authors call attention to the fact that not only in the foci of "uta", but also in areas of the other forms of American cutaneous leishmaniasis, dogs are frequently found infected. They emphasize the necessity of searching for the infection in donkeys and of performing hemocultures and xenodiagnosis with sandflies in human, canine and equine cases, to verify their possible role as sources of infection, and not merely as dead ends in the epidemiological chain of the disease.

The records of 50 patients (31 men and 19 women, ranging in age from 49 to 89 years) undergoing definitive below-knee amputation for ischemia from May 1971 to May 1979 were reviewed. Forty-three (86%) had ulceration or necrosis involving the foot or toes. Seven had rest pain without tissue loss. Overall healing rate was 86%. Seven patients (14%) failed to heal and required reamputation above the knee; the functional status of the remaining 43 patients was graded preoperatively and at the time of late follow-up (mean, 3.4 years). Twenty-five of 35 (71%) unilateral below-knee amputees could walk with a prosthesis; ten could not. Seventeen patients (34%) either required an additional, higher amputation or did not use the knee joint to increase mobility. The patient with marginal circulation and marked preoperative functional limitations may have the above-knee level as the chosen site for amputation.