Vectorial importance of triatominae bugs (Hemiptera: Reduviidae) in Guaymas, Mexico.

The study was conducted in Guaymas city, Sonora, in Northwestern Mexico. Triatomines were collected manually during daytime, within and around houses selected randomly, with one person searching for bugs during one hour per house. Collected bugs were identified and analyzed for Trypanosoma cruzi infection. From a total of 279 collected specimens there were 123 females, 65 males and 91 nymphs (entomological indexes: 63% infestation, 68.4% colonization, 8.5% density and 13.5% stacking). There were 251 (90%) triatominae bugs infected with T. cruzi, one of the highest natural infestation levels recorded in Mexico. The insects collected were identified as Triatoma rubida (91%) and T. recurva (9%). Previous reports for the same locality (1959) indicated the presence of T. rubida in the wild, we found T. rubida within houses, and T. recurva as a peridomestic bug. Unplanned housing developments in originally wild areas may have favored T. cruzi transmitters to migrate from the wild and into human dwellings.

Disseminated histoplasmosis with unusual cutaneous lesions in a patient from the Philippines.

The incidence and prevalence of histoplasmosis in Southeast Asia has not been extensively described. The first microbiologically documented case of disseminated histoplasmosis with cutaneous papulonodules in a 56-year-old woman from the Philippines is reported. She presented with fever and generalized papulonodular lesions in various stages, which evolved into vesicles with central necrosis that resembled molluscum contagiosum with an indurated erythematous halo. Biopsies revealed a granulomatous mass of lymphohistiocytic and epithelioid cells with intracellular budding yeast cells and dark nuclei. Cultures were positive for Histoplasma capsulatum. The patient was treated with amphotericin B (3 g) and 5-fluorocytosine (50 mg/kg/day), followed by ketoconazole (400 mg/day). Her clinical course was complicated by intractable hemolytic anemia that was initially treated with corticosteroids. A splenectomy was subsequently performed. Pneumonia and a brain abscess caused by Nocardia asteroides were secondary complications. Nine months after her admission, repeat testing was diagnostic for systemic lupus erythematosus. This patient serves to re-emphasize that cutaneous lesions in an immunocompromised patient must be evaluated by biopsy and culture analysis. Disseminated histoplasmosis in the immunocompromised host may present with unusual cutaneous lesions, and must be considered even in a nonendemic area.

Evaluation of aerosolized triamcinolone acetonide as a replacement for aerosolized beclomethasone dipropionate.

Substitution of aerosolized triamcinolone acetonide for aerosolized beclomethasone dipropionate in treatment of 30 chronic asthmatics resulted in subjective improvement in all patients. There was reduction in requirement of systemic steroids and inhaled beta adrenergics. No adrenal suppression or oropharyngeal candidiasis occurred after replacing beclomethasone dipropionate with triamcinolone acetonide.

Overt and covert aspects of adult speech perception.

The relationship between verbal report and cardiac orienting response measures of speech discrimination in adult listeners was examined in two experiments using stimuli and paradigms previously employed in studies of infant speech perception. The results of Experiment I revealed that all listeners, those who reported discrimination of a synthetic [ba-ga] change (Group D) as well as those who did not (Group ND), demonstrated cardiac discrimination of the stimulus shift. However, this pattern of cardiac activity, both at stimulus onset and the shift, was found to be different in these two groups of listeners. Experiment II replicated the Group D results using a slightly different cardiac paradigm and quasinatural speech syllables. The implications of these findings for developmental research on speech perception with older infants, children, and populations with language disorders are discussed.