Prevalence of multi-gastrointestinal infections with helminth, protozoan and Campylobacter spp. in Guatemalan children.

BACKGROUND: The prevalence of multi-infections with helminthes, protozoans and Campylobacter spp. in Guatemalan children is a reflection of differences in the risk factors related to pathogen transmission. METHODOLOGY: Two hundred and eighty-nine fecal samples were collected from children of the Guatemalan highlands and patterns of pathogen occurrences were evaluated using an immunoassay for Campylobacter spp., a formalin-ether concentration followed by observation of unstained slides for helminthes and trichome stains of fecal smears for protozoans. Specimens were examined microscopically using 100, 400 and 1000x magnification. RESULTS: Prevalence of Ascaris lumbricoides, Campylobacter spp., Giardia duodenalis, Entamoeba histolytica/E. dispar and Trichuris trichiura were 55.1%, 30.8%, 21.5%, 19.8% and 19.4%, respectively. Overall, the prevalence of at least one intestinal pathogen was 85.5%. Multi-infections were found in 43% of the children harboring pathogens. CONCLUSIONS: Infections with Campylobacter spp., E. histolytica/E. dispar, T. trichiura and G. duodenalis were closely associated with the presence of co-infection with A. lumbricoides. T. trichiura infection was related to co-infection with A. lumbricoides and Campylobacter spp. Infections with G. duodenalis and T. trichiura were related to co-infections with either Campylobacter spp. or E. histolytica/E. dispar. The prevalence of multi-gastrointestinal infections with helminthes, protozoans and Campylobacter spp. in children was found to be related to age and gender.

Legg reduction maneuver for patients with anterior shoulder dislocation.

Few manual techniques for reducing anterior shoulder dislocations are easy to perform in the clinical setting, and many of these techniques require sedation. The authors describe a technique, the Legg reduction maneuver, that is easy to perform on site and requires no premedication. Clinical experience indicates that proper use of this maneuver can successfully relocate a patient's anterior shoulder dislocation. The relocated arm can then be placed in an immobilizer and receive further medical management as appropriate. The Legg reduction maneuver allows the physician to work with the natural tendencies of muscle groups in the patient, rather than against them. Thus, the technique can be performed without sedation. In addition, because no traction is placed on the injured shoulder, the potential for neurovascular injury is decreased.