Outbreak of cryptosporidiosis among veterinary students.

We describe an outbreak of human cryptosporidiosis in 5 veterinary students in contact with experimentally infected calves. All persons experienced symptoms of gastroenteritis, with the main complaint of diarrhoea lasting for 1-13 days. The persons recovered spontaneously; one was hospitalized for 10 days. The diagnosis was based on the demonstration of Cryptosporidium oocysts from stools by the smear method and the formalin-ether concentration method, both combined with the acid-fast staining technique. Both methods gave almost equal results. The role of Cryptosporidium as an occupational risk is discussed.

Cryptosporidiosis associated with traveling and giardiasis.

The aim of this study was to reveal sources where cryptosporidiosis may be acquired. We studied 4545 patients, from whom 5730 stool samples were obtained for the diagnosis of parasitic infections during 13 mo, and found that 119 of these patients (2.62%) excreted oocysts of Cryptosporidium. About two-thirds of the patients reported no animal contacts. There were no cases among children under the age of 5 yr, which is evidence against endemicity, and the prevalence was highest (6.22%) in young adults aged 15-29 yr. The sex distribution was unremarkable: of the 119 patients, 56 were men and 63 were women. Most patients reported a recent trip abroad, which had taken place 12 times more frequently during the previous month than earlier. Cryptosporidiosis was five times more frequent in patients who had recently visited Leningrad than in others, and seven times more frequent in patients with Giardia lamblia than in others. Sporadic cryptosporidiosis occurs mainly in travelers, and seems to be acquired from similar sources as giardiasis.

Frequency, multiplicity and repertoire of intestinal protozoa in healthy homosexual men and in patients with gastrointestinal symptoms.

Various conventional parasitological methods were used to study three faecal samples from 153 homosexual men and 119 patients with abdominal symptoms. In 59.5% of the homosexual men 198 protozoa were identified, and in 31.9% of the patients the number of protozoa was 51. Cryptosporidium and Giardia lamblia were more frequent in the patients, while various amoebae were more frequent in the homosexual men. The frequency, multiplicity and repertoire of intestinal protozoa in the homosexual men were very similar to those reported from other parts of the world, but quite different from those associated with gastrointestinal illness in the local general population.

Negative staining method with nigrosin for the detection of cryptosporidial oocysts: a comparative study.

A comparison was made between two methods for the detection of cryptosporidial oocysts in human faecal sediments of formalin-ether concentrates: a cover-slipped, wet method (containing Gram's iodine) and an air-dried, negative staining method using nigrosin solution. A modified Ziehl-Neelsen technique was used as a reference method. The negative staining method with nigrosin gave a positive diagnosis more often than the cover-slipped wet method. A comparison of the nigrosin method with the modified Ziehl-Neelsen method gave almost identical results. Restaining the nigrosin slides with the modified Ziehl-Neelsen technique showed that the round, refractile bodies were cryptosporidial occysts.

Cryptosporidium: a frequent finding in patients with gastrointestinal symptoms.

1422 faecal samples sent by general practitioners for routine parasitological examination were surveyed in 3 months. Of the 10.8% short-listed for special examination for cryptosporidium oocysts, 14 (9.1%) were positive. Charcot-Leyden crystals were not associated with cryptosporidiosis. All 14 patients had symptoms of gastrointestinal infection, which seemed to be related to a trip abroad. The incubation period varied between 4 and 12 days. Clinically cryptosporidiosis could not be distinguished from giardiasis, but its duration was shorter (median 10 days), strong abdominal pain and cramps were commoner, and bloating, anorexia, and weakness were less common. The disease can be diagnosed by identification of oocysts in faecal samples that have undergone formalin-ether concentration. There is no specific treatment for it, and recovery is spontaneous.

Five-year survival of 728 patients after myocardial infarction. A community study.

This study deals with the five-year survival of 728 myocardial infarction patients who survived the first 28 days after the onset of symptoms. The series was collected by the Helsinki Coronary Register and includes all cases of acute myocardial infarction in the population who were under 66 years of age during the period 1 July 1970 to 30 June 1971. Of the 219 patients who subsequently died, 81.8 per cent died from ischaemic heart disease. The mortality was highest during the first year after the acute phase but did not decrease after the second year. The mortality was higher in patients with a transmural infarction (five-year mortality 34.0%) compared with those with a nontransmural infarction (19.7%). The mortality also was higher for recurrent acute myocardial infractions than for first attacks. The five-year mortality for women was less (20.5%, age-adjusted) than for men (31.6%). This is mainly because of the higher incidence of nontransmural infarcts in women. Acute ischaemic heart disease is more common, more often fatal, and has a poorer long-term prognosis in men than in women in Helsinki. The acute mortality from acute ischaemic heart disease is high in Helsinki when compared with other WHO registers and, in addition, the long-term prognosis seems to be relatively poor in Helsinki.

The effect of gemfibrozil on serum lipids in diabetic patients.

The effect of gemfibrozil, a new hypolipidaemic compound, on serum lipids, lipoproteins and ophthalmic signs was studied in 20 diabetics during a 28 week trial. Ten of the patients were taking oral hypoglycaemic agents and another ten insulin. Genfibrozil elevated the proportion of alpha-lipoproteins (HDL) (P less than 0.005) in patients on oral agents to the same level as in those using insulin, who experienced no change in HDL. The pre-beta-lipoprotein proportion (VLDL) decreased (P less than 0.001) along with the serum triglyceride level in patients on oral agents only. The proportion of beta-lipoproteins (LDL) remained unchanged in both groups. The serum cholesterol and total lipid levels decreased significantly whether the patients were on oral treatment or insulin. The gemfibrozil was well tolerated. A minor increase in diabetic therapy was made in 9 patients in order to control the blood sugar levels. The ophthalmic signs were generally unchanged.

The prognostic value of the P wave morphology in the discharge ECG in a 5-year follow-up study after myocardial infarction.

The discharge ECG's of 641 patients with acute myocardial infarction (AMI) (WHO categories "definite" and "possible" AMI) were studied to assess the prognostic value of P wave morphology as an index of left ventricular dysfunction. Of 69 patients with abnormal P terminal force (PTF), i.e., --0.03 mm.sec. or more negative, 53.6 per cent died within the next 5 years of ischemic heart disease, compared with 20.4 per cent of 558 patients with normal PTF. The odds ratio (age-corrected risk to die, Mantel-Haenszel test) was 4.1 (95 per cent confidence limits 2.4 to 7.0). The mortality curve of patients with normal PTF was linear whereas there was an abrupt rise in mortality rate during the first six months if PTF was abnormal. Of a group of 15 patients with the frontal axis of the terminal P wave --30 degrees or more negative, 8 died (Odds ratio 4.7; 1.3 to 17.1). Ten patients had atrial fibrillation, and five of them died (Odds ratio 2.; 0.5 to 12.9). In 14 cases the duration of the P wave in Lead II was 0.12 sec. but it showed no relationship to mortality (p less than 0.10). The significance of the P wave morphology on the discharge ECG to long-term survival after MI has been demonstrated. These simple ECG variables, related to left ventricular failure, can easily be put to clinical use to differentiate MI patients who are in greater risk of dying during the chronic phase.