Seasonal abundance patterns of the sandfly Phlebotomus papatasi in climatically distinct foci of cutaneous leishmaniasis in Israeli deserts.

Among foci of cutaneous leishmaniasis in Israel, population densities of the vector sandfly Phlebotomus papatasi Scopoli (Diptera: Psychodidae) were assessed during April-October 1999 in the mesic Negev desert and the hyper-xeric Arava valley, using sticky traps placed overnight near host burrows of the fat sand rat, Psammomys obesus Cretzschmar (Cricetidae: Gerbillinae). Population dynamics of Ph. papatasi differed between the Negev (study sites on sand near Mount Keren and on loess at Nizzana ruins) and the Arava valley (study sites on sand at Shezaf and in a fallow field near irrigation at wadi Arava). At the Negev sites, sandfly abundance peaked in spring (April or May), whereas at Arava sites Ph. papatasi population densities were bi-modal, with peaks in both spring and autumn (September or October). This might be conducive to sustaining enzootic Leishmania major Yakimoff & Schokhor (Kinetoplastida: Trypanosomatidae). In both areas, Ph. papatasi densities were much higher at the site with moister soil, raising transmission risks of zoonotic cutaneous leishmaniasis.

Toxicological studies of organophosphate and pyrethroid insecticides for controlling the fruit fly Dacus ciliatus (Diptera: Tephritidae).

The fruit fly Dacus ciliatus Loew is a pest of the fruits of many cucurbit species. We studied the effect of organaophosphate and pyrethroid compounds on the adult flies by using surface contact and oral administration. In contrast to other fruit flies, we found that organophosphates were ineffective against D. ciliatus. This was supported by the insignificant decrease of head acetylcholinesterase activity. All tested pyrethroids showed satisfactory killing ability, rapid and massive knockdown effect, and prevention of oviposition. Piperonyl butoxide considerably increased the toxicity of pyrethroids, which can be explained by oxidase detoxification of these compounds in D. ciliatus. It can be concluded that pyrethroids have high potential for controlling D. ciliatus.

Transvaginal sonography as the ultimate diagnostic tool for the management of ectopic pregnancy: experience with 840 cases.

OBJECTIVE: To evaluate the efficacy of transvaginal sonography and serum beta-hCG levels as diagnostic tools for deciding whether to perform operative laparoscopy in the treatment of presumed ectopic pregnancy (EP). DESIGN: A prospective protocol for the evaluation and treatment of women with presumed EP. SETTING: Department of Obstetrics and Gynecology, Haemek Medical Center, Afula, Israel. PATIENT(S): Eight hundred forty women with presumed EP who were seen in our emergency department from January 1988 through December 1995. INTERVENTION(S): On the basis of specific sonographic signs and beta-hCG levels, we performed immediate operative laparoscopy in patients with demonstrable extrauterine fetal heart activity or >100 mL of fluid in the pelvic cavity. We followed up all other patients, using defined criteria for laparoscopic intervention. MAIN OUTCOME MEASURE(S): The accuracy of transvaginal sonography in predicting EP was evaluated as part of the described protocol. RESULT(S): Overall, 380 patients were found to have EP. Of these, 331 were identified positively by transvaginal sonography and 49 were not. In 27 of 358 laparoscopies, no EP was found. The sensitivity of transvaginal sonography for the prediction of EP was 87% and the specificity was 94%. The positive and negative predictive values were 92.5% and 90%, respectively. CONCLUSION(S): In this protocol, which invariably captured the true location of the products of conception, using transvaginal sonography as the primary modality in the evaluation of patients with presumed EP resulted in the use of laparoscopy mainly as a treatment tool. This approach is both safe and economical.

Recovery of ovarian function after laparoscopic detorsion.

In an attempt to preserve ovarian function, we managed 58 women with adnexal torsion by laparoscopic detorsion. Follow-up ultrasound examinations were performed on 54 of the women. Follicular development was evident in 49 of 52 (94.2%) women with normal-sized ovaries. We conclude that ovarian function returns in the majority of women with adnexal torsion managed conservatively.