Since the Beginning

This chapter traces Catholic international sisters in the history of the United States, from the eighteenth century to the present time. The chapter discusses the primarily European origin of many sisters and religious institutes in the first three centuries of sisters’ immigration, and the Asian, African, and Latin American origin of international sisters’ migration to the United States today. It describes the invitations from some bishops and priests in the United States to some religious institutes, and the sisters’ frequent accompaniment of co-ethnics in this country. It discusses the many educational and healthcare institutions the sisters built in this country, and the ministries they also conducted.

HEMATOLOGICAL CHARACTERISTICS OF YEMENI ADULTS AND CHILDREN WITH VISCERAL LEISHMANIASIS. COULD EOSINOPENIA BE A SUSPICION INDEX?

Background and objectives: Delay in the diagnosis of visceral leishmaniasis (VL) particularly in non-endemic areas is associated with higher mortality. In our experience, we found that marked bone marrow eosinopenia was a very frequent accompaniment of VL and might be a useful clue for the diagnosis, which indicates the opportunity for further morphological assessment. The aim of this study was to describe the hematological characteristics including peripheral blood and bone marrow findings of Yemeni adults and children with VL.Methods: We conducted a descriptive analytic study to evaluate systematically peripheral blood and bone marrow findings of Yemeni adults and children with VL. Peripheral blood and bone marrow aspiration of patients with bone marrow aspirate confirmed VL were examined. Forty-seven patients with the main age (±SD) of 17.34±11.37 years (Range: 1-60) were included in the study. Fifty-one non-VL subjects with splenomegaly and pancytopenia or bicytopenia served as control group.Results: All patients with VL had anemia, 41 (87%) leukopenia, 42 (89%) neutropenia, 44 (94%) thrombocytopenia, 42 (89%) eosinopenia, 34 (72%) pancytopenia and 13 (28%) had bicytopenia. In bone marrow examination 40 (85%) showed hypercellularity, 44 (94%) eosinopenia, 24 (51%) dyserythropoiesis, 22 (47%) lymphocytosis, 8 (17%) plasmacytosis, 27 (57%) decreased iron stores and 20 (43%) showed decreased sideroblasts. Comparison of VL patients with the control group showed significantly more frequent peripheral blood eosinopenia and lymphopenia and marrow eosinopenia. There was no significant difference between adults and children in any of the hematological features.Conclusion: Anemia, leukopenia, neutropenia, thrombocytopenia, eosinopenia, pancytopenia and marked bone marrow eosinopenia were the most common findings. The finding of marked bone marrow eosinopenia is a significant clue for the diagnosis of visceral leishmaniasis in patients who present with splenomegaly associated with cytopenias. This finding is particularly valuable in non-endemic areas.Keywords: Visceral Leishmaniasis, Yemen, Early Diagnosis, Hematological Features, Bone Marrow Eosinopenia.

WATER QUALITY MONITORING OF GROUNDWATER IN THE RESIDENTIAL SHANGRI-LÁ- GOIÂNIA NORTH AREA

The water is one human fundamental rights, however, the simple access the water doesn't guarantee the health of who consumes it, considering that if the water is not inside of the established quality patterns it can bring serious damages so much to the human, as the fauna and the flora of an area. The accomplishment of that study is justified like this for the importance of the water for the human survival, once that resource being contaminated in some way it can bring irreversible damages to the population health. The objective constituted in monitoring the water quality of the groundwater in a division into lots, Residential Shangri-Lá located in the north area of Goiânia, through analyses of environmental control. The hypothesis that orientated of this work constituted in to show that the population uses cisterns as alternative for the obtaining of water, because the population has no access to conventional water supply. For the realization of this study samples of water were collected in the residential and it was made analyses physical-chemistries (dissolved oxygen, turbidity, true color, pH and total phosphorus) and microbiological heterotrophic contamination, escherichia coli and total coliforms). It was verified with the monitoring and analyses that the underground water used Shangri-Lá in the Residential it is not in alarming levels of contamination not even for industrial activities, septic sewages or other factors, the people's health can be committed for the failures of potability of the water consumed by residents of the condominium, demonstrating like this the need of frequent accompaniment and the reevaluation of the measures of hygienic handling in these places, due to the possibilities of contamination of several orders.

Congenital anorchia, acquired anorchia, testicular maldescent, and varicocele

This chapter describes the causes, symptoms and clinical management strategies of three disorders affecting the testes; anorchia (both congenital and acquired), testicular maldescent, and varicocele. Absence of both testes in baby boys (bilateral congenital anorchia) is infrequent. Unilateral anorchia or monorchidism is more common. Vascular accidents in gestation appear to be the major cause of anorchia. Bilateral anorchia is associated with changes in luteinizing hormone, follicle-stimulating hormone, and testosterone levels. Once the diagnosis of bilateral anorchia is made, both sterility and the requirement for androgen replacement therapy need to be considered. For treatment, androgen replacement therapy induces pubertal virilization and maintains it in adult life. Torsion and orchidectomy or failed orchiopexy for maldescent are the commonest causes of acquired anorchia. Clinical evaluation and androgen replacement therapy for acquired anorchia are as for congenital anorchia. Normal testes may not complete descent into the scrotum until after birth, particularly in premature infants. The pathological condition of testicular maldescent generally includes incompletely descended or ectopic testes. Infertility is an important problem in patients with a past history of maldescended testes, though whilst the causes of maldescended testes may be multifactorial, the majority of infertile patients with maldescended testes have no other relevant clinical features. Clinical guidelines for treatment of maldescended testes recommend orchiopexy for congenital forms between 6 and 12 months of age, and as soon as possible for those discovered later and for acquired maldescent. Varicocele is one of the most enigmatic and controversial areas in reproductive medicine; a dilation of the pampiniform plexus that usually affects the left side. Its pathogenesis, effects on the testis and, particularly, the benefits of treatment for infertility remain uncertain. Some adults with varicoceles complain of testicular discomfort, a feeling of weight or a dragging sensation in the scrotum. However, many men with a varicocele are unaware of its presence. The mechanism of development of the common varicocele is regarded as a missing or incompetent valve, although they can also result from portal hypertension or intra-abdominal venous obstruction. Asymmetrical testicular size is a frequent accompaniment to the presence of a varicocele, and on average poorer semen quality is present in affected men. They are most easily detected with the man standing upright. Inspection of the scrotum shows an enlargement of the left side of the scrotum, and the dilated veins maybe apparent. Most treatments involve venographic or surgical obstruction of the incompetent veins, though a variety of surgeries have also been performed. The association between varicoceles and infertility is controversial and a Cochrane Review concluded that there is insufficient evidence to support varicocele treatment for infertility. However, the field remains confused and contradictory.

Self-Inflicted Wounds, Template-Directed Gap Repair and a Recombination Hotspot: Effects of the mariner Transposase

Aberrant repair products of mariner transposition occur at a frequency of ~1/500 per target element per generation. Among 100 such mutations in the nonautonomous element peach, most had aberrations in the 5′ end of peach (40 alleles), in the 3′ end of peach (11 alleles), or a deletion of peach with or without deletion of flanking genomic DNA (29 alleles). Most mariner mutations can be explained by exonuclease “nibble” and host-mediated repair of the double-stranded gap created by the transposase, in contrast to analogous mutations in the P element. In mariner, mutations in the 5′ inverted repeat are smaller and more frequent than those in the 3′ inverted repeat, but secondary mutations in target elements with a 5′ lesion usually had 3′ lesions resembling those normally found at the 5′ end. We suggest that the mariner transposase distinguishes between the 5′ and 3′ ends of the element, and that the 5′ end is relatively more protected after strand scission. We also find: (1) that homolog-dependent gap repair is a frequent accompaniment to mariner excision, estimated as 30% of all excision events; and (2) that mariner is a hotspot of recombination in Drosophila females, but only in the presence of functional transposase.

The effects of anxiety on psychiatric morbidity in patients with multiple sclerosis

Our objective was to assess the point prevalence and effects of clinically significant anxiety in patients with Multiple Sclerosis (MS). One hundred and fifty two consecutive patients with MS attending an outpatient clinic underwent neurological examination and were assessed for psychopathology with the Hospital Anxiety and Depression Scale, the 28 item General Health Questionnaire and a questionnaire probing suicidal thoughts or intent. Clinically significant anxiety, either with or without depression, was endorsed by 25% of patients, three times the rate for depression. Females were significantly more anxious than males. Anxiety co-morbid with depression, rather than anxiety or depression alone, was associated with increased thoughts of self harm, more somatic complaints and greater social dysfunction. Patients with increased psychopathology were not more likely to be taking psychotropic medication. The results provide preliminary evidence that anxiety, which may be often overlooked clinically, is a frequent accompaniment to depression, thereby adding to the morbidity associated with MS. The implications of the findings to MS patients' quality of life are emphasised.

A DISTINGUISHED ENGLISH AND AMERICAN PHYSICIAN ADVOCATE GUMLANCING FOR TEETHING INFANTS: JOHN DARWALL OF BIRMINGHAM IN 1830 AND JOHN LOVETT MORSE OF BOSTON IN 1908

So far as I know, no present day pediatric textbook recommends gum-lancing to relieve the symptoms caused by the cutting of the infant's teeth. But within the memory of many older practitioners, the value of this procedure was still supported by a number of the leading pediatricians of their day. One of the most avid proponents of gumlancing was Dr. John Darwall of Birmingham, England, who wrote: With respect to the gums, the moment they become red and inflamed they should be lanced, nor can any harm result from this practice, if the lancet be clean . . . An objection has been made, and even by medical men, that should the gums heal over the teeth after they have been lanced, they become harder than they were at first, and consequently that the teeth will have more difficulty in protruding. Unprofessional persons might be excused for making such a remark and drawing such an inference, but in medical men it is utterly disgraceful. Convulsions, inflammation of the eyes and many other diseases frequently accompany teething; it will be in vain to administer medicines until the gums have been lanced.1 Almost a century later the highly respected John Lovett Morse of Boston advocated gumlancing to relieve the infant's fever, which he considered to be a frequent accompaniment of teething. He cited the following personal experience: A boy, 17 months old, began to be fussy and a little feverish the night of April 14. The next evening the temperature was 103°F., the next day 100°F. in the evening.

OBSERVATIONS ON THE CONDITIONS OF DIETARY HEPATIC INJURY (NECROSIS, CIRRHOSIS) IN RATS

Experimental dietary hepatic injury (diffuse or focal necrosis and cirrhosis in rats, with or without ascites and pleural and pericardial effusion) is determined by the dietary factors instrumental also in the production of fat infiltration of the liver and thus opposed to the lipotropic activity of casein. Accordingly, rats maintained on a diet low in casein with a moderately high or high content of fat and without choline regularly exhibited hepatic injury after between 100 and 150 days. Supplements of l-cystine had an aggravating effect on the production of cirrhosis of the liver, whereas a supplement of choline alone reduced the severity and the incidence of hepatic injury, although not decisively. The combined administration of l-cystine plus choline or of dl-methionine in adequate doses, however, proved to be highly effective in preventing injury to the liver. These conclusions have been corroborated by the use of different modifications of the basal diet. Rats with dietary hepatic injury exhibit, in sequence, changes that vary from diffuse necrosis resembling human acute or subacute yellow atrophy to advanced portal cirrhosis. Diffuse necrotizing nephrosis was a frequent accompaniment of the hepatic injury. Cystine again, proved to be a factor which aggravated this condition.