The distribution of common intestinal nematodes along an altitudinal transect in KwaZulu-Natal, South Africa.

In order to study the effect of climate and topography on the distribution of common, intestinal nematodes in schoolchildren, changes in prevalence were investigated along an altitudinal transect from approximately 50 m above sea level (asl), near the coast, to approximately 1700 m asl, in the foothills of the Drakensberg Mountains, KwaZulu-Natal, South Africa. These changes were related to several permutations of temperature, rainfall and evaporation, using univariate and multiple regression analyses. A total of 693 primary schoolchildren aged between 7 and 15 years was examined from six communities along the 150-km transect.

Schistosoma mansoni in migrants entering South Africa from Moçambique--a threat to public health in north-eastern KwaZulu-Natal?

Objectives: To identify possible public health consequences of Schistosoma mansoni infections in migrants entering north-eastern KwaZulu-Natal and Mpumalanga and Northern Province from southern Moçambique.

Design: (i) Intestinal parasite surveys, one sample per person, within a 4-month period; (ii) temperature recordings and snail collections in an irrigation system.

Setting: North-eastern KwaZulu-Natal and Kruger National Park, Mpumalanga and Northern Province.

Prevalence and intensity of Schistosoma haematobium urinary schistosomiasis in the Port St Johns district.

A urinary schistosomiasis survey undertaken in the Port St Johns district of the former Transkei showed the parasite to be endemic and noted an increase in overall infection rates in the region compared with previous studies. There was a general stability in infection over the sampling period 1987-1989. Prevalence rates were low to moderate with an overall prevalence of 42%.

Nursing as the promotion of well-being: the client's experience.

An essential question of the discipline of nursing is: What do nurses do to promote the client's well-being? Using a phenomenological-hermeneutic approach to inquiry, this study explored the client's experience of nursing as the promotion of well-being, explicating in three distinct metathemes the meaning of well-being as transforming and nursing as caring. Based on this critical view of nursing, prospective directions for education, research and practice are suggested.

The therapeutic aspects of acceptance.

Problem: What does acceptance mean to hospitalized adolescents?

Methods: Using a phenomenological research approach, the authors asked hospitalized adolescents (N = 6) on a psychiatric unit to describe how acceptance from psychiatric-mental health nurses was experienced by them.

Findings: Three essential themes emerged: (a) the nurse who shows acceptance is seen as a friend, (b) acceptance generates a sense of well-being, and (c) acceptance produces feelings of comfort with the nurse.

Conclusions: In acceptance, adolescents experience nurses as unique individuals who provide comfort and nurturing.

Successful treatment of early infective endocarditis and mediastinitis in a heart transplant recipient.

We report a case of bacterial endocarditis in a heart transplant recipient that was diagnosed 6 weeks after operation when a transesophageal echocardiogram revealed vegetations on both sides of the atrial septum. The patient also had postoperative mediastinitis and pericarditis. He underwent two mediastinal explorations, pericardiectomy, and 22 weeks of antibiotics and is free of infection 1 year after transplantation.

Relationship of left atrial pressure and pulmonary venous flow velocities: importance of baseline mitral and pulmonary venous flow velocity patterns studied in lightly sedated dogs.

Prior clinical and animal studies have shown a markedly different relationship between left atrial pressure and the systolic fraction of pulmonary venous flow but have not discussed possible reasons for this discrepancy. To examine the possibility that these disparate results are due to differences in baseline mitral and pulmonary venous flow velocities, we recorded both velocities with left atrial and left ventricular pressure under different loading conditions in eight lightly sedated normal dogs. With constant atrial pacing at 85 beats/min, mean left atrial pressure was increased from 5.

Gastro-intestinal parasites of the Samango monkey, Cercopithecus mitis, in Natal, South Africa.

Eight gastro-intestinal tracts of Cercopithecus mitis labiatus from Karkloof, Natal, and 121 fecal samples from C. m. erythrarchus from Cape Vidal, Natal, were examined for helminth parasites and/or their eggs.

Estimation of left ventricular filling pressures using two-dimensional and Doppler echocardiography in adult patients with cardiac disease. Additional value of analyzing left atrial size, left atrial ejection fraction and the difference in duration of pulmonary venous and mitral flow velocity at atrial contraction.

Objectives: The purpose of this study was to determine whether left atrial size and ejection fraction are related to left ventricular filling pressures in patients with coronary artery disease.

Background: In patients with coronary artery disease, left ventricular filling pressures can be estimated by using Doppler mitral and pulmonary venous flow velocity variables. However, because these flow velocities are age dependent, additional variables that indicate elevated left ventricular filling pressures are needed to increase diagnostic accuracy.

The art of nursing: the experience of patients and nurses.

Historical and contemporary conceptualizations of nursing have not addressed the art of nursing from an experiential research approach. This study explores patients' and nurses' experiences of the art of nursing using a phenomenological-hermeneutic approach to enquiry that allows for exploration of the empirical experience. Explicating a paradigm of the art of nursing, five distinct metathemes express nursing as art and describe the complex artistic processes that are lived through the nurse and patient.

The persistence of hepatitis B antigen in the bloodmeal of the potential medicinal leech, Asiaticobdella buntonensis.

The persistence of the hepatitis B virus surface antigen (HBsAg) was used as an index of the survival time of this virus within the gastro-intestinal tract of the potential southern African medicinal leech, Asiaticobdella buntonensis. HBsAg was tested for in blood/faecal material at five intervals over 15 weeks. Samples from both the midgut and the rectum remained positive for the entire test period, although with decreasing strength.

Bacteriological investigation of the occurrence and antibiotic sensitivities of the gut-flora of the potential southern African medicinal leech, Asiaticobdella buntonensis (Hirudinidae).

The lack of availability of medicinal leeches is a major impediment to the widespread use of leech therapy for treatment of congested flaps and replants in southern Africa. An investigation into the suitability of an alternative leech, the indigenous southern African leech, Asiaticobdella buntonensis, was therefore started. The risk of hospital-acquired infection related to the use of leeches and the antibiotic sensitivities of bacteria isolated from the gastro-intestinal tract of wild-caught leeches were investigated.

Snail predation by larvae of Sepedon scapularis Adams (Diptera: Sciomyzidae), a potential biocontrol agent of snail intermediate hosts of schistosomiasis in South Africa.

Malacophagous larvae of the fly Sepedon scapularis Adams were shown experimentally to be effective predators of three species of aquatic pulmonate snails tested as prey: Bulinus africanus (Krauss) an important intermediate host of Schistosoma haematobium (Bilharz), Bulinus tropicus (Krauss) and the invasive species Physa acuta Draparnaud. Survival of S. scapularis larvae from instar to instar was negatively affected by the size of prey snails, since larvae tended to be asphyxiated by the mucous secretions of the snails, or by the larval hydrofuge hairs becoming entangled in snail faeces.

Pulmonary venous flow velocity: relation to hemodynamics, mitral flow velocity and left atrial volume, and ejection fraction.

Abnormal pulmonary venous flow velocity patterns are present in multiple cardiac disease states, but the determinants of pulmonary venous flow velocity have not been fully elucidated. To determine the relative importance of several proposed factors that could influence pulmonary venous flow, anatomic, hemodynamic, and Doppler mitral and pulmonary venous flow velocity data were compared in 50 consecutive patients undergoing cardiac catheterization for clinical reasons. Pulmonary venous diastolic flow velocity was most strongly related to left ventricular isovolumetric relaxation time (r = -0.

A preliminary parasitological analysis of fecal samples from a wild population of Costa Rican squirrel monkeys (Saimiri oerstedi).

Fecal samples (n = 18) were obtained from a wild population of squirrel monkeys, Saimiri oerstedi, in Costa Rica. The parasite cysts, eggs, and larvae recovered from these samples are described.

Diastolic mitral regurgitation with atrioventricular conduction abnormalities: relation of mitral flow velocity to transmitral pressure gradients in conscious dogs.

Diastolic mitral regurgitation is a common finding that can be detected with use of Doppler echocardiographic techniques in patients with atrioventricular (AV) conduction abnormalities. With use of simultaneous hemodynamic and Doppler techniques, mitral flow velocity, mitral valve motion and transmitral pressure gradient were studied during 50 cardiac cycles each of spontaneous or atrial paced first- and second-degree AV block in five lightly sedated dogs. Diastolic mitral regurgitation was detected during atrial relaxation on all beats in which ventricular contraction was delayed greater than 190 ms.

Doppler flow velocity patterns of the superior vena cava, inferior vena cava, hepatic vein, coronary sinus, and atrial septal defect: a guide for the echocardiographer.

Pulsed-wave Doppler provides the echocardiographer the advantage of range resolution; confusion as to the source of Doppler shift information is unusual. One area of the heart that may lead to interpretive difficulties, however, is the right atrium because the right atrium receives blood flow from three venous sources and from the left atrium when an atrial septal defect is present. Our article presents information on the normal pulsed-wave Doppler spectral displays for the superior vena cava, inferior vena cava, hepatic vein, and coronary sinus.

Experimental cardiac tamponade: a hemodynamic and Doppler echocardiographic reexamination of the relation of right and left heart ejection dynamics to the phase of respiration.

A hallmark of cardiac tamponade is pulsus paradoxus. However, the exact mechanism of pulsus paradoxus and the relation of left and right ventricular ejection dynamics remain controversial, with some studies suggesting an inverse relation in ventricular filling and ejection and others citing a more important role for the effects of right heart ejection dynamics delayed by transit through the pulmonary artery bed. To specifically reexamine this issue, six sedated but spontaneously breathing dogs were studied during experimental cardiac tamponade with use of extensive hemodynamic instrumentation and Doppler methods.