Leishmaniasis is a cluster of diseases caused by protozoa in the genus Leishmania. There are three basic clinical forms: cutaneous, mucocutaneous, and visceral leishmaniasis. The present review focuses on the diagnosis and treatment of cutaneous and mucocutaneous leishmaniasis. Characteristics of both the human host and the parasite species influence the clinical disease manifestations that range from asymptomatic exposure, to self-healing skin ulcers, to life-threatening widespread destructive ulcerations. Whether through medical treatment or through spontaneous resolution, skin ulcerations generally result in disfiguring scars with significant social and economic impact. Tests to confirm the diagnosis should be performed on patients who have recently visited endemic areas and have skin or mucosal manifestations consistent with leishmaniasis. Treatment depends on the species of Leishmania and the risk of widespread or disfiguring disease. Because of increasing trends in global travel, educating health care providers to recognize and treat leishmaniasis in both endemic and non-endemic countries is imperative.

Relationships between hormonal and metabolic changes around parturition and colostrum yield and composition were investigated in 16 Landrace x Large White primiparous sows. Blood samples were taken daily from d 105 of pregnancy to d 2 postpartum (with d 0 being the day of parturition). Colostrum samples were taken at the onset of parturition (T0), and then 3, 6, and 24 h later (T3, T6, and T24, respectively). Colostrum yield was calculated from the beginning of parturition until 24 h later by adding colostrum intake of individual piglets, which was estimated from their BW gain. Colostrum yield averaged 3.22 +/- 0.34 kg. Four sows had very low colostrum production (1.10 +/- 0.12 kg; n = 4), whereas the others produced between 2.83 and 4.64 kg of colostrum (3.93 +/- 0.16 kg; n = 12). Compared with the high-colostrum-producing sows, the low-colostrum-producing sows tended (P < 0.1) to have greater plasma concentrations of progesterone during the 20-h prepartum and tended (P < 0.1) to have smaller plasma concentrations of prolactin 40 and 30 h before parturition. Sows with a low colostrum yield had greater plasma concentrations of glucose than sows with a high colostrum yield from d -9 to -2 (P < 0.05). At the onset of parturition, colostrum from low-producing sows had greater percentages (P < 0.01) of DM, lipids, and GE, but less (P < 0.05) lactose, than that from high-producing sows. The Na:K ratio in colostrum during the 6 h postpartum was greater (P < 0.01) in low-producing sows than in high-producing sows, indicating that cellular junctions between epithelial mammary cells were less tightly closed. Concentrations of IgG in colostrum varied greatly between sows and decreased by approximately 80% between T0 and T24. Within high-producing sows, concentrations of IgG in colostrum at T0, T3, and T6 were negatively correlated (P < 0.05) with lactose concentrations in colostrum at the same times and were positively correlated (P < 0.05) with plasma concentrations of IGF-I measured from d -9 to 0. In contrast, no correlation (P > 0.1) was found between IgG concentrations in colostrum at any time and prolactin, estradiol-17beta, progesterone, or cortisol. In conclusion, sows that produced a low yield of colostrum were characterized by a leaky mammary epithelium and reduced synthesis of lactose, related to delayed hormonal changes before parturition.