These preliminary results suggest that follow-up of low income, minority women with abnormal screening mammograms could be enhanced by improved communication of results. Future studies should extend these findings with larger samples and in other settings and populations.

This article presents a study on seroepidemiological, entomologic, and

No abstract

Recent data suggest that hepatitis C viral (HCV) infection may induce a significant autoimmune reaction to platelets, but the mechanism is unknown. Many patients with chronic hepatitis C, in fact, have high levels of platelet-associated immunoglobulin G (PAIgG) and HCV-RNA is present in the platelets of 100% of those patients with thrombocytopenia and high PAIgG levels. Hepatitis C virus infection has been associated with the development of thrombocytopenic purpura, sometimes triggered during interferon (IFN) therapy. In such cases, the treatment of the underlying disease is a difficult problem to solve. We report the case of a patient with chronic hepatitis C, who developed life-threatening thrombocytopenic purpura after a prolonged course of IFN-alpha2b over a 4-year period. Treatment with anti-immunoglobulin gammaglobulin (Polyglobin; Química Farmaceutica Bayer, Barcelona, Spain) had a transient effect on the platelet count, but prolonged therapy with prednisone was necessary for definitive relief of the haematological complication. Two years later, the patient was treated with combined therapy, including ribavirin (1200 mg/day) and IFN-alpha2b (5 mU, t.i.w.) for 12 months. This therapy induced a sustained response, both biochemical and virological, without haematological complications. This observation suggests that ribavirin may be of benefit in the treatment of immune-mediated thrombocytopenia in patients with chronic hepatitis C, preventing the harmful effect of IFN-alpha but also allowing both drugs to be combined so as to increase the probability of sustained remission of the liver disease.

Introducción. Dado el reiterado hallazgo de adultos y formas inmaduras de Triatoma maculata capturados en domicilios y peridomicilios en la localidad de Xaguas (Venezuela), se analizó la viabilidad de una colonia de laboratorio de esta especie alimentada con sangre humana y su estructura espacial. Objetivos. Analizar la viabilidad del ciclo de T. maculata alimentado con sangre humana en condiciones de laboratorio y caracterizar la estructura espacial de una población de T. maculata proveniente de ambientes domiciliarios y peridomiciliarios del centro-occidente de Venezuela. Materiales y métodos. La alimentación con sangre humana se llevó a cabo en lotes por estadio, utilizando un alimentador artificial, y la estructura espacial de los insectos por sexo y ambiente fue analizada mediante morfometría geométrica. Resultados. Los hallazgos fueron: fecundidad promedio, 27,70 huevos/hembra/vida, tiempo promedio de postura de huevos, 32,74 días, y longevidad promedio de la hembra, 39,15 días; el mayor tiempo en V estadio fue de 45,9 días y el menor en I estadio, 18,41 días; la mayor mortalidad fue de 77,78% y el menor porcentaje de muda en V estadio, de 22,23%. No se encontraron diferencias en el tamaño de alas y cabezas; sí se encontraron diferencias de conformación entre las cabezas de un mismo sexo de diferentes hábitats; sólo se encontraron diferencias de conformación de alas entre los machos del domicilio y peridomicilio. Conclusiones. T. maculata de la localidad de Xaguas podría encontrarse en un estado de adaptación al domicilio con fuentes sanguíneas diferentes al humano y en un estado incipiente de adaptación al domicilio con la sangre humana como fuente de alimentación.Palabras clave: Triatoma, adaptación biológica, caracteres sexuales, supervivencia, reproducción, enfermedad de Chagas.Viability and spatial structuring in a Triatoma maculata (Hemiptera: Reduviidae) laboratory colony fed with human blood Introduction. Immature and adult forms of Triatoma maculata have been captured repeatedly in and around the homes in the town of Xaguas, Venezuela. Because of its potential as a Chagas disease vector, a study was undertaken to evaluate the effect of human blood feeding on the viability and spatial structuring of a laboratory colony of this species . Objective. The effect of human blood feeding was determined for the viability of a T. maculata laboratory colony, as well as its spatial structuring. Material and methods. Insects were fed with human blood on artificial feeder. Spatial structuring was undertaken by the generalized analysis of by geometric morphometry. Results. The average fecundity of 27.7 eggs/female/lifetime was found, with a mean time to oviposition of 32.7 days, and a female longevity of 39.2 days. The longest inter-molt period was at the fifth nymphal stage (45.9 days), whereas the shortest was at 18.4 days, during the first nymphal stage. The highest mortality of nymphs was observed at the fifth nymphal stage (77.8%). The lowest molting percentage was observed in the fifth nymphal stage (22.2%...