Sporotrichosis is the most common subcutaneous mycosis in South America. Classic infection is associated with traumatic inoculation of soil, vegetables, and organic matter contaminated with Sporothrix schenckii. Zoonotic transmission has been described in isolated cases or in small outbreaks. Since 1998, we have been observing an increasing number of cases of sporotrichosis in persons from the city of Rio de Janeiro, Brazil, and surroundings. From 1998 to 2001, 178 cases of culture-proven sporotrichosis had been diagnosed. Female patients predominated, and the median age was 39 years. The most frequent clinical presentation was lymphocutaneous disease. Of the 178 patients, 156 reported domiciliary or professional contact with cats with sporotrichosis, and 97 of these patients had a history of receipt of cat scratch or bite. The patients received itraconazole as first-line treatment. This study suggests that feline transmission of sporotrichosis was associated with a large and long-lasting outbreak of the disease in Rio de Janeiro.

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We have determined the effectiveness and degree of motor block produced by the new local anaesthetic, ropivacaine, when used for caudal anaesthesia in children. We studied 60 children, aged 3-6 yr, ASA I, allocated randomly in a double-blind manner, to receive one of two local anaesthetics: 0.375% ropivacaine 1.0 ml kg-1 or 0.375% bupivacaine 1.0 ml kg-1. Patients were anaesthetized with continuous infusion of propofol 200 micrograms kg-1 min-1. The lungs were ventilated with 50% nitrous oxide in oxygen. Heart rate and arterial pressure were measured every 5 min after administration of local anaesthetic until discharge from the recovery room. The extent of motor block in the recovery room was scored as 1-3. Adverse events and time to first analgesic requirements were recorded. Patients in the two groups did not differ in age, weight or height. There were no differences in heart rate or arterial pressure between the two groups. No adverse events were observed. The degree of motor block was significantly different between the two groups. The ropivacaine group showed a shorter duration of motor block than the bupivacaine group (P < 0.05). Postoperative analgesia was required at a mean time of 5 (SD 3.2) h in the ropivacaine group compared with 5 (2.8) h in the bupivacaine group. These findings suggest that caudal anaesthesia with ropivacaine in paediatric patients is effective and produces less motor block in the postoperative period.

The domestic cat has played an important role in the transmission of sporotrichosis in Rio de Janeiro and seems to have contributed to this unusual clinical manifestation.

The use of a single small dose of ketamine in a pediatric population undergoing tonsillectomy could reduce the frequency or even avoid the use of rescue analgesia in the postoperative period independent of whether used before or after the surgical procedure.

We compared in a randomized double-blind study, the postoperative analgesia and degree of motor block produced by the new local anaesthetic ropivacaine, with bupivacaine, for caudal anaesthesia in children. Eighty children, 2-5-years-old, ASA I, received one of two local anaesthetics; either ropivacaine 0.25% (1.0 ml x kg(-1)) or bupivacaine 0.25% (1.0 ml x kg(-1)). They were sedated with a continuous infusion of propofol (200 microg x kg(-1) min(-1). The lungs were ventilated with a mixture of 50% nitrous oxide with oxygen. 60 min after local anaesthetic injection, and every 60 min, the extent of the motor block in the recovery room was scored as 1-3, according to a modified Bromage scale. Adverse events and the time to the first analgesic requirement were reported. Patients in the two groups did not differ with respect to age, weight and height. There were no differences in heart rate and arterial pressure between the two groups(P>0.05). No adverse events were observed. The ropivacaine group showed a shorter duration of motor block than the bupivacaine group (P<0.05). The first postoperative analgesic requirement was a mean (sd) of 5 h+/-4.32 after the operation in the ropivacaine group and 5 h+/-3.81 for the bupivacaine group. These findings suggest that caudal anaesthesia with ropivacaine 0.25% in paediatric patients can be effective, with less motor blockade in the postoperative period.

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Schistosoma haematobium is present in about 53 African countries and in the Middle East, with the helminth showing high endemicity in these regions (CEGET-CNRSAtlas-WHO/1987, home page-WHO). Urinary schistosomiasis is an infectious disease of marked epidemiological importance for both natives and tourists exposed to the helminth in endemic regions.Treatment of urinary schistosomiasis has shown great advances with the introduction of praziquantel into the therapeutic arsenal (Bormann et al. 2001, De Clerq et al. 2002. Advantages of this drug include its easy administration (40 mg/kg body weight, a single dose by the oral route), low toxicity, and low intensity of side effects (McMahon 1983, Pugh & Teesdale 1983, Kahama et al. 1999, Rey 2001. These important factors have contributed to the tolerance with and easy application of individualized and mass treatments (Stephenson et al. 1989, King et al. 1992. Nevertheless, failure of praziquantel treatment of various proportions has been reported (Herwaldt et al. 1995, Liang et al. 2000. So, it is necessary to be sure about the + Corresponding author. E-mail: silva.iran@ig.com.br PATIENTS AND METHODSThree 24-h urine samples were collected from 26 patients at minimum intervals of one week. The patients were Brazilian military men who were part of the United Nation peace mission in Mozambique in 1994, age between 26 and 55 years old, median age of 29 years. The principal condition was the report of exposure in Licungo river and signals and symptoms affecting the genitourinary tract after exposure.Helminth eggs were recovered by spontaneous sedimentation and subsequent centrifugation of the urine sample. The total urine volume was transferred to glass chalices and left to stand for 24 h. After this period, 10 ml of the initial sediment was removed with a glass pipette held close to the bottom of the chalice and centrifuged at 3500 r.p.m. for 5 min. One-hundred microliters of the centrifuged material was removed with a glass pipette held close to the bottom of the tube, mounted on a slide, coverslipped, and observed under a microscope at magnifications of 100× and 400×. For endoscopic examination, an Olympus model 19 CH cystoscope with a 30 o eyepiece was used. 446 446 446 446 Schistosoma haematobium in Brazilians • • • • • Iran Mendonça da Silva et al.After the positive diagnosis, the patients were treated with 40 mg/kg body weight praziquantel administered in a single dose. Three other 24-h urine exams were repeated at 7-day intervals by the same technique, after a minimum period of 21 days after treatment. Treatment was repeated under medical supervision to ensure the correct use of the drug. In the case of suspicion of lesions, all individuals were submitted to cystoscopy followed by biopsy and histopathological examination at 6-month intervals, after each treatment or retreatment, under the same conditions as used for the initial diagnosis. The urine examination, with the same technique, was repeated after each cistoscopy.In the case of evidence of vesical involveme...