Trypanosomiasis: Relative Frequency in the United States, Tryparsamide Therapy in Refractory Cases

Abstract

1-The technic be correct.2-That the liver excrete the dye. 3-That the hepatic, cystic and common ducts be patent. 4-That the gall-bladder have the ability of emptying and filling itself. 5-That the gall-bladder once filled, it be of a size to contain a sufficient amount of dye to give rise to a shadow.6-That the gall-bladder be able to concen trate the dye.Failure to secure a shadow in the presence of a standard technic indicates:"1-Failure of absorption of the dye.2-Cystic duct occlusion (stone, catarrhal or other condition producing obstruction).3-Hepatic insufficiency. 4-Small gall-bladder with obliterated lumen."The contraindications given by Dr. Carmen -of the Mayo Clinic are:1-Obstruction of the common duct.2-Extensive hepatic damage.3-Marked diabetes. 4-Hyperthyroidism.5-Arteriosclerosis.6-Cardiac disease, especially that attended with fibrillation. 7-Hyperemisis.8-Advanced cirrhosis of the liver. 9-Pregnancy.This new direct view of the opaque gall-bladder shows us the opaque stones, and also those that are non-opaque when surrounded by bile, in the form of negative shadows. We are also able to locate the position of the gall-bladder, and have an idea, as to the size, shape and emptying power of the gall-bladder, and learn to a certain extent the function of the liver.Considering the difficulty there is in diagnosing vague pathological abdominal conditions, roentgenologists feel that the visualization of the gall-bladder, taking in consideration both the direct and indirect methods, is an extremely valuable adjunct to medicine and that it is rather underestimated by the entire profession.

African Trypanosomiasis in Two Travelers from the United States

“…The first reported cases of African trypanosomiasis in the United States occurred in the 1920s [2][3][4] in expatriates who acquired West African trypanosomiasis while working in areas of endemicity. No further infections were documented among United States travelers until the late 1960s (table 1), perhaps because control programs had nearly eliminated disease transmission throughout Africa.…”