Sanitary Area Research Articles

An Update on Louisville MSD's Basement Backflow Prevention Program – 10 Years and 6,700 Installations Later

Louisville and Jefferson County Metropolitan Sewer District (MSD) is responsible for stormwater and wastewater service for the Louisville, Kentucky metropolitan area. A longstanding problem for MSD has been basement flooding due to sewers that are surcharged from wet weather. A non-traditional program was developed by MSD as a means to address this problem in a cost effective and timely manner. The Plumbing Modification Program began in 1993 as part of the combined sewer overflow program. The program pays for the installation of plumbing modifications inside of customers homes to protect against basement flooding due to wet weather surcharged sewers. Initially established for the combined sewer area only, the program has grown to include the entire combined and sanitary sewer service area. The program has been extremely successful. To date approximately 6,700 installations have been completed with a total construction cost of over $10.5 million.

Environmental assessment of an uncontrolled sanitary landfill, Pocos de Caldas, Brazil

There are more than 20,000 uncontrolled sanitary landfill areas in Brazil. The paper reports an integrated study undertaken to develop an environmental assessment of the uncontrolled sanitary landfill area of the city of Pocos de Caldas, State of Minas Gerais, Brazil. A number of remedial alternatives were evaluated. The USGS modular 3D finite difference groundwater flow model (Modflow) and Modular 3D Finite Difference Mass Transport Model (MT3D) software were used to simulate groundwater flow and contaminant transport modelling, as well as to predict changes due to the proposed remediation measures. The remedial alternatives considered for normal conditions from 20 to 40 year periods were waste removal, vertical cut-off barriers, extraction wells and top capping. The results indicated that extraction wells and waste removal are the best alternatives because they significantly reduce both the extension and levels of the contamination plume even after 5 years. The extraction well proved a less expensive remedial alternative than waste removal.

Estado de salud de los muy ancianos: situación clínica y funcional de la población centenaria

We planned a prospective and descriptive analysis of the centenarian population in Lugo sanitary area, establishing their social, functional and medical status as well as its relationship with their basic hematological and biochemical parameters. During the study period between January 2001 and September 2003, participants were visited at home by a doctor and a nurse. The following variables were assessed: social status, past medical history, physical examination, functional status (Barthel index), blood analysis. 54 centenarians were interviewed, 16 men and 38 women. 75.9% were widows; 87% lived with their family and 57,4% in urban areas. 79.6% had followed studies. All of them had their own incomes. Regarding past medical history, 64.8% had some visual or auditive disturbances, 81.5% were taking medical drugs, 59.3% had some surgical intervention and 46.3% had been hospitalized for medical reasons. Their vaccination status was poor. Functional status, assessed by Barthel index, showed an average of 59 +/- 36.4, higher in men (82.7 +/- 28.7) than in women (49.6 +/- 35.1) (p<0.003). Blood samples were analyzed in 51 cases, there were not significant differences among them regarding sex or physical disability. The features of the centenarian population of Lugo are similar to other countries. It is an heterogeneous group. There are more women, but their clinical and functional status are significantly worse than in males. We have not founded a relationship between hematological and nutritional parameters and the degree of functional dependence in centenarians.

Characteristics of tuberculosis in patients older than 65 years in the sanitary area of Cadiz (Spain)

Tuberculosis in the elderly is an increasing public health problem. To describe the epidemiological, clinical and microbiological characteristics of tuberculosis in patients over 65 years old, as compared to younger patients. We reviewed the case histories of tuberculosis, microbiologically diagnosed by Ziehl-Neelsen/auramine smear and Löwenstein-Jensen culture, in patients over 65 years old, in the sanitary area of Cadiz (Spain). We detected 49 new cases (37 males) of tuberculosis in elderly subjects. The infection rate in this age group (16.3/100,000 inhabitants) is lower than in people younger than 65 years old (21.1/100,000 inhabitants). The most common symptoms were cough (44.9%), fever (40.8%) and dyspnea (44.9%). Neither of them were infected by the human immunodeficiency virus nor were parenteral drug abusers. Thirty seven percent of cases had a history of previous tuberculosis, and in 75.5% the disease location was pulmonary. The Ziehl-Neelsen/auramine smear was negative in 53.1% of the samples. The number of patients older than 65 years old with tuberculosis has increased in the sanitary area of Cadiz (Spain). This group of patients shows different epidemiological and clinical characteristics than younger patients.

Prevalence of thyroid dysfunction in adults over age 60 years from an urban community.

Thyroid dysfunction affects a considerable portion of the elder population. The aim of the present study has been to assess the prevalence of thyroid dysfunction in adult healthy subjects over age 60 years from our population. We performed a descriptive, cross-sectional study in the setting of a sanitary area in an urban community in Madrid (Spain). Serum concentrations of thyrotropin (TSH) and free thyroxine (FT4) were determined by an electrochemiluminescency assay in all participants after antecubital venous sampling. A second examination, including the measurement of triiodothyronine and thyroid autoantibodies, was performed in subjects with abnormal results. A total of 127 women and 167 men, aged 60 to 84 years, were studied. We identified 6 subjects (all women) with hypothyroidism (2.04 %) and 19 (6 women, 13 men) with hyperthyroidism (6.46 %, 95 %CI 3.65 - 9.27 %). There were 3 cases (1.02 %) of subclinical and 3 cases (1.02 %) of overt hypothyroidism. In the hyperthyroid group only one patient (0.34 %) showed overt hyperthyroidism. TSH test did not detect erroneously any case of hypothyroidism or hyperthyroidism, although one patient with hyperthyroidism was not diagnosed by this test. FT4 test detected erroneously two cases of hypothyroidism; however, it was the only way to detect the patient with overt hyperthyroidism. In conclusion, in our population over age 60 years the prevalence of hypothyroidism was 2.04 % and that of hyperthyroidism 6.46 % (95 %CI 3.65 - 9.27 %). The total prevalence of thyroid dysfunction was, therefore, 8.50 % (95 %CI 5.31 - 11.69). Our data suggest that TSH test is probably enough to screen for thyroid dysfunction in adults over age 60 years.

Sarcoidosis en el área sanitaria de León: Epidemiología y clínica

The incidence of sarcoidosis is different among distincts geographic areas, probably due to climate variations. At present, there is in Spain few studies that correlate the observed cases with a concrete population. The aim of this study is to investigate the epidemiology of sarcoidosis in Leon"s sanitary area, in comparison with others spanish geographic areas. Moreover, we present a description of the clinic and radiologic characteristics of the studied cases. We analyzed the cases of sarcoidosis attended in the area from 1993 until 2001. The incidence, age, sex, place of residence and clinic-radiologic characteristics are described. The population data of the sanitary area to calculate the incidence were obtain from the Insalud"s data base. The climatology values were collected from the National Institute of Meteorology. The incidence of sarcoidosis in Leon"s sanitary area was 1,37/100.000 habitants/year, and was similar to that founded in Catalonia, Galizia and others provinces of the Castilla and Leon community. We observed a higher incidence of sarcoidosis in female patients, because of predominance of cases among women aged forty years or more. No differences between rural and urban populations were founded. The clinical characteristics were similar those described in other geographics areas of our country. Although there are climate differences between the geographics areas of Spain, these aren"t enough to explain his influence in the incidence of sarcoidosis, which is similar in all of them, at least in the middle north of the country.

The need of vaccination against hepatitis A in patients with chronic liver disease : fact or fancy?

Purpose: It has been suggested that there is an ongoing change in recent years, in the prevalence of anti HAV antibody among portuguese population, particularly related to overall improvement in sanitary conditions, both in urban and rural areas in the last 3 decades. This lower prevalence would be related with the lower infection rate in children, adolescents and young adults.

Métodos e técnicas aplicados na avaliação ambiental do aterro da BR-040 da Prefeitura Municipal de Belo Horizonte - MG

Esse trabalho representa a primeira parte da seqüência de três artigos a serem publicados pela Revista Escola de Minas - REM, sobre a avaliação do nível de contaminação por metais pesados e substâncias orgânicas na área do Aterro Sanitário da Prefeitura Municipal de Belo Horizonte-MG, Brasil, como resultado da Dissertação de Mestrado na área de Concentração Geoquímica Ambiental, defendida junto ao Departamento de Geologia da UFOP, em julho de 1998. Essa primeira publicação trata-se dos métodos e técnicas utilizados na realização dos trabalhos. A discussão dos resultados será feita nos próximos dois artigos. A área está situada às margens da BR-040, km 2, na divisa do município de Belo Horizonte com o município de Contagem. Amostras de solos coletadas em áreas sem lixo sobreposto e em áreas cobertas por lixo urbano com diferentes idades, além de amostras de água superficial, do nível freático e de chorume, foram analisadas por meios físicos e químicos. As análises físicas incluíram análises textural, mineralógica e micromorfológica. As análises químicas permitiram determinar a capacidade de troca catiônica dos diversos solos da área. As formas de retenção dos metais no solo foram investigadas por extrações químicas seqüenciais nas seguintes frações: total, trocável, matéria orgânica e óxidos de ferro e manganês, realizadas em amostras de 07 perfis de solos e de 02 trincheiras abertas no perfil de resíduos sólidos. Para o estudo das águas, foram coletadas e analisadas 09 amostras, incluindo as de chorume. As análises físicas e químicas dos solos permitiram o entendimento da mobilidade dos metais pesados e sua dispersão nos perfis.

Estudio observacional de los urocultivos y antibiogramas realizados ambulatoriamente en un área de salud

Background: the empirical treatment of the urine tract infection is a frequency practice in Primary Health Care. To obtain the best results we should base ourselves on the bacterial population and their sensibility to the antibiotics. Objectives: to study the bacterias responsible for the urine tract infections in the community in Almeria and their sensibility in vitro to antibiotics, like fundaments for the election of the best empirical treatment. Design: cross descriptive study. Subjets and methods: we studied all the cultures made in the year 2000 and first trimester of 2001 to inhabitants of the country of Almeria belong to the Sanitary Area of the Hospital Torrecardenas. Results: 19,546 cultures was studied. 15,551 of them were polluted or they were negative. Between 10,000 and 90,000 colonies were cultivated in 381 and in 1,673 grew 100,000 or more colonies. E. co-li was the most frequency germ (52.8%). Followed by Enterococcus faecalis in 247 samples (11.5%), Group B streptococcus in 176 (8.2%), Proteus mirabilis in 151 samples (7.0%) and Klebsiella pneumoniae in 122 (5. 7%). The most effective antibiotics in vitro in decrecent order were gentamicin, amoxicillin-clavulanate, nitrofurantoin, 3 rd generation cephalosporin and cefuroxime, with an effectiveness between 80 and 90%. Fosfomycin, ciprofloxacin and norfloxacin were effective between 65 and 70% of the cultures. Trimethroprin sulfamethoxazole and pipemidic acid had an effectiveness near to 55% and lastly ampicilina, with resistances in 65% of the cultures. Conclusions: we must revise the indication of norfloxacin and fluoroquinolone in general as best empirical treatment amoxicillin-clavulanate, nitrofurantoin, 3 rd generation cephalosporins and cefuroxime can be considered like an alternative, although these two last must be in reservation in de way of a coherent antibiotic politics.

Factores predictores de reingreso hospitalario no planificado en pacientes dados de alta de una Unidad de Corta Estancia Médica

To determine the independent factors that predict unplanned hospital readmission in patients who are admitted to a Short-Stay Medical Unit (SSMU). DESIGN AND FIELD OF THE STUDY: Prospective cohort. Sanitary area: 500,000 inhabitants. Patients who survived to an hospital admission in the SSMU of our hospital (n = 196, a = 0.05, d = 7). We studied demographic variables, social situation, history of previous admissions to hospital, from each patient. From the index admission we included diagnosis, severity of the disease, complications, type of admission and co-morbility. Validated tests were done to measure functional capability, grade of dependence and psychologic situation. After a three month interval readmission was determined if there had been an urgent admission to any hospital in a 10-day, 28-day or 3-month interval after discharge caused by the same principal diagnosis. A descriptive analysis of the variables was made, and a univariate analysis to stablish their association to readmission. The predicting factors for readmission were calculated by means of logistic regression. The 60.2% were males, the median of the age was 72 years. 75% started or carried out only primary school; 40% were single, separated or widowed; 12% lived alone and 1.5% in an institution. Principal diagnosis at the time of index admission were: chronic obstructive pulmonary disease, congestive cardiac failure, ischemic heart disease, asthma, pneumonia, cardiac arrhythmia and acute cerebrovascular disease. Readmission rate at 10, 28 days and 3 months was 3.6%, 9.7% and 13.3%, respectively. The independent predicting factor for readmission in the 10 days interval from discharge was the number of days of hospitalization in the last year (OR: 1.02, 95% CI: 1.0-1.05). For readmission in a 28-day and 3-month interval from discharge, the only independent predicting factor was the number of admissions to any hospital in the last 3 years (OR: 1.71, 95% CI: 1.32-2.22 and OR: 1.62, 95% CI: 1.28-2.05 respectively). From the studied factors, those that predict unplanned hospital readmission of patients discharged from a Short-Stay Medical Unit cannot be modified.

Home hospitalization in light of demographic changes and new health challenges

Today, the most important demographic change taking place is the rapid aging of the population. While this phenomenon is having a growing and profound impact on all spheres of society, its greatest impact is in the health area, affecting all levels of health care and leading to the need for new resources and new structures. Out of that, in many countries have come different alternatives as well as in-patient, outpatient, and in-home programs that are geared toward improving health care and helping set priorities. One of these new initiatives is home hospitalization, or home health care. One objective of this study was to describe and analyze the characteristics of a population in Spain that was assisted through home hospitalization (HH). Another objective of the study was to comment on the role that HH can play as a mechanism for integration and coordination between health care levels, in the face of the challenges occurring with the reorganization of health care policies and programs, especially those directed at the elderly. A retrospective descriptive study was done of patients assisted through HH in Sanitary Area 9 of the Autonomous Community of Valencia, which is on the eastern coast of Spain. The area's population was 321,361, of whom 60,079 (18.7%) were 60 or older, including 43,044 (13.4%) who were 65 or older. A descriptive study of the analyzed variables was done, with the mean and standard deviation being computed for quantitative variables, and the absolute and relative frequencies (percentages) being calculated for the qualitative variables. Of the patients studied, 78% of them were 65 or older, with an average age of 73 years. They were predominantly women. Of the total group, 72% of them had chronic diseases, and 67% had at least one associated secondary diagnosis. There was an important problem of communication between the two principal levels of care, primary care and hospital care, which obviously had an impact on the patients and on the quality and effectiveness of their health care. Furthermore, it was found that HH finds its greatest utility with and is an effective tool for an adult or elderly population that has multiple chronic degenerative or terminal diseases. The results of this study highlight the need to create or strengthen channels and mechanisms for interinstitutional communication that will guarantee continuity of care. The ongoing, effective care of the health and well-being of elderly persons requires different levels of health interventions. This care should be comprehensive, adequate, integrated, of high quality, humanized, timely, and coordinated between the two principal levels of health care. In the final analysis, these factors will determine the quality of the health care for geriatric patients and the capacity to solve their health problems.

CARACTERIZAÇÃO GEOFÍSICA DE ÁREAS UTILIZADAS PARA DISPOSIÇÃO DE RESÍDUOS SÓLIDOS URBANOS

In recent years has been a steady increase in geoenvironmental engineering projects that deal with some kind of contaminant, leading to changes and enhancement in the site characterization techniques. One of the major concerns is the soil and water contamination caused by the waste disposal. In situ testing methods often provides good information about sites affected by groundwater contamination problem where stratigraphical, geotechnical, hydrogeological and other environmental informations are required on a specific and/or screening basis. Geophysical techniques is a good way to get some information required in a good site characterization program. This paper presents and compares results obtained by characterization programs carried out in a deactivated waste landfill and in the actual sanitary landfill areas, in Ribeirao Preto region, State of Sao Paulo, Brazil. In the first site domestic waste were inappropriate disposed in an area constituted by porous soils overlapping sandstones of Botucatu Formation. The actual sanitary landfill operates according to technical rules in a favorable area, composed by clayey residual soil from basalts of the Serra Geral Formation. The site characterization program included geoelectrical sounding and profiling surveys. The results showed that integrating this geophysical techniques and elaborating a rational planning it is possible to assess the volume of waste, flow path and evaluate the environmental impact caused by the waste disposal.

Estudio comparativo del neumotonómetro respecto al tonómetro de Goldmann para el cribado de presión intraocular (PIO) elevada en atención primaria

Evaluation of reliability of measurements of IOP obtained with air-puff noncontact tonometer respect the obtained with the conventional Goldmann tonometer. As well, analysis of the possibility of a higher difference between the measurements by both methods respect the fact of being myope or hypermetrope. Comparative study of two measurement methods. General ophthalmology clinic and primary care clinic of our sanitary area. Aleatory sample among the patients who went to the general ophthalmology clinic for any cause from the first of May to the thirtieth of June of 1996. The patients with predisposing processes for glaucoma were excluded, as well as those who suffered ocular surgery or those who took drugs which influenced the IOP. The ophthalmologist made three measurements of IOP in each eye and the sight of all the patients were tested. The arithmetic average was made among every three measurements. The physician of primary care made three measurements of IOP in each eye with the air-puff noncontact tonometer, and the arithmetic average was made. 81 patients were included, from whom 7 presented high IOP. The sensibility of the air-puff noncontact tonometer, compared with Goldmann tonometer, was 86% (95% CI, 18.20-99.63%), and the specificity 84% (95% CI, 89.66-78.08%). The air-puff noncontact tonometer obtained measurements between 1.116 and 2.008 mmHg higher than the Goldman tonometer. This difference, worthless from the clinic point of view, didn't find a relationship with the fact of being myope or hypermetrope. It was found a positive lineal association between the measurements made by both methods, with a correlation coefficient of 0.8086 (p < 0.001, 95% CI, 0.7476-0.8560). The results obtained are similar to the ones of other published series. A tendency of higher measurements with the air-puff noncontact tonometer is observed. It hasn't been observed a higher difference between both methods in myopes. The air-puff tonometer is a valid reliable technique to be used in primary care, it is easy to use, it doesn't transmit infectious illnesses, and it isn't necessary to use anaesthetic or staining eyedrops.

Characterization of landfill leachates and studies on heavy metal removal.

This study covers a thorough characterisation of landfill leachates emerging from a sanitary landfill area. The landfill leachates were obtained in the acidic stage of landfill stabilisation. Their organic content was high as reflected by the high BOD5 (5 day biological oxygen demand) and COD (chemical oxygen demand) values. They were also highly polluted in terms of the parameters TKN (total Kjeldahl nitrogen), NH4-N, alkalinity, hardness and heavy metals. Nickel was present in these wastewaters at a significant concentration. With regard to the high heavy metal content of these wastewaters, several physicochemical removal alternatives for the heavy metals Cu, Pb, Zn, Ni, Cd, Cr, Mn and Fe were tested using coagulation, flocculation, precipitation, base addition and aeration. Additionally, COD removal and ammonia stripping were examined. Co-precipitation with either alum or iron salts did not usually lead to significantly higher heavy metal removal than lime alone. The major methods leading to an effective heavy metal removal were aeration and lime addition. Nickel and cadmium seemed to be strongly complexed and were not removed by any method. Also lead removal proved to be difficult. The results are also discussed in terms of compliance with standards.

4-31-20 The prevalence of multiple sclerosis in the sanitary area of Calatayud, Northern Spain

4-31-20 The prevalence of multiple sclerosis in the sanitary area of Calatayud, Northern Spain

Organ doses, detriment and genetic risk from simple X-ray examinations in Ma´laga (Spain)

This work has been carried out with the aim of evaluating, as a reference, some radiological magnitudes which affect patients receiving radiation from X-ray sources. The sample was the population tended by the Radiological Service of the 'Na. Sra. de la Victoria' University Hospital and who have been treated with some of the five simple explorations: chest, abdomen, lumbar spine, hip and pelvis. The primary beam of radiation delivered by the different generators have been measured by means of non-invasive methods, which allows us to estimate the effective dose. Likewise, we have evaluated the dose in gonads and the contribution that each technique provides to the genetically significant dose (GSD= 158.59 μGy) and to the somatic significant dose (SSD = 3.19 mSv-year). Moreover, we have calculated the annual dose per capita (0.15 mSv) and the contribution that performs to the detriment (G) of these tests of conventional radiology. The results obtained are analogous to the reference values proposed in the area of E.C.M. Furthermore, we also include the values of child expectancy and the number of exploration performed in the Health Sanitary Area Malaga-West classified according to type, age and sex of the patient.

Death in its season: class, environment and the mortality of infants in nineteenth-century Sheffield.

Until the early twentieth century urban living carried with it a cost on health. For infants these risks were heightened considerably. Overcrowding and high population densities, insufficient water supplies and inadequate systems of excrement removal, all increased the vulnerability of infants to infection within the urban environment. But these risks of death were not shared equally by the urban population. Drawing on the results of a nominative record-linkage study for Sheffield, this paper examines the geographical and social inequalities in infant mortality within the urban environment. It compares the seasonal pattern of infant deaths on a class-specific basis across a broad range of differing sanitary areas within the town. Although the summer months posed the greatest threat for all infants, these risks varied considerably according to socio-economic background and also according to the part of the town where the infant lived. And although both factors exerted an independent contribution to the pattern of infant mortality, the effects were cumulative. These results are discussed in relation to historical interpretations and also the nineteenth-century debates about the causes of infant mortality.

Applications of Geochemistry to Production, Storage, and Use of Natural Gas: ABSTRACT

Geochemistry has become a standard tool in the exploration for oil and gas. Many of the concepts and techniques developed for exploration can be used with equal effectiveness in identifying environmental problems related to the production, storage, and use of natural gas. Contamination of shallow aquifers as a result of improperly completed gas or oil wells is a problem in some area. Similarly, gas which has migrated from underground gas-storage reservoirs also can contaminate shallow aquifers. Many shallow aquifers contain relatively high concentrations of microbially generated methane, and therefore detection of hydrocarbons is not sufficient to determine the source of the gas. Although microbial gas can frequently be distinguished from thermogenic gases by the absence of ethane and heavier hydrocarbons, migration through hundreds or thousands of feet of porous sediments can result in changes in the chemical composition of the gas, analogous to the changes that occur as gas passes through a chromatographic column. Therefore, the absence of heavier hy rocarbons is not always an indicator of source. Carbon isotopic composition of methane, however, appears to be relatively unaffected by migrational changes and can generally be used to distinguish between microbial and thermogenic methane. Questions also frequently arise as to the source of gas from gas and oil wells around the margins of gas-storage reservoirs. Although chemical analysis can sometimes be useful in distinguishing between storage gas and native gas, these gases are sometimes chemically quite similar. In the event that the gases cannot be distinguished chemically, determination of the carbon and/or the hydrogen isotopic composition of the methane may still provide positive identification. Gases generated in sanitary landfills or marshy areas sometimes can be interpreted as being the result of leakage from pipelines. In addition to the techniques already mentioned, radiocarbon dating of methane can be used to identify gases from these sources. End_of_Article - Last_Page 245------------

Episodios de toxicidad en moluscos de aguas marinas costeras de la Provincia de Buenos Aires (Argentina) asociados a algas toxígenas (marzo de 2008-marzo de 2013)

A partir de un monitoreo de microalgas toxígenas y toxinas en moluscos iniciado en 2008, llevado a cabo entre San Clemente del Tuyú y Mar Azul (Zona Norte) y en la Bahía Anegada (Zona Sur) de la Provincia de Buenos Aires fueron registrados cuatro brotes de toxicidad por toxina paralizante de moluscos (PSP) y ocho brotes por toxinas lipofílicas de moluscos (DSP/no determinadas). Los resultados obtenidos fueron empleados como herramienta técnica a partir dela cual la autoridad de aplicación (Dirección Provincial de Pesca del Ministerio de Asuntos Agrarios de la Provincia de Buenos Aires) fundó la decisión de imponer once vedas y una alerta sanitaria al consumo, extracción y comercialización de moluscos. Tres de los brotes por PSP se produjeron en la Zona Norte y la especie asociada fue Gymnodinium catenatum. El cuarto episodio se produjo en Puerto Quequén, durante un muestreo eventual, asociado a Alexandrium tamarense. En esta misma zona se produjeron tres de los eventos de toxicidad por DSP, y las especies asociadas fueron Dinophysis acuminata y D. caudata. Los restantes cinco episodios de toxicidad por toxinas lipofílicas ocurrieron en la Zona Sur, en una o más de las tres zonas clasificadas sanitariamente como A por SENASA, y ninguno pudo ser asociado a alguna de las especies toxígenas conocidas.

TREATMENT OF THE MORE COMMON WORM INFECTIONS.

THE COMMON INTESTINAL PARASITES, both protozoa and helminths, are endemic in the US, particularly in the more rural southern and southeastern areas. The west and east coasts have a relatively large Chinese and Puerto Rican population, and among them one finds Clonorchis sinensis and Schistosoma mansoni infections as well as other parasites. International travel, especially to the more glamorous but less sanitary areas of the world, where helminth (worm) infections are common, is increasing. Thus, it is evident that we not only have our own and imported parasites in this country, and that others or similar ones will occasionally be brought in in the future, but also that parasitic infections may be seen by physicians in any part of the US. Fortunately, there are effective and specific drugs available which, if administered properly, will result in a definitive cure in most instances. However, the relative specificity of the drugs requires