RESUMEN
During two legionellosis outbreak investigations, one at a geriatric centre and the other in high-rise housing for seniors, it was observed that additional cases of legionellosis occurred in nearby smaller residential settings. This apparent geographical cluster of legionellosis occurred in the same general area of a community water storage tank. No potential airborne sources in or near the area could be identified, but a community water system storage tank that was centrally located among case residences spurred an investigation of water-quality factors in the identified investigation area. Conditions conducive for Legionella growth, particularly low chlorine residuals, were found. The rate of legionellosis among residents aged ⩾50 years in the investigation areas (61·0 and 64·1/100 000) was eight times higher than in the rest of the service area (9·0/100 000) and almost 20 times higher than the statewide annual average incidence rate (3·2/100 000). A water mains flushing programme in the area was launched by the water utility, and water samples taken before and during flushing found L. pneumophila.
Asunto(s)
Brotes de Enfermedades/estadística & datos numéricos , Legionelosis/epidemiología , Microbiología del Agua , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Infecciones Comunitarias Adquiridas/epidemiología , Infecciones Comunitarias Adquiridas/etiología , Ambiente , Femenino , Viviendas para Ancianos , Humanos , Legionelosis/etiología , Masculino , Persona de Mediana Edad , New Jersey/epidemiología , Abastecimiento de Agua , Adulto JovenRESUMEN
Epidemiologic studies in New Jersey have examined the relationship between exposure to water contaminants and the occurrence of leukemias, non-Hodgkin's lymphomas, and adverse reproductive outcomes. Public drinking water supplies need to be monitored on a continual basis.
Asunto(s)
Monitoreo del Ambiente , Contaminantes Químicos del Agua/efectos adversos , Anomalías Inducidas por Medicamentos/etiología , Adulto , Niño , Femenino , Humanos , Recién Nacido , Leucemia/inducido químicamente , Linfoma no Hodgkin/inducido químicamente , Masculino , New Jersey , Embarazo , Factores de RiesgoRESUMEN
Nonspecific esterase (NSE) is used to identify normal and leukemic mononuclear phagocytes cytochemically. It can be demonstrated by the hydrolysis of alpha-naphthyl acetate or butyrate. NSE from leukapheresed leukemic monocytes were extracted with several types of detergent and grouped into two isoelectric point (pl) categories based on the ease of solubility: pl 5.7-6.3 (8 bands) greater than or equal to pl 6.6-7.6 (6 bands). Normal monocytes yielded only the pl 5.7-6.3 isozymes. Isozymes from both leukemic and normal monocytes were inhibited similarly by sodium fluoride, pH less than 4.7, and a serine active site inhibitor. All isozymes were bound by Sepharose-concanavalin A (Con-A) and displayed similar substrate preferences and pH v activity slopes. Under the conditions of detergent solubilization, the smallest mol wt species retaining enzymatic activity was 50 +/- 5 kd. Despite these similarities, the isozymes of pl 5.7 through 6.3 and pl greater than 6.3 exhibited different degrees or types of inhibition by phenylmethylsulfonyl fluoride (PMSF), resistance to heat and antigenic character. Thus, the esterase isozymes represent two families of glycoproteins, both of them probable cell surface enzymes, resembling classical liver carboxyl or B-esterases (EC 3.1.1 1).
Asunto(s)
Hidrolasas de Éster Carboxílico/sangre , Isoenzimas/sangre , Leucemia/enzimología , Monocitos/enzimología , Carboxilesterasa , Hidrolasas de Éster Carboxílico/antagonistas & inhibidores , Cromatografía de Afinidad , Humanos , Focalización Isoeléctrica , Isoenzimas/antagonistas & inhibidores , Leucemia/sangre , Peso Molecular , Especificidad por SustratoRESUMEN
Hypocalcemia is a frequent accompaniment of acute renal failure, but paradoxically hypercalcemia also has been described in association with acute renal failure. In this paper we describe two patients who provide some insights into both the potential clinical importance and mechanism of the hypercalcemia associated with acute renal failure. The clinical significance is emphasized by the presence of diffuse metastatic calcification observed at postmortem examination in one patient. In both patients the increase in serum calcium concentration was not coincident with a decrease in serum phosphorus concentration; when measured in one patient, serum levels of parathyroid hormone were undetectable. These findings, along with the consistent association with rhabdomyolosis, support the proposal that the hypercalcemia of acute renal failure is caused by dissolution of dystrophic calcifications in traumatized muscle and may lead to severe metastatic calcifications.