RESUMO
Sera from 1,419 patients who attended a Barbadian general practice for a variety of complaints between 1st April and 30th April 1988 were examined for leptospiral agglutinins by the microscopic agglutination test. Sera from patients presenting with pyrexia of unknown origin, jaundice or kidney complaints, and from those whose titre was > 1:400, were also examined by the ELISA for IgM and IgG antibodies. Only one patient was diagnosed clinically as possibly having mild leptospirosis, but three others had been recently infected and some mild cases may have been missed. Altogether, 177 of the patients (12.5 percent) were positive at titres> 1:50. These were 104 of the 739 males (14 percent) and 73 of the 680 females (11 percent) (no statistically significant difference). Seropositivity tended to increase with age (p<0.01), and the highest rates were in agricultural workers (35 percent), labourers (24 percent) and non-manual outdoor workers (19 percent). The difference in seropositivity between the various indoor and outdoor occupational groups was highly significant (p<0.005). Autumnalis (31 percent of the sero postives), Panama (15 percent), Australia (14 percent) and Pyrogenes (11 percent) were the serogroups most commonly recorded among the seropositive patients. Autumnalis predominated in each of the main occupational groups except indoor non-manual workers where Panama, Pyrogenes and Australis occurred more frequently. Ninety-five per cent of the positive titres ranged between 1:50 and 1:400. Titres tended to increase with age, but there was no obvious association between higher titres and particular occupations (AU)
Assuntos
Humanos , Masculino , Feminino , Leptospirose/diagnóstico , Leptospirose/epidemiologia , Barbados/epidemiologia , Febre , Icterícia/congênito , Ensaio de Imunoadsorção Enzimática/instrumentação , Imunoglobulina M , Fatores EtáriosRESUMO
Since furosemide, a sulfonamide diuretic, has been recommended for use in the newborn infant, a study was made of its effect on the bilirubin-binding capacity of albumin. Furosemide was compared to sulfisoxazole, a known displacer of bilirubin, by means of three methods. First, aliquots of whole blood from 20 icteric infants were diluted in phosphate buffer along with expected clinical concentrations of furosemide and sulfisoxazole. The red cells and globulins were then isolated and bilirubin concentrations were measured in these two fractions. The addition of Furosemide resulted in the displacement of bilirubin from albumin to red cells and globulins. Mole for mole, furosemide displaced bilirubin about as well as sulfisoxazole. Second, the hydroxybenzeneazobenzoic acid dye binding test of Porter and twaters was performed using the sera of eight jaundiced newborn infants. The mean dye binding capacity of the sera was significantly reduced with the addition of furosemide to a final concentration of 2 mug/ml. Third, the administration of furosemide (5 mg/kg) or sulfisoxazole (50 mg/kg) to adult Gunn rats resulted in a significant fall in mean serum bilirubin concentration compared to saline controls. Furosemide, like sulfisoxazole, is a potent displacer of bilirubin and should be used with caution in jaundiced infants.