Diagnosis of tuberculous pleurisy using the biologic parameters adenosine deaminase, lysozyme, and interferon gamma.

We compared the parameters pleural adenosine deaminase (PADA, determined in 405 patients), the PADA/serum ADA ratio (P/SADA; 276 cases), pleural lysozyme (PLYS, 276 cases), the PLYS/serum LYS ratio (P/SLYS; 276 cases), and pleural interferon gamma (IFN, 145 cases) regarding their ability to differentiate tuberculous pleural effusions from others. The 405 pleural effusions were classified by previously established criteria as tuberculous (91), neoplastic (110), parapneumonic (58), empyemas (10), transudates (88), or miscellaneous (48). The intermean differences between the tuberculous group and each of the others were statistically significant for all five parameters (p < 0.01 for PLYS and P/SLYS with respect to the empyema group; p < 0.001 otherwise), except for PADA and P/SADA with respect to the empyema group. All the tuberculous pleurisy cases had PADA values of 47 U/L or more, as compared to only 5 percent of the other cases (sensitivity, 100 percent; specificity, 95 percent). P/SADA was above 1.5 in 85.7 percent of tuberculous effusions and 11 percent of the others (sensitivity, 85.7 percent; specificity, 89 percent). PLYS, with a diagnostic threshold of 15 g/ml, had a sensitivity of 85.7 percent and a specificity of 61.6 percent; P/SLYS, with a threshold of 1.1, had a sensitivity of 67.3 percent and a specificity of 90.3 percent; and IFN, with a threshold of 140 pg/ml, had a sensitivity of 94.2 percent and a specificity of 91.8 percent. The lowest misclassification rate was achieved by PADA, with statistically significant differences (p < 0.001) with respect to P/SADA, PLYS, and P/SLYS, but not with respect to IFN. The only significant pairwise correlations among these parameters were between P/SLYS and PADA and between P/SLYS and P/SADA. We conclude that PADA and IFN are useful parameters for early diagnosis of tuberculous pleurisy, and that the other parameters considered have no advantages over PADA and IFN for this purpose (though the high specificity of P/SLYS may be noted).

4-nitrophenyl phosphatase activity of the red blood cell membrane in essential hypertension.

In this paper we report the levels of the 4-nitrophenyl phosphate hydrolysing activity of the red blood cell membrane in 46 hypertensive patients as compared to 41 normal controls and eight secondary hypertensives. This activity has at least two components; one of them is dependent on the presence of magnesium and potassium ions, and more sensitive to sodium, ATP, heat and -SH blockers than the cation-independent activity. This component appears increased in membranes from essential hypertension patients, correlating to the clinical seriousness of the condition, while remaining at control level in the secondary hypertension patients. The cation-independent component of this activity does not differ significantly in any of the groups studied.

Biotyping of Campylobacter jejuni and Campylobacter coli infections in Spain.

Biochemical profiles were studied in 102 Campylobacter isolates from patients affected by enteric disease in Orense (Spain) over a 1-year period. The isolates were identified as hippurate-positive Campylobacter jejuni (n = 90), Campylobacter coli (n = 10) and hippurate-negative C. jejuni (n = 2). Seventy-seven of the hippurate-positive and both hippurate-negative C. jejuni isolates were biotyped as C. jejuni subsp. jejuni biotype 1, nine as C. jejuni subsp. jejuni biotype 2 and four as C. jejuni subsp. doylei. Hippurate-hydrolysis was correlated to a simple scheme based on L-arginine arylamidase production, propionate assimilation and malate assimilation which yielded sensitivity and specificity values of 0.90 and 1.00, respectively. Effective grouping of nalidixic acid-resistant C. jejuni and C. coli isolates (38.5% of the total) was also achieved.

[Reference intervals of hematologic parameters in the elderly]. / Intervalos de referencia de parámetros hematológicos en ancianos.

Red blood cell counts, haemoglobin, haematocrit, MCV, MCH, MCHC, RDW, platelet count, plateletcrit, platelet distribution width, white blood cell count, white cell differential count (absolute and per cent) and serum iron were studied in 167 people (96 women and 71 men) aged between 60 and 89 years. Significant differences between both sexes were found for all values except RDW, platelet count and percent differential count of white cells. The intervals comprising the central 95% of each values were calculated. In the time of the analysis, only haemoglobin concentration in men showed significant decrease with ageing, although inverse correlation with age was observed for haemoglobin, red cell count and haematocrit in men, and for platelet count in women.

Unsuspected sources of soybean exposure.

BACKGROUND: Hidden allergens in processed foods can provoke severe allergic reactions in sensitive individuals. The presence of soy proteins in typical Spanish sausage products (chorizo, salchichón, mortadella, and boiled ham), doughnut and soup stock cubes has not been reported previously. METHODS: The present article reports two examples of severe allergic reactions due to the ingestion of foods that unexpectedly contained soybean proteins. Allergollogic study included skin prick tests with the implicated foods and their components, serum specific IgE and bronchial and oral provocation tests. RESULTS: Skin test, serum-specific IgE, and bronchial and oral challenge tests (the latter, in one patient) were positive against soy and the above mentioned processed foods in which the presence of soybean flour was confirmed. CONCLUSIONS: This report demonstrates the importance of hidden allergens in allergic reactions to foods and the need to scrutinize closely every food component.

Incidence and transmission of antibiotic resistance in Campylobacter jejuni and Campylobacter coli.

One-hundred and two Campylobacter clinical isolates were characterized for their in-vitro resistance to erythromycin (1.9%), three fluoroquinolones (31.3-34.3%), tetracycline (43.1%), kanamycin (4.8%), ampicillin (18.6%) and other 16 antimicrobial agents. Conjugative transfer of tetracycline and kanamycin resistances among these strains was achieved and small plasmids of 4.3, 4 and 1.9 kb were observed in kanamycin-resistant Campylobacter coli strains.

Determination of iron by the Ferrochem II: interference by tuberculostatics.

Iron levels in samples from certain treated tuberculous patients are underestimated by the Ferrochem II analyser. Of the tuberculostatic drugs examined for a possible interference, isoniazid, ethambutol, rifampicin, pyrazinamide and Rifater (a mixture of rifampicin, isoniazid and pyrazinamide), only pyrazinamide and Rifater (due to its pyrazinamide content) were associated with iron levels differing significantly (p < 0.001) from those of controls, with means of -317.2 and -185.6 mumol l-1 for pyrazinamide and Rifater respectively as against 9.91 mumol l-1 for the controls. The negative interference (I) due to pyrazinamide was independent of iron level in the samples but dependent on pyrazinamide concentration in the same (P) (r = 0.9993), I = -0.4380P-0.4276.