Antimicrobial susceptibility of Leptospira isolates from dogs and rats to 12 antimicrobial agents

This study determined the antimicrobial susceptibilities of 67 isolates of Leptospira from dogs (suspect canine cases: n=7 and stray dogs: n=6) and rodents (n=54) in Trinidad to 12 antimicrobial agents using broth microdilution and macrodilution techniques. Commonly used antimicrobial agents such as the penicillin G and ceftriaxone had relatively low minimal inhibitory concentrations (MICs) while doxycycline displayed a relatively higher value but was still considered to be effective. While imipenem was the most effective with low MIC values in vitro, sulphamethoxazole-trimethoprim had the highest i.e. least effective. Based on these results, the drugs commonly used in the treatment of leptospirosis (penicillin G, penicillin-streptomycin, doxycycline and ceftriaxone) in both humans and animals in Trinidad appear to have similar MICs and MBCs in vitro when compared with published reports. The serovar of Leptospira spp. and in most cases the origin of the isolates did not significantly (P>0.05) influence their susceptibilities to the antimicrobial agents tested

Seroepidemiology of leptospirosis in dogs and rats in Trinidad

Stray dogs (n=207), suspected canine cases of leptospirosis (n=50) and rats (n=200) from the Caribbean island of Trinidad were subjected to the Microscopic Agglutination Test (MAT) for leptospirosis. The seroprevalence in stray dogs was 15.5% (n=32), the predominant serogroup was Icterohaemorrhagiae (14.5%; n=30) with agglutinations to serovars Copenhageni at 5.8%, Icterohaemorrhagiae at 4.8%, Mankarso at 3.9%. The seroprevalence among suspected canine cases was 72% (n=36) with Icterohaemorrhagiae again being the predominant serogroup at 60% inclusive of serovars: Copenhageni, 44%; Mankarso, 14%; and Icterohaemorrhagiae 2%. A seroprevalence of 16.5% was determined in rats, all agglutinations were to the Icterohaemorrhagiae serogroup (inclusive of serovars Copenhageni, 9.5%; Icterohaemorrhagiae, 5.5%; and Mankarso, 1.5%). Overall serovar Copenhageni was the most common serovar as 11.6% of all the animal species tested by the MAT were positive and may be an important zoonotic serovar in Trinidad. The titres of infecting serovars of Leptospira in suspected canine cases of leptospirosis were considerably higher than that found in stray dogs and in rats where the lowest titres were found. Age and sex were not significant risk factors except in the case of rats where age was significant, indicating that juvenile rats were at a significantly higher risk. There was no definite pattern of the distribution of positive animals or the serovars when using the MAT. Data obtained in the current study indicate that dogs and rats in Trinidad have the potential to be sources of leptospiral infections for humans. This potential has public health implications making it imperative to control rat and stray dog populations in the island to reduce the risk of human leptospirosis.

Hurricane preparedness among healthcare workers in St James

OBJECTIVE: To assess the preparedness of health workers in St James, Jamaica, to respond to natural disasters. METHODS: A cross-sectional survey was conducted on a 25% quota sample of hospital and health department staff in St James in 2005 (n = 307). Awareness of and attitudes to disaster management policies, plans and training and how these influenced their response in Hurricane Ivan were evaluated Statistical package for the Social Science 11.5 was used to summarize quantitative data, while qualitative data were analyzed manually. RESULTS: Most respondents (67%) knew of the disaster plan but only 40% had been trained in disaster management. More nurses (68%) and paramedicals (51%) reported being trained than ancillary/ auxilliary (33%), medical (21%) or administrative/clerical (18%) staff Most (96%) had participated in at least one disaster preparedness drill, usually a fire drill, but not in the previous two years. Attitudes towards disaster management were positive (99% insisted training should be compulsory, 95% agreed they should help in a hurricane). The majority (86%) reported being available to work at any time and 77% had worked as scheduled during Hurricane Ivan. Transportation and personal responsibility (to children, elderly or property) were the main limiting factors. Provisions for staff welfare (eg transportation, protective gear, media updates) were perceived as inadequate. Having defined disaster response roles was positively correlated with age, years of service and occupation (p < 0.01) CONCLUSION: Health workers in St James have positive attitudes to disaster management but require routine training to compensate for staff turnover. More attention must be given to staff welfare during disasters.

Biochemical abnormalities in multiple myeloma

Monoclonial gammopathies can either be benign or more commonly malignant. The commonest disease associated with it is multiple myeloma. Over the seven-year period 1984-1990, two hundred and thirty-four monoclonal gammopathies were seen at the University Hospital, Jamaica. Multiple myeloma was diagnosed in one hundred and fifty-six cases (84 males and 72 females). The diagnosis of most of the others were not known as the samples came from other institution. Of the patients with myeloma, the most common immunoglobulin type was IgG followed by IgA and then pure light chain disease. Only in about half of the cases where urine was analysed was Bence-Jones protien found. The majority of the cases had abnormal total serum protein, albumin and total globulin concentrations. Most of the cases also were in renal failure. Hypercalcaemia, hyperphoshataemia, elevated alkaline phosphate, gammaglutamyl transferase and aspartate aminotransferase occured in about one-third of them. These results were not much different from those reported in other countries

Year-round total serum IgE and IgG4 levels in allergic and non-allergic West Indian Medical Students

Twenty-four allergic and non-allergic West Indian medical studients and pathology technologists had repeated serum IgE and IgG4 levels determined over a one-year period. Contrary to previously published reports on this type of population, total serum IgE levels were usualaly consistently normal (18 of 24 subjects) with little variation throughout the year. The remaininh six subjects, all allergic, showed moderately elevated levels (620 - 1096 KU/1). Total serum IgG4 was elevated in most of the allergic and non-allergic subjects (18 of 24). Perinnial exposure to molds and house dust mite in this tropical environment could possibly produce the chronic antigenic stimulation responsible for the elevation in serum IgG4 levels found in this study

Linfocitosis aguda infecciosa. / Acute infectious lymphocytosis

Se revisan los casos de tres pacientes con linfocitosis aguda infecciosa cuyo diagnostico se fundamento en el hallazgo de hiperleucocitosis en el hemograma, producida por la presencia de numerosos linfocitos pequenos, en ninos con un cuadro clinico de deposiciones liquidas, fiebre y ausencia de adenopatias y visceromegalia.En los hemogramas, exceptuando la linfocitosis absoluta, no habia otras alteraciones, salvo en un caso con anemia nutricional secundaria a enfermedad celiaca. El mielograma realizado en un caso, solo mostro aumento del porcentaje de linfocitos pequenos. El estudio virologico de secrecion faringea y deposiciones hecho en los ninos fue negativo. Los pacientes tuvieron una rapida evolucion clinica, mejorando todos en el plazo de una semana antes de 3 semanas. Estos hallazgos concuerdan con lo descrito en la literatura

Anemia hemolitica por carencia de vitamina E en recien nacido de bajo peso de nacimiento. II. Falta de respuesta a la vitamina E oral y recuperacion con la forma parenteral. / Hemolytic anemia due to vitamin E deficiency in newborn of low birth weight. II. Lack of answer to the oral vitamin E and recovery with the parenteral form

1. Se presenta la respuesta a la administracion oral y parenteral de Vitamina E,evaluada por la modificacion del test de Hemolisis por peroxido de hidrogeno en recien nacidos de bajo peso de nacimiento entre los 32 y 83 dias de vida. 2. Con la administracion de Vitamina E oral no se observo normalizacion del test en un periodo de siete dias despues de administrada. Con la Vitamina E parenteral,en cambio, los valores se normalizaron en el mismo plazo