ABSTRACT
Epidemic, louse-borne typhus persists in the rugged, mountainous areas of Ethiopia and much of northeastern and central Africa as well as in the rural highlands of Central and South America, where the conditions of living favor the harboring of body lice and where antibiotic treatment and effective louse-control measures are unavailable. The historical significance and current epidemiology of typhus, including the reservoir of Rickettsia prowazekii in flying squirrels in the United States, are reviewed, and the clinical presentation, laboratory findings, and hospital course in the cases of 60 patients admitted with epidemic, louse-borne typhus to the St. Paul's Hospital in Addis Ababa, Ethiopia, are described. Treatment of this disease with oral doxycycline, tetracycline, or chloramphenicol prevents complications and results in prompt resolution of symptoms.
Subject(s)
Disease Outbreaks , Disease Reservoirs , Rickettsia prowazekii/isolation & purification , Sciuridae , Typhus, Epidemic Louse-Borne/epidemiology , Adolescent , Adult , Africa/epidemiology , Animals , Blood Cells , Blood Chemical Analysis , Ethiopia/epidemiology , Female , Humans , Male , Middle Aged , Typhus, Epidemic Louse-Borne/blood , Typhus, Epidemic Louse-Borne/urine , Urine/chemistry , Urine/cytologySubject(s)
Internal Medicine , Interprofessional Relations , Mental Disorders/therapy , Psychology , Psychotherapy , Adult , Ambulatory Care , Female , Humans , Male , Patient Care TeamABSTRACT
The mechanisms of renin release after furosemide (F) and ethacrynic acid (EA) in man were examined. We evaluated whether acute volume shifts within the low pressure system after F induce renin release via neural pathways. Immersion in a water-bath or beta-blockade reduced the increase of plasma renin concentration after F but not after EA. It is concluded that acute renin release after F but not after EA in man is partially due to neurally mediated reflexes originating from volume receptors in the cardiopulmonary area.
Subject(s)
Ethacrynic Acid/pharmacology , Furosemide/pharmacology , Renin/physiology , Adult , Blood Pressure , Heart Rate , Hematocrit , Humans , Immersion , Kidney/physiology , Male , Reflex/drug effects , Renin/blood , Renin/metabolism , Sodium/urineABSTRACT
UNLABELLED: A new method for the measurement of renin in human plasma is described. The method is based on the introduction of the internationally available renin standard of the Medical Research Council (MRC) London, as a calibration system. Thus, some principal disadvantages of methods expressing results in renin reaction velocity (angiotensin generation rate) only are avoided. Both renins, unknown and standard, react with a sheep substrate preparation and are handled identically throughout the whole procedure including the angiotensin I radioimmunoassay (RIA). The plasma renin concentration (PRC) is given in 10(-6) MRC-renin units (muM/ml). RESULTS: the renin standard is free of angiotensin, angiotensinases, and angiotensinogen; it is stable on storage. Identical enzyme kinetics are shown for both renins. An interference between endogenous and exogenous substrate could be avoided. The potentially harmful influences of proteins from the enzyme incubation mixture of the RIA dose response curve are shown. The use of an angiotensin I calibration system could be omitted. Using a standard renin dilution from 250-0.9 muU/ml also the full biological range is covered. When giving an unrestricted diet the preliminary normal values of PRC are 21.9 +/- 12.6 muU/ml in recumbent and 40.1 +/- 19.8 muU/ml in upright position (n = 16,x +/- s, age 20-35 years). Earlier findings of age-dependency of PRC were confirmed.
