The results of seven serologic tests for diagnosis of human brucellosis were evaluated. The titrated Rose Bengal test, microagglutination test, microtiter-adapted Coombs test, and immunocapture-agglutination test (Brucellacapt) were positive for all sera from patients with acute brucellosis. The immunoglobulin G (IgG), IgM, and IgA commercial enzyme immunoassays (ELISAs) failed to show specific antibodies in 3 patients, 10 patients, and 1 patient, respectively. The sensitivity of ELISA is not higher than that of conventional tests.Brucellosis is an endemic zoonotic disease in many parts of the world, notably in Mediterranean countries and the Middle East. The diagnosis of brucellosis is made by the isolation of Brucella species (i.e., in blood cultures), but this method is successful in only 40 to 70% of cases (18). Therefore, laboratory diagnosis of brucellosis very often relies on detecting specific serum antibodies (5, 19). Several serological tests have been used for the diagnosis of human brucellosis. The serum agglutination test (SAT) for brucellosis, developed by Wright et al. in 1897 (17), is still the reference to which other tests are compared. Other notable tests that have been developed since then are the Rose Bengal test, complement fixation test, indirect Coombs test, enzyme immunoassay (ELISA) (6, 15), and, more recently, an immunocapture-agglutination test (Brucellacapt) (10). However, the interpretation of these tests is often difficult in areas of endemicity in which a large part of the population has contact with animals or products of animal origin and could develop antibodies against Brucella. In this study, the results obtained with seven different tests for detection of Brucella-specific antibodies in an area of endemicity were analyzed. A 12-month clinical and serologic follow-up was performed after the treatment was started. As a reference, the antibody levels in the healthy population of that area were also tested.One hundred twenty serum samples from 25 patients with acute brucellosis and 90 from healthy individuals (blood donors) were included in this study. The diagnosis of brucellosis was based on clinical findings and on either positive blood cultures for Brucella or the presence of serum antibodies (SAT titer Ն 160). At least three blood cultures were drawn from each patient at diagnosis. Follow-up cultures were drawn at the end of the treatment and 3, 6, and 12 months later. For four patients the 12-month cultures were not performed. Brucella was identified according to MunichЈs taxonomy criteria (8). Serum samples were collected on admission and 1, 3, 6, and 12 months later. For four patients the 12-month control sample was not assayed. For the group of blood donors only one serum sample was analyzed. The titrated Rose Bengal test, microagglutination test (MAT), microtiter-adapted Coombs test, Brucellacapt, and ELISAs for immunoglobulin M (IgM), IgG, and IgA antibodies were performed on each serum sample. The microtiter-adapted Coombs test was not performed for the group of hea...

The aim of this study was to determine the plasma levels, cardiac release and splanchnic extraction of atrial natriuretic factor in cirrhosis with ascites. The plasma concentration of immunoreactive atrial natriuretic factor in samples obtained from an antecubital vein was measured in 18 healthy volunteers and in 35 cirrhotics with ascites. In 11 of these cirrhotics and in 11 patients admitted to the hospital for the study of a thoracic pain who had no clinical or hemodynamic signs of cardiac failure (control group), the plasma levels of immunoreactive atrial natriuretic factor in samples from the coronary sinus, right atrium, pulmonary artery, hepatic vein and femoral vein were determined and the coronary sinus blood flow measured by thermodilution. Cirrhotic patients showed significantly higher plasma levels of immunoreactive atrial natriuretic factor in each vascular territory studied than did control subjects (coronary sinus: 101.2 +/- 10.6 vs. 26.1 +/- 4.7 fmoles per ml; right atrium: 32.5 +/- 5.8 vs. 9.4 +/- 3.5; pulmonary artery: 36.8 +/- 10.1 vs. 7.5 +/- 2.4; hepatic vein: 10.7 +/- 2.0 vs. 2.7 +/- 0.8; femoral vein: 18.2 +/- 2.4 vs. 3.1 +/- 0.9; antecubital vein: 14.7 +/- 1.6 vs. 4.0 +/- 0.8). The coronary sinus blood flow was also higher in cirrhotics (200 + 22 ml per min) than in controls (105 +/- 7 ml per min). Consequently, the estimated cardiac release and cardiac production of immunoreactive atrial natriuretic factor were strikingly increased in cirrhotics (13,334 +/- 2,007 and 5,484 +/- 1,734 fmoles per min, respectively) as compared to control subjects (1,669 +/- 338 and 1,431 +/- 350 fmoles per min, respectively; p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

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