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Biomedical subjects

S Darougar

Publications and source records attributed to S Darougar.

At least 73 records · Page 4Linked to original sources

A double-blind comparison of topical therapy of chlamydial ocular infection (TRIC infection) with rifampicin or chlortetracycline.

A double-blind stratified trial was carried out on 85 patients to assess the efficacy of topical therapy with 1% chlortetracycline eye ointment in comparison with 1% rifampicin eye ointment in the treatment of chlamydial ocular infection of sexually transmitted origin (paratrachoma). Patients included were selected on the basis of positive culture for Chlamydia trachomatis. A 6-week course of treatment with chlortetracycline or rifampicin 3 times daily gave a clinical cure rate of 80% and 75% and a microbiological cure rate of 93% and 86% respectively. In patients who were not cured the intensity of inflammatory responses was considerably reduced.

Administration, Topical↗

Chlamydiae and inflammatory bowel disease.

No association was found between inflammatory bowel disease and infection with C. trachomatis or C. psittaci when patients were tested for the presence of these organisms using immunohistological, cell culture isolation, and serological techniques.

Adult↗

Chlamydia and the Curtis-Fitz-Hugh syndrome.

Ten women with acute right upper-quadrant abdominal pain but negative results for biliary investigations had a current or past history of pelvic inflammatory disease. A diagnosis of the Curtis-Fitz-Hugh syndrome was made and was confirmed in five patients by laparoscopy. Neisseria gonorrhoeae was not isolated from the cervical and urethral swabbings of seven patients tested. Chlamydia trachomatis was isolated from the endocervical canal in one of six patients examined. Of sera from nine patients tested by a micro-immunofluorescence test, nine and six samples respectively showed type-specific IgG and IgM antibodies against C trachomatis serotypes D-K. Type-specific IgG and IgA antibodies were also detected in the cervical and urethral discharge of two out of five patients and in the peritoneal aspirate of two. The presence of high titres of IgG or IgM in sera and IgG or IgA in the local discharges of our patients suggests that C trachomatis was probably the cause of the CFH syndrome.

Adolescent↗

Immediate hypersensitivity in the guinea pig conjunctiva. III. long-term persistence of the hypersensitive state and characterization of antibodies.

The ocular immediate hypersensitivity reaction in guinea pigs to topically applied normal rabbit serum can be evoked as long as 4 years after sensitization. The reaction was as severe and tended to persist for longer than that evoked 6 months after sensitization. Passive cutaneous anaphylaxis tests showed that very high titres of homocytotropic antibodies were present and that both IgE- and IgG1-like antibodies were involved. Sensitization with one set of injections instead of two was not consistently successful and the response on challenge was mild to moderate. Pretreatment of eyes with Isoptocarpine before antigenic challenge had no effect on the response. The addition of bacterial lipopolysaccharide to the first set of sensitizing injections produced hypersensitivity in animals which were otherwise refractory to sensitization.

Animals↗

Ocular and dermal delayed hypersensitivity reactions in guinea-pigs following infection with guinea-pig inclusion conjunctivitis agent (Chlamydia psittaci).

Guinea-pigs which had been sensitized to guinea-pig inclusion conjunctivitis agent by ocular infection, were given ocular and dermal challenges with a range of doses of agent. Ocular delayed-type hypersensitivity responses were elicited by a wide range of doses. Such responses were associated with the presence of chlamydial inclusions and inflammatory cells. The EID50 for ocular reinfection was only slightly higher than that for primary ocular infection. Dermal delayed-type hypersensitivity reactions were produced only when high doses of agent were used. The relevance of these observations to human chlamydial eye disease is discussed.

Animals↗

Comparative sensitivity of fluorescent antibody staining of conjunctival scrapings and irradiated McCoy cell culture for the diagnosis of hyperendemic trachoma.

The sensitivity of an indirect fluorescent antibody (FA) staining technique for detecting chlamydial inclusions in scrapings from the whole conjunctiva (upper tarsus, upper fornix, and lower lid) was compared with the sensitivity of culture in irradiated McCoy cells for the diagnosis of hyperendemic trachoma. In a group of 211 patients with various grades of active trachoma from the Bandar Abbas area of Southern Iran 42 patients were positive for chlamydiae by either method. There was little difference between the rates of positivity of FA staining of the scrapings from the whole conjunctiva (28 positives) and culture in irradiated McCoy cells (32 positives). In the patients included in this study chlamydial inclusions were detected in 15 eyes by examination of FA stained scrapings taken from the upper tarsal conjunctiva, whereas inclusions were detected in 40 eyes by the additional examination of scrapings taken from the upper fornix and lower lid (P less than 0.001). The examination of FA stained scrapings taken from the whole conjunctiva and spread as a single but larger smear may provide a satisfactory alternative to cell culture methods for the diagnosis of trachoma, particularly for field studies when cell culture facilities are not available.

Cells, Cultured↗

Guinea-pig inclusion conjunctivitis as a model for the study of trachoma: clinical, microbiological, serological, and cytological studies of primary infection.

The course of primary ocular infection with guinea-pig inclusion conjunctivitis agent was followed in 2 groups of animals. One group of fully grown animals was repeatedly scraped; the other of small animals was used on 1 occasion only and scraped after clinical examination. The intensity of conjunctival inflammation was measured, conjunctival scrapings were taken, and the numbers of polymorphonuclear cells, mononuclear cells, and epithelial cells containing chlamydial inclusions were counted, and the level of antibodies in serum was measured. It was found that inflammation of the conjunctiva lasted for about 30 to 40 days, and the clinical features (oedema, hyperaemia, papillary reaction) were very similar in the 2 groups. Inclusions and polymorphonuclear cells were found for up to 21 days, and mononuclear cells were found on days 7 to 25. Serum antibodies were first detected on day 10 and reached a peak on day 21. The intensity of inflammation was significantly higher on day 2 in the animals which had been scraped. After this the severity of the inflammation and the course of disease were similar in the 2 groups.

Animals↗

Development of chronic conjunctivitis with scarring and pannus, resembling trachoma, in guinea-pigs.

Guinea-pigs were repeatedly infected with guinea-pig inclusion conjunctivitis agent. Reinfection caused severe conjunctival inflammation, and repeated reinfection led to chronic inflammation lasting for many months. This was followed by the development of pannus, follicles on the palpebral conjunctivae, scarring of the lower palpebral conjunctiva, and deformities of the lower lid. Reinfection was accompanied by small numbers of inclusion-bearing cells, small numbers of polymorphonuclear cells, and high numbers of mononuclear cells. There was no increase in the level of serum antibodies. The chronic conjunctivitis was associated with high numbers of mononuclear cells and no inclusions or polymorphonuclear cells. The response to reinfection appears to be a delayed-type hypersensitivity reaction, and we suggest that the chronic inflammation, pannus, scarring, and lid deformities associated with hyperendemic trachoma may be due to repeated reinfection combined with delayed-type hypersensitivity.

Animals↗

Family-based suppressive intermittent therapy of hyperendemic trachoma with topical oxytetracycline or oral doxycycline.

A controlled double-blind stratified trial was carried out in a village in Southern Iran to assess the efficacy of family-based intermittent therapy of hyperendemic trachoma with topical oxytetracycline oily suspension twice daily for 7 days each month, or oral doxycycline 5 mg per kilogram of body weight once a month, in comparison with a control group which received vitamin pills once a month. In addition all other members of the selected children's families were also treated with the same regimen of therapy. The treatment was given for a period of 1 year by 3 field technicians, each responsible for one regimen of therapy. Examining the whole conjunctiva 4 months after the start of therapy, we observed no marked difference in the cure rate or the number of patients with moderate to severe trachoma between the groups treated with antibiotics and the control group. When treatment was continued for 12 months, a marked decrease in the prevalence of trachoma and in the grades of intensity of inflammatory responses as well as the positivity rate for Chlamydia trachomatis was observed in the groups treated with the topical oxytetracycline or oral doxycycline compared with the control group. While there was no marked difference between the efficacy of these 2 regimens of mass chemotherapy, the monthly intermittent therapy with a single dose of doxycycline offers the advantage of being more practical and less expensive for mass control of trachoma by requiring approximately one-tenth of the staff, transport, and other facilities required for the intermittent topical therapy with tetracycline eye ointment.

Child↗

Indirect micro-immunofluorescence test for detecting type-specific antibodies to herpes simplex virus.

A rapid indirect micro-immunofluorescence test capable of detecting and differentiating type-specific antibodies to herpes simplex virus is described. The test proved highly sensitive and, in 80 patients with active herpes ocular infection, antibody was detected in 94%. No anti-herpes antibody was detected in a control group of 20 patients with adenovirus infections. Testing of animal sera prepared against herpes simplex virus types 1 and 2 and of human sera from cases of ocular and genital herpes infections showed that the test can differentiate antibodies to the infecting serotypes. Specimens of whole blood, taken by fingerprick, and eye secretions, both collected on cellulose sponges, could be tested by indirect micro-immunofluorescence. Anti-herpes IgG, IgM, and IgA can also be detected.

Animals↗

Epidemiology of infection by serotypes D to K of chlamydia trachomatis.

Non-specific urethritis (NSU) is a sexually transmitted disease; 50% of cases are due to Chlamydia trachomatis, so that this is the commonest sexually transmitted infection in the developed world. Chlamydial infection is now readily diagnosable and the evidence increasingly suggests that it is underdiagnosed. Chlamydial conjunctivitis (in the newborn baby or the adult) in the developed world is a complication of sexually transmitted genital infection by C trachomatis and it indicates a large reservoir of such infections. Because of the association of sexually transmitted diseases, systemic treatment for such chlamydial conjunctivitis should not be given until full genital and serological investigators have been carried out. Chlamydial infection causes serious complications (that were formerly often thought to be gonococcal), such as epididymitis in young men and salpingitis on young women. It may cause local complications in the eye of the newborn baby and even pneumonia in babies and fatal endocarditis in adults. The diagnosis of NSU should lead to the correct treatment of the male patient and of his sexual partners. It is the promiscuous woman, who does not have a regular sexual partner to report back to her that he has NSU, who is at particular risk of undiagnosed chlamydial infection. Routine genital investigations for chlamydia are particularly indicated in her case. Following the parallel of gonorrhoea, it seems that the use of contact tracers may be an effective method for controlling chlamydial infection.

Adult↗

Subclinical pneumonia due to serotypes D-K of Chlamydia trachomatis. Case reports of two infants.

Pneumonia due to serotypes D-K of Chlamydia trachomatis occurred in a 10-week-old baby, who had been successfully treated with chlortetracycline eye ointment for chlamydial ophthalmia neonatorum, and in a 7-week-old baby being treated for the same condition. Clinical signs of pneumonia were minimal. Such chlamydial pneumonia in infants must be under-diagnosed. Infants with chlamydial ophthalmia neonatorum are now routinely treated with erythromycin suspension by mouth in addition to chlortetracycline eye ointment.

Adult↗

Prevalence of antichlamydial antibody in London blood donors.

The prevalence of type-specific antichlamydial antibody in a population of blood donors in London was studied using a microimmunofluorescence test. Twenty-six (17%) of 150 women and 38 (26%) of 150 men had antichlamydial antibody (IgG at greater than or equal to 1/16 or IgM greater than or equal to 1/8 or both). Of these, five (3%) women had one (0.75%) man had this antibody directed against Chlamydia trachomatis serotypes D-K, responsible for genital infections, and one man had antibody to Chlamydia psittaci agents. The remaining 57 men and women had antibody against an atypical chlamydial isolate designated Chlamydia IOL-207, which is iodine-negative and serologically distinct from both C trachomatis and C psittaci. The nature and location of infection by this agent are obscure. The results of this study suggest that the prevalence of sexually transmitted infection with C trachomatis serotypes D-K in a normal adult population in London is very low.

Antibodies, Bacterial↗

Chlamydia, cytomegalovirus, and Yersinia in inflammatory bowel disease.

The relationship of three infectious agents, Chlamydia, cytomegalovirus, and Yersinia enterocolitica, to the aetiology, clinical course, and diagnosis of Crohn's disease was studied. There was no evidence of chlamydial infection in Crohn's disease and no indication either that cytomegalovirus alters the outcome of acute attacks or that infection with Y. enterocolitica is being misdiagnosed as Crohn's disease.

Acute Disease↗

Juxtapapillary choroiditis in association with rising antichlamydial antibody.

We present the case of a 21-year-old girl with a uniocular juxtapapillary choroiditis. During the course of her illness the titre of antichlamydial IgG increased from 1/32 to 1/4096 against Chlamydia trachomatis TRIC serotypes J and C, and antichlamydial IgM appeared in her blood. Toxoplasma dye test was positive at a level of 1/128 but no increase in the titre of antibody was detected during the course of her infection. The relevance of these findings to her ocular lesion is discussed.

Adult↗

Isolation of Chlamydia trachomatis from different areas of conjunctiva in relation to intensity of hyperendemic trachoma in school children in Southern Tunisia.

The simplified one-passage technique of culture in irradiated McCoy cells, in conjunction with certain other developments in technique, was used to isolate Chlamydia trachomatis from specimens collected from 78 children with trachoma in Douz, Southern Tunisia. The results show that C. trachomatis is not confined to the upper tarsal area of the conjunctiva in hyperendemic trachoma. The higher isolation rate and corresponding increase in the number of inclusions obtained from swabbings of the upper fornix and lower lid in addition to the conventional collection from the upper tarsus show the superiority of collecting specimens for culture from the whole conjunctiva. Specimens could be collected from the whole conjunctiva by using 1 swab for each eye and pooled for subsequent inoculation, so that the laboratory incurred no additional work. A close correlation was observed between isolation rate, together with the number of inclusions, obtained in cell culture, and intensity of inflammatory disease in hyperendemic trachoma. The sensitivity and practicability of this cultural test should provide a valuable laboratory index for use in epidemiological and therapeutic studies of trachoma.

Child↗