{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T19:17:46Z","timestamp":1761765466332},"reference-count":29,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2011,9,1]]},"abstract":"<jats:p>The aim of this study is to investigate the changes in clinical pattern and therapeutic measures in leptospirosis-associated acute kidney injury; a retrospective study with 318 patients in Brazil. Patients were divided according to the time of admission: 1985\u20131996 (group I) and 1997\u20132010 (group II). Patients were younger in group I (36 \u00b1 13 versus 41 \u00b1 16 years, <jats:italic>P<\/jats:italic> = 0.005) and the numbers of oliguria increased (21% versus 41% in group II, <jats:italic>P<\/jats:italic> = 0.014). Higher frequency of lung manifestations was observed in group II (<jats:italic>P<\/jats:italic> &lt; 0.0001). Although increased severity, there was a significant reduction in mortality (20% in group I versus 12% in group II, <jats:italic>P<\/jats:italic> = 0.03). Mortality was associated with advanced age, low diastolic blood pressure, oliguria, arrhythmia, and peritoneal dialysis, besides a trend to better mortality with penicillin administration. Leptospirosis is occurring in an older population, with a higher number of oliguria and lung manifestations. However, mortality is decreasing and can be the result of changes in treatment.<\/jats:p>","DOI":"10.4269\/ajtmh.2011.11-0080","type":"journal-article","created":{"date-parts":[[2011,9,6]],"date-time":"2011-09-06T18:47:57Z","timestamp":1315334877000},"page":"479-484","source":"Crossref","is-referenced-by-count":14,"title":["Different Patterns in a Cohort of Patients with Severe Leptospirosis (Weil Syndrome): Effects of an Educational Program in an Endemic Area"],"prefix":"10.4269","volume":"85","author":[{"given":"Elizabeth F.","family":"Daher","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Geraldo B.","family":"Silva","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rafael S. A.","family":"Lima","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rosa M. S.","family":"Mota","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hermano A. L.","family":"Rocha","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Krasnalhia L\u00edvia S.","family":"de Abreu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adller G. C.","family":"Barreto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eanes D. B.","family":"Pereira","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S\u00f4nia M. H. 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