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Klebsiella pneumoniae (KP) is a nosocomial pathogen causing difficult-to-treat infections. The presence of virulence genes and antibiotic resistance of 109 KP isolates from hospitalized patients were investigated. Among them, 68.8% were multi-drug resistant (MDR) and 59.6% produced extended‐spectrum beta‐lactamases (ESBLs). Metallo-β-lactamases (MBLs) were produced by 22% of isolates (mainly from anus), including 16.5% of isolates producing New Delhi metallo-β-lactamase (NDM-1). The genes encoding adhesins (fimH—91.7%, mrkD—96.3%), enterobactin (entB—100%) and yersiniabactin (irp-1—88%) were frequently identified. The genes encoding salmochelin (iroD—9.2%, iroN—7.3%) and colibactin (clbA, clbB—0.9%) were identified rarely. Iron acquisition system-related kfu gene and wcaG gene involved in capsule production were identified in 6.4% and 11% of isolates, respectively. The rmpA gene associated with hypermucoviscosity was present in 6.4% of isolates. In 19.2% of isolates magA gene was detected, specific for K1 capsule serotype, while 22.9% of isolates showed K2 capsule serotype. The rmpA, iroD or iroN genes being diagnostic biomarkers for hypervirulent KP (hvKP) were detected in 16.5% of isolates. We found that 55.5% of hvKP were MDR and produced ESBLs, thus hospital KP isolates pose a serious threat to the healthcare system.

SummaryThe ubiquitin-proteasome system (UPS) removes damaged and unwanted proteins by attaching ubiquitin to lysines in a process termed ubiquitination. Little is known how functional components of the UPS, often exposed to erroneous labeling by ubiquitin during functioning, avoid premature proteolysis. An extensive lysine-less region (lysine desert) in the yeast E3 ligase Slx5 was shown to counteract its ubiquitin-dependent turnover. We conducted bioinformatic screens among prokaryotes and eukaryotes to describe the scope and conservation of this phenomenon. We found that lysine deserts are widespread among bacteria using pupylation-dependent proteasomal degradation, an analog of the UPS. In eukaryotes, lysine deserts appear with increasing organismal complexity, and the most evolutionarily conserved are enriched in the UPS members. Using VHL and SOCS1 E3 ligases, which elongate their lysine desert in the course of evolution, we established that they are non-lysine ubiquitinated, which does not influence their stability, and can be subject to proteasome turnover irrespective of ubiquitination. Our data suggest that a combination of non-lysine ubiquitination and ubiquitin-independent degradation may control the function and fate of the lysine-deficient proteome, as the presence of lysine deserts does not correlate with the half-life.

Methicillin-resistant Staphylococcus aureus (MRSA) is responsible for hard-to-treat infections. The presence of 19 virulence genes in 120 MRSA isolates obtained from hospitalized patients and genetic relationships of these isolates were investigated. The eno (100%) and ebps (93.3%) genes encoding laminin- and elastin binding proteins, respectively, were ubiquitous. Other adhesion genes: fib (77.5%), fnbB (41.6%), bbp (40.8%), cna (30.8%) encoding proteins binding fibrinogen, fibronectin, bone sialoprotein and collagen, respectively, and map/eap (62.5%), encoding Eap, were also frequent. The etB and etD genes, encoding exfoliative toxins, were present in 15.6% and 12.5% isolates, respectively. The splA, splE and sspA, encoding serine protease were detected in 100%, 70.8% and 94.2% isolates, respectively. The tst gene, encoding toxic shock syndrome toxin-1 was found in 75% isolates. The cna, map/eap and tst genes were the most common in wound isolates and much less common in blood isolates. We identified 45 different spa types, t003 (21.7%) and t008 (18.8%) being the most common. The t003 was the most frequent among isolates from the respiratory tract (35.5%), while t008 in blood isolates (40%). Identification of virulence factors of MRSA is important for evaluation of pathogen transmission rate and disease development.

Background The nerve root sedimentation sign is a magnetic resonance (MR) sign, shown to be present in central lumbar spinal stenosis. The lack of sedimentation of the nerve roots to the dorsal part of the dural sac is consistent with the positive nerve root sedimentation sign. Purpose To validate the reliability of the nerve root sedimentation sign in diagnosis of different grades of lumbar spinal canal stenosis. Material and Methods This study was a retrospective review of 101 consecutive MR imaging (MRI) studies obtained on patients with clinically suspected lumbar canal stenosis. Based on the minimum anteroposterior (AP) diameter of the dural sac the study sample was classified into two groups: a group with morphological lumbar spinal stenosis; and the group of patients free from stenosis (AP > 12 mm). Patients with stenosis were further subclassified based on its severity: severe stenosis (AP ≤ 10 mm); and moderate stenosis (AP > 10 mm to ≤ 12 mm). Results Positive sedimentation sign was identified in 81% of patients with severe lumbar spinal stenosis and 14% of patients with moderate stenosis. No patients without lumbar spinal stenosis had a positive nerve root sedimentation sign. Of patients with a positive nerve root sedimentation sign, 89% presented with neurological claudication. Conclusion The nerve root sedimentation is a useful tool for identification of patients with both severe clinical and morphological lumbar spinal stenosis; however, its performance in the diagnosis of patients with moderate morphological spinal stenosis is poor.

Computed tomography is a modern technique producing high quality image of scanned organs. It plays a significant role in diagnostic work-up on orthopedics wards. This paper presents an analysis of management of two cases of Hawkins type I talar neck fracture with ankle joint rotation. In both patients, the diagnosis was based on conventional radiographs of the ankle joint in two projections and was subsequently verified with CT scans. The findings of a CT scan of the talus had a significant impact on further treatment and physiotherapy. Non-surgical treatment consisting in immobilization with a short leg cast combined with medication and magnetic field therapy produced a positive therapeutic outcome. A follow-up CT scan of the talus revealed bone union with remodelling in both patients. The functional outcome according to the AOFAS scale should be regarded good. Computed tomography is the radiological modality for detecting talar neck fractures and determining the presence of displacement. Follow-up CT scans evaluate the natural process of bone healing, which is crucial for treatment decisions regarding weight-bearing status. A correct diagnosis based on CT helps to prevent the development of necrosis and posttraumatic (secondary) degenerative changes as well as advanced physical disability, especially among youn­ger patients, in whom the injury is most common, consequently helping to avoid a long and costly treatment.

Tropospheric ozone forms in photochemical reactions or by refuse burning and combustion of exhaust gases from engines, and during some industrial processes. The mean ambient ozone concentration doubled during the last century, and in many urban areas has reached the phytotoxic level. In the present study, there was determined the effect of ozone fumigation on levels of individual flavonoids, chlorophylls, carotenoids and total phenols in the cotyledons of four common buckwheat cultivars (Hruszowska, Panda, Kora and Red Corolla). Six-day-old buckwheat seedlings were grown in controlled conditions and treated with an elevated dose of ozone (391 μg · m−3) during 5 days for 1 h each day. After the experiment, the cotyledons of the seedlings were analysed for individual flavonoids, chlorophylls, carotenoids and total phenols. Shoot elongation was also measured. Individual types of flavonoids in buckwheat cotyledons were found to respond to an elevated ozone dose in various ways. The response was also dependent on the cultivar evaluated. In the cotyledons of ozonized buckwheat seedlings, contents of C-glucosides of luteolin and apigenin decreased or did not change depending on the cultivar examined. In the case of flavonols, the contents of quercetin-3-O-rhamnosyl-galactoside and rutin (quercetin-3-O-rhamnosyl-glucoside) were markedly reduced in most cultivars. O3 had no effect on the level of anthocyanins and chlorophylls but it decreased carotenoids, and tended to inhibit buckwheat growth. In conclusion, a thesis can be formulated that, due to high reduction in important flavonoids, an elevated level of ambient ozone decreases the nutritional value of common buckwheat seedlings.

Summary An osseous Bankart lesion is commonly seen in patients with an anterior shoulder dislocation. It is defined as a detachment of the anteroinferior labrum associated with a glenoid rim fracture. Radiological studies are crucial not only for detecting glenoid bone defects but also for measuring the amount of bone loss. The precise quantification of the bony defect is crucial for the therapeutic desicion-making and clinical outcomes. Although we know that major glenoid bone loss requires surgical intervention, none of the studies performed so far answered the question what size of the defect should be an indication for open surgery procedures. Moreover, there is still no consensus on the exact percentage of glenoid loss that results in a higher risk of re-dislocations. In our opinion, there is a strong need for a consensus on universally accepted measuring techniques of the glenoid defect as well as on algorithms with validated glenoid bone loss threshold values for therapeutic decision-making. In this study, we review the techniques described so far in the literature and try to assess if any of these techniques should be treated as a leading method of detecting and quantifying osseous glenoid lesions.

Snapping hip syndrome is an audible or palpable snap in a hip joint during movement which may be accompanied by pain or locking. It is typically seen in young athletes performing activities requiring repeated extreme movements of the hip. It may also follow a physical trauma, intramuscular injections or surgeries. There are two main forms of snapping hip: extra- or intra-articular. Extra-articular snapping hip is elicited by an abnormal movement of specific tendons and is divided into two forms: internal and external. The internal form of snapping hip syndrome is attributed to an abrupt movement of an iliopsoas tendon against an iliopectineal eminence. Radiograph results in patients with this form of snapping tend to be normal. Dynamic ultrasound is the gold standard diagnostic technique in both forms of extra-articular snapping hip syndrome. The objective of the following text is to describe a step-by-step dynamic ultrasonography examination in internal extra-articular snapping hip syndrome in accordance to the proposed checklist protocol. To evaluate abrupt movement of an involved tendon, the patient needs to perform specific provocation tests during the examination. With its real-time imaging capabilities, dynamic ultrasonography detects the exact mechanism of the abnormal tendon friction during hip movement in a noninvasive way. It also allows for a diagnosis of additional hip tissue changes which may be causing the pain.

Degenerative spine disease is a serious social problem. In most cases, it causes pain and neurological symptoms. Most patients are therefore referred for magnetic resonance imaging (MRI). The article discusses the relationship between back pain and magnetic resonance changes. The signification of some of the radiological symptoms remains controversial. Some of them are markers of acute pain, others may be clinically insignificant, occurring with age. Authors presents some of the magnetic resonance alterations and based on the latest articles discusses their clinical significance. The issues of performing routine, control MRI examination due to chronic back pain and the incidence of new radiological findings were also discussed.

Yersinia enterocolitica is a foodborne pathogen which is primarily responsible for gastrointestinal infections. The presence of the virulence genes in Y. enterocolitica strains isolated from children and antimicrobial resistance was studied in this work. The PCR, biotyping and disc diffusion method were used for analysis of Y. enterocolitica strains. Most of Y. enterocolitica strains belonged to biotype 4 and all carried ail, myfA and ystaA genes. Most of them also had the plasmid yadA gene. These genes were also detected in the strains of biotype 2, while in the two strains of biotype 1A only myfA gene was found. The blaA gene was present in all the strains of biotype 4 and 2, while blaB in the strains of biotype 2 and in some of biotype 4 strains. The presence of β-lactamase genes in Y. enterocolitica was not detected in biotype 1A. All strains were resistant to ampicillin, 76.2% and 47.6% were resistant to ticarcillin and piperacillin, respectively. Two strains (9.5%) were resistant to amoxicillin/ clavulanic acid and aztreonam, three (14.3%) to chloramphenicol, four (19%) to amikacin and trimethoprim/sulfamethoxazole, six (28.6%) to gentamicin. A few strains of Y. enterocolitica were multidrug resistant. The Y. enterocolitica strains isolated from the faeces of children suffering from diarrhea carried virulence genes and some of them were resistant to antibiotics used in extra-intestinal yersiniosis treatment.

Guz Frantz (lity pseudobrodawkowaty nowotwór trzustki, guz Hamoudiego) jest rzadkim, zwykle łagodnym guzem o nieznanej etiologii, występującym głównie u młodych kobiet. Guz ten jest zazwyczaj bezobjawowy, może być jednak przyczyną bólu lub dyskomfortu ze strony jamy brzusznej. W opisywanym przez nas przypadku guz był przyczyną bólu brzucha u 14-letniej, zdrowej dotychczas pacjentki. W wykonanych badaniach obrazowych – ultrasonografii oraz tomografii komputerowej – uwidoczniono dużą masę guza w nadbrzuszu i śródbrzuszu lewym, którego punktem wyjścia była najprawdopodobniej trzustka. Wykonano biopsję metodą laparoskopową, potwierdzającą wstępne rozpoznanie. Guz wraz z ogonem trzustki usunięto metodą laparotomii bez powikłań. Opisany przez nas przypadek pokazuje, iż lity pseudobrodawkowaty guz trzustki może być rzadką przyczyną bólu brzucha u pacjentów pediatrycznych.

Escherichia coli is the most frequent cause of urinary tract infections. We investigated the possible associations between the origin of strains, antimicrobial resistance, the presence of urovirulence factors, and biofilm-forming ability.Antibiotic susceptibility of E. coli strains was tested by disk diffusion method. Hemagglutination assays were performed for phenotypic characterization of the cell surface. Multiplex PCR was used for detection of virulence genes and for determination of phylogenetic relationships.The resistance to ampicillin (55.5%) and tetracycline (39.3%) was significantly more frequent than to other antimicrobial agents. The fim gene was present in 92.5% of strains. The sfa and pap genes were found in 53.8% and 38.7% of strains, respectively. The pap gene was significantly less frequently detected in strains from dialysis patients. The hly gene was present in 18.5% of strains. The aer gene was detected in 52.6% and cnf in 12.1%, while afa was detected in 4.6% of strains. Most strains belonged to the B2 and D phylogenetic groups. The aer gene was significantly associated with strains producing strong biofilms.The E. coli strains causing cystitis in hospitalized patients differed in terms of resistance to antibiotics, virulence genes, and potential for biofilm formation.

Ageing leads to irreversible alterations in the nervous system, which to various extent impair its functions such as capacity to learn and memory. In old neurons and brain, similarly to what may take place in other cells, there is increased oxidative stress, disturbed energetic homeostasis and metabolism, accumulation of damage in proteins and nucleic acids. Characteristic of old neurons are alterations in plasticity, synaptic transmission, sensitivity to neurotrophic factors and cytoskeletal changes. Some markers of senescence, whose one of them is SA-beta-galactosidase were used to show the process of neuronal ageing both in vitro, and in vivo. Some research suggest that, despite the fact that neurons are postmitotic cells, it is cell cycle proteins which play a certain role in their biology, e.g. differentiation. However, their role in neuronal ageing is not known or explained. Ageing is the serious factor of development of neurodegenerative diseases among others Alzheimer disease.