Search

Choroby układu sercowo-naczyniowego pozostają w społeczeństwach krajów wysoko rozwiniętych główną przyczyną zgonów. Pomimo licznych badań nadal nie wyjaśniono w pełni ich patogenezy. Nadzieję na poprawę sytuacji wiąże się z poznaniem roli mikrofloryjelitowej, która poprzez wytwarzane metabolity, a także interakcję z organizmem gospodarza może wywierać wpływ na procesy zdrowia i choroby. W niniejszej pracy porównano wyniki badań własnych oraz europejskich badań populacyjnych w aspekcie wpływu drobnoustrojów na występowanie chorób układu sercowo-naczyniowego. Ustalono, iż wybrane grupy bakterii są istotne w kontekście występowania zaburzeń gospodarki lipidowej, odgrywających kluczową rolą w rozwoju miażdżycy. Dzięki wykorzystaniu badań molekularnych możliwe staje się porównywanie wyników badań mikrobiomu i poszukiwanie związków mikroflory z procesami patologicznymi w różnych populacjach. [ABSTRACT FROM AUTHOR]

Objectives: The aim of the study was to evaluate the level of cognitive and social functioning in two groups of schizophrenia patients using clinical tools, psychological tests, QEEG, and changes in the brain-derived neurotrophic factor (BDNF) activity in subjects' serum., Methods: Randomly selected men diagnosed with schizophrenia were enrolled in the study and divided into two groups. Gr. 1 was formed by patients who did not undergo a structured rehabilitation program, while Gr. 2 was formed by patients undergoing standard rehabilitation, as provided in theprogramof the Psychiatric Rehabilitation Unit. Both groups underwent a comparative analysis of demographic parameters and based on: PANSS, AIS, GSES, and BCIS, psychological tests CTT-1, CTT-2, d2, QEEG, and changes in blood BDNF levels. To assess the effect of rehabilitation, the results obtained in both groups were compared after 12 weeks and their analysis was performed in accordance with assumptions for the experimental project. The study presents research hypotheses and pre-test and post-test comparisons of the groups, on the basis of selected research tools., Results: The data obtained in measurement 1 indicate that both groups did not differ significantly in terms of: age, education, place of residence, treatment at outpatient facilities, medicines taken, and suicide attempts. Differences concerned: marital status, children, number of hospitalizations, and employment status. Furthermore, no significant differences were found for the studied groups concerning: serum levels of the brain-derived neurotrophic factor, values obtained on the PANSS, AIS, and GSES, and alpha/theta, theta/beta and theta/SMR ratios. The analyses performed in measurement 2 indicate that structured rehabilitation influences reduce negative symptoms, cause an increase in BDNF levels, cause an improvement in cognitive and social functioning and positively influence the perception speed and accuracy., Conclusions: The positive effect of structured rehabilitation influences allows to say that rehabilitation represents a necessary part of the comprehensive psychiatric treatment and should already be implemented during the first episode of the illness.

The increasing body of evidence implies that brain-derived neurotrophic factor (BDNF) is the most common neurotrophin in the nervous system, playing an important role as an effectiveness indicator for rehabilitation interventions in schizophrenia patients. Currently, with the modern laboratory and instrumental diagnostic methods it is possible to diagnose deficits influencing the level of patient's functioning and use them as a basis for establishing individual re-adaptation programs for schizophrenia patients considering various forms of the therapy in different environments. Based on the PubMed and Scopus search tools a review of the available literature was performed and the paper presents current results of studies analyzing a relationship between selected rehabilitation interventions used in schizophrenia patients and changes in BDNF levels (a correlation between BDNF levels and physical activity and EEG Biofeedback therapy). Out of 240 records identified in total, the ones concerning the subject matter of the paper were taken into account. Studies concerning use of the presented method appear to indicate usefulness of BDNF factor in evaluation of effectiveness of implemented rehabilitation interventions in this group of patients. Changes in neurotrophin levels may indicate a synergy of the central and the peripheral nervous system, and high BDNF levels depending on physical activity and a neuromodulating effect of the EEG Biofeedback therapy may indicate their effectiveness. Use of various neurorehabilitation methods may improve the social functioning in schizophrenia patients. Treating BDNF as a biological indicator of those processes may represent an interesting hypothesis.

Acquired perforating dermatosis (APD) represents a heterogenous group of skin disorders characterized histopathologically by transepithelial elimination (TEE) of dermal structures. APD is manifested clinically as multi-localized, papulo-nodular skin lesions accompanied by a refractory pruritus. APD typically coexists with long-term disorders, most often diabetic kidney disease (DKD). The paper presents a case of a 56-year-old male patient with chronic kidney disease (CKD) and concomitant acquired reactive perforating collagenosis (ARPC), which is a subtype of APD. Etiological theories of ARPC as well as current diagnostic and treatment principles in dermatosis were described. On the basis of the presented case report and the literature review attention was paid to diagnostic difficulties associated with APD. The assumption was made that APD can be an underdiagnosed disease and thus it is not treated correctly. According to the authors’ opinion, this is an important circumstance to popularize the knowledge about APD.

Background: The presence of co-infections induced by tick-borne pathogens in humans is an important epidemiological phenomenon. This issue has attracted growing attention of doctors and people working under conditions of an increased risk of being exposed to tick bites., Material and Methods: The research group consisted of 93 individuals with current anti-immunoglobulin M/G (IgM/ IgG) Borrelia burgdorferi or IgG anti-Anaplasma phagocytophilum. The respondents were identified during the screening survey in a group of farmers and foresters occupationally exposed to tick bites. The aim of the work was to analyse the frequency of antibodies to specific antigens of B. burgdorferi and the levels of cytokines in forestry workers and farmers with B. burgdorferi monoinfections and B. burgdorferi / A. phagocytophilum co-infections. Statistical analysis was performed using the Chi2, Mann-Whitney U and Kruskal-Wallis tests., Results: There is a stronger generation of IgG antibodies to B. burgdorferi antigens in patients with B. burgdorferi / A. phagocytophilum co-infections, such as variable major protein-like sequence expressed (VlsE) (p < 0.05), p19 (p < 0.02), p17 (p < 0.05) and complement regulator-acquiring surface protein 3 (CRASP3) (p < 0.02) compared to persons with B. burgdorferi monoinfections. The discrepancies in the synthesis of cytokines interleukin 6 (IL-6), IL-10, and tumor necrosis factor α (TNF-α) have not been found in persons with B. burgdorferi monoinfections and B. burgdorferi / A. phagocytophilum co-infection., Conclusions: The immune response directed against B. burgdorferi is stronger in patients co-infected with B. burgdorferi and A. phagocytophilum than in those with monoinfection., (This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.)

The authors presents case report of a 59-years-old man with triple vessel coronary artery disease, hypertension after myocardial infarction of the inferior wall with sternal wound complcations after coronary bypass grafting (CABG). On the fourth postoperative day the patient developed sternal dehiscence with wound infection. Infection was caused by Staphylococcus haemolyticus--coagulase-negative methicillin-resistant strain, MRCNS. An antimicrobial therapy and negative pressure wound therapy were used for complete wound healing.

Unlabelled: Idiopathic membranous nephropathy (IMN) is a chronic glomerular disease. It is result of new discovery that the production of anti-PLA2R autoantibodies, reacting with phospholipase A2 receptor on the surface of podocytes. Specific antibodies occur in IMN patients blood in exacerbated of disease, and disappear during remission. It suggest that analyse of these parameter can prove quick diagnosis to recognize and monitoring treatment process. The aim of our work was to determine anti-PLA2R in patients with suspected IMN and persons during/after treatment in order to monitor the effectiveness of therapy., Material and Methods: The study group consisted of 22 patients. Patients were divided into two groups: Group A--patients with symptomatic nephrotic syndrome in the course of membranous nephropathy; Group B--patients diagnosed with IMN who monitored the effectiveness of therapy. We collected the serum samples for all patients and determined of anti-PLA2R autoantibodies by indirect immunofluorescence test., Results: Antibodies were detected in 12 patients (54.54%): diagnosed (n = 5) and monitor (n = 7). All of patients with exacerbated disease process in monitored group had positive test results., Conclusions: Our data suggest that anti-PLA2R is a sensitive diagnostic method and good for monitoring of disease activity, but nevertheless a need for further research on a larger group of patients to confirm that the test is a reliable source of diagnostic information.

Background: The aim of the work was to analyze the incidence of infection with Borrelia burgdorferi in forestry workers and farmers, major groups occupationally exposed to tick bites., Material and Methods: The study group included 275 workers (171 foresters and 104 farmers). The control group consisted of 45 people, who have not been occupationally exposed to tick bites. The screening Elisa and Wb tests for the presence of anti-Borrelia IgM/IgG antibodies were performed in all subjects of the study and control groups. Statistical analysis was performed using the Chi2 test., Results: The positive results denoting the presence of anti-Borrelia IgM/IgG antibodies were found in 55% of farmers and 28% of foresters occupationally exposed to Lyme borreliosis and coming from the area of South Podlasie Lowland and Lublin Polesie. The differences between the forestry workers and the control group (p < or = 0.00001) and between farmers and the control group (p < or = 0.001) were statistically significant. The species, such as B. spielmanii and B. bavariensis, which have not yet been reported in Poland, are significant etiologic agents of Lyme disease., Conclusion: The risk of occupational exposure to the B. burgdorferi infection is high for foresters and farmers, and the infection with spirochetes is frequently confirmed on the basis of positive results of the Wb test. The presence of specific antibodies against protein antigens of B. spielmanii and B. bavariensis suggest that these bacteria can cause Lyme disease both independently and in participation with other Borrelia species, which influences the development of the clinical manifestations of infection.

Introduction: The infection caused by Borrelia burgdorferi initiates a number of reactions in the human immunological system and particular behaviors of the infectious factor. The aim of work was to analyze the level of circulating immune complexes (CIC) due to infection with Borrelia burgdorferi in persons professionally exposed to tick bites., Material and Methods: The group of tested consisted of 275 persons, who are professionally exposed to tick bites, including 171 foresters and 104agriculturists. The controlled group consisted of 45 people, living permanently ortemporarily in Biata Podlaska, city in the South Podlasie Lowland, who have not been exposed professionally on tick bites.The screening test ELISA (Euroimmun) has been carried among all persons from the tested group towards the presence ofantibodies IgM/IgG anty-Borrelia. Among those who met positive or delimited results from screening test Elisa, another test of Western blot (Wb, Euroimmun, Virotech GmbH) has been carried in order to confirm the infection. The serum which has been taken from a group of persons being professionally exposed to infection of B. burgdorferi and persons from a controlled group, has been tested in terms of estimating levels of circulating immune complexes CIC C1q (Elisa, DRG)., Results and Conclusion: The circulating immune complexes (CIC) are increasingly generated at persons with present IgM and/or IgG anty-Borrelia but their existence accompanied by the presence of strongly expressed humoral response does not affect the diagnostic effectiveness of infections with B. burgdorferi.

Unlabelled: The registered infection and outbreaks of epidemic tend to monitor potential reservoirs of Legionella infection. According to the Act of 29 March 2007 on the requirements for the quality of water intended for human consumption are required to test for the presence and number of Legionella in the water system of hospitals. In case of detection of L. pneumophila serogroup 1 (SG 1) or increased above normal number other serogroups of bacteria it is necessary to eradicate these bacteria from the water system. The aim of this study was to assess the degree of contamination of the water supply system of selected public buildings and analyze the effectiveness of disinfection methods for the elimination of L. pneumophila in hot water systems., Material and Methods: The materials for this study were hot and cold water samples which were collected from the water supply system of 23 different objects. Enumeration of Legionella bacteria in water samples was determined by membrane filtration (FM) and/or by surface inoculation methods according to the standards: PN-ISO 11731: 2002: "The quality of the water. Detection and enumeration of Legionella" and PN-EN ISO 11731-2: 2008: "Water quality--Detection and enumeration of Legionella--Part 2: Methodology of membrane filtration for water with a small number of bacteria"., Results: L. pneumophila was present in 164 samples of hot water, which accounted for 76.99%. In all tested water samples L. pneumophila SG 2-14 strains were detected. The most virulent strain--L. pneumophila SG 1 was not detected. In examined 23 objects in 12 of L. pneumophila exceed acceptable levels > 100 CFU/100 ml., Conclusions: The presence of L. pneumophila SG 2-14 demonstrated in all examined objects, indicating the risk of infection, and the need for permanent monitoring of the water system supply. The thermal disinfection is the most common, inexpensive, and effective method of control of L. pneumophila used in examined objects, but does not eliminate bacterial biofilm. Disinfection using the filters stopped of L. pneumophila, and was the method of complementary thermal disinfection. Chlorine dioxide is a very effective biocide for large numbers of L. pneumophila in water systems.

Breast cancer is the most common neoplasm among women. The risk of disease increases with age, particularly in postmenopausal period. The method of treatment depends on the stage of disease, state of receptors and molecular subtype. Depending on indications there are few options: surgical treatment, radiotherapy, hormonotherapy, chemotherapy and targeted therapy. Systemic treatment of metastatic triple-negative breast cancer is not satisfying. Hopes are laid upon poly(ADP-ribose) polymerase inhibitors. Studies over these substances in both: in connection with the standard chemotherapy and as monotherapy bring promising results. The article presents the molecular basics of polymerase poly(ADP-ribose) function as well as the possibilities of using its inhibitors in treatment of triple-negative breast cancer.

Unlabelled: The differentiation between streptococcal pharyngotonsillitis and that of viral etiology is crucial, since it allows to discriminate patients who need to be treated with the use of antibiotics from those who only need symptomatic treatment. For that purpose, Centor/Mclssac's scale, based on the clinical examination and a history of a patient, is suggested by "Polish Recommendations for the diagnosis and treatment of community-acquired respiratory tract infections 2010". In patients who have obtained two or more points according to this scale, a definitive diagnosis of streptococcal pharyngotonsillitis depends on the identification of the bacterium, which can be performed by throat swab culture or by rapid antigen detection test. The aim of the study was to evaluate utility of clinical differentiation, rapid antigen detection test and throat swab culture for appropriate antibiotic therapy of acute pharyngotonsillitis in children. To the best of our knowledge, this is the first survey of this type carried out in Poland., Material and Methods: 42 children in the age of 3-14 years with acute pharyngotonsillitis who obtained at least two points in Centor/ Mclssac's scale took part in our study. Two throat swabs were obtained from every child, one of them was used to perform rapid test, and the second one was cultured on Columbia blood agar. Grey-white colonies with beta-hemolysis were classified to the groups A, B, C, D, F and G according to Lancefield with the use of bacitracin discs and latex agglutination test., Results: 50% of children obtained 4 points and 40.5% of them received 5 points in Centor/Mclssac's scale. QuickView+ Strep A test turned up to be consistent with culture in 97.6% of cases. On the grounds of rapid test and culture results patients were subdivided into 3 groups: I--infected with S. pyogenes (50.0%), II--infected with other groups of beta-hemolytic streptococci (9.5%), III--infected with viruses (40.5%)., Conclusions: It is impossible to recognize streptococcal pharyngitis only on clinical grounds, the diagnosis must be confirmed by laboratory methods. In children with high risk of streptococcal pharyngitis QuickView+Strep A test possesses diagnostic value comparable to culture in the detection of S. pyogenes, however negative rapid test results in such patients should be confirmed by culture. Antibiotic therapy should be initiated on the base of microbiological examination.

Background: Ventilator-associated pneumonia (VAP) occurs in approximately 10-20% of mechanically ventilated patients, and is associated with an extremely high mortality rate (up to 70%). The purpose of the study was to determine the susceptibility spectrum of Klebsiella, Pseudomonas and Acinetobacter strains isolated from VAP patients., Methods: We analysed 81 strains of microorganisms isolated from bronchoalveolar lavages (BAL) of VAP patients. The minimal inhibitory concentrations (MIC) of antibiotics recommended for empirical therapy were determined using an automated VITEK 2 system, and for the MIC of doripenem - the Etest assay. Results were analysed following the guidelines of the Clinical and Laboratory Standards Institute., Results: For infections caused by the group of bacteria under investigation, the most successful regimen was monotherapy with carbapenems (doripenem, meropenem and imipenem). Cephalosporins (cefepim and ceftazidim) were less effective in vitro. The worst results were obtained with the combination of piperacillin/tazobactam with aminoglycosides (amikacin or gentamicin) or fluoroquinolones (ciprofloxacin)., Conclusions: Antibiotic monotherapy proved to be more effective in VAP patients than combined therapy; the best results were achieved with carbapenems. Doripenem showed strong activity in vitro against P. aeruginosa and Klebsiella sp. and should be considered for empirical VAP therapy; however, carbapenems may be less effective against Acinetobacter baumannii. The wide range of bacteria, and their broad range of susceptibility to antibiotics, suggests the need for modification of current recommendations.

This article reviews the most important aspects of antibiotic treatment failure in respiratory tract infection which may occur with empirical as well as under target antibiotic therapy. Potential risk factors leading or predisposing to treatment failure exist in hospital acquired infections which cover polymicrobial aetiology with high multidrug resistance bacteria, changed conditions of pharmacokinetic and pharmacodynamic (PK/PD) parameters of antibiotics, bioavailability, drug interactions and inactivation. Microbial determinants of treatment failure includes bacterial physiology in laboratory cultures and inside the host, inadequate drug choice, lack of knowledge of PK/PD parameters with insufficient antibiotic level in target tissue. Differences between microbial in vitro tests and clinical outcome can be caused by varied CFU concentration, growing phase, nutritional, pH and redox conditions. Many factors of treatment failure are focused on bacterial biofilm structure and phenomenon of small-colony variants (SCVs) which both display reduced susceptibility to antimicrobial agents protected by matrix feature, enhanced production of PIA and by slow multiplication of biofilm forming cells.

Surgical site infections - SSI belong to one of the most frequent and serious post-operative complications occurring in patients. They lead to extended hospitalization period, to increase of treatment costs, morbidity and mortality among patients. The surgical antibiotic prophylaxis is one of the most significant procedures which goal is to reduce infectious complications and to complement surgical effects. Proper surgical antibiotic prophylaxis should be distinguished by: appropriate time of application and administration adequate to the kind of treatment and quality of the drug, proper selection of the antibiotic which considers microbiological as well as pharmacological conditions which has established clinical effectiveness.

The bacterial skin and soft-tissue infections occur commonly and are characterized by more or less intensified changes within skin and subcutaneous tissue. The bacterial skin infections give rise to significant therapeutic problems associated with increasing resistance etiological agents of these infections to antibiotics and chemotherapeutics. The aim of this study was to assess the distribution of various Gram-positive microorganisms in skin lesion observed in ambulatory patients in a period from June 2005 to December 2006. There were 116 bacterial strains isolated and identified from clinical samples: Staphylococcus aureus, coagulase - negative staphylococi (S.epidermidis, S. xylosus, S.capitis, S.saccharolyticus), Propionobacterium acnes, Streptococcus spp. (S.agalactiae, S.pyogenes) i Corynebacterium spp. (C. striatum, C. amycolatum, C. aquaticum). In the further part of this study we analyzed a profile of their susceptibility to antibiotics and chemotherapeutics in relation to drugs recommended for the empirical therapy. The resultant resistance patterns among the examined bacterial isolates are indicative of certain divergence between recommended empirical antibiotic therapy and actual antimicrobial susceptibility of many etiologic factors of skin and soft-tissue infections.

Surgical site infection (SSI) is one of the most common and serious postoperative complication of modern surgery. It contributes to an increase of morbidity, mortality, prolonged hospitalization and costs of treatment. The optimal strategy in order to reduce wound infections in surgery is SSI knowledge of risk factors associated with a patient, surgery and postoperative care as well as the caution of fundamental recommendations concerning prevention, which include: preparation of patient for surgery, preparation of antiseptic principles for hand skin of the operation team, the proceedings in the case of allegation of infection or colonization within the operation team members, preoperative antibiotic prophylaxis, procedures and aspects of aseptic surgical technique, postoperative care and the rules for monitoring infections in the surgical ward.

The Aim: of our study was the identification of microorganisms causing vascular graft infections and the evaluation of their antimicrobial susceptibility., Material and Methods: 25 patients with infected vascular graft, took part in our research. In 19 patients late type of infection was recognized, in 6 the infection was qualified as early. Purulent discharge obtained from the fistula was inoculated on the bacteriological media. Antimicrobial susceptibility was assessed by disc-diffusion method., Results: Staphylococcus aureus and Pseudomonas aeruginosa proved to be the most frequently isolated microorganisms. Mixed infection, caused by two distinct bacteria, occurred in 5 patients; in all cases one species belonged to Gram-positive, and the second one to Gram-negative bacteria. In 50% of patients with early type infection different species of Gram-negative rods were present, in 37,5% of them S. aureus and S. epidermidis were isolated. In late type infection Gram-negative rods were isolated from 54,5% of patients and Gram-positive bacteria from 31,5% of patients. The most frequently isolated species appeared to be Pseudomonas aeruginosa. The isolated species of bacteria varied depending on the degree of infection (according to Shilagy and Samson)., Conclusions: A diversity of isolated species, the presence of mixed infections and resistance patterns typical for hospital flora among bacteria infecting vascular grafts cause that antibiotic therapy should always be based on the results of microbiological examination.

Purpose: The goal of this study is to determine the usefulness of the PCR method in the diagnosis of endophthalmitis., Materials and Methods: 30 clinical specimens 18 AH and 12 VF were obtained from 20 eyes with the clinical diagnosis of endophthalmitis. These included: 14 cases after cataract surgery, 1 case post trabeculectomy, 2 cases after penetrating traumas, and 3 cases after endogenous endophthalmitis. The same samples were analysed using 2 different methods: 1. conventional microbiological techniques (microscopy and diagnostic culture) and 2. PCR directed at 16S rDNA using universal primers., Results: In the aqueous humor the causative pathogen was identified in one case (5.2%) by using diagnostic culture compared with seven cases (39%) by using PCR methods. In the vitreous samples the pathogen was identified in one case (9%) by using conventional method compared with five cases (50%) by using PCR. Microscopic preparation was difficult to evaluate in all samples., Conclusions: PCR performed on aqueous humor and vitreous fluid is a reliable tool for diagnosis of causative organism particularly in smear and culture negative specimens. By using universal primers we are able to detect the presence of pathogen in case of endophthalmitis and than potentially by using DNA probe hybridization to determine the species of the bacteria. The discrimination between infection or non-infection endophthalmitis plays the main role in a succesful therapy.

Objectives: To estimate the microbiological profile of vaginal flora in 30 women with gynecologic problems and 20 pregnant women complaining about pathological symptoms {pruritus, burning, vaginal discharge}., Materials and Methods: The discharge from posterior vaginal vault was examined microbiologically on the Columbia Agar with sheep blood, MacConkey and Sabourand cultures incubated of 48 hours in the temperature of 37 degrees C., Results: Bacterial infections were detected in 33 cases (66%), 12 of these women (24%) lived in urban, 21 (42%) in rural environment. From bacteria isolated from the vagina, most often because at 14 women stepped out Streptococcus agalactiae, at 11 Enterococcus faecalis at 8 Escherichia coli. In 5 cases bacterial inflammation was caused by two kinds of bacterium. At two women stepped out both Enterococcus faecalis and Escherichia coli. In single cases it was Klebsiella pneumoniae and Proteus vulgaris, Escherichia coli and Streptococcus agalactiae. In all cases of inflammation mycosis was called out by from Candida albicans. One ascertained it at 14 among all given an examination women. Mixed inflammations called out both by mycosis and bacterial stepped out in 3 cases in age of 21-30. At two women it was Candida albicans and Streptococcus agalactiae, at one inflammation mycosis accompanied Enterococcus faecalis., Conclusions: The common reason of vaginitis are bacterial infections caused by Streptococcus agalactiae, Enterococcus faecalis, E coli. Both, place of living and women' s age influence the type of etiological factor.

Purpose: The aim of the study was to evaluate the species of the microorganisms and their susceptibility to antibiotics in congenital nasolacrimal duct obstruction in children., Material and Methods: The pus secretion after lacrimal sac massage was obtained from 81 children with congenital nasolacrimal duct obstruction. The laboratory diagnostics was performed using typical microbiological procedures. The modification of these procedures was 24-hour pre-incubation in sugar boullion., Results: The most frequently isolated bacteria were Staphylococcus epidermidis (28%) and Staphylococcus aureus (22%). The isolated staphylococci (only coagulase-negative species MRSE) were resistant to methicillin in 2 cases. Streptococci were obtained in 20% isolations: Streptococcus pneumoniae (14%), Streptococcus viridans (6%). Gram-negative bacilli Pseudomonas aeruginosa and Moraxella spp. and Candida albicans were isolated in a few cases. Negative results of the cultures were obtained in 25% cases., Conclusions: The microorganisms typically constituting physiological flora of conjunctival sac may become the pathogens in the complications of congenital nasolacrimal duct obstruction in children.

Antiphospholipid syndrome (APS) is one of the most often secondary thrombophilic state, characterized by recurrent arterial and venous thrombosis, recurrent pregnancy loss, and the presence of circulating antiphospholipid antibodies. Ophthalmologic features are present in 15-88% of the patient with primary APS. In this article pathogenesis and clinical picture, especially ocular complications are presented.

Fifty children aged 8-17 years with histologically confirmed chronic gastritis were investigated for Helicobacter pylori (H. pylori) presence in gastric mucosa bioptates taken during endoscopy. Three invasive tests (histology, rapid urease test and culture) were done. H. pylori was stated in 26 patients (56%). In this group the positive results were as follows: histology--96.4%, urease test--82.1%, culture--60.7%. The consistency of positive results ranged from 60.7% to 78.6%, being most often for histology and urease test. In 91% of non-infected patients the endoscopic features were limited to erythematous, oedematous and exsudative changes of gastric mucosa, whereas in patients with H. pylori infection the prevalence of antral nodularity was noted in 60.7%. The probable causes of non compatible test results are discussed.

Nitric oxide is a unique molecule with simple chemical structure and sophisticated and heterogeneous functions in human organism. In this article, we reviewed possible participations of nitric oxide in physiological and pathological states inside the eye (eg. glaucoma, cataract, uveitis and retinal disorders).

Purpose: The aim of the study was to evaluate antimicrobial properties of silicon oil in vitro against Staphylococcus aureus, Pseudomonas aeruginosa, Candida albicans, which are considered the major causative agents of endophthalmitis., Material and Methods: The clinical isolates of representative microorganisms (S. aureus, P. aeruginosa, C. albicans) were selected. The bacteria and the fungus were separately inoculated in PDMS 5000 (produced by AcriMed, Germany). Control inoculations in physiological saline and sugar bouillon were performed. The samples of 0.01 ml from each medium were diluted, according to serial dilution procedure and inoculate on Petri plate dishes 5% sheep blood agar for bacteria and Sabouraud medium for Candida albicans. After 24 h incubations for bacteria and 48 h incubations for fungus, CFUs were counted., Results: All the microorganisms revealed an apparent decrease in CFUs in PDMS 5000. The total elimination was observed for S. aureus after 5 days. For P. aerugisosa solitary colonies (less than 25 CFUs) were observed up to 7 days. After 7 days of incubation no growth of P. aeruginosa was observed. High C. albicans CFU values were counted up to 3 day of the incubation. After 5 days single fungal colonies were observed. CFUs of the examined microorganisms declined slightly in physiologic saline. A growth pattern similar to the growth curve of microorganisms was observed in sugar boullion., Conclusions: Our study indicates that silicon oil could have an antimicrobial activity against Staphylococcus aureus, Pseudomonas aeruginosa, Candida albicans, which are considered the major causative agents of postoperative endophthalmitis.

Purpose: Evaluation of antiphospholipid antibodies in the serum and aqueous humor in patients with glaucoma., Material and Methods: 48 persons (38 women and 17 men), aged 30-86 (mean age 70), suffering from glaucoma was examined. There were 19 with POAG, 18 with PACG and 11 with PEXG. All patients have undergone trabeculectomia. The group of 20 operated, because of age-related cataracta patients (7 men and 13 women), aged 47-82 (mean age 65) constituted a control group. All patients agreed to samples collection. In plasma and anterior chamber fluid the level of antiphospholipids antibodies classes IgM and IgG were measured, using ELISA method (commercial kits produced by Euroimmun) according to producent's instruction. Statistical analysis was performed using U Mann-Whitney test., Results: The mean values of antiphospholipids in both group are put in the table. The significant differences between glaucoma and no-glaucoma patients were observed in levels of IgG in serum (p=0.014) and in levels of IgM antibodies in aqueous humor (p=0.013)., Conclusions: The presence of elevated levels of antiphospholipid antibodies in aqueous humor and serum may be a risk factor in progression of glaucomatous neuropathy.

Purpose: There is increasing evidence suggesting, that nitric oxide may be implicated in the pathogenesis of glaucoma. The aim of the study was to evaluate nitric oxide level in aqueous humor of glaucoma patients., Material and Methods: The examined group was constituted by 26 persons (13 women and 13 men), aged 60-86 (mean age 70) suffering from glaucoma. In 14 patients glaucoma was classified as POAG and in 12 as PACG. All patients have undergone trabeculectomia. The 14 patients was operated because of age-related cataract (8 women and 6 men), aged 47-82 (mean age 65), constituted a control group. All patients agreed to samples collection. Level of nitric oxide in anterior chamber fluid was assessed using commercial kits based on Griess reaction (R&D) according to manufacturer's instruction. Statistical analysis was performed using U Mann-Whitney test., Results: The mean level of nitric oxide in aqueous humor was not significantly different between glaucoma and cataract group (p=0.535). The level of NO in humor aqueous was statistically significantly lower in patients with primary open angle glaucoma than in patients with primary angle closure (p=0.022), and than in control group (p=0.053). No statistically significant differences in the level of nitric oxide in humor aqueous between PACG and cataract patients were observed (p=0.365).

Purpose: Evaluation of the serum and aqueous humor antibodies to beta-2 glycoprotein I in patients with glaucoma., Material and Methods: 48 persons (38 women and 17 men), aged 30-86 (mean age 70), suffering from glaucoma was examined. There were 19 with POAG, 18 with PACG and 11 with PEXG. All patients have undergone trabeculectomy. The group of 20 operated patients, because of age-related cataracta (7 men and 13 women), aged 47-82 (mean age 65), constituted a control group. All patients agreed with samples collection. In plasma and anterior chamber fluid, the level of antibodies to b-2 glycoprotein I classes IgA and IgG were measured using ELISA method (commercial kits produced by Euroimmun), according to producer's instruction. Statistical analysis was performed using U Mann-Whitney test when both groups were compared and Spearman test to comparisons concerning single group., Results: Significant changes between glaucoma and cataract patients were observed in anti-b-2 glycoprotein I antibodies class IgA in aqueous humour (p=0.04) and in serum (p=0.03)., Conclusions: Knowledge of the immunological pathogenesis in the glaucomatous nerve damage can be curtailed or even prevented with the use of proper agents. Indeed, there are many intriguing new therapeutic possibilities on the horizon. To determine the clinical potential of serum antibodies in glaucoma patients, a randomized clinical trial would be necessary. It is the preliminary communication.

Purpose: The evaluation of the relationships between the antibodies anti beta-2 glycoprotein I in serum and aqueous humor of the glaucoma patients to the visual field defects., Material and Methods: 48 persons (38 women and 17 men), aged 30-86 (mean age 70), suffering from glaucoma was examined. There were 19 with POAG, 18 with PACG and 11 with PEXG. All patients have undergone trabeculectomy. In plasma and anterior chamber fluid the level of antibodies to beta-2 glycoprotein I classes IgA and IgG were measured using ELISA method (commercial kits produced by Euroimmun), according to producer's instruction. The visual field defects were examined with Humphrey static perimetry. Statistical analysis was performed using Spearman test., Results: There were no significant correlations between antibodies anti beta-2 glycoprotein I, static perimetry, age and duration of the disease., Conclusions: There have not been stated any relationships between the static perimetry to antiphospholipid antibodies level in serum and aqueous humor in patients with glaucoma. It is the preliminary communication.

Unlabelled: Changes in the peritoneal fluid environment have been implicated in the pathogenesis of endometriosis as well as in the decrease of fertility. Tumor necrosis factor alpha (TNF alpha) and interferon gamma (IFN gamma) play a critical role in the generation of the immune response, leading to the enhanced proinflammatory cytokines and free radicals production., Materials and Methods: 59 women were studied, including 24 patients with unexplained infertility, 10 infertile women with endometriosis (Io or IIo rAFS), 11 patients with PCOS and 14 patients with tubal occlusion. TNF alpha and IFN gamma concentrations were measured in the PF using commercially available ELISA kits., Results: Peritoneal fluid IFN gamma concentrations did not differ significantly between the studied groups. TNF alpha levels were significantly (p = 0.02) higher in the PF of endometriotic patients compared to women with tubal infertility. The positive correlation (R = 0.83; p < 0.01) has been found between TNF alpha and IFN gamma levels., Conclusions: Increased PF TNF alpha levels observed in patients with endometriosis may play a role in activation of peritoneal macrophages. Positive correlation between TNF alpha and IFN gamma suggests their synergistic stimulatory effect on the immunocompetent PF cells.

Unlabelled: Although more and more is known about chronic autoimmune diseases, attempts to establish one trigger factor have been unsuccessful. The role of endogenic factors is beyond doubt. But it is emphasized that environmental factors are necessary to cause the disease. Infections are taken under consideration as trigger mechanism in the development of autoimmune diseases including chronic arthritis. Both numerous viruses and bacteria are among the microorganism mentioned. We considered it sensible to conduct research on Mycoplasma pneumoniae infections in a group of patients with juvenile idiopathic arthritis (JIA)., Materials: 19 patients diagnosed with JIA aged between 6-17 were investigated for Mycoplasma pneumoniae infection whose blood was examined for antibodies against Mycoplasma pneumoniae in class IgG and IgM. The control group comprised 20 children of similar age admitted to hospital with digestive tract complaints., Methods: Serologic tests were made in serum. Marking of antigens of class IgM and IgG were made by Elisa method using commercial kits produced by Scientific Point. Quantitative calculations of a level of antigens were done using appropriate standards, positive and negative serum of reference standard and calibration curve., Results: In 11 patients positive reaction for Mycoplasma pneumoniae in class IgG was observed and only in 2 in class IgM with low titer. In the control group positive reaction was observed in 3 children (15%). The fact that 58% of patients were infected (contact either with Mycoplasma pneumoniae) indicates that in the group of our patients with JIA, infections with these bacteria might have had a role in triggering the disease.

Objectives: To investigate the possible role of oxidative stress in the pathogenesis of female infertility, we examined the peritoneal fluid (PF) and plasma lipid peroxides levels in infertile women., Materials and Methods: 4-hydroxynonenal (4-HNE) and malonyldialdehyde (MDA) concentrations were measured in peritoneal fluid and plasma samples obtained from: 10 infertile women with minimal and mild endometriosis, 24 patients with unexplained infertility, 11 women with PCOS and 14 patients with tubal infertility., Results: PF lipid peroxides level was significantly higher in women with idiopathic infertility compared to other groups. Plasma 4-HNE and MDA concentrations did not differ significantly between the infertile groups. No significant difference or relationship was observed between peritoneal fluid and plasma lipid peroxides levels., Conclusions: Increased free radicals activity in the peritoneal fluid environment may be the factor responsible for some cases of "unexplained infertility".

The aim of our study was to evaluate the frequency of C. pneumoniae infection in abdominal aortic aneurysm (AAA) patients by measuring C. pneumoniae specific serum IgG, IgM and IgA levels and the activation of their immune system by measuring the concentrations of IL-10, IL-12, IFN-gamma and TNF-alpha in patients' serum. Microimmunofluorescence method was applied to evaluate the level of anti-C. pneumoniae IgG, IgA and IgM. The concentrations of cytokines were evaluated using ELISA method. Serologic markers of persistent C. pneumoniae infection have been detected in 25/28 (89.3%) patients and in 6/20 (30%) healthy controls. In 40% (10/25) of patients with serologic markers of persistent C. pneumoniae infection high titers of specific IgG and IgA indicated active infection--reinfection or exacerbation of chronic infection. Mean concentrations of IL-10, IL-12, IFN-gamma and TNF-alpha indicated lack of protection against intracellular pathogens. Since all patients in this group were diagnosed as having symptomatic AAA, we suggest that active infection can exacerbate inflammation in the AAA wall and accelerate progression of the disease. In our opinion patients with active C. pneumoniae infection may be candidates to the antimicrobial treatment.

Objectives: To assess the concentrations of tumor necrosis factor alpha (TNF-alpha), interferon gamma (IFN-gamma) and lipid peroxides (the marker of free radicals activity) in peritoneal fluid (PF) of infertile women with minimal and mild endometriosis., Materials and Methods: 19 women were studied, including 9 infertile women with minimal or mild endometriosis and 10 patients with tubal occlusion (the reference group). Lipid peroxides (malonyldialdehyde and 4-hydroxynonenal), TNF-alpha and IFN-gamma concentrations were measured in the PF using commercially available kits., Results: Concentration of IFN-gamma was detectable in PF of 7 (77.8%) women with endometriosis and in PF from 3 (30%) patients with tubal occlusion. Neither TNF-alpha or lipid peroxides PF concentration differed significantly (p < 0.05) between the groups. In the group with endometriosis we have found a positive correlation (R = 0.77, p = 0.04) between the concentrations of TNF-alpha and IFN-gamma., Conclusions: Our results suggest that oxidative stress in the PF doesn't appear to play a role in endometriosis-associated infertility.

Objectives: To assess the concentration of Plasma Glutathione Peroxidase (plGPx) in the peritoneal fluid (PF) of patients with unexplained infertility and infertile women with minimal and mild endometriosis., Materials and Methods: 33 women were studied, including 8 infertile women with minimal or mild endometriosis, 15 patients with unexplained infertility and 10 patients with tubal occlusion (a reference group). Concentration of plGPx was measured in the PF using a commercially available ELISA kit (Oxis Inc.)., Results: The plGPx concentration was significantly (p = 0.04) lower in PF from women with unexplained infertility (846 +/- 177 ng/ml) compared to the reference group (1023 +/- 238 ng/ml), but did not differ significantly (p = 0.25) between women with endometriosis (918 +/- 81 ng/ml) and patients with tubal infertility., Conclusions: Our results suggest that low peritoneal plGPx concentration may play a role in the pathogenesis of infertility.

Objectives: To evaluate the activity of an extracellular superoxide dismutase (EC SOD) and total antioxidant status in peritoneal fluid (PF) and plasma from women with unexplained infertility (UI)., Materials and Methods: PF and plasma samples were collected from 10 women with UI and 10 patients with tubal infertility (reference group). TAS was measured using Randox diagnostic reagent system. The activity of EC SOD was estimated using Calbiochem assay kit., Results: TAS was significantly lower in PF from women with UI. Plasma TAS did not differ significantly between the groups. Peritoneal TAS was significantly lower compared to plasma TAS and there was a positive correlation between PF and plasma total antioxidant status. Activity of EC SOD did not differ significantly between the groups in either PF and plasma samples., Conclusions: These data demonstrate that low antioxidant status of PF but not that of blood may be responsible for idiopathic infertility. The activity of EC SOD doesn't appear to play a role in UI.

The aim of our study was to evaluate the frequency of Chlamydia pneumoniae infection (especially chronic infection) in COPD patients. Microimmunofluorescence method has been applied Chlamydia pneumoniae Micro-IF test (Labsystems) has been used. The levels of specific IgG, IgA and IgM have been estimated in patients' serum. According to serologic criteria, 64.1% of COPD patients and 20.5% of healthy controls appeared to be chronically infected with Chlamydia pneumoniae (p < 0.001). Taking in account COPD severity, persistent Chlamydia pneumoniae infection has been present in 68.2%, 57.1%, and 50% of patients with severe, moderate and mild COPD, respectively. Our study has revealed that chronic Chlamydia pneumoniae infection occurs more frequently in COPD patients than in healthy controls and in patients with severe COPD than in ones with mild and moderate disease. It is possible that persistent Chlamydia pneumoniae infection can initiate or amplify inflammatory reactions in the respiratory tract. The results suggest a need to diagnose chronic Chlamydia pneumoniae infection in COPD patients and, if confirmed, to take an attempt of antimicrobial therapy.

The aim of our study was to evaluate the frequency of Chlamydia pneumoniae infection (especially chronic infection) in 41 asthma patients. They have been assigned to 3 groups, according to disease severity. Control group consisted of 35 age matched healthy volunteers (without cardiac and pulmonary diseases). The levels of specific IgG, IgA and IgM in patients' serum have been estimated using indirect microimmunofluorescence. According to serologic criteria, 23(56.1%) asthma patients and 4(11.4%) healthy controls have appeared to be chronically infected with Chlamydia pneumoniae (p < 0.001). Acute Chlamydia pneumoniae infection was present in 3(7.3%) asthma patients and in 2(5.7%) healthy controls. Taking in account asthma severity, persistent Chlamydia pneumoniae infection has occurred more frequently in patients with moderate and severe asthma than in ones with mild asthma. Acute Chlamydia pneumoniae infection was present in 9.1% and 12.5% of patients with mild and severe asthma respectively.

The authors analysed a way of pregnancy ending and indications to cesarean section in group 256 diabetic pregnant women. We estimated that percentage for cesarean sections was 51.56%. We noticed downward tendency of elective indications to cesarean section (the most common was gestosis) and upward tendency of intrapartum indications (the most common was fetal distress syndrome). The percentage of cesarean sections in diabetic pregnant women group in our study is similar to results from the other centres.

Authors had retrospectively analyzed basic exponents of perinatal care of 256 pregnant diabetic woman in years 1993-1998 hospitalized and delivered in Clinic of Obstetrics and Gynaecology in the town of Bytom. Our results were very similar to the other of Referent Centres Of Technical Methods Bank Used in Diagnostic and Therapy of Diabetes: cesarean sections percentage 51.56%, 4.7% of undelivered pregnancies, 2.34% of new-born delivered with multiple congenital defaults, 17.2% of macrosomies and 39.8% pre-term deliveries were noted. Disadvantage perinatal effects in diabetic women might be reduced by very early diagnosis of diabetic and intensive biophysical and biochemical fetal care, which is strongly suggests by the authors.

Diabetes during pregnancy is a pathological state causing many metabolic disorders, not only in carbohydrate metabolism. The aim of the study was to estimate the changes of lipids metabolism and changes of L-ascorbic acid serum concentration in pregnancy complicated by diabetes. In tested groups values of lipids metabolism parameters were lower in diabetic group compared to control group. The lowest mean values of concentration of total cholesterol, LDL cholesterol and triglycerides were found in gestational diabetes group, while the lowest mean value of HDL cholesterol concentration was found in pregestational diabetic group. The L-ascorbic acid mean values correlated negatively with total cholesterol concentrations, LDL cholesterol and triglycerides levels.

Objective: To estimate the concentration of malonyldialdehyde (MDA) and total antioxidant status in the peritoneal fluid (PF) of patients with unexplained infertility (UI) and infertile women with minimal and mild endometriosis., Materials and Methods: PF was obtained during laparoscopy from 8 women with UI, 12 infertile women with endometriosis (I degree and II degrees rAFS) and 10 women with benign noninflammatory ovarian tumours. All laparoscopies were performed in the follicular phase of the cycle. MDA concentration was measured according to Ledwozyw method, TAS was measured spectrophotometrically using RANDOX diagnostic reagent system., Results: We found significantly higher concentration of MDA in PF from both patients with UI (p = 0.03) and with endometriosis (p = 0.046) compared to the control group. TAS was significantly (p = 0.027) higher in PF of women with UI but did not differ significantly (p = 0.49) between patients with endometriosis and controls., Conclusions: Our results show that an imbalance between lipid peroxides and the antioxidant system in PF environment may be one of the main factors responsible for the UI. In the group with endometriosis a marginally significant difference in MDA levels, no significant differences in TAS and data from the literature, suggest that accelerated lipid peroxidation in PF doesn't appear to play a role in the endometriosis associated infertility.

In 55 hemodialyzed and 15 patients on CAPD the presence of hepatitis B and C markers was estimated before the beginning of the vaccination series against hepatitis B with Engerix B vaccine. The initial anti-H Bs antibody titres was also estimated in these patients. The patients without H Bs Ag who have the anti-Hbs titres below 10 IU/I were qualified for this vaccination. The vaccination was needed by 40% of hemodialyzed patients H Bs(-) and 93% patients on CAPD. After completing the half year lasting series of vaccinations, the serological answer in vaccinated patients was estimated. The protective antibody titres above 10 IU/I was produced by 62.5% of patients on hemodialysis and 64.4% of patients on CAPD. The presence of anti-HCV antibodies had insignificant influence on the ability of producing the protective antibody titres in vaccinated patients.

Regulation of immunological processes associated with complement system activation and immunoglobulin binding depends, among others, on the presence of sialic acids. In haemodialysed patients an increase is found of serum sialic acid level. The purpose of the work was the determination of sialic acid content in gamma-globulins and C-reactive protein, that is in immunologically active glycoproteins. The relationship was also studied between the amount of sialic acids and the level of immune complexes. After examination of a group of 15 haemodialysed patients increased degree of sialization of gamma-globulins was found, as compared with a control group. However, the degree of sialization of C-reactive protein in these patients was decreased in relation to the control group. The changes observed in sialic acid content in gamma-globulins and C-reactive protein in haemodialysed patients modify the function and persistence in circulation of these glycoproteins which may be one of the causes of immunological disturbances in these patients.

The study involved 17 patients on IPD. Blood serum levels of IgG, IgA, IgM, circulating immune complexes, complement and proteins were determinated at the beginning of therapy, after 3, 6, 12 months on IPD and after 1 year on hemodialysis. The frequency of peritonitis was noted during this time. Peritonitis was the most frequent during first 3 months on IPD. No differences in blood serum levels of IgG, IgA, IgM, in the specific periods of IPD were noted. A significant increase in blood serum circulating immune complexes in patients on IPD and hemodialysis compared to the control group was found. A significant decrease in blood serum of C3 complement in patients on IPD and hemodialysis in comparison with the controls were found. A significant decrease in blood serum proteins at the beginning of IPD and after 3 months IPD in comparison with proteins concentration in patients on hemodialysis was observed.