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Almost as soon as antibiotics were introduced to treat infectious diseases, it could be observed that bacteria were able to develop resistance against them. Currently, multidrug-resistant strains are being isolated mainly in the hospital environment. These are primarily non-fermenting Gram-negative bacilli, which exhibit both natural and acquired resistance to multiple antibiotics and disinfectants rendering them difficult to eradicate. The development of new, effective and safe substances that prevent troublesome infections is greatly needed to provide alternative therapeutic options for patients. There is increasing interest in drugs of natural origin, including essential oils. It is of particular interest that, although active against many bacterial strains, they do not contribute to antibacterial resistance against their components. The aim of our study was to evaluate the in vino antibacterial activity of thyme oil against multidrug-resistant strains of A. baumannii and P. aeriginosa using the disc diffusion and macrodilution methods. The strains were isolated from patients hospitalized in the years 2013-2014. The in vitto antibacterial activity of thyme oil was assessed by the disc diffusion method and the inhibition zones for the oil at different concentrations, produced against A. baumannii, ranged from 7 to 44 mm. Low level of activity of thyme oil was observed against P. aeruginosa strains. The results of serial dilution tests confirmed the high activity of thyme oil against A. baumannii isolates, expressed as MIC values ranging from 0.25 to 2 μL/mL. These results suggest the need for further studies of antibacterial activity of essential oils, especially against multidrug-resistant bacterial isolates.

The aim of this study was to evaluate antifungal activity in a diverse group of chlorine-containing xanthone and phenoxyethyl amine derivatives - and to select the most promising compounds for further studies. The antifungal efficacy of 16 compounds was tested with qualitative and quantitative methods against both reference and clinical strains of dermatophytes, moulds and yeasts. The disc-diffusion method has demonstrated that from 16 tested compounds, 7 possess good antifungal activity against dermatophytes and/or moulds while none of them has shown good efficacy against yeasts or bacterial strains. The most active compounds (2, 4, 10, 11, 12, 15, 16) were tested quantitatively by broth dilution method to obtain MIC values. The MIC values against dermatophytes ranged from 8 to 64 μg/ml. Compound 2 was the most active one against dermatophytes (MIC 50 and MIC 90 were 8 μg/ml). The MIC values for moulds ranged from 16 to 256 μg/ml. Compound 4 was the most active one against moulds, with MIC 50 and MIC 90 values amounting to 32 μg/ml. Among the tested compounds, compound 4 (derivative of xanthone) was the most active one and expressed good antifungal efficacy against clinical strains of dermatophytes and moulds. However, another xanthone derivative (compound 2) was the most active and selective against dermatophytes.

Superficial fungal infections due to dermatophytes are common over the world and their frequency is constantly increasing. The aim of our study was to discuss fungal infections with frequency of occurrence, clinical stages and aetiology in patients admitted to dermatological ward and microbiological laboratory of the specialist hospital in Krakow. Investigations performed between 1995 and 2010 included the group of 5333 individuals. Dermatophyte infections, confirmed by culture, were revealed in 1007 subjects (18.9%), i.e. in 553 males and 454 females. The most frequent clinical forms of infections were tinea unguium and tinea pedis, caused mainly by Trichophyton rubrum and by Trichophyton mentagrophytes. Tinea corporis, tinea manuum, tinea capitis and tinea cruris constituted a small percentage of infections and the main aetiological factors of these dermatomycoses were also T. rubrum and T. mentagrophytes. Between 1995 and 2000 there were stated small differences in the number of isolated strains of dermatophytes in comparison with the number of examined patients. Since 2006 there has been observed a decrease in number of patients in our hospital with suspected fungal infections, but per cent of positive cultures has remained unchanged in comparison with earlier period.

Over 75% of children with Down's syndrome fail to accommodate accurately on near targets. This deficit must result in optically blurred images for near work. This present study set out to evaluate the controlled use of bifocal spectacles as an aid to near focusing. Although sometimes used clinically, no systematic studies of bifocals for children with Down's syndrome have been reported.This was a comparative non-randomised interventional study. Thirty-four children with Down's syndrome of primary school age (5-11 years) took part, assigned in equal numbers to form two matched groups. All children received a full optometric assessment prior to entering the study. The treatment group was prescribed bifocal spectacles with a +2.50 addition, and the control group provided with single vision lenses to correct any clinically significant refractive error. Three follow-up visits were made over a 5-month period after spectacle provision.The treatment group showed consistently more accurate accommodation than the control group both through the bifocal segment, and, unexpectedly, through the distance part of the lens (p0.05). Compliance with new spectacles was high in both groups (82% fully compliant).Bifocals confer benefit to children with Down's syndrome who under-accommodate, both directly (better focusing through the bifocal) and indirectly (by encouraging improved accommodation through the distance part of the lens). Based on the results of this study, eye examinations of children with Down's syndrome should routinely include a measure of accommodation at near, and bifocal spectacles should be considered for those who show under-accommodation.

Superficial fungal infections due to dermatophytes are common over the world and their frequency is constantly increasing. The aim of our study was to discuss fungal infections with frequency of occurrence, clinical stages and aetiology in patients admitted to dermatological ward and microbiological laboratory of the specialist hospital in Krakow. Investigations performed between 1995 and 2010 included the group of 5333 individuals. Dermatophyte infections, confirmed by culture, were revealed in 1007 subjects (18.9%), i.e. in 553 males and 454 females. The most frequent clinical forms of infections were tinea unguium and tinea pedis, caused mainly by Trichophyton rubrum and by Trichophyton mentagrophytes. Tinea corporis, tinea manuum, tinea capitis and tinea cruris constituted a small percentage of infections and the main aetiological factors of these dermatomycoses were also T. rubrum and T. mentagrophytes. Between 1995 and 2000 there were stated small differences in the number of isolated strains of dermatophytes in comparison with the number of examined patients. Since 2006 there has been observed a decrease in number of patients in our hospital with suspected fungal infections, but per cent of positive cultures has remained unchanged in comparison with earlier period.

Inflammatory bowel diseases (IBD) constitute a group of incurable, inflammatory GI diseases of unknown etiology and the chronic course, with periods of spontaneous disease remissions and aggravations (Muszynski, 2001). This group of diseases includes Crohn`s disease and ulcerative colitis. They are characterized by inflammatory reactions and changes in the structure of intestinal mucosa (Rzeszutko, 2006). IBD etiopathogenesis is not clearly defined. The most essential etiological issues include environmental factors, genetic conditioning, abnormalities of intestinal immunological mechanisms and the bacterial flora (Konturek, 2001). The inflammation which develops in the intestine is mostly due to improper, low-fiber diet which is based on highly processed products and on the poor physical activity. Familial diseases confirmed in 10% of cases speak for the genetic source. Immunological mechanisms which develop in response to food and bacterial antigens are extremely significant (Muszynski, 2001; Polinska et al., 2009). A markedly increased interest has been observed in the intestinal microflora which is believed to be essential in inducing IBD development and in relapses of its clinical symptoms. Bacteria which are normally resident in the GI tract determine the proper work of intestines and protect from excessive proliferation of undesired microorganisms. The contribution of the intestinal flora to the development of the biofilm, which prevents the colonization of pathogens including fungi of the genus Candida in the GI tract, is extremely significant. The area of interest in fungi which are a part of microflora and constitute a potential source of systemic dissemination by colonizing the GI tract has greatly increased lately (Berhardt & Knoke, 1997). In the normal environment fungi are in balance with the bacterial flora and as commensals do not induce the inflammation. The main cause of its development, however, is the immune system impairment and a decrease of immunity. It affects patients with neoplasms and transplant recipients (Pfaller & Diekema, 2007; Warnock & Campbell, 1996). Other diseases causing inflammations are: diabetes and other endocrinopathies, infections due to HIV virus and also surgical procedures, damaged tissues and inflammations of the

The pathogenesis of inflammatory bowel disease (IBD), is related to the effect of fungal presence in the gastrointestinal tract (GI) on IBD development.One hundred twenty-six patients underwent mycological investigation. We analyzed of the occurrence of fungal infection in the clinical material collected from the GI tract of patients with IBD and control groups. We assessed fungal flora transmission from the oral cavity to further segments of the GI tract based on comparative studies of genotypes of fungal strains. The studies were carried out using conventional methods. The fungal genotypes were determined with the PCR-RAPD method.Of 407 samples, 220 of them had fungi. The most frequently isolated species was C. albicans in patients with IBD and in control group, respectively 84.4% and 81%. Analysis of the streak patterns of the products of the PCR-RAPD reaction carried out for C. albicans strains isolated from the material collected from 10 patients, showed 100% affinity between the strains cultivated from the same patient. Genetic affinity between the strains was confirmed in 3 primers used in the examination.The presence of fungi in the oral cavity of patients with IBD may affect more frequent colonization of the colonic mucosa in the active phase of disease. Genetic affinity of C. albicans strains indicates the possibility of fungal transmission from the oral cavity to further segments of the GI tract.

The aim of this study was the isolation and structural elucidation of steroidal glycosides from the underground parts of ramson Allium ursinum L. The structures of the isolated compounds were established based upon chromatographic methods and 1D- and 2D-NMR, MS and IR analyses. The mixture of two steroidal saponins: (25R)-spirost-5-en-3b-ol tetrasaccharide and (25R)-spirost-5, 25(27)-dien-3b-ol tetrasaccharide, along with a 3-hydroxypregna-5,16-dien-20-one glycoside were identified. The results of in vitro cytotoxic activity of the mixture of spirostanol saponins against cell lines melanoma B16 and sarcoma XC and human fibroblasts HSF are also reported. The spirostanol saponins mixture was investigated to determine its in vitro antimicrobal activity against Trichophyton mentagrophytes and Microsporum canis.

In the present study on animal model of ulcerative colitis the influence of fungal colonization on the severity of inflammatory lesions in the colon and the course of their healing was evaluated. The results of our studies revealed, that significant fungal colonization (over 10(4) CFU/ml) delayed ulcer healing in the colon. It corresponded with the decrease of colonic blood flow (CBF) in the region of lesions and increase of interleukin (IL)-1beta, tumor necrosis factor(TNF)-alpha level in the serum. Introduction of antifungal therapy (fluconazole) or probiotic in rats inoculated with Candida accelerated the process of ulcer healing in the colon, expressed through the reduction of macro- and microscopic lesions in the colon and decrease of MPO, IL-beta TNF-alpha serum level.

A series of 2-substituted xanthone derivatives 8-20 containing selected allyl, cinnamyl, morpholine, and imidazole moieties were synthesized and tested for their antifungal and antibacterial in-vitro properties. Of the newly synthesized derivatives, ten revealed antifungal activity especially against Trichophyton mentagrophytes (the biggest inhibition zones ranged 35 mm for 11 and 13). 2-(3-(Allylamino)propoxy)-9H-xanthen-9-one hydrochloride 9 inhibited growth of all of the examined fungal species. Significant efficacy against evaluated yeasts and dermatophytes was also observed for 6-chloro-2-methyl-9H-xanthen-9-one derivatives 11-13 containing encyclic amine moieties. Additionally, compounds 9, 11, and 12 hindered development of bacteria species but in a lesser degree. They were efficacious against Staphylococcus aureus, Escherichia coli, and Enterococcus faecalis.

Present-day methods of successful treatment of inflammatory bowel diseases (IBD) result from a better understanding of their pathophysiology due to advances in preclinical studies in this area of knowledge. Until recently microbiological studies have been focused on the bacterial aspects in pathogenesis of GI disorders, however in the last years an interest in the presence of fungi in the gastrointestinal tract has also increased. In this study using an animal model of ulcerative colitis, the impact of fungal colonization of the colon on the intensity of inflammatory changes in the colonic mucosa and the course of their healing was carried out. The macroscopic and microscopic criteria relating to the changes of weight of examined fragments of the colon were evaluated while assessing differences between groups tested. The intensity of intestinal inflammatory changes was determined by assessment of such parameters, as colonic blood flow (CBF), the level of MPO as a marker of colonic neutrophil infiltration intensity and the plasma levels of IL-1beta; and TNF-alpha concentrations. Results at the 3rd day after TNBS rectal administration revealed an increase of weight of isolated segments of inflammed colon, a decrease of CBF and the 4-5 fold increase of plasma MPO activity. Candida colonization of colon mucosa of rats delayed healing of colonic ulcers, induced by TNBS and this was associated with the increased expression of plasma IL-1beta and TNF-alpha levels. Administration of antifungal (fluconazole) or probiotic (Lacidofil) treatment to C. albicans infected rats exerted favorable effect on healing of inflammatory changes in the colon because the area of ulcerations in groups of rats treated with fluconazole or Lacidofil was significantly smaller in comparison with those inoculated with Candida solution only. Administration of fluconazole or Lacidofil significantly decreased the weight of colon segments, the MPO activity and the plasma IL-1beta and TNF-alpha levels, as compared with respective values in the group receiving Candida only. The results of our studies indicate the deteriorating influence of Candida on the healing process of inflamed colon in the animal model of ulcerative colitis. Concomitant therapy with probiotic or antifungal treatment improved healing of colonic lesions, decreased the weight of inflamed colonic tissue and also attenuated the MPO activity and plasma proinflammatory cytokines IL-1beta and TNF-alpha levels.

A triterpene saponoside (LTS-4) isolated from the underground parts of Lysimachia thyrsiflora L. was defined as 3-O-{beta-D-xylopyranosyl-(1 --2)-beta-D-glucopyranosyl-(1 --4)-[beta-D-glucopyranosyl-(1 --2)]-alpha-L-arabinopyranosyl}-cyclamiretin A. Structure assignment was performed on the basis of spectroscopic data including homo- and heteronuclear 1D and 2D NMR (COSY, TOCSY, NOESY, HETCOR, HMBC and DEPT) and FAB-MS studies. The compound was tested in vitro for antimicrobial and cytotoxic activity.

The influence of microbiological factor is taken into consideration in the pathogenesis of ulcerative colitis (UC). The aim of studies was to: 1.evaluate the presence of significant fungal colonization, over 10(5) CFU/ml in patients with UC and the control group (irritable colon syndrome, IBS); 2. estimate the influence of antifungal treatment in the activity of UC.We evaluated 72 patients aged from 18-72 years, 60 patients with UC, 12 with IBS. Clinical investigation: initially and after 4 weeks interview and colonoscopy with colon biopsies for histology and mycology were taken. Activity of UC was evaluated according to: clinical, endoscopic and histological IACH criteria. 13 patients with significant fungal colonization were given antifungal treatment. Biopsies for histology were stained with hematoxylin-epsin (H-E). Qualitative and quantitative mycolo-gical evaluation was performed according to Muller method.1. Significant fungal colonization was more frequent in patients with UC history over 5 years, in comparison with shorter disease history and IBS, in 33.3%, 13.8% and 1.3% respectively. 2. Candida albicans was most often isolated in 91.7% of cases. 3. Initial analysis of the activity index of UC in patients with significant and non-significant fungal colonization did not revealed differences between these groups, 13.84 and 14.0 respectively. 3. After 4 weeks stronger decrease of the UC activity index was observed in patients with significant fungal colonization treated with antifungal treatment, in comparison with patients not given antifungal therapy: 8.0 and 10.41 respectively, p0.01. Differences were significant according to clinical 2.23 (C) -3.33 (D), p0.05 and endoscopic cryteria: 3.46 (C) -4.84 (D), p0.01.1. Significant fungal colonization of colon may influence the activation of UC. 2. Longer disease history may be the risk factor of significant fungal colonization in colon. 3. Antifungal treatment in patients with significant colonization caused clinical improvement of UC.

The aim of this study was to estimate the frequency of fungal colonization of the stomach of patients suffering from gastric ulcer (GU) and chronic gastritis (CG) and the influence of fungal colonization of the stomach on the process of ulcer healing. We investigated 293 patients aged 20-80 years. Before and after 4 weeks of sucralfate treatment they underwent endoscopy of the stomach, histological examination of biopsies taken from the ulcer margin or inflamed gastric mucosa and mycological examinations of the gastric juice, surface brushing and biopsies. The studies revealed a high concentration of fungi in 54.2% patients with GU and 10.3% with CG. Candida albicans was the most frequently isolated organism. Fungal colonization of the stomach impairs the process of gastric ulcer healing. Control examination after 4 weeks of sucralfate therapy showed the ratio of GU healing in 62% of patients with a high concentration of fungi in comparison with 78% of patients not colonized with fungi (P < 0.05). A significantly longer duration of ulcer symptoms in the group of patients with a high concentration of fungi in the stomach was also observed. There was no correlation between the level of fungal antibodies, of Candida antigen in the serum and the concentration of fungi in the stomach.

PURPOSE. To investigate the development of refractive errors and strabismus in a cohort of children with Down syndrome. METHOD. Data for 55 children with Down syndrome who are participating in this longitudinal study of visual development, first examined by us when aged less than 2 years and on at least two other occasions, were analyzed. Mohindra retinoscopy was used to measure refractive error. Ocular alignment was assessed using the Hirschberg test and, when possible, the cover test. RESULTS. Despite the high prevalence of large refractive errors in children with Down syndrome, longitudinal data showed that these are not always present in early infancy. Twenty-one (38%) of the children were emmetropic throughout the study. Of the 24 children with a significant refractive error at the outset, only 6 (25%) showed emmetropization. The others retained or increased their refractive errors. The remaining 10 children were emmetropic at the outset, but then had a significant refractive error develop. There is a high prevalence of strabismus in children with Down syndrome (29% of the total group), which cannot be attributed to the presence of hypermetropia or anisometropia. CONCLUSIONS. The retention or development of infantile refractive errors in many children with Down syndrome indicates a failure of emmetropization. All children were at risk of strabismus whatever the refractive error. The findings have implications for timing of screening programs. (Invest Ophthalmol Vis Sci. 2003;44:1023‐1030) DOI:10.1167/iovs.01-0131

Purpose: Almost 57% of children with Down syndrome have significant refractive error (hypermetropia ≥+3.00 D, myopia ≥−1.00 D) (Woodhouse et al., 1997); they are 17 times more likely to have significant long or short sight than their typically developing peers. Also, for the age range 4.5 months to 11.1 years, 34% of children with Down syndrome have strabismus, compared with 4–7.5% of control children (British College of Optometrists, 1991–94). In addition, 82% of our cohort of children with Down syndrome (n = 100) have reduced accommodation at near. In order to investigate the influence of accommodation accuracy on refractive error and strabismus, this study compared the above parameters in children with Down syndrome who accommodated accurately with those who did not. Methods: Accommodation was measured using dynamic retinoscopy technique at testing distances of 25, 16.6 and 10 cm. An accommodative lag of plano to 0.75 D is normal for typically developing children (Rouse et al., 1984). Accurate accommodation for our cohort was therefore defined as ≤0.75 D lag of accommodation (at a minimum of two of three testing distances). Children with Down syndrome who accommodated accurately were age matched with a child with inaccurate accommodation, based on their most recent visit for which a full data set was available. Results: Chi-square analysis of the data for the two groups revealed that there was a greater number of children with significant hypermetropia (p = 0.003) and strabismus (p = 0.003, Fisher's exact test) in the under-accommodating group. Conclusion: Children with Down syndrome who under-accommodate are more likely to be strabismic and have significant hypermetropia.