Etiologic factors of pleural empyema as a potential source of nosocomial infections

Pleural empyema still comprises an important therapeutic problem despite the availability of effective antibiotic therapy. This disorder is characterised by 20% mortality rate. Moreover, the involvement of multi-drug resistant bacterial strains may pose a risk of a nosocomial spread to other hospitalised patients. In the present study we have analysed 184 bacterial strains isolated from 63 patients with pleural empyema. A predominance of aerobic bacteria was detected, both Gram-positive cocci and Gram-negative bacilli. Staphylococci isolated from the clinical samples were characterised by a high percentage of strains resistant to gentamicin (86.3%) and methicillin (38.2%). The other important etiological agents were Pseudomonas aeruginosa and Gram-negative enteric rods of the Enterobacteriaceae family. Only 1 strain of anaerobic bacteria was detected. The enteric bacilli were characterised by a low percentage of isolates susceptible to most of the tested antibiotics (< 60%), with an exception of ciprofloxacin (68%) and imipenem (100%). These multi-drug resistant strains may spread nosocomially to other patients.     

Neutrocyte-to-lymphocyte ratio predicts the presence of a replicative hepatitis C virus strand after therapy with direct-acting antivirals

Residual HCV-RNA can persist in liver tissue and peripheral blood mononuclear cells (PBMCs) long after antiviral therapy of chronic hepatitis C in patients repeatedly negative for viral RNA in serum. This occult infection associates with impaired immune response and the risk of lymphoproliferative disorders or progressive liver disease. There are currently no monitoring strategies for patients after treatment. We investigated if serum inflammation markers and interferon lambda (IFNL) genotype can be predictors of the presence of HCV-RNA and the replicative HCV-RNA (−) strand in patients who reached sustained virological response after interferon-free therapy. Forty-two consecutive patients who remained HCV-RNA negative in serum 24 weeks after the end of treatment (EOT) and during the follow-up were enrolled. Total HCV-RNA and HCV-RNA (−) strand were detected using ultrasensitive RT-PCR in PBMCs collected 12–15 months after EOT. Polymorphisms within IFNL3–IFNL4 region (rs12979860 and ss469415590) were genotyped with allele-specific PCR. Viral RNA was found in PBMCs from 31 (74%) patients, and of those 29 (69%) were also positive for HCV-RNA (−). Neither normalization of alanine aminotransferase nor IFNL genotype predicted the presence of residual HCV-RNA. A significantly higher neutrocyte-to-lymphocyte ratio (NLR) 24 weeks after the start of treatment predicted elimination of replicative HCV-RNA strand (OR 0.23; 95% CI 0.10–0.86; P = 0.019). Patients with no HCV-RNA (−) in PBMCs showed a greater increase in neutrocyte count between EOT and baseline (P = 0.028). Lack of significant elevation of NLR after therapy with direct-acting antivirals could predict the presence of residual replicative HCV-RNA strand in PBMCs.

     

Conversion of Geraniol into Useful Value-Added Products in the Presence of Catalysts of Natural Origin: Diatomite and Alum

This article presents research related to the transformation of geraniol (GA), leading to the formation of products with very valuable properties. In the planned method, heterogeneous catalysts of natural origin in the form of alum and diatomite were used as catalysts. Initially, the process which we investigated was the process of isomerization of GA, but it turned out during the studies that GA is also transformed in other reactions. Before catalytic tests, these two minerals were subjected to detailed instrumental analyses using the following methods: XRD, SEM/EDX, XRF and FTIR, which allowed to obtain their full morphological characteristics. During the catalytic tests, the influence of such relevant parameters on the GA transformations was determined: temperature from 80 to 150 °C, catalyst content from 5 to 15% by weight and the reaction time from 15 min to 24 h. The tests presented in the article were carried out under atmospheric pressure (in air) as well as without the use of a solvent. The optimal conditions for the transformations of GA were determined on the basis of its conversion and selectivities of transformation to the main products in the form of: beta-pinene (BP), 6,11-dimethyl-2,6,10-dodecatriene-1-ol (DC) and thumbergol (TH). The above products were formed with the highest selectivity, respectively: 100 mol%, 50 mol% and 52 mol%. The results of the syntheses showed that for GA the best transformation results were obtained at the temperature of 80 °C (for both tested catalysts), with the catalyst content of 1 wt % (for both tested catalysts) and for the reaction time of 1 h (for diatomite)) and 3 h (for alum).     

Whipple's disease with generalized lymphadenopathy

A case of Whipple's disease in 44 year-old man with generalized limphadenopathy of superficial and retroperitoneal lymph nodes was presented. Differential diagnostics with lymphatic neoplasm was necessary.     

Tonsil enlargement after liver transplantation in adults--reason enough for tonsillectomy? Two cases of tonsillar posttransplantation lymphoproliferative disease.

Posttransplantation lymphoproliferative disease (PTLD) is a well-known complication of solid organ and bone marrow transplantation. It is agreed that the main causes of PTLD are chronic infection with Epstein-Barr virus (EBV); the intensity, rather then the type, of immunosuppression used; and underlying recipient disease. Hepatitis C virus (HCV) and cytomegalovirus, as cofactors of EBV infection, have been suggested to increase the risk of PTLD. Use of calcineurin inhibitors, anti-CD3 monoclonal antibody (OKT3), and antithymocyte globulin may increase the risk of PTLD. On the other hand, mycophenolate mofetil, sirolimus, and the anti-interleukin-2 receptor monoclonal antibodies Daclizumab and basiliximab have not been demonstrated to increase the risk of PTLD. The incidence of PTLD after liver transplantation (LT) is estimated to be 1.5-3%, but a tonsillar location is extremely rare in adults. Thus, little is known about the best diagnostic tools for and treatment by LT recipients with tonsillar PTLD. Here, we report 2 cases of adult LT recipients with tonsillar PTLD. Tonsillectomy was used as a diagnostic tool and treatment option and resulted in complete remission for >2 years. Considering the high mortality and diagnostic difficulties of PTLD, together with the relatively low risks of tonsillectomy, we recommend tonsillectomy for treating tonsil enlargement of unknown cause and suspected PTLD in LT recipients. A larger series of patients and prospective studies comparing different treatment options will be needed to substantiate our recommendation.     

Schirmer test I and BUT (break-up-time) in patients treated with topical antiglaucoma drugs for a long time]

PURPOSE: The aim of this study was to evaluate Schirmer test I and BUT in patients after long-term topical antiglaucoma medication. MATERIAL AND METHODS: 59 glaucoma patients on stable regimen of one or two antiglaucoma drugs (for a minimum 1 year) and 30 healthy people were checked for changes of the precorneal tear film. Tear secretion was measured by Schirmer test I and stabilization of precorneal film by break-up time. RESULTS: We found no influence of antiglaucoma drugs on tear secretion. Statistically significant decrease in break-up time was found in glaucoma patients. CONCLUSIONS: Long-term topical antiglaucoma medication may alter precorneal film stabilization.     

Immunorelatedness of Oligopeptidases from Lactobacillus and Lactococcus and Proline Iminopeptidase from Propionibacterium using Double Immunodiffusion Assay

Double immunodiffusion assay showed that species of lactobacilli produce immunologically unrelated oligopeptidases. Polyclonal antibodies (PAbs) specific for intracellular 70 kDa oligopeptidase type PepO from Lactobacillus curvatus reacted with intracellular protein(s) of cell-free extract (CFE) from Lb. paracasei and Lb. casei but not with intracellular proteins of Lb. plantarum , Lb. pseudoplantarum or Lb. helveticus . PAbs specific for 70 kDa oligopeptidase from Lactococcus lactis did not react with proteins in CFE from lactobacilli but at similar PepO activity reacted, with different affinity, with proteins in CFE of various lactococcal cultures. Antibodies specific for intracellular proline iminopeptidase from Propionibacterium freudenreichii reacted with proteins in the CFE from cultures of other dairy propionibacteria only.