Acute respiratory failure in patients with Guillain-Barré syndrome and myasthenic crisis treated with plasmapheresis in the intensive care unit

We present the cases of two patients with Guillain-Barré syndrome and one with myasthenic crisis who developed acute respiratory failure and needed mechanical ventilation in the intensive care unit. All the patients were treated with plasmapheresis, resulting in weaning from mechanical ventilation, and eventually complete functional recovery. Early treatment with plasma exchange shortens the treatment duration, whereas early intubation can prevent life-threatening complications.     

Prevalence of Borrelia burgdorferi sensu lato in ticks, Ixodes ricinus in Tarnowskie Góry district

Borrelia burgdorferi is an aetiological factor of borreliosis (Lyme disease). The main vectors of Borrelia burgdorferi are larvae, nymphs, and females of Ixodes ricinus. The aim of this paper was to analyse infection parameters of Borrelia burgdorferi in a selected populations of Ixodes ricinus. The study was conducted in Tarnowskie Góry administrative district (Krupski M?yn, Zielona, Lubliniec, Tarnowskie Góry, Swierklaniec, Tworóg, and Zbros?awice). A total of 85 ticks were collected with a piece of cloth dragged over the vegetation. The Borrelia burgdorferi infection was confirmed with a PCR method, using flagellin protein gene DNA amplification. DNA of Borrelia burgderferi sensu lato was present in 14 ticks, which constituted 16.5% of the population studied. The percentage of infected females and nymphs was 26.8%, 22.2%, and 5.6%, respectively. A high prevalence of the pathogen (50%) was in ticks revealed in the recreation areas and the community forest in Swierklaniec.     

Hemolytic uremic syndrome

Hemolityc anemia, thrombocytopenia and acute renal failure are characteristic features of hemolytic uremic syndrome (HUS). The disease occurs mainly in infants and little children, sometimes it occurs in adult people. Most often it occurs in the course of diarrhorea cause by E. coli O 157:H7. Many other agents can induce HUS. The case of 54 year old female with HUS which developed in the course of diarhoea was reported. The course of HUS was complicated by multiorgan--brain, heart, pancreas and liver injure. Hemodialysis and plasmapheresis were used in the treatment. The treatment made the health recovery possible in our case.     

Why vaginal hysterectomy?

The article presents current view on vaginal hysterectomy. Arguments in favour of this miniinvasive, minimal access surgical technique are presented. In conclusion the authors underline that vaginal hysterectomy is a cheap, miniinvasive technique which doesn't require expensive, sophisticated equipment and, what is the most important, which is relatively easy to learn. Due to these advantages, if hysterectomy is necessary, vaginal route should be considered as a technique of choice. While taking a decision which technique to choose, a surgeon should rather look for contraindications for vaginal hysterectomy than indications for this technique.     

Functional changes of mouse placental multidrug resistance phosphoglycoprotein (ABCB1) with advancing gestation and regulation by progesterone

Multidrug resistance phosphoglycoprotein (ABCB1) has been shown to limit maternal-fetal transfer by actively excluding ABCB1 substrates. The authors have previously demonstrated a marked decrease in placental ABCB1 expression in the human and mouse with advancing gestation. In the present study, it is hypothesized that the decrease in ABCB1 expression will result in increased transplacental transfer of ABCB1 substrates over the second half of gestation and that progesterone exhibits a regulatory role on placental ABCB1 expression and function. The authors demonstrate a significant increase in transplacental transfer of [(3)H]digoxin (an ABCB1 substrate) in late gestation (E18.5; P < .001) when compared to earlier embryonic days. Furthermore, maternal plasma progesterone levels did not influence expression or function of ABCB1. The authors conclude that the fetus is increasingly exposed to both endogenous and exogenous substrates of ABCB1 present in the maternal circulation with advancing gestation and that progesterone does not elicit a regulatory role on placental ABCB1 expression or function in vivo.