Could Legionella pneumophila infection cause bronchial hyperreactivity

11 children with bronchial hyperreactivity were tested for Legionella pneumophila serotype 1 and 2-14, including 3 girls, who were treated a year before because of atypical pneumonia, probably caused by Legionella pneumophila, 2 brothers of the girls and 6 children from a different village as well as 5 adults--parents of the girls. In all of them a significant level of antibodies against Legionella pneumophila serotype 2-14 was detected with indirect immunofluorescence. One of previously treated girls presented with increased level of IgG antibodies (ELISA), the remaining two had increased levels of IgA against Legionella pneumophila serotype 1. Other patients in the group presented no IgM, IgA or IgG against Legionella pneumophila serotype 1. Patients with bronchial hypersensitivity received clarithromycin and inhalation steroids with good clinical effect.     

Susceptibility to respiratory infections in school children after measles. Results of epidemiological study in Krakow

Purpose of the study was answering the question whether measles experienced in young children may lead to an increased susceptibility to respiratory infections. In order to verify the hypothesis, the analysis of the prospective study on respiratory morbidity in children has been carried out in Krakow. In the course of the study a detailed epidemiologic interview on current and past respiratory diseases diagnosed by physician was collected in consecutive years of the survey (1995-1997). Susceptibility to respiratory infections has been defined as excess number of respiratory episodes over the third quartile of the distribution of number of episodes in upper and lower respiratory tract. The results of the study showed that susceptibility to upper respiratory infections was about twice so high (OR = 1.97; 95%CI: 1.27-3.05) among those children who experienced measles. Amongst other factors potentially responsible for an increased susceptibility to respiratory infections, only atopy and fungal exposure within home were associated with the higher risk The analysis performed for lower respiratory episodes confirmed the findings obtained for upper respiratory tract infections, however, the effect of atopy was much higher pronounced.     

Prevalence of antibodies and vaccination against measles,mumps and rubella in Polish population

The data according number of cases and morbidity rates of measles, mumps and rubella as well as antibody prevalence against diseases above mentioned in Polish population were shown. The impact of mass vaccination on decreasing of measles incidence and number of reported rubella congenital syndrome was observed. The possibility of elimination these diseases in the near future was discussed.     

Cancer risk assessment: present and future

Risk assessment is a process based on available scientific information about properties of a given agent, and its effect on biological processes to evaluate potential adverse consequences of exposure to that particular agent. Occupational cancer risk assessment might be considered as a more specific application of the process aimed at finding out whether a particular workplace exposure would lead to cancer. In 1983, a comprehensive model or paradigm of risk assessment was developed by the US National Academy of Sciences (NAS). The overall risk assessment process comprises the following elements: (a) hazard identification, which involves the qualitative determination of whether a particular agent causes a particular adverse effect in humans; (b) dose-response assessment, which describes how such effects are related to the dose; (c) exposure assessment, which estimates the level of human exposure to the substance with and/or without regulatory controls; (d) risk characterization as summary judgments on the existence and magnitude of the public health problem. In this article the authors discuss all the elements of the risk assessment process and present current approaches to this problem as well as research needs in this area.     

Value of lead aVR in the detection of significant left main coronary artery stenosis in acute coronary syndrome

BACKGROUND: Electrocardiographic lead aVR is usually ignored in patients with chest pain. ST segment elevation in aVR may have diagnostic value in patients with acute coronary syndrome (ACS) and significant stenosis or obstruction of the left main coronary artery (LMCAS), especially when accompanied by ST segment elevation in lead V(1). AIM: To asses the value of lead aVR and V1 for the detection of LMCAS in patients with ACS. METHODS: The study group consisted of 150 patients (mean age 60.6+/-9.5 years, range 33-78 years) with ACS, including 46 with LMCAS and 104 without LMCAS. ECG recordings obtained on admission were compared between these two groups. RESULTS: In patients with LMCAS, ST segment elevation in lead aVR was two times more frequent than in remaining patients (69.6% vs 34.6% p=0.0001) whereas there were no differences in lead V(1). Sensitivity of ST elevation in aVR in detection of LMCAS was 69.6%, specificity - 65.4%, positive predictive value - 47.1%, and negative predictive value - 82.9%. In patients with LMCAS, ST segment depression was significantly more often present in ECG leads other than aVR (45.6% vs 23.1% p<0.01). Patients with LMCAS more often had hypertension (95.6% vs 77.9% p<0.05) and three-vessel disease (78.3% vs 31.8%, p<0.0001). CONCLUSIONS: The assessment of lead aVR in patients with ACS may indicate LMCAS. Additional analysis of lead V(1) does not improve diagnostic accuracy.     

Rib hump correction in patients with idiopathic thoracic scoliosis treated by the Cotrel-Duboussete method

Background. This article evaluates correction of rib hump in patients with idiopathic thoracic scoliosis who had been treated by the Cotrel-Dubousette method. Material and methods. We investigated 35 patients pre- and postoperatively in this study. Back surface measurements were studied pre- and postoperatively using our own device. Scoliosis correction was assessed by comparing pre- and postoperative x-rays. Results. We found reduced height, width, length, area of the bottom of the hump, angles of the slope of the humps, surface rotation angle, and difference between hump and depression. Localization of the hump was changed by bringing the top of the hump to the base line (C7-L4) and by displacing the top far from the C7 spinal process. Conclusions. The Cotrel-Dubousette method can be used to correct rib hump and change its localization. Few correlations were found between back surface measurement and radiological outcome.     

The influence of tensometric evaluation of the pain threshold on the nature of resistance exercising in disorders of the knee joint

Background. We evaluated the usefulness of tensometric examination of the quadriceps as a means of assessing the pain threshold for the subcartilage layer in the patellofemoral joint and the knee joint. Material and methods. Our study, carried out from 2000 to 2003, included 131 patients, 77 men and 54 women, age 12-52. The examination results were compared with those for the unaffected leg. After each examination a new level of exercise workload was established, always just below the pain threshold. Examinations were repeated after one, three and six months. Results. The level of the pain threshold in most cases excluded workloads involving flexion of the knee at 90 degrees , 45 degrees , and 0 degrees . Training with a load adapted to the pain threshold served as endurance training, and should be regarded as a way to harden the cartilage. When the exercise load was adjusted in accordance with tensometric examination results, cartilage resistance to pressure increased. This kind of training allows the patient to achieve painlessly 80-90% strength in the quadriceps (compared to the healthy leg) in 6-12 months. Conclusions. Tensometric examination of the knee is a useful instrument in the evaluation of sensitivity to pain in the subcartilage layer, enabling the evaluation of the range of pressure that does not induce subcartilage pain when the joint is under load by working muscles. Properly selected workloads have a favorable impact on resistance to pressure and cause a virtually complete restoration of quadriceps strength after 6-12 months of rehabilitation.