Hepatitis B in Poland in 2001

2,394 cases of hepatitis B (including 114 infections with both HBV and HCV) were reported in 2001 in Poland; the incidence rate was 6.2 per 100,000 population. The total number of cases decreased by 431 and incidence rate by 1.1 comparing to 2000. From 1993 to 2001 decline in number of cases was 5.5 times. This decline was mainly the result of vaccination of children and high risk patients though the improvement of sterilisation procedures could be of significance, especially in persons below 60 years of age. About 96.3% of all cases were hospitalised. Regional differences in both, the incidence rate and percentage of hospitalizations were observed. The incidence of hepatitis B per 100,000 was higher in urban (7.0) than in rural (4.9) population. The lowest incidence (0.4) was observed in children aged 0-4 years; in older children (5-9 years of age) the incidence rates were 4.5 in boys and 2.2 in girls. The highest ranging incidence, from 5.5 to 8.2 was found in the age group 15-24 years, especially in boys and young men (from 7.4 to 11.6) living in urban areas.     

Myxopapillary ependymoma of the lateral ventricle with local recurrences: histopathological and ultrastructural analysis of a case

An exceptional case of a recurrent intracranial ependymoma of myxopapillary type arising from the lateral ventricle is reported in a 37-year-old man. This distinctive morphological variant of ependymoma is virtually restricted to the region of cauda equina and filum terminale or occasionally to pre- or post-sacral soft tissue. The intracranial cases of myxopapillary ependymoma are extremely rare and are generally associated with the primary ependymal tumour at the typical lumbosacral site. This case of intraventricular myxopapillary ependymoma did not demonstrate any MRI evidence of a primary spinal cord tumour. Moreover, the initial diagnosis of this histologically benign tumour was followed by two tumour recurrences during the three-year follow-up period. To our knowledge, this is the third documented case of a primary intraventricular myxopapillary ependymoma and the first one of intracranial localisation associated with local recurrences.     

Changes of percentages in immune cells phenotypes and cytokines production during two-year IFN-β-1a treatment in multiple sclerosis patients

Abstract. Objective: The aim of the study was to find out whether INF--1a influences the immune profile of peripheral blood (PB) leukocytes in MS patients. Method: We have studied 20 patients with relapsing-remitting form of MS treated with INF--1a using twocolor cytometry. We determined immune cells phenotypes and production of some cytokines: IL-4, IL-10, IL-12, IFN-, before drug administration and after starting the treatment. Results: In MS patients an increased percentage of CD14⁺CD86⁺ cells and CD3⁺CD25⁺ cells was noticed after 6, 9 and 12 months of INF--1a therapy. Among cytokine-producing cells we noted an increased fraction of CD3⁺IL-4, CD14⁺IL-10 and CD14⁺IL-12 cells after 12 months, which decreased to the level observed before treatment after 24-month therapy. Conclusions: IFN--1a treatment was associated with significant changes in immune response. This effect was mostly evident within the first year of treatment.     

Measles in Poland in 2003

In Poland 48 measles cases were registered in 2003 (0.13 per 100,000 population)--of which 65% were cases imported from Chechnya and Afghanistan. Measles outbreaks occurred in 3 centers for immigrants. In total, 31 cases were reported, of which 96.8% were unvaccinated, and 93.5% were under 15 years of age. Of 17 local cases, 5 (29.4%) cases occurred in unvaccinated persons, 3 (17.6%) in persons vaccinated with one dose and 7 (41.2%) in those vaccinated with two doses of measles vaccine (administered at the age of 13-15 months and 7 years). Among 12 vaccinated cases only one 2-year old child was recently vaccinated. The remaining cases were in the 3-7 and 10-24 age ranges. The most affected were infants (incidence 0.57 per 100,000), 1-year old (0.28) and 2-year old children (incidence 0.27). Cases among adolescents and adults over 15 years of age increased from 23.5% in 2002 to 47.1% in 2003. The increasing age of locally-acquired cases, together with constantly high immunization coverage indicates high effectiveness of vaccinations in Poland. Out of all reported cases 13 (38%) were hospitalized. There were no deaths due to measles in Poland in 2003. Poland participates in the WHO Measles Elimination Strategy. Presently, the most important is the maintenance of a sensitive and timely surveillance of measles and measles-compatible cases, with serologic confirmation of one rash-like illness per 100 000 population. The performance of the surveillance system is insufficient with only 55 measles-compatible cases reported in 2003 (15% of expected reports). Serologic confirmation of cases was also insufficient, with 22 cases (40.0%) confirmed by IgM ELISA test. These results indicate the need to maintain the high immunisation coverage and improve measles surveillance system.     

Depression in patients with Parkinson's disease

The aim of our study was to assess the frequency of depression in group of patients with Parkinson's disease (PD) who fulfilled the diagnostic criteria of PD, had normal CT scans and responded well to L-dopa treatment. The sample consisted of 73 consecutive patients (34 women and 39 men), mean age 65.7 (41-81) years, mean duration of disease 6.7 years. Besides neurological examination, in all the patients the degree of motor impairment was evaluated using the UPDRS, H-Y, and SE scales. Moreover, a sociodemographic questionnaire, psychological tests (MADRS, MMSE), and a quality of life scale (PDQ-39) were used. Depression (MADRS scores > 19) was found in 25 (34.2%) of the patients, with major depression (scores > 28) diagnosed in 7 patients (9.5%) and moderate depression (scores between 20 and 28)--in 18 cases (24.6%). In comparison to non-depressed patients, those with depression were older by 0.9 years on the average, their onset of the disease occurred later by 1.7 years, and their mean duration of the disease was longer by 2.6 years. These differences were not statistically significant. Dementia (MMSE scores < or = 23) did not differentiate between the two groups: it was found in 27 depressed patients (37.4%) and in 26 (35.6%) of those without depression. Patients in the depressed group suffered statistically more often from sleep disorders (19 vs. 14; p < 0.001). In this group motor impairment was significantly more marked, as measured by the UPDRS (32.2 vs. 46.8; p < 0.001) and H-Y (2.54 vs 2.98; p < 0.007), and their quality of life as measured by PDQ-39 questionnaire was significantly lower (36.4 vs. 82.24; p < 0.00002). Our data indicate the presence of depression in 34.2% of the sample, i.e. a somewhat lower prevalence rate than that reported in other studies. This may be due to the fact that only outpatient population was analysed, and outpatients are seldom categorized as degree 4 and 5 on the H-Y scale. Depression on PD patients was correlated with their more severe motor disability and considerably lower quality of life. This may suggest a relationship with progression of the disease and more pronounced changes in cerebral neurotransmitters (i.e. endogenous origin), or PD patient's response to their limited mobility and isolation in later stages of the disease (i.e. reactive origin). However, the two factors--endogenous and reactive--may be overlapping, since a majority of PD patients suffer from mild to moderate depression.     

Influenza in Poland in 2003

Following two years of low influenza incidence in Poland, the activity of this disease markedly increased in 2003. In total 1,216,285 cases of influenza like illness were registered (incidence 3,184.4 per 100,000). Regionally the incidence ranged from 1,195.7 in Zachodniopomorskie to 5,719.7 per 100,000 in Mazowieckie. Children and adolescents under 15 years of age accounted for 41.7% of all cases (507,102 cases, age specific incidence 7,579.0 per 100,000). In this age group the incidence varied regionally from 2,718.1 in Podlaskie to 14,087.6 per 100,000 in Mazowieckie. 3,128 patients (0.26% of all cases) required hospital admission. There were 141 deaths due to influenza (mortality 0.12%) in 2003, in 78.7% these were persons over 70 years of age. Nineteen strains of influenza virus were isolated in 2003 in Poland, including 15 strains of subtype A(H3), 3 strains of subtype A(H1) and one strain of type B. Besides, in other 10 cases influenza A infection was confirmed by direct immunofluorescence test. All isolated influenza strains were antigenically similar to the vaccine strains recommended for the epidemic season 2002/03 and 2003/04.     

Influence of orphenadrine upon the protective activity of various antiepileptics in the maximal electroshock-induced convulsions in mice

Orphenadrine is an anticholinergic drug used in the treatment of Parkinson’s disease, and is also known to exert nonspecific antagonistic activity at the phencyclidine binding site of the N-methyl-D-aspartate (NMDA) receptor. The aim of this study was to assess the anticonvulsant properties of orphenadrine and to evaluate its effect on the anticonvulsant activity of antiepileptic drugs against maximal electroshock-induced seizures in mice. Orphenadrine given at a dose of 5.65 mg/kg elevated the electrical seizure threshold from 5.7 (5.4 – 6.1) to 6.8 (6.3–7.3) mA, while a dose of 2.8 mg/kg was ineffective. The ED₅₀ values of orphenadrine administered 10,30 and 120 min before maximal electroshock-induced convulsions were 16.8 (11.3–25.1), 17.8 (15.7–20.0) and 25.6 (23.3–28.3) mg/kg, respectively. Orphenadrine at a sub-threshold dose of 2.8 mg/kg significantly enhanced the anticonvulsant activity of valproate by reducing its ED₅₀ value from 315.8 (270.0–369.4) to 245.9 (207.1–292.0) mg/kg without affecting the free plasma levels of valproate. However, orphenadrine failed to enhance the protective activity of carbamazepine, phenytoin, phenobarbital, lamotrigine, topiramate, or oxcarbazepine against maximal electroshock-induced seizures.     

Hysteroscopy in cases of abnormal uterine bleeding and abnormal ultrasonographic findings of uterine cavity-own experience

OBJECTIVES: In the paper authors present indications and results of using diagnostic and operative hysteroscopy in the clinical practise and compare histological result with introductory diagnosis of ultrasonography and hysteroscopy. MATERIALS AND METHODS: In period of 01.06.1998-01.09.2002 148 hysteroscopy were done with in 58 diagnostic and 90 operative histeroscopies. Received material was sent to histological research. RESULTS: non-pathologic change was diagnosed in 37 women, 43 endometrial polyps, 20 submucous myomas, 5 polyps and myomas together. CONCLUSIONS: 1. Most often observed change in intrauterine pathology were endometrial polyps and submucous myomas. 2. In a few cases only hysteroscopy let us discover the reason of pathological bleedings from the uterus. 3. hysteroscopy has become the method necesary in some cases of gynaecological pathology.