Malaria in Poland in 2000

In 2000, 24 malaria cases were registered in Poland. All of them were imported, mainly from Africa (15 cases). Plasmodium falciparum infection was confirmed in 15 cases, P. vivax--in seven. Among 24 malaria cases 22 were men and 20 in 20-49 years old group. Eleven persons travelled abroad in the connection with their job, six--as tourists, three--came from malaria endemic or epidemic countries. In 2000, 25-year old man with malaria falciparum died.     

Body cell mass repletion and improved quality of life in HIV-infected individuals receiving oxandrolone

BACKGROUND: The aim of this study was to measure changes in body cell mass (BCM) and quality of life in HIV-infected individuals undergoing oxandrolone therapy. Previous studies on oxandrolone have neither quantified changes in BCM using criterion methods nor quality of life using an HIV-specific instrument. METHODS: Twenty-five HIV-infected patients (15 with an AIDS diagnosis) on standard antiretroviral and nutrition management were studied before and an average of 18.6 weeks after the initiation of oxandrolone therapy, as prescribed by their primary care physician for the treatment of weight loss. BCM was estimated from intracellular water measured by multiple dilution. Lean soft tissue mass (LTM) was measured by dual-energy X-ray absorptiometry. Quality of life was evaluated by the Functional Assessment of HIV Infection (FAHI) questionnaire. RESULTS: Significant gains in body weight (2.6 +/- 3.0 kg; p < .0001), BCM (3.6 +/- 3.0 kg; p < .0001), and LTM (3.0 +/- 2.9 kg; p < .0001) occurred over an average course of 18.6 weeks of treatment. Overall quality of life improved (p = .056) and appetite improved (p = .032), both of which were positively associated with weight gain (p = .040 and p = .022, respectively). CONCLUSIONS: This is the first study involving oxandrolone therapy in HIV infection to document changes in quality of life and BCM, the metabolically active component of lean body mass that reflects nutritional status better than other more global body composition parameters. Nutritional status and quality of life can improve in HIV-infected individuals receiving a combined therapeutic approach that includes oxandrolone.     

The effect of rivastigmine on cognitive functions and regional cerebral blood flow in Alzheimer's disease and vascular dementia: follow-up for 2 years

BACKGROUND AND PURPOSE: The aim of the work was to investigate the effect of treatment with rivastigmine, one of the inhibitors of acetylcholinesterase (AChE-I) on the regional cerebral perfusion (rCBF) and the cognitive functions of the brain in patients with Alzheimer's Disease (AD) and Vascular Dementia (VaD). MATERIAL AND METHODS: The investigations of rCBF were carried out using SPECT (Single Photon Emission Computed Tomography). The results given concern investigations of patients carried out at the onset of the investigation, after 12 months, and 24 months of rivastigmine treatment. RESULTS: In patients with AD it was found that treatment with rivastigmine increases rCBF by 5-7% in the temporal areas during the first 12 months. In the frontal areas the increase was by 3-5%. During the next 12 months rCBF with an accuracy of 2% returned to the initial level, with the exception of the motor cortex, where it remained on the level increased by 5-6%. However, the cognitive functions remained constant during the first 12 months of treatment and decreased significantly during the next 12 months. In patients with VaD rCBF increased in all the regions of the brain except for the temporal posterior regions, and remained at an elevated level for the next 12 months. The cognitive functions deteriorated slowly, but to a much lesser degree than in the case of AD. CONCLUSIONS: From the investigations carried out it follows that treatment with rivastigmine during 24 months prevents a decrease of rCBF in patients with AD. However, the cognitive functions deteriorate after 24 months.     

Relation between wall thickening on gated perfusion SPECT and functional recovery after coronary revascularization in patients with previous myocardial infarction

Purpose This study aimed to evaluate whether wall thickening analysis by gated perfusion single-photon emission computed tomography (SPECT) is useful in predicting functional recovery after revascularization.Methods Forty-one patients with previous myocardial infarction and left ventricular (LV) dysfunction (ejection fraction, EF, 36±6%) who were scheduled for revascularization underwent rest ^99mTc-sestamibi gated SPECT.Results Of 131 akinetic or dyskinetic segments at baseline echocardiography, 82 (63%) recovered after revascularization. Compared with wall thickening analysis, perfusion imaging provided higher sensitivity (78% vs 50%, P<0.0001) and specificity (80% vs 71%, P<0.0005). Among segments with 55% sestamibi uptake (viable), those with detectable wall thickening had a higher likelihood of functional recovery than those with absent wall thickening (95% vs 77%, P<0.05). In segments with improved function, the absence of wall thickening was associated with lower sestamibi activity than was observed when detectable wall thickening was present (58±14% vs 71±13%, P<0.0005). An increase in EF of 5% was detectable in 22 (54%) patients. For the prediction of EF improvement, perfusion imaging provided a higher sensitivity than wall thickening analysis (68% vs 41%, P<0.05), while specificity was not significantly different (68% vs 74%). The prevalence of patients with functional recovery did not change when wall thickening analysis was considered in addition to perfusion status (73% in patients with detectable wall thickening and 70% in those without; P=NS).Conclusion In patients with coronary artery disease, wall thickening analysis by gated perfusion SPECT provides additional information compared with perfusion data for the prediction of segmental functional recovery. However, on a patient basis, wall thickening assessment seems to be of more limited value than perfusion status.     

Pseudomonas aeruginosa strains harbouring an unusual blaVIM-4 gene cassette isolated from hospitalized children in Poland (1998-2001)

OBJECTIVES: During 1997-2001, 151 isolates of imipenem-resistant Pseudomonas aeruginosa were obtained from clinical specimens taken from children hospitalized in Warsaw, Poland. These strains were investigated further to determine the mechanism of resistance. METHODS: The strains were analysed by a combination of genotyping and PCR-based strategies. RESULTS: Eleven of these strains were found to contain the metallo-beta-lactamase (M beta L) gene bla(VIM-4). The first strain appeared in 1998, and P. aeruginosa strains harbouring this M beta L have become endemic in this hospital since then. All P. aeruginosa strains belonged to serotype O:6, and PFGE analysis revealed four different patterns and three sub-types. All 11 M beta L-producing strains contained an identical class 1 integron with the usual 5' and 3' conserved sequences. The integron included two resistance cassettes, aacA4 in the first position and the bla(VIM-4) cassette in the second position. The bla(VIM-4) gene included an unusual direct repeat of 169 bp of the 3' portion of the bla(VIM-4) gene. CONCLUSIONS: An unusual bla(VIM-4) M beta L has become endemic in P. aeruginosa isolates infecting Polish children hospitalized on surgical wards. The formation of this unusual bla(VIM-4) gene cassette could be explained by a mechanism involving deletion of a segment of an ancestral tandem repeat of bla(VIM-4) via slipped strand replication, mediated by a combination of polymerase and integrase.     

Visual system involvement in selected zoonotic diseases. II. Trichinellosis

Trichinellosis is the medical problem that is still actual in our country. The paper presents recent taxonomic data regarding Trichinella spp. as well as selected epidemiologic aspects. Pathomechanism of trichinellosis and the outline of clinical pathology are also discussed. The image of lesions involving organ of sight, diagnostic methods and treatment are described with details as well. The paper is highlighting the role of ophthalmologist in early diagnosis of trichinellosis.     

Androgen receptor versus erbB-1 and erbB-2 expression in human prostate neoplasms

A subject of current interest, especially in the development of androgen refractory prostate cancer, is the androgen receptor (AR) activation by growth factor receptors. Here, we report our work on the measurement of AR mRNA and protein expression in benign prostatic hyperplasia (BPH) and prostatic carcinoma (PCA) and evaluation of the relationship between AR, erbB-1 and erbB-2 gene expression determined in the same tissue. In order to define AR, erbB-1 and erbB-2 in human prostate neoplasms 36 benign prostatic hyperplasia, 46 prostatic carcinoma and 12 normal prostate gland samples were analysed. According to distant metastasis PCA tissues were divided into two categories: i) T1-4N0-3M0 (25 samples) and ii) T4N2-3M1 (21 samples). AR, erbB-1 and erbB-2 mRNA expression was estimated by RT-PCR. AR protein expression, both in nuclear and cytoplasmic fractions, was measured by Western blot technique. The association of AR mRNA and protein expression with erbB-1 and erbB-2 gene expression was evaluated. It was found that in clinically invasive (group II of PCA) prostate cancer cases AR mRNA expression was significantly correlated with erbB-2 mRNA expression (Spearman R coefficient 0.86, p<0.05). Interestingly, AR protein expression in this group of PCA was determined mainly in nuclear fraction. By Western blot AR protein was identified in 76.0% (16/21) and 23.8% (5/21) of PCA group II nuclear and cytoplasmic fractions, respectively. Furthermore, the mean AR protein level in nuclear fraction of clinically invasive (group II) PCA (0.82+/-0.04) was significantly higher (p<0.05) as compared to the normal group (0.56+/-0.11). In the case of T4N2-3M1 samples, significant correlation between AR protein level in nuclear fraction and erbB-2 mRNA expression (Spearman R coefficient 0.53, p<0.05) was stated.     

Partner violence as a risk factor for mental health among women from communities in the Philippines, Egypt, Chile, and India

Although studies have documented the associations between Intimate Partner Violence (IPV) and mental health, few have been done in developing countries. In this study, the association between IPV and mental health in women from different developing countries was established. Women, 15 to 49 years old with at least one child 18 years old or younger, were randomly selected from communities in Chile, Egypt, India, and the Philippines (N = 3974). The Self Report questionnaire (SRQ) was used to assess mental health. Women with a score on the SRQ of 8 or more, or who reported ever attempting suicide, were classified as having poor mental health. Physical IPV was defined as being slapped, hit, kicked, beaten or threatened by a male partner during the past year. Psychological violence included being insulted or belittled, threatened or abandoned. Between 22.5% (in Egypt) to 41% (in Chile) of participating women reported a score of eight or more on the SRQ. High score on the SRQ were significantly associated with current physical and psychological IPV in the samples from all participating countries except Chile. Twelve percent of women in Chile, 2.6%, in Egypt, 7.5% in India and 1.6% in the Philippines reported attempting suicide. Suicide attempts were also associated with current physical IPV in the Philippines, Egypt, and India, and with psychological violence in Egypt and India. IPV is significant risk factor for poor mental health in these developing countries. Efforts to reduce IPV should be considered as part of a mental health program.