Biomedical subjects
Publications and source records attributed to D Prokopowicz.
Four patients with severe form of trichinellosis were treated with plasmapheresis. We noticed clinical improvement and favourable alterations in laboratory profiles (morphology and immune response parameters in the blood). The effect of plasmapheresis therapy in patients with trichinellosis was considered beneficial. No major complications of plasmapheresis were observed.
HIV infection and parenteral drug abuse are at increased risk of developing Candida infection. Central nervous system (CNS) infection is an exceptional finding. We present fatal CNS infection by Candida humicola in drug abuser at late stage of HIV disease. In MEDLINE we have found only 3 reports about pathogenicity Candida humicola in humans (ophthalmopathy, conjunctivitis, melanonychia). Our case report suggests, that spectrum of pathogens dangerous to persons with AIDS increases.
Studies were carried out on the neutrophil activity in a course of ulcerative colitis. Activity of lysozyme in blood serum as a granulocyte-derived enzyme was assessed. The studies included 60 patients who had 82 relapses and 11 patients with remissions. They were classified into mild, moderate and severe relapse according to severity of disease. Increased activity of lysozyme in blood serum was shown. That may indirectly prove the role of functional state of neutrophils in the disease.
Studies were carried out on the neutrophil activity in a course of a ulcerative colitis (UC). Phagocytic ability of granulocytes was assessed in spontaneous and stimulated nitroblue tetrazolium (NBT) reduction test. The studies included 60 patients who had 82 relapses and 11 patients with remission. They were classified into mild, moderate and severe relapse according to severity of disease. Increased phagocytic ability of neutrophils in spontaneous and stimulated NBT reduction test was shown.
Serum alpha-fetoprotein (AFP) concentration was measured in 41 patients with different stages of liver cirrhosis demonstrated through scored Child-Pugh classification. Mean value was elevated up to 65.9 21.9 U/l, butstatistically significant difference in comparison with control group was observed only in patients classified as Child-Pugh C. AFP concentration revealed significant positive correlation with score values. Dynamics of AFP during one-year follow up demonstrated three-fold and statistically significant increase of its concentration, that was accompanied by elevation of mean score values.
beta 2-microglobulin (beta 2-m) has been identified as the light chain of the class I major histocompatibility complex proteins, which plays an important role in immune response, especially in T-lymphocytes activation. The aim of the study was to evaluate serum beta 2-m concentration in patients with trichinosis in different phases of this illness. beta 2-m was determined with ELISA in 7 patients twice: in the first week of the hospitalization during acute phase of trichinosis and 21-25 days later, after abatement of clinical signs. It was found that beta 2-m was significantly elevated at the beginning of the illness and decreased, but in the fourth week of the hospitalization it was still high. There was a positive correlation between beta 2-m and absolute count of eosinophils in blood in the first (r = 0.77, p < 0.05) and in the fourth week of hospitalization (r = 0.65, p < 0.05). It is concluded that beta 2-m may have certain importance in the activation of eosinophils and may serve as a marker of immune activation in the course of trichinosis.
In 94 our of 2570 individuals vaccinated against tick-borne encephalitis (TBE) with FSME-Immun the level of IgG antibodies to TBE virus were tested. The examination was performed before and 2.5 years after the first dose of full cycle vaccination, which according to the manufacturer, consists of three doses. The maintenance of specific seroconversion was detected in 91.9% of the studied subjects. No statistically significant differences in antibody levels were found in the different age groups. None of the immunized subject developed TBE up to the present time.
Comparison of serological EIA tests available in Poland, used in diagnostics of Lyme borreliosis: VIDAS Lyme Screen II (LYT II)-bioMérieux (France), Lyme Borreliosis-Dako (Denmark), Borrelia Recombinant-Biomedica (Austria) was carried out in sera of 112 persons: 39 inhabitants of Białowieza area-Lyme borreliosis endemic region, 43 persons with Lyme borreliosis (first of all erythema migrans and neuroborreliosis), 27 healthy persons (control group), 3 persons with serologically confirmed rheumatoid arthritis. Compatibility of results in all tests was 73%, and it was the highest in control group (78%) and in neuroborreliosis patients (76%). Sensitivity of all tests was similar and varied from 77% (Dako) up to 81% (Biomedica). The highest specificity (93%), positive (94%) and negative (74%) predictive values demonstrated bioMérieux test. The lowest error of method for positive results showed bioMérieux (2,48%) and Dako-IgG (2,94%), whereas for negative Biomedica-IgG (0). There were no positive (false) results in sera of patients with rheumatoid factor dependent on cross reaction.
The aim of the study was evaluation of seasonal variability in presence of specific antibodies against Borrelia burgdorferi in Białowieza area, as an endemic region of Lyme borreliosis. Specific IgM and IgG antibodies against 41-kDa antigen of Borrelia burgdorferi B31 strain were investigated with an enzyme immunoassay in sera of 300 Białowieza inhabitants between September 1993 and May 1994. The highest prevalence of IgM antibodies was observed in September 1993 (43.4%), with decrease during winter and spring (down to 15.7% in April) and accompanying the highest prevalence of IgG antibodies (17.7% in April 1994). Quantitative determination of antibodies level expressed as corrected optical density revealed similar tendency. From 33 persons, that revealed IgM antibodies in September 1993, 26 (79%) had no IgM or IgG antibodies. Specific IgG antibodies found in 7 persons in September, were still present in 4.
Cell mediated as well as humoral immune response was evaluated in 14 lyme arthritis patients. Significant decrease of T cells percentage was observed in comparison to normal values. It was related particularly to CD4+ subset and resulted in significant decrease of CD4+/CD8+ ratio. Statistically significant increase of B cells percentage was accompanied by elevated concentrations of immunoglobulin M, complement components C3 and C4. Immunoglobulins A and G, as well as circulating immune complexes remained on the normal level. These results indicate suppression of cellular and activation of humoral immune response in patients with Lyme arthritis.
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Detection rate of G. intestionalis in feces with direct microscopy has been compared with the immuno-enzymatic technique detecting protein GSA 65 with Alexon Inc., ProSpec T/Giardia reagents kit. The results obtained with both methods have further been compared with those obtained by microscopic examination of the duodenal content. Detectability of Giardia intestinalis with EIA technique with the use of ready-made kit has been assessed. Feces have been collected from 371 patients. Protein GSA 65 has been present in 170 samples, 45.8%, examined with the use of ProSpec T/Gardia kit. Giardia intestinalis cysts have been detected microscopically in the feces of 37 patients, i.e. in 22.3%. Microscopic examinations carried out by three independent examiners have shown marked diversity in the rate of positive results, being 0.1% (examiner A), 28.6% (B), and 45.2% (C). Comparison of G. intestinale detectability of all 3 techniques used have shown absence of protein GSA 65 in 2 out of 9 examined patients. However, trophozoits have been present in the duodenal content. Test performed with kits made by Alexon Inc. and DIALAB have given 45.8% and 60.7% of the positive results, respectively.
The causes and clinical manifestations of Clostridium difficile infection in children are described in this report. The studies were performed on three children aged up to 3 years. Risk factors as well as possible diagnostic and therapeutic procedures are discussed.
Clostridium difficile is a Gram-positive bacillus which had been identified as the source of potent exotoxins: toxin A and toxin B. C. difficile infection usually follows antibiotic therapy and results from unrestrained growth of pathogenic strains of C. difficile in the colon. Typical clinical findings include: diarrhoea with blood and mucus, fever, abdominal pain, nausea, loss of body weight. In the past the diagnosis was based on positive result of stool culture but now several tests are available: latex-agglutination test, enzyme immunoassays and fluorescence-immunoenzymatic tests. Diagnostic methods enable quick and safe detection of C. difficile antigens or toxins and proper management. Poor susceptibility of C. difficile strains to common antibiotics hinders choosing the effective therapy.
Delayed-type hypersensitivity skin reaction performed with Multitest CMI as an indicator of cell-mediated immunity, has been evaluated among 20 adults with giardiasis. There were no correlation found between Multitest CMI score and clinical course of the disease, but significant correlation was observed in relation to CD4/CD8 ratio, an another indicator of cell-mediated immunity. Multitest CMI score revealed lower values in giardiasis patients than in controls, and it was associated with significantly higher frequency of hypoergic reactions among subjects.
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Lyme borreliosis (LB) caused the tick-borne spirochete B. burgdorferi, is associated with a wide variety of manifestations including dermatologic, rheumatologic, neurologic and cardiac abnormalities, that can differ from one region to another. To define clinical picture of LB in Poland, particularly in north-eastern region, we studied in 46 patients. Diagnosis of LB was established according to criterion, including serological confirmation with ELISA LB seems to be disease, which renal prevalence in Poland is higher, than it was primarily estimated. Clinical picture of the disease does not differ significantly from observed in other parts of the world. The only, but important exception is more frequent manifestation of B. burgdorferi infections with meningitis or/and encephalitis (48% of patients).
The clinical course of HIV infection and results of autopsy examination in 49 years old patient was shown. The attention was paid to difficulties of diagnosis of opportunistic infections in a patients with advanced HIV disease. Variety of infectious factors, that could affect a patient with significant immunodeficiency was outlined.