Biomedical subjects
Publications and source records attributed to J Zajkowska.
There is presented the case of tuberculous cervical lymphadenitis of 60 years old patient who was hospitalized in Clinic of. Parasitic Diseases and Neuroinfection in 1992 and diagnostic difficulties connected with it.
In analysed material of 31 patients with TBE (tick borne encephalitis) we noticed symptoms evidence the impact of TBE virus vestibular system. We showed that 21 patients had disorders like dizziness and lack of balance. And 11 patients had inaudility of conductive and receiving type what was the evidence of injury of vestibular nerve. In these 11 patients we observed not normal recording of optokinetical reaction.
In the years 1963-1992, 560 patients with the diagnosis of trichinosis were treated in the Department of Parasitic Diseases and Neuroinfections, including 310 women (55.3%) and 250 men (44.7%) aged from 6 to 75 years. Out of this number of patients in 59 cases (10.5%) myocardial damage was found in the course of the disease. The most frequently found changes in ECG record were ventricular repolarization disturbances (66.1%) which persisted in 18.6% of cases before discharge from the hospital. Depolarization disturbances accounted for 32.2% of cases and persisted before discharge from the hospital in 10.1% of patients. In 6.7% of patients, persistence of pathological ECG record was found during the 4th month after the hospitalization which may be an evidence of prolongation of the inflammatory process within the myocardium.
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In the years 1985-1989 in a department for parasitic and occupational diseases in Białystok, 112 patients were hospitalized with the diagnosis of lymphocytic meningitis. The most common aetiological factor were viruses (30.6%), arboviruses (25.9%), and then herpes viruses (6.25%), and mumps virus (5.3%). In 36 patients (32%) no aetiological factor of the inflammatory process was established. In 22 patients (19.6%) a simultaneous hepatocellular damage was found in the form of jaundice (15 patients, that is 13.4%), and hepatomegaly in seven patients. The observed hepatic involvement was found in the group of patients with severe clinical course of meningitis. Most frequently hepatic reaction was observed in the group of lymphocytic meningitis caused by arboviruses. Among the biochemical indices of hepatocellular damage a significant increase in relation to normal value was found of serum bilirubin level (mean = 1.75 mg%; normally mean = 1.1 mg%), alanine aminotransferase activity was 2.5 times higher than the mean normal value (mean = 77.6 IU; normal value mean = 30 IU). The observed hepatic changes were transient and regressed together with the regression of acute inflammatory state in the central nervous system.
The diagnosis of cat scratch disease is hampered by the fact the basic laboratory investigations fail to demonstrate characteristic changes of this disease, and the diagnosis is based usually on epidemiological history and the clinical symptom complex. The diagnosis is confirmed by the complement binging test with the antigen obtained from pathologically changed lymph nodes with values over 1.5 being pathognomonic for the disease, and by the cutaneous tests of Hanger-Rose and Mollaret. The authors present 2 cases treated for the disease stressing differences in its course.
BACKGROUND: The aim of this study was to evaluate the concentrations of soluble CD4, CD8 and CD25 antigens in the serum of patients with early LocaLized, (group I, n = 22 patients) and early disseminated Lyme borreliosis (group II n = 23 patients), before and after antibiotic therapy compared with controls (group III n = 7 healthy persons). MATERIALS AND METHODS: The diagnosis of Lyme borreliosis based on clinical features was confirmed by ELISA and Western blot. The assays of sCD4, sCD8 and sCD25 concentrations were performed using Endogen (USA) kits. RESULTS: In group I the sCD4 level decreased in examination 2 (p < 0.001) compared to examination 1. The mean concentration of sCD8 in initial examination 1 in group II was higher than in controls (p < 0.0001); it decreased in examination 2 but was still higher (p < 0.01) than in controls (p < 0.006). Prior to treatment mean sCD25 concentration in group II was higher compared to controls (p < 0.0008) like in examination 2 after treatment (p < 0.02) and this persisted. The mean value of sCD8 in initial examination 1 before treatment in group II was higher than in group I (p < 0.00001). CONCLUSION: Increased initial concentrations of sCD8 and sCD25 indicate the activation of CD8 and CD25 lymphocytes and their role in immunopathogenesis of Lyme disease. Elevated levels of sCD8 in group II before and after treatment suggest a significant involvement of CD8 lymphocytes, indicating the role of long-lasting cellular response in this stage of Lyme disease.
The authors review the literature concerning clinical characteristics of neuroborreliosis with special focus on mental disorders. The patients develop mental disorders during the acute phase of the disease and even after several years. These disorders are often accompanied with various neurological syndromes. The authors discuss the most common mental disorders connected with neuroborreliosis: encephalopathy, cognitive disorders, dementia, depression, anxiety disorders. The paper describes the problem of neuroborreliosis in psychiatry, especially in the endemic regions.
The aim of this study was the assessment of certain PMN functions involving migration, chemotaxis, phagocytic activity and intracellular oxygen-dependent killing in patients with TBE. The examination involved 47 persons treated in the Department of Infectious and Neuroinfectious Diseases Medical Academy in Białystok. Two examinations were done: before and just after treatment. Control group contained 29 healthy persons. Migration and chemotaxis were assessed by agarose method of Nelson and al. and Glaser and al. Phagocytic activity was examined by microscopic method and intracellular oxygen-dependent killing by reduction test of NBT by Parks method. Analysis of results showed a decrease of all examined parameters both before and after treatment. It indicates a depression of non-specific cellular response in patients with Lyme meningoencephalitis.
Since 1987 when Januszkiewicz and Kieda first described borreliosis, it is commonly recognized as infection of the nervous system in Poland, especially in north-east region. The diagnosis of the disease is mainly based on typical clinical signs, supported by serological testing. In 14 patients with clinical symptoms of neuroborreliosis CT and MR were performed to evaluate CNS changes. MR examinations were abnormal in 36%. Most patients (60%) presented cerebral atrophy. In 2 cases areas of abnormal signal were identified within cerebral white matter as well as within the brain stem. In the first case it was, recognized as demyelination focus, in second one MR showed evidence of or were suggestive of vascular involvement. In one case symmetrical calcifications were also found in internal capsules. Neuroradiological signs in Lyme disease are not specific. Neuroborreliosis has to be considered when patients present foci of hyperintense signal (T2-weighted images) in white matter and brain stem.
Between 1989-1990, 502 individuals exposed to the animals with rabies or suspected of rabies reported to out-patient clinic of agricultural occupational diseases at the K. Dłuski Hospital and to the Department of Parasitic and Occupational Diseases in the Medical Academy in Białystok. Sixty one (12.2%) of these individuals were vaccinated. Most frequently these people were attacked by dogs (70.4%), cats (11.4%), rats (6.5%), and foxes (3.2%). Rabies was diagnosed only in 9.8% of cases (Negri bodies in the brain and positive immunofluorescence test.). A vaccine inactivated on the human diploid tissue (Institute Merieux) was applied without any postvaccination complications. Transient micro-macular rash on face and chest of 3 patients, and local inflammatory reaction in 2 patients did not disturb vaccination process. Active-passive immunization was used in case of extensive lesions.