Polski tygodnik lekarski (Warsaw, Poland : 1960)最新文献

Basing on the own experience, the authors discuss causative treatment of sepsis, mainly of unknown etiology. Emphasis is on the depression of immunological system in the acute phase of the disease. Therefore, a combined treatment with 2, often 3 or even 4 bacterial antibiotics is recommended, together with passive immunotherapy, and in certain cases surgical removal of the infection foci.

A case of patient with the tuberculosis of lymph nodes and esophago-cutaneous fistula in the course of AIDS has been presented. A valve has been formed within fistula enabling to visualize a free passage only after an oral contrast administration. It is worth noting that tuberculosis frequently accompany severe course of AIDS.

Etiopathogenetic, diagnostic, and clinical problems seen in the adult patients with sepsis have been discussed. An emphasis is on the diagnostic problems in an early stage of infection as well as bacteriological findings. The authors stress that sepsis usually develops in patients with depressed immunological system.

The effect of discontinuation of injecting drug use and administration of methadone was investigated in 43 HIV-infected drug abusers. In 20 (46.5%) out to them an improvement in the immune status as measured by CD4+ lymphocyte percentage and CD4/CD8 lymphocyte ratio was observed, while remaining 23 persons (53.5%) showed stable or decreasing values of both parameters. In the control group which consisted of 23 persons who continued injecting drug use, only 3 (13%) out of the showed increase in the CD4+ lymphocyte percentage and CD4/CD8 lymphocyte ratio. It seems that discontinuation of injecting drug use may improve the function of immune system in HIV-infected drug addicts and could be an important factor in the approach for treatment of these patients.

In 1993, 80 patients (43 female and 37 male) with tick-borne encephalitis were hospitalized in Clinic of Neuroinfections and Parasitic Diseases of Medical School in Białystok. 6 (7.5%) patients were jaundiced, 16 (20%) had hepatomegaly. We noticed increased enzymatic activity of aspartate aminotransferase (x = 74.5 U/l) in 9 (11.25%) cases, alanine aminotransferase (x = 89.5 U/l) in 11 (13.75%) cases, increased level of bilirubin in blood (from 1.4 to 3.5 mg/dl) in 7 (8.75%) cases. Protein level in blood was average x = 5.95 g/dl, percentage of albumin was average x = 48.61%, globulin--x = 14.62%. Prothrombin index and ammonia blood level were in normal range. Observed pathological changes were transient and referred mainly to patients with severe clinical course of disease.

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 sequential changes in avidity of antibodies to Toxoplasmosis gondii were investigated. The values of avidity were observed to be significantly lower in serum samples drawn in early stages of infection than 3-4 months later and increasing with time of duration of the infection. A correlation was found between antibody avidity and antibody level measured in international units (IU/l), whereas, no correlation was observed between avidity, IU/l and antibody titers.

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.