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EN
Purpose: In response to penetration by the spirochete Borrelia burgdorferi, neutrophils trigger the mechanisms of intracellular killing, including the generation of reactive oxygen and nitrogen species, e.g. superoxide anion radical and nitric oxide (NO). Overproduction of these reactive molecules leads to oxidative stress which contributes to lipid peroxidation and protein nitration. The major products of these processes include malonyldialdehyde (MDA) and nitrotyrosine, the biomarkers of NO action in the in vivo conditions. The study objective was to assess the serum levels of total nitric oxide and its biomarkers in patients with Lyme borreliosis before treatment, and to elucidate the relationship between these parameters. Materials and Methods: Clinical types of the disease were considered: early (Erythema migrans - EM) and late (Lyme arthritis - LA). The serum level of total NO was determined by using Griess’ reaction, MDA was measured by spectrophometry according to Buege and Aust, whereas nitrotyrosine by the immunoenzymatic ELISA method. Results: The study revealed significantly higher serum levels of NO, MDA and nitrotyrosine in the two study groups of patients as compared to healthy people. The analysis of the results with respect to various types of borreliosis showed significantly higher levels of malonyldialdehyde in patients with EM as compared to those with LA. Moreover, a correlation was noted between the serum levels of total NO and nitrotyrosine in the early and late type of borreliosis. Conclusions: High serum levels of total NO, MDA and nitrotyrosine observed in patients with Lyme borreliosis indicate on enhancement of lipid peroxidation and protein nitration, which in consequence may enhance the inflammatory process in patients with Lyme borreliosis.
2
Content available Neurootological manifestations of Lyme borreliosis
100%
EN
Introduction: The incidence of tick-borne diseases in Poland and Europe is increasing which is considered to be due to climate warming which promotes the growth of tick populations. Lyme borreliosis is the most prevalent leptospirosis in the US and Europe. Due to the potential for serious complications and the lack of specific prevention, diagnostic vigilance is essential so as to ensure early diagnosis and implementation of treatment. The main pathogen-transmitting vector is the tick species Ixodex ricinus. The suborder of ticks (Ixodida) belongs to the Acari subclass of arachnids. The natural reservoir of B. burgdorferi consists of small and medium-sized mammals and birds. Around ¾ of patients with Lyme disease report complaints and present disease symptoms within in the head and neck. The symptoms are diverse and may occur at all stages of the disease. These include headaches, neck pain and stiffness, sore throat, dizziness, cervical lymphadenopathy, otalgia, tinnitus, sudden hearing loss, and facial muscle paresis. Despite numerous papers being published on neurological manifestations of Lyme disease, the issues regarding the location of damage within the course of the auditory pathway and the balance system remain unanswered. In some cases hearing disorders may be due to central damage while others may be due to peripheral damage. Aim: The article provides an overview of reports on the clinical course and manifestation of Lyme borreliosis.
EN
Background. The study aimed to evaluate the scope and level of rural residents’ knowledge on the prevention of Lyme borreliosis and how this knowledge is used by residents of some selected rural areas of Lublin Province. Material and methods. A survey methodology was conducted with a sample of respondents of the Firlej and Kock communes (Lubartów County) and Borki commune (Radzyń Podlaski County). The study group involved 100 rural residents aged 18-67 years (mean 43; SD 0.14). Results. Among rural residents participating in the study, 35% are engaged in agriculture, and 61% have backyard gardens. 14% of the respondents have experienced a single tick bite, while 26% multiple bites. Out of those respondents who have experienced tick bites, only 12.5% have undergone diagnostic tests for the presence of Lyme borreliosis. The reported bite sites were found mostly in the lower limb (55%), stomach (40%), upper limb (30%), and the observed symptoms included first of all: muscle pain (50%), headache (37.5%), impaired concentration (20%), fever (17.5%), bone and joint pain (12.5%). A total of 30% farmers and rural residents consider their knowledge on the prevention of tick-borne diseases as minimal. Conclusions. It is necessary to undertake educational activities that would not only contribute to an increase in the level of knowledge of countryside residents on the prevention of tick-borne diseases but also lead to taking appropriate measures when bites occur.
PL
Wprowadzenie. Celem badań była ocena zakresu i poziomu wiedzy na temat profilaktyki boreliozy z L yme i powszechności jej stosowania wśród mieszkańców wybranych obszarów wiejskich z terenu województwa lubelskiego. Materiał i metody. Badania ankietowe przeprowadzono wśród mieszkańców gminy Firlej i Kock (powiat lubartowski) oraz gminy Borki (powiat radzyński). Grupę badaną stanowiło 100 mieszkańców obszarów wiejskich, w wieku 18-67 lat (śr. 43; SD 0,14). Wyniki. Wśród mieszkańców wsi biorących udział w badaniu 35% zajmuje się rolnictwem, a 61% posiada przydomowy ogródek. Jednokrotnego pokłucia przez kleszcze doświadczyło 14% respondentów, zaś wielokrotnego 26%. Spośród osób pokłutych przez kleszcze tylko 12,5% wykonywało badania diagnostyczne w kierunku boreliozy z L yme. Najczęściej badani informowali o ukłuciach w obrębie kończyny dolnej (55%), brzucha (40%), kończyny górnej (30%), a obserwowane objawy to bóle mięśni (50%) i bóle głowy (37,5%), osłabienie koncentracji (20%), gorączka (17,5%), bóle kostno-stawowe (12,5%). Łącznie 30% rolników i mieszkańców terenów wiejskich ocenia swoją wiedzę zakresie profilaktyki chorób odkleszczowych jako minimalną. Wnioski. Konieczne jest podjęcie działań edukacyjnych, które przyczynią się do zwiększenia poziomu wiedzy mieszkańców wsi w zakresie zasad profilaktyki chorób odkleszczowych i podejmowania odpowiednich czynności w sytuacjach, kiedy dojdzie do pokłucia przez kleszcze.
5
Content available remote Choroby odzwierzęce w okulistyce. Część III – zmiany w przebiegu boreliozy
88%
OphthaTherapy
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2020
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tom 7
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nr 2
96-102
EN
Borreliosis is a disease that was discovered in the 1970s, but its pathophysiological mechanisms and clinical course are not yet fully understood. The number of diagnosed Lyme disease cases in Poland has been increasing over the last decade. Poland has seen endemic Lyme disease, with one of the highest rates of infection in Europe. It is a zoonotic, vector-related disease that is transmitted by ticks that are infected with Borrelia burgdorferi spirochetes. One of the least known, poorly documented, and rarely recognized forms of Lyme disease is ocular borreliosis. Ocular alterations can occur in both the anterior and posterior segments of the eye, depending on the phase of the disease. In early stages when the tick bite is close to the eyeball, erythema-containing spirochetes can spread to the eyelids and conjunctiva of the eye per continuum. In the second phase when spirochetes spread throughout the whole body but have a predilection for nerve tissue, they occupy cranial nerves. This may also affect the optic nerve, less often oculomotor nerves and the retina. This phase of ocular borreliosis is associated with neuroborreliosis. In this stage, ocular borreliosis usually coexists with meningitis or encephalitis. In addition to the history and clinical picture of Lyme disease, accurate diagnoses based on commercially available serological tests are fundamentally important in Poland. This article describes three phases of Lyme disease. We explain the reasons for its clinical differences in the old and new worlds from an epidemiological perspective. The clinical picture, treatment, and prognosis of Lyme disease are discussed.
PL
Borelioza, choroba odkryta w latach 70. XX w., o nie do końca jeszcze wyjaśnionych mechanizmach patofizjologicznych i obrazie klinicznym, wzbudza powszechne zainteresowanie. Liczba rozpoznawanych przypadków boreliozy w Polsce w ciągu ostatniego dziesięciolecia rośnie. Nasz kraj jest endemiczny dla boreliozy, mamy jeden z najwyższych odsetków osób zarażonych w Europie. Borelioza to odzwierzęca choroba wektorowa przenoszona przez kleszcze, powodowana przez krętki Borrelia burgdorferi. Jedną z najmniej znanych, udokumentowanych i rzadko rozpoznawanych postaci jest borelioza oczna. Zmiany mogą powstać zarówno w przednim, jak i w tylnym odcinku oka, zależnie od fazy choroby. We wczesnej fazie, gdy ukąszenie przez kleszcza nastąpiło blisko gałki ocznej, rumień zawierający krętki może „przez ciągłość” objąć powieki lub spojówki oka. W drugiej fazie, gdy krętki rozprzestrzenią się po całym organizmie i z powodu predylekcji do tkanki nerwowej zajmują nerwy czaszkowe, może to dotyczyć także nerwu wzrokowego, rzadziej nerwów okoruchowych oraz siatkówki. Zatem borelioza oka w drugiej fazie jest rodzajem neuroboreliozy. W tej fazie zwykle przebiega z zapaleniem opon i/lub mózgu. Obok wywiadu i obrazu zmian podstawowe znaczenie w rozpoznaniu ocznej boreliozy mają dostępne komercyjnie w Polsce badania serologiczne. W artykule opisano ważny dla zrozumienia tej jednostki chorobowej fazowy przebieg boreliozy. Wyjaśniono przyczyny różnic w przebiegu klinicznym występujące w starym i nowym świecie, opisane z punktu widzenia epidemiologii. Omówiono obraz kliniczny, leczenie i rokowanie w boreliozie ocznej.
EN
Lyme borreliosis (LB) is the most common tick-borne disease in Europe and the number of cases continues to grow. The aim of the following paper was to present the epidemiological situation and standards of LB diagnosis in the two neighboring countries of Central-Eastern Europe, i.e. Poland and Ukraine. Lyme borreliosis is considered endemic both in Poland and Ukraine. In Poland, the surveillance system for LB was started in 1996, as the number of LB cases increases systematically. Presently, LB occupies a prominent place amongst occupational diseases. In Ukraine, registration of LB began in 2000, and the incidence of this disease in the country increases each year. At the same time, Ukraine does not officially recognize LB as an occupational disease, which would provide the sick with proper social guarantees. Poland has available recommendations issued by the Polish Society of Epidemiology and Infectious Diseases for diagnosis and treatment of LB. In turn, common recommendations for methods of diagnosis and treatment of LB in Ukraine are still missing. In the absence of any guidelines on laboratory diagnostics of LB in Ukraine, some serious efforts should be made to harmonize standards in the diagnosis of Lyme disease in this country, which could be based on the guidelines in force in European countries.
PL
Borelioza z Lyme (LB) jest najczęstszą chorobą przenoszoną przez kleszcze w Europie, a liczba zachorowań stale rośnie. Celem pracy było przedstawienie sytuacji epidemiologicznej oraz standardów diagnostycznych LB w dwóch sąsiadujących krajach Europy Środkowo-Wschodniej: Polsce i Ukrainie. Borelioza z Lyme uważana jest za endemiczną zarówno w Polsce jak i Ukrainie. W Polsce system nadzoru dla LB rozpoczęto w 1996 roku, a liczba rejestrowanych przypadków zachorowań systematycznie rośnie. Borelioza z Lyme zajmuje czołowe miejsce wśród rozpoznawanych w Polsce chorób zawodowych. Na Ukrainie rejestracja LB rozpoczęła się w 2000 roku, a częstość występowania tej choroby rośnie z każdym rokiem. Brakuje jednocześnie oficjalnego uznania LB jako choroby zawodowej z odpowiednimi gwarancjami socjalnymi. W Polsce dostępne są rekomendacje Polskiego Towarzystwa Epidemiologii i Chorób Zakaźnych dotyczące diagnostyki i leczenia LB. Zalecenia dotyczące metod diagnozowania i leczenia LB na Ukrainie są na dzień dzisiejszy nieobecne. W związku z brakiem rekomendacji dotyczących diagnostyki laboratoryjnej LB na Ukrainie, należy podjąć starania zmierzające do harmonizacji standardów w diagnostyce boreliozy z Lyme w tym kraju na podstawie wytycznych obowiązujących w krajach europejskich.
EN
INTRODUCTION: Lyme borreliosis (LB) is the most common tick-borne human disease. The objective of the study was to carry out preliminary evaluation of the incidence of hearing impairments in LB patients. MATERIAL AND METHODS: Audiometric tests were carried out on 66 patients with diagnosed LB (aged between 18 and 45 years). All the women and men were divided into two major groups: 1 – early, disseminated LB and 2 – late LB; among them subgroups of Lyme neuroborreliosis (LNB) were distinguished. The hearing organ was diagnosed on the basis of tonal audiometry, extended high-frequency tonal audiometry (up to 18 kHz), impedance audiometry and speech audiometry tests. RESULTS: Abnormal results of the audiometric tests were recorded in 66.7% of patients. The statistical analysis indicates a significant role of borrelial infection (p = 0.017). Most of those were in patients suffering from late stages of the disease, both in patients with LB and LNB. CONCLUSIONS: The study revealed the occurrence of hearing impairment of different degrees in more than one half of the patients with LB, especially in the late stages of the disease. The results indicate the necessity for further comprehensive studies, considering hearing and balance disorders in the course of LB, comprising larger groups of patients.
PL
WSTĘP: Borelioza z Lyme (Lyme borreliosis – LB) jest najczęstszą chorobą odkleszczową u ludzi. Celem pracy było przeprowadzenie wstępnej analizy występowania zaburzeń słuchu u chorych na LB. MATERIAŁ I METODY: Testy audiometryczne objęły 66 chorych z rozpoznaną LB, w wieku od 18 do 45 lat. Wszyscy badani (kobiety i mężczyźni) zostali podzieleni na dwie główne grupy: 1 – wczesnej, rozsianej LB i 2 – późnej LB; wśród nich zostały wyodrębnione podgrupy pacjentów z rozpoznaniem neuroboreliozy (Lyme neuroborreliosis – LNB). Diagnostykę narządu słuchu przeprowadzono na podstawie badań audiometrii tonalnej, audiometrii tonalnej rozszerzonej (o wysokiej częstotliwości do 18 kHz), audiometrii impedancyjnej i audiometrii mowy. WYNIKI: Nieprawidłowe wyniki testów audiometrycznych stwierdzono u 66,7% badanych, a analiza statystyczna wskazała na istotny związek z zakażeniem Borrelia burgdorferi (p = 0,017). Większość stanowiły osoby z późną LB, zarówno bez, jak i z LNB. WNIOSKI: Zaburzenia słuchu różnego stopnia występują u ponad połowy chorych na LB, zwłaszcza w późnych stadiach procesu chorobowego. Uzyskane wyniki wskazują na konieczność prowadzenia dalszych wszechstronnych badań uwzględniających uszkodzenie narządu słuchu i równowagi w przebiegu LB, obejmujących większe grupy chorych.
EN
A group of 180 patients with diagnosed Lyme borreliosis were examined for the presence of infection with Borrelia burgdorferi sensu lato (B. burgdorferi s.l.) by serologic tests with B. burgdorferi s.l. antigens (IgM-ELISA, IgG-ELISA, IgM-immunoblot, IgG-immunoblot) and by polymerase chain reaction (PCR, nested-PCR) for detection of B. burgdorferi s.l. DNA in peripheral blood. A total of 61.7%, 53.9%, 62.2%, and 59.4% of the examined patients’ sera showed positive or borderline results in the serologic tests IgM-ELISA, IgG-ELISA, IgM-immunoblot, and IgG immunoblot, respectively. The results of the tests IgM-ELISA and IgM-immunoblot were significantly correlated (p<0.001). A higher degree of the correlation (p<0.000001) was found at the comparison of results obtained with IgG-ELISA and IgG-immunoblot. The correlation between the positive findings in the IgM-ELISA and detection with IgM-immunoblot the diagnostically important B. burgdorferi s.l. OspC surface protein was relatively low but statistically significant (0.01B. burgdorferi s.l. antigen, the VlsE protein (p<0.000001). The presence of B. burgdorferi s.l. DNA was found by PCR in 20 out 180 examined blood samples (11.1%). No correlation was found to exist between the PCR results and the results of any of the serologic tests for detection of anti B. burgdorferi s.l. antibodies of IgM class. PCR results correlated significantly at a relatively low level (0.01Borrelia burgdorferi sensu lato.
EN
The results of a longitudinal epidemiological survey in two contrasting habitats in an area of the Mazury Lakes district of Poland indicate that both host and vector (Ixodes ricinus) densities, may be the most important risk factors for the tick-transmitted spirochetes of Borrelia burgdirferi s.l. However, the results also highlight that even related host species, such as the wild rodents Apodemus flavicollis and Clethrionomys glareolus that share the same habitat, can show quite different dynamics of tick infestation. We provide evidence that the woodland populations of A. flavicollis and C. glareolus are more frequently infested with larvae than nymphs, and more frequently with both stages than M. arvalis in the neighbouring open fallow lands. The prevalence of infestation with larvae varied from 92% for A. flavicollis, and 76% for C. glareolus to 37% for M. arvalis. Other factors, such as population age structure and sex, were also shown to impact on tick densities on hosts at particular times of the year and hence on the zoonotic risk. Moreover, particular species of rodents from different habitats, A. flavicollis (woodlands) and Microtus arvalis (fallow lands) carry infected immature I. ricinus ticks more frequently than C. glareolus voles (woodlands). Thus, the relative contribution of each species to the cumulative reservoir competence differs among species living in the woodland habitats and in relation to voles living in the fallow lands. It follows, therefore, that any factor which reduces the relative density of A. flavicollis in comparison to other hosts in the wild rodent community, will reduce also the risk of human exposure to Lyme borreliosis spirochetes.
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tom 44
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nr 1
EN
The aim of these studies was to attempt to infect dogs by their inoculation with cultured Borrelia burgdorferi isolated from ticks in Poland and to use PCR and N-PCR to evaluate the spread of infection. Polish strain 236/2 of B. burgdorferi isolated from Ixodes ricinus and cultured in BSK-H medium (passage 4 and 5) was used for dog inoculation. Throughout the experimental trial all dogs, including the control, remained healthy. None of them became hyperthermic nor demonstrated clinical signs of the disease, but seroconversion was observed. During our experiments it was demonstrated that the culture of spirochete in BSK-H medium is time consuming, does not always yield spirochetes and requires up to 4 weeks growth time. Application of PCR and N-PCR confirmed the replication of B. burgdorferi in infected dogs. Spirochetes were demonstrated almost in all internal organs of challenged animals as well as in skin, muscles, adipose tissue, joints and urine. Results of our studies indicated, that PCR and N-PCR can be used for detection of B. burgdorferi both in infected BSK-H medium or internal organs of challenged dogs. The high sensitivity and specificity of both tests enable tchem to be used for laboratory diagnosis of dog borreliosis and for monitoring of the spread of infection within the animal.
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tom 44
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nr 1
EN
The elaboration of optimal parameters for PCR and Nested-PCR for the detection of Borrelia burgdorferi in dogs was the aim of the studies. Two sets of primers were designed on the base of the highly conserved flagellin-encoding gene of B. burgdorferi. Amplification of 437 bp and 144 bp fragments of flagellin gene was confirmed in 9 reference BSK-H cultured strains tested, including Polish isolate 236/2. The replication of strain 236/2 of B. burgdorferi in Vero cells was also confirmed by PCR. The application of both PCR and N-PCR for examination of 51 sera collected from dogs with clinical signs indicating natural infection with B. burgdorferi enabled detection of spirochetes in 14 samples. Results of our studies confirmed the high sensitivity and specificity of elaborated PCR and N-PCR which can be used to detect B. burgdorferi sensu lato strains both in inoculated BSK-H medium and Vero cells as well as in serum samples of naturally infected dogs.
EN
The effect of urbanisation on parasite prevalence, especially these associated with human diseases, such as Lyme borreliosis, is of high interest. The blackbird Turdus merula is a ground-feeding species particularly predisposed to constitute a Borreliella spp. (Lyme borreliosis causative agent) reservoir. So, the aim of the study was to examine if the tick infestation level and their Borreliella spp. infection prevalence differs in blackbirds resident in two disparate habitats in Poland – one highly urbanized (in Warsaw agglomeration) and the other forested (in Mazurian Lake region). The infection in ticks feeding on blackbirds was ascertained based on detection of bacterium DNA (PCR). The prevalence of tick infestation in urban and forest-living blackbirds was similar (90 and 91.7%, respectively) but the mean number of parasites per bird was markedly greater in the forest (4.0 ind.) than in the urban populations (1.5 ind.). Even though, the Borreliella spp. infection of the ticks was significantly greater in the urban (46.7%) than in forest habitat (35.4%). Additionally, in the urban site more birds carry at least one infected tick than in the forest. The results of the study seem to confirm the role of blackbirds in establishing Borreliella spp. reservoir. Special regard should be given to highly urbanized areas, where the relative increase in the relevance of birds as tick hosts and pathogen transmitters may pose high risk to public health. Thus, the study constitutes a small-scale but an important contribution to our understanding of the role of birds in maintenance of Borreliella spp. foci in urban habitats.
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