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EN
Left ventricular assist device (LVAD) is one of the modern management therapies in patients with advanced heart failure, and it serves as a bridge to heart transplantation or even as destination therapy. However, it is burdened with a high risk of thromboembolic, hemorrhagic, and infectious complications despite prophylactic management. Splenic abscesses, as septic complications following implantation of mechanical ventricular support, have not yet been described in the literature. We report of a patient with severe left ventricular insufficiency (NYHA II/III), pulmonary hypertension, and arrhythmia who underwent implantation of the Heart Ware® pump for left ventricular support with simultaneous tricuspidvalvoplasty, as a bridge therapy to heart transplantation. During two years after LVAD implantation, the patient had three MRSA skin infections, localized at the exit site of the drive-line connecting the artificial ventricle with external unit, that were complicated by sepsis and treated with broad-spectrum antibiotics. A few months later, abdominal CT revealed two abscesses in the spleen, and the patient was qualified for splenectomy. Open splenectomy was performed under full-dose anticoagulant therapy with continuous intravenous infusions of unfractionated heparin (UFH). The intra- and postoperative course was uneventful. UFH therapy was continued for 6 days, and oral anticoagulation was re-administered on day 4 after surgery. The patient was discharged on day 7 after surgery with primary healed wound. Open splenectomy, performed with full-dose anticoagulant therapy, proved to be an effective and definitive method of treatment without any complications.
EN
Interferons (IFNs) are pivotal regulators of immunological processes. This paper describes mainly type I interferons -α and -β and their recently recounted signaling pathways, especially connected with ISGs - interferon stimulated genes, having a crucial role in regulating IFN recruitment. Moreover, the paper shows the data on the role of interferons -α and -β in infections - not only commonly known viral infections, but also bacterial, fungal and parasitic.
3
Content available remote Immunoinflammatory responses in gastrointestinal tract injury and recovery
100%
EN
Inflammation is a non-specific immune response to infection, irritation or other injury, the key features being redness, warmth, swelling and pain. A number of mediators are released which alter the resistance of mucosa to injury induced by noxious substances. Oxidative stress is a unifying mechanism of injury in many types of disease processes, including gastrointestinal diseases. It has been defined as an imbalance in the activity of pro and antioxidants. Pro-oxidants favour free radical formation while antioxidants inhibit or retard the same. A number of markers of oxidative stress have been identified. This review provides an overview of various mediators of inflammation and oxidative stress, and diverse approaches for prevention and treatment of gastrointestinal inflammation.
4
Content available remote Treatment of Vascular Prosthesis Infections - 15 Years of Experience
100%
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2010
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tom 82
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nr 3
130-139
EN
The aim of the study was to present the results of treatment for vascular prosthesis infections.Material and methods. From January 1993 until January 2008, 47 patients were treated at Department of General and Vascular Surgery Bródnowski Hospital due to symptomatic, late vascular graft infections. The most common local symptoms were groin abscesses, often with bleeding complications. All patients with diagnosed vascular prosthesis infections were treated operatively.Results. Fifty-three operations were performed, resulting in the regression of infection symptoms in 17 cases (63%), with 37% of cases leading to amputation. Mortality in the patients examined amounted to 37%; 46.4% of cases displayed recurrent infection. The period of hospital treatment oscillated between 12 to 221 days (av. 74 days).Conclusions. 1. Aggressive operative treatment of vascular prosthesis infections is burdened by high percentages of recurrence and amputation. 2. Less radical operative treatment techniques yield similar results. 3. A uniform protocol for diagnosed vascular prosthesis infection is currently lacking.
EN
Safe water is still a major problem for travellers in many countries worldwide. In the last decade several new technical developments were made and more data exist about traditional procedures to produce safe water. This update includes such data with special regard to UV-C and held devices and SODIS.
EN
Purpose: Central line care bundle comprises a few evidence-based interventions for improving patients' outcomes and recovery process. This semi-experimental study aimed to determine the effect of pediatric central line care bundle implementation on central line-associated bloodstream infections (CLABSI) rates. Materials and methods: A central line care bundle was implemented for pediatric surgery patients (n=70). Baseline observations were made to determine the central line care bundle compliance of healthcare professionals for 435 catheter days. Subsequently, physicians and nurses were educated about the central line care bundle. After the implementation period, 722 catheter days were observed to determine post-implementation compliance. Baseline CLABSI rates were compared with post-implementation CLABSI rates. Results: It was found that the entire central line care bundle compliance was 32.4% pre-implementation and 86.3% post-implementation. After education, the physicians' and nurses' central line care bundle compliance showed statistically significant improvement (p= 0.0001). There were five CLABSI events in the pre-implementation period and three CLABSI events in the post-implementation period. It was determined that the number of CLABSI decreased in the post-implementation period compared to the pre-implementation period, but this difference was not statistically significant (p= 0.207). Conclusions: Central line care bundle implementation decreased the CLABSI rates. It is recommended the Implementation of a central line care bundle on the care of pediatric surgery patients with the central venous catheter.
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2009
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tom 81
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nr 4
165-171
EN
Vascular prosthesis infection in aorto-femoral position presents a life-threatening complication. Two operative modalities are utilized in the authors center: own superficial femoral veins (SFVR) and silver salts bonded anatomic reconstruction (AgR).The aim of the study was comparison of the two treatment methods in terms of early and distant clinical resultsMaterial and methods. 35 patients were qualified for infected aorto-femoral graft removal. In years 2000-2004 SFVR was conducted in 19 patients and in years 2005-2007 16 patients had AgR done. These groups were compared in terms of demographic, co-morbidity, vascular reconstructions history, infection symptoms and bacterial contamination. Then treatment results analysis was performed including: operation course, mortality, postoperative morbidity, amputation rate and further observation results.Results. There were no differences in demographic and co-morbidity between the groups. First operation/clinical symptoms onset interval was significantly longer for AgR patients (8 vs 3.3 years, p=0.001). Purulent inguinal sinus was dominating infection manifestation in both groups. Swab results were similar for both groups (Gram+ species dominated in both). Analysis of course and results of operative treatment revealed that AgR operation time was shorter than SFVR (195 vs 317, p<0.001), intraoperative blood requirement was also lower for AgPR (1.6 vs 3.1, p<0.05). Postoperative death, postoperative bleeding, reinterventions and amputation rate were higher for SFVR than AgR, however differences were not significant. During follow-up no infection recurrence was observed.Conclusions. We believe that AgPR is superior comparing with SFVR for patients with infected vascular prosthesis in the aorto-femoral prosthesis. Further investigations are mandatory to confirm our results.
EN
Permeability of the intestine to ⁵¹Cr-EDTA administered intragastrically was assessed in mice infected with Trichinella spiralis, in gerbils infected with Trichostrongylus colubriformis and in rabbits infected with Obeliscoides cuniculi. The results showed that, compared with the worm-free control animals, there was a significant increase in the recovery of ⁵¹Cr-EDTA in the urine five hours after the administration of the ⁵¹Cr-EDTA in all infected animals, about six times more in mice, ten times more in gerbils, and five times more in rabbits. Increased gut permeability appeared to be associated with changes in the mucosal surface of the gut, directly related to the action of the worms on the epithelium.
EN
On the basis of the faecal examination and necropsies, prevalence of infection, number of species and egg counts (EPG) were estimated. A comparison of EPG of ewes and their lambs showed, that of the group of lambs with the lowest EPG, 25% were from resistant mothers while in the group with the highest EPG - 31.25%
EN
The effect was studied of the M. expansa homogenate administered with Freund’s complete adjuvant and Propionibacterium granulosum - on the humoral response of lambs spontaneously infected with Moniezia sp. Statistically significant increase in precipitating, complement fixing and haemagglutinating antibodies was observed in lambs immunized with homogenate injected with Freund’s adjuvant. Limitation of prevalence of infection observed in immunized animals was not statistically significant.
EN
Five sheep were experimentally infected with bovine immunodeficiency virus (BIV). All animals seroconverted to BIV p26 core protein by 6 weeks after inoculation and developed persistent lymphocytosis. Proviral DNA has been continually detected only in one sheep and temporarily present in other two animals. All attempts to rescue the BIV from peripheral blood leukocytes of uninfected sheep have failed during experiment. The established model of bovine lentivirus infection in sheep provides valuable data to examine the pathogenesis of BIV and related retroviral infections.
17
Content available Health Risks Related to Tattoo Procedure
88%
EN
Nowadays, tattoos have become a very common form of body decoration. However, they carry a risk of numerous complications – ranging from allergies to cancer. The study was divided into two parts. Adult persons, 156 men and 149 women, with one or more tattoos, participated in the first part of study. Anonymous respondents filled in the authorial questionnaire consisting of 14 questions and posted on the Internet. The second part of the study concerned of tattoo salons (n=38) employees. The aim of the study was to examine the awareness of people who are tattooing the body about the possible risks associated with such intervention, as well as the ability to obtain information from tattoo artists and analyze client cards in terms of the most important information about tattooing. The second part of the study was devoted to the analysis of the tattoo consent forms. Most tattoo salons clients claimed that they signed a tattoo consent and were informed about contraindications and possible complications. However, only in very rare cases allergic tests were reported. There were few cases of complications among the respondents. There is a need to educate both the clients of tattoo salons and tattooists themselves. Attention should be paid to the necessity of filling in the informed consent.
EN
Pediatric rhinosinusitis in children is defined as a presence of two or more symptoms with one of them either being nasal blockage or nasal discharge and headache/facial pain or cough. Chronic rhinosinusitis (CRS) is recognized when the four most common symptoms such as cough, rhinorrhea, nasal congestion and post-nasal drip with a slightly higher predominance of chronic cough are present for over 12 weeks and influence the quality of life. CRS should be considered in respect of unique conditions due to the differences in predisposing factors (immunological and others) as well as the anatomy of the sinuses between children and adults. Adenoids are a prominent contributor to CRS in young children, both from bacteriologic and immunologic status. Older children suffer from CRS in the same manner as adults. During evaluation of a child with CRS symptoms , one should always consider the possibility of an underlying disease as a contributing factor. Diseases impacting sinuses and nasal function include CF, primary ciliary dyskinesia (PCD) and a variety of normal immune deficiencies, including the still-developing immature immunity of healthy young children. Surgical intervention for rhinosinusitis is usually considered for patients with CRS who have failed maximal pharmacological treatment. There are two important consensus statements for pediatric chronic sinusitis (CRS): European Position papers on Rhinosinusitis and Nasal Polyps - EPOS 2012 and Clinical Consensus Statement: Pediatric Chronic Sinusitis American Academy Otolaryngology-Head Neck Surgery 2014. Both of them contain necessary information and recommendations for diagnosis and treatment of CRS in children.
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