Underestimation of hepatitis E virus seroprevalence in soldiers from the Polish Special Forces

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Opieka paliatywna nad chorym ze zdekompensowaną marskością wątroby

In this article a case of a patient with decompensated liver cirrhosis in whom an effective pain manage­ment was introduced with a significant reduction of pruritus intensity was submitted. Because of the liver insufficiency the care for cancer patients require a more intense monitoring regarding symptomatic treatment and sometimes causes necessity of resignation from some drugs administration. Even more caution is required during palliative treatment of patients diagnosed with decompensated liver cirrhosis. Schemes of the treatment of decompensated liver cirrhosis comprise many drugs, which are not being used in everyday clinical practice in palliative medicine. The application of these drugs in a depicted pa­tient provided a significant improvement in efficacy of symptom management. Concurrently significant contraindications appeared for the use of drugs, which could be used in patients without liver cirrhosisW artykule przedstawiono przypadek chorego z rozpoznaniem raka wątrobowokomórkowego, u którego zastosowano skuteczne leczenie bólu i objawów dekompensacji marskości wątroby. Opieka nad chorymi na nowotwory ze współistniejącą niewydolnością wątroby wymaga większego nadzoru w zakresie leczenia objawowego, przy czym niejednokrotnie konieczne jest odstawienie i modyfikacja sposobu dawkowania niektórych leków. Niezbędne jest dokładne monitorowanie chorych ze zdekompensowaną marskością wątroby, której terapia obejmuje wiele leków, często nie stosowanych u pacjentów objętych opieką paliatywną. Zastosowanie ich u opisanego chorego zapewniło skuteczne leczenie świądu skóry, encefalopatii wątrobowej, narastającego wodobrzusza i bólu. Jednocześnie stwierdzono przeciwwskazania do stosowania leków, których użycie byłoby możliwe u chorych bez marskości wątroby

The carriage of potentially pathogenic β-haemolytic streptococci (β-HS) in healthy adult inhabitants of Wielkopolska, Poland

Background . Acute pharyngitis is a common disease in primary health care patients. Beta-hemolytic streptococci (β-HS ) are a frequent etiological agent, while swab culture from the throat and palatine tonsils is the gold standard for diagnosis. Objectives. The evaluation of the prevalence of potentially pathogenic β-HS carriage in young adult inhabitants of Wielkopolska. Material and methods. The study included 205 healthy young adult (18–44 years old) (29.0 ± 6.4) inhabitants (M – 95, F – 110) of Wielkopolska (Poland). Two swabs were taken from the throat: the first one was used to perform a rapid antigenic diagnostic test (RAD T) for group A streptococci (GAS ) and the second to grow a conventional culture. If β-HS grew, isolates were serotyped according to Lancefield. In addition, simple demographic and medical data were collected from the subjects. The study was financed from funds granted within the first edition of the “Give a hand” project (Karol Marcinkowski Poznan University of Medical Sciences). Results . Positive throat cultures were obtained in 15.6% out of 205 persons (n = 32). The distribution of β-HS serogroup results was as follows: group C (GCS ) – 17 cases (53.1% of cases where β-HS was positive), group F (GFS) – 9 cases (28.1%), GAS – 3 people (9.4%) and group G (GGS ) – 3 subjects (9.4%). The growth of the discussed bacteria in cultures was moderate or high in 53% of these cases. RAD T was positive in 5 cases (but only one person had GAS in throat culture). The positive culture result was significantly more frequent in men (62.5% out of 32 cases with β-HS growth, p = 0.0460). Conclusions . 1. The possibility of β-HS carriage must be taken into account when analysing the results of throat swab cultures. 2. GAS carriage is significantly lower than non-GAS carriage. 3. GCS were the most prevalent among non-GAS. 4. Being male may predispose individuals to β-HS carriage

Hepatitis E virus IgG seroprevalence in HIV patients and blood donors, west-central Poland

Objective: To assess hepatitis E virus (HEV) seroprevalence in HIV patients and blood donors from one region in Poland. Methods: A group of 490 persons (244 HIV patients and 246 blood donors) aged 18–55 years were examined using the anti-HEV IgG assay (Wantai Biological Pharmacy Enterprise, Beijing, China). An analysis of the association between certain factors and the presence of this HEV exposure marker was conducted in both groups. Results: An HEV seropositivity rate of 50.2% was found. There was no difference in HEV seroprevalence between blood donors (49.6%, 122/246) and HIV patients (50.8%, 124/244) (p = 0.569). The anti-HEV IgG positivity rate increased with age as follows: 36.2% (59/163) in persons aged 18–30 years, 52.0% (92/177) in individuals aged 31–40 years and 63.3% (95/150) in those aged 41–55 years. HEV infection occurred in 56.4% (31/55) of people who had never travelled abroad. Conclusions: Wielkopolska Region in west-central Poland is an area hyperendemic for HEV infection. In this part of Poland, the exposure of HIV-positive persons to this virus is not greater than that of healthy blood donors

Moderate and severe pharyngitis in young adult inhabitants of Poznan, western Poland

Background. Acute pharyngitis is a frequent clinical problem. Objectives. To assess: the frequency of streptococcal etiology (β-HS ) in moderate to severe pharyngitis among young adult patients, the accuracy of the Centor score (CS ) in predicting the likelihood of the β-HS etiology and the usefulness of the rapid antigen detection test (RAD T) in the appropriate selection of patients that ought to be treated with antibiotics. Material and methods . 202 individuals (101 patients and a sex- and age-matched control group) aged 18–44 participated in the study. Two throat swabs were performed: the first one to carry out RAD T for group A streptococci (GAS ), and the second one to grow a conventional culture. Data on the antibiotic therapy were recorded as well. Results. β-HS were responsible for one-third of the studied cases of pharyngitis (GAS – 22.8%, 23/101; high non-GAS colony count – 9.9%, 10/101). The frequency of the isolation of β-HS depending upon the CS was as follows: CS 2 – 13.2% (5/36), CS 3 – 40.5% (15/36), CS 4 – 61.5% (16/36). RAD T’s effectiveness in identifying GAS was significantly higher than that of CS alone (p < 0.001). Antibiotics were prescribed in 59 cases, including 45% of RAD T-negative patients (35/77). The primary choice was penicillin (37.3%, 22/59). Conclusions . In young adult pharyngitis patients with CS 2-4, β-HS are responsible for a minority of cases. Among these bacteria, almost one third are non-GAS . Centor criteria, as the only diagnostic tool in predicting the streptococcal etiology of the disease, are of moderate usefulness. The use of RAD T significantly increases the diagnostic accuracy of GAS –related pharyngitis

Comparative Seroprevalence of Hepatitis A And E Viruses in Blood Donors from Wielkopolska Region, West-Central Poland

The objective of the present study was to investigate the seroprevalence of HAV and HEV in Polish blood donors (BDs). One hundred and ten randomly selected healthy BDs, living in Wielkopolska Region were tested for anti-HAV IgG and anti-HEV IgG with commercial assays. The seroprevalence of anti-HAV was 11.8%; anti-HEV were detected in 60.9% of BDs (p &lt; 0.0001). Consumption of risky food was more common in anti-HEV-positive BDs (59.1% vs. 33.3%; p = 0.01). Twelve out of 20 BDs (60%) with no history of travel abroad were exposed to HEV. Wielkopolska Region, Poland should be regarded as a new HEV infection-hyperendemic area in Europe

The carriage of potentially pathogenic β-haemolytic streptococci (β-HS) in healthy adult inhabitants of Wielkopolska, Poland

Background . Acute pharyngitis is a common disease in primary health care patients. Beta-hemolytic streptococci (β-HS ) are a frequent etiological agent, while swab culture from the throat and palatine tonsils is the gold standard for diagnosis. Objectives. The evaluation of the prevalence of potentially pathogenic β-HS carriage in young adult inhabitants of Wielkopolska. Material and methods. The study included 205 healthy young adult (18–44 years old) (29.0 ± 6.4) inhabitants (M – 95, F – 110) of Wielkopolska (Poland). Two swabs were taken from the throat: the first one was used to perform a rapid antigenic diagnostic test (RAD T) for group A streptococci (GAS ) and the second to grow a conventional culture. If β-HS grew, isolates were serotyped according to Lancefield. In addition, simple demographic and medical data were collected from the subjects. The study was financed from funds granted within the first edition of the “Give a hand” project (Karol Marcinkowski Poznan University of Medical Sciences). Results . Positive throat cultures were obtained in 15.6% out of 205 persons (n = 32). The distribution of β-HS serogroup results was as follows: group C (GCS ) – 17 cases (53.1% of cases where β-HS was positive), group F (GFS) – 9 cases (28.1%), GAS – 3 people (9.4%) and group G (GGS ) – 3 subjects (9.4%). The growth of the discussed bacteria in cultures was moderate or high in 53% of these cases. RAD T was positive in 5 cases (but only one person had GAS in throat culture). The positive culture result was significantly more frequent in men (62.5% out of 32 cases with β-HS growth, p = 0.0460). Conclusions . 1. The possibility of β-HS carriage must be taken into account when analysing the results of throat swab cultures. 2. GAS carriage is significantly lower than non-GAS carriage. 3. GCS were the most prevalent among non-GAS. 4. Being male may predispose individuals to β-HS carriage

Changes in Inflammatory Markers after Administration of Tocilizumab in COVID-19: A Single-Center Retrospective Study

The COVID-19 pandemic requires the development of effective methods for the treatment of severe cases. We aimed to describe clinical outcomes and changes in inflammatory markers in Polish patients treated with tocilizumab. The medical charts of SARS-CoV-2-positive patients treated in the Department of Infectious Diseases between 4 March and 2 September 2020 were retrospectively analyzed. The patients who received tocilizumab according to the Polish Association of Epidemiologists and Infectiologists guidelines were selected for the study. We identified 29 individuals who received tocilizumab, out of whom 11 (37.9%) died. The individuals who died had significantly higher maximal interleukin-6 (IL-6) and lactate dehydrogenase (LDH) serum levels than survivors. After administration of tocilizumab, further increase in LDH and IL-6 was a prognostic factor for unfavorable outcomes. Among inflammatory markers, 7-day mean of IL-6 serum concentration was the best predictor of death (cut-off: &ge;417 pg/mL; area under ROC curve = 0.81 [95% Confidence Interval: 0.63&ndash;0.98]). The serum concentrations of inflammatory markers before administration of tocilizumab did not predict the outcome, whereas IL-6 and LDH measurements after administration of tocilizumab seemed to be of predictive value