Clostridium difficile infection in Polish pediatric outpatients with inflammatory bowel disease

The prevalence of Clostridium difficile infection (CDI) in pediatric patients with inflammatory bowel disease (IBD) is still not sufficiently recognized. We assessed the prevalence of CDI and recurrences in outpatients with IBD. In addition, the influence of IBD therapy on CDI and antimicrobial susceptibility of the potentially causative C. difficile strains was assessed. This was a prospective, single-center, observational study. All specimens were obtained between January 2005 and January 2007 from the IBD outpatient service and screened for C. difficile and its toxins. C. difficile isolates were genotyped by PCR ribotyping. Diagnosis of Crohn’s disease (CD) and ulcerative colitis (UC) was based on Porto criteria. Severity of disease was assessed using the Hyams scale (for Crohn’s disease) and the Truelove–Witts scale (for ulcerative colitis). One hundred and forty-three fecal samples from 58 pediatric IBD patients (21 with Crohn’s disease and 37 with ulcerative colitis) were screened. The risk of C. difficile infection was 60% and was independent of disease type (CD or UC) (χ2 = 2.5821, df = 3, p = 0.4606). About 17% of pediatric IBD patients experienced a recurrence of CDI. All C. difficile strains were susceptible to metronidazole, vancomycin and rifampin. A high prevalence of C. difficile infection and recurrences in pediatric outpatients with IBD was observed, independent of disease type. There was no significant correlation between C. difficile infection and IBD therapy. PCR ribotyping revealed C. difficile re-infection and relapses during episodes of IBD in pediatric outpatients

Functionality of the connections of forest roads with public and other internal roads

The forestry communication system is included in larger transport areas through forest roads connections mainly with public roads, but also with internal ones. The possibility of realization of these connections and defining their technical parameters is very important, as it concerns the cooperation of various property owners as well as interference of the State Forest units into other land (road lane). The aim of the research was to analyse the exits, i.e. connections of forest roads with public or other internal roads, necessary to ensure the functioning of the communication system of the forest district. We investigated existing as well as the planned to be built exits. The research was carried out based on the developed information sheet regarding the scale and scope of issues related to the operation of the exits. We received back 412 information sheets and analysed the data according to the category of the road and the regional directorates of the State Forests (RDSFs). The total number of functioning exits the State Forests equals 108,239. The exits number varies from 2505 in RDSF Piła to 12,341 in RDSF Olsztyn and depends on the number of forest districts and their area, which is confirmed by the high number of exits in RDSF Bialystok, Szczecin and Wroclaw (tab. 1). The highest number of exits (53,455) was found for junctions with commune roads, and then district roads (31,190). A large number of exits (8111) was recorded for roads that do not have the status of a public road. More than a half of the surveyed forest districts (262) demonstrated the need to build 9072 new exits from various road categories, indicating primarily exits from communal roads and district roads (tab. 2). No need of building the exits to national roads was exhibited by 320 forest districts, and by 253 units for regional, 183 for district and 211 for communal roads

31 Brachyterapia HDR w leczeniu paliatywnym raka oskrzela i tchawicy

WstępW paliatywnym leczeniu raka oskrzela i tchawicy jedną z metod skutecznych w zwalczaniu duszności, krwioplucia i innych dolegliwości jest brachyterapia. Metoda ta umożliwia podanie wysokiej dawki na okolicę guza z jednoczesnym ograniczeniem dawki w tkankach narządów krytycznych. W pracy omówiono wyniki brachyterapii HDR chorych na zaawansowanego raka oskrzela i tchawicy.Materiał i metodyW okresie od maja 1999 do marca 2000 r. leczono w Wielkopolskim Centrum Onkologii 49 chorych na raka oskrzela i tchawicy. Zastosowano dawkę 3 × 7,5 Gy lub 1–3 × 10 Gy liczoną w odległosci 1 cm od osi aplikatora. Stosowano źródło Irydu 192, wykorzystując aparat GAMMAMED 12i. Wszyscy chorzy nie zostali zakwalifikowani do zabiegu oraz radykalnej radioterapii ze wzglęidu na zaawansowanie choroby. Chorych poddano obserwacji klinicznej oraz bronchoskopowej, oceniając remisję miejscową oraz ustępowanie duszności, kaszlu oraz cech niedodmy w obrazie rtg. Średni okres obserwacji wynosił 6 miesięcy.WynikiCałkowitą remisję guza potwierdzoną w bronchoskopii oraz badaniach radiologicznych stwierdzono u 4 chorych (8,2%), częściową remisję u 38 chorych (77,6%), brak remisji – u 7 chorych (14,3%). U 5 chorych w okresie 6 miesięcznej obserwacji zaobserwowano całkowite ustąpienie dolegliwości oraz zmian w obrazie bronchoskopowym (CR), u 26 – częściową poprawę. u 18 – chorych stabilizację choroby lub progresję. 4 chorych zmarło w tym okresie. Poza powierzchowną martwicą błony śluzowej stwierdzoną u 9 chorych nie stwierdzono innych powikłań po leczeniu.WnioskiPaliatywna brachyterapia HDR jest dobrze tolerowaną oraz efektywną metodą leczenia chorych z obturacją dróg oddechowych wywołaną guzem nowotworowym

Matrix metalloproteinases in urinary system tumors. Part II - Matrix metalloproteinases in urinary bladder carcinoma

Matrix metalloproteinases (MMPs), also referred to as matrixines, provide a group of proteolytic enzymes. They belong to the family of endopeptidases that break down elements of the extracellular matrix, resulting in its continuous remodeling. Their activity is regulated at multiple levels, while tissue inhibitors of metalloproteinases play a major role in this process. Metalloproteinases play a significant part in neoplastic processes due to their contribution to local tumor invasion, the formation of distant metastases, as well as to angiogenesis Urinary tract tumors pose a significant diagnostic and therapeutic challenge and their incidence tends to grow every year. The aim of this second part of the review is to describe the urinary system structure and function, and to highlight the contribution of matrix metalloproteinases to the development of urinary bladder tumor

Matrix metalloproteinases in urinary system tumours. Part I - Matrix metalloproteinases in renal cell carcinoma

Extracellular matrix metalloproteinases - MMPs, also referred to as matrixines, provide a group of proteolytic enzymes. They belong to the family of endopeptidases that break down elements of extracellular matrix, resulting in its continuous remodelling. Their activity is regulated at multiple levels, while tissue inhibitors of metalloproteinases play a major role in this process. Metalloproteinases play a significant part in neoplastic processes due to their contribution to local tumour invasion and formation of distant metastases, as well as to angiogenesis Urinary tract tumours pose a significant diagnostic and therapeutic challenge and their incidence tends to grow every year. The aim of this part of review is to describe extracellular matrix and matrix metalloproteinases and to highlight the contribution of matrix metalloproteinases in the development of renal clear cell carcinoma

Matrix metalloproteinases in urinary system tumors. Part II - Matrix metalloproteinases in urinary bladder carcinoma

Matrix metalloproteinases (MMPs), also referred to as matrixines, provide a group of proteolytic enzymes. They belong to the family of endopeptidases that break down elements of the extracellular matrix, resulting in its continuous remodeling. Their activity is regulated at multiple levels, while tissue inhibitors of metalloproteinases play a major role in this process. Metalloproteinases play a significant part in neoplastic processes due to their contribution to local tumor invasion, the formation of distant metastases, as well as to angiogenesis Urinary tract tumors pose a significant diagnostic and therapeutic challenge and their incidence tends to grow every year. The aim of this second part of the review is to describe the urinary system structure and function, and to highlight the contribution of matrix metalloproteinases to the development of urinary bladder tumor

87. High dose rate endobronchial brachytherapy in the management of advanced bronchial cancer – comparison of different doses

IntroductionIn palliative treatment of lung cancer one of most efficient methods in overcoming difficulties in breathing caused by endobronchial obstruction is brachytherapy. From regard on location of the change on some of the patients brachytherapy is a treatment from choice. Brachytherapy in single cases is performed as radical treatment, in most of cases due to advanced clinical stage has an palliative aim. Because of lack of clear consensus regarding value of doses used in brachytherapy there are different fraction doses used in clinical treatment. The work is about result (t of palliative treatment with high dose rate brachytherapy using different treatment schemas.Material and methodsFrom May 1999 to February 2000 in Greatpoland Cancer Centre were treated 69 patients on bronchial cancer using high dose rate brachytherapy. They were disqualified from radical treatment due to advanced clinical stage. The age of the patients ranged from 39 to 76 years, average 53,2 years. 51 patients received total dose of 22,5 Gy in 3 fractions every week, 18 patients received one single fraction of 10 Gy. Patients were divided into two groups according to clinical stage and Karnofsky scare for single fraction patients were qualified when Karnofsky scare was smaller then 50. They have undertaken clinical and endobronchial observation with rating of local remission and retiring difficulties with breathing, cough and hemoptysis in thirst, third, sixth and twelve month of observation.ResultsAfter 4 weeks from the end of the treatment in 61/69 (88,4%) patients has been ascertained subjective improvement (retiring of all symptoms). In 12 cases was found out complete remission (CR), in 49 partial remission (PR) of tumour. During one year of observation 45 patients died, in 10/24 cases we observed still an improvement of dyspnoea, in 14/24 cases we observed recurrence and progression of disease. There was no statistical difference in survival between two groups of patients treated with different schema.Conclusions1.Brachytherapy in advanced lung cancer was an efficient method that caused in many patients retiring of the symptoms and improvement of life quality.2.Both treatment schema had similar efficiency in overcoming difficult breathing.3.High local dose did not influenced the growth of the frequency of complications