Tolerancja immunologiczna u pacjenta z autosomalnym dominującym zwyrodnieniem wielotorbielowatym nerek po transplantacji nerki

Mimo dużego postępu w zakresie leczenia immunosupresyjnego pacjentów po transplantacji narządów unaczynionych i zmniejszeniu odsetka epizodów ostrego odrzucania nie uzyskano poprawy odległych wyników przeżycia przeszczepionego narządu ani jego biorcy. W poszukiwaniu nowych rozwiązań terapeutycznych podejmuje się próby wywołania w organizmie biorcy stanu tolerancji wybiórczej dla antygenów narządu przeszczepionego. W niniejszej pracy opisano przypadek pacjenta z autosomalnie dominującą postacią zwyrodnienia wielotorbielowatego nerek (ADPKD, autosomal dominant polycystic disease), u którego z powodu ciężkich powikłań septycznych, które wystąpiły krótko po transplantacji, odstawiono leczenie immunosupresyjne i nie zaobserwowano ostrego odrzucania przeszczepionej nerki. Zanalizowano możliwe mechanizmy wywołania tolerancji immunologicznej w opisywanym przypadku. Forum Nefrologiczne 2010, tom 3, nr 3, 174-17

Association between HLA-DQA1, HLA-DQB1 alleles and risk of early pregnancy loss

The aim: The aim of the study is to identify HLA-DQA1, HLA-DQB1 allele and to assess the risk of early pregnancy loss of women, couples with reproductive failure in the first trimester of pregnancy in comparison with fertile women, couples. The study group (B) enrolled 61 couples with reproductive failure and the control group (C) enrolled 20 fertile couples with at least 2 children. Method: HLA-DQA1 gene typing was performed using PCR-sequence-specific primer (SSP) on the high resolution level according to established procedure of labeling and using the detection kit (FASTYPETM DQASSP Typing, FASTYPETM DQA „High Resolution” Typing Sheet) purchased from Bio-Synthesis (USA). Results: In female patient the highest risk quotient was associated with alleles HLA-DQA 01101/0105 OR 7,19 (95% CI 1,18-5,23; p=0,03) and HLA-DQB5 OR 3,67 (95% CI =1,11-12,0; p=0,037). The lowest but statistically significant risk of pregnancy failure in this group was related to allele HLA-DQB6 OR 0,48 (95% CI=0,22-1,04; p=0,087). In patient and control couples the significantly increased risk of pregnancy failure was related to the frequency of HLA-DQB5 allele OR 2,3 (95% CI 1,09-4,82; p=0,035) . The lowest risk quotient in the patient couples was associated with HLA-DQ 0302/0303 allele OR 0,44 (95% CI 0,14-1,36; p=ns). Conclusion: HLA-DQA and HLA-DQB allele might influence pregnancy outcome in the Polish population, but further studies are necessary in this regard

Vaccination against influenza among medical students of selected Medical Universities in Poland in the 2014/2015 influenza season

Vaccinations against influenza are one of the most beneficial elements of prevention. Adoption of measures to popularize vaccination among reluctant to be vaccinated against influenza Polish population, especially in the environment of future doctors should be one of the priorities in the universities. The article analyzes the level of basic knowledge, opinions and declared behaviors related to influenza and its prevention among medical students of selected Medical University in Poland. The study included 1,031 individuals during the 2014/2015 epidemic. It represented a diverse population of sex, age, place of residence. For the purpose of the research an original questionnaire was used. The results were subjected to statistical analysis, which reveals that only 76 individuals got inoculated against influenza, which accounted for only 7.37% of the study population of students studying in various academic centers in Poland. Analysis of own research shows that regularly over the last five influenza seasons only 70 individuals (6.79%) have got inoculated, while the vast majority – 72.45% of the population did not get inoculated at all, and 20.75% occasionally declared inoculation against the influenza. Despite seasonal influenza epidemics, undertaken educational and preventive tests among vulnerable group rather a pessimistic picture emerges of the Polish population

Antibacterial activity of rosemary, caraway and fennel essential oils

Introduction: Recently, interest in essential oils used in natural medicine, has been increasing. Essential oils are still being tested for their potential uses as an alternative remedies for the treatment of many infectious diseases

Epidemiological Analysis of Extended-Spectrum β-Lactamase-Producing <i>Klebsiella pneumoniae</i> Outbreak in a Neonatal Clinic in Poland

Klebsiella pneumoniae is one of the most common etiological agents isolated from epidemic outbreaks in neonatal wards. We describe how an extended-spectrum β-lactamase-producing K. pneumoniae (ESBL-KP) outbreak in a neonatal ward was extinguished. During the outbreak, which lasted over two months, 26 neonates were tested for K. pneumoniae, and 42 environmental swabs were taken. Drug susceptibility was determined for the isolated strains, and their virulence and phylogenetic similarity were checked. ESBL-KP colonization was confirmed in 18 neonates, and six were also confirmed to be infected. All strains isolated from patients represented one clonal type, K. pneumoniae. One strain isolated from an environmental source was determined to be a unique pulsed-field gel electrophoresis pattern. Gestational age and Apgar score were assessed as statistically significant for neonates with ESBL-KP infection. The epidemiological measures taken have been successful, and no further cases appeared. Immediate tightening of hospital hygiene rules, screening of all hospitalized neonates, and cohorting ESBL-KP-positive patients proved effective in controlling and ending the outbreak. The lack of ESBL-KP in the environment suggests that the outbreak was transmitted by colonized hospital staff. This theory could be confirmed by introducing mandatory screening for medical personnel

Lactobacillus rhamnosus administration causes sepsis in a cardiosurgical patient : is the time right to revise probiotic safety guidelines?

A 24-year-old female patient developed sepsis resulting from preoperative administration of probiotics following an aortic valve replacement. Blood cultures revealed the causative agent to be the probiotic Lactobacillus rhamnosus, which has recently been implicated as an emerging aetiology of infection in those taking probiotics. In the past few years, probiotic use in hospitals has increased greatly. However, there is growing global evidence that the use of probiotics in patients with organ failure, immunocompromised status and dysfunctional gut barrier mechanisms can cause infections. This and other reports show the importance of establishing generally recognized safety guidelines

Evaluation of Chemical Changes in Laboratory-Induced Colistin-Resistant Klebsiella pneumoniae

This study evaluates the electrical potential and chemical alterations in laboratory-induced colistin-resistant Klebsiella pneumoniae, as compared to the susceptible strain using spectroscopic analyses. The minimal inhibitory concentration (MIC) of colistin, ζ-potential and chemical composition analysis of K. pneumoniae strains are determined. The results obtained for the K. pneumoniaeCol-R with induced high-level colistin resistance (MIC = 16.0 ± 0.0 mg/L) are compared with the K. pneumoniaeCol-S strain susceptible to colistin (MIC = 0.25 ± 0.0 mg/L). Fourier transform infrared (FTIR) and Raman spectroscopic studies revealed differences in bacterial cell wall structures and lipopolysaccharide (LPS) of K. pneumoniaeCol-R and K. pneumoniaeCol-S strains. In the beginning, we assumed that the obtained results could relate to a negative charge of the bacterial surface and different electrostatic interactions with cationic antibiotic molecules, reducing the affinity of colistin and leading to its lower penetration into K. pneumoniaeCol-R cell. However, no significant differences in the ζ-potential between the K. pneumoniaeCol-R and K. pneumoniaeCol-S strains are noticed. In conclusion, this mechanism is most probably associated with recognisable changes in the chemical composition of the K. pneumoniaeCol-R cell wall (especially in LPS) when compared to the susceptible strain