Wspolczesne zagadnienia z zakresu epidemiologii i patologii klinicznej tradu

Contemporary problems have been presented, related to pathogenesis, clinical pathology and epidemiology of leprosy. It has been stressed that intensity of cell mediated immune response in the patient determines not only resistance or susceptibility to infection with Mycobacterium leprae but also defines traits of clinical pathology in leprosy, thus providing the basis for modern clinical classification. Present aims and investigative methods in lepra epidemiology have been shown. Current data have been provided on spread of leprosy in various parts of the world, mainly those remaining under monitoring by the World Health Organization. The data point to significant decrease in registered leprosy cases in the regions beginning from 1986 and, in particular, in years 1990- 1994. The decrease has resulted from adequate verification of the disease stage in the patients and from applying the recommended multidrug therapy. The needs and perspectives of actions aiming at combatting leprosy have been described, aiming at eradication of leprosy as the international health problem till the year 2000. It has been stressed that at present, leprosy is no longer a hopeless disease and that it can be cured when sufficiently early diagnosed and properly treated

New problems of the clinic of trichinellosis

Selected clinical problems have been discussed in the light of new data on pathogenesis. This has been illustrated by own observations in trichinellosis patients. Value of nail fald capillaroscopy in estimation of spread and intensity of capillary lesions in trichinellosis has been discussed. Changes in eosinophilia have been presented in patients treated with anthelmintics or corticosteroids at the acute stage of symptoms (3rd week). Pathophysiology of gastrointestinal phase of invasion has been discussed and pathomorphology of small intestine biopsies has been presented as observed in trichinellosis patients with diarrhoea. Attention has been drawn to atypical course of trichinellosis, noted with increasing frequency, particularly in persons infected with sylvatic strain of Trichinella spiralis. It is worth stressing that in patients exhibiting an atypical, clinical pattern of trfchinellosis accompanied by low blood eosinophilia, treatment with anthelmintics and corticosteroids is started as a rule with a delay, thus promoting a very intense Trichinella invasion and unfavourable outcome