[Efficacy of low-dose albendazole therapy in hydatic liver disease: a case report]. / Skutecznosc terapeutyczna malych dawek albendazolu w bablowicy watroby--opis przypadku.

Hydatid liver disease is the most common form of human echinococcosis in Poland. Epidemiological data show a rising number of cases recognised last years. It is probably because of easier availability of ultrasound examination and computed tomography in the diagnostic procedures. While surgery remains the only approach for a radical cure, the chemotherapy with albendazole has became a useful advance in the management of cystic echinococcosis for the problem patient (inoperable disease, widely disseminated cysts, high surgical risk, etc.). The authors describe a patient with hydatid liver disease successfully treated with albendazole as a alternative treatment to surgery. A cyclic treatment of 28 days with 2 week break in between for 9 months with low doses of albendazole (6 mg/kg) resulted in clinical improvement and involution of hepatic cysts.

[Echinococcus granulosus and Echinococcus multilocularis invasions in north-eastern Poland]. / Inwazje echinococcus granulosus i Echinococcus multilocularis w pólnocno-wschodniej Polsce.

During the last 10 years 70 cases of echinococcosis were diagnosed in the Department of Infectious Diseases, Medical University School of Bialystok, of whom 63 were Echinococcus (E.) granulosus infections. The Urban population (70%) and women (60%) dominated among infected persons. Seven cases were due to E. multilocularis infection. A family and endemie focus of E. multilocularis human invasion has been identified.

Adverse reactions to tick-borne encephalitis vaccine: FSME-Immun.

Vaccination against tick-borne encephalitis with FSME-Immun vaccine was started in the Department of Infectious Diseases, University Medical School of Bialystok, Poland, in 1992. No serious adverse reactions after vaccine administration were observed. Post-vaccine side effects were reported in 242 (11.3%) persons after the first dose (n = 2,135) and only in 14 patients (1.2%) after the second one (n = 1,183). These effects were mild and transitory. No relationship was observed between the frequency of adverse reactions, general or local, and the initial anti-TBE virus antibody titres or the age of the immunized individuals. Post-vaccine side effects were reported significantly more frequently among people not bitten by ticks.

Tick-borne encephalitis and concomitant infection with Borrelia burgdorferi.

Concomitant tick-borne encephalitis and Borrelia infection in 43 year old farmer living in a village on the border of the Knyszyn Forest was described. Diagnosis was based on anamnesis and objective examination, and was confirmed by serological tests.

Vaccination against tick-borne encephalitis--distant evaluation.

In 94 our of 2570 individuals vaccinated against tick-borne encephalitis (TBE) with FSME-Immun the level of IgG antibodies to TBE virus were tested. The examination was performed before and 2.5 years after the first dose of full cycle vaccination, which according to the manufacturer, consists of three doses. The maintenance of specific seroconversion was detected in 91.9% of the studied subjects. No statistically significant differences in antibody levels were found in the different age groups. None of the immunized subject developed TBE up to the present time.

Enzyme immunoassay in the diagnosis of Lyme borreliosis.

Comparison of serological EIA tests available in Poland, used in diagnostics of Lyme borreliosis: VIDAS Lyme Screen II (LYT II)-bioMérieux (France), Lyme Borreliosis-Dako (Denmark), Borrelia Recombinant-Biomedica (Austria) was carried out in sera of 112 persons: 39 inhabitants of Bialowieza area-Lyme borreliosis endemic region, 43 persons with Lyme borreliosis (first of all erythema migrans and neuroborreliosis), 27 healthy persons (control group), 3 persons with serologically confirmed rheumatoid arthritis. Compatibility of results in all tests was 73%, and it was the highest in control group (78%) and in neuroborreliosis patients (76%). Sensitivity of all tests was similar and varied from 77% (Dako) up to 81% (Biomedica). The highest specificity (93%), positive (94%) and negative (74%) predictive values demonstrated bioMérieux test. The lowest error of method for positive results showed bioMérieux (2,48%) and Dako-IgG (2,94%), whereas for negative Biomedica-IgG (0). There were no positive (false) results in sera of patients with rheumatoid factor dependent on cross reaction.

Epidemiological and clinical aspects of acute hepatitis C in north-eastern Poland.

The availability of more reliable assays made infections caused by hepatitis C virus (HCV) emerging as an extremely common and insidiously progressive disease. Since 1993, in 51 out of 798 patients admitted to Department of Infectious Diseases with acute hepatitis, HCV was diagnosed as a causative agent. Seventy one percent of acute hepatitis C cases were hospital associated and city residents represented the majority of all cases. The epidemiological data and clinical course of acute hepatitis C was analysed and compared with acute hepatitis B. The frequency of acute hepatitis C increased during last 3 years in Bialystok region. The clinical course of acute hepatitis C was generally milder than acute hepatitis B, with lower aminotransferases activities and bilirubin level.

Prevalence of antibodies against tick-borne encephalitis among residents of north-eastern Poland.

In 37 out of 613 (6%) residents of north eastern Poland, IgG antibodies to tick-borne encephalitis virus (TBEV) were detected at levels exceeding the diagnostic value of 60 VIEU/ml. The prevalence of the antibodies was not related to sex or place or residence. However, significantly higher antibody levels were found in the group of forest workers than in individuals not professionally connected with forestry.

[Immunity against tick-borne encephalitis in healthy residents of endemic areas]. / Odpornosc na kleszczowe zapalenie mózgu u osób zdrowych zamieskalych na terenach endemicznych.

Specific IgG antibodies against Tick-Borne Encephalitis Virus (anti-TBEV) at levels exceeding 60 VIEU/ml were detected in almost 14% of forestry workers and in 1.5% of other healthy persons, residents of the endemic area. Mean levels of anti-TBEV were similar in comparable subgroups of men and women, or subgroups of urban and rural residents, however, increased levels of these antibodies were found in elderly persons.

[Active immunization against tick-borne encephalitis virus infection in residents of North-Eastern Poland]. / Uodpornianie czynne mieszkanców pólnocno-wschodniej Polski przeciw zakazeniu wirusem kleszczowego zapalenia mózgu.

Group consisted of 78 persons was selected among 1587 persons vaccinated against tick-borne encephalitis. Efficiency of vaccination, controlled by measurement of specific IgM and IgG antibodies presence, was evaluated as 70.2% (47.4%-90%). The highest efficiency was observed in urban residents occasionally stayed in forest areas, that showed trace, of antibody level at the begining of study.

[Endemic threat of Lyme borreliosis in Bialowicza forestry area]. / Zagrozenie endemiczne borelioza z Lyme w regionie Puszczy Bialowieskiej.

Lyme Borreliosis is a serious diagnostical and therapeutical problem in regions with high exposure of residents to ticks, which are Borrelia burgdorferi vectors. The aim of this study was to estimate occurrence of specyfic antibodies and symptoms of Lyme Borreliosis in Bialowieza area, as a region of potential endemic presence of this disease. Antibodies against B. burgdorferi were found, with an immunoenzymatic assay, in 71 from among 143 of examined persons (49.7%). Diagnosis of Lyme Borreliosis was established in 54 persons (37.7% of examined population) according to criterions of Lyme Disease Foundation and Centers for Diseases Control. Symptoms of joints involvement (polyarticular or restricted to knee joints) and peripheral nervous system involvement (predominantly radiculalgia lumbosacralis) were most frequently observed in clinical picture. These results motivate to recognize Bialowieza region as an endemic area of Borrelia burgdorferi infections.

[Distribution of antibodies against Encephalitis ixodica viruses among north-east healthy populations of Poland]. / Wystepowanie przeciwcial przeciwko wirusowi kleszczowego zapalenia mózgu wsród mieszkanców Polski pólnocno-wschodniej.

We have undertaken the investigations for the detection of the presence of antibodies against Encephalitis ixodica viruses among North-East population of Poland. We have found these antibodies in 6.5% among 676 of tested healthy persons. The highest % of detected antibodies were noted in forest rangers and in physicians acting as hunters. Our data seems to indicate that Encephalitis ixodica is still actual disease in this region. Therefore one can suggest the necessity vaccination against Encephalitis ixodica.

[Diagnostic and prognostic value of the assessment of selected indicators of humoral immunity in alcoholism-related pathology of the liver]. / Diagnostyczne i prognostyczne znaczenie oceny wybranych wskazników humoralnej odczynowosci immunologicznej w poalkoholowej patologii watroby.

The purpose of the study was evaluation of the usefulness of selected indices of humoral immune responsiveness in the differential diagnosis of post-alcoholic hepatocellular damage. The study was carried out in 105 patients: 10 patients with a history of alcohol abuse without clinical and biochemical evidence of hepatocellular damage, 2) patients with alcoholic cirrhosis, 3) patients with post-inflammatory cirrhosis. The prognostic usefulness of the determinations of serum IgM, C3 and C4 complement components and circulating immune complexes in early diagnostic of alcoholic liver disease was demonstrated. It was noted also that increased serum IgA level may be a useful index differentiating of cirrhosis after hepatitis from alcoholic cirrhosis.

[Plasmapheresis and amino acid mixtures of "Aminosteril-Hepa" type preparations in treating hepatic encephalopathy]. / Plazmafereza i mieszanki aminokwasów typu preparatu "Aminosteril-Hepa" w leczeniu encefalopatii watrobowej.

An effect of Aminosteril-Hepa intravenous infusions or plasmapheresis on selected amino acids, ammonia, alpha-aminonitrogen serum levels and serum GGTP activity was analysed in 28 patients with liver cirrhosis with and without hepatic encephalopathy. The patients were given protein controlled dietary treatment. It was found, that plasmapheresis exerted more potent effect on previously elevated ammonia and serum alpha-aminonitrogen levels as well as serum GGTP activity than intravenous infusions of Aminosteril-Hepa. It was clearly seen in patients with liver cirrhosis without hepatic encephalopathy. Aminosteril-Hepa intravenous infusions decreased serum glutamine levels to higher degree than plasmapheresis. Both types of therapy have had no significant effect on serum phenylalanine, tyrosine, and tryptophan levels in all patients.

[Risk of development of hepatitis B virus infection among alcoholics]. / Zagrozenia populacji osób naduzywajacych alkoholu zakazeniem wirusem hepatitis B (HBV).

The frequency of incidence of positive serological markers of hepatitis B virus infection among a population of alcoholics in the region of Bialystok has been analysed. It was demonstrated that the highest frequency of detection of hepatitis B virus infection appears in a group of patients with post-alcoholic liver cirrhosis (60 percent). Acute virus hepatitis of the B type in alcoholics is characterised by a tendency towards retarded seroconversion of HBe antigen to HBe antibody with a subsequent development of chronic infection and liver cirrhosis.

Morphologic changes of small intestine epithelium in the course of post-alcoholic liver cirrhosis.

Morphologic changes of the duodenal mucous membrane were studied in 50 patients (20 with post-alcoholic liver cirrhosis and 30 non-alcoholic with postinflammatory liver cirrhosis). The macroscopic condition of the duodenal mucous membrane was evaluated during endoscopic examination; evaluation of the histopathologic changes in the biopsy specimens of the duodenal mucous membrane was carried out according to the criteria of Whitehead et al. (Digestion, 13 (1975) 129). Endoscopic examinations showed changes of chronic inflammatory process of the duodenal mucous membrane in 60% of the patients in both groups. The microscopic studies did not show essential differences in the intensity of histopathological changes of the duodenal mucous membrane between both groups, i.e, alcohol is not a decisive factor evoking or intensifying pathological changes of the duodenum.

[Immune modulating effect of isoprinosine in patients with post-alcoholic liver cirrhosis]. / Immunmodulatorische Wirkung von Isoprinosine bei Patienten mit postalkoholischer Leberzirrhose.

Immunomodulating effect of isoprinosine was estimated in group of 10 patients with postalcoholic liver cirrhosis and compared with another group of 10 patients with postinflammatory liver cirrhosis with infection of hepatitis B virus. Disturbances of immunologic reactivity in the patients with postalcoholic liver cirrhosis mainly concerned increased immunoglobulin G, A concentrations in the blood serum, decreased percentage values of lymphocytes T and their subpopulations (lymphocytes T4 and T8) and increased percentage of lymphocytes B. Disturbances of the examined indices of the immunologic reactivity in the group of patient with postinflammatory liver cirrhosis concerned increased concentrations of circulating immunologic complexes, immunoglobulins A and M in the blood serum and decreased percentage of lymphocytes T and their subpopulation. Treatment with isoprinosine resulted in different immunologic effect in the examined patients concerning mainly increased concentrations of circulating immunologic complexes in the blood serum and increased percentage values of lymphocytes T, T4, T8, B in the course of postalcoholic liver cirrhosis. Patients with postinflammatory liver cirrhosis treated with isoprinosine mainly showed decreased concentrations of circulating immunologic complexes, immunoglobulins A, M the blood serum, increased percentage values of lymphocytes T4 and T8.

[Effect of differentiated diet therapy on the clinical results and biochemical indicators in chronic hepatic encephalopathy]. / Wplyw zróznicowanego leczenia dietetycznego na efekty kliniczne i wskazniki biochemiczne w przewleklej encefalopatii watrobowej.

Effects of differentiated diet with reduced proteins or diet without proteins with simultaneous use of lactulose or the preparation enriched with aliphatic amino acids with aminosteril-hepa chain on the clinical results and the ammonia, phenols, alpha-amino nitrogen, tyrosine, phenylalanine and tryptophan++ concentrations in the serum have been studied. It has been demonstrated that limitations of proteins in the diet or diet without proteins with the use of lactulose or amino acids mixtures above does not influence significantly the clinical amelioration or biochemical indices of encephalopathy or coma during the liver cirrhosis course. Homogenates of the liver and brain of patients who died due to encephalopathy and liver cirrhosis showed high contents of ammonia, tyrosine, phenylalanine and tryptophan++.