Influenza: Underestimated in Children Below 2 Years of Age.

Children under 2 years of age may receive antiviral therapy when influenza is suspected. Signs of influenza are frequently unclear and testing is indicated. The aim of the study was to assess the usefulness of clinical signs and the rapid influenza diagnostic test (RIDT) in diagnosing influenza and in choosing the appropriate treatment. In the 2015-2016 influenza season, 89 children under 2 years of age (56.7% of 157 children diagnosed with influenza) were hospitalized. There were 74 RIDT and 70 reverse transcription polymerase chain reactions (RT-PCR) performed for the purpose of diagnosis, either test per child. Eighty-three percent of children (74/89) presented with fever, 55.1% (49/89) with cough, and 39.3% (35/89) with both cough and fever. The RIDT was positive in 31.1% (23/74) of cases. The highest percentage of positive RIDT was within the first 24 h of disease, decreasing dramatically thereafter (70% vs. 13-17%, respectively). The RIDT shortened the time to diagnosis by 43.8 h/patient (an average €149 gain in treatment costs). The mean delay for RT-PCR-based diagnosis was 33.5 h/patient (an average €114 loss in treatment costs). We conclude that clinical signs have a low diagnostic sensitivity in children under 2 years of age. Likewise, RIDT is of low sensitivity, being diagnostically useful only in the first 24 h. The PCR is recommended for the diagnosis, but that requires a constant access to the method.

Long-term estradiol-17ß exposure decreases the cholinergic innervation pattern of the pig ovary.

Elevated levels of endogenous estrogens in the course of pathological states of ovaries, as well as xenoestrogens, may lead to hyperestrogenism. It has previously been demonstrated that long-term estradiol-17ß (E2) administration in adult gilts affected the population of sympathetic intraovarian nerve fibers. The aim of this study has been to determine the effect of long-term E2 exposure on the cholinergic innervation pattern of porcine ovaries. Intraovarian distribution and the density of nerve fibers immunoreactive (IR) to vesicular acetylocholine transporter (VAChT) and/or neuronal isoform of nitric oxide synthase (nNOS), vasoactive intestinal polypeptide (VIP), somatostatin (SOM) were determined. From day 4 of the first estrous cycle to day 20 of the second studied cycle, experimental gilts were intramuscularly injected with E2, while control gilts received corn oil. The ovaries were then collected and processed for double-labelling immunofluorescence. After E2 administration, the total number of fibers IR to VAChT, nNOS and VIP decreased significantly. The numbers of VAChT-, nNOS- and VIP-IR fibers within the ground plexus were significantly lower, while they were significantly higher around small or medium tertiary follicles. In the E2-affected ovaries, the numbers of nNOS- and VIP-IR fibers were significantly higher near secondary follicles and VAChT-IR in the vicinity of medullar blood vessels. In turn, around the latter structures there were significantly lowered populations of nNOS- and VIP-IR nerve fibers. These results suggest that the elevated E2 levels that occur during pathological states may affect the cholinergic innervation pattern of ovaries and their function(s).

[Laparoscopic cholecystectomy in elderly patients]. / Cholecystektomia laparoskopowa u pacjentów w wieku podeszlym.

The report presents results of the treatment of cholecystolithiasis in old patients (65 years). We compared two groups of the patients: first group treated using laparoscopic method, second group (control) where we performed classic cholecystectomy. Both of these groups were comparable according to age and sex.

Effects of methoprene and permethrin on paedogenetic larvae of Heteropeza pygmaea and Mycophila speyeri (Diptera: Cecidomyiidae).

The effects of methoprene and permethrin on larvae of Heteropeza pygmaea Winnertz and Mycophila speyeri (Barnes), two Cecidomyiid species of paedogenetic insect mushroom pest, were investigated in sterile culture at concentrations of 0.1-100 micrograms/g. The two highest concentrations of permethrin caused complete mortality of M. speyeri but only low mortality of H. pygmaea. The main sublethal effects of permethrin on both species were reduced fecundity and reduced mother-larval width. Methoprene had only sublethal effects on both species. At all doses, methoprene caused an increase in H. pygmaea generation time but a reduction in hemipupal width and fecundity according to dosage. The effects on M. speyeri were similar but more severe.

[Fetal doppler flow velocimetry measurements as indications for cesarean section]. / Dopplerowskie badania przeplywowe plodu we wskazaniach do ciecia cesarskiego.

An effort was made to analyze fetal umbilical and cerebral arteries Doppler flow velocimetry patterns in pregnancies terminated with cesarean section emphasizing risk to the fetus. The flow velocimetry measurements were carried out at least 7 days prior to deliveries. The incidence of abnormal values of flow indices (SD, RI i PI) and ratio (CPR) were compared in pregnant women who delivered by cesarean section due to: I--threatening fetal distress (n = 28)--elective cesarean sections were performed on pregnant women with chronic placental insufficiency symptoms; II--fetal distress (n = 22)--emergency cesarean sections; III--obstetric indications for cesarean section (no symptoms of fetal distress were present). Increased resistance in placental circulation, and decreased resistance in cerebral vessels finally leading to reversed diastolic umbilical flow occur more often in pregnant women with chronic placental insufficiency. Umbilical factor seems to be responsible for the observed in every studied group higher incidence of abnormal flows in middle cerebral than in umbilical artery. Fetal Doppler flow velocimetry of umbilical and middle cerebral arteries allow for finding of the most proper time of high-risk pregnancy termination, hence should be considered in the elective cesarean sections.