Effectiveness of influenza vaccine in patients on hemodialysis--a review.

The influenza virus is one of the most common causes of viral respiratory tract infections. Some chronic diseases predispose to a severe course of the disease and increase the risk of complications and death. To minimize the risk of infection and complications, care of patients with increased risk should include prophylactic measures such as the administration of a seasonal influenza vaccine. An influenza vaccine is the best and cheapest method of influenza prevention. It is indicated for patients with chronic kidney disease, both during conservative treatment and renal replacement therapy. Many studies that have assessed the efficacy of an influenza vaccine in patients on hemodialysis have found that immune deficiency predisposes these patients to infection and a severe course of the disease. Because the immune response to a standard influenza vaccine in this population is weak, the studies covered many aspects of vaccination, including the need for a booster dose. Unlike in a healthy population, the efficacy of an influenza vaccine in patients on hemodialysis might be insufficient; however, the vaccine is still able to induce immunity in a significant number of patients. Considering the latest data and the results of studies described above, the recommendation of a seasonal influenza vaccine should be obligatory in all hemodialysis patients. This paper is based on original articles available from Medline database. The most recent and most significant literature on the influenza vaccine in patients on hemodialysis has been reviewed.

[Influence of smoking cigarettes on the development of the child and its health condition]. / Wplyw palenia tytoniu na rozwój dziecka i jego stan zdrowotny.

35.5% of Polish society is active smokers and as many as 20% of pregnant women. Influence of passive smoking on fetuses and children is bigger than active smoking on adults. The aim of this scrutiny was to develop relationship between preschool children passive smoking and their health condition. Research was made with the use of 100 anonymous questionnaires among parents of children from nursery schools in Opole. We received the following results: active smokers lived in almost half of examined families (44%), the most numerous group of smokers was parents (80.5%). The most often (43.3%) children were exposed on 20 cigarettes per day. 40.9% parents smoked outside, on the balcony, however the rest of them inside, in various rooms of the house. Most of parents thought that the health condition of their children was good, but more smokers than non-smokers estimated it as bad (11.4% vs. 1.8%). To the question how often are their children sick the most parents in both groups answered that 1-3 times per year. Most frequent illnesses concerned children of smokers and it was mainly respiratory tract diseases. Antibiotics intake was more often among children of smokers than non-smokers. Relationship between their children health condition and cigarette smoking confirmed 90% of parents. Denied it 10% and all of them were smokers. It indicates the need of better education of both, parents and children, in the field of harmful effects of passive smoking on health.

[Cigarette smoking in medical personnel and evaluation of this problem by smoking and non-smoking patients]. / Palenie papierosów przez personel medyczny i ocena tego problemu przez palacych i niepalacych pacjentów.

Cigarette smoking is a problem in all environments, including health service workers. It increases the number of ill people and accelerates death. The aim of this study was to diagnose the problem of smoking in medical staff and evaluation of this problem by patients. Research was made in hospitals and out-patient clinics in Opole by using an anonimous questionnaire. Along years there has been a decrease of smoking initiation age: 60-years-old-women had their first cigarette in 70% after them finished 18 years old, while most 30-year-old-women had it before. Every year the level of education in medical staff grows up, but the number of smokers in them does not fall down. It is still common to smoke in non-smokers and pregnant woman presence in spite of knowledge about passive smoking. Also pregnancy is not always strong argument to complete quit smoking, among medical staff as well. Smoking medical personnel has definitely negative evaluation by non-smoking patients (70%), a bit less negative it is seen by smoking patients. As the research showed, promotion of nonsmoking workers by employers could be a motivation to quit smoking.

[Asthma bronchial among children and youth exposed to tobacco smoke]. / Astma oskrzelowa u dzieci i mlodziezy a narazenie na dym tytoniowy.

Purpose of this work was to judge progress of diagnosed bronchial asthma among children and youth that are exposed on tobacco smoke in aspect of number of exacerbation of disease, therapy (doses of corticosteroids) and number of hospitalizations. There were two groups of patients with bronchial asthma under examination, first one were children and youth that are exposed on tobacco smoke, and the other group of children and youth that are not exposed on tobacco smoke. We discovered statistically significant difference in number of exacerbation of disease among those two groups, also bigger therapeutic and prophylactic doses of inhaled steroids during treatment, and much more often hospitalizations among children and youth that are exposed on tobacco smoke.

[Cigarette smoking and immunity disorder]. / Palenie papierosów a zaburzenia odpornosci.

Cigarette smoking addiction is one of the cardinal factors the diseases of respiratory system, cardio-vascular system and neoplasms. A part of them is the effect of immunosupression. It includes both morphologic changes (atrophia of lymphoid tissue) and cell functional disorder of the immune system. Cell-mediated response Th1-type, which is responsible for pathogens invasion, is depleted, whereas Th2-type is increased and has its effect on higher frequency of allergic diseases. Susceptibility to neoplasmatic changes is also augmented.

Ultrastructural evaluation of activated forms of microglia in human brain in selected neurological diseases (SSPE, Wilson's disease and Alzheimer's disease).

Activated forms of microglia were ultrastructurally evaluated in three neurological diseases of different aetiology (subacute sclerosing panencephalitis--SSPE, Wilson's disease and Alzheimer's disease). The occurrence of activated rod, ramified and amoeboid microglia was found in the investigated diseases. The widest ultrastructural variability of microglia was in SSPE, including the presence of mitotic chromosomes or centrioles in its cytoplasm, which indicates microglia proliferation. In the nuclei of activated microglia, some nuclear bodies with different structures were frequently seen, whereas lamellar structures (similar to developing Birbeck's bodies--pathognomonic to Langerhans-type dendritic cells) were observed in the cytoplasm. The activated forms of microglia with apoptotic features were found only in SSPE cases. Some apoptotic nuclei were filled with nucleocapsids of measles virus. In Alzheimer's disease, activated microglia was most frequently bound to senile plaques. Ramified microglia was in contact with amyloid fibrils, which penetrated its cytoplasm and reached the nuclear membrane and channels of rough endoplasmic reticulum, or was situated among dystrophic neurites. Rod microglia was found predominantly at the edge of senile plaques. In Wilson's disease, the ultrastructure of activated microglia showed mostly indirect forms between rod, ramified and amoeboid microglia. The microglia ultrastructure suggests that its morphological form may express functional involvement in the pathogenesis of a given disease entity.

Dendritic and microglial cells in pups of alcohol-treated female rats.

Alcohol ingestion by female rats during pregnancy and/or lactation leads to developmental anomalies of different organ systems, retardation and immune system impairment in their offspring. In humans, these disorders are termed foetal alcohol syndrome (FAS), or foetal alcohol effect (FAE) if abnormalities are of lesser degree. The study materials consisted of brain, liver and spleen samples collected ten days post partum from neonatal rats born to dams treated with 12% alcohol at a dose of 6 g/kg body mass during pregnancy or during pregnancy and/or lactation. Microglial and dendritic cells were assessed by light (histochemical and immunohistochemical methods) and electron microscopes. Histochemically, the presence of microglia (ramified, amoeboid and rod) and dendritic cells in the studied organs was detected, but only some of them demonstrated the expression of major histocompatibility complex, class I and II (MHC I, II) on their surfaces. Ultrastructural observations revealed immature morphology of part microglial cells, whereas their euchromatin nuclei maybe showed rather high transcription activity. The preliminary study of dendritic cells at ultrastructural level does not indicate pronounced changes. Abnormalities were mostly pronounced in pups born to alcohol-treated dams during pregnancy and during pregnancy and lactation. These observations suggest that microglia and dendritic cells may be regarded as early markers of alcohol-induced impairments. The reduced immune efficiency in animal FAS/FAE models may be due to both immaturity of these cells and low expression of MHC I and II molecules, which renders it difficult for microglial and dendritic cells to present foreign antigens to helper lymphocytes T, which delays the cascade of immune response.

Morphological analysis of active microglia--rod and ramified microglia in human brains affected by some neurological diseases (SSPE, Alzheimer's disease and Wilson's disease).

The activation of microglial cells in pathological conditions is manifested primarily by their proliferation, as well as by the occurrence of a new morphological form--rod microglia. In the present study immunohistochemical identification of rod microglial phenotype against ramified microglia was performed on segments of 17 brains derived from 7 cases of encephalitis of viral aetiology (including 5 SSPE cases), 6 cases of Wilson's disease and 4 cases of Alzheimer's disease. Segments from frontal, temporal and occipital lobes, cerebellum and brainstem were subjected to histological, histochemical and immunohistochemical reactions. The presence of activated rod and ramified microglia was observed in sections derived from all structures of the brains under study. Both morphological forms of activated microglia reacted to antibodies: HLA II, CD68, HAM56 and lectin RCA-1. Expression of HLA II molecules was less intensive on the surface of microglial rod cells. A positive reaction to PCNA antibody was mainly observed in rod/elongated/cylinder-shaped nuclei, which is a characteristic feature of rod microglia. In the study material, the localisation of microglial processes seemed to depend rather on the structural topography of the cell in the brain than on the nuclear shape of the activated microglial cell. Our observations revealed a strong similarity between immunohistochemical phenotypes of both morphological forms of microglia with the indication that rod microglia is a first developmental form of activated microglia.