Application of the appropriate molecular biology-based method significantly increases the sensitivity of group B streptococcus detection results.

BACKGROUND: Streptococcus agalactiae (group B streptococcus: GBS) is a leading cause of early- and late-onset diseases in neonates. Reliable results of GBS carriage investigation among pregnant women may decrease the incidence of neonatal infection and mortality. AIM: To compare the results of conventional culture investigation with those of the US Food and Drug Administration-approved nucleic acid amplification test (BD Max GBS (Becton Dickinson)), and to establish our own protocols of standard polymerase chain reaction (PCR). METHODS: A total of 250 vaginal-rectal swabs from three different hospitals in Bydgoszcz, Poland, were used to evaluate GBS carriage. Standard laboratory technique (overnight culture in broth enrichment media) results were compared with those of BD Max GBS assay (Becton Dickinson) and two standard PCR protocols, established to detect the cfb and 16S rRNA S. agalactiae genes, from the overnight cultures of the samples in the liquid enrichment media. FINDINGS: The overall GBS carriage was estimated as 16.4-23.2%, depending on the applied detection method. The highest percentage of positive results, from each lab-oratory was obtained with the application of BD Max GBS assay. The differences in the number of positive results obtained with this particular method were statistically significant. Overall, 27 discrepancies were noted for the results obtained with the application of the methods compared. CONCLUSIONS: The methods applied for GBS detection differ in sensitivity. A culture technique, though very specific, appears to be less sensitive at detecting S. agalactiae compared with the commercially available BD Max GBS assay or in-house PCR protocols established for this purpose.

Characteristics associated with outcome in patients with first-ever posterior fossa stroke.

BACKGROUND AND PURPOSE: Factors such as infarct volume, infarct location and symptom severity can considerably influence long-term outcome in posterior fossa strokes. The decision about therapy can sometimes be complicated by discrepancies between infarct volume and clinical severity. We aimed to evaluate imaging and clinical parameters possibly influencing long-term outcome in patients with first-ever posterior fossa stroke. METHODS: Imaging was performed on a 3-T magnetic resonance imaging scanner. Sixty-one of 1795 patients from the observational 1000Plus and LOBI studies (NCT00715533 and NCT02077582, clinicaltrials.org) were enrolled, meeting the inclusion criteria of first-ever posterior fossa stroke and magnetic resonance imaging examination within 24 h after symptom onset. Infarcts were classified as belonging to a proximal, middle or distal territory location in the posterior fossa. Good outcome was defined as a modified Rankin scale score of ≤1 at 3 months. RESULTS: The largest lesion volumes on diffusion-weighted imaging on day 0 and fluid attenuation inversion recovery (FLAIR) on day 6 were found in the middle territory location with a median volume of 0.4 mL on diffusion-weighted imaging and 1.0 mL on FLAIR on day 6 versus 0.1/0.3 mL in the proximal and 0.1/0.1 mL in the distal territory location of the posterior fossa, respectively. Parameters associated with poor outcome were older age (P = 0.005), higher National Institutes of Health Stroke Scale score on admission/discharge (P = 0.016; P = 0.001), larger lesion volumes on FLAIR on day 6 (P = 0.013) and dysphagia (P = 0.02). There was no significant association between infarct location and modified Rankin scale score on day 90. CONCLUSION: Infarct volume and clinical severity, but not infarct location, were the main contributors to poor long-term outcome in first-ever posterior fossa strokes.

Matrix metalloproteinases in human spontaneous intracerebral hemorrhage: an update.

BACKGROUND: In default of a plausible and satisfactory causal treatment for hemorrhagic stroke, a role of matrix metalloproteinases (MMPs) in the pathogenesis of cerebrovascular diseases has recently been widely discussed. The well-known impact of MMPs on extracellular matrix destruction triggered by inflammation as a foundation for several diseases, including stroke, is very much in evidence. Newly, some additional aspects of MMP function considering their intracellular activity crucial for neuronal death following ischemic brain damage have emerged. The effect of blood-brain barrier disruption caused by MMPs on the prognosis in patients suffering from spontaneous intracerebral hemorrhage (ICH) has been of interest since it throws a new light upon the pathogenesis, course and possible therapeutic approaches for this least treatable and at the same time most life-threatening form of stroke. Hence, we primarily aimed to review the current clinical knowledge on the significance of metalloproteinase activation in the course of spontaneous intracranial hemorrhage in humans. We also provide a brief characterization of the MMP enzyme family and report on the latest findings on issues arising from experimental studies. METHODS: A Medline search using the following key words was performed: matrix metalloproteinases + spontaneous intracerebral hemorrhage/intracranial hemorrhage/bleeding/hemorrhagic stroke. We accepted studies reporting on MMP expression in adult patients with spontaneous ICH, as well as its relation to radiological and clinical features and patients' outcome. For the final review, 18 clinical studies were considered. MMP inhibition was reviewed on the basis of 11 relevant experimental studies. Also, some relevant reports on the biology of MMPs and their pathophysiology in ICH were reviewed. RESULTS AND CONCLUSIONS: Many studies provide convincing evidence of a detrimental role of MMPs in ICH, stressing their association with neuroinflammation. The role of MMPs in hemorrhagic stroke appears critical for hematoma and brain edema growth as well as for neuronal death, which are understood as secondary brain injury and may have a considerable clinical impact. Although data on human spontaneous ICH are scarce and mostly based on small populations, they reveal the apparent correlation between MMPs and clinical and radiological ICH features as well as the functional outcome, which might rationalize future therapeutic strategies. However, attempts at MMP inhibition in spontaneous ICH have solely been made under experimental conditions and were associated with a wide range of possible side effects. Therefore, further comprehensive, elucidating investigations in this field are vital before any conclusions could be translated to humans.

[Indoor air quality in schools]. / Qualité de l'air à l'intérieur des écoles.

Indoor air quality in schools has received particular attention over the past several years. Children are considered as one of the most sensitive groups to atmospheric pollution because their bodies are actively growing and they breathe higher volumes of air relative to their body weights than adults do. They also spend more time in school or group structures (preschools, day nurseries) than in any indoor environments other than the home. The analysis of children's exposure to air pollution at school requires the identification of the main pollutant sources present in these educational institutions. Both a strong contribution of outdoor pollution and a very specific pollution bound to school activities such as the use of paints, markers, glues, and manufactured ink eraser pens, exist. The ventilation in school buildings also plays an important role in air quality. A higher air exchange may improve thermal comfort and air quality. The cause of indoor air pollution is a combinatory effect of physical, chemical, and biological factors, and the adequacy of ventilation in the environment. Several pollutants have been reported to exist in classrooms such as bacteria, molds, volatile organic compounds, persistent organic pollutants and microparticles. There is a correlation between the concentrations of the pollutants and onset of health problems in schoolchildren. We observe predominantly respiratory symptoms as well as a prevalence of respiratory diseases such as asthma and allergies. This study shows that poor indoor air quality affects children's health.

[Tumor of the neck as the primary sign of thyroid cancer]. / Guz szyi jako pierwotny objaw raka tarczycy.

From 1974 to 1994 in Otolaryngology Department of County Hospital No 1 in Rezszów, Poland in 35 patients tumor of neck derived from thyroid gland has been revealed. There were 22 females and 13 males, aged 16 to 78 (mean age 48), among the patients. Pathology examination of surgery removed tumors has revealed malignancy in 19/35 (54%) cases, non-neoplastic tumors in 11/35 (32%) cases and non-malignant tumors in 5/35 (14%) cases. Among malignant tumors metastasis of papillare adenocarcinoma was the most frequent pathology (37%). Authors analyze feature of the thyroid gland derived tumors based on their size, consistency, localization, mobility, towards surroundings and the picture during surgery. Because of the presence of thyroid gland malignant tumor metastasis without clinical symptoms, author emphasised the necessity of its consideration in differential diagnosis.

[Problems with treatment in patients with tongue and/or floor of the mouth neoplasms]. / Problemy postepowania leczniczego u chorych z rakiem jezyka i/lub dna jamy ustnej.

From 1974 to 1993 in Otolaryngology Department of County Hospital No 1 in Rzeszów, Poland in 98 patients cancers of the oral tongue and/or floor of the mouth have been diagnosed. Pathology examinations revealed squamous cell carcinoma in 98% of the total number of patients. Based on the hospital data and control examinations authors have analyzed retrospectively 42 patients (35 male and 7 female, aged 32-90). Because of the advanced stage of the disease as many as 17 patients have applied only palliative treatment. 13 patients were treated surgically followed by radiotherapy and/or chemotherapy, 9 patients were treated with radiation and 3 patients have radiotherapy and chemotherapy. 3, 5, and 10 years survivals have been estimated.

[Tracheotomy in inoperable thyroid cancer]. / O tracheotomii w nieoperacyjnym raku tarczycy.

Based on own material of 7 patients and the references authors have presented difficulties of tracheotomy in case of advanced thyroid cancer. Influence of general condition and difficulties connected with local state have been discussed. Authors have described suggestions which facilitate surgery and let to avoid complications.

[Follicular carcinoma of the ectopic lingual thyroid]. / Rak pecherzykowy ektopowej tarczycy jezykowej.

The ways of origin and the methods of diagnosing of the ectopic thyroid gland have been described. The authors have shown the case of follicular carcinoma of ectopic lingual thyroid gland in 35 years woman. The effective surgery (labiomandibuloglossotomy and total extirpation of the tumor) and following irradiation therapy with 131I haven't revealed recurrence of the disease during 2.5 years observation. The permanent substitution therapy with thyroxine has secured the euthyreotic state for the patient.