Distribution of the CMV glycoprotein gH/gL/gO and gH/gL/pUL128/pUL130/pUL131A complex variants and associated clinical manifestations in infants infected congenitally or postnatally.

Human cytomegalovirus (CMV) is a major cause of morbidity in fetuses following intrauterine infection. The glycoprotein (g) envelope trimeric gH/gL/gO and pentameric gH/gL/pUL128/pUL130/pUL131A complexes are required for CMV entry into fibroblasts and endothelial/epithelial cells, respectively, and both are targets for neutralizing antibodies. The role of sequence variability among viral strains in the outcome of congenital CMV infection is controversial. Variation in the CMV UL75 gene encoding glycoprotein H (gH), the UL115 (gL), the UL74 (gO), and the UL128 locus (UL128L) encoding three structural proteins (pUL128, pUL130, and pUL131A) was determined in 82 newborns with congenital CMV infection and 113 infants with postnatal or unproven congenital CMV infection. Genotyping was performed by sequencing analysis of PCR-amplified fragments and the PCR-restriction fragment length polymorphism (RFLP) method, and the viral load was measured by quantitative real-time PCR. The obtained results demonstrated that (1) different CMV variants and mixed CMV infections can be detected in newborns infected congenitally; (2) the gH1 genotype, UL130 variant 6, and UL131A variant 1 were associated with some signs/symptoms within cohort of pediatric patients, mainly consisting of infants with symptomatic CMV infection. The results revealed that pUL130, pUL131A, and gH polymorphisms seemed to be associated with the outcome of CMV infection in infants.

Association of TLR3 L412F Polymorphism with Cytomegalovirus Infection in Children.

Intracellular Toll-like receptor 3 (TLR3) recognizes viral double-stranded RNA (dsRNA) and activates antiviral immune responses through the production of type I interferons (IFNs) and inflammatory cytokines. This receptor binds to dsRNA molecules produced during human cytomegalovirus (HCMV) replication. TLR7 senses viral single-stranded RNA (ssRNA) in endosomes, and it can interact with endogenous RNAs. We determined the genotype distribution of single-nucleotide polymorphisms (SNPs) within the TLR3 and TLR7 genes in children with HCMV infection and the relationship between TLR polymorphisms and viral infection. We genotyped 59 children with symptomatic HCMV infection and 78 healthy individuals for SNPs in the TLR3 (rs3775290, c.1377C>T, F459F; rs3775291, c.1234C>T, L412F; rs3775296, c.-7C>A) and TLR7 (rs179008, c.32A>T, Q11L; rs5741880, c.3+1716G>T) genes. SNP genotyping was performed using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and capillary electrophoresis. The HCMV DNA load was quantified by real-time PCR. We found an increased frequency of the heterozygous genotype TLR3 L412F in children with HCMV infection compared with uninfected cases. In individuals with a mutation present in at least one allele of the L412F SNP, an increased risk of HCMV disease was found, and this result remained highly significant after Bonferroni's correction for multiple testing (Pc < 0.001). The heterozygous genotype of this SNP was associated with the increased risk of HCMV disease in an adjusted model that included the HCMV DNA copy number in whole blood and urine (P < 0.001 and P = 0.008, respectively). Moreover, those with a heterozygous genotype of rs3775296 showed an increased relative risk of HCMV infection (P = 0.042), but this association did not reach statistical significance after correction for multiple testing. In contrast, the rs3775290 SNP of TLR3 and TLR7 SNPs were not related to viral infection. A moderate linkage disequilibrium (LD) was observed between the SNPs rs3775291 and rs3775296 (r2 = 0.514). We suggest that the L412F polymorphism in the TLR3 gene could be a genetic risk factor for the development of HCMV disease.

TLR9 -1486T/C and 2848C/T SNPs Are Associated with Human Cytomegalovirus Infection in Infants.

Toll-like receptor 9 (TLR9) recognizes non-methylated viral CpG-containing DNA and serves as a pattern recognition receptor that signals the presence of human cytomegalovirus (HCMV). Here, we present the genotype distribution of single-nucleotide polymorphisms (SNPs) of the TLR9 gene in infants and the relationship between TLR9 polymorphisms and HCMV infection. Four polymorphisms (-1237T/C, rs5743836; -1486T/C, rs187084; 1174G/A, rs352139; and 2848C/T, rs352140) in the TLR9 gene were genotyped in 72 infants with symptomatic HCMV infection and 70 healthy individuals. SNP genotyping was performed by using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Digested fragments were separated and identified by capillary electrophoresis. The HCMV DNA copy number was measured by a quantitative real-time PCR assay. We found an increased frequency of heterozygous genotypes TLR9 -1486T/C and 2848C/T in infants with HCMV infection compared with uninfected cases. Heterozygous variants of these two SNPs increased the risk of HCMV disease in children (P = 0.044 and P = 0.029, respectively). In infants with a mutation present in at least one allele of -1486T/C and 2848C/T SNPs, a trend towards increased risk of cytomegaly was confirmed after Bonferroni's correction for multiple testing (Pc = 0.063). The rs352139 GG genotype showed a significantly reduced relative risk for HCMV infection (Pc = 0.006). In contrast, the -1237T/C SNP was not related to viral infection. We found no evidence for linkage disequilibrium with the four examined TLR9 SNPs. The findings suggest that the TLR9 -1486T/C and 2848C/T polymorphisms could be a genetic risk factor for the development of HCMV disease.

Mannose-binding lectin in chronic hepatitis C in children.

OBJECTIVE: To investigate effect of mannose-binding lectin (MBL) genetic polymorphisms and phenotype in chronic hepatitis C and its impact on response to antiviral therapy in children. METHODS: Fifty four children with chronic hepatitis C, aged 2.5-18 years were enrolled. Forty-five children were treated with interferon-α (IFN-α) alone (n = 2) or IFN-α and ribavirin (n = 43). Twenty-one children who responded to antiviral therapy were defined as sustained responders to therapy (IFN-SR). Before therapy, MBL genotypes and serum MBL levels (by ELISA) were determined. MBL genotype distribution and levels were correlated to disease characteristics and response to therapy. RESULTS: Children with chronic hepatitis C who did not respond to antiviral therapy (IFN-NR) presented more frequently MBL2 polymorphisms, although this did not reach significance (p = 0.08). MBL levels were significantly lower in children classified as IFN-NR when compared to children defined as IFN-SR (1.623 ng/ml vs. 3.699 ng/ml), (p = 0.04). Serum activity levels of ALT and AST were higher in children with A/O MBL genotype when compared to group with A/A genotype (p < 0.05). CONCLUSIONS: Our findings suggest negative effect of MBL deficiency (defined by genotype and phenotype) on progression of chronic hepatitis C in children and response to antiviral therapy.

Cytomegalovirus alpha-chemokine genotypes are associated with clinical manifestations in children with congenital or postnatal infections.

Human cytomegalovirus (HCMV) is the leading cause of congenital infections. The aim of our study was to determine the prevalence of genotypes based on the highly polymorphic UL146 and UL147 HCMV genes and the relationship between the genotype and symptoms or viral load. We analyzed samples from 121 infants with symptomatic HCMV infection, including 32 congenitally infected newborns. The G7 and G5 genotypes were predominant in postnatal infection, whereas the G1 genotype was prevalent in congenital infection. Central nervous system (CNS) damage and hepatomegaly were detected more frequently among children infected with the G1 genotype than in those infected by other genotypes. An association between the viral genotype and viruria level was found. There was a strong correlation between HCMV genotypes determined through the UL146 and UL147 sequences (ĸ=0.794). In conclusion, we found that certain vCXCL genotypes are associated with clinical sequelae following HCMV infection.

Relationship between toll-like receptor 2 Arg677Trp and Arg753Gln and toll-like receptor 4 Asp299Gly polymorphisms and cytomegalovirus infection.

OBJECTIVES: The association among specific single-nucleotide polymorphisms (SNPs) in TLR2 (Arg677Trp, Arg753Gln) and TLR4 (Asp299Gln) and human cytomegalovirus (CMV) infection was studied in infants and adults. METHODS: The TLR2 and TLR4 polymorphisms were genotyped in 151 patients with CMV infections and in 78 unrelated healthy individuals. Genotyping was performed by restriction fragment length polymorphism (RFLP) analysis of PCR-amplified fragments. The viral load was measured by quantitative real-time PCR. RESULTS: Almost all of the patients with CMV infections were wild-type homozygotes without TLR2 and TLR4 polymorphisms. No significant differences in TLR2 and TLR4 polymorphisms were observed between infants with or without CMV infection. Compared with adults with CMV infections, heterozygosity for the TLR2 Arg677Trp and TLR4 Asp299Gly SNPs was detected more frequently in healthy individuals (p<0.05). Logistic regression analysis showed that the wild-type TLR2 genotype was associated with an increased risk of CMV infection and that heterozygosity for TLR2 and TLR4 SNPs diminished the risk of CMV infection in adult patients. An association between CMV load and the TLR4 SNP was found. CONCLUSION: Our results suggest that the wild-type TLR2 genotype may be a risk factor for CMV replication in adult patients.

Cytomegalovirus glycoprotein H genotype distribution and the relationship with hearing loss in children.

Cytomegalovirus (CMV) is a leading cause of congenital infection and a leading infectious cause of hearing loss in children. The ORF UL75 gene encodes envelope glycoprotein H (gH), which is essential for CMV entry into host cells and the target of the immune response in humans. However, the distribution of gH variants and the relationship between the viral genotype, viral load, and sequelae in children infected with CMV is debated. The UL75 genetic variation of CMV isolates from 42 newborns infected congenitally with CMV and 93 infants with postnatal or unproven congenital CMV infection was analyzed. Genotyping was performed by analysis of PCR-amplified fragments, and the viral load was measured by quantitative real-time PCR. There were no differences in the distribution of gH genotypes in the children infected congenitally and postnatally. Mixed-genotype infections with both gH1 and gH2 variants were detected in approximately 25% of the examined patients. No relationship between UL75 gene polymorphisms and the symptoms at birth was observed. The results suggest that the infection with gH2 genotype diminishes the risk of hearing loss in children (P = 0.010). In addition, sensorineural hearing loss was associated with CMV gH1 genotype infection in infants (P = 0.032) and a high viral load in urine (P = 0.005). In conclusion, it was found that the gH genotype does not predict clinical sequelae in newborn infants following congenital CMV infection. However, these results suggest that the gH genotype might be associated with hearing loss in children.

Efficacy of pegylated interferon α-2b and ribavirin in chronic hepatitis C virus (genotypes 1 and 4) infection.

BACKGROUND AND OBJECTIVE: The course of chronic hepatitis C in children is often mild or asymptomatic, but may lead to liver cirrhosis and neoplasm. The aim of our study was retrospective evaluation of treatment efficacy using pegylated interferon (IFN)-α2b with ribavirin in children and adolescents with chronic hepatitis C, both treatment naïve and re-treated. METHODS: The study comprised 79 patients with chronic hepatitis C ages 8 to 18 years (43 patients re-treated; 54 infected with genotype 1 hepatitis C virus and 25 with genotype 4), treated with pegylated IFN-α2b (1.5 µg · kg⁻¹ · week⁻¹) plus ribavirin (15 mg · kg⁻¹ · day⁻¹) for 48 weeks. The primary endpoint was sustained virologic response (SVR). RESULTS: Early viral response (EVR) was observed in 43.1% and end-of-treatment response in 47.9% of patients. In 44.3% of patients, SVR was achieved, which was maintained for at least the next 6 months. Patients not treated before significantly more frequently attained EVR, end-of-treatment response, and SVR (64%, 65.6%, and 63.9%, respectively) as compared with re-treated patients (30%, 33.3%, and 27.9%, respectively). Among 28 patients who attained EVR, 23 achieved SVR. In 2 patients, despite lack of EVR, SVR was observed. There were numerous adverse effects. They were not so severe as to discontinue therapy. CONCLUSIONS: Combined therapy with pegylated IFN-α2b and ribavirin in patients with chronic hepatitis C, infected with hepatitis C virus genotypes 1 and 4, was more effective in treatment-naïve patients (63.9%) as compared with re-therapy cases (27.9%). SVR was maintained for at least the next 6 months in all of the patients. The applied treatment has limited efficacy and evokes numerous adverse effects; thus, search for new methods of treatment is mandatory.

Distribution of cytomegalovirus gN variants and associated clinical sequelae in infants.

BACKGROUND: Human cytomegalovirus (HCMV) is the most widespread cause of congenital infection. The effects of various viral strains and viral loads on the infection outcome have been under debate. OBJECTIVES: To determine the distribution of gN variants in HCMV strains isolated from children with congenital or postnatal infection and to establish the relationship between the viral genotype, the viral load, and the sequelae. STUDY DESIGN: The study population included congenitally HCMV-infected newborns and children with postnatal or unproven congenital HCMV infection. The genotyping was performed by RFLP analysis of PCR-amplified fragments, and the viral load was measured by quantitative real-time PCR. RESULTS: Our results demonstrated that the HCMV genotypes gN3b, gN4b, and gN4c were prevalent in the patients examined. There were no differences in the distributions of gN genotypes in the congenitally and postnatally infected children. Multiple HCMV strains were detected in both groups of children. A significant association between the HCMV gN4 genotype and the incidence of neurological disorders was observed (p=0.045). Our results suggest that the detection of the gN2 or the gN4 genotype may be indicative of serious manifestations in children. In contrast, the gN3b and the gN1 genotypes represent less pathogenic HCMV strains. The HCMV load in urine was significantly higher in children with congenital infection compared with children with postnatal infection. No correlation was found between the viral load and the genotype. CONCLUSION: Our results suggest that the gN genotype may be a virological marker of symptomatic HCMV infection in newborns.

[Thyroid dysfunctions in children with chronic hepatitis C during interferon alpha-2b therapy]. / Zaburzenia czynnosci tarczycy u dzieci z przewleklym zapaleniem watroby typu C leczonych interferonem alfa-2b.

Thyroid dysfunctions are the most frequently described extrahepatic syndromes which complicate HCV infection. Application of interferon in the treatment of chronic hepatitis C increases the frequency their occurrence. The aim of this study was analysis of the frequency of thyroid dysfunctions in children with chronic hepatitis C treated with recombined and pegylated interferon alpha-2b. The study was comprised of 50 children (19 girls, 31 boys) aged from 4 years to 18 years (average 14 years and 6 months) with chronic hepatitis C. Thirty children were treated with recombined interferon alpha-2b and ribavirin, while twenty children received the pegylated interferon alpha-2b and ribavirin. In all children the concentration of thyroid hormones: TSH, fT3 and fT4; as well as the concentration of thyroid antibodies: anty-TG and anty-TPO were examined before beginning of treatment and immediately on its completion. The control group was comprised of 25 children (13 girls, 12 boys) aged from 5 years to 18 years (average 13 years and 6 months) with no observed diseases of liver or thyroid gland. The conducted examinations did not reveal any significant difference in frequency of abnormal concentration occurrence of TSH and fT4 in children with chronic hepatitis C in relation to the control group (respectively: 34% and 20%). However, an abnormal concentration of fT3 was more frequently observed in children infected with HCV, but the average values of this hormone concentration did not significantly differ in both analysed groups of children (respectively: 3.8112 pg/ml and 3.8012 pg/ml). The combined treatment of interferon alpha and ribavirin did not influence more frequent occurrences of abnormal thyroid hormone concentrations, in comparison to their values before treatment. Clinical symptoms of thyroid dysfunction did not accompany the incorrect concentrations of thyroid hormones. Before the treatment, incresed concentration of antithyroid antibodies was observed in a similar percentage of the HCV infected children, as of the healthy children (respectively: 8 and 12%). However, in the group treated with ribavirin and interferon alpha, and especially its pegylated form, the increased concentration of antithyroid antibodies was frequently observed (32% children). The abnormal values of antithyroid antibodies appeared more frequently in girls (10/16). The conducted examinations showed frequent appearance of abnormal values of thyroid hormones and antithyroid antibodies, which indicates the necessity of a systematic control of thyroid gland function in children with chronic hepatitis C treated with interferonem alpha.

[Acute disseminated encephalomyelitis in children as the result of aseptic meningitis - a report of two cases]. / Ostre rozsiane zapalenie mózgu i rdzenia kregowego u dzieci jako nastepstwo jalowego zapalenia opon mózgowo-rdzeniowych - opis dwóch przypadków.

Acute disseminated encephalomyelitis (ADEM) is an inflammation of the spinal cord and brain. Diagnosis of ADEM, due to its rare occurrence and lack of definite laboratory indices, is difficult and is never totally certain. The clinical criterion required for the diagnosis is presence of acute symptoms from the brain and/or spine with fever, occurring after viral or bacterial infection, vaccination or serum administration. Differentiation between ADEM and acute multiple sclerosis in children is difficult, and diagnosis of ADEM may only be confirmed after years of observation, especially as multiple sclerosis is more common than ADEM. The most useful tool in differentiation between the two diseases is MRI. The aim of the study was to present two cases of ADEM with unknown aetiology after aseptic meningitis in children.

[Role of the PD-1/PD-L1 pathway in immunopathology of HBV infection as the chance on the new therapeutic strategy]. / Rola szlaku PD-1/PD-L1 w immunopatogenezie zakazenia HBV jako szansa na nowa strategie terapeutyczna.

Many individuals infected with HBV become chronic carriers and they liver disease may progress to cirrhosis and HCC. The newest data suggests that the interaction between positive and negative costimulatory molecules expressed on T cells are performing the role in the regulation ofT cells immune response. In the last years they were described programmed death-1 (PD-1) [CD279] and programmed death-ligand 1 (PD-L1) [CD274] in immunopathology of HBV infections. In acute exacerbation of hepatitis B, high level of PD-1 expression significantly mediated CD8+T cells apoptosis and protecting before damaging the liver. In the period of recovering, activation of the PD-1/PD-L 1 pathway should dynamically decrease, and if it isn't taking place, increased expression of the PD-1 plays a crucial role in inhibiting the function of virus-specific CD4+ and CD8+ T cells in chronic viral infections. The aim of this article was to explore the potential role of (PD-1/PD-L) pathway in antiviral immunity during HBV infection. Blockade of PD-1/PD-L1 pathway may open a novel therapeutic strategy for restoring the function of the exhausted CD8+ T cells, and enhancing viral control during chronic viral infections.

[The role of selected risk factors in Barrett's esophagus development]. / Ocena roli wybranych czynników ryzyka w rozwoju przelyku Barretta.

UNLABELLED: Barrett's esophagus is the proved stage of increasing risk for development of esophageal adenocarcinoma. Why among wide spread GERD, a few patients only develop Barrett's esophagus is still not clear. AIM OF THE STUDY: To define the factors, which significantly increase the risk for development Barrett's esophagus. MATERIALS AND METHODS: The study involved 36 patients hospitalized in the years 2005-2007 in the Department of Digestive Tract Diseases, Medical University in Lódz, with diagnosed Barrett's esophagus (based on gastroscopy with biopsy and histopathologic findings). For the analysis, two control groups of healthy subjects were chosen: I--35 patients (mean age 54.3 years) with normal gastroscopy, II--40 patients (mean age 54.2 years) who had not undergone gastroscopy Risk factors were evaluated according to the self-elaborated, filled-in questionnaire. The following risk factors were taken into consideration: age, sex, BMI, stimulants (cigarettes, alcohol and coffee), diet, eating habits (preferred food, fruit and vegetables consumption, regularity and quantity of meals), physical activity, heartburn sensation, swallowing disorders, nausea, other diseases and family history. RESULTS: Mean age of patients with diagnosed Barrett's esophagus was 55.9 +/- 11.2 years; in men: 55.7 +/- 12.2 and in women: 56.3 +/- 9.2. In the analyzed group there were 25 men (69.4%) and 11 women (30.6%), the man/woman ratio was 2.3:1. In the group with diagnosed Barrett's esophagus the heartburn sensation was observed in 30 (83.3%) patients, overweight and obesity (BMI >25 kg/m2) in 22 (61.1%) patients, 16 (44.4%) patients smoked cigarettes, 11 (30.6%) had swallowing problems, 12 (33.3%) suffered from nausea. Factors and symptoms, mentioned above have been significantly more often observed, as compared to I and/or II control group (p < or = 0.05). Statistical significance for other analyzed factors was not reached (significance value p < or = 0.05). CONCLUSIONS: Barrett's esophagus is associated with: male sex, overweight and obesity (BMI > 25 kg/m2), cigarette smoking, heartburn sensation, swallowing disorders and nausea.

[Mumps--effect of immunizations on epidemiological situation]. / Swinka--wplyw szczepien na sytuacje epidemiologiczna.

In 2004, 57% of States included mumps vaccine in their routine national immunization programmers. Nevertheless WHO reported then global increase of mumps cases--654 216 in 2004 compared to 334 064 cases in 2003. Cases registered in Europe accounted for 38% of general accidents. In Poland, since 2004 above 90% of population suffered from mumps since 19 years old. After 2006, after introduction second mumps vaccine dose for children at age 10 years in polish routine national immunization program, particularly will be exposure to risk of mumps infection and mumps complications unvaccinated and seronegatived aged in 1985-1995.

[The analysis of the hepatitis C virus infection course and efficacy of treatment dependence on HLA A antigens in children and youth]. / Analiza zwiazku przebiegu zakazenia wirusem zapalenia watroby typu C oraz skutecznosci leczenia dzieci i mlodziezy z antygenami HLA A.

UNLABELLED: The hepatitis C virus (HCV) infection course and efficacy of treatment may be depended on HLA antigens. The aim of the study is attempt to define dependence between the course of HCV infection and efficacy its treatment and HLA A antigens in children and youth. PATIENTS AND METHODS: To the study included 61 patients (51 after treatment for HCV infection and 10 not treated). The average age was 13.77 years (range 5-18 years). Patients were divided to subgroups in depend on effect of the treatment: virusological and biochemical response. Antigens HLA A were molecularly typed on the low resolution method. To statistical analysis we applied the chi-square test. RESULTS: We demonstrated no statistical significant dependences between HCV infection course and efficacy of its treatment children and youth HLA A antigens. However we observed following tendencies: antigens HLA A *01 and HLA A *02 can be related to unprofitable course of infection and unsuccessful antiviral therapy; HLA A *03 can be favorable prognostic factor for HCV infection course and response to treatment; HLA A *24 can be related to mild course of infection and profitable response to treatment; HLA A *11 can be favorable prognostic factor for course of infection; HLA A *30 can be profitable for efficacy of treatment and HLA A *25 can be disadvantage for it. Probably study performed with larger group of patients could gain dependencies statistical significant. CONCLUSIONS: It is possible that course if HCV infection and efficacy of antiviral treatment are depended on HLA A antigens.

[Underestimated problem of Chlamydia infections]. / Niedoceniany problem zakazen Chlamydiowych.

Microorganisms which belong to Chlamydophila sp and Chlamydia sp genus are intracellular pathogens with characteristic life cycle. In humans the most common infections are caused by Chlamydophila pneumoniae i Chlamydia trachomatis.These pathogens are mainly responsible for infections of upper respiratory tract, infections of urinary tract and conjunctivitis. They are also considered to take part in patophysiology of Atherosclerosis, nervous system diseases and exacerbation of chronic respiratory tract diseases.

Lipid metabolism in children with chronic hepatitis C, A preliminary report.

BACKGROUND/AIMS: The importance of lipid metabolism in the pathogenesis of chronic hepatitis C has been recognized in recent years. Bearing in mind remote sequelae of chronic hepatitis C in children, it seems reasonable to seek to determine potential risk factors for the development of cirrhosis and carcinogenesis. The aim of the study was to assess lipid metabolism in children with chronic HCV-related hepatitis. METHODOLOGY: The study comprised 16 children with chronic hepatitis C and 16 healthy controls. In all the children anthropometric data and after, overnight fasting, serum levels of total bilirubin, AST, ALT, total cholesterol, LDL-cholesterol, HDL-cholesterol and triglycerides were investigated. In the study group biopsy specimens were assessed. RESULTS: Macrovesicular steatosis in numerous hepatocytes was found in 3 children. Total cholesterol level in children with chronic hepatitis was significantly lower than in control group (p < or = 0.05). Mean values of body mass, height, body mass index (BMI), levels of bilirubin, HDL-cholesterol, LDL-cholesterol, triglycerides and HDL/C index did not differ significantly between the two groups. No correlation between lipid parameters and histological markers, hepatic enzymes, patient age, weight, height or BMI was found. CONCLUSIONS: Neither obesity nor hyperlipidemia, which are recognized risk factors for steatosis were found in children with HCV-related hepatitis. Lower cholesterol levels in children with chronic HCV infection compared to the controls and only scarce signs of steatosis which were noted could suggest the risk, existing already in such young patients, of developing fatty liver disease with its consequences including cirrhosis and neoplastic disease.

[Specific features of Borrelia burgdorferi infection in children]. / Odrebnosci przebiegu zakazenia kretkiem Borrelia burgdorferi u dzieci.

Clinical picture of Borrelia burgdorferi infection has been presented in 89 children from Lodz region. The analysis showed significant domination of cases with non specific symptoms (41.6%) as: fever or headache and cases with affected central and peripheral nervous system (30.3%). Peripheral cranial nerves paralysis and symptoms of cerebrospinal meningitis dominated among children with neuroborreliosis. Unlike descriptions concerning adults, majority of the observed symptoms were changes characteristic for I stage of the disease. Dermatosis was found only in (19%) child and symptoms of arthritis in (9%) of them. Contact with tick was stated in 56.8% of the analysed children. Incidence of the disease occurred throughout the whole year, more frequently in summer and autumn months.

[Haemophilus influenzae infections in children]. / Zakazenia haemophilus influenzae u dzieci.

Haemophilus influenzae is a gram-negative bacteria. The capsular form of this bacteria, mainly type b, is responsible for severe bacterial meningitis. In the study course of Haemophilus influenzae meningitis in two children was presented. In one of these children the clinical course of meningitis was particularly serious. The child was unconscious, the generalized swellings, pneumonia, increase and damage of liver, diarrhoea, heavy anaemia as well as disorders of blood coagulation were observed. In second child the beginning of disease was not characteristic, what delayed the proper diagnosis. The duration of children treatment was from 16 to 18 days. The permanent damages of central nervous system were not observed in both children

[Evaluation of the somatic development in children with chronic virus hepatitis]. / Ocena rozwoju somatycznego dzieci z przewleklym wirusowym zapaleniem watroby.

The aim of the study was an evaluation of the somatic development of children with chronic hepatitis B, C and HBs antigen positive and finding the correlation between the nutrition status, the duration of disease and the aminotransferase activity. The somatic development was examined on the basis of body height and weight measurement and calculation of body mass index and Cole's index. Lowered body height and weight was observed in 25% of the children with chronic HCV infection. In the group of children with chronic hepatitis B there was no body weight loss, but a lowered body height was observed in 9.1%. No correlation between the duration of the disease and the nutrition status in children with chronic hepatitis B and C was proved.