[Brain abscess: analysis of prevalence and clinical course]. / Bakteryjne ropnie mózgu jako problem oddzialu zakaznego.

The aim of the study was the analysis of the patients with bacterial meningitis and brain abscess who were treated in the Department of Infection Disease and Hepatology of Medical University in Lodz in years 1996-2005. We reviewed their clinical presentation, bacteriology treatment and outcome retrospectively. Among 135 patients who were confirmed cases of bacterial meningitis 16 identified as having brain abscesses. The prevalence rate of brain abscesses significantly increased in years: 2004-2005. The common predisposing factors were otic and teeth infections, sinusitis, penetrating head trauma, and bacterial endocarditis. Solitary abscess was found in 56% of the cases while in 44% of the cases multiple abscess were found. The most common presentation: headache, fever and neurological deficit were present in 37% of the cases. 75% of patients were disqualified from early neurosurgical intervention and antibiotic therapy were recommended. The antibiotic therapy was effective only in 1 patient. The mortality rate was 38% and 56% of the survivors had late neurological defects. The prevalence rate of brain abscesses significantly increased in years 2004-2005. Over all mortality was very high and antibiotic therapy hasn't been effective treatment in brain abscess at the late stage of its evolution. The early neurosurgical intervention is recommended. Late neurosurgical intervention strongly influences poor outcome in patients with brain abscess.

[Sepsis and other serious infection patients treated in department of infectious diseases--in own experiences]. / Posocznica i inne ciezkie zakazenia w Oddziale Chorób Zakaznych (z doswiadczen wlasnych).

Results of treatment of 99 adults hospitalized for sepsis and bacterial neuroinfection and spontaneous bacterial peritonitis (SBP) in Intensive Care Unit of Department of Infectious Diseases, Medical University of Lódz are presented. Etiology, confirmation of diagnosis according to common microbiological criteria, source of sepsis and final results of treatment were analysed. There were 22,5% death among patients with sepsis and 29,4% cases of neuroinfection. 35% cases of sepsis methycyllin-resistant Staphylococcus aureus and Staphylococcus epidermidis (MRSA) were the infectious agent.

[Pegylated interferon-alfa 2a with ribavirin in chronic viral hepatitis C (final report)]. / Pegylowany interferon alpha-2a z rybawiryna w leczeniu przewleklego wirusowego zapalenia watroby typu C (raport koncowy z badan).

UNLABELLED: We evaluated the efficacy and safety of peginterferon alfa-2a [40KD] (Peg-IFNalpha-2a) plus ribavirin in patients with chronic hepatitis C in an open-label programme in a routine clinical setting in Poland. Patients received Peg-IFNalpha-2a 180mg/week plus ribavirin 800-1200 mg/d for 48 weeks. Sustained virological response (SVR) was defined as undetectable HCV RNA (<50IU/mL) at the end of follow-up (week 72). 466 adults were enrolled. Most patients (87.3%) had genotype 1 infection. 440 subjects (94,4%) completed treatment. The overall SVR rate was 55.7%. A higher SVR rate was obtained in treatment-naïve patients (58.7%) than in relapsers (47.8%; p=0,048). SVR rates in genotype 1 and non-1 patients were 51.1% and 88.5%, respectively (p<0.001). There were significant higher SVR rates in patients with lower baseline fibrosis (p=0,01). There were no differences in SVRs by gender or viral load. Hemoglobin, leukocyte and neutrophil levels decreased significantly during treatment, but returned to baseline after the end of treatment. ALT levels decreased significantly during treatment in patients with and without an SVR. 38.4% of patients experienced adverse events like neutropenia, anemia, thrombocytopenia, and other. There was one death (severe thrombocytopenia). CONCLUSIONS: The overall SVR achieved in this predominantly genotype 1 population was 55.7%. SVR rates were significantly higher in treatment-naïve patients, those with non-1 genotypes, and in patients with lower baseline fibrosis scores.

[Usefulness of plasma procalcitonin (PCT) estimation to diagnose patients in departments of infectious diseases]. / Przydatnosc oznaczania stezenia prokalcytoniny (PCT) w surowicy krwi u chorych diagnozowanych w oddzialach obserwacyjno-zakaznych.

PCT is a new highly sensitive and specific marker of bacterial and fungi infection--to be used in differential diagnosis at Infectious Diseases Departments. Author in this paper presents structure and mechanism of stimulation of PCT as a factor of "early infection's fase" for many infectious agents: bacteria, fungi, viruses and parasites. PCT may be found useful in diagnosing diseases; for ex.: sepsis, meningitis, inflammation of respiratory system, spontaneous bacterial peritonitis (SPB) and other local inflammatory foci (otitis media, endocarditis). PCT level is low in systemic inflammatory response syndrome (SIRS) and multiorgan dysfunction syndrome (MODS) of non-infectious origin (< 0.5 ng/ml), medium in case of localized infections (1.0-2.0 ng/ml) and in severe cases of disseminated infections (sepsis-->SIRS-->MODS) high (approximately 20 ng/ml).