[Hospital infections in surgical wards]. / Zakazenia szpitalne w oddzialach zabiegowych.

Nosocomial infections are defined as these which develop during the patient's stay at hospital or shortly after its leaving. In Poland The Society of Nosocomial Infections has been trying to estimate the problem. To deal with it the card for registration of nosocomial infection has been developed. The data used in this project embraces the registration of the nosocomial infections in 1998. The registration cards were sent to the computer centre where they were analysed. 91 hospitals took part in the project. The material consisted of 301,813 cards. The number of patients taken into account in operative departments reached 170,036. In 2,384 cases nosocomial infections were discovered which is 1.4 per cent of all. Nosocomial infections were observed to be similarly frequent in regional hospitals and teashing hospitals. The immune system, not well developed (newborns) or weakened (old age) proroves the danger of nosocomial infection. The time of the infected patient's stay at hospital is twice longer than usually. It needs additional treatment, both operative and pharmacological, which is connected with high costs. The most common systems that usually get infected are respiratory, urinary and wounds. Clinical course of nosocomial infections is rather mild. The programme of nosocomial infections registration allows to better estimate the scale of the problem.

[Hospital infections in general surgery wards]. / Zakazenia szpitalne w oddzialach chirurgii ogólnej.

In 1997 the hospital infections programme was accepted by the National Association for Infectious Diseases (Polskie Towarzystwo Zakazen Szpitalnych--PTZSz). About 100 hospitals from Poland participated in the surveillence system introducing nosocomial infection registration cards in their units. The results of the research were sent to the PTZSz. The results from general surgery departments in 1998 were analysed. This year 79 general surgery units took part in nosocomial infection programme of PTZSz, sending from 1 to 2259 questionnaires. The analysis included 48,964 nosocomial infection registration cards. Nosocomial infection developed in 1,031 cases in the general surgery departments what accounted for 2.11% of all treated patient in that period. Surgical site infections were the most often place of nosocomial infections (37.1%), next skin and soft tissue infections (20.1%), and finally respiratory tract infections (17.6%). The average duration of hospitalization in general surgery departments was 10.2 days. In case of nosocomial infection occurrence the time of treatment was extended three times. The most frequent aetiological pathogenes of nosocomial infections were as follows: Escherichia coli and Staphylococcus aureus.

The significance of selected epidemiologico-clinical factors in the prevalence of the Helicobacter pylori infection in young males.

A serological diagnosis (ELISA test) was carried out of infections by Helicobacter pylori in 1200 young males (recruits in the Polish Army) and the influence of selected epidemiologico-clinical factors (civil status, place of residence, profession, economical conditions, tobacco smoking, consumption of alcohol, diseases of the parodontonium, nutritional habits) on the prevalence of the infection was studied. Specific antibodies were detected in 228 (19%) of the persons tested. Of the eight factors analyzed, only three parodontium diseases, tobacco smoking and place of residence (of decreasing importance in that order), had a statistically significant relationship to infection by Helicobacter pylori in young males.

Significance of the 14C-urea breath test in the determination of the location infected by Helicobacter pylori in the alimentary canal.

118 patients with chronic gastritis were the subject of the tests; they were divided into two groups on the basis of a bacteriological (culture) diagnosis of the infections by Helicobacter pylori: group I-patients with the infection present only in the stomach; group II-patients with the infection synchronically occurring in the mouth and the stomach. Both groups underwent the 14C-urea breath test to detect the Helicobacter pylori infection. In general, for the patients of group I the radioactivity of the samples of blown air showed a single maximum after ca 15-25 min. For patients of group II two maxima were obtained, the first after ca 5 min and the second after ca 15-25 min. Our investigations indicate that the 14C-urea breath test can not only be used to detect patients infected by Helicobacter pylori but also to establish the location (mouth, stomach) in the alimentary canal of the infection by that bacterium.

[Levels of N-nitrosamine in gastric juice of patients after surgery for ulcers]. / Stezenie N-nitrozoamin w soku zoladkowym u chorych operowanych z powodu choroby wrzodowej.

The concentration of N-nitrosamines was determined in the gastric juice of 170 patients between 6 months and 33 years after operation for ulcer disease, including 38 patients after resection with the Rydygier method (BI-R), 36 after Billroth II method (BII), 35 after truncal vagotomy with pyloroplasty (VP), 41 after highly selective vagotomy (WWW) and 20 after gastroenterostomy (ZZJ). The concentration of N-nitrosamines in the gastric juice was estimated chromatographically. It was confirmed that their concentration in the stomach was the highest after ZZJ and BII resection, lowest after WWW.

Role of the enterotest in the diagnosis of the Helicobacter pylori infections.

Among 128 patients with gastric and duodenal ulcer a diagnosis was made of Helicobacter pylori infections using the 14C-urea breath test (reference) as well as by a bacteriological test; from each patient the material for culture was obtained in two ways: Through gastroscopy-segments, and through an enterotest. It was shown that the diagnostic value of the enteroprobe in the detection of the Helicobacter pylori infection was relatively high in comparison with the results of the culture of the segments of the mucosa, especially for ulcers of the pyloric area and of the duodenum, whereas that value fell considerably for located in the cardia of the stomach. The entero-probe is thus recommended as a method of diagnosing Helicobacter pylori infections (using the bacterial material for culture and the antibiogram) but only for peptic ulcers of a selected location (pyloric area, duodenum).

The relationship between the frequency of the appearance of IgG against Helicobacter pylori and the main blood groups among patients with ulcer sickness and stomach cancer.

Among the 763 patients with ulcers and stomach cancer, including the control group of 586 blood donors, the search for a relationship between the spread of infection and the main blood groups was defined by the appearance of IgG against H. pylori in blood plasma (the ELISA test). The statistical analysis, however, did not prove that the frequency of the appearance of specific antibodies against H. pylori was statistically important in relation to the ABO blood groups.

[Comparison of thrombosis rate after laparoscopic and conventional interventions with the I(125) fibrinogen test]. / Vergleich der Thromboserate nach laparoskopischen und konventionellen Eingriffen mittels des J125-Fibrinogen-Tests.

The purpose of the present work was to compare the frequency of thrombosis in patients after laparoscopic and conventional operations. The diagnosis of thrombotic complications of the veins of the legs was determined by means of the I125 fibrinogen test. This isotopic test was chosen because it enables the early diagnosis of a thrombosis of the venous sinus of the calf at a stage at which no clinical symptoms have yet appeared. It was shown that in the group of patients submitted to laparoscopic intervention only 19 (18.8%) developed thrombotic complications out of the 101 patients, whereas in the group of conventionally operated patients 42 cases (45.7%) occurred in the 92 patients. Moreover, there was a statistically significant difference in the incidence of thrombotic complications in patients after laparoscopic cholecystectomy in comparison with the traditional operative method, with 14 cases (23.3%) out of 60 patients versus 35 (62.5%) out of 56 patients, respectively.

[The effect of Helicobacter pylori infection and duodenogastric reflux on the histology of gastric mucosa in peptic ulcers]. / Wplyw zakazenia Helicobacter pylori i refluksu dwunastniczo-zoladkowego na obraz histologiczny blony sluzowej zoladka w chorobie wrzodowej.

In a group of 96 patients with peptic ulcer (36 patients with ulcer of the stomach, 60 patients with ulcer of the duodenum) we analysed the alterations of the mucosa of the stomach associated with the ulcer. A significantly frequent occurrence was shown of the athropic gastritis and of the dysplasia in patients with ulcer of the stomach in comparison with the group of patients with ulcer of the stomach in the comparison with the group of the patients with ulcer of the duodenum. Among the patients analysed we also appraised the alterations on the picture of the stomach mucosa of the Helicobacter pylori infection, of the duodeno-gastric reflux as well as of the concentration of the bile acids and of lysolecithin contained in the gastric juice in the ulcerous disease of the stomach and of the duodenum. The presence of the Helicobacter pylori infection was identified bacteriologically, the duodeno-gastric reflux was diagnosed with the radionucleide method and the concentration of the bile acids and lysolecithin in gastric juice was determined chromatographically. It was confirmed that the Helicobacter pylori infection as well as the bile acids and the lysolecithin the concentration of which in the gastric juice in patients with an ulcer in the stomach were significantly higher in comparison with patients with and the ulcer in the duodenum, were a decisive factor for more exacerbated histological alterations of the mucosa of the stomach in case of ulcer of the stomach.

[Coexistence of infection of the oral cavity and stomach and duodenal mucosa with Helicobacter pylori in patients with ulcer and chronic gastritis]. / Koexistenz der Infektion der Mundhöhle sowie der Magen- und Duodenalschleimhaut mit Helicobacter pylori bei Patienten mit Ulkuskrankheit und chronischer Gastritis.

In a group of 260 patients with a peptic ulcer of the stomach or the duodenum and/or chronic gastritis, bacteriological tests were conducted aiming at the detection of Helicobacter pylori in the mucosa of the stomach and the duodenum and in the gingival pockets. The presence of the infection of the mucosa of the stomach and/or of the duodenum was confirmed in 197 patients (75.8%). In this group of patients the bacteria occurred simultaneously in the oral cavity in 77 (39.1%) patients. It was found that the frequency of coexistence of Helicobacter pylori infection in the gingival pockets with an infected gastric or duodenal ulcer was not statistically significant. However, there was a statistically significant correlation between the frequency of Helicobacter pylori infection in the oral cavity (83.3%) and the simultaneous occurrence of extensive infection of the gastric mucosa.

[Helicobacter pylori--comparison of selected diagnostic methods]. / Helicobacter pylori--porównanie wybranych metod diagnostycznych.

Among 108 persons sick from chronic gastritis, 61 with ulcus ventriculi and 91 with ulcus doudeni, diagnostic of Helicobacter pylori with simultaneous utilization of the following methods: direct preparation of homogenous tissue (gastrobiopsy), histological preparation (coloring by Giemza method), culture and serologic test (ELISA and IFP) was carried out. It was proved that among sick persons under examination depending on the diagnostic methods used, frequency of the infection was as follows 20%--direct preparation, 63.8%--histological preparation, 68.1%--culture, 81.5%--serologic test. Differences in prevalence of H. pylori in respective sickness depending on diagnostic methods were noted. It was also determined on the ground of discrimination analysis that in order to obtain the best diagnostic value the most advisable is to couple serologic test and histological examination.

[Duodenogastric reflux and Helicobacter pylori infection in chronic gastritis--evaluation of risk factor significance and risk factor interactions]. / Refluks dwunastniczo-zoladkowy i zakazenie Helicobacter pylori w przewleklym zapaleniu zoladka--ocena znaczenia czynników i wystepujacych miedzy nimi interakcji.

Among 184 sick persons with chronic gastritis proved histologicaly, frequency of appearance of duodenal gastric reflux was estimated scintigraphically, and frequency of appearance of IgG against Helicobacter pylori by serologic test (ELISA and IFP). Reflux was proved in 70 (38%) cases, whereas in 152 (82.6%) specific IgG was found. Using GLM program in the statistic analysis it was found that impact of each of these factors on inflammatory changed gastric mucous membrane is different. The weakest impact of reflex was on appearance of GChA in stomach, impact was 1.9 times higher on appearance of GChpA, GChSimp.--6.4 times higher and of GChSup. as high as 23.9 times. Whereas the weakest impact of Helicobacter pylori was on appearance of GChSimp. in stomach, in appearance of GChSup. the impact was 1.4 times higher, GChpA--1.9 times higher, while GChA 2.1 times higher. Taking into consideration interaction between reflux and infection it was proved that bacterial factor (Helicobacter pylori) acts on gastric mucous membrane (except chronic superficial inflammation) from 2.3 to 30.1(!) times higher (depending on form of chronic inflammation) than duodenal-gastric reflux.

Serological diagnosis of infection by Helicobacter pylori in chronic ulcer disease.

The authors estimated the frequency of occurrence of the infection by Helicobacter pylori in the long term gastroduodenal ulcer disease. The serological diagnosis (ELISA test) was carried out in 175 patients, suffering from this disease for at least two years, to reveal the existence of specific IgG against Helicobacter pylori. The study confirmed the frequent occurrence of infection by Helicobacter pylori in the gastro-duodenal ulcer disease of the stomach (59.2%) and the duodenum (83.7%). It was found that mainly in men the existence of specific IgG against Helicobacter pylori (in the ulcer of the stomach 63.3% and in the ulcer of the duodenum 89.9%!). The results indicate the necessity of taking into consideration the infection by Helicobacter pylori in the treatment of perennial gastro-duodenal ulcer disease.