Epidemiology, clinical history and microbiology of peritonsillar abscess.

The purpose of this investigation was to explore the epidemiology, clinical history and microbiology of peritonsillar abscess (PTA). A retrospective review of PTA cases treated at the Department of Otolaryngology, Regional Specialist Hospital in Radom, Poland between 1st October 2003 and 30th September 2013 was undertaken. A total of 111 PTA patients were admitted. The study population consisted of 57.7 % males and 42.3 % females, with an average age of 31.0 (range 5-78) years. Smokers comprised 22.0 % of the study group. The seasonal variation of PTA was statistically insignificant (p = 0.45). Recurrent tonsillitis occurred in 35.5 % of patients. In comparison with the rest of the study population, patients with a history of recurrent pharyngotonsillitis had higher incidence of previous PTA episodes [odds ratio (OR) 17.8, 95 % confidence interval (CI) 2.1-148.7, p = 0.001]. Also, they were more frequently treated with antibiotics prior to hospitalisation (OR 4.6, 95 % CI 2.0-10.9, p = 0.0005) and had significantly longer hospital stay (p = 0.03). Bacterial cultures of abscess aspirates were performed in 40.5 % of patients. Monomicrobial growth was detected in 77.8 % of aerobic cultures. Streptococcus pyogenes, growing most frequently in monoculture, was found in 28.9 % of aerobic cultures. PTA patients with and without recurrent pharyngotonsillitis differed with regard to clinical history and course of disease. The percentage of smokers among PTA patients was lower than that described in the literature. Monomicrobial growth predominated in PTA aspirate cultures. S. pyogenes proved to be the most frequent pathogen.

Spread of a single multiresistant methicillin-resistant Staphylococcus aureus clone carrying a variant of staphylococcal cassette chromosome mec type III isolated in a university hospital.

The purpose of the study was the molecular characterization of methicillin-resistant Staphylococcus aureus (MRSA) isolates cultured from patients treated in seven wards of a university hospital in Lublin, Poland, over a 14-month period. Eleven nosocomial MRSA isolates were analyzed. Phenotypic identification of the isolates as MRSA was confirmed by the detection of the nuc and mecA genes using a multiplex PCR assay. The MRSA isolates were further characterized by pulsed-field gel electrophoresis, 16S-23S rRNA spacer length polymorphism analysis, and the simplex and multiplex SCCmec PCR assays. The MRSA isolates were found to be multiresistant: in addition to resistance to beta-lactam agents, they demonstrated resistance to ciprofloxacin, tetracycline, erythromycin, and gentamicin. The MRSA isolates were genetically identical and shared common pulsed-field gel electrophoresis profiles and 16S-23S rRNA spacer length polymorphism profiles. The PCR-based method revealed that the profile of the Lublin clone was identical to that of the Brazilian pandemic MRSA isolates. By SCCmec typing, all MRSA isolates harbored the C variant of the SCCmec type III that differed from the typical SCCmec type III pattern by the lack of locus F (414 bp). The results of this study indicate the spread of a single, multiresistant, MRSA clone in various wards of a university hospital over a 14-month period. The SCCmec structure harbored by the Lublin clone has previously been identified among Polish MRSA isolates representing the HoMRSA-Pol1 clone. The data from this study indicate that the Lublin MRSA clone is most probably genetically related to the HoMRSA-Pol1 clone. Moreover, this latter clone belongs to ST239, the same sequence type as the Hungarian and Brazilian pandemic MRSA isolates.

Study on myeloperoxidase role in antituberculous defense in the context of cytokine activation.

Myeloperoxidase (MPO), next to the NO synthase2 (NOS2), and NADPH oxidase, is the key enzyme of the oxidative burst responsible for the antimicrobial immunity. Because MPO participates in the eradication of Mycobacterium tuberculosis in the in vitro model and the extracellular enzyme may activate cells to cytokine synthesis, we investigated the changes in the enzyme concentration in serum of patients with active pulmonary tuberculosis (TB) and correlations between MPO and TNF-alpha, IFN-gamma, and IL-12. To our knowledge, our study is the first to indicate the involvement of MPO during active TB which manifested itself in the significant increase in serum concentration. The statistically significant elevation of TNF-alpha and IL-12 was also noticed in serum of the TB positive group. The statistical analysis revealed no correlation between the cytokine and MPO production in the studied cases. However, the increase in TNF-alpha and IL-12 serum concentration with simultaneous elevation of serum MPO in the group of the highest enzyme concentration may imply that correlation between the enzyme and the cytokines should not be excluded. Our study suggests possible involvement of MPO in the antituberculous, immunological response, and implies its connection with TNF-alpha and IL-12 activation.

IL-6 and sIL-6R concentration in the cerebrospinal fluid and serum of MS patients.

BACKGROUND: The aim of this study was to determine the concentration of cytokine IL-6 in correlation with its soluble receptor sIL-6R in the serum and CSF of MS patients. MATERIAL AND METHODS: The study group consisted of 52 MS patients in clinical stage 2-7 according to the Kurtzke Scale (mean 3.6 +/- 1.8); the disease duration ranged from 2 to 22 years. The levels of interleukin-6 and sIL-6R in serum and CSF were determined using commercial ELISA kits. RESULTS: An significant increase of IL-6 (p=0.03) was found in the serum of MS patients (12.1 +/- 1.8 pg/ml) in comparison to the control group (6.6 +/- 4.5 pg/ml). The concentration of IL-6 in the CSF of MS patients was 13.4 +/- 1.77 pg/ml, and in the majority of patients was higher than in the serum. The highest mean IL-6 concentrations in serum and CSF were found in patients with a longer disease duration, although the differences were not statistically significant. We found some degree of dependence between the serum IL-6 concentration and the level of disability on the Kurtzke scale. The concentrations of sIL-6R in serum (34.0 +/- 39.0 pg/ml) and cerebrospinal fluid (1.4 +/- 3.3 pg/ml) were significantly higher in MS patients than in the controls. CONCLUSIONS: IL-6 and its soluble receptors are involved in a complex immunological reaction that is characteristic for MS. However, the significant differences in the results obtained here from those reported in other studies make it rather unlikely that IL-6 and its receptors could be used as surrogate markers of MS activity.

[Lipid peroxides, tumor necrosis factor alpha (TNF-alpha) and interferon gamma (IFN-gamma) in peritoneal fluid from infertile women with minimal and mild endometriosis]. / Produkty peroksydacji lipidów, czynnik martwicy nowotworów alpha (TNF-alpha) oraz interferon gamma (IFN-gamma) w plynie otrzewnowym nieplodnych kobiet z lagodna postacia endometriozy.

OBJECTIVES: To assess the concentrations of tumor necrosis factor alpha (TNF-alpha), interferon gamma (IFN-gamma) and lipid peroxides (the marker of free radicals activity) in peritoneal fluid (PF) of infertile women with minimal and mild endometriosis. MATERIALS AND METHODS: 19 women were studied, including 9 infertile women with minimal or mild endometriosis and 10 patients with tubal occlusion (the reference group). Lipid peroxides (malonyldialdehyde and 4-hydroxynonenal), TNF-alpha and IFN-gamma concentrations were measured in the PF using commercially available kits. RESULTS: Concentration of IFN-gamma was detectable in PF of 7 (77.8%) women with endometriosis and in PF from 3 (30%) patients with tubal occlusion. Neither TNF-alpha or lipid peroxides PF concentration differed significantly (p < 0.05) between the groups. In the group with endometriosis we have found a positive correlation (R = 0.77, p = 0.04) between the concentrations of TNF-alpha and IFN-gamma. CONCLUSIONS: Our results suggest that oxidative stress in the PF doesn't appear to play a role in endometriosis-associated infertility.

Rate of Staphylococcus aureus nasal carriage in immunocompromised patients receiving haemodialysis treatment.

Specimens from the nose and throat were collected from 28 long-term haemodialysed patients. Staphylococcus aureus strains were isolated from sixteen patients who been on haemodialysis for over 113 months. Cytokine levels, as well as full blood cell differential counts and cell surface antigens were determined in these patients. The serum concentration of TGF-beta was significantly higher in patients carrying Staphylococcus aureus. CD14 and HLA-DR molecule expression on monocytes, as well as NK cell percentage was significantly different in S. aureus carriers. Our preliminary results suggest that immune status imbalance in haemodialysed patients could be related to the high incidence of S. aureus nasal carriage and infections.

Total antioxidant status of peritoneal fluid in infertile women.

OBJECTIVE: To determine whether impairment of the antioxidant systems of peritoneal fluid might be a factor responsible for infertility. STUDY DESIGN: Total antioxidant status was measured in peritoneal fluid obtained from 18 infertile women suffering from minimal or mild endometriosis, 23 patients with unexplained infertility, 12 women with tubal infertility and 13 fertile women. RESULTS: Total antioxidant status was significantly lower in peritoneal fluid from women with unexplained infertility (0.49+/-0.21 mmol/l) compared to both fertile patients (0.67+/-0.24 mmol/l, P=0.02) and women with tubal infertility (0.76+/-0.26 mmol/l, P=0.001). Peritoneal fluid total antioxidant status did not differ significantly between patients with endometriosis (0.61+/-0.2 mmol/l), tubal infertility and the fertile group (P>0.05). CONCLUSIONS: Our results suggest that low antioxidant status in peritoneal fluid may play a role in the pathogenesis of infertility.

[The relation between Chlamydia pneumoniae infection and abdominal aortic aneurysm]. / Zwiazek zakazenia Chlamydia pneumoniae z patogeneza tetniaka aorty brzusznej.

The aim of our study was to evaluate the frequency of C. pneumoniae infection in abdominal aortic aneurysm (AAA) patients by measuring C. pneumoniae specific serum IgG, IgM and IgA levels and the activation of their immune system by measuring the concentrations of IL-10, IL-12, IFN-gamma and TNF-alpha in patients' serum. Microimmunofluorescence method was applied to evaluate the level of anti-C. pneumoniae IgG, IgA and IgM. The concentrations of cytokines were evaluated using ELISA method. Serologic markers of persistent C. pneumoniae infection have been detected in 25/28 (89.3%) patients and in 6/20 (30%) healthy controls. In 40% (10/25) of patients with serologic markers of persistent C. pneumoniae infection high titers of specific IgG and IgA indicated active infection--reinfection or exacerbation of chronic infection. Mean concentrations of IL-10, IL-12, IFN-gamma and TNF-alpha indicated lack of protection against intracellular pathogens. Since all patients in this group were diagnosed as having symptomatic AAA, we suggest that active infection can exacerbate inflammation in the AAA wall and accelerate progression of the disease. In our opinion patients with active C. pneumoniae infection may be candidates to the antimicrobial treatment.

[Peritoneal fluid and plasma 4-hydroxynonenal and malonyldialdehyde concentrations in infertile women]. / Stezenie 4-hydroksynonenalu i dialdehydu malonowego w plynie otrzewnowym i osoczu krwi nieplodnych kobiet.

OBJECTIVES: To investigate the possible role of oxidative stress in the pathogenesis of female infertility, we examined the peritoneal fluid (PF) and plasma lipid peroxides levels in infertile women. MATERIALS AND METHODS: 4-hydroxynonenal (4-HNE) and malonyldialdehyde (MDA) concentrations were measured in peritoneal fluid and plasma samples obtained from: 10 infertile women with minimal and mild endometriosis, 24 patients with unexplained infertility, 11 women with PCOS and 14 patients with tubal infertility. RESULTS: PF lipid peroxides level was significantly higher in women with idiopathic infertility compared to other groups. Plasma 4-HNE and MDA concentrations did not differ significantly between the infertile groups. No significant difference or relationship was observed between peritoneal fluid and plasma lipid peroxides levels. CONCLUSIONS: Increased free radicals activity in the peritoneal fluid environment may be the factor responsible for some cases of "unexplained infertility".

[Glutathione peroxidase concentration in the peritoneal fluid from infertile women]. / Stezenie peroksydazy glutationowej w plynie otrzewnowym nieplodnych kobiet.

OBJECTIVES: To assess the concentration of Plasma Glutathione Peroxidase (plGPx) in the peritoneal fluid (PF) of patients with unexplained infertility and infertile women with minimal and mild endometriosis. MATERIALS AND METHODS: 33 women were studied, including 8 infertile women with minimal or mild endometriosis, 15 patients with unexplained infertility and 10 patients with tubal occlusion (a reference group). Concentration of plGPx was measured in the PF using a commercially available ELISA kit (Oxis Inc.). RESULTS: The plGPx concentration was significantly (p = 0.04) lower in PF from women with unexplained infertility (846 +/- 177 ng/ml) compared to the reference group (1023 +/- 238 ng/ml), but did not differ significantly (p = 0.25) between women with endometriosis (918 +/- 81 ng/ml) and patients with tubal infertility. CONCLUSIONS: Our results suggest that low peritoneal plGPx concentration may play a role in the pathogenesis of infertility.

[Total antioxidant status and activity of an extracellular superoxide dismutase in peritoneal fluid and plasma from women with unexplained infertility]. / Calkowity potencjal antyoksydacyjny oraz aktywnosc zewnatrzkomórkowej dysmutazy ponadtlenkowej w plynie otrzewnowym oraz osoczu kobiet z niewyjasniona nieplodnoscia.

OBJECTIVES: To evaluate the activity of an extracellular superoxide dismutase (EC SOD) and total antioxidant status in peritoneal fluid (PF) and plasma from women with unexplained infertility (UI). MATERIALS AND METHODS: PF and plasma samples were collected from 10 women with UI and 10 patients with tubal infertility (reference group). TAS was measured using Randox diagnostic reagent system. The activity of EC SOD was estimated using Calbiochem assay kit. RESULTS: TAS was significantly lower in PF from women with UI. Plasma TAS did not differ significantly between the groups. Peritoneal TAS was significantly lower compared to plasma TAS and there was a positive correlation between PF and plasma total antioxidant status. Activity of EC SOD did not differ significantly between the groups in either PF and plasma samples. CONCLUSIONS: These data demonstrate that low antioxidant status of PF but not that of blood may be responsible for idiopathic infertility. The activity of EC SOD doesn't appear to play a role in UI.

[Chronic Chlamydia pneumoniae infection in patients with asthma]. / Przewlekle zakazenie Chlamydia pneumoniae u chorych na astme oskrzelowa.

The aim of our study was to evaluate the frequency of Chlamydia pneumoniae infection (especially chronic infection) in 41 asthma patients. They have been assigned to 3 groups, according to disease severity. Control group consisted of 35 age matched healthy volunteers (without cardiac and pulmonary diseases). The levels of specific IgG, IgA and IgM in patients' serum have been estimated using indirect microimmunofluorescence. According to serologic criteria, 23(56.1%) asthma patients and 4(11.4%) healthy controls have appeared to be chronically infected with Chlamydia pneumoniae (p < 0.001). Acute Chlamydia pneumoniae infection was present in 3(7.3%) asthma patients and in 2(5.7%) healthy controls. Taking in account asthma severity, persistent Chlamydia pneumoniae infection has occurred more frequently in patients with moderate and severe asthma than in ones with mild asthma. Acute Chlamydia pneumoniae infection was present in 9.1% and 12.5% of patients with mild and severe asthma respectively.

[Chronic Chlamydia pneumonia infection in patients with chronic obstructive pulmonary disease]. / Przewlekla infekcja Chlamydia pneumoniae u chorych na przewlekla obturacyjna chorobe pluc.

The aim of our study was to evaluate the frequency of Chlamydia pneumoniae infection (especially chronic infection) in COPD patients. Microimmunofluorescence method has been applied Chlamydia pneumoniae Micro-IF test (Labsystems) has been used. The levels of specific IgG, IgA and IgM have been estimated in patients' serum. According to serologic criteria, 64.1% of COPD patients and 20.5% of healthy controls appeared to be chronically infected with Chlamydia pneumoniae (p < 0.001). Taking in account COPD severity, persistent Chlamydia pneumoniae infection has been present in 68.2%, 57.1%, and 50% of patients with severe, moderate and mild COPD, respectively. Our study has revealed that chronic Chlamydia pneumoniae infection occurs more frequently in COPD patients than in healthy controls and in patients with severe COPD than in ones with mild and moderate disease. It is possible that persistent Chlamydia pneumoniae infection can initiate or amplify inflammatory reactions in the respiratory tract. The results suggest a need to diagnose chronic Chlamydia pneumoniae infection in COPD patients and, if confirmed, to take an attempt of antimicrobial therapy.

Is there any correlation between the total number of neutrophils in plasma and concentration of interleukin-8 in psoriatic patients?

INTRODUCTION: Interleukin-8 is a chemotactic agent for neutrophils which causes their simultaneous activation. This cytokine of the chemokines family contributes considerably to the processes observed in the psoriatic epidermis with the participation of neutrophils. MATERIAL AND METHODS: The level of IL-8 in plasma of psoriatic patients during the period of acute and chronic relapses, the number of neutrophils in blood, and the correlation between these parameters were analysed. The study included 55 patients affected by psoriasis (psoriasis severity and activity index ranging from 16.20 to 70.20) and 10 people of the control group. Psoriatic patients were divided into two groups: 'acute psoriasis'--with an acute relapse of the disease (up to one month)--15 patients, and 'chronic psoriasis'--with a longer period of relapse--40 patients. IL-8 plasma levels were determined with the use of the ELISA method. The total number of neutrophils was assessed in blood and smears, and calculations were performed. RESULTS: The results of the study showed higher levels of IL-8 in the plasma of patients with acute psoriasis, however, an elevated number of neutrophils in this group was not statistically significant.

Interleukin-6 concentration in serum and cerebrospinal fluid in multiple sclerosis patients.

INTRODUCTION: The aim of the investigation was to determine pleiotropic cytokine IL-6 concentrations in serum and CSF of MS patients, with regard to clinical circumstances. MATERIAL AND METHODS: The study covered 27 MS patients: 23-51 years old; in the 2-7 clinical stage according to Kurtzke's Scale; mean 3.6 +/- 1.8; disease duration time ranged between 2-22 years. Serum and CSF interleukin-6 were determined by the use of commercial ELISA kits. RESULTS: Increase of Il-6 in serum of MS patients was found (12.1 +/- 1.8 pg/ml) in comparison to the control group (6.6 +/- 4.5 pg/ml) (p = 0.03). Concentration of IL-6 in CSF of MS patients was 13.4 +/- 1.77 pg/ml and in the majority of patients it was higher than in the serum. The highest mean of IL-6 concentrations in serum and CSF have been found in patients at the longer disease duration time, although there were not statistically significant. We have found some degree of dependence between serum IL-6 concentration and the level of disability in Kurtzke's scale. CONCLUSIONS: IL-6 participation in the basic MS immune processes is confirmed by its elevated concentration in serum and CSF, its relation to disease severity with the more expressed rise in cerebrospinal fluid.

[Malonyldialdehyde and total antioxidant status in the peritoneal fluid of infertile women]. / Stezenie dialdehydu malonowego oraz calkowity potencjal antyoksydacyjny w plynie otrzewnowym nieplodnych kobiet.

OBJECTIVE: To estimate the concentration of malonyldialdehyde (MDA) and total antioxidant status in the peritoneal fluid (PF) of patients with unexplained infertility (UI) and infertile women with minimal and mild endometriosis. MATERIALS AND METHODS: PF was obtained during laparoscopy from 8 women with UI, 12 infertile women with endometriosis (I degree and II degrees rAFS) and 10 women with benign noninflammatory ovarian tumours. All laparoscopies were performed in the follicular phase of the cycle. MDA concentration was measured according to Ledwozyw method, TAS was measured spectrophotometrically using RANDOX diagnostic reagent system. RESULTS: We found significantly higher concentration of MDA in PF from both patients with UI (p = 0.03) and with endometriosis (p = 0.046) compared to the control group. TAS was significantly (p = 0.027) higher in PF of women with UI but did not differ significantly (p = 0.49) between patients with endometriosis and controls. CONCLUSIONS: Our results show that an imbalance between lipid peroxides and the antioxidant system in PF environment may be one of the main factors responsible for the UI. In the group with endometriosis a marginally significant difference in MDA levels, no significant differences in TAS and data from the literature, suggest that accelerated lipid peroxidation in PF doesn't appear to play a role in the endometriosis associated infertility.