Prevalence and estimated incidence of Toxoplasma infection among pregnant women in Poland: a decreasing trend in the younger population.

This study investigated the prevalence of specific Toxoplasma gondii IgG in pregnancy, the incidence of congenital toxoplasmosis and the prevalence trend of T. gondii infection among pregnant Polish women between 1998 and 2003. The study population comprised 4916 women who were admitted to the Polish Mother's Memorial Hospital Research Institute in Lódz. Their sera were tested for specific IgG and IgM antibodies to T. gondii, and the incidence of T. gondii infection was calculated from the increase in prevalence rates of IgG antibodies in various age groups. Specific IgG antibody was found in 41.3% (95% CI 39.9-42.7) of pregnant women, and the prevalence of IgG increased with age. The linear trend was significant (p <0.001), with an annual seroconversion rate of 0.7% (95% CI 0.004-0.010). The risk of primary infection was estimated to be 0.5% for 9 months, i.e., an incidence of 5/1000 pregnancies. Assuming a 30% maternofetal transmission rate, 1.5/1000 neonates were infected in utero. Seroprevalence during the 6-year study period decreased from 45.4% in 1998 to 39.4% in 2003, with a yearly decline in prevalence of 1.0% (p 0.02). The most important contributory factor to this decline was the group of women aged 19-29 years, among whom seroprevalence decreased significantly (p 0.007). Specific IgM was found in 244 (4.9%) women.

Comparison of the efficacy and tolerability of amoxycillin/clavulanic acid 875 mg b.i.d. with cefuroxime 500 mg b.i.d. in the treatment of chronic and acute exacerbation of chronic sinusitis in adults.

The efficacy and safety of amoxycillin/clavulanic acid (AMX/CA) (875/125 mg b.i.d. for 14 days) were compared with that of cefuroxime axetil (500 mg b.i.d. for 14 days) in a multicenter, open, parallel-group, randomized clinical trial in 206 adults with chronic or acute exacerbation of chronic sinusitis. Clinical response was similar, with 95% of AMX/CA-, and 88% of cefuroxime-treated, clinically evaluable patients cured (95% confidence interval; -0.6% to +15%). In bacteriologically evaluable patients, cure rates, defined as eradication of the original pathogen with or without re-colonization with non-pathogenic flora, were also similar, with 65% of AMX/CA- and 68% of cefuroxime-treated patients cured (95% confidence interval; -18% to +15%). However, clinical relapse was significantly higher in the cefuroxime group: 7% (7/89) of clinically evaluable patients, compared with 0% (0/98) in the AMX/CA (p=0.0049) group. A similar incidence of possible or definite adverse events related to the study drug was reported for both treatments (AMX/CA 4.4%, cefuroxime 4.3%), the most frequent being diarrhea. Four adverse events were recorded as serious or life-threatening with only one considered related to the study drug (urticaria, cefuroxime). AMX/CA 875/125 mg b.i.d. for 14 days is as effective and well tolerated as cefuroxime axetil 500 mg b.i.d. for 14 days in the treatment of chronic, or acute exacerbation of chronic sinusitis, but is associated with a significantly lower clinical relapse rate.

Serological investigation in children infected with Ascaris lumbricoides.

The study included 260 hospitalised children with suspected infection with human ascaris. In serological diagnostics a protein antigen obtained from Ascaris lumbricoides was used. ELISA method was applied. IgG antibodies were detected. Positive results were found in 15% of the examined children. No relation to the gender or demographic conditions was found. The most frequently observed symptoms in the patients with Ascaris lumbricoides were: abdominal pain--87%, diarrhoea 15%. In 31% of the cases eosinophilia was found. Scatoscopy was carried out for all the patients, using the PARASEPT system and Kato and Miura methods as well as decantation and flotation. The examination, which was repeated three times, did not show cysts or eggs. Serological investigation exhibits higher sensitivity than the traditional methods. Their use in recognising ascariasis in humans significantly facilitates diagnostic procedures, especially in the lung phase of the disease, the larval stage or in cases of infection with an individual parasite, when the faeces samples do not contain the eggs. Serological investigation is also useful in all cases of suspected VLM.

The significance of the level of antibodies in the evaluation of the effects of treatment of toxocariasis.

The observation of a group of 168 children treated for toxocariasis shows that the most frequent symptoms at the time of the physical examination were abdominal pains--41%; headache was observed in 12% cases. Eosinophilia was found in 9.2% cases. The final diagnosis was based on the results of serological investigation. The level of IgG antibodies was established by the ELISA method using the excretory--secretory antigen of Toxocara canis larvae. A few years of studies lead to the observation that after treatment the return of the level of antibodies to normal is a very slow process--positive results are found in 57% of patients even after 4 to 7 years, and the decrease of the mean titre of antibodies does not exceed 45%. The observations show that examination of the level of antibodies in the way hitherto applied does not provide a satisfactory indication of the positive effect of treatment. Therefore, it is necessary to develop a system of additional laboratory tests that will allow a faster evaluation of the effects of treatment of this disease.

[Maternal serum cytokines in labor, pregnancy and chorioamnionitis]. / Wyniki oznaczen wybranych cytokin w surowicy ciezarnych oraz rodzacych przedwczesnie i o czasie.

UNLABELLED: The purpose of our study was to compare maternal serum levels of interleukin-6, interleukin-8, tumor necrosis factor-alpha and interferon-gamma in gravidities, during spontaneous term and preterm labor and their relation to histologic chorioamnionitis. METHODS: We investigated 61 women: 10 in preterm labor, 36 in term labor and 15 healthy pregnant nonlabouring controls. Venous bloods for cytokines determinations were obtained during the first stage of labor and during routine screening tests. Titers of cytokines were measured by means of ELISA technique. All births after preterm deliveries were examined to establish histologic chorioamnionitis. RESULTS: Serum levels of IL-6 and IL-8 were significantly elevated both in term (mean: IL-6: 17.5 +/- 58 pg/ml; IL-8: 148 +/- 215 pg/ml) and preterm labor (IL-6: 23 +/- 44 pg/ml; IL-8: 332 +/- 389 pg/ml) when compared to nonlabouring gravidities (IL-6: 5 +/- 7 pg/ml; IL-8: 14 +/- 11 pg/ml). IL-6 and IL-8 titers were statistically similar in term and preterm labors and in patients with and without histologic chorioamnionitis. TNF-alpha and IFN-gamma were not statistically analyzed because only a few patients had detectable serum levels of these cytokines. CONCLUSION: Serum levels of IL-6 and IL-8 in both: term and preterm labor are elevated in comparison to nonlabouring gravidities. The elevated levels of these cytokines are not connected with coexisting chorioamnionitis.

[Serum cytokines in patients with ovarian cancer and benign ovarian cysts]. / Wyniki oznaczen wybranych cytokin w surowicy chorych na raka jajnika lub lagodne torbiele jajników.

UNLABELLED: The aim of our study was to evaluate serum interleukin-6 (IL-6), interleukin-8 (IL-8), tumor necrosis factor-alpha (TNF-alpha) and interferon-gamma (IFN-gamma) as tumor markers--study based on the data about tumor cytokines production and tumor-host interactions. METHODS: We investigated 48 women: 17 with ovarian cancer untreated before, 16 with benign ovarian cysts and 15 healthy controls. Venous blood for cytokines determinations were obtained before operations and during routine screening tests. Titers of cytokines were measured by means of ELISA technique. RESULTS: In the control group the upper limit of normal IL-6 titers (95th percentile) was 5.5 pg/ml; the mean IL-8 concentration was 9.6 +/- 15.1 pg/ml and the upper limit of normal was 37 pg/ml; serum TNF-alpha and IFN-gamma were not detectable. In patients with benign ovarian cysts the levels of all investigated cytokines didn't differ significantly from healthy controls. Women with ovarian cancer had significantly higher serum IL-8 levels (mean: 290.5 +/- 351 pg/ml) than healthy controls or women with benign ovarian cysts; 88% of them had IL-8 titers above the normal. The IL-6 titers in ovarian cancer were also higher but didn't reach statistical significance, 53% of them had IL-8 titers above the normal. TNF-alpha and IFN-gamma levels in ovarian cancer were similar to patients with benign ovarian cysts. CONCLUSION: Serum IL-8 levels in patients with ovarian cancer were significantly higher when compared to healthy controls and benign ovarian cysts and in almost 90% of ovarian cancers the titers of IL-8 were increased. Additionally, 53% of women with ovarian cancer had elevated serum IL-6 levels.

[Bacteriologic evaluation of middle ear fluid during the course of secretory otitis media in children]. / Bakteriologiczna ocena plynu z ucha srodkowego w przebiegu o.m.s. u dzieci.

Fluid collected from tympanic cavity during operation from 43 children with O.M.S. was subjected to bacteriological examination. After the collection, each sample was immediately applied to Bactec Peds Plus/F liquid medium from Becton Dickinson. The number of samples, where each genus and species of bacteria were found, was determined, as well as the number of samples where every two genus coexisted; also the pH genes, in which each genus was found were calculated. Obtained results showed that 22 species of bacteria, belonging to 6 genus lived in the samples. The most commonly occurring genus were Staphylococcus, Streptococcus and Haemophilus; the most rare genus were Moraxella and Bacillus. The most common species were: Haemophilus influenzae (18.6% of samples), Staphylococcus aureus (14.0%), Staphylococcus epidermidis (11.6%), Staphylococcus warneri (9.3%) and Streptococcus oralis (7.0%). Streptococcus coexisted most frequently with Staphylococcus and Haemophilus; Staphylococcus--with Haemophilus and Bacillus; Haemophilus--with Streptococcus and Staphylococcus. The pH ranges for the three most often found genus were: for Staphylococcus--7.7-9, for Streptococcus--7.7-9.3 and for Haemophilus--8.2-8.8.

[The use of maternal serum cytokines in the predicting of the efficacy of tocolytic therapy in case of the threat of preterm labor]. / Przydatnosc oznaczen wybranych cytokin w surowicy ciezarnych w przewidywaniu skutecznosci tokolizy w przypadkach zagrazajacego porodu przedwczesnego.

OBJECTIVES: The purpose of our study was to evaluate the use of maternal serum IL-8, IL-6, IFN-gamma levels in the predicting of the efficacy of tocolytic therapy in preterm labor. MATERIALS AND METHODS: We investigated prospectively the group of 47 women in singleton pregnancies with threatened preterm labor in less than 36 weeks gestation and administered tocolytic therapy. RESULTS: In 19 of them tocolysis failed (group II and they delivered premature newborns (the group I--successful tocolysis consisted of remaining 28 women). The incidence of clinical chorioamnionitis, histologic chorioamnionitis and inherited infection of newborns was significantly higher among women refractory to tocolytic therapy (10.2%, 36.8%, 26.3% versus 0%, 3.6%, 0%, respectively, p < 0.05). Maternal serum IL-8, IL-6, IFN-gamma (by means of ELISA technique) and CRP, WBC, ESR levels were measured at the admission to the study. The mean WBC, ESR and the median (range) IFN-gamma (0 (0-7.1) and 0.9 (0-10.4) pg/ml, respectively) didn't differ in both groups. The concentrations of serum IL-8, IL-6, CRP were significantly higher in the group of failed tocolysis (median (range): IL-8: 22.7 (6.3-83.2) vs 3.0 (0-26.0) pg/ml; IL-6: 7.4 (0-21.0) vs 0 (0-11.3) pg/ml; CRP: 1.8 (0.6-7.0) vs 0.6 (0.6-3.9) mg/dl; p < 0.05). Serum IL-8 determinations (definition of abnormal test: > 8 pg/ml) were found the most reliable in the prediction of tocolysis failure with a sensitivity 87.5%, specificity 81.8%, positive predictive value 77.8%, negative predictive value 90% and accuracy 84.2%. Also reliable were IL-6 determinations (IL-6 > 6 pg/ml had a sensitivity 75%, specificity 90.9%, positive predictive value 85.7%, negative predictive value 83.3% and accuracy 84.2%) and CRP determinations (CRP > 1.2 mg/dl had a sensitivity 75%, specificity 81.8%, positive predictive value 75%, negative predictive value 81.8% and accuracy 78.9%). The efficacy of IFN-gamma, WBC and ESR was significantly lower. CONCLUSIONS: Our data revealed that the maternal serum IL-8, IL-6 and CRP determinations are very useful in the predicting of the efficacy of tocolytic therapy in women with threatened preterm labor. The use of IFN-gamma, WBC, ESR was significantly lower.

[Maternal serum cytokines concentrations during normal pregnancy and labor]. / Wyniki oznaczen wybranych cytokin w ciazy niepowiklanej i w porodzie.

OBJECTIVES: The purpose of our study was to determine maternal serum concentrations of IL-8, IL-6, IFN-gamma during normal pregnancy and labor. MATERIALS AND METHODS: Maternal serum IL-8, IL-6 and IFN-gamma levels were measured by means of ELISA technique in 41 healthy pregnant women in 22-42 week gestation and 15 healthy women in labor at term. All newborns and afterbirths had no signs of infection. RESULTS: IL-8 values for pregnant women ranged from 1.98 to 35.2 pg/ml with the median value 10.24 pg/ml, and the 95th percentile 24.5 pg/ml. IL-8 values for women in labor at term ranged from 3.96 to 54.8 pg/ml with the median 10.4 pg/ml. No statistically significant changes in serum IL-8 concentration were observed during pregnancy or in labor. Serum IL-6 concentrations in pregnant women ranged from 0 to 21.7 pg/ml with the median value 0 pg/ml, and the 95th percentile 15.5 pg/ml. Serum IL-6 concentrations in women in labor at term were significantly higher (p < 0.05): ranged from 0 to 39.2 pg/ml with the median 10.1 pg/ml and 95-th percentile 33.5 pg/ml. Maternal serum IFN-gamma concentrations in pregnant women ranged from 0 to 9.8 pg/ml with the median value 3.9 pg/ml, the 95th percentile 9.2 pg/ml and didn't differ during labor at term: range from 0 to 14.5 pg/ml, median 1.9 pg/ml. CONCLUSIONS: Our data revealed that maternal serum IL-8 concentrations didn't changed during the course of pregnancy and in labor. Women in labor had significantly elevated serum IL-6 concentrations compared to those in pregnancy. We didn't observed such changes in serum IFN-gamma levels.

[Infection with parvovirus B19 in pregnant women]. / Infekcje parvowirusem B19 u kobiet ciezarnych.

The viral infection caused by Parvovirus B19 which occurs at pregnant women may be reason of many different kinds of complications during pregnancy. Until this time it is not known the frequency of the Parvovirus infections at pregnant women in Poland. We have based our studies on a group of 78 pregnant women with symptoms of a abortion, a premature imminent labour, premature labor and intrauterine death of foetus. In 10 cases (12.8%) we have confirmed a presence of antibodies IgM class antiparvovirus B19 at patients serum. It seems that the Parvovirus infection is one of most often reasons of unsuccessful pregnant.

Esters of cephalosporins. Part III. Separation and properties of the R and S isomers of the 1-acetoxyethyl ester of cefuroxime.

Two separation methods for the R and S isomers of the 1-acetoxyethyl ester of cefuroxime [I] were evaluated. Physico-chemical and biological properties of these isomers were studied. It was found that the R isomer after oral administration to rats is absorbed better and faster than the isomer S.

Esters of cephalosporins. Part II. Differences in the properties of various forms of the 1-acetoxyethyl ester of cefuroxime.

Physico-chemical and microbiological properties of three different forms (crystalline and two amorphous ones) of the 1-acetoxyethyl ester of cefuroxime and bioavailability after oral administration to rats have been investigated. Relation between physico-chemical properties of these forms and their bioavailability is observed. It is shown, that for oral administration the most appropriate is an amorphous form obtained by rapid evaporation of a solvent from solution of the ester.