Persistent infection by Salmonella enterica servovar Typhimurium: are synbiotics a therapeutic option? – a case report

Little is known about the prevalence of persistent human infections by nontyphoidal Salmonella (NTS). Recently published study results indicate that a small fraction (at least 2.2%) of NTS-infected patients continue to shed Salmonella for an extended period of time (up to years). Despite the recommendation not to use antibiotics for the treatment of uncomplicated NTS-Salmonella infection, little treatment guidance is available. Clinical findings from a NTS-patient indicate that administration of synbiotics (probiotic bacteria plus prebiotic) might be considered as a treatment option. We report data of a patient who was treated with a synbiotic preparation containing nine different probiotic bacteria and the prebiotic fructooligosaccharides (FOS). Starting from day one of the treatment, the patient experienced an improvement of symptoms and was symptom-free at the end of a 10 days treatment course. After finishing the treatment, the stool proved to be Salmonella enterica serovar Typhimurium negative. In vitro pathogenic inhibition studies showed the inhibitory effects of the multistrain synbiotic mixture against S. Typhimurium. Growth of S. Typhimurium was also inhibited by individual bacterial strains making part of the composition of the mixture. However, he inhibitory effects of individual strains varied significantly, with those of Streptococcus thermophilus St-21 and Lactobacillus helveticus SP-27 exhibiting the strongest inhibitory effect. Persistent infections by S. Typhimurium are a severe concern for the affected patients. Besides the symptomatic burden, infected persons are banned from work in certain areas (e.g. food related service). In addition, patients with persistent S. Typhimurium infections are a threat for the public health in general, as they serve as a reservoir for NTS transmission. The findings indicate that treatment with a synbiotic preparation might provide a treatment option for persistent S. Typhimurium infections. More clinical data have to be gathered to confirm the relevance of this potential treatment approach.

Plasma ghrelin and interleukin-6 levels correlate with body mass index and arterial blood pressure in males with essential hypertension

We examined an association between ghrelin, including its major isoforms, interleukin-6 (IL-6), body mass index (BMI), and mean arterial pressure (MAP) in male overweight patients with essential hypertension. Twenty hypertensive male patients with newly diagnosed essential hypertension (EH) before starting drug treatment and 22 age-matched healthy controls were enrolled in the study. Fasting total plasma ghrelin (TGhr), acyl ghrelin (AGhr), des-acyl ghrelin (DGhr) and IL-6 were determined and correlations between studied parameters were calculated. We found significantly lower total plasma ghrelin and higher plasma IL-6 in hypertensives when compared with the control. In patients with hypertension the negative correlations were found: between TGhr and BMI, DGhr and BMI, TGhr and MAP, and between DGhr and MAP. IL-6 positively correlated with BMI and MAP in hypertensive subjects. No correlations between all forms of ghrelin and IL-6 were noted. The changes in plasma ghrelin and IL-6 contribute independently to the elevated blood pressure in essential hypertension. Negative correlation of DGhr and MAP may suggest its hemodynamic involvement in regulation of blood pressure.

Vasodilatory effect and endothelial integrity in papaverine- and milrinone-treated human radial arteries

Prevention of the vasospasm is an important aspect of coronary artery bypass grafting (CABG) with the use of radial artery (RA) as the conduit. We compared the effect of two phosphodiesterase inhibitors papaverine and milrinone on vasodilation and endothelial integrity of human RA segments harvested from 20 CABG patients. Vasodilatory effect of the drugs were assessed by organ bath technique in RA rings precontracted with KCl and phenylephrine. Endothelial integrity was evaluated by CD34 immunofluorescence in frozen sections. Vasorelaxation induced by papaverine was significantly greater as compared to that induced by milrinone (90.47% ± 10.16% vs. 78.98% ± 19.56%, p<0.05). Similarly, pretreament with papaverine more strongly inhibited the contractile response of RA rings to KCl (6.0 ± 8.0 mN vs. 26.7 ± 21.5 mN, p<0.001). Papaverine was also superior to milrinone in the preservation of endothelial integrity (75.3% ± 12.9% vs. 51.8% ± 18.0%, p<0.02). In conclusion, papaverine seems to be more suitable than milrinone for prevention of vasospasm in radial artery conduits used for CABG.

Population genetics of 15 autosomal STR loci in the population of Pomorze Zachodnie (NW Poland)

Allele frequency data and forensic efficiency parameters for 15 STR loci: D8S1179, D21S11, D7S820, CSF1PO, D3S1358, TH01, D13S317, D16S539, D2S1338, D19S433, vWA, TPOX, D18S51, D5S818, FGA were estimated from a sample of 600 unrelated individuals from the Pomorze Zachodnie (NW Poland). The combined MP and PE for all 15 loci are 3.9x10(-18) and 0.9999988, respectively. Pairwise comparisons between Northwestern Poland and other Polish populations were performed.

The effects of neurotensin on selected parameters of lipid metabolism in rats

15 nM/kg b.m. of neurotensin (NT) caused a significant inhibition of LMA within 30 min of administration and this effect persisted up for to the 240 th minute of the experiment. A 15 nM/kgb.m. dose also caused a reduction in SLA which persisted up to the 120 th minute. Sixty minutes after an intraperitoneal administration of NT a decrease in the cholesterol and NEFA levels and an increase in the TG and glycerol levels were observed. These effects were inhibited by the NTR2-blocker (levocabastine) and were not subject to change after an in vivo application of SR 48692.

Biochemical markers of bone turnover in girls with secondary amenorrhoea

Our aim has been to evaluate the influence of menstrual disturbances of the secondary amenorrhoea type on the metabolism of bone tissue. We pursued this goal by determining selected biochemical markers of bone metabolism. Alkaline phosphatase and osteocalcin were used as indices of bone remodelling. Deoxypiridinoline was used as an index of bone tissue resorption.

Abdominal aortic aneurysm: association between haptoglobin phenotypes, elastase activity, and neutrophil count in the peripheral blood

To investigate the role of genetic factors on susceptibility to atherosclerotic arterial disease, the influence of haptoglobin phenotypes (Hp) on serum elastase activity, neutrophil count, and elastin concentration in the aorta was measured in patients with abdominal aortic aneurysm (AAA; n=52) and aortoiliac atherosclerotic occlusive disease (AOD; n=37). Findings (serum elastase activity, peripheral blood neutrophil count) were compared to a control group (CG) of 37 subjects without atherosclerosis. Hp phenotyping performed by starch-gel electrophoresis produced a haptoglobin-hemoglobin complex of three phenotypes: Hp1-1, Hp2-2, and Hp2-1. Distribution of Hp phenotypes was similar in the three study groups (AAA, AOD, CG). Significant increases in serum elastase activity and neutrophil count was measured in Hp2-1 phenotype of AAA patients. Although the aorta wall of aneurysm patients contained less (p<0.001) elastin than that of AOD patients, no significant difference of aorta elastin concentration between the three Hp phenotypes, including Hp2-1, was measured. The postulated association of AAA susceptibility with Hp2-1 phenotype was supported by the study data that demonstrated an increase in serum elastase activity in patients undergoing AAA repair.

[Quality of life and working status in patients with coronary artery disease treated by percutaneous coronary angioplasty during long-term observation]

Improvement in the quality of life is nowadays widely acknowledged as an important factor in assessment of the long-term outcome of the actually pursued treatment. Percutaneous transluminal coronary angioplasty (PTCA) has been used in the treatment of coronary disease in ca. 1/3 of patients. The present study aimed to assess the quality of life in 567 patients successfully treated by PTCA in the period 1987-1996. In the observation period spanning 2.5-12 years (5.5 years on average) 26 patients (4.6%) died. A specially designed questionnaire was sent out to the remaining 541 patients, in which they were asked to attempt a subjective assessment of their general health condition and physical fitness, as well as to comment on the quality of their family and social life following angioplasty. The filled-in questionnaire was returned by 447 patients (82.6%). Their functional status, assessed in compliance with the CCS criteria, was perceptibly improved after the procedure and at the end of the observation period 70.5% of patients had no significant coronary complaints. A durable improvement after PTCA was claimed by 85.7% of patients, for 38.2% the result of PTCA turned out to be much better than originally expected, while 47.9% admitted that the procedure actually complied with their expectations. No improvement whatsoever was reported by 11.8%, while 2.3% of patients claimed their condition to have deteriorated since. In their own assessment, normal sexual life after PTCA was still pursued by 63.1% of patients, though men appeared to be more active in that domain than women (68.0% vs. 44.7%, p = 0.0001). Notable improvement was reported by 15.2%, while deterioration was claimed by 17.2%; in both cases it was significantly more frequent in men (improvement 17.0% vs 8.5%, p = 0.042, deterioration 19.5% vs 8.5%, p = 0.012). Angioplasty had no impact on their social relations in 78.8% of patients, while 21.2% of them are commonly perceived as the disabled persons. The need for psychotherapy (counselling) was expressed by 15.9%. The analysis of the key factors determining the actual quality of life in patients, carried out in the sub-groups, did not yield significant differences between the patients with stable and unstable angina, patients below and over 50 years of age, patients with complete and incomplete revascularisation, nor in patients who experienced or not, cardiac events during the follow-up. The significant differences between men and women were encountered only with respect to their sexual life. Diabetics in comparison with non-diabetics significantly more frequently reported improvement in their sexual life, full resumption of their non-occupational activities, generally showed more appreciation for the overall outcome of the PTCA procedure. Diabetics much less frequently experienced improvement in their general physical fitness, generally regarded the need for regular medical check-ups as a hindrance, as well as were more frequently perceived as the disabled persons. The working status of the patients after angioplasty failed to improve, however, as nearly half of them, despite the successfully completed procedure, was granted disability pensions or took advantage of the voluntary retirement schemes. Only 7.2% of the non-working patients well within their statutory employment age successfully returned to their employment, although not on a full-time basis. Patients who had completed their primary or secondary education were found to leave their employment twice more frequently than the ones with academic education. Similarly, patients living in the rural areas or in small towns (less than 40.000 inhabitants) left their employment twice more frequently than the ones living in major cities.

CONCLUSIONS

Both the functional status of patients and the majority of the analysed factors determining the quality of life--in the subjective assessment of those patients--improved significantly after a successful PTCA. This improvement is irrespective of the patients' age, symptoms of unstable angina during the procedure, extensiveness of revascularisation as well as cardiac events during the follow-up. Nearly half of the working patients tend to leave their employment after a successful percutaneous revascularisation, while the non-working patients are seldom prompted to resume their employment by the successful procedure. Patients with academic education, living in major cities, are usually found to resume their original employment most frequently.

The applicability of biochemical markers of bone metabolism for predicting the risk of bone fractures and for the assessment of bone tissue resorption in the course of osteoporosis

The role of increased metabolism of bone tissue as a risk factor for bone fractures in the course of osteoporosis has been investigated. The importance of the assay of biochemical markers of bone remodelling for determining the degree of bone tissue resorption has been evaluated.

[Quality of life in diabetic patients with coronary artery disease treated with percutaneous coronary angioplasty]

Increased restenosis rate, higher incidence of coronary events, and, in some studies also increased mortality are observed during long-term follow-up in patients (pts) with diabetes mellitus treated with percutaneous coronary angioplasty. This is why some authors suggest that indications for PTCA in the group of diabetic pts should be significantly limited. The aim of our study was the estimation of clinical condition and quality of life in diabetic patients who underwent PTCA procedure in order to establish indications for percutaneous revascularisation in this group of pts. The study group consisted of 54 diabetic patients who were successfully treated with percutaneous coronary angioplasty in the period of 1987-1996. All pts were assessed clinically and quality of life was estimated on the basis of specially designed questionnaire. During mean 5-year follow-up 1(1.9%) patient died, 2 (3.7%) pts had acute myocardial infarction, restenosis was diagnosed in 25 (46.3%) pts. Repeated revascularisation was necessary in 27 (50%) pts. Significant clinical improvement was observed in the pts from the study group as compared to their clinical condition before the procedure (CCS 0 or I--61% vs 0%, p < 0.0001, III--9% vs. 39%, p < 0.0003, IV--1.9% vs. 22%, p < 0.001). The rate of pts who were employed did not change in consequence of successful PTCA procedure. The number of pts returning to work was equal to the number of patients receiving social benefits. Subjective improvement was declared by 87% of pts. Lack of angina pectoris episodes was reported by 52% of pts and in 35% of pts the number of angina pectoris episodes was significantly reduced. Better tolerance of physical activity was declared by 59% of pts, and 65% of the studied pts fully came back to their non-professional activities. Partial return to non-professional activities was possible for 24% of pts. Normal sexual activity was declared by 65% of pts. Only 9% of the studied pts experienced significant limitation in their sexual activity. PTCA met the expectations of 89% of pts while the number of negative opinions, i.e. the lack of subjective improvement, impaired quality of life, or disappointment with the results of the PTCA procedure did not exceed 13%. Significantly worse results of the selected parameters describing the quality of life were observed in the group of diabetic pts treated with insulin.

CONCLUSIONS

PTCA improved quality of life in 60-90% of pts with diabetes mellitus, nevertheless, did not affect the employment status of successfully treated pts. Patients who needed insulin therapy had worse indicators of life quality, however thorough analysis suggest that PTCA can be advised as a method of treatment in the group of diabetic patients with coronary artery disease.

[Quality of life in patients after implantation of pacemaker type DDD]

The aim of this study was to evaluate quality of life in pts with DDD pacemakers. The study group consisted of 343 pts (181 F, 162 M), mean age 66.7 +/- 2.5 y (19-92) in whom DDD pacemakers were implanted in the years 1992-1998 due to sick sinus syndrome (213 pts) or AV block (130 pts). Follow-up period was 111-2574 days, mean 924.58 +/- 550 days. The QOL assessment was based on the questionnaire prepared at our Center. The questionnaires were mailed to the pts. The significant improvement in overall well-being (p < 0.001), physical capacity (p < 0.005) and concentration (p < 0.025) was found as compared to the time before implantation. The incidence of syncopy decreased after implantation (p < 0.001). The pts complained of: limitation of arm moving (50.1%), anxiety for disturbances of PM function (41.4%), resignation from job (17.2%), restriction of sport activity (15.7%), necessity for follow-up visits (15.7%) and limitation of sex activity (10.2%). There were not significant differences in QOL between pts paced due to SSS or AV block. We found significant improvement in QOL after implantation of DDD pacemakers. The questionnaire-based assessment of QOL may be useful in management of DDD-paced pts.

Successful culture of rat embryos on human serum: use in the detection of teratogens

Growth of head-fold-stage rat embryos cultured with human serum for 48 hours was enhanced by supplementation with glucose. Embryo growth (protein and DNA contents) varied with the source of the serum. Serum from 16 of 19 untreated subjects produced normal embryos. Serum from five subjects undergoing cancer chemotherapy and six subjects receiving anticonvulsants was either lethal or teratogenic.