Arthritis in children as a result of a previous infection caused by Yersinia enterocolitica and Yersinia pseudotuberculosisInfections caused by Yersinia enterocolitica and Yersinia pseudotuberculosis, often referred to as Yersiriiosis, are classified as diseases occurring in human and animals which originate from their reservoir in a natural environment (sapronosis).Infection occurs orally by contaminated food or water, f pseudotuberculosis and Y enterocolitica are gram-negative, rod-shaped bacterias of the genus Yersinia, belonging to the family' of Enterobacteriaceae.They are enteric pathogens, responsible for triggering a large number of different symptoms ranging from diarrhea and abdominal pain, to more systemic ones such as fever or scarlatinform skinrash.Others may include myocarditis, Crohn's disease.Reiter's syndrome, chronic pancreatitis, ankylosing spondylitis, acute interstitial nephritis, Kawasaki syndrome, conjunctivitis, erythema nodosum, lymphadenopathy (1) and arthritis (2, 3).Reactive arthritis develops 1-4 weeks after gastrointestinal or urogenital infections caused by Yersinia.The finding of LPS structures of Yersinia in the synovial fluid of human joints is widely regarded to be of pafarnouht importance in the pathogenesis of arthritis (4-6).Studies suggest that a superantigen YPM, which is produced in vivo by Yersinia, is responsible for the induction of IgG synthesis in infected patients.Significantly higher antibody level in the patients with systemic symptoms and the presence of YPM-responsive cells in their lymph nodes suggest that this superantigen may have a key role in the disease process ( I ).Owing to the wide diversify of symptoms, Kers/nfo-associated arthritis can pose a complicated diagnostic problem and suggest a rheumatic origin of the disease.In that case, due to the impossibility of isolating the microorganisms at this stage of infection, the basis for the confirmation of diagnosis is the measurement of specific antibody levels against antigen О of Y. enterocolitica and T pseudotuberculosis (t, 8).The aim of the study was to determine the relationship between symptoms of arthritis and infections caused by Y. enterocolitica and Y. pseudotuberculosis in children. MATERIAL AND METHODSBlood samples of 68 randomly chosen patients from the Pulmunology and Reumatology Ward, Children Hospital of Lublin.Poland, were examined for the presence of antibodies against Yersiniae.A group of 17 children patients with the highest levels of immunoglobulins IgA.IgM and IgG against Yersinia was consequently chosen and carefully studied.A broad array of different clinical
Health resort rehabilitation of the cardiological patientsHealth resort rehabilitation consists in the health improvement of the patients after sudden cardiological incidents.The volume of health resort rehabilitation has radically changed over the years.The reason is the development, which improves the general condition of patients, gives them an opportunity to return to activity, but at the same time keeps them from the correction of the existing factors of risk.Cardiological rehabilitation releases the physical strength of the organism, modifies risk factors, and is an introduction to the secondary prevention and physical rehabilitation (1-3).The treatment of the patients after myocardial infarction consists of three stages.They are: hospital rehabilitation, posthospital early rehabilitation (sanatorium), posthospital late rehabilitation (dispensary).Stage I. Hospital rehabilitation.The aim of the first stage of rehabilitation is the quickest achievement by the patient of the initiative in everyday activities.After the treatment in the hospital the patient is most often directed to a sanatorium for the continuation of treatment (4).Stage II.Posthospital rehabilitation.This stage consists in the complex influence on the patient and the introduction of the secondary prevention.It can be held in a sanatorium or in an outpatients' department.The second stage is held mostly in a sanatorium.The aim of the action in sanatorium is the continuation of treatment, physical rehabilitation, psychical rehabilitation and risk factors' modification.During this stage complex physical rehabilitation takes place.The authors of the articles referred to below say that the optimal physical programme gives physiological, biochemical, and haemodynamical effects for the patient after the myocardial infarction (5,6).A systematic physical activity releases heart spasms frequency, also in the state of rest, alleviates an increase in the blood pressure during the effort, which makes possible broadening of the physical activity of the patients after the myocardial infarction (7-9).Sanatorium rehabilitation is also a counteraction with risk factors.Implementation of the secondary preventive rules is necessary to prevent the next myocardial infarction and release the risk of complications.Psychical rehabilitation is an indisputable component of the full programme of cardiological rehabilitation affecting stress symptoms, reducing fear and anxiety and also teaching proper techniques of coping with stress (2,10,11).Stage III.Dispensary rehabilitation.Its aim is the improvement of the tolerance of effort, the support of temporary effects of treatment, and releasing the risk of disease relapse.It is realized in cardiological clinics and by family doctors, through conducting periodical control examinations and verification of pharmacological treatment.The aim of the research was the recognition of the rehabilitation benefit and rehabilitation influence on the tolerance of effort, lifestyle and the psychical condition of the cardiological patients.
Premalignant and malignant skin diseases Assessment of proliferation indexesMalignant diseases, such as proliferative skin lesions are characterized by inappropriate cell increase.Activation of proto-oncogenes and inactivation of tumour suppressor genes are the harmful genetic events that are responsible for malignant transformation (1).Carcinogenesis in the skin is a complicated process characterized by the appearance of cells which have escaped from the normal growth control mechanisms, following in an increase of proliferative activity in the cells (2).The prevalent risk factors for skin cancer are exposure to ultraviolet (UV) radiation and fair skin that is receptive to sunburn.Increasing frequency of exposure, immune status, age, male gender and DNA repair disorders such as xeroderma pigmentosum also assist to increased risk (3).The association between UV exposure and cancer is powerful for SCC but less well-defined for BCC, as nearly one third of all BCC originates in anatomical sites receiving minimal UV exposure.Skin temperature may also be a risk factor.Cultured immortalized human kératinocytes have been shown to spontaneously transform to a tumorigenic phenotype when incubated at elevated temperature (4).Some investigations indicate that human papilloma virus infection may be a risk factor for skin cancer, though the relationship is not clear (5).Solid-organ transplant recipients are at extremely high risk for SCC (6).The long-term immunosuppressive therapy is probably the cause of the increased frequency of SCC in these patients, particularly in persons with chronic actinic damage (7).The mechanism of UV-induced photo carcinogenesis appears to implicate the inactivation of the p53 tumour suppressor gene (8).Several studies have reported that p53 distortions play a critical role in the development and progression of various human malignancies.The p53 gene is involved in the regulation of cell cycle control and apoptosis'.Mutations in this gene could presumably cancel p53 function, allowing accumulation of mutant cells due to loss of the UV-induced apoptosis of DNA-damaged cells (9).This leads to clonal expansion of p53-mutated kératinocytes, which could eventually acquire the second mutation that leads to the progression to multiple mutations.They can be accumulated.Therefore, this clonal expansion is regarded as a key initiating step in epidermal carcinogenesis (10).Precancerous dermatoses occur prior to development of epidermal malignancies (6).Because skin lesions are visible and easily accessible, skin cancer provides us with an excellent model for studying the development and growth of cancer in humans.Furthermore, the carcinogenic agents to the skin are well known.This is of special interest so far as UV radiation is the most important carcinogen and puts a specific signature on the DNA (10).Actinic keratosis (AK), also known as senile or solar keratosis is the most common precancerous dermatosis and is attributable to UV radiation (11).This UV-induced lesion is usually seen as multiple lesions in sun-exposed skin in elderly persons.This sunrelated disease may develop into carcinoma in situ or invasive SCC.However, it is a controversial subject, based on the absence of a clear-cut distinction between AK and SCC (12).AK occur from proliferation of transformed
