Seroprevalence of Coxiella burnetii antibodies among students of the Faculty of Medicine in Kosice (Slovakia).

Titers of immunoglobulin IgG against phases I and II of Coxiella burnetii were determined in 241 students of the Faculty of Medicine by ELISA method and the respective risk factors were evaluated, e.g., rural and urban life, consumption of milk, contact with animals and gender, which may be associated with exposure to C. burnetii. Phase I antibodies (Abs) were detected in 59 serum samples (24.4 %) at antibody level of 1: 100-1: 400. Phase II Abs were found in 179 persons (74.2 %). The titers were in the range of 1: 100-1: 1600. The titer > or =1: 800 of IgG was used as a cut-off level, and was detected only in 20 students (8.2 %). No significant difference in the prevalence of Abs was detected either between the students living in rural and urban environment (78.8 and 73.2 %, respectively) or between males and females (74.0 and 74.7 %, respectively). Abs were detected more frequently in raw milk consumers (68.1 %) and in students who kept some animals (73.7 %).

Diabetes mellitus and candidiases.

Patients in various clinical states of diabetes mellitus (according to the recommendation of the American Diabetes Association) as a primary diagnosis were examined for fungal infections by Candida species. Candida spp. were detected in urine, in the material taken from the mouth cavity, nails, skin lesions, ears and eyes, by cultivation on the Sabouraud agar, CHROMagar Candida, and by saccharide assimilation. In the group of diabetics with symptoms of oral candidiasis and denture stomatitis C. albicans was identified in 8 cases, C. tropicalis in 3, C. parapsilosis in 2; 1 strain of C. guilliermondii was also isolated. In patients with urinary tract infections the presence of C. albicans was shown in 12 cases; C. parapsilosis was detected in 6 cases and two strains of each C. tropicalis and C. krusei were also isolated. In patients with leg ulcers C. albicans (25 cases), C. parapsilosis (5), C. tropicalis (3) and one strain of each C. krusei and C. robusta were isolated. Otomycosis was associated with one strain of C. albicans, C. parapsilosis, C. tropicalis and C. guilliermondii. C. albicans was most frequently associated with onychomycosis, paronychia and endophthalmitis; C. parapsilosis was the second most rated yeast.

Ionic hemolysis behavior of erythrocytes in rats of both sexes.

Erythrocyte microrheology changes were measured by cation-osmotic haemolysis in Wistar albino rats of both sexes. Erythrocyte membrane biophysical properties were estimated using the method of cation-osmotic haemolysis (COH) described by Nicak and Mojzis [Comp. Haematol. Int. 2 (1992), 84-86]. COH in male rats was higher in low ionic strength medium (spectrin skeleton) but without of statistical significance. The significantly higher COH in male rats in comparison with female rats was observed in higher ionic strength media. COH and erythrocyte deformability is also discussed. We suggest that changes in biophysical state of spectrin skeleton are followed by changes in lipid bilayer properties.

Occurrence of Candida strains in cases of paronychia.

A total of 43 patients, 11 males and 32 females, with paronychia of the fingernails were examined for the presence of Candida spp. The yeast species isolated were identified using standard laboratory methods, including germ-tube production, morphology on rice agar with Tween 80, and mainly fermentation and assimilation of saccharides. In the male group, two Candida species were detected: C. albicans as the dominant species in 9 patients and C. parapsilosis in 2 cases. Similarly, C. albicans was the prevalent species also in females (n = 17); other Candida species detected were C. parapsilosis (n = 7), C. tropicalis (5) and C. krusei (3). In addition to the genus Candida, the following anaerobic and aerobic microorganisms were isolated from patients of both groups: Fusobacterium spp., Bacteroides spp., Staphylococcus aureus, alpha-hemolytic streptococci, group A beta-hemolytic streptococci, Klebsiella pneumoniae, Neisseria spp. and Pseudomonas aeruginosa.

Otomycoses of candidal origin in eastern Slovakia.

Mycological analysis of swabs and scraping samples from the external ear canals of 40 patients with clinically diagnosed otomycosis (10 neonates, 30 adults) revealed the presence of fungi as etiological agents. They were investigated microscopically using 20 % potassium hydroxide, and by cultivation on Sabouraud's glucose agar. The Candida species were identified using the germ-tube test, micromorphology observations of colonies on rice agar, and particularly by the commercial kit AUXAcolor. The following Candida species were identified in the aural material examined: C. albicans (n = 21; 52.5 %), C. parapsilosis (11; 27.5), C. tropicalis (3; 7.5), C. krusei (3; 7.5), C. guilliermondii (2; 5.0). The above yeasts were present in samples together with Staphylococcus epidermidis (31), S. aureus (16), alpha-hemolytic streptococci (14), Neisseria spp. (14), Proteus mirabilis (3), Pseudomonas aeruginosa (3), Escherichia coli (1) and Haemophilus influenzae (1). The most frequent predisposing factors for otomycosis were swimming in public pools and/or bath, spa and diabetes mellitus.

The detection of anti-Candida antibodies on experimental animal models.

The levels of anti-Candida antibodies were determined in experimental animals immunized with 4 different yeast doses (0.3, 0.6, 1.2, 2.4 x 10(8) CFU) at weekly intervals. After immunization (sampling intervals 1, 2, and 3 months), the intravenous blood was examined for the presence of serum anti-Candida antibodies. After one month, the titers of anti-Candida antibodies reached 1:40-1: 1280 and remained at the same level after two months in the majority of animals; only in a few of them the titers increased or were detected de novo. After three months, when the animals were no longer immunized, a decreasing trend in antibody titers was detected in the majority of animals.

Candida--agent of the diaper dermatitis?

Occurrence of Candida spp. was determined in a population of 60 infants, 1-15-month-old, with diaper dermatitis, admitted to a neonatal intensive care unit in Hospital Saca (Kosice, Slovakia). Specimens were obtained from the perianal, pubic, inguinal, or gluteal areas that showed signs of secondary infection as manifested by erythema, oozing, vesiculopustular lesions, and pus formation. The most frequently isolated species was C. albicans (41), followed by C. parapsilosis (8), C. tropicalis (4), C. pulcherrima (4), C. guilliermondii (2), and C. zeylanoides (1). Other organisms present in the mixed culture from the diaper area were Staphylococcus aureus (6), Escherichia coli (3), and 2 strains of each group B and D streptococci, and Proteus mirabilis. Infants diapered exclusively in disposable diapers showed less rash than those diapered exclusively or sometimes in cloth diapers.

Effect of vaccination therapy for acne, using a staphylococci antigenic complex in combination with clindamycin.

A group of 46 patients with acne vulgaris were prescribed clindamycin in combination with a vaccination therapy using a staphylococci antigenic complex (Polystafana; Sevapharma, Czechia). Acne papulopustulosa was diagnosed in 36 patients and acne indurata in 10 patients. The clinical effect of clindamycin and Polystafana was determined on the basis of the regression of the inflammatory manifestation of acne: regression by 0-30% was considered unsuccessful, by 30-80% satisfactory, and above 80% excellent; the immunomodulation effect of the treatment was evaluated in parallel. The clinical effect was excellent in 21 patients with acne papulopustulosa and in 6 with acne indurata; it was accompanied by pronounced immunomodulation effect as both cellular and humoral immunity was also tended to return to normal values. A satisfactory clinical effect was observed in 15 patients with acne papulopustulosa, whose cellular immunity component was also stimulated. Only 4 patients with acne indurata failed to respond successfully. These were the patients who showed a pronounced deficit of the cellular immunity component persisting even after the treatment. The administration of clindamycin in combination with Polystafana vaccination can be recommended as an effective means for the treatment of acne vulgaris.

Comparative study of the topographic localization of NADPH diaphorase positive cells in the rabbit and pheasant thymuses.

Nicotinamide adenine dinucleotide hydrogen phosphatediaphorase (NADPHd) histochemistry was used as a marker for nitric oxide synthase (NOS). In the rabbit thymus, NADPHd staining was observed between the capsule and corticomedullary junction in radially oriented blood vessels in the cortex. The outer surface of the thymic lobule and interlobular septa showed adipocytes clumped together. There was a high density of NADPHd positive cells in the medulla, without a sharp boundary in corticomedullary space. In addition to radially oriented blood vessels in the cortex, they were also found as solitary profiles with well stained walls in the medulla. Neuronal plexuses were localized in perivascular topography. In the pheasant thymus, NADPHd positive cells were present as clusters which were distributed in the medulla and the corticomedullar area. NADPHd positive nerve fibres were localized in perivascular topography.

Detection of anti-Candida antibodies in neonates from a Neonatal Intensive Care Unit.

Anti-Candida antibodies were determined in a group of preterm neonates from a neonatal intensive care unit with serious diseases including candidemia. Antibodies to C. albicans blastospores, i.e. antibodies to C. albicans surface mannan and to C. albicans germ tubes were detected. Higher titers of antibodies to blastospores (1:320) occurred in all patients examined while antibodies to C. albicans germ tubes (with the highest titer of 1:160) were present in 32 out of 66 neonates examined. The highest titers of both anti-C. albicans blastospore antibodies and anti-C. albicans germ tube antibodies were detected in neonates with candidemia and disorders of saccharide metabolism.

Fungal diseases of the respiratory tract.

The proportion of Candida and non-Candida species in the clinical material from patients with respiratory-tract diseases was determined. C. albicans was isolated in 102 cases. An additional 89 strains of yeasts, isolated in association with respiratory diseases, belonged to 10 non-albicans Candida spp. and Cryptococcus spp. The prevailing species, which occurred in 47 cases, was C. parapsilosis. C. tropicalis, C. glabrata, and C. guilliermondii were isolated in 12, 10, and 9 cases, respectively. Four strains of C. krusei and three strains of C. lusitaniae and one strain each of C. freyschussii, C. robusta, C. zeylanoides, and Cryptococcus neoformans were also isolated.

Candida species isolated from cerebrospinal fluid.

In the period from November 1998 to June 2001 13 cases of nosocomial meningitis were reported. Candida albicans was isolated from 54% of the patients (7); C. parapsilosis from 23% (3); C. tropicalis from 15% (2) and C. krusei from 8% (1). C. albicans was isolated from the cerebrospinal fluid (CSF) of five children with the following diagnoses: nonspecified tumor of the central nervous system, Hodgkin's disease, meningitis, suspect neuroinfection, and sepsis. Examination of CSF allowed us to detect 2 strains of C. albicans from adult patients, one after neurosurgery because of a brain tumor and one with a vascular disease of the brain. C. parapsilosis was found in CSF from two premature children and one child with epilepsy. Two isolates of C. tropicalis were obtained from both blood and the CSF of a child from the neonatal intensive care unit and from a child from pediatric oncology with multiple malignant neoplasms. Only one strain of C. krusei was found in the oral cavity and CSF of a patient after neurosurgery performed after head trauma.

Candidal urinary tract infections caused by non-albicans Candida species.

The incidence of non-albicans Candida and non-Candida species isolated from the urine of patients admitted to various departments of the Faculty Hospital of the Medical Faculty of Safárik University in Kosice was examined. From a total of 94 samples of analyzed urine 58 strains of C. albicans and 36 strains of yeasts belonging to 6 species of non-albicans Candida and non-Candida spp. were detected: C. parapsilosis (n = 23), C. tropicalis (6), C. krusei (3), C. robusta (2), C. catenulata (1) and Cryptococcus neoformans (1). In relation to the diagnosis, the yeasts were isolated from patients suffering from a kidneys disease, epididymitis, diabetes, neoplastic diseases, urogenital anomalies, obstructive uropathy, cystitis, prostatitis, hemolytic-uremic syndrome, and others.

The frequency of Candida species in onychomycosis.

Mycological investigation of 108 nail specimens taken from a total of 41 patients examined over three years included direct microscopy and repeated cultures. A higher incidence of onychomycosis of the fingernails (75%) was observed in women while afflictions of the toenails (71%) prevailed in men. The highest prevalence of onychomycosis was found in patients between 50 and 70 years of age. Candida albicans was the dominant organism causing onychomycosis (prevalence rate 60.9%), followed by C. parapsilosis (19.6%), C. tropicalis (9.8), C. krusei (4.9), C. guilliermondii and C. zeylanoides (2.4% each).

Detection of anti-Candida antibodies by the indirect immunofluorescence assay in patients with cancer in the orofacial region.

An indirect immunofluorescence assay was performed to detect antibodies to Candida albicans blastospores and germ tubes. Serum specimens were obtained from 82 patients with neoplastic diseases in the orofacial region and thrush of the oral mucosa. C. albicans was identified in the oral cavity of 63 patients investigated but serum anti-Candida antibodies were detected in only 23 of them. Serological examination showed that titers of antibodies to C. albicans blastospores ranged from 1:20 to 1:1280. High titers from 1:640 to 1:1280 were detected in patients without antibiotic, cytostatic, or radiotherapeutic treatment. The titers of antibodies to C. albicans germ tubes ranged from 1:20 to 1:640. Our results indicate that titers of antibodies to the C. albicans germ tubes were lower and were detected in a smaller number of patients.

[An overview of the regulation of basic functions of the digestive system]. / Prehlad regulácií základných funkcií tráviaceho systému.

The gastrointestinal system is the gate through which nutritive substances, vitamins, minerals, and fluids enter the body. Proteins, fats and complex carbohydrates are broken down into absorbable units (products of the digestion) in the digestive tract and finally they are absorbed together with vitamins, minerals and water into the blood or the lymph. The digestive and absorptive functions of the gastrointestinal tract depend on the various mechanisms, which adjust the food, put it through the gastrointestinal tract and mix it together with digestive enzymes secreted by the salivary glands, stomach, pancreas, small intestine and with bile. Some of these mechanisms depend on the spontaneous activity of the smooth muscles, others involve the somatic and autonomous reflexes, paracrine effects of the chemical substances, hormones and local gastrointestinal hormones. The aim of this paper is to review the essential factors participating in the regulation of these processes (mainly motility and secretion) from the mouth cavity, stomach, duodenum, gallbladder, pancreas, small intestine and large intestine to the defecation. The basic regulatory factors are summarized in the schemes from the sources of the physiological textbooks, which are accepted in the whole world for the education of physiology in the medical faculties.

Yeast-like microorganisms in eye infections.

The proportion of yeast species involved in eye infections in 11 patients was examined. The presence of yeast organisms as causative agents of endophthalmitis was found in corneal smears (n = 4), conjunctival swabs (4), and vitreous fluid (3). Altogether 5 strains of Candida albicans, 2 strains of C. krusei and one strain each of C. guilliermondii, C. parapsilosis, C. tropicalis and Cryptococcus neoformans were isolated from the clinical material. The hematogenic origin of endophthalmitis was proved in 7 cases on the basis of positive blood samples and in 2 cases by the isolation of yeasts from the tip of an intravenous catheter. Endophthalmitis-supporting risk factors such as indwelling intravenous catheters, prolonged use of broad-spectrum antibiotics and chemotherapy, surgical intervention, diabetes mellitus, and malignancy were observed in the patients.

Candida-associated denture stomatitis.

Candida-associated denture stomatitis was demonstrated by its cultivation in 171 out of 240 patients examined with partial or total dentures. After taking smears from lesions of the oral mucosa (tongue, cheeks, palate) and the contiguous denture surface by cotton wool swabs and inoculating them onto Sabouraud glucose agar and CHROMagar Candida, individual yeast species were identified by a germ tube, filamentous, and assimilation tests employing the commercial kit AuxaColor. Seven Candida species were identified in smears from the oral mucosa lesions and the contiguous denture surface: C. albicans (95 patients), C. tropicalis (26), C. parapsilosis (20), C. krusei (14), C. guilliermondii (12), C. lusitaniae (1) and C. freyschusii (1). Diabetes mellitus, neoplastic diseases, chemotherapy, radiotherapy, and broad-spectrum antibiotic therapy were identified as some of the large number of factors predisposing patients to stomatitis prothetica.

The histopathological characterization of oral Candida leukoplakias.

Sixty four biopsy specimens of oral Candida leukoplakias were examined. Histological sections were stained with periodic acid-Schiff (PAS) reagent and by Grocott's silver method. C. albicans isolates were cultivated from all the patients but fungal hyphae were proved histologically only in 23 of them. PAS-positive and Grocott-positive elements were exclusively observed in the superficial epithelial layers, e.g., the cornified layer and the stratum granulosum. The inflammatory reaction was characterized by an early phase during which polymorphonuclear cells predominated. The skeletal muscle fascicles immediately adjacent to the infected epithelium showed striking degeneration and atrophy associated with a marked infiltrate of chronic inflammatory cells.

Electrophoretic karyotyping of Candida albicans strains isolated from premature infants and hospital personnel in a neonatal intensive care unit.

Electrophoretic karyotyping was used to compare DNA probes of yeasts isolated from blood of preterm neonates (n = 66) in a neonatal intensive care unit (NICU) and from the hands of healthy hospital personnel (n = 10). The yeasts were identified as Candida albicans using standard laboratory methods. DNA was extracted from yeasts and isolation of identical DNA strains from the pairs nurse-neonate suggested that one nurse transmitted one yeast strain by her hands to three neonates. Four neonates harbored two identical strains originating from two nurses, i.e. each nurse transmitted the same strain to two neonates. In the additional 7 cases transmission of 1 yeast strain by 1 nurse to 1 neonate was observed. Our data suggest that nonperinatal nosocomial transmission of C. albicans occurs in neonates, possibly via cross-contamination being transferred on hands of health care workers. The importance of careful hand washing of staff (health care workers) and other infection-control procedures (to prevent the nosocomial transmission of pathogens in the NICU environment) is emphasized.