Quantitative assessment of serum-specific IgE in the diagnosis of human cystic echinococcosis.

Anti-Echinococcus serum immunoglobulin (Ig)E was assessed by the ImmunoCAP system and compared with anti-Echinococcus serum IgG assessed by enzyme-linked immunosorbent assay (ELISA) and Western blot. The ImmunoCAP system revealed very high specificity (one false positive of 110 healthy individuals), low cross-reactivity (one false positive of 58 patients with other diseases) and decreased sensitivity (73.55%). Receiver operating characteristic analysis displayed a beneficial diagnostic value with high accuracy. Comparison of the ImmunoCAP system with ELISA and Western blot showed significantly higher specificity and significantly lower cross-reactivity compared with the ELISA. Examination of sera from 155 patients with cystic echinococcosis (CE) showed varying levels of anti-Echinococcus IgE (range, 0.01-118.33 kUA/L). However, most samples had moderately elevated IgE levels. Analysis of serum-specific IgE revealed significantly higher sensitivity of the ImmunoCAP system and significantly higher antibody levels in hepatic CE compared with pulmonary CE.

Prospective study of nosocomial fungal meningitis in children--report of 10 cases.

Within an 8-year period, 10 cases of fungal nosocomial meningitis in children 0-13 y old were prospectively identified, 3 caused by yeasts other than Candida spp. (Rhodotorula rubra, Aureobasidium mansoni, Clavispora lusitaniae) and 7 by Candida albicans. Seven patients survived. whereas 3 neonates with fungal meningitis (all due to C. albicans) died. Risk factors for fungal nosocomial meningitis included cancer (2 children), previous neurosurgery (2 children), cranial trauma (1 case) and prematurity with low birthweight (5 cases). All patients except 1 had received broad-spectrum antibiotics before onset of meningitis. In addition to yeasts, bacteria were isolated from CSF of 4 children. One child had additional fungaemia. Univariate analysis was used to compare 10 cases of fungal to 91 cases of bacterial nosocomial meningitis. Except for concurrent bacteraemia, (60 vs 25.3%, P < 0.03), which was more frequently observed among fungal meningitis, there were no significant differences in risk factors, sequelae or outcome (mortality) between patients with fungal vs bacterial meningitis. A review of fungal meningitis reported within the last 20 y is included.

Multicenter randomized study of two once daily regimens in the initial management of community-acquired respiratory tract infections in 163 children: azithromycin versus ceftibuten.

In a randomized trial, we compared the efficacy and toxicity of azithromycin and ceftibuten once daily in the initial (empiric) therapy of proven or suspected community-acquired respiratory tract infections (CARTI) in 163 pediatric patients: 95.5% of those treated with azithromycin and 83.6% of those treated with ceftibuten were cured or improved. Streptococcus pneumoniae was more frequently eradicated in the azithromycin than in the ceftibuten group, whereas gram-negative bacilli were more susceptible to ceftibuten. Elimination rates for Staphylococcus aureus and Haemophilus influenzae were similar; adverse reactions did not differ in both arms. Thus, azithromycin was more effective but equally safe than ceftibuten in the initial therapy of pediatric CARTI.

Rhodotorula spp. fungemia in an immunocompromised boy after neurosurgery successfully treated with miconazole and 5-flucytosine: case report and review of the literature.

A case of Rhodotorula fungemia in a 13-year-old boy after neurosurgery successfully treated with miconazole and 5-flucytosine is reported. Intravascular catheter insertion, broad-spectrum anti-miocrobials, surgery, and immunosuppression are the main risk factors for fungemia.

Conformation-sensitive immunoassay: optimisation, validation and evaluation.

A conformation-sensitive immunoassay (CSI) has recently been developed (Pfund and Bourdage, 1990). This paper describes the optimal laboratory protocol which makes this method useful as an early screening procedure for conformation-sensitive monoclonal antibodies. The method was validated with a panel of 12 monoclonal antibodies. Results from our experiments confirm that this variant of CSI can be applied in the analysis of purified proteins and glycoproteins, as well as complex mixtures of antigens.

[Evolution and prognosis in patients with primary liver cancer. I. The effect of individual factors on the survival of patients with primary liver cancer]. / Prouchvane na evoliutsiiata i prognozata pri bolni s purvichen chernodroben rak. I. Vliianie na otdelni faktori vurkhu prezhiviaemostta pri bolni s purvichen chernodroben rak.

The data of the frequency, evolution and prognosis of 63 patients with primary liver carcinoma which had developed on the basis of liver cirrhosis are presented. An attempt is made to assess the importance of the etiologic factors, type of liver cirrhosis, macroscopic type of the tumor, histologic pattern of the cancer, sex and age for the evolution and prognosis of the disease. The patients with primary liver carcinoma without cirrhosis have a better prognosis. As high risk factors may be accepted: male sex, age over 50 years, toxic factors, hepatitis B virus infection and chronic alcoholism. The macroscopic type of the tumor also affects the prognosis. The histologic pattern of the cancer does not influence the survival of the patients with primary liver carcinoma.

[Evolutionary and prognostic studies of patients with primary liver cancer. II. Multifactorial analysis using a stepped-regression mathematical model and graphics]. / Prouchvane na evoliutsiiata i prognozata pri bolni s purvichen chernodroben rak. II. Multifaktoren analiz s pomoshtta na stupkov regresionen matematicheski model i grafika.

The subject of this study is the evolution and prognosis of 63 patients with primary liver carcinoma assessed bu multifactor regression mathematical model realized with the aid of the program 2R of the statistical package VMDR and by graphic expression of the functions of survival, mortality, speed of mortality function growth and graphic assessment of survival according to Okuda's method. The step regression analysis in 2 steps of the regression mathematical model of the clinical indices pointed out the factors age, edema and liver encephalopathy. By 7 steps in the regression mathematical model of the combined clinical and clinico-chemical indices as basic prognostic factors were selected: prothrombin time, liver encephalopathy, direct bilirubin, age, GGTP and sex.

[A case of chronic recurrent pancreatitis with multiple severe complications]. / Vurkhu edin sluchai s khronichen retsidivirasht pankreatit s monozhestvo tezhki uslozhneniia.

A case of a man 33 years of age with severe hemorrhagic-necrotic chronic recurrent alcoholic pancreatitis is reported. The diagnosis was confirmed by clinical, laboratory-biochemical and ultrasound examinations. The last recurrence of the disease was marked by two cysts in the left hypochondrium proved by ultrasound examination. The laparoscopy revealed two very large pseudocysts filled with hemorrhagic liquid originating from the pancreas. In spite of the active postoperative treatment the patient died of severe hemorrhage--manifested by hematemesis, melaena and hemorrhagic shock. The postmortem examination revealed severe hemorrhagic-necrotic pancreatitis with sequestrations, pancreatic lithiasis and 3 large cysts in the abdomen: of the omentum, subhepatic and in the left hypochondrium as well as a perforated ventricular ulcer.

Influence of the standard stimulus in magnitude estimation of time intervals.

Visually presented time intervals between 100 and 1100 ms were scaled directly. Six different standards within the same range were used. The dependence between the reports and the presented time intervals was found to be linear. Different standards led to estimates lying on different straight lines. The slope of these straight lines decreases upon increasing the standard. Nevertheless the ratio between two neighbouring estimates of each straight line remains invariant with respect to the changes in the standard.