Treatment of acute infectious diarrhoea in infants and children with a mixture of three Lactobacillus rhamnosus strains--a randomized, double-blind, placebo-controlled trial.

BACKGROUND: Multiple studies document that probiotics are effective in treating infectious diarrhoea in children. Lactobacillus rhamnosus GG is the most extensively studied but effectiveness of other strains has been poorly examined. AIM: To determine whether L. rhamnosus strains (573L/1; 573L/2; 573L/3) (Lakcid L, Biomed, Lublin, Poland) would be effective in shortening infectious diarrhoea. METHODS: In a randomized, double-blind, placebo-controlled trial, 87 children (age range: 2 months to 6 years) with infectious diarrhoea were administered Lakcid L at a dose 1.2 x 10(10) CFU or placebo, twice daily, for 5 days. Primary outcome measure was the duration of diarrhoea. Secondary measures were duration of parenteral rehydration, adverse events, and gastrointestinal tract colonization by administered strains. RESULTS: In an intention to treat analysis of 87 children, the mean duration of diarrhoea in the treated group: 84 +/- 56 h; placebo: 96 +/- 72 h (P = 0.36). In rotavirus infection: 76 +/- 35 h vs. 115 +/- 67 h (P = 0.03), respectively. Duration of parenteral rehydration: 15 +/- 14 h vs. 38 +/- 33 h (P = 0.006). Gut colonization by administered strains was 80% and 41% at five and 14 days, respectively. No adverse events were noted. CONCLUSIONS: Administration of L. rhamnosus strains shortens the duration of rotaviral diarrhoea in children but not of diarrhoea of any aetiology. Intervention shortens the time of intravenous rehydration.

Subcutaneous T-cell lymphoma: report of two cases.

We have seen two patients, a 24-year-old man and a 15-year-old girl, with subcutaneous nodules and fever. The histopathological findings in both cases showed a lobular, histiocytic panniculitis with 'bean bag' cells and lymphoid cells identified as immature T-cells. This picture was consistent with subcutaneous T-cell lymphoma associated with cytophagic histiocytic panniculitis. The girl died after 5 months of disease with florid hemophagocytic syndrome; the man was subjected to a course of treatment (CHOP; cyclophosphamide/doxorubicin/vincristine/prednisone) and after 6 months observation his symptoms of nodules and fever disappeared.

[Results of treatment for severe acquired aplastic anemia in children]. / Wyniki leczenia ciezkiej, nabytej niedokrwistosci aplastycznej u dzieci.

The authors evaluated results of treatment of 106 children with acquired aplastic anemia. The patients were divided into 3 groups depending on the severity of their disease. Thirty-nine patients were classified as very severe, 30 as severe and 37 as non-severe according to the modified Camitta criteria. Among them, 47 children were treated with oxymetholone and prednisolone. In this group 32 died. Antilymphocyte globulin (ALG) was given to 48 patients and 20 received cyclosporin A (CsA). The results obtained by these two methods are nearly the same and 5 year survival was 61% and 59% respectively. Bone marrow was transplanted in only one child, who is still in complete remission. Statistical analysis showed a steady increase in incidence of aplastic anemia in the years 1987-1989, which might coincide with the Czarnobyl explosion. However, further research is required to prove this point.

Bilateral bronchioloalveolar carcinoma of the lungs in a 7 year old girl treated for Hodgkin's disease.

In a 7 year old girl who had previously been given intensive treatment for Hodgkin's disease with numerous courses of multiagent therapy including MVPP (nitrogen mustard, vinblastine, prednisone, procarbazine) and who received radiotherapy in a total dose of 32 Gy to the sternal, and 24 Gy to the cervical (left and right) and axillary (left and right) regions, an autopsy revealed bilateral bronchioloalveolar carcinoma of the lungs.

Binding of lectins to human leukaemic cells.

The interactions of five different lectins: peanut (PNA), lentil (LEN), wheat germ (WGA), soybean (SBA), Asparagus pea (FBP) with leukaemic cells obtained from 31 children: 25 with acute lymphoblastic leukaemia (ALL) and 6 with acute myeloblastic leukaemia (AML) were examined in this study. The relationship of lectin-binding ability to cells cytomorphological, cytochemical and immunological features and its potential clinical application were investigated. It has been shown that PNA and LEN receptors were found in the majority of blast cells. The SBA reacting cells were found only in few patients and FBP binding was not found in studied ALL and AML cells. There was a clear difference in the WGA binding capacity in ALL cells with L1 and L2 characteristics respectively. No differences were found in PNA. WGA and LEN reactivity between PAS negative and PAS positive leukaemic cells. Only PNA of all studied lectins seemed to differentiate T- from B-ALL blast cells. Only WGA binding of ALL cells showed the positive correlation to the risk index value.

Human immunodeficiency virus (HIV) antibodies in patients with haemophilia and other inheritable blood clotting disorders in south west Poland (Lower Silesia region).

In order to determine the frequency of HIV antibodies among patients with haemophilia and other inheritable blood clotting disorder in the Lower Silesia region of South-West Poland, we examined a representative fraction comprising 106 patients from a cohort of 302 blood clotting disorder patients. The methods used for detecting HIV antibodies were an ELISA, the immunoblotting test ("Western blot") and an indirect immunofluorescence test. 8 patients were reactive in the ELISA, but only 2 (1.9%) patients were truly seropositive by the confirmation tests. Both patients have received imported commercial factor VIII preparation. Totally 17 patients have been treated with imported factor VIII, thus 12% (95% confidence limits: 1.5-36.5%) of these were seropositive. This figure, which is lower than figures obtained from the USA and Western Europe, is probably due to far less intensive treatment of the patients. None (95% confidence limits: 0-4.1%) of the patients solely treated with blood transfusion and locally produced preparation was HIV antibody positive. These results indicate a low prevalence of HIV infection in this region of Poland but are, on the other hand, a strong argument for an introduction of HIV antibody screening of blood donors to maintain these favourable condition.

Success of bone marrow transplantation in congenital Diamond-Blackfan anaemia: a case report.

A 6-yr-old girl with congenital corticosteroid-resistant pure red cell aplasia was treated with bone marrow transplant from her HLA-identical, MLC-unreactive sister in November 1984 following conditioning with busulfan and cyclophosphamide. Full engraftment was obtained and the patient at 21 months post-transplant is in excellent clinical condition maintaining normal red cell counts. We conclude that BMT should be considered as a therapy for at least the most severe cases of Diamond-Blackfan anaemia resistant to corticosteroids. Successful outcome of this therapy provides an argument for the stem cell origin of this disorder.