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Pathophysiology of portal hypertension

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In last years significant progress in recognizing mechanisms of portal hypertension pathophysiology was done. However, some unclear topics in this disease still exist. Portal hypertension is primarily caused by the increase in resistance to portal outflow and secondly by an increase in splanchnic blood flow. Portal hypertension is associated with changes in the intrahepatic, systemic, and portosystemic collateral circulation. Alterations in vasoreactivity (vasodilation and vasoconstriction) play a central role in the pathophysiology of portal hypertension by contributing to increased intrahepatic resistance, hyperdynamic circulation, and expansion of the collateral circulation. Among vasoactive substances which are activated in portal hypertension nitric oxide (NO) is considered as the most important vasodilator. Endothelin-1 and cyclooxygenase-derived prostaglandins are the main vasoconstrictor factors. The imbalance between the hyperresponsiveness and overproduction of vasoconstrictors and the hyporesponsiveness and impaired production of vasodilators are the mechanisms responsible of the increased vascular tone in the sinusoidal area of the liver. New concepts in the pathophysiology of portal hypertension find the significant role of hepatic stellate cells activated by endothelial factors which cause vascular remodeling as an adaptive response of the portal vessels wall. The most frequent causes of portal hypertension include portal vein thrombosis, storage diseases of the liver, hepatic cirrhosis (independent of etiology), hepatic veins thrombosis and schistosomiasis. Understanding the pathophysiology of portal hypertension could be of great utility in preventing and curing the complications of portal hypertension, such as esophageal varices, hepatic encephalopathy, ascites.
The term Chronic Fatigue Syndrome refers to a complex of symptoms, among which only the presence of profound fatigue of 6 months or more duration is essential for the diagnosis. Presented article reviews current hypothesis, diagnostic criteria and methods of treatment used in this disorder. The cause of chronic fatigue syndrome remains unknown. No form of treatment alters the course of disease. Rest accompanied by program of gentle exercise helps recovery. Pharmacological treatment helps to alleviate the symptoms. The prognosis varies in each case. Recovery takes from one to 10 years.
Cough associated with upper respiratory tract disorders is a common and troublesome problem in children and little is known about the etiology of this type of cough. This study examined the capsaicin cough sensitivity (CS) in children suffering from allergic rhinitis (AR) and upper respiratory tract infection (URI), comparing it with that in healthy children taken as controls (C). CS to capsaicin, spirometry, skin prick tests, and nose-throat examination were performed in 61 children grouped by the diagnosis of AR, URI, and C. The results, in order of C vs. AR vs. URI, expressed as a geometric mean (±95% CI) log10 µM of capsaicin for C2 (the lowest concentration of capsaicin in µmol/l required to induce 2 coughs) were: 1.8 (1.6-1.9) vs. 1.0 (0.8-1.2) vs. 0.48 (0.2-0.8), P<0.001 and for C5 (the lowest concentration of capsaicin in µmol/l required to induce 5 coughs) 2.9 (2.8-2.9) vs. 2.6 (2.5-2.6) vs. 2.1 (2.0 –2.3), P<0.05. We found that CS in children with AR, even when tested out of pollen season, was significantly heightened compared with controls. CS in children with URI was extremely high compared with both C and AR groups. We conclude that pathological processes in the nose of any etiology could cause a sensitization of the cough reflex with decreased cough threshold during asymptomatic period of AR. Cough also is enhanced by acute inflammation in the upper airways in nonatopic children.
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Bovine neonatal pancytopenia in calves in Poland

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Bovine neonatal pancytopenia (BNP), a newly emerged syndrome of discussed etiology in calves, has been diagnosed since 2006. Here we describe first cases of BNP in Poland. Between September 2008 and April 2011, 62 cases of BNP were diagnosed in dairy calves. Bleeding skin lesions were mostly pronounced in summer and early autumn. Severe thrombocytopenia was observed in all sick animals. All calves came from herds vaccinated against BVDV infection with PregSure BVD vaccine (Pfizer). Substitution of colostrum from dams of BNP positive calves with colostrum from dams from herds free of BNP was the only effective measure to avoid new cases in affected herds.
Primary infection with Pneumocystis jirovecii in small children may cause inflammation of the respiratory tract which requires hospitalization. Lack of characteristic clinical symptoms makes it impossible to recognize P. jirovecii infections without performing laboratory analyses. Nasopharyngeal swabs from 70 children with respiratory tract infections were screened for fragments of the P. jirovecii genome. Pneumocystis DNA was found in swabs taken from two (2.9%) of the tested children: a newborn who was infected in the hospital and a six month old baby admitted to hospital two days after pneumonia was diagnosed. The obtained results confirm that primary P. jirovecii infections may occur in the form of acute respiratory tract inflammations suggesting a viral infection. In differential diagnosis of Pneumocystis infections in children molecular methods are useful as their high sensitivity makes it possible to analyze samples obtained in a non-invasive way.
Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease leading to degeneration and loss of motoneurons in the spinal cord anterior horns. Although etiology of the disease is unknown there is a hypothesis assuming that survival motor neuron protein (SMN) may save motoneurons from degeneration not only in spinal muscular atrophy (SMA) but also in ALS. In animal models of ALS the neuroprotective role of SMN was observed but it is not known whether the phenomenon is present in humans. Therefore we decided to examine immunoexpression of SMN and functionally associated with it gemin 2, 3 and 4 in the anterior horn neurons of patients with sporadic form of ALS (sALS). Material and methods: The material was composed of 10 spinal cords of patients with sALS who died at the age of 52–87 years 1–8 years after the onset of the disease. On formalin-fixed and paraffin-embedded spinal cords immunohistochemistry was applied. The immunohistochemical reactions were performed with antibodies against SMN and gemin 2, 3 and 4 according to the avidin-biotin-peroxidase method. Results: In all the examined cases expression of SMN and gemin 3 in spinal cord neurons was found although intensity of the immune reactions was diverse. The immunolabel were the most intense in patients with acute course of sALS and gradually decreased with longevity of the disease. Not only motoneurons but also interneurons and sensory neurons revealed immunoexpression of SMN and gemin 3. The immune reaction to gemin 2 was negative. The immunoreactivity for gemin 4 was also negative or very weak. Conclusions: (1) In humans, expression of SMN and gemin 3 in neurons is present through the whole lifespan. (2) In sALS, expression of gemin 2 and 4 is abnormal: absent or diminished respectively. (3) Presence of all components of the SMN-gemin complex is probably necessary for its normal functioning. (4) Since the immunoreactivity for SMN, and gemin 2, 3 and 4 was similar in all the examined cases and 6 from the 10 cases were at the age of 65–87 years it seems that advanced age has no influence on expression of the investigated proteins. This study was supported by the Ministry of Science and Higher Education grant NN 401 014640
The aim of this research was to analyse the frequency of prevalence and localisation of neoplasms in domestic animals. The material consisted of 1,958 tumours, originating from the area of Lower Silesia, and affecting dogs, cats, horses, cattle, and exotic animals, sampled during the surgery, autopsy or biopsy, and submitted for histopathological diagnosis. Tumours of dogs were the most frequent - 1,700 cases (87%), followed by tumours of cats - 207 cases (10.6%), horses - 20 cases (1%), cattle - 3 cases (0.2%), and exotic animals - 20 cases (1.2%) including mostly tumours of ferrets - 8 cases (0.4%). In relation to similar studies carried out in the same area during 1957-1995 and 2000-2004, an increase in neoplasms in domestic animals was observed. Skin and subcutaneous tissue neoplasms and mammary gland neoplasms (principally adenocarcinomas) dominated.
The aim of the study was to determine the relationship between estrogen and the development of peliosis hepatis. The experiment was conducted on female Wistar rats. Oestradiolum benzoicum was administered i.m. for 8 weeks in different doses. On the basis of the obtained data the authors claim that estrogen can be responsible for the development of vascular disorders described as peliosis hepatis. Furthermore, there is a relationship between the intensification of observed changes and the dose of the injected estrogen. An increased awareness of peliosis hepatis may become an important symptom for a pathologist, especially in patients at risk.
Development of female genito-urinary infections depends on many factors, such as immune system activity, virulence of microorganism and production of factors inhibiting the growth of microorganisms. Taking into account the possibility of relapses or severe complications, it is very important to appropriately diagnose and treat infections. Because of recently observed increase of microbial resistance to antibiotics, researchers are looking for alternatives. In our study we evaluated and compared the concentration of human neutrophil peptides (HNP 1-3) in cervico-vaginal lavages (CVL), obtained from women with vaginitis/cervicitis. Swabs from the posterior vaginal fornix and from the endocervical canal as well as CVL samples were obtained from 32 patients with vaginitis/cervicitis and 29 healthy women (control group). Supernatants of CVL were used for determination of concentration of HNP by ELISA. The difference between concentrations of HNP 1-3 in studied and control groups was statistically significant (p=0.018). The maximal concentration was determined in patients with mixed infections (28.41 ng/ml), and Group B Streptococci, GBS, (28.06 ng/ml), the minimal concentrations in cases of C. trachomatis (mean concentrations did not differ from those in the control group: 16.93 ng/ml and 16.39 ng/ml, respectively). Maximal correlation was determined for control-studied group with isolation of GBS (r=0.79), and very high negative correlation for group of GBS - C. trachomatis (r=-0.98).
Investigations have been undertaken to determine which fungi species are responsible for occurrence of sooty blotch disease in Poland. It was found that disease complex is caused by Tripospermum myrti (Lind) Hughes, Phialophora sessilis de Hoog and Peltaster fructicola Jonhson. There was no evidence of the presence fungus described as Gloedes pomigena which was previosly considered as a casual agent of apple sooty blotch disease in Poland.
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