Freshwater Cyanobacterial Blooms and Primary Liver Cancer Epidemiological Studies in Serbia

A large part of Central Serbia experiences continual shortage of sufficient ground water resources. For that reason, more than 20 reservoirs serve as drinking water suppliers. Significant and persistent cyanobacterial “blooms” have been recognized in nine of them. Samples for cyanotoxin analyses were taken during and after “blooms” in ?elije Reservoir and from Kru?evac town-supplied tap water from that reservoir two days later. Concentration of microcystin-LR was 650 μ gL^–1 in the reservoir, while the tap water contained 2.5 μ gL^–1.

In the two investigated periods, the high primary liver cancer (PLC) mortality of 11.6 from 1980–1990 and extremely high PLC incidence of 34.7 from 2000–2002 were observed in the regions affected by heavy cyanobacterial “blooms.” In contrast, PLC mortality and incidence rates were substantially lower in the regions not affected by cyanobacterial blooms: in 1980–1990 the rate of PLC mortality amounted to 2.7 in Kosovo, 7.6 in Vojvodina, and 8.3 in the non-affected regions of Central Serbia; while in 2000–2002 PLC incidence amounted to 4.1 in Kosovo, 5.2 in Vojvodina, and 13.6 in the non- or less-affected regions of Central Serbia. Keeping in mind that the most affected PLC regions in Central Serbia (Topli?ki, Ni?ki, and ?umadijski regions) have the water supply systems based on six reservoirs found regularly in bloom during summer months and that some of the regions are also connected with two boundary “blooming” reservoirs, representing a total of eight of nine blooming reservoirs, it is easy to presume that the PLC incidence could be related to drinking water quality.

The uneven geographic distribution of liver cancer in Serbia is conspicuous and hot spots could be related to drinking water supply. It is very clear that the high-risk regions for PLC occurrence correspond with drinking water reservoirs continually found with cyanobacterial blooms, and the low risk regions correspond with water supplies not affected by cyanobacteria.     

Atherosclerosis of abdominal aorta and carotid arteries and its correlation with blood serum lipid levels in cholelithiasis

AIM: To elucidate relationship between cholelithiasis and presence and severity of atherosclerosis in abdominal aorta and carotid arteries. MATERIAL AND METHODS: Ultrasound investigation of vessels and abdominal organs, determination of blood serum total, high density lipoprotein cholesterol and triglycerides were carried out in 147 patients with and 167 without (controls) cholelithiasis (mean age 44.2+/-3.1 and 45+/-2.8 years, respectively). RESULTS: Among patients with cholelithiasis 73.2 and 67.6% had atherosclerosis of abdominal aorta and carotid arteries, respectively. This was significantly more than in controls. Compared with controls atherosclerosis of these vessels in all age groups was significantly more pronounced in patients with cholelithiasis. Moreover severity of atherosclerosis was directly related to duration and activity of cholelithiasis. Atherosclerosis of abdominal aorta and carotids was most pronounced in patients with cholelithiasis and concomitant hypertension, ischemic heart disease and obesity. Significant direct correlations were found between blood serum levels of total cholesterol, triglycerides and low density lipoprotein cholesterol and thickness of abdominal aortic wall and carotid artery intima media complex. CONCLUSION: The results evidence for the existence of association between cholelithiasis and presence and severity of atherosclerosis of abdominal aorta and carotid arteries.     

Pathology of the endometrium in women with chronic hepatitis C and HIV infection as a cause of unsuccessful in vitro fertilization attempts

Abstract

Aim: The purpose of the study is to detect endometrial pathology in individuals with blood-borne infections (hepatitis C virus [HCV] and HIV) and to assess the impact of quality of the endometrium on the efficiency of assisted reproductive technologies (ART).

Materials and methods of research: The study involved 56 women of reproductive age, 33 women with HCV, 22 with HIV infection (stages 3 and 4A) and 1 patient with co-infection of HCV and HIV, which was excluded from the further study. Ultrasound investigation of the small pelvic organs, hysteroscopy with biopsy of the mucosa of the uterine cavity, histological examination of the endometrium, determination of HCV RNA and HIV RNA in serum and endometrial tissue by PCR method were conducted.

Results: Ultrasound and histological studies of the endometrium revealed a high incidence of development of hyperplastic and inflammatory processes of the endometrium in women with HCV (86% and 100%) and HIV (51% and 99%). When molecular biological examination of endometrial tissue of these patients was performed with the use of a set of reagents “AmpliSens HCV/HBV/HIV-FL” produced by Federal Budgetary Institution of Science (FBUN) Central Research Institute of Epidemiology of Rospotrebnadzor of Russia, HCV was detected in 16.7% and HIV in 14.3% of cases. In 5% of patients with HCV infection and 7% with HIV, pathogens were detected in the endometrium under the non-detectable viral load in the blood plasma. Lower effectiveness of IVF in women with HIV and HCV is defined compared to the women without blood-borne infections.

Conclusion: Detected HIV and HCV replications in the endometrium is the likely cause of hyperplastic and inflammatory processes of the endometrium leading to reduced efficiency of the ART programs in patients with chronic hepatitis C and HIV.     

A course of acute respiratory virus infections in patients with metabolic syndrome

AIM: To determine specific features of a course of acute respiratory viral infections (ARVI) and changes in immunological status in patients with metabolic syndrome (MS). MATERIAL AND METHODS: Body mass index (BMI), waist circumference, levels of cholesterol, lipoproteins, triglycerides, cytokines and immunoglobulins were measured and glucose tolerance test was made in 120 patients with MS. Registration of ARVI during a year was verified by the presence of antigens in immunofluorescence reaction. RESULTS: MS patients have obesity of an abdominal type and immunoresistance. Concentration of proinflammatory cytokines and leukocyte count in blood increased proportionally to an increase in fat tissue mass, immunoglobulins content went down. ARVI in most evident MS were characterized by a sluggish and areactive onset, longer course, more frequent respiratory and cardiovascular complications. CONCLUSION: MS is a factor of risk of a sluggish and complicated course of ARVI.     

Hematologic and immunomodulatory effects of an interleukin-1 receptor antagonist coinfusion during low-dose endotoxemia in healthy humans

Endotoxin is a component of gram-negative bacteria that causes hematologic and immunologic changes through its induction of cytokines. Interleukin-1 receptor antagonist (IL-1Ra) is a naturally occurring inhibitor of IL-1 that competes with IL-1 for occupancy of cell-surface receptors but possesses no agonist activity. We investigated the ability of human recombinant IL-1Ra to block the effects of low-dose endotoxin. Fourteen healthy male volunteers between 18 and 30 years old were injected intravenously with 3 ng/kg Escherichia coli endotoxin. Concurrent with the injections, nine volunteers received a 3-hour continuous intravenous infusion of IL-1Ra. The other five subjects were given a 3-hour infusion of saline. Volunteers injected with endotoxin experienced a threefold increase in circulating neutrophils over baseline. This neutrophilia was significantly reduced by 48% in subjects administered endotoxin plus IL-1Ra (P = .0253). Ex vivo mitogen-induced peripheral blood mononuclear cell proliferation decreased by greater than 60% at 3 and 6 hours after endotoxin injection (P = .0053). This endotoxin-induced reduction in mitogen response was reversed in subjects coinjected with IL-1Ra (P = .0253). Endotoxin-induced symptoms, fever, and tachycardia were unaffected by IL-1Ra. IL-1 appears to be an important mediator in endotoxemia because some of its hematologic and immunomodulatory effects can be blocked by IL-1Ra.     

Rationale-based nutrition as a factor of anemia prevention in pregnant women

Rational nutrition, based on properly arranged regimen including quantitative and qualitative distribution of the daily ration into meals is one of important elements in correction of anemia, endemic for the West Siberian region. Pregnant women should be referred to a group at risk of this disease; special nutrition standard, therapeutic and prophylactic rations should be created for them with due consideration for communal conditions, health status, and their actual nutrition.     

The factors that affect the results of the serological diagnosis of HIV infection and the screening for anti-HIV]

The laboratory diagnosis of HIV infection and screening for anti-HIV have determined the factors that influence the results of studies performed by ELISA and Western immunoblot. The factors include sensitivity and specificity of the test systems used, storage conditions of and transportation conditions for serum, errors of procedures for reactions, etc. Correlation is between the inactivation of the sera studied and the initial antibody titers during their storage at elevated temperatures. To obtain more valid results of HIV infection serodiagnosis it is necessary to use some test systems differing in the principles of setting up a reaction.