Summary.  Introduction: Intravenous (i.v.) therapy may be associated with important catheter‐related morbidity and discomfort. The safety, efficacy, comfort, and cost‐effectiveness of peripherally inserted central catheters (PICCs) were compared to peripheral catheters (PCs) in a randomized controlled trial. Methods: Hospitalized patients requiring i.v. therapy ≥ five days were randomized 1:1 to PICC or PC. Outcomes were incidence of major complications, minor complications, efficacy of catheters, patient satisfaction, and cost‐effectiveness. Results: 60 patients were included. Major complications were observed in 22.6% of patients in the PICC group [six deep venous thrombosis (DVT), one insertion‐site infection] and 3.4% of patients in the PC group [one DVT; risk ratio (RR) 6.6; P = 0.03]. Superficial venous thrombosis (SVT) occurred in 29.0% of patients in the PICC group and 37.9% of patients in the PC group (RR 0.60; P = 0.20). Patients in the PICC group required 1.16 catheters on average during the study period, compared with 1.97 in the PC group (P < 0.04). The mean number of venipunctures (catheter insertion and blood sampling) was 1.36 in the PICC group vs. 8.25 in the PC group (P < 0.001). Intravenous drug administration was considered very or quite satisfying by 96.8% of the patients in the PICC group, and 79.3% in the PC group. Insertion and maintenance mean cost was 690 US$ for PICC and 237 US$ for PC. Discussion: PICC is efficient and satisfying for hospitalized patients requiring i.v. therapy ≥ five days. However, the risk of DVT, mostly asymptomatic, appears higher than previously reported, and should be considered before using a PICC.

The only significant correlation was noted between urine culture and stenting duration (P < 0.05). Double-J catheter retention in the urinary tract is associated with a high risk of bacterial colonization, while the risk of urine infection is about fourfold lower. There is a great discrepancy between urine and catheter cultures.

It is widely believed that demonstration of fat within a well-marginated renal tumor at computed tomography (CT) is highly suggestive of angiomyolipoma and can rule out renal cell carcinoma. The authors describe a patient in whom CT demonstrated a solid mass containing calcifications and small amounts of fat. Renal cell carcinoma was diagnosed at pathologic examination. The carcinoma had tubular and papillary architectural configurations associated with areas of osseous metaplasia located in the fibrous stroma of the tumor. Renal cell carcinoma should be considered in the differential diagnosis of well-marginated lipomatous renal tumors when intratumoral calcifications are identified at CT. Such calcified, fat-containing renal tumors must be evaluated with surgical exploration and treated as any other indeterminate renal tumors.

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Surface proteins play an important role in the pathogenesis of enterococcal infections. Some of them are candidates for a vaccine, e.g., the frequency of endocarditis in rats vaccinated with Ace protein was 75 % as 12 opposed to 100 % in those who weren't. However, there are other components of enterococcal cells, such as Epa antigens or internalin-like proteins, which may be used in the prophylaxis of infections caused by them. However, also other virulence factors and resistance to antibiotics are important during enterococcal infection. Therefore, the relevance of ace, epa, elrA, other virulence genes, as well as resistance to antibiotics was investigated. 161 Enterococcus faecalis strains isolated from teaching hospitals in Lodz, cultured according to standard microbiological methods, were investigated for the presence of genes encoding surface proteins by PCR. Results were analyzed with v 2 test. The elrA gene was found in all clinical and environmental strains, the ace gene was also widespread among E. faecalis (96.9 %). Both tested epa genes were found in the majority of isolates (83.25 %). There was correlation between the presence of esp and ace genes (p = 0.046) as well as between epa and agg genes (p = 0.0094; v 2 test). The presence of the genes encoding surface proteins investigated in our study in the great majority of isolates implies that they would appear to be required during E. faecalis infection. Therefore, they could be excellent targets in therapy of enterococcal infections or, as some studies show, candidates for vaccines.

Phagocytic and bactericidal activity of granulocytes were estimated in granulocytes of normal and diabetic children. The influence of candidal, tuberculin antigens, and staphylococcal antitoxin on these parameters was also tested. Thirty diabetic and forty healthy children made up the study group. Their ages were 6-18 yr. The disease duration was from 1 to 12 yr. Granulocytes from diabetic children demonstrated a normal ability to absorb staphylococcus. On the other hand, the capacity for intercellular killing of bacteria by granulocytes of diabetic children was decreased.