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Adverse reactions after childhood vaccination in the Czech Republic
Kocourková, Aneta ; Dáňová, Jana (advisor) ; Marešová, Vilma (referee) ; Částková, Jitka (referee)
1 ABSTRACT In the Czech Republic a complex study of adverse reactions after vaccination in children has not been presented yet. Even though reporting of serious adverse reactions to the State Institute for Drug Control (SUKL) is mandatory by law, it is seldom performed. Moreover, there is no analysis correlating adverse reactions that occurred at doctors` surgeries with actual reported adverse reactions to SUKL. The main focus of presented work was to analyze and map adverse reactions appearing after vaccinations from the children's vaccination schedule in the Czech Republic. The study was conducted in the form of retrospective-prospective questionnaires concentrating on adverse reactions, their occurrence, character, seriousness, duration and frequency. Furthermore, the questionnaires also focused on socio-demographic data such as gender, age, residency, parents' education, birth weight. Also, the refusal of the compulsory vaccination was assessed. Occurrence of adverse reactions after vaccination in the Czech Republic was analyzed by questionnaires in pediatricians' surgeries (active surveillance). Obtained data were correlated with data available at SUKL (passive surveillance). The study data showed higher number of collected adverse reactions that number of adverse reactions reported to national program...
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Selected aspects of immunopathogenesis of HIV infection
Bartovská, Zofia ; Holub, Michal (advisor) ; Boštík, Pavel (referee) ; Marešová, Vilma (referee)
Introduction: Virus-specific CD8+ T cells are crucial to suppress the viral replication in HIV infection. Their functional status is important as well. Also, the chronic nonspecific immune activation of T and B lymphocytes plays an important role in the immunopathogenesis of HIV infection. Aim of the study: To analyze the frequency and functional status of HIV-specific CD8+ T cells and the expression of nonspecific activation markers on B and T cells in HIV+ patients and to assess the effect of combined antiretroviral therapy (cART) on these parameters. Patients and methods: Our cohort included 80 HIV+ patients: 36 HIV+ patients on cART, 18 patients without therapy, in whom cART was introduced during our study, 9 patients without therapy, 10 patients with primary HIV infection, 3 long-term non-progressors and 4 patients initially on cART, in whom the therapy was discontinued. Control group consisted of 34 HIV- healthy individuals. We examined CD4+ a CD8+ T cell counts, viral load, expression of nonspecific activation markers on T cells and the frequency of HIV-specific CD8+ T cells by ELISpot method and flow cytometry using MHC tetramers and intracellular cytokine detection. Results: No significant differences in HIV-specific CD8+ T cells were found between treated and untreated HIV+ patients. The frequency...
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Diagnostics of neuroinfection caused by human herpesviruses using nucleic acid amplification methods
Labská, Klára ; Marešová, Vilma (advisor) ; Rožnovský, Luděk (referee) ; Krbková, Lenka (referee)
of thesis Diagnostics of neuroinfection caused by human herpesviruses using nucleic acid amplification methods author: MUDr. Klára Labská supervisor: doc. MUDr. Vilma Marešová, CSc. In recent years, the diagnosis of neuroinfections has undergone a shift towards molecular biology methods. Our research focused on the predictive value of the capture of herpesvirus (HV) DNA in cerebrospinal fluid. In the first study, we examined the presence of DNA neurotropic herpes viruses (HSV1, HSV2, VZV and HHV6) in cerebrospinal fluid in immunocompetent patients with laboratory-confirmed tick-borne meningoencephalitis and enterovirus meningitis and meningoencephalitis. The control group consisted of patients with proven absence of an inflammation in the cerebrospinal fluid. Patients were followed for 6 months. The course of the disease and its consequences, including laboratory tests, were compared between groups of patients with and without the presence of HV DNA. In the second study, we tried to demonstrate the presence of HSV1 DNA in cerebrospinal fluid during its symptomatic reactivation in patients with purulent meningitis. In our group of immunocompetent patients with non-purulent inflammation in the cerebrospinal fluid, the proportion of HV DNA positive patients reached 7.5% (13 out of 173), we also...
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Vaccination issues on the threshold of the third millenium
Šálek, Jiří ; Dáňová, Jana (advisor) ; Marešová, Vilma (referee) ; Fabiánová, Kateřina (referee)
This thesis based on descriptive comparative study is to evaluate different opinions and its influence to vaccination confidence in two branches of students, medical and pedagogical, as both of them plays important roles in children and adults education and, in case of pedagogy, forming the skills of critical thinking. Multi-item, opinion-based, paper-and-pencil typed anonymous questionnaires were distributed within medical students and students of pedagogical fields of study. Data has been sorted and divided into two clusters which underwent a statistical comparison using a logistic regression. From total of 722 respondents, 386 were medical students and 336 were pedagogical students. Most respondents said they were not in favor of alternative medicine; however, a significantly higher number of alternative medicine followers were among the respondents of the Faculty of Education. Positive vaccination perception rate (PVPR) is not dependent on behavioral factors of students at both faculties but it is clearly conditioned by attitude to alternative medicine. Fear of infections dramatically increased the PVPR (up to 6.7x) over those who were not afraid of the infection or were not quite sure whether to fear it. Fear of vaccines side effects clearly reduced the PVPR by at least 84%.
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Clinical and epidemiological features of the most commonly imported febrile illnesses and preventive measures
Trojánek, Milan ; Marešová, Vilma (advisor) ; Rožnovský, Luděk (referee) ; Chlíbek, Roman (referee)
The objective of the presented thesis was to evaluate epidemiological and clinical characteristics of the most significant tropical febrile infections imported to the Czech Republic, which include dengue and chikungunya fever, malaria and enteric fever. This retrospective-prospective study included a total of 292 patients with fever after a stay in the tropics who were treated at the Department of Infectious, Parasitic and Tropical Diseases of Hospital Na Bulovce in the years 2006-2014. The most common illnesses were dengue fever (52.1%), followed by malaria (37.3%), enteric fever (6.2%) and chikungunya fever (4.4%). Dengue fever was imported in 88.2% cases from Southeast or South Asia and malaria in 63.3% from Sub-Saharan Africa. Typical clinical and laboratory findings in dengue fever included headache (72.4%), rash (71.7%), muscle (67.6%) and joint pain (62.1%), leukocytopenia (26.5%), thrombocytopenia (22.4%), and low CRP (57.1%). Presented study confirmed that laboratory parameters differ in the acute and early convalescent phase of dengue fever. A total of 62.7% patients with malaria reported hedache and other frequent symptoms were dyspepsia (45.1%), dehydration (30.4%) and tachycardia (28.4%). Laboratory findings included high CRP (71.4%), decreased platelet count (52.4%) and...
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Adverse reactions after childhood vaccination in the Czech Republic
Kocourková, Aneta ; Dáňová, Jana (advisor) ; Marešová, Vilma (referee) ; Částková, Jitka (referee)
1 ABSTRACT In the Czech Republic a complex study of adverse reactions after vaccination in children has not been presented yet. Even though reporting of serious adverse reactions to the State Institute for Drug Control (SUKL) is mandatory by law, it is seldom performed. Moreover, there is no analysis correlating adverse reactions that occurred at doctors` surgeries with actual reported adverse reactions to SUKL. The main focus of presented work was to analyze and map adverse reactions appearing after vaccinations from the children's vaccination schedule in the Czech Republic. The study was conducted in the form of retrospective-prospective questionnaires concentrating on adverse reactions, their occurrence, character, seriousness, duration and frequency. Furthermore, the questionnaires also focused on socio-demographic data such as gender, age, residency, parents' education, birth weight. Also, the refusal of the compulsory vaccination was assessed. Occurrence of adverse reactions after vaccination in the Czech Republic was analyzed by questionnaires in pediatricians' surgeries (active surveillance). Obtained data were correlated with data available at SUKL (passive surveillance). The study data showed higher number of collected adverse reactions that number of adverse reactions reported to national program...
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The role of molecular genetics methods in diagnostics of neuroinfections
Petroušová, Lenka ; Marešová, Vilma (advisor) ; Göpfertová, Dana (referee) ; Plíšek, Stanislav (referee)
The role of molecular genetics methods in diagnostics of neuroinfections Background: Neuroinfections are serious diseases. They are associated with frequent development of permanent, debilitating consequences or even death. Aim: The aim of this work was to determine possible contribution of molecular genetic methods to diagnosis of neuroinfections and define potentially preventable agents. Methods: The prospective study included 1,463 patients who were hospitalized at the Department of Infectious Diseases in Ostrava in the years 2004-2013 of which 283 patients with purulent meningitis and 1,180 patients with aseptic meningitis. The criterion for the diagnosis was the number of elements in cerebrospinal fluid which had to exceed 5x106 /l. The diagnosis of purulent meningitis was established by cultivation, PCR for the detection of Streptococcus pneumoniae, Haemophilus influenzae, Neisseria meningitidis, and Listeria monocytogenes. The diagnosis of aseptic meningitis was established by serological tests for tick-borne encephalitis, enterovirus, mumps, Mycoplasma pneumoniae, and Lyme disease. PCR was used to investigate enterovirus, influenza virus, VHE and herpes viruses. Result: In case of the 283 patients with purulent meningitis the etiology was established in 73 % cases, PCR method was positive...
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Electron microscopy in the diagnosis of viral gastroenteritis in children less than five years old.
Arientová, Simona ; Marešová, Vilma (advisor) ; Rožnovský, Luděk (referee) ; Krbková, Lenka (referee)
Acute gastroenteritis is one of the most frequent diseases in children worldwide and remains the main cause of childhood morbidity and mortality, particularly in developing countries. Each year as many as 1.5 million children less than first five years die in the world from acute gastroenteritis. Our study has been aimed at demonstrating of the main role of viruses in the aetiology of acute gastroenteritis in children less than five years old and at pointing out the diagnostic potential of electron microscopy in viral gastroenteritis. A prospective study was conducted to analyse the aetiology of diarrhoeal diseases in children less than five years of age admitted to the Department of Infectious Diseases of the Na Bulovce Hospital, Prague, between September, 2006 and June, 2009. All children were tested by faecal culture for bacterial aetiology and by latex agglutination and electron microscopy for viral aetiology. A total of 1059 children were included in the study. The mean age of children was 1.9 years and the mean length of hospitalisation was 5.2 days. An aetiological agent was detected in 1051 children (95.9%). A bacterial aetiology was found in 22 (2.1%) children, bacterial-viral co-infection was found in 183 (17.3%) patients and viruses were detected in 810 (76.5%) patients. The main causes of viral...
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Molecular biological methods in laboratory diagnosis pathogenic leptospires
Kučerová, Petra ; Čermáková, Zuzana (advisor) ; Marešová, Vilma (referee) ; Treml, František (referee)
SUMMMARY Title: "Molecular biological methods in laboratory diagnosis of pathogenic leptospires" During Ph.D. study programe real-time PCR method based on detection of gene encoding surface lipoprotein LipL32 was designed, devised and introduced into clinical laboratory practice of laboratory diagnosis of acute form of leptospirosis. Positive and negative analytical specificity 100 % in both cases was defined and limit of detection in range 1 - 5 copies of genome / ml of liquid biological material was determined. Real-time PCR method was in clinical practice on biological materials gained in period April 2010 - April 2013 from 295 patients suspicious on leptospirosis verified. Total number of 9 persons from whom 15 biological materials originated as LipL32 positive were evaluated. Real-time PCR was tested during the analysis of environmental samples for the presence of Leptospira. From 680 samples (surface water, waste water, wet substrates) were 5 real-time PCR reactions (0.7%) evaluated as borderline, results sequence analysis were repeatedly "uncultivable bacteria." All samples were as negative evaluated. From mention is clear that this method is not suitable for testing these materials. Multilocus sequence typing analysis detecting 5 genes (adk, icdA, rrs2, lipl41 and lipl32 gene) was used to create the...
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