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Penetration of B-lactam antibiotics into cerebrospinal fluid and its relationship to inflammatory markers during invasive bacterial infection
Prášil, Petr ; Buchta, Vladimír (advisor) ; Marešová, Vilma (referee) ; Boštík, Pavel (referee)
Penetration of β-lactam antibiotics into cerebrospinal fluid and its relationship to inflammatory markers during invasive bacterial infection Aim: The penetration of β-lactam antibiotics (ceftriaxone, crystalic penicillin G - potassium salt and cefotaxime) into the cerebrospinal fluid (CSF) was estabilished and the correlation between the penetration and laboratory markers of inflammation was evaluated. Materials and methods: Levels of β-lactam antibiotics in serum and CSF were determined in 24 patients (76 samples). In all patients (n = 24) the CSF/serum ratio for antibiotics was calculated and it was correlated with laboratory markers of inflammation (C-reactive protein, fibrinogen, and CSF numbers of neutrophils). Besides, CSF was examined by a modified bactericidal test in patients (n = 13) with positive bacterial culture. In 14 patients (28 samples) levels of serum antibiotic concentration, both before and after its administration, were measured. Results: Serum levels of ceftriaxone before and after administration (31.2 mg/l ± SD 12.29 and 300.0 mg/l ± SD 125.9, respectively) differed with a statistical significance (p = 0.000156). Further, a significant difference between value of inflammatory markers and value of CSF/serum ratio (Kl/s) of ceftriaxone was observed. Patients with ratio values...
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Prognostic indicators of risk of death and the consequences of purulent meningitis
Džupová, Olga ; Janovská, Daniela (advisor) ; Křížová, Pavla (referee) ; Marešová, Vilma (referee) ; Dostál, Václav (referee)
Purulent meningitis is a life-threatening acute infectious disease of the central nervous system. In preantibiotics period was almost one hundred percent fatality rate of disease, with the discovery of antibiotics and their introduction into medical practice in 30th-50th of the last century has decreased dramatically. In recent decades, despite the use of highly effective antibiotics and intensive care procedures, there was no significant reduction in mortality rate and consequences of the disease. Lethal course of the disease affects 15-30% of patients in adulthood. Although not a common infection diagnosis among the top ten infectious causes of death worldwide. The study was based on evaluation of their own group of patients to determine prognostic factors observed history, course of illness and laboratory characteristics of the clinical outcome of disease in adults.
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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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