Prace uvadi přehled soucasných znalosti o etiologii průjmových infekcnich onemocněni v dětskem věku se zaměřenim na rotaviry jako nejcastějsi původce. Zabýva se epidemiologii a patogenezi rotavirových gastroenteritid. Zdůrazňuje nezbytnost vcasneho rozpoznani zavažne dehydratace a popisuje soucasne lecebne postupy. Upozorňuje na nebezpeci rotavirových nozokomialnich nakaz a uvadi i preventivni opatřeni proti jejich výskytu. Shrnuje diagnosticka a lecebna doporuceni pro pediatrickou praxi.
The TBE virus (TBEV) was first isolated in the Czech Republic by Czech scientists in 1948-1949 from both a patient and also from Ixodes ricinus ticks. However, even before 1948, etiologically unclear summer cases of viral meningoencephalitis had been reported, and likely, at least in part, they are attributable to the TBE virus. These cases were reported mostly from patients in the districts of Beroun (Central Bohemia), Hradec Králové (East Bohemia), Vyškov (South Moravia), and occasionally from the neighborhood of Prague. The official reports of these probable cases of ”tick-borne encephalitis” were registered in the database of the National Institute of Public Health in Prague since 1945.
Our pilot study aimed to determine the effect of tumor necrosis factor-alpha (TNF-alpha) 308 G-->A promoter single-nucleotide polymorphism in pediatric inflammatory bowel disease (IBD), its influence on inflammatory activity and the clinical manifestations.We obtained genomic DNA from 164 subjects, 82 with long-standing IBD aged 8 to 18 years: 46 with Crohn disease (CD) and 36 with ulcerative colitis (UC). Eighty-two healthy children served as the control population. Genotyping was determined by using a restriction enzyme-based assay. TNF-alpha 308 G-->A polymorphism was assessed in terms of inflammatory (C-reactive protein [CRP]) and disease activity. The latter was assessed by the Pediatric Crohn's Disease Activity Index (PCDAI) and the Truelove index for CD and UC, respectively.Significant differences in TNF-alpha 308 A polymorphism were found between the IBD group and controls (P < 0.05) and the UC group and controls (P < 0.001). No differences were noted between TNF-alpha 308 A polymorphism and clinical characteristics in UC. The frequency of the -308 A allele of TNF was not different in CD compared with that in the control group. The frequency of TNF-alpha 308 A genotype was significantly higher in CD patients with predominantly stenosing/penetrating disease compared with patients without complications (P < 0.001) and healthy controls (P < 0.01). In CD patients, those carrying TNF -308 A had a significant increase in CRP (P < 0.05) and the PCDAI (P < 0.05). In CD, CRP levels strongly correlated with the PCDAI (r = 0.6150, P < 0.001). In UC, significant differences among the mean levels of CRP (P < 0.05) and disease activity (P < 0.001) related to TNF-alpha 308 A polymorphism were found. Allele distribution (odds ratio, 12.9; CI, 1.18-140.81, P < 0.001) and CRP serum levels (odds ratio, 1.020; CI, 1.00-1.04, P < 0.001) were independently associated with CD complications.Although not necessarily dictating IBD initiation, the TNF-alpha 308 A polymorphism may play a role in modifying the CD phenotype. The polymorphism may influence disease activity as well as more intense inflammatory activity in both forms of IBD and may modify the progression of chronic digestive tract inflammation.
The human parvovirus B 19 was discovered in 1975 by Cossart in England. Later (1984) evidence was provided that this virus is the etiological agent of erythema infectiosum and hydrops foetalis, and in 1985 it was provided that it is also the etiological agent of some types of arthritis or arthropaties and vasculitis. The diagnosis of the disease caused by this agent is most frequently based on evidence of specific immunoglobulins. The epidemiological and clinical impact of parvoviral infections in the Czech Republic was not known so far. Examination of sera from 562 subjects aged 0-60 years assembled in 1992 in three Czech regions revealed in children, age 0 - 4 years 9.8%, during preschool and school age 27 - 35.7% and in age groups above 15 years a 53.3 - 57.7% seroprevalence of IgG parvovirus B 19, roughly equally distributed among both sexes. The more frequent prevalence of specific immunoglobulins was proved in small groups of female workers in nurseries (66.7%), nursery schools (91.7%) and in blood transfusion stations (77.8%). The seropositivity of the general female population of matched age groups, with the exception of women aged 20 - 24 years, was 53.86%.
The TBE virus (TBEV) was first isolated in the Czech Republic (together in all Central Europe) by Czech specialists in 1948-1949 from both a patient and also from Ixodes ricinus ticks.
During 1988-1992 the hygiene service of the West Bohemian region received 1,954 notifications of Lyme borreliosis (LB), incl. 48.5% confirmed by serological examination. Among the affected systems the skin, joints and the nervous system predominated. The most frequently reported vector were ticks which alone accounted for 57.8%. Contrastly to tick-borne encephalitis, the disease was detected in all districts of the region and in all age groups. The highest morbidity was recorded in women in the age bracket of 45-64 years.
The authors evaluated in 1987-1994 the incidence of nosocomial rotavirus infections during hospitalization in 1718 junior children, 450 senior children and adults admitted with diarrhoeal diseases. Rotavirus infection was revealed in 6.2 and 1.3% of the patients resp. During hospitalization the rotaviruses were the most frequent causal agent of nosocomial infections. Hospital infection was contracted regardless of the initial diagnosis most frequently by patients aged 0-12 months. The majority of nosocomial rotavirus infections was associated with symptoms of diarrhoeal disease, on average symptomatic infections prolonged the hospitalization period by 4.2 days. The authors discuss the possibility to influence the incidence of these infections.
