Study of family clusters of COVID-19 in the Ústí nad Labem Region with a focus on children - clinical picture, secondary transmission, antibody response.

OBJECTIVE: The article presents the results of a study of family clusters of COVID-19 whose aim was to describe the clinical course of the disease in children, to identify secondary transmission in households with infected children, and to find out the differences in the antibody response between children and adults. Data were collected from 3 March 2020 to 25 October 2020, that is at the time when the alpha or delta variants were not dominant. METHODS: A retrospective analysis of data on infected children in the Ústí nad Labem Region collected by the Regional Public Health Authority along with questionnaire data reported by their families. Serological tests were performed in study volunteers. RESULTS: The most common symptoms in children were headache, runny nose, and loss of smell and taste. The hospital admission rates were 0.8% in children and 2.4% in adults. The secondary transmission rate in families where the index case was a child reached 22.6%. It was higher when the index case was a child 11-15 years of age or asymptomatic. The secondary transmission rate in families where the index case was an adult equalled 77.1%. Children had higher IgG antibody levels than adults at post-infection months 4 and 5, but their seropositivity rate was comparable to that of adults. CONCLUSION: Children have a nonspecific clinical course of the disease, which is quite similar as other viroses, and rarely require hospital admission. Secondary transmission in families where the index case was a child is not uncommon and is also possible through contact with an asymptomatic child. After recovery, children have higher levels of antibodies at post-infection months 4 and 5.

The duration of SARS-CoV-2 shedding in patients recovering from COVID-19.

The knowledge of SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) shedding is highly relevant to the diagnosis, treatment and follow-up of patients with COVID-19 (coronavirus disease 2019). Deep nasopharyngeal swabs repeatedly collected from a cohort of one hundred patients with COVID-19 were tested for SARS-CoV-2 RNA using RT-PCR (real-time polymerase chain reaction). The median period of viral genome detectability was 15 days. Furthermore, the authors tested the hypothesis on the relationship between the severity of COVID-19 and the period in which the viral genome is detectable. They did not find any statistically significant difference in the duration of viral clearance between patients with asymptomatic to mild disease or severe disease.

Functionalized hydrogel microparticles prepared by microfluidics and their interaction with tumour marker carbonic anhydrase IX.

Microfluidics allows precise control of the synthesis of microparticles for specific applications, where size and morphology play an important role. In this work, we have introduced microfluidic chip design with dedicated extraction and gelation sections allowing to prepare hydrogel particles in the size range of a red blood cell. The influence of the extractive channel size, alginate concentration and type of storage media on the final size of the prepared alginate microparticles has been discussed. The second part of the work is dedicated to the surface modification of prepared particles using chitosan, pHPMA and the monoclonal antibody molecule, IgG M75. The specific interaction of the antibody molecule with an antigen domain of carbonic anhydrase IX, the transmembrane tumour protein associated with several types of cancer, is demonstrated by fluorescence imaging and compared to an isotypic antibody molecule.

Fluorescent Probes for Monitoring Cholesterol Trafficking in Cells.

Cellular cholesterol plays fundamental and diverse roles in many biological processes and affects the pathology of various diseases. Comprehensive and detailed understanding of the cellular functions and characteristics of cholesterol requires visualization of its subcellular distribution, which can be achieved by fluorescence microscopy. Many attempts have been made to develop fluorescent cholesterol reporters, but so far, none of them seems to be ideal for studying all aspects of cholesterol management. To meet the requirements for the right probe remains a great challenge, and progress in this field continues. The main objective of this review is to not only present the current state of the art, but also critically evaluate the applicability of individual probes and for what purpose they can be used to obtain relevant data. Hence, the data obtained with different probes might provide complementary information to build an integrated picture about the cellular cholesterol.

Synthesis and deposition of a Tröger's base polymer on the electrode surface for potentiometric detection of a neuroblastoma tumor marker metabolite.

The development of novel diagnostic tools is a primary goal in bioanalytical chemistry. Here we report the synthesis of Tröger's base functionalized with amino- and coumarin-units designed as a monomeric unit for the development of an electrochemical cancer sensor. The synthesized receptor was deposited onto a conducting support using electrochemical polymerization, characterized spectroscopically and tested potentiometrically towards metabolites used as tumor markers of neuroblastoma.

Striking antitumor activity of a methinium system with incorporated quinoxaline unit obtained by spontaneous cyclization.

A novel pentamethinium salt was synthesized with an unforeseen expanded conjugated quinoxaline unit directly incorporated into a pentamethinium chain. The compound exhibited high fluorescence intensity, selective mitochondrial localization, high cytotoxicity, and selectivity toward malignant cell lines, and resulted in remarkable in vivo suppression of tumor growth in mice.

[Iatrogenic bile ducts injuries]. / Iatrogenní poranení zlucových cest.

AIM: To evaluate therapeutic options and outcomes of repair of iatrogenic bile duct injuries during cholecystectomy, which were solved in our institution over the past five years. The incidence of this injury is stated in the range of 0-0.4% for open cholecystectomy and 0-0.7% for laparoscopic cholecystectomy. METHODS: Authors present a group of ten patients who were operated on for iatrogenic bile duct injury incurred during cholecystectomy in 2005-2009. All patiens were refered from other hospitals. Three men and seven women aged 20-71 years. The bile duct injury occured twice during open procedure and during laparoscopic procedure in eight. Incomplete lesion was idenified in one case, complete lesions with tissue loss were found in nine patients. Right hepatic artery injuries were found in four patients with tissue loss injury. Nine patients required reconstruction of the biliary tract using hepaticojejunoanastomosis with Roux-Y loop. RESULTS: The bile leak occurred in two patients after reconstruction. In one patient was required early percutaneous transhepatic drainage. The early death occurred in a patient with a complicated course, where our reconstruction of the biliary tract was already in the field of advanced biliary peritonitis as a third operation during 7 days. All other patients are monitored postoperatively at regular intervals in our clinic. They carried out clinical examinations and monitoring of liver enzymes. In the long interval from reconstruction (6-12 months) anastomotic stenosis occurred in three patients. Postoperative radiological intervention in the form of dilation of anastomosis and prolonged transient transanastomotic drainage was necessary (the duration of drainage was 6-7 months). CONCLUSION: Iatrogenic bile duct injury is a serious condition threatening the patient's life from the progressive failure of liver function on the basis of secondary biliary cirrhosis. Due to the nature of lesions arising from laparoscopic cholecystectomy (loss tissue injuries, thermal damage to surrounding structures, the hepatic artery injuries) reconstructions are extremely difficult. For most patients reconstructive operations are the last possible surgical procedures in this area, except for liver transplantation. Hilar reconstructions have a higher probability of stenosis of the anastomosis. If they occur, there are repeated cholangitis, which pass into the secondary sclerosing cholangitis and cause secondary biliary cirrhosis, with all the consequences of disease (portal hypertension, bleeding esophageal varices). For these reasons, it is necessary for careful long-term postoperative monitoring of liver function and good interdisciplinary cooperation, especially with the intervention radiologist in management postoperatively evolving stenosis of anastomoses. It is necessary for the early identification and indication of radiological interventions in order to prevent damage to the liver parenchyma.

[Esophageal replacement using large intestine--experience with 109 cases]. / Náhrada jícnu tlustým strevem--zkusenosti se 109 prípady.

Use of large intestinal transplants in esophageal replacement is an uncommonly used alternative. The authors discuss its indications in benign, as well as in malignant disorders and, based on them, assign them into three groups. Based on historical data and their professional experience, they present reasons for the commonest uses of particular parts of the large intestine. They evaluate introperative, as well as long-term outcomes.

[Video-assisted esophageal resection for carcinoma--ten-year experience]. / Videoasistovaá resekce jícnu pro karcinom--desetileté zkusenosti.

INTRODUCTION: Esophageal procedures belong to the most complicated gastrointestinal procedures. Therefore, esophageal carcinoma patients have been and still are concentrated into specialized centres, equipped with all diagnostic and therapeutic means. At the Ist Surgical Clinic of the LF UP (Medical Faculty of the Palacky University) in Olomouc, esophageal surgery has a long lasting tradition. In the management of malignant esophageal disorders, the clinic prefers the use subtotal esophageal resection, attaching the esophagus transplant to a cervical esophageal stud, to the use of more saving resection with the anastomosis site in the mediastinum. In order to substitute for the resected esophagus, the authors normally use a tubulized gastric flap. In cases, where the stomach cannot be used, the authors use transverse colon to replace the resected esophagus. Classical esophageal procedures have nearly entirely been replaced by video-assisted procedures. Most esophageal resections are performed using video-assisted laparoscopic transhiatal approach. In the management of esophageal tumors which are located at the level of tracheal bifurcation, or below it, the authors use right- sided thoracoscopic approach. MATERIAL AND METHODS: During the past 10 years, 178 patients have undergone subtotal esophageal resection for esophageal carcinoma. In 81 patients (45.5%), the esophagus was resected using classical approach. 35 subjects underwent transhiatal "blind"extirpation according to Orringer, in 46 subjects right-sided thoracotomy was used (subjects with tumors located in the middle third of the thoracic esophagus and higher). Video-assisted approach was used in 97 patients, which included 88 subjects with laparoscopic transhiatal modification of the procedure and 9 subjects, who underwent video-thoracoscopy. OUTCOMES: The mean procedure duration was 242 minutes. The authors recorded the following complications: pneumothorax in 29 patients (16%) and n. laryngeus recurrens palsy in 16 subjects (9%). 13 patients (7%) developed a fistule in anastomosis, which was managed by drainage of the cervical wound. Pulmonary complications were recorded in 55 patients (31%). The mean duration of hospitalization was 12 days, intraoperative death rate was 4.5%. Only 2 out of 8 deaths occurring during the early postoperative period, were surgery-related. In the both cases, mediastinitis developed, resulting from a transponate necrosis in one of the cases and from a bronchial fistule in the other subject. Five subjects exited because of ARDS, which included one case of myocardial infarction. CONCLUSION: When esophageal carcinoma is managed at a clinic equipped with the latest modern diagnostic and therapeutical means, the procedure of esophageal resection is a fairly safe procedure with low death and morbidity rates.

Serological response to tick-borne encephalitis (TBE) vaccination in the elderly--results from an observational study.

BACKGROUND: In the elderly, the incidence of tick-borne encephalitis (TBE) is higher than in younger individuals. At the same time, the responsiveness of the elderly to vaccination may be decreased. Product information for TBE vaccines therefore recommends determining antibody response after two of the three doses required for primary immunization in persons over 60. OBJECTIVE: To determine the proportion of persons aged 60 years or older with insufficient antibody response after administration of two doses of TBE vaccine. METHODS: A retrospective analysis of TBE-specific antibody levels as determined by Immunozym ELISA in serum samples of 185 vaccinees > 60 years of age after the first two of the three vaccinations required for primary immunisation. Patients received either FSME-IMMUN Adult or Encepur Adults at one vaccination centre in the Czech Republic. In a subset of 80 vaccinees, two additional ELISAs and a neutralization test (NT) were performed. RESULTS: Overall, 33 of the 185 individuals (18%) included in the Immunozym analysis had antibody concentrations below putative protective levels after two doses. Geometric mean concentrations and seropositivity rates were higher in individuals vaccinated with FSME-IMMUN than in those vaccinated with Encepur. While the differences in mean antibody levels and/or seropositivity rates in ELISAs for the Neudörfl strain (used in FSME-IMMUN) were significant, no significant differences were obtained for Enzygnost, which uses the Karlsruhe strain (used in Encepur). CONCLUSIONS: After two doses of TBE vaccine, one in five persons aged 60 years or older may be without protective antibodies, confirming the importance of testing the antibody response after the second vaccination and administering an additional dose in the event of insufficient response.