[Murine typhus - rare cause of fever return from Egypt]. / Krysí skvrnivka - vzácná prícina horecky po návratu z Egypta.

Authors present a case report of 42-year male who spent 14 days in August of 2003 in Egyptian seaside summer town Hurghada and later he was admitted to the Infectious Disease Department Prague with the fever lasting 4 days. His symptoms were as follows: strong headache and dry cough. On the 7th and 8th day appeared transient maculopapular rash, laboratory test revealed a slightly elevated C reactive protein and elevation of amino transferases up to 5 times higher than range values, chest X-ray showed hypoventilation opacities on the lower lung fields, other findings were non-specifically changed or normal. The fever dropped after 15 days without any response to administered antibiotics-amoxicillin/clavulanate, clarithromycin a ofloxacin. Weil-Felix reaction with antigen Proteus OX19 (1 : 5120) was highly positive and positive antibodies IgG and IgM against Rickettsia typhi were positive. Later doxycycline was given, problems fully subsided, laboratory values were normalised up to six weeks from the beginning of the disease. Diagnosis was completed as murine typhus. The patient excluded arthropode bit. The authors considered the possibility of inhaled contaminated dust during his visit of the port. The above given case was firstly referred in the Czech Republic and still it is the only case.

[Parameters of cellular immunity in maternal and umbilical cord blood in relation to air pollution. Preliminary results of a pregnancy outcomes study]. / Parametry bunecné imunity v materské a pupecníkové krvi ve vztahu k znecistení ovzdusí. Predbezné výsledky projektu výsledky tehotenství.

BACKGROUND: The study is a part of the project Pregnancy Outcome (Teplice Program) examining effects of polluted environment on the quality of reproduction in Teplice (high polluted) and Prachatice (control) districts. Selected parameters of cell mediated and humoral immunity in maternal and umbilical samples after delivery were assayed. METHODS AND RESULTS: Lymphocytes in 768 samples of maternal venous blood and 739 samples of umbilical blood collected in May 1994-October 1997 were phenotyped using flow cytometry. Medical and personal questionnaires were used to obtain data on clinical risk factors during pregnancy, health and life style of mothers, the course and prolongation of labour and newborn's status. The percentages of T and NK lymphocytes in both umbilical and maternal blood were associated with a number of variables, including the course of labour. After adjustment for the other predictors, the percentage of NK lymphocytes was found significantly higher in Teplice than in Prachatice samples--in both maternal and umbilical blood. CONCLUSIONS: A part of the observed difference between distribution of NK and T lymphocytes can be attributed to living in the polluted district. To see effects of polluted environment, the association of seasonal difference in levels of major pollutants with seasonal changes in lymphocyte phenotype will be analyzed.

[Indicators of progression of HIV infection and their application to therapy]. / Ukazatele progrese infekce HIV a jejich vyuzití v terapii.

The authors evaluated in a group of 217 HIV positive patients the mutual relationship of the number of CD4+T lymphocytes and the level of the viral load of HIV RNA. Using correlation analysis evidence was provided of a not very marked negative correlation of the two indicators. As it was assumed that the relationship of the two parameters is influenced by the applied therapeutic procedures which reduce in particular the viral load, the two parameters were evaluated in relation to treatment. The closest relationship of the two investigated parameters was found in the group treated by monotherapy with zidovudine, followed by the group treated with a combination of two preparations (two nucleoside inhibitors of reverse transcriptase). In the group treated by three preparations (two nucleoside inhibitors of reverse transcriptase and a protease inhibitor) the relationship of the two parameters was least close. Investigation of the level of the viral load of HIV RNA and number of CD4+T lymphocytes is of major importance for the introduction of antiretrovirus treatment and selection of a suitable combination of antiretrovirus preparations. It makes it also possible to follow up the effectiveness of this treatment.

[Acute phase proteins in acute pancreatitis]. / Proteiny akutní fáze u akutní pankreatitidy.

The submitted investigation deals with the value of assessment of selected reactants of the acute stage in patients with acute pancreatitis and their follow-up in the course of the disease. For the investigation C-reactive protein, alpha-1-antitrypsin and haptaglobin were selected. In addition to the prognostic impact the authors focused attention on assessment of the dynamics of individual proteins and their importance for the early detection of complications in acute pancreatitis with different etiologies. The high CRP level on admission of severe cases of pancreatitis--mean 166.9 mg/l (range from 100 to 320 mg/l)--correlated with other signs suggesting severe pancreatitis and the latter was confirmed by computed tomography (CT), surgery or post-mortem examination in 90% of the patients with a CRP level above 100 mg/l. This correlation was not confirmed for alpha-1-antitrypsin or haptaglobin.

[Immunologic follow-up of HIV-positive patients. C3, C4 complement components during HIV infection]. / Imunologické sledování HIV pozitivních pacientu. C3, C4 slozky komplementu v prubehu HIV-infekce.

Investigations of the authors' patients with HIV infection revealed marked changes in the C3 and C4 components of complement. Of 61 investigated patients with HIV infection only 23 patients (37.7%) had values of the C3 component at the level recorded in controls. Values of the C4 component comparable with the control group were recorded in 24 patients (39.3%). From figures 1 and 2 it apparent that in the investigated group there is a striking hypercomplementaemia of both components, as compared with hypocomplementaemia.

[Immunologic study in HIV-positive patients. Hypergammaglobulinemia in HIV infection]. / Imunologické sledování HIV pozitivních pacientu. Hypergamaglobulinémie u HIV-infekce.

In all groups of patients--HIV, ARC, AIDS carriers--elevated serum concentration of IgG, IgA, IgM were found. In the group of HIV carriers a significant increase of the serum concentration of IgG at the 5% level was observed and of IgM at the 1% level. In patients with ARC a significant increase of IgG and IgA was found at the 5% level and of IgM at the 1% level. In patients with AIDS significantly raised IgG values at the 5% level were recorded, and of IgA and IgM at the 1% level. In IgA a permanent increase of values occurs in AIDS carriers. In the AIDS stage 86% of the patients have values higher than mean +/- SD of controls. In all three stages of HIV infection a rise of concentrations of circulating immunocomplexes was observed (p < 0.01). The highest levels were recorded in patients with AIDS. In none of the patients the presence of antinuclear antibodies was detected. The authors discuss also possible causes of hypergammaglobulinaemia in HIV infection.

[Immunologic monitoring of HIV-positive patients. T-lymphocytes and their subpopulations in various clinical stages of HIV infection]. / Imunologické sledování HIV pozitivních pacientu. T-lymfocyty a jejich subpopulace v ruzných klinických stadiích HIV-infekce.

The authors evaluate T-lymphocytes and their sub-populations, the immunoregulating index and white cell haemogram in patients in different clinical stages of HIV infection. They discuss the importance of the investigated parameters, in particular the number of CD4+ T-lymphocytes in the peripheral blood stream as a laboratory criterium for the development of the disease. From the paper ensues that evaluation of the number of CD4+ T-lymphocytes in the peripheral blood stream can help to estimate the time of the primary infection and the selection of an optimal time for starting azidothymidine therapy, but alone it does not suffice for establishment of the prognosis of the development of the HIV infection.

[Levels of C-reactive protein in serum--comparison of 2 methods used for quantitative determination]. / Koncentrace C-reaktivního proteinu v séru--srovnáni dvou metod pouzívaných pro jeho kvantitativní stanovení.

The authors compared the results of two methods used for the quantitative assessment of C-reactive protein: the method of radial immunodiffusion and the microturbidimetric method. The testing was based on examination of 68 sera from patients. The samples comprised sera with a CRP concentration under 230 mg/l. There was a statistically significant correlation between the results of the two compared methods (r = 0.949, p = 0.0001).

Morbidity and immunological test in miners working in mines with low ionizing radiation level.

Total count of morbidity as well as prevalence of upper respiratory tract diseases (RTD) were followed in 210 miners working in shale mines with a low level of ionizing radiation regarding their smoking habits. After one and half year of observation were performed some tests of humoral immunity in the blood serum and saliva (immunoglobulins G, A, M and sIgA) as well as some tests of non-specific indices (alpha 2 macroglobulin -A 2M, transferrin -TRF, lysozyme -- LYS). The number of healthy non--smokers reached 41.3%, whereas the number of healthy smokers was only 26.5% (P less than 0.05). The greater was the number of diseases in single subjects, the greater was the difference between smokers and non-smokers (P less than 0.005). The difference between RTD morbidity of smokers and non-smokers was not significant in the subgroup of miners employed less than 10 years, but the length of employment it rose significantly (P less than 0.002) in disfavour of the smokers. The difference between smokers and non-smokers is emphasized by ageing. The mean levels of immunoglobulins (IgG, IgA, IgM) are significantly higher in healthy non-smokers in comparison with other miners; that is stressed also by distribution analysis. The distribution analysis. The distribution of A 2M values is also significantly different in the subgroup of healthy non-smokers compared with other miners. Highly significant differences were found between healthy non-smokers and other miners by discrimination analysis of coupled tests. The differences among the paired comperformed some tests of humoral immunity in the blood serum and saliva (immunoglobulins are apparently cooperative in the prevention of RTD. In contrast to that the level of A 2M are in reverse relationship to the levels of Ig; in the subgroup of healthy non-smokers low levels of A 2M are in connection with high levels of Ig of all three classes. The results are discussed from the point of view of the smoker's habits, the length of employment in mine's environment, the age of the miners and the supposed genetical factors.