Fingerprints of the Local Moment Formation and its Kondo Screening in the Generalized Susceptibilities of Many-Electron Problems.

We identify the precise hallmarks of the local magnetic moment formation and its Kondo screening in the frequency structure of the generalized charge susceptibility. The sharpness of our identification even pinpoints an alternative criterion to determine the Kondo temperature of strongly correlated systems on the two-particle level, which only requires calculations at the lowest Matsubara frequency. We showcase its strength by applying it to the single impurity and the periodic Anderson model as well as to the Hubbard model. Our results represent a significant progress for the general understanding of quantum field theory at the two-particle level and allow for tracing the limits of the physics captured by perturbative approaches for correlated systems.

Attractive Effect of a Strong Electronic Repulsion: The Physics of Vertex Divergences.

While the breakdown of the perturbation expansion for the many-electron problem has several formal consequences, here we unveil its physical effect: flipping the sign of the effective electronic interaction in specific scattering channels. By decomposing local and uniform susceptibilities of the Hubbard model via their spectral representations, we prove how entering the nonperturbative regime causes an enhancement of the charge response, ultimately responsible for the phase-separation instabilities close to the Mott metal-insulator transition. Our analysis opens a new route for understanding phase transitions in the nonperturbative regime and clarifies why attractive effects emerging from a strong repulsion can induce phase separations but not s-wave pairing or charge-density wave instabilities.

Antithrombin as a marker of severe acute hepatitis B.

BACKGROUND: Acute hepatitis B (AHB) can run a severe course, which sometimes leads to a fulminant disease with acute liver failure (ALF). Pro-coagulation factors are well-established markers of AHB severity, but less is known about the levels of anti-coagulation parameters in AHB. METHODS: In this study, we demonstrate that antithrombin (AT) plasma levels were associated with AHB severity in 161 patients. RESULTS: Nine (6%) patients had severe AHB (i.e. international normalized ratio [INR] ≥ 1.6 and total bilirubin ≥ 10 mg/dL). Coagulopathy (i.e. INR > 1.2 and/or AT < 80%) was observed in 65 (40%) AHB patients on admission. Low initial plasma AT levels (i.e. < 80%) were observed in 56 (35%) patients. In all, plasma AT levels decreased in 91 (57%) patients during their hospital stay. Both baseline and nadir AT levels were significantly lower in severe than in mild and moderate AHB. Moreover, the concentration of AT negatively correlated with INR, aspartate aminotransferase, and total and conjugated bilirubin levels. Interestingly, nadir AT levels positively correlated with the duration of hospitalization. CONCLUSIONS: These results indicate that plasma AT levels can be used as an additional marker of AHB severity.

[Hepatitidis E virus]. / Virus hepatitidy E.

UNLABELLED: The number of detected cases of hepatitis E (HE) shows an increasing trend in the Czech Republic, probably due the introduction of new diagnostic methods and greater awareness of HE. In most cases, the source of infection has remained unconfirmed or entirely unclear. The causative agent, the hepatitis E virus (HEV), belongs to the Hepeviridae family. Recently, many isolates from mammals, birds, and fish have been identified. HEV is widespread among farm pigs and wild boar populations all over the word. Both species serve as HEV reservoirs. Consumption of undercooked meat or offal from the reservoir animals is considered to be unsafe due to zoonotic transmission of HEV. The aim of the present article is to summarize recent findings regarding HEV. KEY WORDS: hepatitis E - zoonosis - food-borne infection.

[Human hantavirus diseases - still neglected zoonoses?]. / Onemocnení cloveka zpusobená hantaviry - stále opomíjené zoonózy?

Hantavirus disease is the most common rodent-borne viral infection in the Czech Republic, with a mean annual incidence of 0.02 cases per 100 000 population and specific antibodies detected in 1% of the human population. Four hantaviruses (Puumala, Dobrava-Belgrade, Tula, and Seewis) circulate in this country, of which Puumala virus (responsible for a mild form of hemorrhagic fever with renal syndrome called nephropathia epidemica) and Dobrava-Belgrade virus (causing haemorrhagic fever with renal syndrome) have been proven to cause human disease. The aim of this study is to provide a comprehensive review of the hantaviruses occurring in the Czech Republic, based on the literature published during the past three decades, including their geographical distribution and clinical symptoms. The recent detection of Tula virus in an immunocompromised person as well as reports of Seoul virus infections in Europe highlight the possible emergence of neglected hantavirus infections in the foreseeable future.

[Immune response in the pathogenesis of hepatitis C virus infection]. / Imunitní odpoved v patogenezi infekce virem hepatitidy C.

The pathogenesis of hepatitis C virus (HCV) infection is regulated by the host immunity and several metabolic factors affecting liver metabolism, including oxidative stress, insulin resistance, and hepatic steatosis. Both innate and adaptive immunity play an important role in HCV infection. Cytotoxic lymphocytes have a crucial role in viral eradication or viral persistence. Major cause of viral persistence during HCV infection could be the development of a weak antiviral immune response to the viral antigens, with corresponding inability to eradicate infected cells.

Evaluation of potential biomarkers for the discrimination of bacterial and viral infections.

PURPOSE: Timely knowledge of the bacterial etiology and localization of infection are important for empirical antibiotic therapy. Thus, the goal of this study was to evaluate routinely used biomarkers together with novel laboratory parameters in the diagnosis of infection. METHODS: In this prospective study, 54 adult patients with bacterial infections admitted to the Department of Infectious Diseases were included. For comparison, 27 patients with viral infections were enrolled. In these patients, white blood cell (WBC) counts, differential blood counts, serum levels of procalcitonin (PCT), IL-1ß, IL-6, IL-8, IL-10, IL-12, TNF-α, IFN-γ, soluble CD14 (sCD14), heparin-binding protein (HBP), cortisol (Cort), and monocyte surface expression of TLR2, TLR4, HLA-DR, and CD14 were analyzed. Also, these biomarkers were evaluated in 21 patients with acute community-acquired bacterial pneumonia (CABP), as well as in 21 patients with pyelonephritis and urosepsis. RESULTS: The highest sensitivity and specificity (expressed as the area under the curve [AUC]) for bacterial infection were observed in serum concentration of PCT (0.952), neutrophil and lymphocyte counts (0.852 and 0.841, respectively), and serum levels of HBP (0.837), IL-6 (0.830), and Cort (0.817). In addition, the serum levels of IFN-γ and Cort were significantly higher and IL-8 levels were lower in CABP when compared to pyelonephritis or urosepsis. CONCLUSIONS: From the novel potential biomarkers, only PCT demonstrated superiority over the routine parameters in the differentiation of bacterial from viral infections. However, some of the novel parameters should be further evaluated in larger and better characterized cohorts of patients in order to find their clinical applications.

[Infectious complications of biological therapy]. / Infekcní komplikare biologické lécby.

Biological treatment represents a significant progress in the therapy of many serious diseases. Together with the growing knowledge of pathophysiology and subsequent development of new therapeutic agents, this progress will definitely lead to further expansion of biologics. Since biologics interfere with many mechanisms of host defence, which may sometimes be compromised by them, increased risk of infectious complications must be taken into account. Patients treated with biologics are prone to classical virulent infections (e.g. listeriosis, legionellosis and tuberculosis) and opportunistic infections such as progressive multifocal leukoencephalopathy. Furthermore, suppression of the immune response that is caused by biologics may lead to reactivation of latent infections such as tuberculosis or viral hepatitis B. Therefore, the knowledge of basic mechanisms by which biologics modify the immune response is important for a rapid clinical diagnosis of possible aetiology of infectious complications.

[Viral hepatitis B in a patient with follicular lymphoma treated with biological therapy]. / Virová hepatitida B u pacientky s folikulárním lymfomem lécené biologickou terapií.

Reactivation, recurrence or acute infection with hepatitis B virus (HBV) represent severe complications of biological therapy. Reported is a case of a 58-year-old female treated in the past with cytostatics and rituximab for follicular lymphoma, in whom HBV infection was detected during a follow-up of the contacts of her partner diagnosed with acute viral hepatitis B. At the beginning, the patient had a very high serum level of HBV DNA (4.3 × 108 IU/mL) and therefore she was treated with combined antiviral therapy (lamivudine and tenofovir). After 10 months, the serum level of HBV DNA decreased significantly (3,100 IU/mL) and the combined antiviral therapy was switched to monotherapy with tenofovir. Another 5 months later, the serum level of HBV DNA was only 950 IU/mL. This case demonstrates important clinical problems connected with HBV infection in immunocompromised persons.

[A case of acute hepatitis E acquired in the Czech Republic]. / Prípad akutní virové hepatitidy E získané v Ceské republice.

We report a case of 54-year-old female, who was diagnosed with acute viral hepatitis E with uncomplicated anicteric course of the infection. The patient did not have a specific travel history to endemic areas and the infection has been acquired in the Czech Republic. The epidemiologic history was remarkable only because she consumed undercooked pork meat. A differential diagnostic process of acute viral hepatitis in our conditions as well as problems of acute viral hepatitis E as an autochtonous infection in Western and Central Europe are discussed.

[Liver diseases of infectious aetiology]. / Onemocnení jater infekcní etiologie.

Review article is dealing with the problems of infectious diseases of the liver. Attention is paid to the basic infectious agents, jaundice accompanying infectious diseases and focal infections of the liver. Specific infections of the liver are supplemented by brief pathological and anatomical characteristics.

Infectious arthritis: clinical features, laboratory findings and treatment.

An infection of native joints leads generally to suppurative arthritis, which may be of one joint (monarticular) or several joints (oligoarticular). Bacteria that produce symptoms in multiple joints during bacteraemia, such as Neisseria gonorrhoeae, may also induce inflammation in the neighbouring tendon sheaths. Viral infections frequently involve multiple joints and produce inflammation without suppuration. Chronic granulomatous monarticular arthritis may occur because of infection with either mycobacteria or fungi, which must be differentiated from other causes of chronic monarticular arthritis. A sterile arthritis may occur early in infection (as with hepatitis B), or later (as with a post-infectious arthritis). Any patient presenting with an inflamed joint should have infection as a diagnostic possibility and appropriate cultures must be performed.

Interferon-gamma and cortisol levels in cerebrospinal fluid and its relationship to the etiology of aseptic meningoencephalitis.

The aim of the study was to analyze the concentrations of Th1/Th2 cytokines and cortisol in the cerebrospinal fluid (CSF) from patients with aseptic meningoencephalitis (AM). The study enrolled 37 patients with AM and 11 control subjects. CSF concentrations of IL-2, IL-4, IL-5, IL-10, IFN-gamma, and TNF-alpha were analyzed using cytokine bead array and flow cytometry; CSF cortisol concentrations were measured by a RIA method. Cortisol was detected in 37 CSF samples (100%) from patients with AM, and it was significantly elevated in comparison to control subjects. IFN-gamma was detected in 32 CSF samples (86.5%) and IL-10 was detectable in 9 CSF samples (24.3%). The CSF cortisol levels correlated negatively with the duration of AM. The intrathecal concentration of IFN-gamma correlated positively with CSF numbers of leukocytes and lymphocytes, and negatively with the duration of AM. The etiology of AM influenced the CSF cortisol concentration, which was significantly higher in patients with tick-borne encephalitis when compared to persons with AM of unknown origin and control subjects. The results indicate that the prevailing intrathecal immune reaction during AM is shifted to a Th1-like response, whereas anti-inflammatory response in the brain is executed by the effect of cortisol.

[Successful treatment of chronic hepatitis C in hemophiliacs based on historical development of therapeutic protocols]. / Uspesnost lécby chronické hepatitidy C u hemofiliku v závislosti na historickém vývoji doporucených lécebných schémat.

Chronic infection with hepatitis C virus is very frequent among hemophilic patients in all developed counties, including the Czech Republic. Because of a possibility of developing serious terminal stages of infection, liver cirrhosis and hepatocellular carcinoma, the tendency in treatment of patients with chronic hepatitis C is to start it as soon as possible and thus reduce the probability of developing these advanced stages of disease which are difficult to treat. Treatment of hemophilic patients with chronic hepatitis C started in the Department of Infectious Diseases, University Hospital Brno Bohunice, in 1996. Used treatment schemes have reflected historical evolution of treatments used to treat chronic hepatitis C. Initially, alpha-interferon (IFN) was administered in monotheraphy (6 patients), later, since 1999, a combination of alpha-IFN and ribavirin was administered (13 patients), and since 2001 a combination of pegylated interferon (PEG-IFN) and ribavirin (3 patients) was administered. In all the patients the individual treatments took 12 month. Sustained negativization of HCV RNA in serum has not been achieved in any patient treated only with alpha-IFN. In patients who were administered the combination of alpha-IFN and ribavirin this effect appeared in 4 from 7 cases without history of treatment with alpha-IFN (57%), one from 2 relapses and one from 3 non-responders. The combination PEG-IFN and ribavirin was effective in the only one patient who relapsed after alpha-IFN and ribavirin and in one from the two non-responders to this combination. The tolerance and safety of treatment was good in haemophilia patients and could be fully compared to those in other patients with chronic hepatitis C.

[Initial experience with treatment of chronic hepatitis C in HIV-positive patients]. / První zkusenosti s lécbou chronické hepatitidy C u HIV-pozitivního nemocného.

A 30 years old man originating from Ukraine was infected by the human immunodeficiency virus (HIV) and virus of hepatitis C (HCV) due to injection administration of drugs of abuse in his own country before coming to Czech Republic. He was infected by genotype 3 of HCV and the infection became chronic. Under the influence of a three-combination anti-retrovirus therapy his conditions related to HIV infection became stable and it proved to be possible to apply a combined treatment by alpha-interferon and ribavirin at commonly used doses for the period of 12 months. In the course of therapy the HCV nucleic acid (HCV RNA) disappeared from serum and serum activity of alanine aminotransferase (ALT) became normal. However, two months after the therapy ended a relapse of the disease occurred--HCV RNA reappeared in serum and ALT activity increased. The therapy was well tolerated. A rapid decrease of hemoglobin level during the first four weeks of therapy was stopped by reduction of ribavirin dose.

[A case of Babesia microti imported into the Czech Republic from the USA]. / Prípad infekce Babesia microti importované do Ceské republiky z USA.

Human babesiosis is a zoonotic tick-borne protozoan infection caused by several species of the genus Babesia. It is a rare disease in Europe. Until recently, 31 cases have been described. Most of them were severe infections caused by a cattle parasite Babesia divergens in splenectomized patients. In contrast, a rodent species Babesia microti was responsible for hundreds of cases of human babesiosis in the U.S.A. In this report we describe the first case of human babesiosis in the Czech Republic. To our knowledge, it is also the first case of symptomatic B. microti infection imported to Europe from the United States.

Administration of antibiotics before admission in patients with meningococcal disease.

PURPOSE: To determine whether parenteral or oral antibiotics given before admission to a regional hospital with a special intensive care unit (ICU) reduce the case fatality rate in patients with meningococcal disease. DESIGN: Prospective analysis of 164 consecutive patients with meningococcal disease admitted to 5 regional hospitals in the Czech Republic between August 1996 and October 2001. Main outcome measure was number of deaths from meningococcal disease. Fisher's exact test was used for statistical analysis. MAIN FINDINGS: Nine out of 116 patients (8%) given antibiotics before admission died, compared with five deaths in 48 patients (10%) admitted without such a treatment (p = 0.55). None of 19 patients given oral or combined oral and parenteral pre-admission antibiotics died. CONCLUSION: Parenteral and probably also oral antibiotics given before admission to a regional hospital and an adequate treatment of shock can reduce the case fatality rate from meningococcal disease.

[The SEN virus--will there be another letter in the alphabet of viral hepatitis?] ]. / SEN virus--chystá se nové písmeno v abecede virových hepatitid?

The SEN virus (SENV) is a small nonenveloped single-stranded DNA virus which is probably a circovirus. By phylogenetic analysis it is possible to differentiate genotypes SENV A-H. The pathway of transmission of infection is not known so far but the infection by this virus is frequent in recipients of blood transfusions and liver grafts and in intravenous drug addicts. This suggests possible parenteral transmission of infection. Other routes of transmission of the infection are also possible as the virus can be detected also in a significant proportion of young subjects without the risk of parenteral infection in the case-history. Whether SENV causes hepatitis has not been proved unequivocally so far. The prevalence of this infection does not differ significantly in patients with different liver diseases, acute or chronic viral or non-viral. SENV infection very probably does not influence the course of chronic hepatitis C.