Molecular study of mycobacterial strains prevalent in the Czech Republic in 2014.

AIM: To identify Mycobacterium tuberculosis strains prevalent in the Czech Republic in 2014. MATERIAL AND METHODS: DNA from 269 M. tuberculosis strains obtained from patients residing in the Czech Republic in 2014. Based on a step-by-step analysis, the strains were classified into genetically related groups using the MIRU-VNTRplus website. RESULTS: Four global lineages were identified: 1 Indo-Oceanic, 2 East-Asian (13.8%), 3 Central-Asian, and 4 Euro-American (83.6%) with the following sublineages: Haarlem (44.2%), H37Rv, Cameroon, Latin American-Mediterranean (LAM), Haarlem / X, NEW-1, URAL, S, X, TUR, and UgandaI. Fully identical repetitive sequences were found in 27.1% of strains belonging to two global lineages: 2 East-Asian (2 groups) and 4 Euro-American (21 groups): sublineages Haarlem (11 groups), H37Rv (3 groups), Cameroon (2 groups), Haarlem / X (2 groups), X (1 group), LAM (1 group), and S (1 group). In the set of study strains, seven were multidrug resistant without clustering. Four MDR strains belonging to global lineage 2 East-Asian (Beijing) and three MDR strains belonging to global lineage 4 Euro-American (2 strains of sublineage Latin American-Mediterranean (LAM), and 1 strain of sublineage Haarlem). CONCLUSIONS: A one-year study aimed at the identification of mycobacterial strains prevalent all over the Czech Republic in 2014. The study is the first to present data on the geographical distribution of M. tuberculosis strains in the population.

The phenotypic spectrum of fifty Czech m.3243A>G carriers.

BACKGROUND: Mitochondrial myopathy, Encephalopathy, Lactic Acidosis and Stroke-like episodes syndrome (MELAS) is a common mitochondrial disorder with varying multisystemic clinical manifestation. We present a comprehensive clinical picture of 50 Czech m.3243A>G carriers with emphasis on the sequence of symptoms in symptomatic patients. RESULTS: Symptoms developed in 33 patients (66%) and 17 carriers remained unaffected (34%). The age of onset varied from 1month to 47years of age, with juvenile presentation occurring in 53% of patients. Myopathy was the most common presenting symptom (18%), followed by CPEO/ptosis and hearing loss, with the latter also being the most common second symptom. Stroke-like episodes (SLE) occurred in fourteen patients, although never as a first symptom, and were frequently preceded by migraines (58%). Rhabdomyolysis developed in two patients. The second symptom appeared 5.0±8.3years (range 0-28years) after the first, and the interval between the second and third symptom was 2.0±6.0years (range 0-21years). Four of our patients remained monosymptomatic up to 12years of follow-up. The sequence of symptoms according to their time of manifestation was migraines, myopathy, seizures, CPEO/ptosis, SLE, hearing loss, and diabetes mellitus. The average age at death was 32.4±17.7years (range 9-60years) in the juvenile form and 44.0±12.7years (range 35-53years) in the adult form. Some patients with SLE harboured very low heteroplasmy levels in various tissues. No threshold for any organ dysfunction could be determined based on these levels. CONCLUSIONS: Sufficient knowledge of the timeline of the natural course of MELAS syndrome may improve the prediction and management of symptoms in patients with this mitochondrial disease.

Propranolol in the treatment of infantile haemangiomas: lessons from the European Propranolol In the Treatment of Complicated Haemangiomas (PITCH) Taskforce survey.

BACKGROUND: Oral propranolol is widely prescribed as first-line treatment for infantile haemangiomas (IHs). Anecdotally, prescribing practice differs widely between centres. OBJECTIVES: The Propranolol In the Treatment of Complicated Haemangiomas (PITCH) Taskforce was founded to establish patterns of use of propranolol in IHs. METHODS: Participating centres entered data on all of their patients who had completed treatment with oral propranolol for IHs, using an online data capture tool. RESULTS: The study cohort comprised 1097 children from 39 centres in eight European countries. 76·1% were female and 92·8% had a focal IH, with the remainder showing a segmental, multifocal or indeterminate pattern. The main indications for treatment were periocular location (29·3%), risk of cosmetic disfigurement (21·1%) and ulceration and bleeding (20·6%). In total 69·2% of patients were titrated up to a maintenance regimen, which consisted of 2 mg kg(-1) per day (85·8%) in the majority of cases. 91·4% of patients had an excellent or good response to treatment. Rebound growth occurred in 14·1% upon stopping, of whom 53·9% were restarted and treatment response was recaptured in 91·6% of cases. While there was no significant difference in the treatment response, comparing a daily maintenance dose of < 2 mg kg(-1) vs. 2 mg kg(-1) vs. > 2 mg kg(-1) , the risk of adverse events was significantly higher: odds ratio (OR) 1 vs. adjusted OR 0·70, 95% confidence interval (CI) 0·33-1·50, P = 0·36 vs. OR 2·38, 95% CI 1·04-5·46, P = 0·04, Ptrend < 0·001. CONCLUSIONS: The PITCH survey summarizes the use of oral propranolol across 39 European centres, in a variety of IH phases, and could be used to inform treatment guidelines and the design of an interventional study.

Oil contrast lymphography and respiratory function.

We reviewed our experience with direct oil contrast lymphography for pulmonary complications in more than 1500 lymphangiograms done since 1969. The vast majority of patients showed little subjective or objective (chest x-ray, pulmonary function test, and gas exchange) evidence of oil embolization even in those with mild to moderate cardiopulmonary disease. In 1% there was evidence on chest x-ray 24 hours after lymphography of tiny patchy infiltrates consistent with oil emboli. Although the indications for oil contrast lymphography have been sharply restricted with availability of newer imaging methods, it is nonetheless a safe and well-tolerated procedure even in patients with mild to moderate pulmonary dysfunction.

[Use of a rapid method of cryopreservation of bovine embryos for non-surgical transfer in transplantation practice]. / Vyuzití rychlého zpusobu kryokonzervace embryí skotu pri nekravavém prenosu v transplantacní praxi.

The embryos were frozen and thawed in Cassou minipaillette by a rapid method. Embryos with cryoprotective agent (glycerol, 1.5 M) were placed directly into the freezing medium at the temperature of -6 to -7 degrees C, frozen after seedling at the temperature decrease by 0.3 to 0.5 degrees C per minute to the temperature of -32 degrees C and then transferred directly into liquid nitrogen. They were thawed in a bath warm 20 to 37 degrees C. After thawed the cryoprotective agent was evacuated in 1.1 M sucrose. The best-quality embryos were selected for freezing. Out of these 366 thawed so far, with average survival of 74.31%. The total of the 268 thawed embryos were transferred ipsilaterally, by a non-surgical method, to 190 synchronised heifers, out of which 105 (55.26%) got in calf. Rapid freezing method based on 1.5 M of glycerol and thawing at the presence of 1.1 M sucrose proved effective and suitable for practice, as not only sufficient reviviscence of embryos and their survival in womb are guaranteed, but also a substantial shortening of the freezing as well as thawing process.

[Diagnosis of vibriosis in bulls at breeding stations through lavages of the artificial vagina]. / Diagnostika vibriózy u býku na plemenárských stanicích lavázemi umelé vaginy.

The objective of the study was to test the suitability of lavages of artificial vaginas which are used for collecting ejaculate for diagnosing the Campylobacter fetus subsp. fetus germs. According to the results of the investigation this method may be considered equal to the method of lavages of the prepuce. However, it is important to point out the advantages: it eliminates the danger of an accident, it enables quality lavage in the laboratory. To caputure the Campylobacter fetus the filtration through diaphragm filters is used together with the culture medium Fluid Thioglycollate medium (Difco) with an additive of agar, 10% ram blood and antibiotics (bacitracin, novobiocin). The catch rate in the prepuce lavages is 26.9%, in lavages of the artificial vagina 26.1%. The insignificant difference between the errors of the methods, i.e. the number of negative findings by employing one method and positive results with the other method, is 24.4% in lavages of the artificial vagina and 22.0% in lavages of the prepuce.