Breastfeeding During Military Service: Different Countries, Different Possibilities.

INTRODUCTION: Breastfeeding is a human biological norm that is widely acknowledged as the ideal form of nutrition for all infants. Human milk saves lives, improves long-term health for the both mother and infant, and significantly reduces health care-related costs. The American Academy of Pediatrics recommends exclusive breastfeeding for at least 6 months and thereafter to continue with breastfeeding, in addition to complimentary foods for at least 1 year or longer. The World Health Organization extends this recommendation to at least 2 years or beyond this age. MATERIALS AND METHODS: Multiple complex policies and directives would not be necessary if a federal law would entitle all new mothers to an adequate length of paid maternity leave and would protect parents during the time they personally care for their infants. Although a nationally mandated maternity leave is not available, the DoD should create a coherent global policy applicable to all active duty personnel across all branches of the U.S. Military. A global policy would govern positive change across all military branches and create consistent work conditions conducive for mothers to achieve their personal breastfeeding goals. In addition, a global policy would improve the military employees' health as well as maintain retention of military personnel. RESULTS: A comparison of the U.S. Armed Forces to the Czech Armed Forces shows that the individual breastfeeding policies and directives of the U.S. Military branches are certainly steps in the right direction to support breastfeeding military members. CONCLUSION: The well-documented evidence of long-term breastfeeding health benefits in addition to the economic benefits justifies such global military policy and would be a foundation to a national maternity leave policy, given that the USA is the only developed country without nationally mandated statutory entitlement to paid maternity leave.

The wide-spectrum antimicrobial effect of novel N-alkyl monoquaternary ammonium salts and their mixtures; the QSAR study against bacteria.

Quaternary ammonium salts (QASs) have been widely used for disinfection purposes because of their low price, high efficacy and low human toxicity for decades. However, precise mechanisms of action nor the powerful versatile agent against all antimicrobial species are known. In this study we have prepared 43 novel N-alkyl monoquaternary ammonium salts including 7 N,N-dialkyl monoquaternary ammonium salts differing bearing alkyl chain either of 12, 14 or 16 carbons. Together with 15 already published QASs we have studied the antimicrobial efficacy of all water-soluble compounds together with standard benzalkonium salts against Gram-positive (G+) and Gram-negative (G-) bacteria, anaerobic spore-forming Cl. difficile, yeasts, filamentous fungi and enveloped Varicella zoster virus (VZV). To address the mechanism of action, lipophilicity seems to be a key parameter which determines antimicrobial efficacy, however, exceptions are likely to occur and therefore QSAR analysis on the efficacy against G+ and G- bacteria was applied. We showed that antibacterial activity is higher when the molecule is larger, more lipophilic, less polar, and contains fewer oxygen atoms, fewer methyl groups bound to heteroatoms or fewer hydrogen atoms bound to polarized carbon atoms. In addition, from an application point of view, we have formulated mixtures, on the basis of obtained efficiency of individual compounds, in order to receive wide-spectrum agent. All formulated mixtures completely eradicated tested G+ and G- strains, including the multidrug-resistant P. aeruginosa as well as in case of yeasts. However, effect on A. fumigatus, Cl. difficile and VZV the exposition towards mixture resulted in significant reduction only. Finally, 3 out of 4 formulated mixtures were safer than reference commercial agent based on benzalkonium salts only in the skin irritation test using reconstructed human epidermidis.

Increasing incidence of tuberculosis diagnosed by surgery: a single centre analysis in low-incidence country.

OBJECTIVE: The aim of this study was to assess the incidence of thoracic tuberculosis (TB) in patients who underwent surgery for indeterminate lung nodules, mass and pleural effusions. METHODS: A monocentric retrospective study was carried out from 2012 to 2018 in a high-volume thoracic surgery centre. All patients with finding of thoracic TB within surgery and/or confirmed post-surgery were studied. Demography, origin, TB related symptoms, immunosuppression, type of surgery, and complication of surgery were analyzed. RESULTS: During the seven-year period TB was diagnosed in 71 cases, 58% were men. The mean age was 50 years. 21% of the cases had family history of TB or were successfully treated for TB in the past. 14% of patients had prior history of treatment for malignancy. Five patients (7%) received immunosuppressive therapy. The indication for surgery was indeterminate lung nodules and mass in 55 patients (77.5%) and indeterminate recurrent or persistent pleural effusions in 21 patients (22.5%). In five patients (7%) a lung carcinoma and a concomitant TB infection was detected. 63 of the cases (88.7%) had positive real-time PCR TBC test. Direct microscopic detection of Mycobacterium tuberculosis detected TB in five cases (7%). The microbiological diagnosis by culture was achieved in 19 patients (26.8%). Two patients (2.8%) were diagnosed with multidrug-resistant TB. Surgical procedure complications occurred in nine cases (12.7%). CONCLUSIONS: Although the overall incidence of TB in the Czech Republic is low and constantly continues to decrease, the number of TB detected by surgical procedures is increasing. Surgery still remains an important tool in diagnostics of nonobvious cases of TB, especially in patients with a potential risk of malignancy.

Inhibitory effect of hop fractions against Gram-positive multi-resistant bacteria. A pilot study.

AIM: Our research focused on the antimicrobial effects of purified hop (Humulus lupulus L.) fractions including α-bitter acids (humulones), ß-bitter acids (lupulones) and xanthohumol, and a commercial CO2 hop extract of bitter acids against reference and multi-resistant strains of Gram-positive and Gram-negative bacteria and against selected yeast strains. METHODS: In vitro testing of antimicrobial activity was performed according to standard testing protocols (EUCAST). The effects of hop extracts on bacterial/yeast strains at concentrations below MICs were also determined and the antimicrobial potential of hop extracts was compared with selected antibiotics using optical density measurement. RESULTS: The fractions were effective not only against reference strains of Gram-positive bacteria but, more importantly, against their methicillin- and vancomycin-resistant variants. No antimicrobial effect was detected against Gram-negative bacterial strains. Among the tested substances, xanthohumol was identified as the hop fraction with the most potent antimicrobial properties. It was also found that hop substances exerted their antimicrobial effects at concentrations considerably lower than the determined MICs, with the strongest effect in case of α-bitter acids in enterococci. CONCLUSION: The search for and research of new compounds with antimicrobial properties represents a possible solution to the current global problem of bacterial resistance. Our data suggest a desirable activity of hop fractions against some multi-resistant bacterial strains. Thus, hops might find use as a source of potential antimicrobial agents applicable in both human and veterinary medicine.

Strong antimicrobial activity of xanthohumol and other derivatives from hops (Humulus lupulus L.) on gut anaerobic bacteria.

Anaerobic bacteria, such as Bacteroides fragilis or Clostridium perfringens, are part of indigenous human flora. However, Clostridium difficile represents also an important causative agent of nosocomial infectious antibiotic-associated diarrhoea. Treatment of C. difficile infection is problematic, making it imperative to search for new compounds with antimicrobial properties. Hops (Humulus lupulus L.) contain substances with antibacterial properties. We tested antimicrobial activity of purified hop constituents humulone, lupulone and xanthohumol against anaerobic bacteria. The antimicrobial activity was established against B. fragilis, C. perfringens and C. difficile strains according to standard testing protocols (CLSI, EUCAST), and the minimum inhibitory concentrations (MICs) and minimum bactericidal concentrations (MBC) were calculated. All C. difficile strains were toxigenic and clinically relevant, as they were isolated from patients with diarrhoea. Strongest antimicrobial effects were observed with xanthohumol showing MIC and MBC values of 15-107 µg/mL, which are close to those of conventional antibiotics in the strains of bacteria with increased resistance. Slightly higher MIC and MBC values were obtained with lupulone followed by higher values of humulone. Our study, thus, shows a potential of purified hop compounds, especially xanthohumol, as alternatives for treatment of infections caused by select anaerobic bacteria, namely nosocomial diarrhoea caused by resistant strains.

[Biological factors influencing infectious diseases transmitted by invasive species of mosquitoes]. / Éiologické factory ovlivnující vybrané infekcní nemoci prenásené invazivními druhy komáru.

Studies focused on arbovirus diseases transmitted by invasive species of mosquitoes have become increasingly significant in recent years, due to the fact that these vectors have successfully migrated to Europe and become established in the region. Mosquitoes, represented by more than 3 200 species, occur naturally worldwide, except in Antarctica. They feed on the blood of warm-blooded animals and by this route, they are capable of transmitting dangerous diseases. Some species can travel a distance of 10 km per night and can fly continuously for up to 4 hours at a speed of 1-2 km/h. Most species are active at night, in the evening or morning. It usually takes a mosquito female about 50 seconds to penetrate the skin of mammals and the subsequent blood meal usually takes about 2.5 minutes. Mosquitoes live for several weeks or months, depending on the environmental conditions. The VectorNet project is a European network of information exchange and sharing of data relating to the geographical distribution of arthropod vectors and transmission of infectious agents between human populations and animals. It aims at the development of strategic plans and vaccination policies which are the main tasks of this time, as well as the development and application of new disinfectants to control vector populations.

[Classical and less known NK cells].

Natural killer (NK) cells represent an important component of the human body´s defense against viruses, bacteria and other intra-cellular pathogens as well as against tumor cells. NK cells are capable of very fast response without prior sensitization. They produce a wide range of cytokines and chemokines regulating both innate and acquired immune responses. Similar to excessive physical activity, stress can lead to a reduction in the numbers of NK cells, consequently increasing the susceptibility of the organism to viral, bacterial or parasitic diseases. Historically, NK cells were viewed as natural killers with relatively simply regulated functions. But new findings have shown that NK cells play roles in many processes and regulation of their functions in many infectious diseases represents a complex issue. This review presents new potential roles of NK cells in viral infections, autoimmunity and their specific functions in some organs.

In vitro antimicrobial activities of cinnamon bark oil, anethole, carvacrol, eugenol and guaiazulene against Mycoplasma hominis clinical isolates.

AIMS: The aim of this study was to evaluate the antimicrobial effects of five natural substances against 50 clinical isolates of Mycoplasma hominis. METHODS AND RESULTS: The in vitro activity of selected natural compounds, cinnamon bark oil, anethole, carvacrol, eugenol and guaiazulene, was investigated against 50 M. hominis isolates cultivated from cervical swabs by the broth dilution method. All showed valuable antimicrobial activity against the tested isolates. Oil from the bark of Cinnamomum zeylanicum (MBC90 = 500 µg/mL) however was found to be the most effective. Carvacrol (MBC90 = 600 µg/mL) and eugenol (MBC90 = 1000 µg/mL) also possessed strong antimycoplasmal activity. CONCLUSIONS: The results indicate that cinnamon bark oil, carvacrol and eugenol have strong antimycoplasmal activity and the potential for use as antimicrobial agents in the treatment of mycoplasmal infections.

[Treponema pallidum subspecies pallidum -- the causative agent of neurosyphilis]. / Treponema pallidum, subspecies pallidum - puvodce neurosyfilis.

Neurosyphilis is defined as infection of central nervous system by Treponema pallidum subspecies pallidum. Neurosyphilis can develop at any stage after initial infec-tion and is reflected in laboratory results. The pathogenesis of neurosyphilis is similar to that of classical form of syphilis. Individuals with persistent abnormalities in the cerebrospinal fluid are at risk of the development of clinical manifestations. Proper understanding of particular forms of neurosyphilis for differential diagnosis is important to determine potential risk of the development of progressive disease in neurology.

[Bacterial infection as a cause of infertility in humans]. / Bakteriální infekce jako prícina neplodnosti u lidí

Microorganisms which are present in the human urogenital tract may be involved in the development of inflammatory changes negatively affecting the genitals in both men and women. Pathological conditions due to inflammatory alterations may result in complete loss of fertility. Infections of the urogenital tract are responsible for 15% of all cases of infertility in couples. Negative impact on the human reproduction is mainly caused by direct damage to the genital tract mucosa by metabolic products of microorganisms or by induction of pro-inflammatory responses of the body. Another mechanism is indirect impact of microorganisms on the genital function. Moreover, the effect of bacteria on spermatogenesis and semen quality is important in men. Infections mainly caused by Chlamydia trachomatis or Neisseria gonorrhoeae represent the greatest risk in terms of permanent consequences for human reproduction. As for other sexually transmitted disorders, such as infections caused by Gardnerella vaginalis, urogenital mycoplasmas or ureaplasmas, the link between infection and infertility has been intensively researched.

[Molecular biological and epidemiological -characteristics of the varicella-zoster virus (VZV)]. / Molekulárnebiologické a epidemiologické charakteristiky viru planých nestovic (VZV).

The genetic diversity and epidemiology of VZV results from an interplay of the geographic area, climate conditions, and population factors. Studies of the genetic diversity of VZV can have direct implications for both the epidemiological and evolutionary analyses and identification of the genetic correlates of VZV pathogenicity or resistance to antiviral drugs.

Genotyping of varicella-zoster virus (vzv) wild-type strains isolated in the Czech Republic.

OBJECTIVES: Monitoring of the varicella-zoster virus is becoming an important tool for analysis of the circulation of individual strains of VZV which differ not only at the genomic level, but show a variability in their clinical and epidemiological characteristics. Such data are not available on a large scale from the Czech population and could help understanding the epidemiological and evolutionary characteristics of the virus, as well as its potential for reinfection and increased pathogenesis in the population groups at higher risk for complications. The main aim of this study was detection and monitoring of wild-type or vaccine VZV strain isolates in the region of Eastern Bohemia and genotypic characterization of these isolates. MATERIAL: A total of 273 clinical samples were obtained from patients exhibiting symptoms of varicella zoster virus (VZV) infection manifested as chickenpox or herpes zoster (HZ) treated in the Faculty Hospital of Charles University, Medical School in Hradec Kralove, Czech Republic. METHODS: Characterization of individual short VZV DNA sequences was performed utilizing restriction fragment length polymorphisms (RFLPs), PCR and sequencing. Single nucleotide polymorphisms (SNP) in open reading frames (ORF) 21, 22 and 50 were used to identify individual VZV strains. RESULTS: All clinical isolates (97 from varicella, 176 from herpes zoster) were VZV positive wild-type strains. Sequencing analysis showed that 89 isolates were of the European E1 genotype, 180 were of the European E2 genotype and 2 were identified as the Mosaic M1 strain. In addition, for the first time in this region two unusual genotypes were identified, both representing a combination of E1 and M2 strain specific SNPs. CONCLUSION: Our prospective VZV genotyping study which is the first to monitor the VZV epidemiological situation in the Czech Republic using such a large set of clinical specimens, has provided valuable epidemiological data and identified two unique VZV recombinants.

An unusual case of multi-recurrent herpes zoster (Hz): a case report.

AIMS: We report a case of multi-recurrent herpes zoster in a 53-year-old Caucasian woman treated repeatedly at the Faculty Hospital Hradec Kralove, Czech Republic over the years 2009 - 2011. METHODS: Specific PCR methods targeting single nucleotide polymorphisms (SNPs) in open reading frames (ORF) 38, 54 and 62 were utilized to determine vaccine or wild type varicella-zoster (VZV) strains followed by SNPs analysis using two amplicons in ORF 22 and/or ORF 21/ORF 50. Additional genotyping in ORF 1, 6, 9 and 28 was subsequently performed due to the unusual results. RESULTS: Three sets of clinical specimens from one patient (from hospital visits 2, 3 and 4) were analyzed and the presence of an unusual wild-type strain of VZV was discovered. The VZV strain isolated from the lesions bears a combination of markers characteristic both for Mosaic 2 (M2) and European 1 (E1) wild-type VZV strains. CONCLUSION: This is the first report of atypical wild-type VZV strain circulating currently in Czech Republic.