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Biomedical subjects

J Beran

Publications and source records attributed to J Beran.

At least 37 records · Page 2Linked to original sources
PubMed2000

[Problem situations between health personnel and patients (results of an analysis of patient complaints)].

Many problem situations arising between patients and medical officers have their source in the psyche of the persons involved. The aim of this study is to analyse psychological factors which may cone in these situations, and an attempt to describe, interpret and categorize them. We took as our starting point an analysis of protests submitted by patients (or their relatives) which were discussed by the management of the Faculty Hospital in Pilsen during the period of one year. We dealt with finished cases where the issue of the protest was of a psychological nature. Problem situations often arise under the influence of the following factors: personality features, the handling of information, maladaptation to a disease or situational factors. Majority of problem situations can be understood, prevented, and--if they arise--can be effectively handled. Pre-graduation and continuous education in this areas should provide a significant aid.

Czech Republic↗
PubMed2000

Effect of host bacteria genotype on spontaneous reversions of Bacillus subtilis bacteriophage phi29 sus17 nonsense codon.

Gene 17 of Bacillus subtilis bacteriophage Phi29 is an early gene playing a role in DNA replication. Its mutant sus17(112) carries the TAA nonsense triplet at the fifth codon of the gene. We isolated and sequenced 73 spontaneous revertants producing normal-size plaques on bacteria without an informational suppressor gene. In all revertants, the TAA triplet was changed by a one-base substitution and the sequences CAA, AAA, TTA, TAC and TAT were recovered at its place. The spectrum of these mutations was markedly influenced by the genotype of the bacteria in which the revertants arose. In agreement with the results described in Escherichia coli, the ratio of transversions to transitions (CAA being the only transition acceptable) was higher in strains harboring the functional allele recA(+) than in those with recA4. Our results support the idea that also in the Gram-positive B. subtilis, the spectra of spontaneous mutations are specifically modified by an SOS function. It is assumed that the single-stranded DNA chains generated in the course of phage DNA replication might act as an inducing factor.

Bacillus Phages↗
PubMed2000

CT-guided internal fixation of a hangman's fracture.

Most hangman's fractures are treated conservatively. If surgery is indicated, an anterior approach using a C2/C3 graft and plate fusion is usually preferred. Another surgical method according to Judet is direct transpedicular osteosynthesis by the dorsal approach. This surgery is frequently rejected because of the high risk of spinal cord damage or vertebral artery tear. Direct transpedicular osteosynthesis of hangman's fracture according to Judet is a "physiological operation" that does not cause fusion and creates anatomical conditions. This procedure enables appropriate reduction, compression of fragments and immediate stabilization of the C2 segment. A new aspect of Judet's method of internal fixation of a hangman's fracture is now proposed. Computed tomographic (CT) guidance is used to ensure safe and exact introduction of two screws from the posterior approach. This method of CT-guided internal fixation of hangman's fracture allows, preoperatively, for an accurate assessment of the pattern and course of fracture line, selection of the anatomically safest screw path and determination of an appropriate screw length. The procedure also allows for accurate intraoperative control of instrument and implant placement, screw tightening, fracture reduction and anchoring of the screw tip in the contralateral cortex, using repeated CT scans. The procedure is performed in a CT unit under sterile conditions. This method was used in the treatment of eight male and two female patients aged 21-71 years. All treated patients were without neurological deficit. Follow-up ranged from 12 to 57 months (mean 33.3 months). No intraoperative or early or late postoperative complications were apparent. This new aspect of the surgical procedure ensures highly accurate screw placement and minimal risks, and fully achieves the "physiological" internal fixation.

Adult↗
PubMed2000

Reactogenicity and immunogenicity of a Lyme disease vaccine in children 2-5 years old.

Two doses of a recombinant Lyme disease vaccine (15 and 30 microg) were administered to children 2-5 years old (0-1-month schedule) and were well tolerated. Both doses were highly immunogenic with geometric mean titers 1 month after vaccination of 4366 and 9877 ELISA units (EU)/mL, respectively. Nearly all subjects had antibody levels of > or = 1400 EU/mL, suggesting protective tick titre for one tick season.

Antibodies, Bacterial↗
PubMed2000

[Epidemiologic problems in hantavirus infections].

The objective of the submitted paper was to present some information pertaining to epidemiological problems of hantavirus infection. In the Czech Republic the prevalence of these infections is not alarming but in the world cases of haemorrhagic fever with renal syndrome (HFRS) as well as hantavirus pulmonary syndrome (HPS) are reported. On the territory of the Czech Republic there are foci of hantaviruses and in conjunction with summer tourism or working activities abroad the import of this infection cannot be ruled out. With regard to the serious character of some forms of the disease it is essential to follow up this problem systematically.

Czech Republic↗
PubMed1999

Immunogenicity of a recombinant Borrelia burgdorferi outer surface protein A vaccine against Lyme disease in children.

BACKGROUND AND OBJECTIVE: A recombinant lipoprotein vaccine against Lyme disease, containing 30 microg of Borrelia burgdorferi outer surface protein A (OspA) with aluminum adjuvant, has been shown in a large US field trial of subjects >/=15 years of age to offer 76% efficacy against clinical Lyme disease after 3 injections given at 0, 1, and 12 months. Lyme disease is also an important problem in children; thus, OspA vaccine trials in children are needed. The purpose of this study was to investigate the safety and immunogenicity of 2 different doses of lipoprotein OspA with aluminum adjuvant vaccine in healthy children 5 to 15 years of age in a double-blind, randomized study. STUDY DESIGN: In a double-blind study, 250 children from the Czech Republic were randomly assigned to receive 15 microg or 30 microg of OspA vaccine at 0, 1, and 2 months. Serum samples, obtained before vaccination and 1 month after the second and third doses, were analyzed for antiOspA antibody. Solicited and unsolicited symptoms were collected from diary cards. RESULTS: Local pain at the injection site was reported by approximately 76% of the 250 children. Headaches (after 5% to 18% of the injections) and malaise (after 2% to 16% of the injections) were the most frequently reported general symptoms. Local and generalized symptoms were not different between the 15 microg and 30 microg groups, and all symptoms resolved within 4 days. Both doses were highly immunogenic, with the 30 microg dose eliciting higher antibody levels. Seroconversion occurred in 99% of the 250 children. CONCLUSIONS: The OspA vaccine against Lyme disease was well tolerated and highly immunogenic in children.

Adolescent↗
PubMed1999

Cyclical fluctuations in blood pressure, heart rate and cerebral blood volume in preterm infants.

Many recently published papers describe cyclical changes of cerebral circulatory variables, mainly in cerebral blood flow velocity (CBFV) performed with Doppler sonography. In this paper we focus on another important variable of cerebral circulation: on cerebral blood volume (CBV) measured by near infrared spectrophotometry (NIRS). In a retrospective analysis of NIRS measurements in 20 preterm infants (median 27 3/7 weeks of gestation), the dominating frequencies and prevalence of cyclical changes of CBV and its possible correlation with peripheral circulatory variables (mean arterial pressure and heart rate) was examined. In 19 out of the 20 infants cyclical changes of CBV were found within a frequency range of 2-4.7 cycles/min which is comparable to the results of the Doppler studies describing fluctuations in CBFV. A dominating frequency of heart rate (HR), was found only in 12 out of 20 infants, and it was with 2.1-3.8 cycles/min in a similar range compared to CBV. In mean arterial blood pressure (MABP), however we detected cycles with longer periods every 1-2.5 min in 14 out of 20 infants. There was a significant coherence between MABP/CBV and HR/CBV. The area under the coherence curve, however, was significantly larger between MABP and CBV as compared to HR and CBV (P = 0.0007, Wilcoxon signed-rank test).

Blood Pressure↗
PubMed1999

Seroprevalence of viral hepatitis A in the Czech Republic.

Over recent decades, the epidemiology of hepatitis A has changed in most European countries: the age of infection has been shifting towards older age groups. In view of this evolution and the central location of the Czech Republic in Europe, we wanted to assess current anti-hepatitis A seroprevalence. We determined the anti-hepatitis A seroprevalence among three different groups: military personnel between 1991-1995, prior to their deployment as UN troops, civilians participating in a national serological survey in 1996 and volunteers for vaccine clinical trials in 1996. The anti-HAV prevalence <20 years of age was about 4%; in the age cohort 40-49 it ranged between 47 and 51%. Only over the age of 60 years was the seroprevalence rate >85%. The risk of acquiring HAV is low for younger age groups. We could demonstrate some regional differences with higher rates in some age strata for the North Bohemian region and the lowest rates in East Bohemia and Prague. Compared to archived sera from a previous serological survey in 1984 we demonstrate a shift towards low endemicity. For the first time it is shown that an Eastern European country, i.e. the Czech Republic, is a country with a low endemicity for HAV. Substantial parts of the population are or will be at an increased risk of HAV infection and active immunisation against HAV should be considered.

Adolescent↗
PubMed1999

Alternative vaccination schedules (0, 1, and 6 months versus 0, 1, and 12 months) for a recombinant OspA Lyme disease vaccine.

We have compared the immunogenicity profile of a recombinant lipoprotein outer-surface protein A (OspA) Lyme disease vaccine administered on schedules of 0, 1, and 6 months (group 1) or 0, 1, and 12 months (group 2) to 800 healthy subjects, aged 15-50 years. One month after the second dosing, geometric mean titers of IgG antibodies to OspA were 1,309 ELISA units (EL.U)/mL in group 1 and 1,404 EL.U/mL in group 2. One month after the third dosing, the titers were 7,205 EL.U/mL and 10,659 EL.U/mL, respectively. Using bioequivalence methodology, we showed that the two vaccination schedules elicit an equivalent immune response 1 month after administration of dose 3: at that point, 91%-93% of all subjects had titers > or =1,400 EL.U/mL, proposed to be protective for one tick season. The vast majority of local and systemic symptoms were mild to moderate and of limited duration. The 0, 1, and 6 months vaccination schedule is a viable alternative to the 0, 1, and 12 months schedule and can provide protection against Lyme disease during one tick season.

Adolescent↗
PubMed1998

[Psychological factors and heart diseases].

We are often faced with patients with increased psychosocial stress, anxiety and depression and various cardiovascular symptoms such as hypertension, tachycardia, arrhythmia and chest pain. Psychological factors are important in particular in ischaemic heart disease and in arterial hypertension. In this respect chronic as well as acute stress plays a part. The problem of stress as a risk factor of these diseases of civilization is investigated. Some psychopathological signs may lead first to cardiological examination but their origin is within the psychic sphere of the patient. In the diagnostic sphere of some diseases which belong primarily into the cardiological or psychiatric sphere collaboration at a scientific as well as practical level is necessary.

Anxiety↗
PubMed1998

Concomitant vaccination against hepatitis A and typhoid fever.

BACKGROUND: The purpose of this study was to evaluate the reactogenicity and immunogenicity of a hepatitis A vaccine (Havrix-1440TM) when administered simultaneously with a Vi polysaccharide typhoid vaccine. METHODS: Two open, randomized studies were conducted using 2 and 4 treatment groups respectively, at the Clinique Notre-Dame de Grâce, Belgium (Study 1) and University Hospital of Hradec Kralové, Czech Republic (Study 2). SUBJECTS: Healthy adults aged 18-50 years were administered either both vaccines concomitantly in separate arms or a single injection of the two vaccines mixed extemporaneously (Study 1), or one injection of each vaccine alone, or the combined vaccine, or both vaccines concomitantly in separate arms (Study 2). The study measured solicited and unsolicited signs and symptoms until 28 days post-vaccination. Anti-hepatitis A and anti-Vi titers were determined in pre- and post-vaccination sera. RESULTS: The vast majority of local and general symptoms were mild to moderate and all resolved without sequelae. No serious adverse events were reported in either study. In study 1, geometric mean antibody titers (GMTs) were similar after extemporaneous syringe mixing of both vaccines (anti-Vi = 1159 EL.U/mL; anti-HAV = 302 EL.U/mL) and after concomitant vaccination (anti-Vi = 1331 EL.U/mL; anti-HAV = 367 EL. U/mL). In study 2, GMTs following vaccination with either vaccine alone, both vaccines administered concomitantly or as a combined vaccine (anti-Vi: 1307, 1247 and 942 EL.U/mL, respectively; anti-HAV: 462, 517 and 432 EL.U/mL, respectively) were not significantly different (p = .45 for anti-HAV, p = .18 for anti-Vi). Seroconversion rates were > 94.4% in all cases. CONCLUSIONS: The inactivated hepatitis A and Vi polysaccharide typhoid vaccines are safe and well tolerated when administered simultaneously (mixed or concomitant) and as a combined vaccine. Subjects seroconverted to both antigens to the same extent as the monovalent vaccines and there was no cross-interference in the immune profiles of the vaccines.

Adolescent↗
PubMed1998

[Soluble adhesion molecules in patients with pre-eclampsia].

Plasma concentrations of the circulating adhesion molecules ICAM-1 (CD54), VCAM-1 (CD106) were determined in 31 women with pre-eclampsia, 9 women with HELLP syndrome, and 13 women with transient pregnancy induced hypertension (PIH). Data were compared with a control group of 157 healthy pregnant women of the same gestational age. Furthermore, concentrations of circulating E-selectin (CD62E), P-selectin (CD62P), and PECAM-1 (CD31) were determined in a subpopulation of 17 women with pre-eclampsia. Plasma concentrations of circulating ICAM-1, VCAM-1, E-selectin, and PECAM-1 were significantly elevated in women with pre-eclampsia compared to healthy control pregnant women. Circulating ICAM-1 and VCAM-1 levels were also significantly elevated in the pre-eclampsia group compared to women with PIH. Concentrations of circulating P-selectin varied strongly in all experimental groups (SD > 70% of the mean), most likely reflecting various degrees of thrombocyte degranulation in the individual samples. Finally, longitudinal profiles of cICAM-1 and cVCAM-1 concentrations were determined in 123 healthy pregnant women between the 16th and the 42nd week of gestation. This analysis identified cICAM-1 and cVCAM-1 as tightly regulated plasma parameters that varied in a small concentration range. Concentrations of cICAM-1 and cVCAM-1 did not vary during pregnancy and the determined concentrations corresponded to the reported reference levels of nonpregnant individuals.

Adult↗
PubMed1998

Evaluation of reactogenicity and immunogenicity of two influenza vaccines (vaxigrip and fluarix) in the season 1996-1997.

Influenza is a very serious disease, which causes thousands of deaths all over the world every year. As there is so far no sufficiently effective causal therapy of influenza the main function of vaccination lies in prevention. Influenza is a major problem especially in collective facilities. Therefore, great emphasis is laid in the Czech Republic Army on the vaccination of military groups and on the evaluation of reactogenicity and immunogenicity of the vaccines used. The specific aim of the clinical trial was to evaluate the reactogenicity and immunogenicity of two inactivated split influenza vaccines Fluarix and Vaxigrip in healthy adult volunteers aged 18-60 years with stress on military groups. The study was designed as an open clinical trial with 2 groups each of 100 volunteers in one centre. Randomisation was not conducted so that each group received only the vaccine specified beforehand. Both the inactivated split vaccines evaluated, Vaxigrip and Fluarix are highly immunogenic both against declared and other antigenic variants of influenza. The study has demonstrated a favourable trend in the preparation of influenza vaccines towards a marked reduction of general solicited symptoms as compared with previous years. Despite minute differences in immunogenicity and reactogenicity, the vaccines are generally speaking comparable, and in healthy individuals aged 18-60 years they induce a sufficient protection against the onset and development of influenza. The results of our open clinical trial (without randomisation) have again proved that both manufacturers produce vaccines of a high European standard.

Adolescent↗
PubMed1996

Hepatitis A vaccination by Havrix in the Czech U.N. Troops according to data of seroprevalence in 1991-1995.

Viral hepatitis A is a common disease, particularly in developing countries. All staff and troops of the U.N. (United Nations) are vaccinated by the Havrix vaccine. Till 1995 we did not vaccinate Czech troops which have operated in the area of former Yugoslavia. The main goal of this study was to obtain data about the seroprevalence of hepatitis A antibody among the Czech U.N. troops before their departure to the conflict area and to optimize the vaccination approach. The serum samples were examined by the MEIA (Microparticle Enzyme Immunoassay) method in the fully automated system for immunoassays IMx in the Military Institute of Health in Ceské Budĕjovice. We used HAVAB kits of Abbott Company. 692 serum samples (military staff of the Czech U.N. troops in Yugoslavia) were examined in 1991-1995. In the laboratory 19 samples were eliminated due to small amounts (less than 50 microliters) or haemolysis. 673 (1991 - 65, 1992 - 296, 1993 - 265, 1994 - 35, 1995 - 12) were investigated. The staff was divided into four age cohorts by decades (20-29, 30-39, 40-49, 50-59); 26.0%, 47.4%, 24.9% and 1.7%, respectively. There were 253 (37.4%) positive samples and 420 (62.6%) negatives ones, ratio 1:1.7. The ratio of the positive and negative samples--immunity rate and seroprevalence--were 1:0.4 (26.2%), 1:0.6 (37.9%); 1:0.9 (46.4%) and 1:2.7 (72.7%), respectively in the age cohorts. The results show a relatively low seroprevalence of the anti-HAV antibody in all the age cohorts and necessity to vaccinate the Czech U.N. troops by the special basic schedule--Havrix 2 x 720 E.U. at the same time. This regimen will be used in the new units that will be stationed in Bosnia. So far 200 persons have been vaccinated in this way.

Adult↗
PubMed1996

The seroprevalence of the "total" anti-HAV antibody in the Czech UNPRO Forces (1991-1995).

Viral hepatitis A is a common disease particularly in developing countries. That disease is endemic and it is always associated with poor standards of sanitation. All staff and troops in the U.N. (United Nations) are vaccinated by the Havrix vaccine. Till 1995 we did not vaccinate the Czech troops which have operated in the area of the former Yugoslavia. The main goal of this study was to obtain data about the seroprevalence of hepatitis A antibody among the Czech U.N. troops before their departure to the conflict area. The serum samples were investigated by the MEIA (Microparticle Enzyme Immunoassay) method in the fully automated system for immunoassays IMx in the Military Institute of Health in Ceské Budĕjovice. We use the HAVAB investigation kits of the Abbott company. We obtained 884 serum samples (military staff of the Czech U.N. troops in Yugoslavia) in the years 1991-1995. In the laboratory we excluded 19 of the samples due to the small amount (less than 50 ul) or hemolysis. We investigated 865 of them (1991--65, 1992--296, 1993--265, 1994--35, 1995--204). The staff was divided into four age cohorts by ten years (20-29, 30-39, 40-49, 50-59), where the distribution of percentage was 32.6%, 43.6%, 22.5%, and 1.3% respectively. The positive samples were 287 (average seroprevalence was 33.2%, CI 30.1%-36.3%), the negative ones were 578 (66.8%). The seroprevalence 18.1% (CI 13.6%-22.6%), 36.1% (CI 31.3%-40.9%), 47.1% (CI 40.1%-54.1%), 72.7% (CI 46.4%-99.0%) in the age cohorts. The results show relatively low seroprevalence of the anti-HAV antibody in all the age cohorts and necessity to vaccinate the Czech UNPROFOR or IFOR units by Havrix before their departure to conflict area.

Adult↗
PubMed1995

[Tuberculin tests in school leavers in canton Berne , Neuenburg and Wallis 1992/1993].

To determine the prevalence of tuberculosis infection in Switzerland, standardized tuberculin tests using 2 units of tuberculin Berna PPD RT 23, administered by specially trained personnel, were performed on school leavers in 3 Swiss cantons in 1992/1993. Of the 7036 school leavers, averaging 15 years of age, only 294 (4.18%) were not BCG-vaccinated. Non-vaccinated persons had tuberculin test indurations > 15 mm in 2.04% (6663 BCG vaccinated persons in 1.14%). Calculations of potentially influential factors using stepwise ordinal polychotomous regression showed that tuberculin test indurations are significantly larger after BCG vaccination, as well as with increasing age at immigration from high prevalence tuberculosis countries. Indurations were smaller with increasing time passed since BCG vaccination, as well as in females. Pets at home did not significantly influence the size of tuberculin reactions. Theoretically the positive predictive value of tuberculin tests in Switzerland is small because of the low tuberculosis prevalence. From our data the maximal prevalence of infection in 15-year-olds is estimated at 0.91% (2.48% in the non-vaccinated) in Swiss and 2.54% (9.77% in the non-vaccinated) in foreign born school children. These rates, higher than extrapolated from previous studies, are comparable to data from other industrialized countries. They do not warrant a change in BCG vaccination policy in Switzerland, which since 1987 requires BCG vaccination in children immigrating from countries with high tuberculosis prevalence only.

Adolescent↗