Biomedical subjects

M Stanková

Publications and source records attributed to M Stanková.

At least 19 recordsLinked to original sources

PubMed2005

Long-term analysis of the resistance development in HIV-1 positive patients treated with protease and reverse transcriptase inhibitors: correlation of the genotype and disease progression.

In this study, 27 HIV-1-positive patients on long-term highly active antiretroviral therapy (HAART) in the Czech Republic were followed for a period of up to 7 years. Variability of the HIV-1 protease (PR) sequence common in the Czech Republic was observed. Under the pressure of inhibitors of protease (PRIs) and reverse transcriptase (RTIs) mutations in PR were detected. Development of resistance to PRIs was followed by a decrease in CD4 count and increase in viral load. The dynamics of viral load closely corresponded to the accumulation of specific primary mutations in PR and RT. Out of 27 patients 18 developed resistance to PRIs and the prolonged therapy led to the accumulation of a higher number of amino acid changes associated with the resistance and, consequently, cross-resistance to several PRIs was observed. These multi-resistant variants of HIV-1 with mutations in PR could not be inhibited sufficiently with PRIs that are currently available in clinical practice. Efficient yet temporary suppression of viral replication was achieved by a lopinavir (LPV) treatment.

Amino Acid Substitution↗

PubMed2004

Butane intoxication--three case reports.

Three cases of butane intoxication with fatal outcome are described. Butane was applied as a gaseous spray from the lighter refill can. With the exception of non-specific signs of asphyxiation such as tiny subepicardial and subpleural haemorrhages and lung oedema, haemorrhagic microruptures of the myocardial fibres were found. The authors have no plausible explanation regarding this development. Any mechanical damage of the myocardium can clearly be excluded.

Adolescent↗

PubMed2003

Seroprevalence of HHV 8 antibodies among the general population and HIV positive persons in the Czech Republic.

BACKGROUND: The seroprevalence rates of herpesvirus 8 (HHV 8) antibodies were determined for the general Czech population and HIV-positive individuals. OBJECTIVES: Six hundred and sixty six serum samples from the general Czech population and 129 serum samples from HIV-positive persons were tested for the presence of antibodies to the HHV 8 lytic and latent antigens. STUDY DESIGN: HHV 8 antibodies were detected by the indirect immunofluorescence test. RESULTS: In the general Czech population, only 2.4 and 0.3% of the serum samples tested positive for antibodies against the lytic and latent HHV 8 antigens, respectively. As many as 34.9 and 10.9% HIV positive individuals had antibodies to the HHV 8 antigens, respectively. Only three of them have developed Kaposi's sarcoma (KS) to date. At the time of KS diagnosis, the three patients had antibodies to both HHV 8 antigens. HIV-positive homo/bisexuals were at significantly higher risk of acquiring HHV 8 infection compared with HIV-positive heterosexuals. The increase in HHV 8 seroprevalence was associated with progression of the HIV infection from stage A to stage B. No correlation was found between the HHV 8 seroprevalence and CD 4+T-lymphocytes counts or the HIV viral load. CONCLUSIONS: Among the general Czech population, the HHV 8 seroprevalence is as low as in the West European countries. The mean HHV 8 seroprevalence rate in HIV-positive individuals was 34.9% and was comparable with those reported in other low seroprevalence countries.

Acquired Immunodeficiency Syndrome↗

PubMed2003

Cd38 expression on Cd8+ T cells in Human immunodeficiency virus 1-positive adults treated with HAART.

The aim of this study was to assess whether the density of CD38 antigen expression on CD8+ T cells can be used as a marker of activation of the immune system in Human immunodeficiency virus 1 (HIV-1)-positive patients treated with highly active antiretroviral therapy (HAART). T cell subsets, expression of CD38 antigen on CD8+T cells, HIV-1 viral load and stage of the disease were analyzed at baseline and after 12 months of HAART in 24 HIV-1-infected patients. Our data showed that the use of HAART is effective in reducing plasma viral load and in achieving a stable CD4+ count and percentage of CD8+/CD38+ cells. The percentages of CD8/CD38+ cells in HIV-1-infected patients at baseline and after 12 months of HAART were significantly higher than those of controls. Analysis of the density of CD38 expression revealed that it was due to CD8+/CD38+ subsets with low and medium density of antigen expression. Absolute number of CD4+ T cells correlated negatively with the percentage of CD8+/CD38+ cells at baseline of the study. Persistent up-regulation of the CD38 expression on CD8+ T cells and its correlation with the decreased CD4+ count despite the reduction of plasma viral load may reflect residual replication of HIV-1 in reservoirs. Thus, this immunological parameter can serve as a biological marker of HIV-1 infection and might have utility in clinical management of HIV-1-infected persons.

ADP-ribosyl Cyclase↗

PubMed2001

Genetic subtypes of HIV type 1 viruses circulating in the Czech Republic.

We analyzed the genetic diversity of HIV-1 strains circulating in the Czech Republic. Phylogenetic analysis of the env and gag gene sequence fragments from 39 isolates revealed that the majority of these strains (32 of 39, 82%) were of subtype B; other genetic subtypes identified were A, C, F, and recombinant circulating form CRF01_AE. The isolates that did not cluster with subtype B originated almost exclusively from a heterosexual route of transmission. The molecular epidemiological data are suggestive of multiple entry of HIV-1 infection into the Czech Republic and show that the genetic pattern of the HIV-1 strains circulating in this country corresponds to that found in other European countries.

Amino Acid Sequence↗

PubMed2001

Human immunodeficiency virus 1 strains resistant to nucleoside inhibitors of reverse transcriptase in isolates from the Czech Republic as monitored by line probe assay and nucleotide sequencing.

The genetic resistance to nucleoside inhibitors of the reverse transcriptase (RT) of human immunodeficiency virus I (HIV-1) isolates in the Czech Republic was examined by a line probe assay (LiPA) and nucleotide sequencing. The results of LiPA analysis of 294 blood specimens obtained from 156 patients revealed a high incidence of mutations in the RT gene related to resistance to various drugs (67.3%) in various combinations. Mutations in RT gene (M41L, K70R and T215Y/F) conferring the resistance to zidovudine (ZDV) were most frequent (62.6%), that (M184V) responsible for the resistance to lamivudine (3TC) was less frequent (33.7%), while those linked to the resistance to dideoxyinosine (ddl) and dideoxyinosine together with dideoxycytidine (ddl/ddC) were rather rare (6.5% and 5.1%, respectively). LiPA gave a high rate of uninterpretable results due to codon hybridization failure, especially in HIV-1 isolates of non-B subtype. Thirty-two specimens were analyzed also by direct sequencing of a part of RT gene. The results obtained by LiPA and the sequencing were highly concordant for codons successfully analyzed by both methods, but the sequencing provided information also about the codons that could not be analyzed by LiPA. A high prevalence of resistant strains in the Czech Republic and their heterogeneity justifies a regular HIV-1 resistance testing. LiPA turned out as a fast, powerful and most reliable tool for such a purpose. However, due to an increasing diversity of HIV-1 strains circulating in the Czech Republic, LiPA cannot replace the nucleotide sequence analysis.

Base Sequence↗

PubMed2000

[Case-mix classification in post-acute and long-term care. Validation of Resource Utilization Groups III (RUG-III) in the Czech Republic].

BACKGROUND: Czech facilities for non-acute, continuing care provide care for very heterogeneous group of residents with different clinical characteristics, care needs and resource use. The rate based funding of LTC doesn't reflect patient case-mix. Therefore, a case mix system RUG based on per diem resource use is being used abroad for rational and fair LTC funding. METHODS: The validity of RUG-III has been evaluated and its use for financing of LTC and geriatric care in CR examined. In a sample of 1162 residents from 18 institutions patients were assigned to one of 44 RUG-III groups regarding their clinical characteristics. Data were analyzed using analysis of variance with individual care time per patient per day as independent and RUG-III groups as dependent variables. Weighted means for each group (case-mix indexes, CMI) were calculated. RESULTS: The RUG-III system achieved 59% variance explanation of total per diem costs of nursing and therapy/rehabilitation care and meets criteria of clinical validity. The CMIs for individual groups span from 0.39 to 2.70 i.e. differences in resource use between groups were sevenfold. Resource use within groups was relatively homogeneous. CONCLUSIONS: The RUG-III represent a suitable case-mix system for nonacute institutional care in the Czech health care. Besides its use for payment incentives, RUG-III can be used in facility management, quality assurance process and for comparative analyses on national and international level.

Aged↗

PubMed1999

Encephalitozoon intestinale infection in an AIDS patient--a case report.

The first case of one of the most frequent intestinal microsporidians, Encephalitozoon intestinale, is reported from an AIDS patient in the Czech Republic. The patient experienced diarrhoea and was found to have microsporidia spores in stool. Species determination by electron microscopy confirmed the diagnosis of the microsporidian, E. intestinale. The CD4-count at the time of the diagnosis was 73 cells/mm3, IRI = 0.21. Only after symptomatic therapy and rehydration the patient stopped the complaining, and although he refused an antimicrosporidial therapy, the CD4-count one month later increased to 200 cells/mm3 and patient didn't suffered from diarrhoea. Six months after the first finding of microsporidia, the patient was admitted to the hospital care for progressive encephalopathy and developing wasting syndrome again with the intermittent diarrhoea. The patient was treated with albendazole at that time. Nevertheless, after 14 days of albendazole therapy, he still remained positive for E. intestinale spores in the stool (urine specimens remained negative for all the time). The patient died after a two-month hospitalisation and the apparent cause of death was purulent bronchopneumonia, wasting syndrome with microsporidiosis, and HIV encephalopathy. Generalised mycobacteriosis (MAC) was also found from the autopsy material.

AIDS-Related Opportunistic Infections↗

PubMed1999

[Indicators of progression of HIV infection and their application to therapy].

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.

CD4 Lymphocyte Count↗

PubMed1997

[Urinary and fecal incontinence in geriatric facilities in the Czech Republic].

BACKGROUND: Incontinence represents one of the common problems in long-term care geriatric facilities and nursing homes. However, in the Czech Republic data on prevalence, severity and incontinence-associated factors for nursing home residents are not available. The aim of the study was to report the prevalence of urinary (UI) and bowel incontinence (BI) in different geriatric facilities and to identify factors positively associated with incontinence. METHODS AND RESULTS: In a sample of 1162 residents of 18 long-term care facilities UI has been found in 684 residents (63.3%). Health and social care facilities did not differ significantly (60.7 vs 65.6%). Of the incontinent 294 residents (27.2%) suffered from permanent/daily incontinence, 390 (36.1%) from occasional transitory UI. Prevalence of BI reached 54.4%, as well as double incontinence (45.9%). Cognitive impairment, self-care ADL and/or mobility dependency and bed rest are factors significantly associated with UI (for all P < 0.001). However, age, gender and urinary tract infection did not reach the statistical significance (P = 0.280-0.069). Risk adjustment/stratification for UI revealed the prevalence of 33.0% in the low risk group. In the high risk group (high ADL dependency and severe cognitive impairment) the prevalence came up to 96.0%. CONCLUSIONS: Our study presents the first results focused on incontinence problem in long-term care geriatric institutions in the Czech Republic. High prevalence of this condition makes incontinence an important medical, nursing and economical yet neglected problem.

Aged↗

PubMed1997

Parasitic opportunistic infections in Czech HIV-infected patients--a prospective study.

To determine the frequency of opportunistic parasites, especially causative agents of microsporidiosis and cryptosporidiosis in HIV-infected patients in the Czech Republic, more than 75% of all Czech HIV-infected patients were examined during this study. Target staining techniques were used for parasitological examination of stool, sputum and urine of HIV-infected patients. In addition, their sera were examined by indirect ELISA technique with specific antigens from E. cuniculi, E. hellem and C. parvum. Specific antibodies to T. gondii were detected by CF test. In 2.1% of HIV-infected patients microsporidia E. bieneusi and E. intestinalis were found by parasitological examination, 5.3% of HIV-infected patients were seropositive to E. cuniculi and 1.3% to E. intestinalis were found by parasitological examination, 5.3% of HIV-infected patients were seropositive to E. cuniculi and 1.3% to E. hellem antigens in the high titre of 600. All blood donors (control group) were seronegative in these titres. C. parvum oocysts were found in one AIDS patient, 10.5% patients were seropositive to C. parvum in higher titres (600, 1800). Occurrence of T. gondii antibodies was not significantly greater in HIV-seropositive patients (27.5%) than in the control group (21.4%). P. carinii was detected in 13.6% of the patients. This study shows the quite low occurrence of opportunistic parasitoses among Czech HIV-infected patients. Although the high prevalence of specific antibodies against causative agents of microsporidiosis and cryptosporidiosis was recorded, the number of clinical cases was low.

AIDS-Related Opportunistic Infections↗

PubMed1996

Library generation through successive substitution of trichlorotriazine.

The decreasing reactivity of tri-, di- and monochlorotriazine was utilized for the solid-phase construction of a combinatorial library with three randomized positions, using 20 amino acids and 50 amines as building blocks. The first chlorine atom was selectively substituted by coupling a large excess of trichlorotriazine to the support-bound amino acid, thus avoiding simultaneous substitution of the second chlorine. The second and third diversity positions were selectively introduced by coupling amines at different temperatures. Mixtures of model compounds were synthesized and analyzed, showing the correct representation of all expected components. A library composed of 12,000 compounds was generated using this method.

Amino Acids↗

PubMed1996

[Sublimate intoxication].

Acute oral intoxication with inorganic mercury compounds (in particular mercury bichloride sublimate) is characterized in particular by corrosion of the mucous membranes of the digestive tract associated with necrotizing sublimate nephrosis, with microscopically selective necrosis of the proximal tubule cells. Toxicological analysis of the affected organs (stomach, oesophagus) confirms the diagnosis.

Adult↗

PubMed1995

Library of libraries: approach to synthetic combinatorial library design and screening of "pharmacophore" motifs.

Construction of synthetic combinatorial libraries is described that allows for the generation of a library of motifs rather than a library of compounds. Peptide libraries based on this strategy were synthesized and screened with model targets streptavidin and anti-beta-endorphin antibody. The screens resulted in observation of expected motifs providing evidence of the effectiveness of the suggested approach.

Amino Acid Sequence↗

PubMed1995

[Detection of HIV virus antibodies in saliva].

The authors evaluate the use of saliva as alternative biological material for detection of HIV antibodies. If collected properly and when using the appropriate ELISA methods, HIV antibodies can be assessed in saliva with considerable sensitivity and specificity. Testing in saliva eliminates many disadvantages found when assessing HIV antibodies in serum. It does not require trained staff for blood sampling, collection and processing of saliva reduces the risk of professional infection to a minimum and can be carried out also under field conditions. A great advantage is the easy and unpretentious transport of collected samples to the laboratory, even long distance transport at extreme temperatures (transport medium in the testing kit Omni-SAL ensures great stability of the sample as well as proper collection of the sample). Alternative testing in saliva is useful in particular for epidemiological surveillance and for screening of HIV antibodies in population groups with a high risk of infections such as drug users and commercial works where it is often very difficult to obtain blood samples for examination.

Enzyme-Linked Immunosorbent Assay↗

PubMed1994

Mycobacterial infections in patients with AIDS in a low HIV prevalence area.

The Czech Republic is characterized here as both a low HIV prevalence area (1.64 registered positivity per 10(5) population and 45 AIDS patients notified in the 1986-93 period) and a low tuberculosis prevalence area (mortality rate 0.8, incidence of bacillary pulmonary cases 11.3 per 10(5) population and risk of infection 0.04 in 1990). From 1986 to 1993 a total of 10 cases of mycobacterial infections complicating AIDS or ARC disease were registered in the Czech Republic in 9 male patients aged from 29 to 55, 8 homosexuals, and one woman aged 48. Classical pulmonary tuberculosis caused by M. tuberculosis was diagnosed in one male patient and was controlled by antituberculosis chemotherapy. The remaining mycobacterial infections were caused by the following opportunistic mycobacterial pathogens. (a) M. avium in five individuals, four of them died of a disseminated disease; (b) M. kansasii--in two patients, one died of a disseminated infection; (c) M. xenopi--involved in a fatal generalized CMV, and cryptococcal and mycobacterial infection; (d) M. fortuitum caused a generalized disease in a case of exhaustive multifocal encephalopathy. Authors conclude that under conditions of low prevalence of both HIV and tuberculosis infection the risk to AIDS patients of contracting classical tuberculosis is low. A relatively frequent occurrence of non-tuberculosis mycobacterial disease in AIDS patients afflicted with the impaired immunity is explained by transmission of opportunistic mycobacteria from the environment.

AIDS-Related Complex↗

PubMed1994

[Clinico-histopathologic correlations in cytomegalovirus retinitis in the acquired immunodeficiency syndrome].

The authors describe histological changes of the retina and chorioid in cytomegalovirus retinitis in a patient with manifest AIDS who died after a severe opportunic infection. Consistent with data in the literature, they describe in addition to necrotic changes also inflammatory manifestations in the retina and chorioid and the presence of intranuclear inclusions typical for CMV infection.

AIDS-Related Opportunistic Infections↗

PubMed1993

[Immunologic follow-up of HIV-positive patients. C3, C4 complement components during HIV infection].

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.

AIDS-Related Complex↗