Assessment of antibodies against surface and outer membrane proteins of Anaplasma phagocytophilum in Lyme borreliosis and tick-borne encephalitis paediatric patients.

To examine evidence of positive antibodies against immunogenic proteins of Anaplasma phagocytophilum in patients with other tick-borne infections and to diagnose possible co-infections, 412 serum specimens were tested by immunoblotting using three specific Anaplasma antigens: surface proteins p44 and Asp62 and outer membrane protein A (OmpA). In total, 284 serum samples from children with Lyme borreliosis and 12 serum samples from children with tick-borne encephalitis were tested. Sera from patients with viral aseptic meningitis (n = 47) and from blood donors (n = 69) were used as controls. Among all serum specimens from patients with tick-borne infections submitted for this study, six samples (2·0%) showed positive IgM reactions and seven samples (2·4%) were IgG positive for A. phagocytophilum by immunoblot. Borderline reactivity was found in 30 samples (10·14%) for IgM and 36 samples (12·2%) for IgG. The difference between patients and blood donors was statistically significant for IgM (P = 0·006) and for IgG (P = 0·0007) antibodies. A statistically significant result was obtained for IgG (P = 0·02) but not for IgM between patients and children with aseptic meningitis. Immunoblot using three specific antigens provides novel information about the positivity of antibodies to A. phagocytophilum in children with other tick-borne infections. Taking into account clinical and laboratory findings of children despite antibody positivity, no case of human granulocytic anaplasmosis was demonstrated.

[Benign acute childhood myositis as a complication of influenza B and its differential diagnosis]. / Benigní akutní myozitidy u detí jako komplikace chripky B a jejich diferenciální diagnostika.

STUDY AIM: Analysis of the course of benign acute childhood myosistis during the influenza epidemic of 2012/2013, with a focus on the clinical specificities, laboratory findings, diagnostic and therapeutic approaches, and prognosis. METHODS: A retrospective study was conducted of 10 patients with myositis during influenza infection. The haematological and biochemistry parameters were analysed. A direct real time-PCR assay was used to detect the virus from nasopharyngeal swabs. RESULTS: Eight of 10 patients were males of an average age of 7.1 years. Muscle disorders emerged during recovery from influenza. They were characterized by a sudden onset of severe pain in the calf muscles with the consequent inability to walk in nine patients. Toe walking was reported in six children and wide-base gait in one patient. The full blood count showed leukopenia (eight cases) and thrombocytopenia (five cases). Blood biochemistry typically detected elevated muscle enzymes (creatine kinase and aspartate aminotransferase) and elevated myoglobin in all patients. Influenza B was confirmed in all study patients. They all recovered spontaneously within two to four days. CONCLUSIONS: Benign acute childhood myositis presents with the clinical picture of transient muscle disorders resulting in difficulty walking and very rarely can be complicated by rhabdomyolysis and kidney failure. It is most often associated with influenza B and affects school age children, mostly males. Good awareness of the condition facilitates the differential diagnosis and enables to rule out other more serious causes of difficulty walking. Symptomatic therapy is an adequate option and the patient recovers spontaneously within a couple of days. Early recognition of the disease avoids unnecessary diagnostic and therapeutic interventions.

[IKARUS Project--incidence of bone events in breast cancer: retrospective analysis of patients in oncological centres in the Czech Republic and Slovakia]. / Projekt IKARUS--zjistení incidence kostních príhod u karcinomu prsu: retrospektivní analýza nemocných dispenzarizovaných v onkologických centrech Ceské a Slovenské republiky.

BACKGROUND: Bone incidents today represent, in terms of frequency and the overall effect on the quality of life of patients with breast cancer, a serious health problem. In a number of clinical studies bisphosphonates have been shown to have a positive impact on reducing the risk of bone events and therefore to be effective in the prevention of bone events. The primary objective of this project was to identify the incidence of bone events in patients with metastatic breast cancer treated in the Czech and Slovak Republics. SUBJECTS: Retrospective, multi-centre, non-interventional, epidemiological and explorative studies to identify the incidence of bone events in the defined group of patients and a description of the practice of prevention and treatment of skeletal events in the years 2000-2005. Enrolled were patients with advanced metastatic breast cancer diagnosed in 2000. METHODS AND RESULTS: Analysis of overall survival and survival to disease progression, analysis of patterns of treatment of bone events and the practice of the use of bisphosphonates in the prevention of bone events in metastatic skeleton affection in the normal conditions of clinical practice, analysis of patient compliance in the treatment with bisphosphonates, analysis of the time interval between the occurrence of bone metastases and the occurrence of bone events and, last but not least, survival analysis of patients in relation to bone events. CONCLUSION: This work has shown that the practice of treatment with bisphosphonates since 2000 and assessed the survival of patients with metastatic breast cancer.