Rhodococcus jostii sp. nov., isolated from a medieval grave.
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The taxonomic position of a bacterial strain isolated from the femur of the remains of Jost Lucembursky, margrave in Moravia, Brno (Czech Republic), was investigated by phenotypic, chemotaxonomic and molecular taxonomic methods. The chemotaxonomic characteristics, including the cell-wall amino acid and sugar compositions, the quinone system and the fatty acid profile, were in good agreement with those of the genus Rhodococcus. The G+C content of the DNA was 67.4 mol%. Comparative 16S rRNA gene sequencing demonstrated that the unknown strain represents a distinct line of descent within the genus Rhodococcus. The nearest relatives of the bacterium were Rhodococcus opacus and Rhodococcus percolatus. The unknown bacterium was readily distinguished from these species by using phenotypic methods. On the basis of phylogenetic and phenotypic evidence, it is proposed that the unknown bacterium be classified as Rhodococcus jostii sp. nov. The type strain is strain IFO 16295T (= CCM 4760T). (+info)
Acute lymphoblastic leukemia incidence during socioeconomic transition: selective increase in children from 1 to 4 years.
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Pre-school acute lymphoblastic leukemia (ALL) peak is consistent in developed but not in developing countries and its magnitude apparently correlates with the socioeconomic status. A population-based study describing ALL incidence during socioeconomic transition has been lacking. Central European post-communist countries (with very low foreign migration and centralized statistics) offer reliable data for the period before and during major socioeconomic changes. Population-based data on Czech ALL patients younger than 18 years were taken from two independent Czech national registries partially overlapping in time (1980-1998, n = 1236 and 1991-1999, n = 570). During the 1980s and 1990s, ALL incidence among children 1-4 years increased 1.5 times (P = 0.01). This increase was more prominent in females than in males (slopes 0.13 and 0.09, P values 0.03 and >0.05, respectively). No significant change was observed in other age groups (0, 5-9, 10-14, 15-17 years or all others combined). We discuss possible underlying socioeconomic factors including infant care and breast-feeding, hygiene, birth order, industry and pollution. Moreover, we try to pinpoint the immunophenotypic/molecular-genetic subsets of ALL that might be socioeconomically affected. Selective increase of ALL in children 1-4 years old provides epidemiological evidence that etiology and/or trigger mechanisms are different for a considerable proportion of these children and that these mechanisms are exogenous. (+info)
Abbey ambitions to celebrate home of genetics.
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A century and a half after the ground-breaking work by Gregor Mendel in establishing the foundation of genetics, efforts are under way to develop a fitting commemoration of his work at his abbey home in Brno. Nigel Williams reports. (+info)
Direct PCR detection of Burkholderia cepacia complex and identification of its genomovars by using sputum as source of DNA.
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We developed a nested PCR assay that detects the recA gene of the Burkholderia cepacia complex in sputum. The product of the first PCR round is also used to identify the genomovar of the pathogen. The protocol achieves high sensitivity and specificity with simple interpretation of genomovar status. (+info)
Rationing of expensive medical care in a transition country--nihil novum?
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This article focuses on rationing of expensive medical care in the Czech Republic. It distinguishes between political and clinical decision levels and reviews the debate in the Western literature on explicit and implicit rules. The contemporary situation of the Czech health care system is considered from this perspective. Rationing reoccurred in the mid 90s after the shift in health care financing from fee-for-service to prospective budgets. The lack of explicit rules is obvious. Implicit forms of rationing, done by physicians at the clinical level prevail, implying uncontrolled power of the medical profession and lacking transparency for ethical considerations of equity to access. It seems to be acceptable for physicians to play the role of allocators, probably because of their experience with rationing during the socialist period. Traditional rationing stereotypes from the previous regime seem to persist despite the health care system transformation during the 90s. (+info)
First kidney transplantation from a non-heart-beating donor in the Czech Republic.
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The long-lasting decline in the number of kidney donors with brain death in recent years is the reason for a quest for new sources of kidney donors in the Czech Republic. One possible source to increase the number of donor kidneys is the program of obtaining kidneys from non-heart-beating donors (NHBDs). Based on previous experience abroad, optimum hospital conditions, and, first of all, three years of experimental work, it was possible to realise an NHBD program for the first time in the Czech Republic, in the Transplant Centre of the Plzen Hospital in early 2002. The first two kidneys were obtained from a donor with a devastating gunshot brain injury (Maastricht criteria, Class III). After machine perfusion (RM3 renal perfusion system, Waters Medical) both kidneys were transplanted into two recipients with chronic renal insufficiency (chronic glomerulonephritis, nephrosclerosis). Both kidneys resumed their function immediately. For immunosuppression, basiliximab (Simulect, Novartis), rapamycin (Rapamune, Wyeth), and methylprednisolone (Urbason solubile forte, Hoechst) were used. To improve renal function, cyclosporine A (Sandimmune Neoral, Novartis) was started later in the course, simultaneously reducing the dose of rapamycin. The postoperative course was uneventful and both patients could be discharged on the twenty-first day of hospitalisation for further care at home. (+info)
Coronary artery bypass grafting in the elderly: pros and cons after three-year follow-up.
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AIM: The elderly represent an ever-growing proportion of the candidates for coronary artery bypass grafting (CABG) surgery. We analyzed the effect of anticipated risks on the early and mid-term outcome of coronary surgery in septuagenarians compared with younger patients. METHOD: We analyzed 1,475 consecutive isolated CABG procedures performed at the Charles University Hospital during the 1995-1997 period and assessed their early and mid-term (3-year follow-up) results with respect to patient age. The patients were divided into two groups: younger (n = 1,324, age < 70 years) and older (n = 151, age > or = 70 years). We studied potential preoperative risk factors, perioperative parameters, and postoperative course. Data on functional status, incidence of major cardiac events, and patient satisfaction with the outcome of surgery 3 years after the operation were collected from the patients by a questionnaire survey. RESULTS: The elderly had lower body mass index and body surface area, more advanced stage of disease according to the New York Heart Association and Canadian Cardiovascular Society classifications, higher prevalence of diabetes, renal dysfunction, and extracardiac arteriopathy. CABG was performed in both groups, with no procedural differences. The older group had higher mortality (7.3% vs 2.3%), incidence of NearMiss+ (outcome measure index; 36.4% vs 18.4%), and post-operative morbidity (56.3% vs 34.6%). Older patients also required longer stay at the intensive care unit and longer hospitalization. Three-year follow-up revealed identical relief of symptoms and improvement of functional status in both groups, with higher mortality in the elderly (15.3% vs 4.5%). The stroke was also more frequent in the elderly (8.6% vs 3.0%), whereas the occurrence of other non-fatal cardiac events was similar in both groups. CONCLUSION: Coronary revascularization in the elderly carries higher but still acceptable risk. The elderly survivors showed similar functional improvement as the younger patients, but the actuarial survival was worse, mainly due to perpetuating cardiovascular illness. Surgical procedure should not be denied to elderly population based on age alone and each patient should be carefully evaluated. (+info)
Corrective surgery of congenital heart defects in neonates: the Prague experience.
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AIM: To assess the outcome and mortality trend in newborns undergoing corrective surgery for congenital heart defect. METHOD: We reviewed the hospital records of 1,033 neonates under 30 days of life, who had congenital heart defects operated on at the Kardiocentrum, Motol University Hospital in Prague, Czech Republic, during 1977-2001. Early and late mortality and reoperation rates were analyzed. RESULTS: A total of 1,156 operations were performed in 1,033 neonates. Obstructive lesions were surgically treated in 56%, left-to-right shunts in 21%, and complex conotruncal lesions in 23% of the cases. Total correction has been achieved in 62% of the neonates. Most operations (75%) were performed in the first two weeks of neonate s life. Early 30-day hospital mortality was 13%. Late mortality, after the discharge from the hospital, was 10%. In the last three years, the hospital mortality rate decreased to about 2%. Out of 590 reinterventions in 379 neonates, with the mortality of 6%, 229 were secondary staged corrections and 190 further palliative procedures aimed mostly toward Fontan or Rastelli type of circulation. Residual or recurrent defects were solved in 62 neonates. There were 30 valve replacements, with 18 mechanical valves and 12 pulmonary valve autotransplantations (the Ross procedure). The homograft valved conduit was used in 38 children. CONCLUSION: Most newborns with critical congenital heart defects can undergo corrective operation under acceptable risk. Due to complex improvements in perioperative, anaesthetic, surgical, and postoperative care, contemporary hospital mortality can be reduced to 1-3%. Palliative procedures still play an important role in the staged treatment of severe complex heart defects in neonates. (+info)