BACKGROUND: The benefit of probiotics in newborn children in relation to allergy and general morbidity later in life appears to be controversial. Allergic diseases represent an increasingly important health problem worldwide in recent years. This is evident in all age groups. The occurrence of allergic illnesses also continues to rise exponentially, and thus the use of preventive and prognostic methods, particularly in children with an inherently higher risk of allergy, is gaining increased importance. Since the advent of probiotics the effect of probiosis on immunity through alterations of composition and function of the human gut microbiome has been increasingly studied. The exact mechanisms have not yet been clearly defined. The Academy of Sciences of the Czech Republic (The Czech Academy of Sciences has suggested that the expression of TH1 and TH2 cytokines in umbilical blood is associated with an increased risk of allergies. The counter -balance of Th1 and Th2 affect Immunoglobulin E (IgE) production and maturation of the gastrointestinal tract epithelium. CASE PRESENTATION: We examined IgE levels in 3000 samples of umbilical blood taken from children born into families with a positive history of allergy in one or both parents from 2007 to 2017. At the age of ten days, those with high IgE were given Colinfant Newborn (a lyophilized non-pathogenic strain of Escherichia.coli) for one month, three times weekly. At 15 months and three years we investigated the levels of Immunoglobulins E,A and G, and the incidence of illness and allergy. The results revealed that allergy and high umbilical IgE is strongly linked with family history (p ≤ 0.001). We also detected differences in seasonality, especially with regards to pollen allergies. Eighty percent of children treated with Colinfant Newborn had significantly reduced IgE and morbidity at 13-15 months and 3 years, and furthermore without any clinical signs of allergy. Normalization of Immunoglobulins A and G was seen in 90% of treated subjects (p ≤ 0.001). These levels significantly correlated with an almost negligible morbidity up to 4 years of life. Colinfant Newborn, a lyophilized strain of Esherichia coli (E. coli), and a normal component of intestinal flora, readily colonizes the intestinal tract. It's long term presence significantly stimulates the production of specific and non-specific intestinal antibodies. and optimalizes immune development through tolerance. In our study Colinfant Newborn reduced the incidence of infections later in life by safely and effectively normalizing immunoglobulin levels in the majority of treated patients. CONCLUSION: Our study strongly suggests as positive effect of physiological Escherichia coli on the microbiome of newborn children as evidenced by a significantly reduced incidence of allergy and morbidity when applied early in life. These benefits appear to be strongly strain specific.

• MeSH
• alergie diagnóza   farmakoterapie   MeSH
• biologická terapie metody   MeSH
• časové faktory MeSH
• centra terciární péče MeSH
• fetální krev imunologie   MeSH
• hospitalizace statistika a číselné údaje   MeSH
• imunoglobulin E krev   MeSH
• kohortové studie MeSH
• lidé MeSH
• mikrobiota MeSH
• následné studie MeSH
• novorozenec MeSH
• novorozenecký screening metody   MeSH
• retrospektivní studie MeSH
• senzitivita a specificita MeSH
• výsledek terapie MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• novorozenec MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH

• Klíčová slova
• COLIFANT NEWBORN,
• MeSH
• anamnéza MeSH
• časná přecitlivělost * farmakoterapie   krev   prevence a kontrola   MeSH
• dítě MeSH
• Escherichia coli imunologie   MeSH
• fetální krev imunologie   MeSH
• imunoglobulin A analýza   imunologie   MeSH
• imunoglobulin E analýza   MeSH
• kojenec MeSH
• lidé MeSH
• morbidita MeSH
• novorozenec MeSH
• odběr fetální krve MeSH
• střevní mikroflóra imunologie   účinky léků   MeSH
• Check Tag
• dítě MeSH
• kojenec MeSH
• lidé MeSH
• novorozenec MeSH

OBJECTIVES: Abdominal pain-related functional gastrointestinal disorders in children include functional dyspepsia, functional abdominal pain, irritable bowel syndrome, and abdominal migraine. We aimed to evaluate a possible association between functional abdominal pain disorders and Helicobacter pylori infection and faecal calprotectin level. METHODS: Prospective observational study including consecutive children with functional gastrointestinal disorders fulfilling Rome III criteria (cases) and age/sex-matched healthy controls. H pylori has been detected by biopsy-based tests and stool-antigen detection, faecal calprotectin by enzyme-linked immunosorbent assay. RESULTS: A total of 56 cases (27 with functional dyspepsia) and 56 controls were enrolled. H pylori being detected in 17 of 56 cases (30.4%) and 4 of 56 controls (7.1%, odds ratio: 5.7; 95% confidence interval [CI]: 1.8-18.2, P = 0.003). H pylori was detected significantly more frequently in cases with functional dyspepsia (14/27, 51.9% odds ratio: 14.0; 95% CI: 3.9-49.7, P = 0.00001) than in controls and not in cases with other well-recognized functional gastrointestinal complaints (3/29, 10.3%). The median faecal calprotectin level was similar in cases (7.8 μg/g, 95% CI: 7.8-8.4) including those with gastritis, and controls (9.1 μg/g, 95% CI: 7.8-11.3). Gastritis features were more frequent in H pylori-infected and noninfected cases with functional dyspepsia (27/27, 100%) than in cases with other abdominal functional complaints (15/29, 51.7%, P = 0.007). CONCLUSIONS: H pylori gastritis and noninfectious gastritis were associated with functional dyspepsia in children referred for abdominal pain-related functional gastrointestinal disorders while faecal calprotectin is not a predictor of gastritis and is similar in children with functional abdominal pain symptoms and in controls.

• MeSH
• biologické markery metabolismus   MeSH
• bolesti břicha etiologie   MeSH
• dítě MeSH
• feces chemie   MeSH
• gastritida komplikace   diagnóza   metabolismus   mikrobiologie   MeSH
• gastrointestinální nemoci komplikace   diagnóza   metabolismus   mikrobiologie   MeSH
• Helicobacter pylori izolace a purifikace   MeSH
• infekce vyvolané Helicobacter pylori komplikace   diagnóza   epidemiologie   metabolismus   MeSH
• leukocytární L1-antigenní komplex metabolismus   MeSH
• lidé MeSH
• logistické modely MeSH
• mladiství MeSH
• prevalence MeSH
• prospektivní studie MeSH
• studie případů a kontrol MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• pozorovací studie MeSH
• práce podpořená grantem MeSH

Akutní pyelonefritida patří mezi infekce horního uropoetického traktu. Infekce močových cest (IMC) řadíme mezi nejčastější onemocnění v dětském věku. Akutní pyelonefritida je definována jako bakteriální intersticiální zánět parenchymu ledvin, který představuje vysoké riziko trvalého renálního poškození s možným rozvojem komplikací. Je často obtížné odlišit na základě klinické symptomatologie cystitidu od pyelonefritidy, zvláště u dětí mladších dvou let, proto je třeba u každého febrilního dítěte zvážit přítomnost infekce močového traktu. Při suspektní akutní pyelonefritidě je nezbytná hospitalizace se současným zahájením adekvátní léčby. Neexistují celosvětově uznávaná jednotná guidelines pro strategii přístupu k infekcím močového traktu. V rámci jednotlivých zemí se liší názory na diagnostiku i léčbu.

Acute pyelonephritis is an infection of the upper urinary tract. Urinary tract infections (UTI) are some of the most frequent diseases of childhood. Acute pyelonephritis is defined as a bacterial interstitial inflammation of the renal parenchyma, and represents a high risk of permanent renal damage with a potential for developing further complications. It is often difficult to distinguish cystitis from pyelonephritis on the grounds of clinical symptoms especially in children up to two years of age. Thus it is important to consider carefully every febrile child for the presence of UTI. Should acute pyelonephritis be suspected, the patient is to be hospitalized and appropriate therapy commenced. There are no known uniform guidelines for a definitive approach to UTI. Criteria for diagnosis and treatment differ among countries.

• Klíčová slova
• infekce močového traktu, renální jizvení, mikční cystouretrografie,
• MeSH
• akutní nemoc MeSH
• antibakteriální látky terapeutické užití   MeSH
• infekce močového ústrojí diagnóza   etiologie   MeSH
• kojenec MeSH
• ledviny patologie   MeSH
• lidé MeSH
• moč mikrobiologie   MeSH
• novorozenec MeSH
• pyelonefritida diagnóza   etiologie   farmakoterapie   MeSH
• ultrasonografie MeSH
• urografie metody   MeSH
• vezikoureterální reflux komplikace   MeSH
• Check Tag
• kojenec MeSH
• lidé MeSH
• novorozenec MeSH
• Publikační typ
• přehledy MeSH

The aims of our study were to evaluate plasma levels of gut hormones in children with Type 1 diabetes mellitus (T1DM) in comparison with healthy controls and to correlate plasma concentrations of gut hormones with blood biochemistry, markers of metabolic control and with anthropometric parameters. We measured postprandial levels of specific gut peptide hormones in T1DM children. Amylin, glucose-dependent insulinotropic polypeptide (GIP), glucagon-like peptide 1 (GLP-1), ghrelin, leptin, pancreatic polypeptide (PP), and polypeptide YY (PYY) were assessed in 19 T1DM children and 21 healthy reference controls. Multiplex assay kit (LINCOplex(®)) was used for determination of the defined plasma hormone levels. T1DM subjects had significantly reduced amylin (p<0.001) and ghrelin (p<0.05) levels, whereas GIP (p<0.05) was elevated when compared with healthy controls. Plasma levels of other measured hormones did not differ statistically between the studied groups. Further analysis of T1DM patients demonstrated an association between body mass index and GLP-1 (r=0.4642; p<0.05), leptin (r=0.5151; p<0.05), and amylin (r=0.5193; p<0.05). Ghrelin levels positively correlated with serum HDL cholesterol (r=0.4760; p<0.05). An inverse correlation was demonstrated with triglycerides (TG) (r= -0.5674; p<0.01), insulin dosage (r= -0.5366; p<0.05), and HbA1c% (r= -0.6864; p<0.01). Leptin was inversely correlated with TG (r= -0.6351; p<0.01). Stepwise regression analysis was performed to enlighten the predictive variables. Our study demonstrated an altered secretion pattern of gut peptide hormones in T1DM children. A close correlation was revealed between these peptides as well as with blood biochemistry, markers of metabolic control and with anthropometric parameters. Further studies are essential to explore this issue in T1DM children.

• MeSH
• biologické markery krev   MeSH
• diabetes mellitus 1. typu diagnóza   krev   MeSH
• dítě MeSH
• gastrointestinální hormony krev   MeSH
• lidé MeSH
• mladiství MeSH
• peptidové hormony krev   MeSH
• prediktivní hodnota testů MeSH
• věkové faktory MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• srovnávací studie MeSH

BACKGROUND: The aim of this study was to improve the efficacy of treatment of complicated pleural effusions. METHODS: In this prospective study, 76 consecutive children (average age 5.0 +/- 4.14 years) fulfilling the required classification criteria were duly treated with chest tube placement and divided into two groups depending on the presence of encapsulated or non-encapsulated effusions. Treatment of the former group was supplemented by intrapleural fibrinolysis. The effectiveness of treatment was assessed in terms of chest tube dwell-time and total length of hospitalization. Regression analysis was performed using independent factors that were associated with these dependent factors. Value differences for P < 0.05 were considered significant. RESULTS: The ultrasound pleural distance and lactic-dehydrogenase content in the pleural fluid was significantly associated with the length of treatment (P < 0.01). Improved response to treatment, reduced duration of hospitalization (9.2 +/- 1.9 vs 11.5 +/- 0.9; P < 0.01) and tube dwell-time (7.6 +/- 1.3 vs 9.5 +/- 0.9; P < 0.01) was achieved in the intrapleural-fibrinolysis-treated group (n= 38) compared with controls (n= 38), with virtually the same total tube output (606.1 +/- 257.5 vs 673.1 +/- 347.4; P= 0.175). All patients were completely cured. Following 104 applications of the fibrinolytic agent there was one change in coagulation parameters: hypofibrinogenemia (in 1%). CONCLUSIONS: The authors recommend intrapleural fibrinolysis as an effective and safe alternative treatment strategy in treating encapsulated pleural effusions in children.

• MeSH
• antibakteriální látky terapeutické užití   MeSH
• bakteriální pneumonie mikrobiologie   terapie   ultrasonografie   MeSH
• délka pobytu MeSH
• dítě MeSH
• drenáž metody   MeSH
• empyém pleurální mikrobiologie   terapie   ultrasonografie   MeSH
• fibrinolytika aplikace a dávkování   MeSH
• hodnocení rizik MeSH
• hospitalizace MeSH
• hrudní trubice MeSH
• injekce do léze MeSH
• kojenec MeSH
• kombinovaná terapie MeSH
• lidé MeSH
• logistické modely MeSH
• mladiství MeSH
• multivariační analýza MeSH
• následné studie MeSH
• pleurální výpotek mikrobiologie   terapie   ultrasonografie   MeSH
• předškolní dítě MeSH
• prospektivní studie MeSH
• streptokinasa aplikace a dávkování   MeSH
• stupeň závažnosti nemoci MeSH
• výsledek terapie MeSH
• Check Tag
• dítě MeSH
• kojenec MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• předškolní dítě MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• srovnávací studie MeSH

AIM: The aim of the study is to evaluate faecal calprotectin (f-CP) in children ≤3 years of age with acute gastroenteritis (AG) as an early predictor of bacterial inflammation. METHODS: We prospectively analysed f-CP levels and diagnostic workup in 107 consecutive children (66 AG, 41 controls). RESULTS: Children with bacterial AG (BAG) was found to have higher diarrheal frequency (p < 0.01), fever (p < 0.01), erythrocyte sedimentation rate (p < 0.001), white blood count (p < 0.01) and C-reactive protein (CRP) (p < 0.001) compared with viral AG (VAG). Vomiting was frequent in VAG (p < 0.001). f-CP negatively correlated with age in controls (r = -0.5998). BAG demonstrated significantly higher f-CP levels [median, 219 μg/g, interquartile range (IQR): 119-350.2] compared with VAG (49.3 μg/g, IQR: 8.8-131.1) as well as controls (26.5 μg/g, IQR: 14.9-55.1) (p < 0.001). VAG and control f-CP levels were similar. f-CP was the best-rated marker of BAG with a diagnostic accuracy of 92%. Receiver-operator characteristic analysis revealed an area under curve of 0.95 for identifying BAG; sensitivity and specificity of f-CP were 93% and 88%, respectively, at an adjusted cut-off point of 103.9 μg/g faeces. Combined f-CP and CRP yield improved diagnostic accuracy of 94% for BAG. CONCLUSION: f-CP facilitates early discrimination between bacterial and viral causes of AG in young children. Combining f-CP with CRP increases the diagnostic power of diagnosing BAG.

• MeSH
• akutní nemoc MeSH
• bakteriální infekce diagnóza   MeSH
• biologické markery metabolismus   MeSH
• diferenciální diagnóza MeSH
• feces chemie   MeSH
• gastroenteritida diagnóza   mikrobiologie   virologie   MeSH
• kojenec MeSH
• leukocytární L1-antigenní komplex metabolismus   MeSH
• lidé MeSH
• předškolní dítě MeSH
• prospektivní studie MeSH
• průjem etiologie   MeSH
• ROC křivka MeSH
• senzitivita a specificita MeSH
• studie případů a kontrol MeSH
• virové nemoci diagnóza   MeSH
• Check Tag
• kojenec MeSH
• lidé MeSH
• mužské pohlaví MeSH
• předškolní dítě MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

• Publikační typ
• abstrakty MeSH

A recently discussed cardiovascular risk factor, asymmetric dimethylarginine (ADMA), is known to act as an endogenous inhibitor of endothelial nitric oxide synthase. The aim of this study was to establish 1) the relationship between ADMA and ultrasonographically or biochemically determined endothelial dysfunction in children, and 2) the effect of folate supplementation on these parameters. The study cohort included 32 children with familial hypercholesterolemia (FH), 30 with diabetes mellitus type 1 (DM1) and 30 age-matched healthy children as the control group. Furthermore, twenty-eight randomly selected FH and DM1 children were re-examined after 3-months supplementation with folic acid. Baseline levels of ADMA and oxidized low density lipoproteins (oxLDL) were significantly higher in FH group than in DM1 and healthy children. Children in DM1 group had significantly lower concentration of homocysteine, but ADMA levels were normal. Folic acid supplementation significantly lowered homocysteine and hsCRP levels in both FH and DM1 group; however, ADMA and oxLDL concentrations remained unaltered. In conclusion, ADMA and oxLDL appear to be associated with endothelial dysfunction in children with FH. Administration of folic acid did not influence these markers in both FH and DM1 children.

• MeSH
• anticholesteremika aplikace a dávkování   MeSH
• arginin analogy a deriváty   krev   MeSH
• azetidiny aplikace a dávkování   MeSH
• biologické markery krev   MeSH
• cévní endotel metabolismus   účinky léků   ultrasonografie   MeSH
• diabetes mellitus 1. typu metabolismus   MeSH
• dítě MeSH
• financování organizované MeSH
• hyperlipoproteinemie typ II epidemiologie   farmakoterapie   metabolismus   MeSH
• kombinovaná farmakoterapie MeSH
• kyselina listová aplikace a dávkování   MeSH
• lidé MeSH
• lipoproteiny LDL krev   MeSH
• mladiství MeSH
• rizikové faktory MeSH
• statiny aplikace a dávkování   MeSH
• vitamin B komplex aplikace a dávkování   MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH

BACKGROUND: Acquisition of Helicobacter pylori occurs mainly in childhood and is significantly influenced by geographical variations. The aim of this study is to evaluate the prevalence of H. pylori infection in a population-based sample of asymptomatic children in the Czech Republic. Furthermore, this study aims to identify potential risk factors associated with this infection. MATERIALS AND METHODS: A prospective, cross-sectional, population-based study was undertaken in 1545 asymptomatic Czech children (aged 0-15 years; male 49.3%). Active H. pylori infection was diagnosed by monoclonal antibody-based antigen-in-stool enzyme immunoassay. Socio-demographic details of each subject were analyzed using a self-administered standardized questionnaire. Multiple regression analysis was performed. RESULTS: Overall, 7.1% of asymptomatic children were diagnosed with H. pylori infection. Of the infected children, 5.8% lived in the general population. A positive association was found with increasing age, although not with gender. Independent risk factors associated with H. pylori infection in our pediatric population were: the number of children in a household (odds ratio [OR] 4.26; confidence interval [CI] 1.91-9.80); lack of formal education of fathers (OR 0.23; CI 0.18-0.64) and institutionalized children (OR 6.33; CI 2.25-26.50). CONCLUSIONS: This study of a large cohort of children demonstrated that, independent of gender, H. pylori infection in the Czech Republic is among the lowest reported in Europe. Socioeconomically disadvantaged children, unfortunately, are still at risk of harboring this potentially preventable infection in this low-prevalence region.

• MeSH
• dítě MeSH
• ELISA MeSH
• feces mikrobiologie   MeSH
• Helicobacter pylori izolace a purifikace   MeSH
• infekce vyvolané Helicobacter pylori diagnóza   epidemiologie   MeSH
• kojenec MeSH
• lidé MeSH
• mladiství MeSH
• předškolní dítě MeSH
• prospektivní studie MeSH
• průřezové studie MeSH
• Check Tag
• dítě MeSH
• kojenec MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• předškolní dítě MeSH
• ženské pohlaví MeSH
• Publikační typ
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika MeSH