UNLABELLED: The aim of the study was to identify the most important systemic and local risk factors for the development of infectious complications in patients with toxic epidermal necrolysis (TEN). MATERIAL AND METHODOLOGY: This is a multicentric study that included all patients with TEN who were hospitalized between 2000-2015 in specialized centres in the Czech Republic and Slovakia. The total catchment area included a population of over 12.5 million inhabitants. The actual implementation of the project was carried out using data obtained from the CELESTE (Central European LyEll Syndrome: Therapeutic Evaluation) registry, wherein specific parameters related to epidemiological indicators and infectious complications in patients with TEN were evaluated as a retrospective analysis. RESULTS: A total of 38 patients (97%) of the group were treated with corticosteroids. The comparison of patients with different doses of corticosteroids did not exhibit a statistically significant effect of corticosteroid administration on the development of infectious complications (p=0.421). There was no effect of the extent of the exfoliated area on the development of infectious complications in this area. The average extent of the exfoliated area was 66% TBSA (total body surface area) in patients with reported infectious complications and 71% TBSA (p=0.675) in patients without infectious complications. In the case of the development of an infectious complication in the bloodstream (BSI), the increasing effect of the SCORTEN (SCORe of Toxic Epidermal Necrosis) value was monitored during hospitalization. Within 5days from the beginning of the hospitalization, the average SCORTEN value was 2.7 in 6 patients with BSI and 3.0 in 32 patients without BSI (p=0.588). In the period after the 15th day of hospitalization, 7 patients with BSI had an average SCORTEN value of 3.4, and 16 patients without BSI had an average SCORTEN value of 2.5 (p=0.079). In the case of low respiratory tract infection (LRTI), the effects of the necessity for artificial pulmonary ventilation and the presence of tracheostomy were monitored. The statistically significant effect of mechanical ventilation on the development of LRTI occurred only during the period of 11-15days from the beginning of the hospitalization (p=0.016). The effect of the tracheostomy on the development of LRTI was proven to be more significant. CONCLUSION: We did not find any statistically significant correlation between the nature of immunosuppressive therapy and the risk of developing infectious complications. We failed to identify statistically significant risk factors for the development of BSI. Mechanical ventilation and tracheostomy increase the likelihood of developing LRTIs in patients with TEN.
- Klíčová slova
- CELESTE registry, infectious complications, risk factors, toxic epidermal necrolysis,
- MeSH
- bakteriální infekce epidemiologie MeSH
- bakteriemie epidemiologie MeSH
- cyklosporin terapeutické užití MeSH
- dospělí MeSH
- fungemie epidemiologie MeSH
- hormony kůry nadledvin terapeutické užití MeSH
- imunologické faktory terapeutické užití MeSH
- imunosupresiva terapeutické užití MeSH
- infekce močového ústrojí epidemiologie MeSH
- intravenózní imunoglobuliny terapeutické užití MeSH
- lidé středního věku MeSH
- lidé MeSH
- mykózy epidemiologie MeSH
- pneumonie epidemiologie terapie MeSH
- registrace * MeSH
- retrospektivní studie MeSH
- rizikové faktory MeSH
- senioři MeSH
- Stevensův-Johnsonův syndrom epidemiologie terapie MeSH
- stupeň závažnosti nemoci MeSH
- tracheostomie MeSH
- umělé dýchání MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika epidemiologie MeSH
- Slovenská republika epidemiologie MeSH
- Názvy látek
- cyklosporin MeSH
- hormony kůry nadledvin MeSH
- imunologické faktory MeSH
- imunosupresiva MeSH
- intravenózní imunoglobuliny MeSH
INTRODUCTION: Toxic epidermal necrolysis (TEN) is a rare, life-threatening autoimmune disease predominantly manifested in the skin and mucous membranes. Today, infectious complications have the dominant share in mortality of TEN patients. Due to the nature of the therapy and administration of immunosuppressive medications, a wide range of potentially pathogenic microorganisms, which cause infectious complications in different compartments in these patients, is not surprising. MATERIAL AND METHODOLOGY: This is a multicentric study, which included all patients with TEN hospitalized between 2000-2015 in specialized centres in the Czech Republic and Slovakia. The total catchment area was over 12.5 million inhabitants. The actual implementation of the project was carried out using data obtained from the registry CELESTE (Central European LyEll Syndrome: Therapeutic Evaluation), when specific parameters relating to epidemiological indicators and infectious complications in patients with TEN were evaluated in the form of a retrospective analysis. RESULTS: In total, 39 patients with TEN were included in the study (12 patients died, mortality was 31%), who were hospitalized in the monitored period. The median age of patients in the group was 63 years (the range was 4-83 years, the mean was 51 years), the median of the exfoliated area was 70% TBSA (total body surface area) (range 30-100%, mean 67%). SCORTEN was calculated for 38 patients on the day of admission. Its median in all patients was 3 (range 1-6; mean 3). Any kind of infectious complication in the study group was recorded in 33 patients in total (85%). In total, 30 patients (77%) were infected with gram-positive cocci, 27 patients (69%) with gram-negative rods, and yeast cells or fibrous sponge were cultivated in 12 patients (31%). A total of 32 patients (82%) were found to have infectious complications in the exfoliated area, 15 patients (39%) had lower respiratory tract infections, 18 patients (46%) urinary tract infections and 15 patients (39%) an infection in the bloodstream. The most common potentially pathogenic microorganism isolated in our study group was coagulase neg. Staphylococcus, which caused infectious complications in 24 patients. Enterococcus faecalis/faecium (19 patients), Pseudomonas aeruginosa (17 patients), Staphylococcus aureus (11 patients) and Escherichia coli (11 patients) were other most frequently isolated micro-organisms. CONCLUSION: The published data were obtained from the unique registry of TEN patients in Central Europe. In the first part, we have succeeded in defining the basic epidemiological indicators in the group of patients anonymously included in this registry. The study clearly confirms that infectious complications currently play an essential role in TEN patients, often limiting the chances of survival. The study also shows a high prevalence of these complications in the period after 15days from the start of hospitalization, when most patients already have completely regenerated skin cover.
- Klíčová slova
- CELESTE registry, Infectious complications, Toxic epidermal necrolysis,
- MeSH
- aspergilóza epidemiologie mortalita MeSH
- bakteriální infekce epidemiologie mikrobiologie mortalita MeSH
- bakteriemie epidemiologie mikrobiologie mortalita MeSH
- dítě MeSH
- dospělí MeSH
- Enterococcus faecalis MeSH
- Enterococcus faecium MeSH
- infekce močového ústrojí epidemiologie mikrobiologie mortalita MeSH
- infekce vyvolané Escherichia coli epidemiologie mortalita MeSH
- kandidóza epidemiologie mortalita MeSH
- katétrové infekce epidemiologie mikrobiologie mortalita MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mykózy epidemiologie mikrobiologie mortalita MeSH
- pneumonie epidemiologie mikrobiologie mortalita MeSH
- povrch těla MeSH
- předškolní dítě MeSH
- prevalence MeSH
- proporcionální rizikové modely MeSH
- pseudomonádové infekce epidemiologie mikrobiologie mortalita MeSH
- Pseudomonas aeruginosa MeSH
- registrace * MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- stafylokokové infekce epidemiologie mikrobiologie mortalita MeSH
- Staphylococcus aureus MeSH
- Stevensův-Johnsonův syndrom epidemiologie mikrobiologie mortalita MeSH
- Check Tag
- dítě MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- předškolní dítě MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika epidemiologie MeSH
- Slovenská republika epidemiologie MeSH
BACKGROUND: There were totally 2320 patients during the period 2004-2013 hospitalised in our workplace with thermal injury, 87 of which were electric burns (3.75%). RESULTS: The majority of electric burns occurred to men 67 cases (76.74%), then to children - 18 cases (20.94%) and the rest to women - 2 cases (2.32%). The mechanism of injury to the group of men was direct contact with the source of current (54.5%), electric arc injury (37.9%), ignition of clothes and subsequently flame (6.1%), and lightning injury (1.5%). The cause of injury to the group of children was contact injury (83.4%), electric arc injury (16.6%); no ignition or lightning injury occurred. The cause of injury in the group of women (2 cases) was contact injury for both; no arc, ignition or lighting injury occurred. The average extent of burn wounds was 11.7% in the group of men, 5.83% in the group of children and 2% in the group of women. Surgical treatment (necrectomy, skin grafting, flap, and amputation) was necessary in 41 cases in the group of men, in 15 cases in the group of children and in 2 cases in the group of women. DISCUSSION AND CONCLUSION: Electric injury is a common problem in modern world. Some authors reported a 16.9% contribution of electric injuries of all hospitalised burn patients. There were 3.75% electric injury cases of all hospitalised burn patients in our department in the last nine years. The occurrence varies from year to year.
- MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- popálení elektrickým proudem epidemiologie etiologie chirurgie MeSH
- předškolní dítě MeSH
- rozložení podle pohlaví MeSH
- věkové rozložení MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- předškolní dítě MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Slovenská republika epidemiologie MeSH
One hundred and four rabbits, five weeks old at the beginning of the experiment, were divided into four groups according to a feed additive treatment. Rabbits of the 1st, 2nd, 3rd and 4th group were fed a basal granulated feed (control), basal feed supplemented with CuSO4.5H2O at 50 mg Cu.kg-1, basal feed supplemented with 150 mg Cu.kg-1, and the latter feed supplemented with 100 mg.kg-1 vitamin E, respectively. The duration of the experiment was 42 days. Addition of Cu at 150 mg.kg-1 increased weight gain non-significantly by 9.1%. This effect was the most pronounced in the first two weeks of fattening. The lowest mortality was observed in rabbits fed the highest amount of additives (7.7% vs. 19.2% in the control). Rabbits were slaughtered at the age of 11 weeks. Neither treatment influenced proportions of saturated, monounsaturated and polyunsaturated fatty acids in lipids extracted from the loin and hindleg muscles. In rabbits fed the highest amount of copper and vitamin E, the cholesterol concentration was significantly decreased by 13.6% and 17.9% in the loin and hindleg meat, respectively. Effects of Cu added at 50 mg.kg-1 were marginal. Copper had no effect on the oxidative stability of meat, measured as thiobarbituric acid-reactive substances in meat stored at 4 degrees C for 0, 3 and 8 days. Vitamin E added in excess of nutritional requirement improved the oxidative stability of meat. In copper-fed rabbits, Cu accumulated in the liver, but not in muscles. Feeding of the basal feed for 7 days to rabbits previously fed copper sulphate decreased the hepatic Cu concentration by 14.0 to 24.4%.
- MeSH
- antioxidancia aplikace a dávkování analýza MeSH
- cholesterol analýza metabolismus MeSH
- hmotnostní přírůstek účinky léků MeSH
- játra chemie MeSH
- kosterní svaly chemie MeSH
- králíci růst a vývoj metabolismus MeSH
- látky reagující s kyselinou thiobarbiturovou analýza MeSH
- maso analýza normy MeSH
- mastné kyseliny krev MeSH
- měď aplikace a dávkování analýza MeSH
- oxidace-redukce MeSH
- potravní doplňky MeSH
- vitamin E aplikace a dávkování analýza MeSH
- zvířata MeSH
- Check Tag
- králíci růst a vývoj metabolismus MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Názvy látek
- antioxidancia MeSH
- cholesterol MeSH
- látky reagující s kyselinou thiobarbiturovou MeSH
- mastné kyseliny MeSH
- měď MeSH
- vitamin E MeSH
Fermentation pattern and yields of microbial protein were investigated in cultures of the rabbit caecal contents supplied with glucose, xylose, starch, pectin and xylan. Rabbits at the age of 4 weeks (before weaning) and 3 months were slaughtered, their caecal contents added at 1.1% to growth media and incubated anaerobically at 39 degrees C for 18 h. Caecal microorganisms of 4-week-old rabbits produced no methane and caproate, less butyrate, but more propionate than microorganisms of 3-month-old rabbits. In both groups of rabbits, fermentation of xylose produced significantly more propionate and less butyrate than fermentation of glucose. More propionate and less acetate was formed from starch than from pectin. In caecal cultures from 4-week-old rabbits with pectin, the molar percentages of acetate was significantly higher and percentages of other short-chain fatty acids (SCFA) lower than in cultures with starch or xylan. In cultures from 3-month-old rabbits, fermentation of pectin and xylan produced similar SCFA profiles, different from SCFA molar composition in cultures with starch. Average production of microbial protein was 129 mg per 1 g of carbohydrate digested (range 110 to 141 mg/g). Protein yields were the same on glucose and xylose, but nonsignificantly higher on starch than on pectin and xylan. It can be concluded that the characteristics of substrate affected fermentation pattern in mixed cultures of rabbit caecal microorganisms. Substrate effects on protein yields were not statistically significant, due to high variation.
- MeSH
- anaerobní bakterie metabolismus MeSH
- cékum metabolismus mikrobiologie MeSH
- fermentace MeSH
- králíci MeSH
- metabolismus sacharidů * MeSH
- proteiny metabolismus MeSH
- sacharidy aplikace a dávkování MeSH
- substrátová specifita MeSH
- techniky in vitro MeSH
- věkové faktory MeSH
- zvířata MeSH
- Check Tag
- králíci MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Názvy látek
- proteiny MeSH
- sacharidy MeSH
Monensin from three different manufacturing companies (Eli Lilly Co., Indianapolis, USA; Pharmachim, Bulgaria; Spofa Prague, Czech Republic) were added to pure cultures of rumen strain Enterococcus faecium CCM 4231 at final concentrations 25 micrograms per ml and 50 microgram per ml. Enterococci represent a strong bacterial group colonizing the rumen regarding to lactic acid production. Ent. faecium CCM 4231 is own, lactic acid-producing isolate from the rumen content of calf with a broad antimicrobial activity (bacteriocin production). This strain was obtained in the microbial preparation Inhicol to protect enteritis in young ruminants, especially. The growth of CCm 4231 strain was inhibited at both concentrations (25 microgram/ml; 50 micrograms/ml) using all three monensins in comparison with controls (Figs. 1 and 2). The beginning of the growth inhibition was detected within 2 hours after ionophore addition. Monensin made in Bulgaria was the most effective of all when the three monensins were compared. No significant differences are found in the effect of monensins made in different production companies. Our results extend the knowledge about inhibition effect of monensin on Gram-positive bacteria, enterococci including. Moreover, the quality of monensins made by different companies is attested synchronous. In general, regarding the practical point of view, it is also contribution for the selection and application of the most suitable additives.
- MeSH
- antibakteriální látky farmakologie MeSH
- bachor mikrobiologie MeSH
- Enterococcus faecium účinky léků růst a vývoj MeSH
- ionofory farmakologie MeSH
- monensin farmakologie MeSH
- zvířata MeSH
- Check Tag
- zvířata MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- Názvy látek
- antibakteriální látky MeSH
- ionofory MeSH
- monensin MeSH
The growth of Enterococcus faecium strains CCM 4231 and EF 26, and Staphylococcus gallinarum SG 31 was inhibited by salinomycin and lasalocid at concentrations of 25 and 50 mg/L. Staphylococcus gallinarum was more sensitive to the additives used than were enterococci. Maximum inhibition (90%) was measured after the growth with the SG 31 strain in the presence of both ionophores. Growth of organisms was more inhibited by salinomycin at 25 mg/L (67.5%) than at 50 mg/L (63%). The inhibitory effect in enterococcal strains reached after the addition of salinomycin and lasalocid (on average) 63 and 58%, respectively. The CCM 4231 strain was more inhibited by salinomycin as well as by lasalocid than was the EF 26 strain.
The fermentation of a basal diet composed of hay and barley (80:20%) was compared with fermentation of three rations in which 5 and 10% of hay and 10% of basal diet were replaced with the above-ground part of Rhaponticum carthamoides Wild in an artificial rumen (Rusitec). Results of 14 days experiments indicated that the digestibility of dry matter, organic matter, detergent fibre, production of CO2 and methane, NH3-N in effluent and total and individual VFA (mmol/day) were not affected in the process of fermentation of experimental diets in comparison with the basal diet. Addition of Rhaponticum carthamoides did not modify the production, utilization and recovery of metabolic hydrogen, glucose utilization, ATP production, YATP and effectiveness of microbial biomass synthesis expressed in g of microbial N/kg of organic fermented biomass. Water extracts of Rhaponticum carthamoides had no influence on growth parameters of a mixed culture of rumen bacteria. Overall results of this experiment indicated that the above-ground part of Rhaponticum carthomoides fully replaced the 5 and 10% portions of hay or 10% portion of the whole diet.
- MeSH
- amoniak metabolismus MeSH
- bachor metabolismus mikrobiologie MeSH
- Bacteria účinky léků růst a vývoj metabolismus MeSH
- fermentace účinky léků MeSH
- ječmen (rod) MeSH
- krmivo pro zvířata MeSH
- kyseliny mastné těkavé biosyntéza MeSH
- léčivé rostliny * MeSH
- lipnicovité MeSH
- methan metabolismus MeSH
- oxid uhličitý metabolismus MeSH
- potravní vláknina metabolismus MeSH
- rostlinné extrakty farmakologie MeSH
- techniky in vitro MeSH
- trávení MeSH
- zvířata MeSH
- Check Tag
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- amoniak MeSH
- kyseliny mastné těkavé MeSH
- methan MeSH
- oxid uhličitý MeSH
- potravní vláknina MeSH
- rostlinné extrakty MeSH
An experiment was made with the Rumen Simulation Technique (Rusitec) in which the fermentation of a mixed ration of hay (12.8 g/d) and bruised barley (3.2 g/d) was compared with the fermentation of the same diet in the presence of 5 mg monensin/d from the USA, CSFR and Bulgaria. The fermentation of the mixed ration was significantly affected by all three kinds of monensin. The digestibility of dry matter (DM) in the rations declined in the presence of monensin from 48% to 40% (tab. I). The digestibility of detergent fibre, cellulose and hemicellulose also declined in the presence of monensin (tab. I). The production of methane decreased (-70%) and CO2 production dropped too, but this decrease could be accounted for by the changes in the production of volatile fatty acids and redistribution of metabolic hydrogen (tab. I). Monensin decreased the production of total volatile fatty acids (-21%), the production of acetic (-35%), n-butyric, n-valeric and isovaleric acids (tab. II) and increased the production of propionic acid (+60%). The production, utilization and recovery of metabolic hydrogen were significantly increased in the presence of all three kinds of monensin (tab. IV). The end products of fermentation were affected by an addition of monensin to the mixed ration. All three kinds of monensin increased energic efficiency of volatile fatty acids, decreased adenosinetriphosphate (ATP) production, the amounts of fermented hexose, organic matter fermented and utilization of glucose (tab. III).(ABSTRACT TRUNCATED AT 250 WORDS)
- MeSH
- bachor fyziologie MeSH
- biologické modely MeSH
- fermentace účinky léků MeSH
- krmivo pro zvířata * MeSH
- monensin farmakologie MeSH
- techniky in vitro MeSH
- zvířata MeSH
- Check Tag
- zvířata MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- Názvy látek
- monensin MeSH
An experiment was conducted with rumen pouch (RUSITEC--Rumen Simulation Technique). In four fermentation vessels (V), percent proportions of hay and barley were as follows: V1--40:60, V2 - 60:40, V3--80:20 and V4--100:0. Every day 5 mg of monensin dissolved in 1 ml 96% ethanol were added to each fermentation vessel. All diets were isonitrogenous, and after an addition of urea the crude protein (CP) content made 13% in each diet. The experiment lasted 12 days: so called steady state period took the first six days when the fermentation conditions were stabilized. Monensin reduced dry matter digestibility, production of total volatile fatty acids, acetic acid, n-butyric and isovaleric acids and acetate: propionate proportion, and it increased the production of propionic and n-valeric acids. The production of methane and CO2 decreased. The higher proportion of hay in diets decreased dry matter digestibility, digestibility of detergent fibre, total and individual volatile fatty acids, CO2, methane energy yield of volatile fatty acids (E), glucose utilization, production of adenosine triphosphate and production of fermented hexoses. The production, utilization and recovery of metabolic hydrogen also decreased. The effectiveness of microbial matter synthesis (YATP = 11.3) was highest during the fermentation of feed containing 60% hay and 40% barley.
- MeSH
- bachor fyziologie MeSH
- fermentace účinky léků MeSH
- krmivo pro zvířata * MeSH
- monensin farmakologie MeSH
- techniky in vitro MeSH
- zvířata MeSH
- Check Tag
- zvířata MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- Názvy látek
- monensin MeSH
