Papers by Miroslav Prucha
The use of “omics” technologies in sepsis diagnostics
Journal of Pharmacogenomics and Pharmacoproteomics, Oct 28, 2017
Critical Care, 2009
Introduction There is considerable uncertainty about the reproducibility of the various instrumen... more Introduction There is considerable uncertainty about the reproducibility of the various instruments used to measure dyspnea, their ability to reflect changes in symptoms, whether they accurately reflect the patient's experience and if its evolution is similar between acute heart failure syndrome patients and nonacute heart failure syndrome patients. URGENT was a prospective multicenter trial designed to address these issues. Methods Patients were interviewed within 1 hour of first physician evaluation, in the emergency department or acute care setting, with dyspnea assessed by the patient using both a five-point Likert scale and a 10-point visual analog scale (VAS) in the sitting (60º) and then supine (20º) position if dyspnea had not been considered severe or very severe by the sitting versus decubitus dyspnea measurement. Results Very good agreements were found between the five-point Likert and VAS at baseline (0.891, P <0.0001) and between changes (from baseline to hour 6) in the five-point Likert and in VAS (0.800, P <0.0001) in acute heart failure (AHF) patients. Lower agreements were found when changes from baseline to H6 measured by Likert or VAS were compared with the seven-point comparative Likert (0.512 and 0.500 respectively) in AHF patients. The worse the dyspnea at admission, the greater the amplitude of improvement in the first 6 hours; this relationship is stronger when dyspnea is measured with VAS (Spearman's rho coefficient = 0.672) than with the five-point Likert (0.272) (both P <0.0001) in AHF patients. By the five-point Likert, only nine patients (3% (1% to 5%)) reported an improvement in their dyspnea, 177 (51% (46% to 57%)) had no change, and 159 (46% (41% to 52%)) reported worse dyspnea supine compared with sitting up in AHF patients. The PDA test with VAS was markedly different between AHF and non-AHF patients. Conclusions Both clinical tools five-point Likert and VAS showed very good agreement at baseline and between changes from baseline to tests performed 6 hours later in AHF patients. The PDA test with VAS was markedly different between AHF and non-AHF patients. Dyspnea is improved within 6 hours in more than threequarters of the patients regardless of the tool used to measure the change in dyspnea. The greater the dyspnea at admission, the greater the amplitude of improvement in the first 6 hours.
Journal of Personalized Medicine, Dec 1, 2022
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Physiological Research, 2019
Abdominal aortic aneurysm (AAA) is a serious condition of unclear pathogenesis and progression. T... more Abdominal aortic aneurysm (AAA) is a serious condition of unclear pathogenesis and progression. Two samples were collected from 48 patients during AAA surgery. One sample was collected from the aneurysm, the other from the aneurysm proximal neck where the tissue did not exhibit any aneurysmal changes. Subsequently, gene expression profiles using microarrays (Illumina) were compared in RNA extracted from the samples. Overall, 2,185 genes were found to be upregulated and 2,100 downregulated; from which 158 genes had a different expression with FDR<0.05 (False Discovery Rate) and FC≥2 (Fold Change). Of this number, 115 genes were over-expressed and 43 under-expressed. The analysis of the gene list based on their biological pathways revealed that the regulation of inflammation was mediated by chemokine and cytokine signaling pathways, the integrin signaling pathway, and T and B cell activation. Moreover, a change was identified in the expression of genes involved in both intercellula...
Syndrome de susceptibilité mendélienne aux infections mycobactériennes : à propos d’un cas d’infection disséminée à Mycobacterium avium
Archives de Pédiatrie, 2013
Mendelian susceptibility to mycobacterial disease (MSMD) is a rare genetic syndrome that predispo... more Mendelian susceptibility to mycobacterial disease (MSMD) is a rare genetic syndrome that predisposes patients to infections caused by weakly virulent mycobacterial species, such as bacillus Calmette-Guérin (BCG) vaccines and nontuberculous environmental mycobacteria in children free of classical immunodeficiencies. This syndrome consists of impaired antimycobacterial immunity (axis IL12/INF-γ) constituting a new immune deficiency and outlining its major role in mycobacterial immunity. We report a new case of MSMD through the observation of a young girl with a disseminated infection due to Mycobacterium avium. The molecular defect was 2 autosomal recessive mutations of the IL12Rβ1 gene (gene encoding for the β1 chain of the IL12 receptor) leading to the absence of the IL12 receptor on the activated T lymphocytes&#39; surface. IL-12RB1 deficiency is the most common genetic etiology of MSMD. Today, there are 6 MSMD-causing genes, leading to 13 distinct genetic disorders. The clinical phenotype differs between patients. The description of the molecular and immunological basis of this syndrome has allowed us to explain the pathophysiology of antimycobacterial immunity and is essential to understanding and managing these diseases.
In recent years, several papers and reviews on biomarkers for sepsis have been published [1,2]. T... more In recent years, several papers and reviews on biomarkers for sepsis have been published [1,2]. The conclusion is unambiguous currently, we do not have a sufficiently sensitive and specific parameter for infectious inflammation. However, transcriptome studies have shown that gene expression in infectious and non-infectious inflammation is different [3,4]. So, what is the problem? It is the current availability of parameters used for the measurement in plasma or serum, which should be specific for infectious inflammation. This availability is given, among other things, by the technologies we use to determine these biomarkers.
Clinical & Experimental Immunology, 2019
Summary The objectives of this study were to evaluate patients with aortic abdominal aneurysm (AA... more Summary The objectives of this study were to evaluate patients with aortic abdominal aneurysm (AAA) with regard to immunoglobulin (Ig)G4-related disease (IgG4-RD). IgG4-RD represents a recently defined condition comprised of a collection of disorders characterized by IgG4 hypergammaglobulinemia, the presence of IgG4-positive plasma cells in organs affected with fibrotic or sclerotizing changes and typical histopathological features. It was identified as a possible cause of vasculitis in large vessels. Studies have been published on a possible association between inflammatory aortic or cardiovascular disease and IgG4-RD. We examined 114 patients with AAA requiring surgery in order to identify findings which are characteristic of IgG4-RD. Aneurysm samples from seven patients showed histopathological features consistent with IgG4-RD and the presence of IgG4+ plasma cells. Only two of these seven patients showed elevated IgG4 serum levels higher 1·35 g/l. In five of the patients, the co...
Detection of miRNAs in Patients with Abdominal Aortic Aneurysm
AORTA
[Idiopathic retroperitoneal fibrosis--Ormond's disease]
Vnitrni lekarstvi, 2008
Ormond disease - idiopathic retroperitoneal fibrosis - is a rare condition characterized in situ ... more Ormond disease - idiopathic retroperitoneal fibrosis - is a rare condition characterized in situ by the development of fibrous plaques in the retroperitoneal space and anatomicaly dependent structures. The associated encasement of both ureters and progress to hydronefrosis of the kidney are typical clinical manifestations. Less typical manifestations are possible (for example chronic periaortitis), where clinical diagnosis is more difficult. The laboratory findings are not specific for this disease and a biopsy is not always possible for anatomical reasons. In these cases, the use of positron emission tomography/computed tomography - has been found to be the solution, specifically for patients with periaortitis. Ormond disease is generally idiopathic, and secondary - to the use of certain drugs, malignant diseases, infections. Idiopathic retroperitoneal disease is thought to result from the clinical manifestation of a systemic autoimmune disease. The purpose of this article is to pr...
[Determination of antiphospholipid antibodies in serum using ELISA]
Epidemiologie, mikrobiologie, imunologie : casopis Spolecnosti pro epidemiologii a mikrobiologii Ceské lékarské spolecnosti J.E. Purkyne, 1994
The authors compare two ELISA methods for the assessment of antiphospholipid antibodies, classes ... more The authors compare two ELISA methods for the assessment of antiphospholipid antibodies, classes IgG and IgM, in serum: ELISA Pin Plate System ALPHA DIALAB Co. and the ELISA method developed in the Research Institute of Rheumatic Diseases. Both methods use cardiolipin as antigen. In the Pin Plate test the immunochemical reaction antigen/antibody does not take place at the surface of the pits of the microtitration plates but on the tip of the next plate. The results of examinations of antiphospholipid antibodies obtained by the tested methods are comparable, the Pin Plate test is quicker and more sensitive, but its price limits routine use.
International Journal of Cardiology, 2011
Clinical outcome and quality of life after interventional treatment of left main disease with dru... more Clinical outcome and quality of life after interventional treatment of left main disease with drug-eluting-stents in comparison to CABG in elderly and younger patients. Clin Res Cardiol 2011;100:439-46. [12] White AJ, Kedia G, Mirocha JM, et al. Comparison of coronary artery bypass surgery and percutaneous drug-eluting stent implantation for treatment of left main coronary artery stenosis. JACC Cardiovasc Interv 2008;1:236-45. [13] Wu X, Chen Y, Liu H, et al. Comparison of long-term (4-year) outcomes of patients with unprotected left main coronary artery narrowing treated with drug-eluting stents versus coronary-artery bypass grafting.
Clinical Microbiology: Open Access, 2015
Introduction: Capnocytophaga canimorsus is a common bacterium in oral cavity of dogs and cats. Se... more Introduction: Capnocytophaga canimorsus is a common bacterium in oral cavity of dogs and cats. Severe sepsis can develop following a dog or cat bite or scratch in susceptible individuals. Main risk factor for severe infections is immune deficit. Case presentation: We describe a case of eighty-one-years old woman with significant comorbidities admitted to the hospital with fever and non-specific symptoms following a fall at home. She was bitten by her dog 3 days prior to admission with a small wound on her hand. She had cardiac arrest with cardiopulmonary resuscitation eleven hours after admission and died ten hours later in ICU from refractory septic shock. PCR confirmed C. canimorsus as a causative organism. Conclusions: Severe infections caused by C. canimorsus can develop following a bite or a scratch by dog or cat. Fulminant sepsis with fatal outcome can rapidly evolve and the main risk factor among patient population is present immune deficiency. Clinicians should be aware of this fact and any person at risk presenting to the hospital with recent bite or scratch injury by dog or cat should be given adequate antibiotic treatment.
Serum lipopolysaccharide-binding protein (LBP) at the first and last examinations in patients with sepsis and septic shock
<b>Copyright information:</b>Taken from "Significance of lipopolysaccharide-bind... more <b>Copyright information:</b>Taken from "Significance of lipopolysaccharide-binding protein (an acute phase protein) in monitoring critically ill patients"Critical Care 2003;7(6):R154-R159.Published online 1 Oct 2003PMCID:PMC374378.Copyright © 2003 Prucha et al., licensee BioMed Central Ltd. This is an Open Access article: verbatim copying and redistribution of this article are permitted in all media for any purpose, provided this notice is preserved along with the article's original URL. There was a statistically significant difference between first and last examination in the group of patients who survived (= 0.009) and in those who did not (= 0.010).
Time course of lipopolysaccharide-binding protein (LBP) levels in surviving and nonsurviving patients with sepsis and septic shock
<b>Copyright information:</b>Taken from "Significance of lipopolysaccharide-bind... more <b>Copyright information:</b>Taken from "Significance of lipopolysaccharide-binding protein (an acute phase protein) in monitoring critically ill patients"Critical Care 2003;7(6):R154-R159.Published online 1 Oct 2003PMCID:PMC374378.Copyright © 2003 Prucha et al., licensee BioMed Central Ltd. This is an Open Access article: verbatim copying and redistribution of this article are permitted in all media for any purpose, provided this notice is preserved along with the article's original URL. Shown are data from patients available for follow up, who were assessed repeatedly at 3- to 5-day intervals for 30 days or until death.
T, Hyanek J: Significance of lipopolysaccharide-binding protein (an acute phase protein) in monitoring critically ill patients. Crit Care 2003
in monitoring critically ill patients
[Idiopathic retroperitoneal fibrosis--Ormond's disease]
Vnitr̆ní lékar̆ství, 2008
Ormond disease - idiopathic retroperitoneal fibrosis - is a rare condition characterized in situ ... more Ormond disease - idiopathic retroperitoneal fibrosis - is a rare condition characterized in situ by the development of fibrous plaques in the retroperitoneal space and anatomicaly dependent structures. The associated encasement of both ureters and progress to hydronefrosis of the kidney are typical clinical manifestations. Less typical manifestations are possible (for example chronic periaortitis), where clinical diagnosis is more difficult. The laboratory findings are not specific for this disease and a biopsy is not always possible for anatomical reasons. In these cases, the use of positron emission tomography/computed tomography - has been found to be the solution, specifically for patients with periaortitis. Ormond disease is generally idiopathic, and secondary - to the use of certain drugs, malignant diseases, infections. Idiopathic retroperitoneal disease is thought to result from the clinical manifestation of a systemic autoimmune disease. The purpose of this article is to pr...
[Immunological monitoring of sepsis using flow cytometry--quantitation of monocyte HLA-DR expression and granulocyte CD64 expression]
Epidemiologie, mikrobiologie, imunologie : casopis Spolecnosti pro epidemiologii a mikrobiologii Ceské lékarské spolecnosti J.E. Purkyne, 2005
Sepsis is a serious disease with a high case fatality rate. A variety of changes in the host immu... more Sepsis is a serious disease with a high case fatality rate. A variety of changes in the host immune responsiveness are observed in the pathogenesis of sepsis, ranging from detrimental hyperinflammation to profound immunoparalysis, i.e. acquired immunodeficiency. The level of monocyte HLA-DR expression reflects the functional status of monocytes as antigen-presenting cells and granulocyte CD64 expression is also indicative of infectious inflammation. Monocyte HLA-DR expression and granulocyte CD64 expression were measured in 49 septic patients and 30 healthy controls using flow cytometry focused on three parameters: positive cell percentage, mean fluorescence intensity and quantitation of antibodies bound per cell (QuantiBRITE). The significance of both monocyte HLA-DR expression and granulocyte CD64 expression in septic patients was confirmed. Monocyte HLA-DR dramatically decreases in septic patients compared to controls, is one of the prognostic factors and correlates with C-reacti...
Antiviral Therapy, 2011
Background Antiviral prophylaxis against cytomegalovirus has been associated with reduced risk of... more Background Antiviral prophylaxis against cytomegalovirus has been associated with reduced risk of allograft rejection and improved allograft survival after renal transplantation. This phenomenon might not be fully explained by preventing the indirect effects of cytomegalovirus. The effect of antiviral agents on lymphocyte function in patients treated with modern immunosuppression has not been studied to date. Methods Adult renal transplant recipients were assigned to 3-month prophylaxis with either valganciclovir (900 mg once daily; n=19) or valacyclovir (2 g four times daily; n=17) as part of an ongoing randomized trial. Subsets of lymphocytes, lymphocyte proliferation and/or cytokine production after in vitro mitogen stimulation were evaluated at the end of prophylaxis and 1 month after withdrawal of antiviral drugs. Results Lymphocyte proliferation was significantly decreased both after phytohemagglutinine (25% ±15% versus 32% ±18%; P=0.025) and concanavalin A stimulation (17% ±9...
Molecular Variability of FLT3/ITD Mutants and Their Impact on the Differentiation Program of 32D Cells: Implications for the Biological Properties of AML Blasts
Blood
FLT3 is the most frequently mutated gene in AML – up to 40% of AML harbor an activating mutation ... more FLT3 is the most frequently mutated gene in AML – up to 40% of AML harbor an activating mutation within FLT3 gene. Though AML is a relatively rare disease, such a high mutability rate, as observed with FLT3 gene, is striking. To elucidate the molecular background of this phenomenon, we have established nine unique FLT3/ITD - carrying 32D cell lines and a set of controls, and subjected them to whole genome expression analysis and 2DE LC/MS proteomics. Data obtained on this so far largest set of ITD mutants indicates that FLT3/ITD positive cells exhibit less mature expression profiles resembling ST-HSC and MkEP/CMP/LMPP progenitors. FLT3/ITD-positive 32D cells overexpress a combination of genes of pluripotency (Etv5, endoglin, EpoR, Mpl, Trfr2, GATA.2, Hemgn, Myb, Dok2, Gli1, Pim3, PML, Ikaros, Pum1, Dlx4, Hox-c8, HoxB9, Runx1, c-Myc, Shh, FL) and early erythroid precursors (EpoR, Trfr2, GATA.1, Klf1), implicating their less mature expression profile than 32D cell lines harboring wild...
Prague Medical Report
Currently, Ormond’s disease is classified among IgG4-associated diseases. Its clinical manifestat... more Currently, Ormond’s disease is classified among IgG4-associated diseases. Its clinical manifestation varies and is characterized by the presence of fibrous retroperitoneal tissue that often affects the ureters or abdominal aorta and iliac arteries. We present a unique case of the polycystic form of Ormond’s disease, imitating tumour in the retroperitoneal space. At the time of diagnosis, the disease was not metabolically active and did not require immunosuppressive therapy. The polycystic mass was removed surgically. There has been no exacerbation of the disease during the last 12 months.
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Papers by Miroslav Prucha