Background. Medication -related osteonecrosis of the jaw (MRONJ) is a rare but serious complication of antiresorptive and/or antiangiogenic therapy. It mainly affects oncological patients, however, it can occur in patients with metabolic bone diseases, although this is less frequent. These lesions not only significantly impair the quality of life but can also have impact on the treatment of any underlying disease. In some rare cases MRONJ can be life-threatening. There is still no ideal consensus for treatment, though surgical therapy has been mostly preferred in recent years. Materials and Methods. A monocentric retrospective evaluation of surgical therapy of MRONJ in osteoporotic patients, treated in the time period 3/2014-3/2018 using the uniform department-specific protocol. Results. 26 osteoporotic patients with 32 MRONJ lesions of stage 1 (9%), stage 2 (75%) and stage 3 (16%) were treated surgically. The maxilla: mandibula ratio was 1:2.2, in 19% of patients there was multiple jaw involvement. 69.2% of patients had received bisphosphonates, 15.4% denosumab and 15.4% had a history of both types of antiresorptive treatment. Complete healing was observed in all patients, in 9% of cases by secondary intention in the mean period of 6 weeks. The mean follow-up was 20.5 months. Conclusion. The presented protocol for surgical therapy was effective in the management of all MRONJ stages in the osteoporotic patients described here. The surgery is indicated as an early treatment to prevent complications and the progression of the lesions. It leads to improvement in quality of life and option to resume antiresorptive therapy if interrupted.

Nowadays, dental diseases are one of the most common illnesses in the world. Some of them can lead to translocation of oral bacteria to the bloodstream causing intermittent bacteraemia. Therefore, a potential association between oral infection and cardiovascular diseases has been discussed in recent years as a result of adhesion of oral microbes to the heart valves. The aim of this study was to detect oral bacteria on pathologically changed heart valves not caused by infective endocarditis. In the study, patients with pathologically changed heart valves were involved. Samples of heart valves removed during heart valve replacement surgery were cut into two parts. One aliquot was cultivated aerobically and anaerobically. Bacterial DNA was extracted using Ultra-Deep Microbiome Prep (Molzym GmbH, Bremen, Germany) followed by a 16S rRNA gene PCR amplification using Mastermix 16S Complete kit (Molzym GmbH, Bremen, Germany). Positive PCR products were sequenced and the sequences were analyzed using BLAST database ( http://www.ncbi.nlm.nih/BLAST ). During the study period, 41 samples were processed. Bacterial DNA of the following bacteria was detected in 21 samples: Cutibacterium acnes (formerly Propionibacterium acnes) (n = 11; 52.38% of patients with positive bacterial DNA detection), Staphylococcus sp. (n = 9; 42.86%), Streptococcus sp. (n = 1; 4.76%), Streptococcus sanguinis (n = 4; 19.05%), Streptococcus oralis (n = 1; 4.76%), Carnobacterium sp. (n = 1; 4.76%), Bacillus sp. (n = 2; 9.52%), and Bergeyella sp. (n = 1; 4.76%). In nine samples, multiple bacteria were found. Our results showed significant appearance of bacteria on pathologically changed heart valves in patients with no symptoms of infective endocarditis.

Animal models are essential in understanding of the mechanisms of sepsis moreover the development and the assessment of emerging therapies. In clinically relevant porcine model, however, a significant variability in the host response has been observed among animals. Thus, there is a strong demand to better understand the potential sources of this heterogeneity. In this study, we compared faecal microbiome composition of 12 animals. Three samples were collected at different time points from each animal. Bacteriome was subjected to 16S rDNA profiling. A significant difference in bacterial composition was associated with the season (p < 0.001) but not with the sex of the pig (p = 0.28), the timing of sample collection (p = 0.59), or interactions thereof (all p > 0.3). The season batch explained 55% of the total variance in the bacteriome diversity. The season term was highly significant from the high-resolution level of the bacterial amplicon sequencing variants up to the level of phylum. The diversity of the microbiome composition could significantly influence experimental model of sepsis, and studies are warranted to demonstrate the effects of gut microbiome diversity on the host-response. If confirmed, control of the gut microbiome should become a standard part of the pre-clinical sepsis experiments.

Úvod a cíl: Kardiovaskulární onemocnění jsou stále jedním z nejčastějších zdravotních a celospolečenských problémů soudobé populace. Orální zdraví je považováno za jeden z rizikových faktorů v rozvoji kardiovaskulárních onemocnění a působení metastatické oportunní infekce orální etiologie je všeobecně známo. Metody: Tato práce vyhodnotila stav orálního zdraví u souboru 187 pacientů Stomatologické kliniky LF UK a FN v Plzni, kteří byli v letech 2015-2018 vyšetřeni v rámci předoperačního vyšetření před plánovanou kardiochirurgickou operací. Doplňující informace přinesla i detekce orálních bakterií na degenerativně změněných srdečních chlopních. Výsledky: Provedené studie přinesly informace o zanedbaném stavu chrupu těchto pacientů; nadpoloviční většina (64,17 %) byla ohrožena metastatickou oportunní infekcí orální etiologie. Experiment prokázal přítomnost genetické informace bakterií orální etiologie na degenerativně poškozených srdečních chlopních u 21 vzorků. Závěr: Práce poukazuje na nedostatečnou sanaci dutiny ústní a s tím spojené riziko metastatické oportunní infekce u pacientů s kardiovaskulárním onemocněním. Stav orálního zdraví pacientů před plánovanou kardiochirurgickou operací by neměl být podceňován. Orální zdraví by mělo být považováno za významný faktor ovlivňující zdraví celkové. Klíčová slova: orální zdraví, metastatická oportunní infekce, kardiovaskulární onemocnění, srdeční chlopně SUMMARY Introduction, aim: Cardiovascular diseases are some of the most common health and society problems in the present population. Oral health is considered as a risk factor in the development of cardiovascular diseases. Contemporary knowledge of the metastatic opportunistic infection of oral etiology is widely known. Methods: This article brings evaluation of oral health in 187 patients undergoing cardiovascular surgery.

No abstract