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Switch from biosimilar infliximab CT-P13 to biosimilar infliximab SB-2 in the long-term maintenance therapy in IBD patients – prospective observational study 从生物类似药英夫利昔单抗CT-P13到生物类似药英夫利昔单抗SB-2在IBD患者长期维持治疗中的转换——前瞻性观察研究
Gastroenterologie a Hepatologie Pub Date : 2023-08-31 DOI: 10.48095/ccgh2023336
Milan Lukáš, Veronika Hrubá, Jindra Reissigová, K. Černá, N. Machková, D. Ďuricová, M. Kolář, Lea Čermáková
{"title":"Switch from biosimilar infliximab CT-P13 to biosimilar infliximab SB-2 in the long-term maintenance therapy in IBD patients – prospective observational study","authors":"Milan Lukáš, Veronika Hrubá, Jindra Reissigová, K. Černá, N. Machková, D. Ďuricová, M. Kolář, Lea Čermáková","doi":"10.48095/ccgh2023336","DOIUrl":"https://doi.org/10.48095/ccgh2023336","url":null,"abstract":"Introduction: Therapeutical switch from originator to biosimilar infliximab has been proved as effective and safety procedure. We have a few information about non-medical swich from one biosimilar to the another biosimilar infiximab. Aim: This is a prospective observational study from one tercial IBD center, performed in 2021 and 2022 which was focused on efficacy and safety after switch from infliximab CT-P13 to infliximab SB-2 in patients with IBD. Methods: The cohort group comprised with 287 patients with IBD who have been consecutively treated with infliximab CT-P13 and they were switched to infliximab SB-2. All the re cruited patients were in clinical and biological sustained remission at mean for 6 months before the switch. Results: We proved that persistence on infliximab SB-2 therapy after the switch was 86.4% of treated patients, no significant changes in clinical inflammatory activities and biological parameters have been detected after the switch. The therapy termination due to side effects or loss of response in 39 patients (13.9%) has been detected due to lost of clinical response, side effects or lost of follow-up. No higher immunogenicity after the switch was found. Conclusion: Non-medical switch from one biosimilar infliximab (CT-P13) to another one (SB-2) was not associated with higher risks of disease destabilisation or immunogenicity. Keywords inflammatory bowel disease, biosimilar infliximab CT-P13, biosimilar infliximab SB-2, therapeutical switch","PeriodicalId":38577,"journal":{"name":"Gastroenterologie a Hepatologie","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78935168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Why should we and should we not use ChatGPT in gastroenterology? 为什么我们应该或不应该在胃肠病学中使用ChatGPT ?
Gastroenterologie a Hepatologie Pub Date : 2023-08-31 DOI: 10.48095/ccgh2023322
J. Kral, Kateřina Waloszková, Jana Selucká, E. Machytka, Julius Špičák, M. Bužga
{"title":"Why should we and should we not use ChatGPT in gastroenterology?","authors":"J. Kral, Kateřina Waloszková, Jana Selucká, E. Machytka, Julius Špičák, M. Bužga","doi":"10.48095/ccgh2023322","DOIUrl":"https://doi.org/10.48095/ccgh2023322","url":null,"abstract":"Summary: Artificial intelligence (AI) is increasingly being incorporated into medicine, including gastroenterology, opening new possibilities for the diagnosis and treatment of digestive tract diseases. ChatGPT, an AI model based on the GPT-4 architecture, has the potential to accelerate diagnosis and treatment, personalize care, educate, and train healthcare professionals, support decision-making, and improve communication with patients. However, with the use of AI come challenges such as the limited ability of AI to replace human judgment, data errors, issues related to security and personal data protection, and implementation costs. The future of ChatGPT in gastroenterology depends on its ability to process and analyze large amounts of data to identify patterns and create individual treatment plans. Thanks to advancements in AI and machine learning, ChatGPT is becoming more accurate and efficient, enabling faster diagnosis and treatment of gastroenterological diseases. In the field of education, ChatGPT will serve as an invaluable source of information on the latest research articles and procedures. Despite the benefits of AI in gastroenterology, it is essential to address issues of ethics, data protection, and collaboration between AI and healthcare professionals. Ensuring proper protocols and procedures will enable the safe and ethical use of AI in medicine. Although AI offers significant potential for improving the quality of care, it is necessary to address challenges associated with data protection, security, and ethics. Key words: artificial intelligence – AI – ChatGPT – gastroenterology","PeriodicalId":38577,"journal":{"name":"Gastroenterologie a Hepatologie","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82628747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Changing epidemiology of Clostridioides difficile infection – increasing number of community-acquired forms and infections in children 艰难梭菌感染流行病学的变化——社区获得性感染和儿童感染数量的增加
Gastroenterologie a Hepatologie Pub Date : 2023-08-31 DOI: 10.48095/ccgh20232315
Martin Sučík, R. Rosoľanka, K. Šimeková, Peter Bánovčin, Martin Schnierer
{"title":"Changing epidemiology of Clostridioides difficile infection – increasing number of community-acquired forms and infections in children","authors":"Martin Sučík, R. Rosoľanka, K. Šimeková, Peter Bánovčin, Martin Schnierer","doi":"10.48095/ccgh20232315","DOIUrl":"https://doi.org/10.48095/ccgh20232315","url":null,"abstract":"Clostridioides difficile colitis has long been considered an infection associated with hospitalization and concomitant antibiotic treatment. However, the increasing number of community cases in recent years has led to a reassessment of the traditional understanding of its epidemiological characteristics. In addition, community-associated forms have been reported many times in children, young adults, or people without comorbidities and with a negative history of antibiotic use in the pre-disease period. These groups have traditionally been considered low risk for the development of the infection. Thus, many studies have naturally investigated the impact of asymptomatic Clostridioides difficile carriers, including neonates and infants, on the transmission of the causative agent in the community. The prevalence of this bacterium in animals, in food and in the environmental setting has also been the subject of research. The goal was to elucidate the role of these factors in the spread of the agent in community settings. In this article, we summarize the current knowledge on confirmed and potential risk factors for community-acquired Clostridioides difficile infection, together with the results of studies examining patient characteristics. We also provide information on the issue of Clostridioides difficile infection in the paediatric population, which is closely intertwined with the community-acquired form of the infection. Keywords asymptomatic carrier state, Clostridioides difficile, epidemiology, community-acquired infections","PeriodicalId":38577,"journal":{"name":"Gastroenterologie a Hepatologie","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90211049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Robotic pancreatic surgery in a high-volume pancreatic cancer surgery center – first experience 机器人胰腺手术在大容量胰腺癌手术中心-首次体验
Gastroenterologie a Hepatologie Pub Date : 2023-08-31 DOI: 10.48095/ccgh2023295
M. Loveček, Pavel Skalický, Dušan Klos
{"title":"Robotic pancreatic surgery in a high-volume pancreatic cancer surgery center – first experience","authors":"M. Loveček, Pavel Skalický, Dušan Klos","doi":"10.48095/ccgh2023295","DOIUrl":"https://doi.org/10.48095/ccgh2023295","url":null,"abstract":"Summary: Introduction: Robotic pancreatic surgery is still not widely used in the Czech Republic. On a global scale, it is gradually being systematically implemented, especially in high-volume centers. The study presents the first experiences with robotic pancreatic surgery in a pancreatic surgery high-volume center in the Czech Republic. Methods: Comparative analysis of the first ten patients operated on robotically for pancreatic pathology with a comparable group operated open (smaller procedures: left pancreatectomy with/without splenectomy, enucleation, central resection) evaluates age, length of hospitalization, ICU stay, blood loss and operative time using non-parametric Mann--Whitney U-test, and complications and rehospitalization using descriptive statistics. The results: The compared sets consist of 10 patients, 5 women, with a robotic procedure (5× enucleation, 4× distal pancreatectomy and central resection – median age 65.3 [46–76] years) and 10 patients, 5 women, with comparable open procedures (5× enucleation, 4× distal resection and central resection – median age 65.5 [52–78]years. Hospitalization length 4.5 days vs. 9 days (P = 0.0003) and operation time 275 min vs. 142 min (P = 0.004) were statistically different in the robotic vs open group. ICU stay and blood loss were lower in the robotic group, but not statistically significant, age was comparable. Complications according to the Clavien-Dindo classification in the open group: 3× type II, 1× type IIIa, 1× type IIIb, in the robotic group 1× type II and 1× type IIIa. Rehospitalization in the open group was 2×, in the robotic group 1x, always for late postoperative complications. Conclusion: Robotic surgery of the pancreas is currently in its infancy in the Czech Republic. The experience so far with the first ten patients operated on using the DaVinci Xi robotic system has yielded promising results in form of shorter hospitalization, but at cost of longer operating time. Key words: pancreatectomy – enucleation – pancreas – robotics – minimal invasiveness – hospital stay – enhanced postsurgical recovery","PeriodicalId":38577,"journal":{"name":"Gastroenterologie a Hepatologie","volume":"73 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77442403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Impact of the COVID-19 pandemic on acute pancreatitis in the Czech Republic – pilot data PANACOTA study (PANcreatitis Acuta in COVid Time Analysis) COVid -19大流行对捷克共和国急性胰腺炎的影响——试点数据PANACOTA研究(COVid - Time分析急性胰腺炎)
Gastroenterologie a Hepatologie Pub Date : 2023-08-31 DOI: 10.48095/ccgh2023307
Martin Harazim, Radek Kroupa, Jiří Jarkovský, Ondřej Šanca, Tomáš Andrašina, Vladimír Procházka, Michal Šenkyřík
{"title":"Impact of the COVID-19 pandemic on acute pancreatitis in the Czech Republic – pilot data PANACOTA study (PANcreatitis Acuta in COVid Time Analysis)","authors":"Martin Harazim, Radek Kroupa, Jiří Jarkovský, Ondřej Šanca, Tomáš Andrašina, Vladimír Procházka, Michal Šenkyřík","doi":"10.48095/ccgh2023307","DOIUrl":"https://doi.org/10.48095/ccgh2023307","url":null,"abstract":"Summary: Introduction: The COVID-19 pandemic had a significant impact on health care. Previous studies point to a possible negative impact of COVID-19 infection on the development and severity of acute pancreatitis. The aim of this study is to analyze the impact of the COVID-19 pandemic on the epidemiology, treatment and prognosis of acute pancreatitis at the population level. Methods: Using data from the National Registry of Reimbursed Health Services (NRRHS) parameters of hospital admissions for acute pancreatitis, the provided health care and treatment outcomes in the pandemic period (2020 and 2021) with previous years (2010–2019) were compared. Results: The incidence during the pandemic was not significantly different from the previous period: 67 vs. 63 per 100,000 population. Hospitalizations for acute pancreatitis in each month of 2020 and 2021 did not correlate with the number of COVID-19 positive patients. The overall mortality rates for acute pancreatitis before and during the pandemic were almost identical – at 3.8% and 3.9%, respectively. There was a trend towards a decrease in the number of surgical procedures, a gradual decrease in ERCPs and an increase in endoscopic drainages throughout the 2010–2021 period. The crude mortality rate of patients hospitalized for COVID-19 and concomitant acute pancreatitis was 14.2% and these patients were operated in 4.7%. Conclusions: Based on pilot population data, the COVID-19 pandemic did not have an impact on the incidence of acute pancreatitis in the Czech Republic. A more severe course and prognosis of the disease was associated with near-term COVID-19 positivity. More frequent indication of surgical and other interventions for acute pancreatitis in COVID-19 positive individuals may have been related to the disruption of standard quality and availability of care. Key words: acute pancreatitis – COVID-19 – epidemiology – endoscopic drainage – surgery – complications","PeriodicalId":38577,"journal":{"name":"Gastroenterologie a Hepatologie","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135946784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Hepatogenous diabetes in liver transplant candidates: prevalence, risk factors and posttransplant outcome – prospective study 肝移植候选者的肝源性糖尿病:患病率、危险因素和移植后结局——前瞻性研究
Gastroenterologie a Hepatologie Pub Date : 2023-08-31 DOI: 10.48095/ccgh20232820
I. Mikova, Denisa Kyselová, Kateřina Dvořáková, M. Dezortova, Milan Hájek, Věra Lánská, Julius Špičák, P. Trunec̃ka
{"title":"Hepatogenous diabetes in liver transplant candidates: prevalence, risk factors and posttransplant outcome – prospective study","authors":"I. Mikova, Denisa Kyselová, Kateřina Dvořáková, M. Dezortova, Milan Hájek, Věra Lánská, Julius Špičák, P. Trunec̃ka","doi":"10.48095/ccgh20232820","DOIUrl":"https://doi.org/10.48095/ccgh20232820","url":null,"abstract":"Klíčová slova: hepatogenní diabetes – diabetes mellitus 2. typu – transplantace jater – inzulinoterapie Summary: Introduction: Diabetes mellitus (DM) associated with liver cirrhosis (hepatogenous DM) has several differences from classical DM type 2 (T2DM), data about its prevalence, risk factors and outcome after liver transplantation (LT) are limited. The aim of this study was to evaluate the prevalence, risk factors and posttransplant outcome of DM diagnosed during the pretransplant investigation in a prospectively followed cohort of LT candidates. Methods: The study included 122 adult patients who were listed for LT in the period from 5/2015 to 4/2017. Presence of DM was evaluated by standard criteria including oral glucose tolerance test (OGTT). Results: DM was present in 54 patients (44.3%) pretransplant, of whom 26 patients (21.3%) had long-term history of DM before they were listed for LT (classical T2DM), and in other 28 patients (23.0%) DM was diagnosed during the pretransplant investigation based on pathological results of OGTT (hepatogenous DM). In 13 patients, de novo DM after LT was diagnosed. On the multivariate analysis, patients with hepatogenous DM had significantly lower BMI (P = 0.015), lower fasting glucose (P = 0.002) and lower glycated hemoglobin (P = 0.010), compared to classical T2DM. In comparison to patients without DM, patients with hepatogenous DM had more frequent occurrence of metabolic syndrome (P = 0.033). Patients with hepatogenous DM were less frequently treated with insulin at 1 month (32.0% vs. 76.2%; P = 0.002), 6 months (20.0% vs. 76.2%; P <0.001), 1 year (20.0% vs. 75.0%; P <0.001) and 2 years after LT (23.8% vs. 66.7%; P = 0.007) than patients with classical T2DM; but they were more frequently treated with insulin than patients without pretransplant DM 1 month after LT (32.0% vs. 7.7%; P = 0.015) and 2 years after LT (23.8% vs. 9.1%; P = 0.029). Conclusion: Hepatogenous DM is frequent in LT candidates (23.0%), it regresses in the majority of patients after LT unlike the classical T2DM, however, insulinotherapy is still necessary up to one quarter of patients even 2 years after LT. Key words: hepatogenous diabetes – type 2 diabetes mellitus – liver transplantation – insulinotherapy","PeriodicalId":38577,"journal":{"name":"Gastroenterologie a Hepatologie","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83801384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
EUS guided drainage of gallbladder: own cohort of 66 patients for the period 2016–2022 from the Hospital Jablonec nad Nisou EUS引导胆囊引流:2016-2022年期间来自Jablonec和Nisou医院的66例患者
Gastroenterologie a Hepatologie Pub Date : 2023-08-31 DOI: 10.48095/ccgh2023326
J. Pintová, Robert Procházka, Michael Man, Vladimír Nosek
{"title":"EUS guided drainage of gallbladder: own cohort of 66 patients for the period 2016–2022 from the Hospital Jablonec nad Nisou","authors":"J. Pintová, Robert Procházka, Michael Man, Vladimír Nosek","doi":"10.48095/ccgh2023326","DOIUrl":"https://doi.org/10.48095/ccgh2023326","url":null,"abstract":"Introduction: EUS-guided gallbladder drainage is a safe and effective endoscopic treatment modality for inoperable patients with severe acute cholecystitis with impending complications. It is also used as a salvage technique for patients with malignant biliary obstruction in whom conventional treatment with ERCP or EUS-guided biliary drainage has failed. Methods: The aim of this retrospective, consecutive cohort (November 2016 to December 2022) was to evaluate the technical and clinical success rates and peri-procedural, early and late complications of EUS-guided gallbladder drainage using the Hot AXIOS metallic lumen-apposing stent. Results: The cohort includes a total of 66 patients, of which 43 were benign and 23 were malignant. Technical success rate was 98.5%, clinical success rate was 98.5%. There were two periprocedural complications (bleeding and stent malposition), and two early post-procedural complications (peritonitis on day 2 after the drainage and subhepatic abscess on day 4 after the drainage), early complications were 6%. Late complications were only minor. Four times, we have observed partially or completely embedded LAMS. There was no recurrence of cholecystitis during the 12 months follow-ups. The mean duration of stent deployment for the benign indication was 327 days, and 199 days for patients with a malignant diagnosis. Conclusion: The evaluation of our cohort confirmed the high technical and clinical success of EUS-guided gallbladder drainage using Hot AXIOS stents with a low complication rate. Keywords EUS guided gallbladder drainage, cholecystostomy, LAMS","PeriodicalId":38577,"journal":{"name":"Gastroenterologie a Hepatologie","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74248362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Biofeedback assisted deep breathing training in refractory disorders of gut-brain interaction – our first experience, impressions and suggestions for further clinical practice 生物反馈辅助呼吸训练在肠脑相互作用难治性疾病-我们的第一次经验,印象和进一步临床实践的建议
Gastroenterologie a Hepatologie Pub Date : 2023-08-31 DOI: 10.48095/ccgh2023289
P. Lipták, I. Tonhajzerova, M. Ďuríček, Z. Visnovcova, N. Ferencova, Diana Vážanová, Peter Bánovčin
{"title":"Biofeedback assisted deep breathing training in refractory disorders of gut-brain interaction – our first experience, impressions and suggestions for further clinical practice","authors":"P. Lipták, I. Tonhajzerova, M. Ďuríček, Z. Visnovcova, N. Ferencova, Diana Vážanová, Peter Bánovčin","doi":"10.48095/ccgh2023289","DOIUrl":"https://doi.org/10.48095/ccgh2023289","url":null,"abstract":"Summary: Introduction: Disorders of gut-brain interaction represents a group of a wide variety of chronic gastrointestinal diseases with plethora of symptoms related to disorder of specific organ. There is no specific cure for DGBI and the therapy is mostly focused on alleviating the symptoms. One of the potential new therapies to alleviate the symptoms could be deep breathing training. Available data suggest that biofeedback assisted deep breathing pacing may lead to reduction of pain perception even visceral pain originating from gastrointestinal tract. Methods: This is a retrospective analysis of clinical data obtained from patients who were treated with deep breathing training for refractory case of disease of gut-brain interaction. The DGBI was diagnosed based on the ROME IV criteria. Before the training, the proper mechanism of deep abdominal breathing was thoroughly explained to the patients. Patients have also filled the STAI-X1, STAI-X2 questionaries to assess their anxiety levels. After initial office-based training, the patients were instructed to continue in home-based deep abdominal breathing for 3 to 5 times a week. The effect of the therapy was evaluated after one month. Results: Fifteen eligible patients were offered biofeedback assisted deep breathing training. Nine patients attended the check-up appointment after 4 weeks and are therefore considered in the analysis. Five patients experienced mild alleviation of the symptoms. Two patients experienced resolution of the symptoms and contrary, two patients didn’t report any change in symptoms. There were no statistically significant changes in the anxiety levels. Conclusion: The deep breathing training for symptom alleviation in disorders of gut-brain interaction seems to be a promising ad on therapy. This is based on published studies and our own experience. However more rigorous data are needed before more definite conclusion. Key words: biofeedback – deep breathing training – IBS – globus – dyspepsia","PeriodicalId":38577,"journal":{"name":"Gastroenterologie a Hepatologie","volume":"1942 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91218901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Dosage forms of oral mesalazine and their clinical use 口服美沙拉嗪的剂型及其临床应用
Gastroenterologie a Hepatologie Pub Date : 2023-08-31 DOI: 10.48095/ccgh20233342
Marek Lapka
{"title":"Dosage forms of oral mesalazine and their clinical use","authors":"Marek Lapka","doi":"10.48095/ccgh20233342","DOIUrl":"https://doi.org/10.48095/ccgh20233342","url":null,"abstract":"Mesalazine or 5-aminosalicylic acid is important substance which is used in therapy of inflammatory bowel disease (IBD), like ulcerative colitis (UC) and Crohn’s disease (CD). On the market, various mesalazine formulations for local (supositoria, rectal foam and enema) and for systemic administration (covered tablets, slow releasing tablets or slow releasing granulates) are available. Some differences between mesalazine formulations are enabling higher flexibility for clinical practice to choose the optimal drug in terms of distribution active drug according to disease activity and location. The pharmacokinetic profile of various mesalazine formulations and impact on the clinical practice are discussed in the text. Keywords inflammatory bowel disease, mesalazine, ulcerative colitis, pharmacokinetics","PeriodicalId":38577,"journal":{"name":"Gastroenterologie a Hepatologie","volume":"181 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80218116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Chest pain as an atypical symptom of acute cholecystitis 胸痛是急性胆囊炎的非典型症状
Gastroenterologie a Hepatologie Pub Date : 2023-08-31 DOI: 10.48095/ccgh2023302
Veronika Kovaříková, Jiří Tůma, Jaroslav Maceček
{"title":"Chest pain as an atypical symptom of acute cholecystitis","authors":"Veronika Kovaříková, Jiří Tůma, Jaroslav Maceček","doi":"10.48095/ccgh2023302","DOIUrl":"https://doi.org/10.48095/ccgh2023302","url":null,"abstract":"Summary: Chest pain is one of the most common symptoms addressed in the internal emergency department and has a broad differential diagnosis. They can be of cardiac or non-cardiac origin. They are generally caused by diseases of the intrathoracic organs, possibly also organs of adjacent regions (neck and abdomen) and involvement of musculoskeletal structures of the chest wall. They often signal an acute, life- -threatening disease and therefore require prompt diagnosis with immediate causal therapy. The history revealed by these complaints is often not typical, they are usually not fully expressed, and even the patient himself is often unable to specify them well. The presented case report describes an interesting case of complicated acute cholecystitis, the initial symptom of which was chest pain with suspicion of acute pulmonary embolism. Physical findings in the abdomen were negative throughout, and inflammatory changes in the gallbladder were noted as an incidental finding on CT angiography, which excluded pulmonary embolism. On further investigation, subcapsular hematoma and hemoperitoneum were diagnosed. After transfer to a higher unit, perforation of the hepatic capsule at the border with the gallbladder bed was detected peroperatively. A cholecystectomy was performed with treatment of venous hemorrhage of the liver parenchyma. Histological description of the resection confirmed phlegmonous inflammation. This case report highlights the importance of differential diagnosis of other possible non-cardiac causes of chest pain, including consideration of unusual causes of ECG waveform changes and elevation of cardiac markers. Effective multidisciplinary collaboration is key as this is a life-threatening condition. Key words: cholecystitis – chest pain – Cope’s sign – ECG changes – bradycardia","PeriodicalId":38577,"journal":{"name":"Gastroenterologie a Hepatologie","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88751402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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