Gastroenterologie a Hepatologie最新文献

{"title":"Ultra-processed food – a threat to liver health","authors":"M. Rác, M. Janíčko, T. Koller, Ľ. Skladaný","doi":"10.48095/ccgh2023123","DOIUrl":"https://doi.org/10.48095/ccgh2023123","url":null,"abstract":"Ultra-processed foods (UPF) are often characterized by low nutritional quality, high energy density, and the presence of additives, substances from packaging, and compounds formed during production, processing, and storage. UPF includes industrial formulations, and usually contains many ingredients. UPF includes sugar, oils, fats, salt, antioxidants, stabilizers and preservatives, food additives, and emulsifiers. Beyond the poor nutritional value, food processing promotes the creation of harmful compounds in the food. Food additives within UPF, promote inflammation, liver dysfunction, and metabolic syndrome, which are based on changes in the microbiome. Obesogens are environmental substances that alter the balance between energy intake and energy expenditure. Obesogens are a subset of environmental chemicals that act as endocrine disruptors affecting metabolic endpoints. The consumption of ultra-processed products has increased dramatically worldwide in the last decades. UPF contributed more than 60% of the mean energy intake. The average content of protein, fiber, vitamins, and calcium in the diet decreases significantly. The roducy contribution of UPFs, while carbohydrate, added sugar, and saturated fat contents increase. Ultra-processed foods contribute most of the added sugars in the western diet. Fructose – the most frequent obesogen, is associated with an increased risk of liver fibrosis. In recent years, there has been growing evidence about the harmful effect of UPF. UPF consumption is associated with metabolic alterations, the incidence of chronic diseases, and excess mortality. There is also evidence for an association with NAFLD, NASH, and fibrosis. High UPF consumption is related to harmful metabolic and hepatic parameters in NAFLD population. Furthermore, the combination of smoking and high UPF intake may amplify liver damage. The evidence from studies, a recommendation to reduce ultra-processed food intake to a minimum should be considered in nutritional guidelines and implemented by public health policy measures. Keywords non-alcoholic fatty liver disease (NAFLD), metabolic syndrome, ultra-processed food (UPF), obesogens, endocrine disrupting chemicals (EDCs)","PeriodicalId":38577,"journal":{"name":"Gastroenterologie a Hepatologie","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89221594","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}

{"title":"Hepatic parenchyma changes in obese paediatric patients","authors":"M. Pršo, L. Pršová, Z. Havlicekova, Z. Michnová, M. Kozar, K. Pršo, P. Bánovčin, Ľ. Skladaný","doi":"10.48095/ccgh2023112","DOIUrl":"https://doi.org/10.48095/ccgh2023112","url":null,"abstract":"Rationale: Non-alcoholic fatty liver disease (NAFLD) is emerging clinical issue in childhood and adolescent age. Present knowledge of NAFLD suggests an important role of genetic and environmental risk factors in the pathogenesis of the disease. Most of the patients are obese, however, NAFLD also occurs in the non-obese group and interestingly, in obese individuals it may be absent. The transabdominal ultrasound examination is the most widely used imaging method for NAFLD screening. Aim: The aim of the study was to assess the impact of paediatric obesity as the main risk factor in NAFLD development. Materials and methods: The degree of steatosis (represented by hepatorenal index) and hepatic parenchyma stiffness (represented by fibrosis liver index) were quantitatively evaluated using ultrasound device in a total of 240 paediatric and adolescent patients divided in subgroups according to age and weight criteria. Results from ultrasound examination were subsequently correlated with anthropometric and laboratory parameters. Results: Hepatorenal index (HRI) and liver fibrosis index (LFI) in healthy term neonates with normal birth weight was significantly lower compared to the control group of healthy normal weight children aged 10–18 years (p <0.001). We did not observe an effect of gender on changes in HRI (p = 0.332) and LFI (p = 0.339) in teenage and adolescent controls. Regardless of gender, normal HRI values in paediatric heathy control group ranged from 1.02–1.23 (10th–90th percentile). The group of obese children aged 10–18 years had HRI and LFI values significantly higher in contrast with healthy normal weight controls. Obese individuals had liver stiffness proportional to BMI (p = 0.005, rs = 0.310), however, the steatosis degree remained unchanged (p = 0.357). Hepatic parenchyma stiffness also increased with waist circumference gain in corpulent patients (p <0.01). Conclusion: Results of this study point to a significant association of obesity and NAFLD in paediatric population. The assessment of HRI and liver stiffness using ultrasound methods have been employed in the diagnosis of early stages of hepatic changes in obese children and adolescent patients at risk of NAFLD development. In addition to the early detection in these changes, ultrasound determination enables non-invasive and real-time assessment of dynamics of the disease and the effect of the administered therapy, which improves control over the disease. Keywords non-alcoholic fatty liver disease, obesity, hepatorenal index, real-time elastography, body roundness index, paediatric age, adolescent age","PeriodicalId":38577,"journal":{"name":"Gastroenterologie a Hepatologie","volume":"69 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87211205","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}

{"title":"Autoimmune pancreatitis in childhood","authors":"Tereza Sarnovská, K. Jelínková, F. Neumann, D. Barnetová, R. Hrdlička","doi":"10.48095/ccgh2023136","DOIUrl":"https://doi.org/10.48095/ccgh2023136","url":null,"abstract":"Autoimmune pancreatitis is an idiopathic inflammatory disease of the pancreas that is rarely encountered even in paediatric patients. However, compared to adult patients, the clinical manifestation and course of the disease in children may differ. We present a case report of a 13-year-old boy admitted to our department with a history of abdominal pain, weight loss, vomiting, and sudden development of jaundice. Initial laboratory parameters showed signs of cholestasis, inflammatory parameters and pancreatic enzymes were in the normal range. ERCP examination demonstrated stenosis of the pancreatic part of ductus choledochus, sonography and MRCP examination showed lesion in the head of the pancreas and signs typical for autoimmune pancreatitis. Based on these findings, treatment with oral corticosteroids was started at an initial dose of 30 mg/day with a gradual reduction to the current maintenance dose, which is 5 mg of prednisone per day. The patient is currently in clinical remission; however, the exocrine dysfunction of the pancreas persists which we are solving by replacement of pancreatic enzymes. The aim of this paper is to present the basic features of the paediatric form of AIP and to point out the differences between AIP in children and adults. Keywords autoimmune pancreatitis, paediatric autoimmune pancreatitis, immunoglobulin G4, MRCP, steroids","PeriodicalId":38577,"journal":{"name":"Gastroenterologie a Hepatologie","volume":"106 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86579037","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}

{"title":"Filgotinib in the treatment of infl ammatory bowel diseases","authors":"M. Lukáš","doi":"10.48095/ccgh2023145","DOIUrl":"https://doi.org/10.48095/ccgh2023145","url":null,"abstract":"","PeriodicalId":38577,"journal":{"name":"Gastroenterologie a Hepatologie","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78946229","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}

{"title":"Neurobiology of liver diseases","authors":"B. Mravec, M. Szántová","doi":"10.48095/ccgh2023103","DOIUrl":"https://doi.org/10.48095/ccgh2023103","url":null,"abstract":"he nervous system is an important factor that participates in the adaptive and compensatory reactions of the body, not only in physiological but also in pathological processes. Alterations in the activity of the nervous system may contribute to the development of somatic diseases and may also influence their progression. Experimental and clinical studies have shown that the nervous system also plays a role in liver diseases. Depending on the disease and on the mechanisms and pathways, the nervous system can play a positive as well as a negative role in liver diseases. The aim of this review is to describe the mechanisms and pathways through which the nervous system affects the development and progression of the most common liver diseases, such as alcoholic liver damage, non-alcoholic fatty liver disease, cholestatic liver diseases, hepatitis, cirrhosis, and hepatocellular carcinoma. In addition, we also describe the possible therapeutic consequences based on the modulation of signal transmission between the nervous system and the liver. Keywords alcoholic liver damage, autonomic nervous system, cirrhosis, chronic hepatitis, hepatocellular carcinoma, cholestatic liver diseases, neurobiology, fatty liver disease","PeriodicalId":38577,"journal":{"name":"Gastroenterologie a Hepatologie","volume":"39 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72510430","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}

{"title":"International experience with Crohn’s disease exclusion diet (CDED) with partial enteral nutrition (PEN)","authors":"N. El‑Lababidi","doi":"10.48095/ccgh2023140","DOIUrl":"https://doi.org/10.48095/ccgh2023140","url":null,"abstract":"The role of dietary intervention in the induction of remission of Crohn’s disease (CD) has been confirmed again by the recent ECCO (European Crohn’s and Colitis Organization) and ESPGHAN (European Society for Paediatric Gastroenterology, Hepatology and Nutrition) guidelines. Exclusive enteral nutrition (EEN) should be the method of choice in induction of remission of active luminal CD in children. Steroids should be reserved for situations when intolerance or infectivity of EEN is present. The main limitations of EEN consist of its monotony and palatability. In search for a safe and at least similarly effective diet, Crohn’s disease exclusion diet (CDED) was developed. The number of published data regarding its safety and efficacy has increased significantly since the publication of the first randomized controlled trial in 2019. CDED seems, to be safe and its efficacy is very promising. It seems that CDED could be used in three scenarios: as a monotherapy, as a part of complex treatment and as rescue therapy in cases of loss of response. The use of CDED is promising but further research for evaluation of its efficacy, including the necessity of using partial enteral nutrition, on larger patient cohorts is required. Keywords Crohn’s disease, exclusive enteral nutrition, steroids, Crohn’s Disease Exclusion Diet (CDED), adherence","PeriodicalId":38577,"journal":{"name":"Gastroenterologie a Hepatologie","volume":"39 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82200722","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}

{"title":"Telemedicine in hepatology – promising solution for our patients?","authors":"Daniel Ján Havaj, Svetlana Adamcová Selčanová, Daniela Žilinčanová, Ľ. Skladaný, J. Vnencakova","doi":"10.48095/ccgh2023130","DOIUrl":"https://doi.org/10.48095/ccgh2023130","url":null,"abstract":"Telemedicine refers to the remote provision of health care. Times of crisis like a pandemic and the increasing global burden of liver diseases call for finding innovative healthcare solutions to maintain and improve the standards of care. Provision of health care from a distance based on remote consultations, visits, and monitoring, in addition to standard care, uncovers the potential to improve the quality of care. Despite its challenges, the utilization of telemedicine in many areas of hepatology has been showing promising effects on access, healthcare quality, and cost-effectiveness. We report a case demonstrating the relevant position of telemedicine in the liver transplant decision-making process and our experiences with telehealth in routine clinical praxis. Keywords telemedicine, telehealth, teleconsultations, televisits, telemonitoring, liver disease, cirrhosis, liver transplantation, health care quality","PeriodicalId":38577,"journal":{"name":"Gastroenterologie a Hepatologie","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75944614","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}

{"title":"Epidemiological and demographic characteristics of individuals with irritable bowel syndrome based on the Rome III vs. Rome IV criteria in the Northern part of Serbia","authors":"Dusan Slankamenac, Darko Dabic, Aleksandra Dabic, Tamara Slankamenac, Andrej Preveden","doi":"10.48095/ccgh202343","DOIUrl":"https://doi.org/10.48095/ccgh202343","url":null,"abstract":"Summary: Background: Rome IV dia­gnostic criteria offer a new definition of IBS as opposed to Rome III. Practically, there have been 3 main changes made from the Rome III criteria to IV, such as abdominal discomfort, the threshold for the frequency of abdominal pain, and the relation of abdominal pain in IBS to defecation. The aims of this study were epidemiology of the IBS population and comparison of the characteristics of the subjects who fulfill Rome III vs. those who fulfill both III and IV criteria with regard to the IBS dia­gnosis. Methods: A sample of adult healthy population from the Municipality of Zrenjanin area was investigated through a questionnaire. All the subjects were approached from 5th March to 17th June, 2020. The study was submitted to and approved by the local Ethics Committee at the city hospital. Results: Based on the conducted survey in the Zrenjanin area, the IBS prevalence was reported to be 26.97% based on Rome III criteria. A larger number of women aged 18–21 was reported to have IBS. The most prevalent subtype noted was IBS-C. A significant correlation was noted between smoking, alcohol, drug abuse, other comorbidities, patient characteristics and stress factors in the IBS identified subjects. Conclusions: To sum up, our study recommends young people to be screened for IBS. Any symptom of change in stool frequency or consistency should raise a suspicion of IBS after undergoing all the relevant investigations for ruling out organic diseases. This will aid their early dia­gnosis and will help to improve their quality of life. Key words: irritable bowel syndrome – Rome III criteria – Rome IV criteria – epidemiology","PeriodicalId":38577,"journal":{"name":"Gastroenterologie a Hepatologie","volume":"33 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73498848","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}

{"title":"Biological therapy of ulcerative colitis during pregnancy","authors":"J. Koželuhová","doi":"10.48095/ccgh202326","DOIUrl":"https://doi.org/10.48095/ccgh202326","url":null,"abstract":"Summary: The annotated case report describes the case of a patient with ulcerative colitis (UC) who was successfully treated with infliximab at the beginning of disease due to failure of conventional therapy. For a long-term remission of UC, it was decided to end bio­logical therapy during the third trimester of pregnancy. For the relapse of UC after the delivery, the initiation of vedolizumab therapy was indicated, after which a remission of UC was achieved, and therefore VDZ maintenance treatment was continued in the following course. A new pregnancy occurred on this therapy, which developed without complications to the indicated treatment. This thesis evaluates the benefits and possible risks of bio­logical treatment during pregnancy. Key words: ulcerative colitis – pregnancy – infliximab – vedolizumab","PeriodicalId":38577,"journal":{"name":"Gastroenterologie a Hepatologie","volume":"139 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86708342","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}

{"title":"On the question of the interchangeability of monoclonal bio­similar antibodies in the treatment of immune-mediated inflammatory diseases","authors":"M. Lukáš, L. Šenolt, S. Gkalpakiotis","doi":"10.48095/ccgh202334","DOIUrl":"https://doi.org/10.48095/ccgh202334","url":null,"abstract":"","PeriodicalId":38577,"journal":{"name":"Gastroenterologie a Hepatologie","volume":"37 3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83128687","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}