Gastroenterologie a Hepatologie最新文献

{"title":"Bariatric restrictive surgeries and nutrition","authors":"Michaela Hosnedl","doi":"10.48095/ccgh2022492","DOIUrl":"https://doi.org/10.48095/ccgh2022492","url":null,"abstract":"In the case of restrictive procedures, more than elsewhere, consistent preparation of the patient is crucial. A nutritional therapist participates in this and tries to pass on partial knowledge not only about nutrition, to such an extent that the patient is subsequently able to continue the reduction himself. The entire multidisciplinary team participates in the education making an effort to maximize the probability of the success of the restrictive procedure and thereby increase the patient’s quality of life. Approaches differ within the individuality of patients and within the type of restrictive procedure. Sufficient motivation and cooperation fundamentally influence the entire process that the person goes through. Keywords restrictive procedures, bariatric surgery, enteral nutrition, nutritional intervention","PeriodicalId":38577,"journal":{"name":"Gastroenterologie a Hepatologie","volume":"51 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73928175","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":"“Vanishing bile duct syndrome” as a manifestation of drug-induced liver damage in a patient after polytrauma","authors":"Xénia Faktorová, M. Žigrai, Silvia Žigraiová, L. Horniaková, Svetlana Adamcová Selčanová, Roman Belica, D. Guga, M. Vyskočil","doi":"10.48095/ccgh2022499","DOIUrl":"https://doi.org/10.48095/ccgh2022499","url":null,"abstract":"Summary: Vanishing bile duct syndrome is a type of drug-induced cholestatic liver injury that occurs when the body is exposed to drugs or other foreign substances. We hospitalized a 44-year-old, so far healthy, male with gradually developing painless icterus and pruritus of the whole body after severe polytrauma. The patient had previously undergone a complex treatment (antibio tics, antifungals, parenteral nutrition, LMWH). Laboratory tests revealed a several-fold elevation of total and conjugated bilirubin with a 3-fold increase in ALP levels, no signifi cant elevation of transaminases, a decrease in prothrombin time and IgG4 antibody positivity. An MRCP scan was performed revealing irregular intrahepatic bile ducts, a dilated common bile duct and characteristics of primary or secondary sclerosing cholangitis. Further examinations ruled out infectious, metabolic, toxic and oncological causes of hepatopathy. A liver bio psy ruled out both autoimmune hepatitis and IgG4 hepatopathy and displayed images of “vanishing bile duct syndrome” in drug-induced liver injury (DILI). Empirical treatment with high-dose intravenous N-acetylcysteine and other hepatoprotective agents led to a gradual decrease of bilirubin, normalization of coagulation parameters and remission of icterus and clinical complaints. This case report points to a cholestatic type of drug-induced liver injury with histologically confi rmed vanishing bile duct syndrome and the need to think of DILI as one of the causes of the otherwise unexplained hepatopathy. Key words: cholangitis – DILI – hepatopathy – IgG4 – vanishing bile duct syndrome","PeriodicalId":38577,"journal":{"name":"Gastroenterologie a Hepatologie","volume":"57 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79567839","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":"Endoscopic findings in cirrhotic children candidates for liver transplantation","authors":"S. Dehghani, M. Abbasi, M. Ataollahi, M. Tahani, F. Parooie, I. Shahramian","doi":"10.48095/ccgh2022479","DOIUrl":"https://doi.org/10.48095/ccgh2022479","url":null,"abstract":"Background: Liver cirrhosis is an end-stage liver failure that can develop as a result of acute or chronic liver disease. Patients are at risk of fatal complications such as portal hypertension and bleeding from esophageal varices. Methods: This cross-sectional study examined the endoscopic findings in child patients <18 years with cirrhosis qualifying as candidates for liver transplantation. Our subjects were children admitted from 2012 to 2017 to the Shiraz Organ Transplantation Center of Nemazee Hospital, Shiraz University of Medical Sciences. The data was collected using a researcher-made questionnaire. Results: We studied 199 patients (49.2% boys) with liver cirrhosis admitted for upper gastrointestinal endoscopy. Their average age was 6.2 ±4.7 years old. The most common clinical sign present at admission was icterus (58.8%). The mean values of the children’s Child-Pugh and PELD/MELD scores were 8.53 ±2.34 and 14.85 ±14.93, respectively. Of 199 children examined, 145 total (72.8%) suffered from esophageal varices, further divided by severity into grades 1, 2, 3, and 4 – 39 (19.7%), 53 (26.8%), 42 (21.2%), 11 (5.6%), respectively. Further symptoms, such as portal hypertensive gastropathy (PHG), gastric erythema, fundal varices, gastric erosion, and gastric ulcer were found in 31.1%, 15.1%, 6.5%, 5.5%, and 2% of the patients, respectively. No associations were observed between esophageal or gastric varices and Child-Pugh (P = 0.076), PELD/MELD score (P = 0.607), clinical symptoms, laboratory parameters, or underlying diseases. Conclusion: Our patients’ main cause of liver cirrhosis was biliary atresia, and the most common presenting sign in endoscopy was esophageal varices. Keywords biliary atresia, esophageal varices, jaundice, endoscopic treatment","PeriodicalId":38577,"journal":{"name":"Gastroenterologie a Hepatologie","volume":"52 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81531661","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":"Abnormal liver functional tests in children with congenital heart diseases – a cross-sectional study in the south-east of Iran","authors":"I. Shahramian, A. Bazi, E. Akhlaghi, N. Noori, M. Tahani","doi":"10.48095/ccgh2022485","DOIUrl":"https://doi.org/10.48095/ccgh2022485","url":null,"abstract":"Background: The clinical implication of abnormal liver functional tests (LFTs) is not well studied in children with congenital heart diseases (CHDs). We aimed to screen LFTs in children with CHDs. Methods: LFTs including liver enzymes (AST, ALT and ALP), as well as direct bilirubin (DB), total bilirubin and albumin were measured in 80 children with CHDs. Results: Ventricular septal defect (VSD), tetralogy of Fallot (TOF), atrial septa defect (ASD), congestive heart failure (CHF) and Patent ductus arteriosus (PDA) accounted for 45 (67.4%), 3 (3.8%), 25 (20%), 2 (2.5%) and 5 (6.2%) of our patients, respectively. Abnormally elevated ALT, AST, ALP, DB, TB and reduced total protein were identified in 3 (3.8%), 21 (26.2%), 6 (7.6%), 10 (12.5%), 7 (8.8%) and 43 (53.8%), respectively. There was no significant difference in LFTs among various CHDs except for AST (P = 0.04). The mean level of AST was significantly lower in children with VSD (31.4 ±10.7 IU/l) than those of TOF (48.3 ±22.8 IU/l, P = 0.03) and ASD (36.8 ±9.8 IU/l, P = 0.03). Conclusion: Considering the respectively high incidence of abnormal LFTs in children with CHDs, it is advisable to regularly monitor these tests to timely manage any progressions toward congestive or ischaemic hepatitis. Keywords congenital heart disease, ventricular septal defect, heart failure, ischaemic hepatitis","PeriodicalId":38577,"journal":{"name":"Gastroenterologie a Hepatologie","volume":"81 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84120042","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":"The impact of insulin resistance and NAFLD after liver transplantation on patient survival and development of chronic kidney disease","authors":"I. Mikova, Denisa Kyselová, K. Dvor̆áková, M. Dezortova, M. Hájek, M. Cahova, H. Daňková, V. Lánská, J. Spicak, P. Trunec̃ka","doi":"10.48095/ccgh2022429","DOIUrl":"https://doi.org/10.48095/ccgh2022429","url":null,"abstract":"Summary: Introduction: Insulin resistance (IR) is a hallmark of non-alcoholic fatty liver disease (NAFLD), which has been associated with worse long-term survival and more frequent occurrence of chronic kidney disease (CKD) than in patients without NAFLD. The aim of our study was to evaluate the impact of NAFLD and IR on survival and renal function in patients after liver transplantation (LT). Methods: Our prospective study included 96 LT candidates who were observed after LT. We evaluated patient survival and occurrence of CKD (defined as estimated glomerular filtration [eGFR] ≤1.00 mL/s/1.73 m2 or overt proteinuria) 5 years after LT and at the end of follow-up. Clinical, laboratory, MR and elastographic evaluation before and 1 year after LT were performed as well as liver biopsy 1 year after LT. Results: Of the factors present 1 year after LT, higher ALT (P = 0.021), ALP (P = 0.012) and everolimus treatment (P = 0.025) increased the risk of death at the end of follow-up, borderline significance was found also for higher waist circumference (P = 0.058), AST (P = 0.059), HOMA-IR (P = 0.056) and presence of fibrosis stage ≥3 in biopsy (P = 0.055). In addition to the presence of CKD 1 year after LT (P <0.001), other independent posttransplant risk factors of CKD 5 years after LT included presence of IR defined as HOMA-IR ≥3 (OR 4.33; 95% CI 1.25–15.04; P = 0.021) and higher serum high-molecular-weight (HMW) adiponectin (OR 1.25; 95% CI 1.03–1.50; P = 0.021). Of the factors present 1 year after LT, diabetes treated by antidiabetics (P = 0.008), higher serum levels od triglycerides (P = 0.031), C-peptide (P = 0.022) and leptin (P = 0.002) and lower total bilirubin (P = 0.006) were associated with lower eGFR at the end of follow-up. We observed a trend towards higher eGFR levels in patients treated with everolimus (P = 0.055). We did not observe an impact of grade of steatosis and presence of steatohepatitis on biopsy 1 year after LT on survival or renal functions. Conclusion: Presence of IR 1 year after LT independently increased the risk of CKD 5 year after LT. Patients with higher HOMA-IR 1 year after LT had a trend towards worse survival at the end of follow-up. Key words: insulin resistance – non-alcoholic fatty liver disease – liver transplantation – chronic kidney disease – survival","PeriodicalId":38577,"journal":{"name":"Gastroenterologie a Hepatologie","volume":"26 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86015750","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":"Is it possible to individualize discontinuation of anticoagulant therapy before preventive colonoscopy?","authors":"J. Cyrany, K. Hejcmanová, R. Chloupková, O. Ngo, O. Májek, M. Zavoral, S. Suchanek, S. Rejchrt, I. Tachecí","doi":"10.48095/ccgh2022386","DOIUrl":"https://doi.org/10.48095/ccgh2022386","url":null,"abstract":"Summary: Background: Hot-snare polypectomy is a standard method for removal of polyps larger than 10 mm. It is recommended to discontinue anticoagulant therapy before this procedure to reduce a bleeding risk. In contrast, diagnostic colonoscopy and cold-snare polypectomy up to 10 mm are considered safe during uninterrupted anticoagulation therapy (with only omission of the direct oral anticoagulant therapy on the day of the procedure). The increasing number of anticoagulated individuals undergoing a colorectal cancer screening program leads to efforts to individualize the interruption of anticoagulation therapy. Aim: Estimation of probability that adenomatous polyp over 10 mm is detected during preventive colonoscopy in the Czech Republic in particular population groups according to gender and age. Methods: We retrospectively analyzed data from prospective database (Registry of Preventive Colonoscopies) covering screening colonoscopies and colonoscopies indicated for immunochemical faecal occult blood test positivity (FIT-positive). A distinction was made between adenoma polyps ≤10 mm and >10 mm. The patient was categorized according to the largest polyp diameter in case of detection of multiple polyps. Results: Between 2016 and 2020, 16,942 and 52,052 adenomatous polyps were found during 55,546 screenings and 119,229 FIT-positive colonoscopies, representing adenoma detection rate (ADR) of 31% and 44%, respectively. The estimate of probability of significant polyp detection (over 10 mm) and the need of hot-snare polypectomy ranged widely (2.3–21.6%) depending on age, sex and indication. It can be estimated to 7% in females and 5–10% in males undergoing screening colonoscopy. For colonoscopies indicated for positive stools for occult bleeding, this probability is approximately two to three times higher in FIT-positive colonoscopies: it exceeds 10% in woman over 60 years of age and is 15% and more in men of all ages (over 20% in men over 60 years of age). Conclusions: The decision to discontinue anticoagulation therapy prior to preventive colonoscopy can be individualized with respect to the indication (screening vs. FIT-positive), age and gender of examined person – we prefer to discontinue the anticoagulation therapy in FIT-positive people over 60 years and/or of male gender. The individual thromboembolic risk during interruption of anticoagulation therapy must be considered depending on the specific indication (e. g. CHA2DS2 VASc score in atrial fibrillation). Key words: colonoscopy – anticoagulant therapy – direct-acting oral anticoagulants – cancer screening – personalized medicine","PeriodicalId":38577,"journal":{"name":"Gastroenterologie a Hepatologie","volume":"49 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77563834","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":"The benefit of biosimilar monoclonal antibodies in the therapy of inflammatory bowel diseases","authors":"M. Lukáš","doi":"10.48095/ccgh2022447","DOIUrl":"https://doi.org/10.48095/ccgh2022447","url":null,"abstract":"Summary: Nineteen years ago, the biosimilars, “copies” of the original therapeutic monoclonal antibodies, have been introduced in the clinical practice. The beginnig was associated with some confusion from health care providers, but today it is indisputable that their implementation in practice was one of the most significant changes that led to an increase in the availability of biological treatment, cost reduction and significant impact on management of patients with inflammatory bowel diseases. Key words: inflammatory bowel disease – biological treatment – biosimilars","PeriodicalId":38577,"journal":{"name":"Gastroenterologie a Hepatologie","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82469048","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":"Colorectal cancer screening program in the Czech Republic – 2021 quality indicators evaluation","authors":"R. Chloupková, O. Ngo, S. Suchanek, M. Zavoral, Lucie Martykánová, K. Hejduk, O. Májek","doi":"10.48095/ccgh2022379","DOIUrl":"https://doi.org/10.48095/ccgh2022379","url":null,"abstract":"Summary: Background: Compared to other European countries, the Czech Republic has long been one of the countries with high rates of incidence and mortality of colorectal cancer. The screening program was implemented in 2000 and has become an essential part of prevention policy in the Czech Republic. Continuous monitoring of the entire screening process is necessary to ensure high quality and the resulting success of the program. The aim of the paper is to present the current results of the National Colorectal Cancer Screening Program using selected indicators in accordance with established recommendations. Material and Methods: The analysis was performed on data on preventive colonoscopies performed in Centers for screening colonoscopy (Centers) in 2021, with selected performance indicators being evaluated (number of preventive colonoscopies, adequate bowel preparation, caecal intubation rate and adenoma detection rate). The resulting performance indicators were evaluated by the published recommendations of the Czech Gastroenterological Society to point to the results of the program as a whole, not to assess individual Centers. Results: The majority (94.7%) of the Centers achieved the basic performance indicator (number of preventive colonoscopies). The performance indicator of adequate bowel preparation was met by 83.6% of Centers (the average proportion of colonoscopies with adequate bowel preparation in the Czech Republic is 93.8%). The optimal proportion of caecal intubation (90.0%) was reached by 87.2% of Centers in 2021. Only 16 Centers (8.5%) did not meet the adenoma detection rate indicator, but a high variability was observed across the Centers (11.6% to 68.2%) – a similar situation was observed in evaluation by gender and indication. A relatively low adenoma detection rate in follow-up colonoscopies after positive FOBT could be related to high and variable FOBT, which may indicate redundant colonoscopies and overburden the Centers. Conclusion: Some Centers do not reach the reference values for performance indicators according to reference values. It is necessary to continue monitoring performance indicators at the level of individual Centers to improve the quality of the entire program. Key words: colorectal cancer – screening – performance indicators – colonoscopy","PeriodicalId":38577,"journal":{"name":"Gastroenterologie a Hepatologie","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85973681","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":"Endosonography and elastography in the diagnosis of pancreatic neuroendocrine tumors","authors":"P. Uhrík, L. Nosáková, M. Kalman, M. Pindura, Z. Uhrikova, P. Bánovčin","doi":"10.48095/ccgh2022418","DOIUrl":"https://doi.org/10.48095/ccgh2022418","url":null,"abstract":"Summary: Introduction: The group of neuroendocrine tumors derived from pancreatic cells is called pancreatic neuroendocrine tumors (PNETs). The combination of EUS and elastography (EG) expands diagnostic and imaging capabilities. Aim: The aim of our work was to determine the representative images of B-mode for PNET, evaluation of a typical EG image of PNETs, use of strain ratio (SR) and “strain histogram” (SH) in differential diagnosis of PNETs, determination of SR and SH cut off value for PNETs and comparison of standardized measurements with literature. Methods: Patients examined at the Internal Gastroenterology Clinic were included in the cohort. A total of 31 patients were examined. The group included 25 patients (8 men, 17 women). The mean age in group was 52.76 years (14–74). Non-invasive examination by endoscopic ultrasonography was performed on all patients. After locating the lesion by ultrasound, the first recording was made after freezing the image in B-mode and performing size measurement. Subsequently, a Strain elastography measurement was performed. In the monitored group we recorded an average size of 12.75 mm. Results: The characteristics of the image in B-mode were as follows for PNETs 68% hypoechogenic, 12% hyperechogenic, 12% isoechogenic and 8% mixed echogenicity. 80% of PNETs in B-mode were sharply demarcated and 20% with blurred borders. The accuracy of the value assignment typical of pancreatic malignancies using elastography was 96% for PNET in 5-degree classification system and 88% for a 4-degree classification, for SR cut off >3.2 with a sensitivity of 80% and SH cut off <50 100%. Discussion: Given the average tumor sizes observed in our study, EUS provides high sensitivity in PNET diagnostics and allows diagnostics at a time when minimally invasive removal is still possible. In addition to the typical picture of hypoechogenicity and the less frequently described pictures of hyperechogenicity and isoechogenicity for PNET, we also observed mixed echogenicity. The elastographic qualitative strain image evaluated by the four- and five- -degree classification proved to be reliable in distinguishing PNET from benign tumors. In quantitative elastography, the values of SR are between malignant and benign deposits of the pancreas, one of the reasons for such values may be the diversity of this group of diseases with different mitotic activity – grade of the tumor. Conclusion: Consistency of the results published by us, shows the applicability of this method in deciding on a definitive diagnosis if tumor histology is not and cannot be available. Key words: neuroendocrine tumor – pancreas – ultrasonography – elastography","PeriodicalId":38577,"journal":{"name":"Gastroenterologie a Hepatologie","volume":"86 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77270924","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":"Bile acid malabsorption in oncology patients","authors":"D. Kohoutová, D. Zogala, J. Doležal, Otto Lang, J. Bureš","doi":"10.48095/ccgh2022399","DOIUrl":"https://doi.org/10.48095/ccgh2022399","url":null,"abstract":"Summary: Bile acid malabsorption (BAM) is caused by dysregulation of enterohepatic circulation of bile acids and their synthesis in the liver. Estimated prevalence is about 1% of adult population. BAM has been substantially underdiagnosed. This condition can be present in one third of patients with diarrhoea-predominant irritable bowel syndrome and in 50–100% of Crohn‘s disease with ileitis or previously resected terminal ileum. Up to one half of oncology patients with pelvic radiotherapy suffer from BAM. SeHCAT test (75Selenium HomoCholic Acid Taurine test) is the gold diagnostic standard and the test has just become available in the Czech Republic. Low-fat diet is the most important dietary modification. Bile acids sequestrants (cholestyramine in the Czech Republic) are the crucial part of pharmacotherapy. Key words: bile acid malabsorption – SeHCAT test – cholestyramine","PeriodicalId":38577,"journal":{"name":"Gastroenterologie a Hepatologie","volume":"79 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77664262","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}