Gastroenterologie a Hepatologie最新文献

{"title":"The importance of home parenteral nutrition in clinical practice – own experience from our workplace","authors":"Andrea Fojtová, Barbora Norek, K. Gazdíková","doi":"10.48095/ccgh202260","DOIUrl":"https://doi.org/10.48095/ccgh202260","url":null,"abstract":"Home parenteral nutrition is an alternative route and form of nutrition in patients with irreversible intestinal failure in whom enteral nutrition is not possible or is insufficient in the long run with an increasing energy deficit. Starting parenteral nutrition at home improves the quality of patients’ life and consequently also the course of the underlying disease, with optimization of clinical manifestations of malnutrition. The most common indications for home parenteral nutrition include large reductions of the absorption area due to intestinal resections (Crohn’s disease surgical complications, ischemic small bowel necrosis due to thrombosis in the superior mesenteric vein or embolism or atherosclerotic occlusion of the superior mesenteric artery, but also intestinal failures of different aetiology and cancer with sufficient utilization of essential nutrients). Keywords home parenteral nutrition, short bowel syndrome, komplikácie","PeriodicalId":38577,"journal":{"name":"Gastroenterologie a Hepatologie","volume":"64 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90268659","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":"Recommendations of the Working Group for IBD for the Diagnosis and Drug Treatment of Ulcerative Colitis","authors":"M. Bortlík, D. Ďuricová, L. Hrdlička, P. Matějková, A. Novotný, P. Drastich, V. Mandys, P. Mináriková, B. Pipek, I. Kajzrlíková, Lenka Nedbalová, J. Koželuhová, N. Machková, V. Zbořil, L. Prokopova, P. Kohout, Z. Šerclová, M. Vašátko, T. Douda, J. Stehlík, K. Mareš, M. Lukáš","doi":"10.48095/ccgh202213","DOIUrl":"https://doi.org/10.48095/ccgh202213","url":null,"abstract":"","PeriodicalId":38577,"journal":{"name":"Gastroenterologie a Hepatologie","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83881585","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":"Biosimilar treatment in paediatric gastroenterology – current view","authors":"J. Bronský","doi":"10.48095/ccgh202242","DOIUrl":"https://doi.org/10.48095/ccgh202242","url":null,"abstract":"Biosimilar drugs (BSD) have been used in the field of gastroenterology since 2013, when the European Medicines Agency approved biosimilar infliximab for the treatment of inflammatory bowel disease (IBD). The view of these drugs has changed significantly in the course of their use. At first, BSDs were used with hesitation, mainly due to the lack of published data on their efficacy and safety and also due to the lack of clinical experience. Over the following years, a number of studies were published that gradually support their importance in the treatment of IBD, and BSDs are now routinely administered to patients naïve to biological treatment, and a number of centres perform switches from the original treatment to a BSD. In paediatrics, a more reserved attitude towards their clinical use persisted for a long time, but with the growing amount of published data, they are also common in clinical practice. This summary article describes the development in the approach of both international and domestic professional societies and physicians-clinicians to the use of BSL and provides references to newly published studies of biosimilar drugs. Keywords pediatrie, biosimilární léčiva, biologic therapy, evropská léková agentura, switch, extrapolace","PeriodicalId":38577,"journal":{"name":"Gastroenterologie a Hepatologie","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82428762","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":"Point-of-care method for measuring infliximab and adalimumab trough levels in inflammatory bowel disease patients on biologic therapy","authors":"K. Kaštylová, K. Černá, Š. Luxová, Petr Sebek, M. Lukáš","doi":"10.48095/ccgh202235","DOIUrl":"https://doi.org/10.48095/ccgh202235","url":null,"abstract":"Aim of the study: To verify whether the results of infliximab and adalimumab concentration measurements by the point-of-care method ProciseDx correspond with the concentrations determined by enzyme-linked immunosorbent assay (ELISA). Methods: Twenty-three infliximab (IFX) and twenty-two adalimumab (ADL) concentrations were compared. IFX and ADL trough levels were measured by the ProciseDx point-of-care (POCT) system based on the Förster resonance energy transfer (FRET) principle, and by standard immunoassay (ELISA) in a clinical laboratory. Results: Spearman‘s correlation coefficient for IFX R = 0.9400 (P = 0.0001) and the weighted Cohen‘s kappa of 0.93 indicate a good correlation between data measured by two different measurement systems. The same excellent correlation of values was achieved for ADL, where R = 0.9098 (P = 0.0001) and the weighted Cohen‘s kappa is 0.834. Conclusion: The ProciseDx POCT system is a highly reliable method for measuring serum trough IFX and ADL levels in IBD patients. It is easy to operate and fast, it brings more effectiveness to the IBD biological treatment and reduces financial and time burden of this therapy. Keywords inflammatory bowel disease, infliximab, adalimumab, biologic therapy, proaktivní terapeutické monitorování léčiv, reaktivní terapeutické monitorování léčiv, point-of-care monitoring","PeriodicalId":38577,"journal":{"name":"Gastroenterologie a Hepatologie","volume":"26 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81304687","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":"Desmoid fibromatosis – a rare mesenteric tumor","authors":"Lukáš Grochol, I. Cibulková, J. Hrudka, J. Hajer","doi":"10.48095/ccgh202267","DOIUrl":"https://doi.org/10.48095/ccgh202267","url":null,"abstract":"In the following report, we present the case of a 31-year-old patient examined for a suspected small bowel tumour. Small bowel tumours are relatively rare and definitive diagnosis is often preceded by surgical resection. The same was true for our patient examined for a soft tissue lesion found with imaging techniques in close proximity to the small intestine. After ruling out hormonal activity, diagnostic laparotomy was performed. Desmoid fibromatosis, a rare tumour of the mesentery, was confirmed histopathologically. Although without metastatic potential, desmoid fibromatosis is a tumour with moderately malignant potential for aggressive growth into surrounding structures and organs and a large percentage of local recurrences.","PeriodicalId":38577,"journal":{"name":"Gastroenterologie a Hepatologie","volume":"50 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89358453","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":"Complicated course of Crohn’s disease of the small intestine in the patient in the eighth decade of life","authors":"Štěpán Peterka","doi":"10.48095/ccgh202230","DOIUrl":"https://doi.org/10.48095/ccgh202230","url":null,"abstract":"Crohn‘s disease (CD) comes within the group of idiopathic bowel diseases (IDP), together with ulcerative colitis (UC). Their common characteristic is that genetically predisposed individuals suffer from chronic digestive tract inflammation. In spite of almost 90 years of experience, CD remains an incurable disease. The clinical manifestation of the disease displays great heterogeneity. A discrepancy between the clinical picture and morphological finding in the digestive tract is one of the typical features of CD. Basic treatment consists of pharmacotherapy – conventional and/or biological – and surgery where needed. The aim is to achieve and maintain deep remission, limit the number of large-scale surgical interventions, and normalise the patients’ quality of life. The case history presents a female patient suffering from CD with extensive penetrating damage of the small intestine diagnosed in the eighth decade of her life. The patient’s case illustrates the difficulty of treating elderly patients, especially in the case of a severe form of Crohn’s disease. Keywords Crohn’s disease, surgical treatment, penetrující forma, exkluzivní enterální výživa","PeriodicalId":38577,"journal":{"name":"Gastroenterologie a Hepatologie","volume":"154 1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90801830","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":"Azathioprine in the therapy of paediatric inflammatory bowel disease – part I: treatment indications, dosing and thiopurine-related adverse events","authors":"Kristýna Pospíšilová, J. Bronský","doi":"10.48095/ccgh2021500","DOIUrl":"https://doi.org/10.48095/ccgh2021500","url":null,"abstract":"Background: Thiopurines (in Europe mainly azathioprine) are widely used in the treatment of inflammatory bowel diseases in children. Due to a prolonged time until the onset of therapeutic effect, those drugs are aimed to be used in the maintenance phase of the therapy rather than for induction of remission. Thiopurines are sometimes used in combination therapy (with aminosalicylates or biological treatment agents). The adverse events of these drugs occur as often as in 15–40% cases and may lead to treatment cessation in a significant number of patients. Aims: To overview available information on (mainly) children suffering from inflammatory bowel disease. Conclusion: Genetic examination accompanied with laboratory monitoring of blood count parameters (specifically at the beginning of therapy) and biochemistry can help prevent some of the severe adverse events. Keywords Crohn’s disease, ulcerative colitis, pediatrie, merkaptopurin, thiopuriny","PeriodicalId":38577,"journal":{"name":"Gastroenterologie a Hepatologie","volume":"33 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73955522","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":"Gluten-related immunogenic peptides in stool as means to monitor compliance with gluten-free diet in children with newly dia gnosed coeliac disease","authors":"R. Vyhnánek, Z. Khaznadar, Roman Vyhnánek, Milan Paulík","doi":"10.48095/ccgh2021519","DOIUrl":"https://doi.org/10.48095/ccgh2021519","url":null,"abstract":"Objectives and study: To compare the values of gluten-related immunogenic peptides (GIP) in stool and anti-tissue transglutaminase IgA antibodies (anti-tTG IgA) in blood in children newly diagnosed with coeliac disease (CD). Methods: All children (2–15 y) newly diagnosed with CD between May 2018 and May 2020 at our clinic who complied with the inclusion criteria were invited to join the prospective study. During workup for CD, a stool sample to measure GIP was taken together with a blood sample to measure anti-tTG IgA. All newly diagnosed children were invited 4 months later for a check-up. Children and their caregivers were asked about known non-compliance with the gluten-free diet (GFD), a blood sample was taken to measure the anti-tTG IgA, and a stool sample was collected to measure GIP. Blood was evaluated for anti-tTG IgA by ELISA, and the stool was tested by quantitative Sandwich ELISA designed to detect and quantify GIP using the G12 antibody. Values of GIP and anti-tTG IgA were compared in terms of their relation to the upper limit of normal (ULN) of the particular method. Results: 29 children (18 girls) were enrolled in the study. The values of GIP in stool at the time of diagnosis were above the ULN (0.15 µg/g) in all children. Average 4.21, median 3.29, standard deviation (SD) 3.7. After the four months, all but three (89.7%) had values of GIP in the reference range. Average 0.29, median 0.12, SD 0.73. Similarly, anti-tTG IgA values were above the ULN (9.9 U/mL) at the time of diagnosis in all children. Average 164, median 195, SD 49. Although the anti-tTG IgA levels were lower at check-up in all but one child, only 10 (34.5%) showed values within the normal range, with an average of 27.9, median 12.0, and SD 38.9. All children declared strict adherence to GFD. Discussion: Using the GIP concentration in stool, adherence to GFD in our cohort of children is very good, better than that described in literature. Conclusion: Measuring GIP in stool could prove a more sensitive indicator of adherence to GFD in the early months after the diagnosis of CD when anti-tTG IgA are still elevated above the ULN due to their well-described gradual decrease after GFD initiation.","PeriodicalId":38577,"journal":{"name":"Gastroenterologie a Hepatologie","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91139043","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":"Eff ect of ursodeoxycholic acid in postcholecystectomy cholestatic hepatopathy verified by ultrasonography","authors":"K. Demková, J. Tokarčík, Tibor Varga, M. Rudnay, D. Šafčák","doi":"10.48095/ccgh2021545","DOIUrl":"https://doi.org/10.48095/ccgh2021545","url":null,"abstract":"Summary: Cholestasis syndrome is accompanied by a large number of diverse liver and biliary tract diseases. Many cholestatic changes are fully reversible in the fi rst phase. However, with long-term cholestasis, extensive hepatocyte dysfunction occurs, the disease progresses, and many cholestatic syndromes result in irreversible liver damage and failure. Cholestatic liver diseases represent an important group of liver diseases that are an indication for liver transplantation. Postcholecystectomy syndrome is an imprecisely defi ned term, which includes a set of ongoing or recurrent or new diffi culties of patients after gallbladder surgery. We distinguish between early postcholecystectomy syndrome immediately in the postoperative period, or late postcholecystectomy syndrome, which occurs months or even years later. Ultrasonography is the fi rst imaging examination method for diseases of the liver and hepatobiliary system. It is a non-invasive method, available, relatively cheap, easily repeatable, and it does not represent a burden for the patient. Common bile duct dilatation after cholecystectomy is a common accidental fi nding that is inconclusive in the absence of clinical symptomatology and with normal laboratory fi ndings. Ursodeoxycholic acid forms the basis of cholestasis therapy, the only treatment whose effi cacy in cholestatic liver disease has been demonstrated in randomized and long-term studies. A further positive is that many years of ursodeoxycholic acid administration are not accompanied by more serious side eff ects. This case report supports the concept of a prompt and at the same time deepening benefi cial eff ect of ursodeoxycholic acid treatment in patients with cholestatic hepatopathy verified by ultrasonography indicated for conservative treatment or refusing invasive treatment. Key words: cholestasis – postcholecystectomy syndrome – ultrasonography – ursodeoxycholic acid","PeriodicalId":38577,"journal":{"name":"Gastroenterologie a Hepatologie","volume":"33 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78764573","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":"Smoking and oncology – off ering smokers a scientifi cally based, less harmful alternative is ethical","authors":"K. Michnová","doi":"10.48095/ccgh202151571","DOIUrl":"https://doi.org/10.48095/ccgh202151571","url":null,"abstract":"","PeriodicalId":38577,"journal":{"name":"Gastroenterologie a Hepatologie","volume":"62 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73988596","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}