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Douda L, Hyšpler R, Mžik M, Vokurková D, Drahošová M, Řeháček V, Čermáková E, Douda T, Cyrany J, Fejfar T, Jirkovský V, Kopáčová M, Kupková B, Vašátko T, Tachecí I, Bureš J. Serum Citrulline and Ornithine: Potential Markers of Coeliac Disease Activity. Acta Medica (Hradec Kralove) 2023; 65:75-82. [PMID: 36735884 DOI: 10.14712/18059694.2022.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
INTRODUCTION To date, there is not generally accepted and universal indicator of activity, and functional integrity of the small intestine in patients with coeliac disease. The aim of our study was to investigate whether serum concentrations of the non-essential amino acids citrulline and ornithine might have this function. METHODS We examined serum citrulline and ornithine concentrations in a subgroup of patients with proven coeliac disease and healthy controls (blood donors). RESULTS A total of 94 patients with coeliac disease (29 men, mean age 53 ± 18 years; 65 women, mean age 44 ± 14 years) and 35 healthy controls (blood donors) in whom coeliac disease was serologically excluded (10 men, mean age 51 ± 14 years; 25 women, mean age 46 ± 12 years) were included in the study. Significantly lower concentrations of serum ornithine were found in patients with coeliac disease (mean 65 ± 3 μmol/L; median 63 μmol/L, IQR 34 μmol/L, p < 0.001). No statistically nor clinically significant differences were found in the citrulline concentrations between the study and control group. CONCLUSIONS Serum ornithine (but not citrulline) may be useful for assessing the functional status of the small intestine in uncomplicated coeliac disease. Further studies involving more detailed analysis of dietary and metabolic changes in patients will be needed to reach definitive conclusions.
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Affiliation(s)
- Ladislav Douda
- 2nd Department of Internal Medicine - Gastroenterology, Charles University, Faculty of Medicine in Hradec Králové and University Hospital Hradec Králové, Czech Republic
| | - Radomír Hyšpler
- Institute of Clinical Biochemistry and Diagnostics, Charles University, Faculty of Medicine in Hradec Králové and University Hospital Hradec Králové, Czech Republic
| | - Martin Mžik
- Institute of Clinical Biochemistry and Diagnostics, Charles University, Faculty of Medicine in Hradec Králové and University Hospital Hradec Králové, Czech Republic
| | - Doris Vokurková
- Department of Clinical Immunology and Allergology, Charles University, Faculty of Medicine in Hradec Králové and University Hospital Hradec Králové, Czech Republic
| | - Marcela Drahošová
- Department of Clinical Immunology and Allergology, Charles University, Faculty of Medicine in Hradec Králové and University Hospital Hradec Králové, Czech Republic
| | - Vít Řeháček
- Transfusion Department, University Hospital Hradec Králové, Czech Republic
| | - Eva Čermáková
- Department of Medical Biophysic, Charles University, Faculty of Medicine in Hradec Králové, Czech Republic
| | - Tomáš Douda
- 2nd Department of Internal Medicine - Gastroenterology, Charles University, Faculty of Medicine in Hradec Králové and University Hospital Hradec Králové, Czech Republic
| | - Jiří Cyrany
- 2nd Department of Internal Medicine - Gastroenterology, Charles University, Faculty of Medicine in Hradec Králové and University Hospital Hradec Králové, Czech Republic
| | - Tomáš Fejfar
- 2nd Department of Internal Medicine - Gastroenterology, Charles University, Faculty of Medicine in Hradec Králové and University Hospital Hradec Králové, Czech Republic
| | - Václav Jirkovský
- 2nd Department of Internal Medicine - Gastroenterology, Charles University, Faculty of Medicine in Hradec Králové and University Hospital Hradec Králové, Czech Republic
| | - Marcela Kopáčová
- 2nd Department of Internal Medicine - Gastroenterology, Charles University, Faculty of Medicine in Hradec Králové and University Hospital Hradec Králové, Czech Republic
| | - Blanka Kupková
- 2nd Department of Internal Medicine - Gastroenterology, Charles University, Faculty of Medicine in Hradec Králové and University Hospital Hradec Králové, Czech Republic
| | - Tomáš Vašátko
- 2nd Department of Internal Medicine - Gastroenterology, Charles University, Faculty of Medicine in Hradec Králové and University Hospital Hradec Králové, Czech Republic
| | - Ilja Tachecí
- 2nd Department of Internal Medicine - Gastroenterology, Charles University, Faculty of Medicine in Hradec Králové and University Hospital Hradec Králové, Czech Republic.
| | - Jan Bureš
- Biomedical Research Centre, University Hospital Hradec Králové, Hradec Králové, Czech Republic
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Abstract
Early gastric cancer is defined histopathologically as a tumour with limited local progression to the mucosa and submucosa. The concept of early cancer was developed in the 1960s in Japan and is now widely accepted. The term of early gastric cancer included cases with/without metastatic lymph node involvement. However, a common characteristic is a favourable prognosis of the disease. The task of the endoscopist is primarily to diagnose (identify) the tumour (precancerous lesions) and to verify it by biopsy. Successful identification must be followed by its correct classification, leading to the choice of an adequate approach, which includes surveillance, endoscopic treatment (resection) or surgical treatment (with or without chemotherapy). The method of treatment is determined primarily by the nature or risk of lymph node involvement.
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Melek J, Štanclová M, Dědek P, Štichhauer R, Koudelka J, Douda T, Tachecí I, Douda L, Vaňásek T, Bureš J. Mucosal healing is not associated with better outcome during 7 years of follow-up in pediatric patients with Crohn's disease. Minerva Pediatr (Torino) 2021:S2724-5276.21.06099-0. [PMID: 33845563 DOI: 10.23736/s2724-5276.21.06099-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Mucosal healing (MH) has become a perspective treatment target in patients with Crohn's disease (CD). Data about the impact of MH on long-term outcome in pediatric patients are still scarce. METHODS 76 pediatric patients with CD were evaluated retrospectively (2000-2015) in a tertiary care center. Based on MH achievement, they were divided into two groups (MH, n= 17; and No MH, n=59). The primary endpoint was to assess the association of MH and the need for CD-related hospitalizations or surgery in pediatric patients with CD. RESULTS The number of hospitalized patients was 24% in the MH group and 42% in the No MH group, P = 0.26. The total number of CD-related hospitalizations was not significant between the MH group and the No MH group (5 vs. 41, P = 0.15). The time to the first hospitalization was 24 months in MH and 21 months in No MH, P>0.99. 24% patients in the MH group and 39% patients in the No MH group underwent CD-related operation, P = 0.39. Time to the first operation was 43 months for MH and 19 months for the No MH group, P = 0.13. The follow-up period was 91 months in the MH group and 80 months in the No MH group, P = 0.74. The use of infliximab was positively associated with MH, P = 0.002. CONCLUSIONS MH was not associated with fewer CD-related hospitalizations or operations in pediatric patients with CD during seven years of follow-up.
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Affiliation(s)
- Jan Melek
- Department of Pediatrics, Faculty of Medicine in Hradec Králové, University Hospital Hradec Králové, Charles University in Prague, Hradec Králové, Czech Republic -
| | - Markéta Štanclová
- Department of Pediatrics, Faculty of Medicine in Hradec Králové, University Hospital Hradec Králové, Charles University in Prague, Hradec Králové, Czech Republic
| | - Petr Dědek
- Department of Pediatrics, Faculty of Medicine in Hradec Králové, University Hospital Hradec Králové, Charles University in Prague, Hradec Králové, Czech Republic
| | - Radek Štichhauer
- Department of Pediatric Surgery and Traumatology, University Hospital in Hradec Kralove, Hradec Králové, Czech Republic
| | - Jaroslav Koudelka
- Department of Pediatric Surgery and Traumatology, University Hospital in Hradec Kralove, Hradec Králové, Czech Republic
| | - Tomáš Douda
- 2nd Department of Internal Medicine - Gastroenterology, University Hospital in Hradec Kralove, Hradec Králové, Czech Republic
| | - Ilja Tachecí
- 2nd Department of Internal Medicine - Gastroenterology, University Hospital in Hradec Kralove, Hradec Králové, Czech Republic
| | - Ladislav Douda
- 2nd Department of Internal Medicine - Gastroenterology, University Hospital in Hradec Kralove, Hradec Králové, Czech Republic
| | - Tomáš Vaňásek
- Hepato-Gastroenterologie HK, s.r.o, Hradec Králové, Czech Republic
| | - Jan Bureš
- 2nd Department of Internal Medicine - Gastroenterology, University Hospital in Hradec Kralove, Hradec Králové, Czech Republic
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Bures J, Kvetina J, Radochova V, Tacheci I, Peterova E, Herman D, Dolezal R, Kopacova M, Rejchrt S, Douda T, Sestak V, Douda L, Karasova JZ. The pharmacokinetic parameters and the effect of a single and repeated doses of memantine on gastric myoelectric activity in experimental pigs. PLoS One 2020; 15:e0227781. [PMID: 31978146 PMCID: PMC6980640 DOI: 10.1371/journal.pone.0227781] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Accepted: 12/28/2019] [Indexed: 12/31/2022] Open
Abstract
Background Memantine, currently available for the treatment of Alzheimer's disease, is an uncompetitive antagonist of the N-methyl-D-aspartate type of glutamate receptors. Under normal physiologic conditions, these unstimulated receptor ion channels are blocked by magnesium ions, which are displaced after agonist-induced depolarization. In humans, memantine administration is associated with different gastrointestinal dysmotility side effects (vomiting, diarrhoea, constipation, motor-mediated abdominal pain), thus limiting its clinical use. Mechanism of these motility disorders has not been clarified yet. Pigs can be used in various preclinical experiments due to their relatively very similar gastrointestinal functions compared to humans. The aim of this study was to evaluate the impact of a single and repeated doses of memantine on porcine gastric myoelectric activity evaluated by means of electrogastrography (EGG). Methods Six adult female experimental pigs (Sus scrofa f. domestica, mean weight 41.7±5.0 kg) entered the study for two times. The first EGG was recorded after a single intragastric dose of memantine (20 mg). In the second part, EGG was accomplished after 7-day intragastric administration (20 mg per day). All EGG recordings were performed under general anaesthesia. Basal (15 minutes) and study recordings (120 minutes) were accomplished using an EGG stand (MMS, Enschede, the Netherlands). Running spectral analysis based on Fourier transform was used. Results were expressed as dominant frequency of gastric slow waves (DF) and power analysis (areas of amplitudes). Results Single dose of memantine significantly increased DF, from basic values (1.65±1.05 cycles per min.) to 2.86 cpm after 30 min. (p = 0.008), lasting till 75 min. (p = 0.014). Basal power (median 452; inter-quartile range 280–1312 μV^2) raised after 15 min. (median 827; IQR 224–2769; p = 0.386; NS), lasting next 30 min. Repetitively administrated memantine caused important gastric arrhythmia. Basal DF after single and repeated administration was not different, however, a DF increase in the second part was more prominent (up to 3.18±2.16 after 15 and 30 min., p<0.001). In comparison with a single dose, basal power was significantly higher after repetitively administrated memantine (median 3940; IQR 695–15023 μV^2; p<0.001). Next dose of 20 mg memantine in the second part induced a prominent drop of power after 15 min. (median 541; IQR 328–2280 μV^2; p<0.001), lasting till 120 min. (p<0.001). Conclusions Both single and repeated doses of memantine increased DF. Severe gastric arrhythmia and long-lasting low power after repeated administration might explain possible gastric dysmotility side effects in the chronic use of memantine.
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Affiliation(s)
- Jan Bures
- 2nd Department of Internal Medicine—Gastroenterology, Charles University, Faculty of Medicine in Hradec Kralove and University Hospital, Hradec Kralove, Czech Republic
- * E-mail:
| | - Jaroslav Kvetina
- 2nd Department of Internal Medicine—Gastroenterology, Charles University, Faculty of Medicine in Hradec Kralove and University Hospital, Hradec Kralove, Czech Republic
| | - Vera Radochova
- Animal Laboratory, University of Defence, Faculty of Military Health Sciences, Hradec Kralove, Czech Republic
| | - Ilja Tacheci
- 2nd Department of Internal Medicine—Gastroenterology, Charles University, Faculty of Medicine in Hradec Kralove and University Hospital, Hradec Kralove, Czech Republic
| | - Eva Peterova
- 2nd Department of Internal Medicine—Gastroenterology, Charles University, Faculty of Medicine in Hradec Kralove and University Hospital, Hradec Kralove, Czech Republic
| | - David Herman
- Department of Toxicology and Military Pharmacy, University of Defence, Faculty of Military Health Sciences, Hradec Kralove, Czech Republic
- Centre of Biomedical Research, University Hospital, Hradec Kralove, Czech Republic
| | - Rafael Dolezal
- Centre of Biomedical Research, University Hospital, Hradec Kralove, Czech Republic
| | - Marcela Kopacova
- 2nd Department of Internal Medicine—Gastroenterology, Charles University, Faculty of Medicine in Hradec Kralove and University Hospital, Hradec Kralove, Czech Republic
| | - Stanislav Rejchrt
- 2nd Department of Internal Medicine—Gastroenterology, Charles University, Faculty of Medicine in Hradec Kralove and University Hospital, Hradec Kralove, Czech Republic
| | - Tomas Douda
- 2nd Department of Internal Medicine—Gastroenterology, Charles University, Faculty of Medicine in Hradec Kralove and University Hospital, Hradec Kralove, Czech Republic
| | - Vit Sestak
- Institute of Clinical Biochemistry and Diagnostics, Charles University, Faculty of Medicine in Hradec Kralove and University Hospital, Hradec Kralove, Czech Republic
| | - Ladislav Douda
- 2nd Department of Internal Medicine—Gastroenterology, Charles University, Faculty of Medicine in Hradec Kralove and University Hospital, Hradec Kralove, Czech Republic
| | - Jana Zdarova Karasova
- Department of Toxicology and Military Pharmacy, University of Defence, Faculty of Military Health Sciences, Hradec Kralove, Czech Republic
- Centre of Biomedical Research, University Hospital, Hradec Kralove, Czech Republic
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Frybova B, Drabek J, Lochmannova J, Douda L, Hlava S, Zemkova D, Mixa V, Kyncl M, Zeman L, Rygl M, Keil R. Cholelithiasis and choledocholithiasis in children; risk factors for development. PLoS One 2018; 13:e0196475. [PMID: 29763444 PMCID: PMC5953441 DOI: 10.1371/journal.pone.0196475] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Accepted: 04/13/2018] [Indexed: 02/07/2023] Open
Abstract
PURPOSE To compare anthropometric data (body mass index [BMI]) in patients without lithiasis to patients with symptomatic simple cholelithiasis or choledocholithiasis. METHODS We retrospectively reviewed data from 147 patients undergoing laparoscopic cholecystectomy between 2001-2015. Complete growth data from 98 patients was compared with anthropometric data from the population of the Czech Republic and a control group (BMI of 100 consecutive patients without biliary stones in abdominal ultrasound who were admitted to a surgical department for suspected appendicitis). RESULTS The BMI of 75 children with simple cholelithiasis and 23 with choledocholithiasis was compared to the standard Czech pediatric population and to the control group. The median age (simple cholelithiasis and choledocholithiasis) was 16 years, and 35 patients (24%) had a family history of gallstones. Types of lithiasis included multiple (n = 120), solitary (n = 11), and sludge (n = 10). Five cases had polyps and one had gallbladder dysplasia. Patients with simple cholelithiasis had significantly higher BMI compared to the control group without cholelithiasis (p<0.0001) and the standard Czech population (p = 0.03). Patients with choledocholithiasis had a mean BMI significantly higher than that of the general population (p = 0.001) and the control group (p = 0.0001). Patients with choledocholithiasis had significantly higher BMI than those with simple cholelithiasis (p = 0.03). CONCLUSION Patients with cholelithiasis had significantly higher BMI than the general population, and patients with choledocholithiasis had significantly higher BMI than patients with simple lithiasis. Elevated BMI is a risk factor for developing choledocholithiasis. ERCP and early laparoscopic cholecystectomy in patients with choledocholithiasis offer equivalent outcomes in patients with simple cholelithiasis.
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Affiliation(s)
- Barbora Frybova
- Department of Pediatric Surgery, Charles University in Prague, 2 Faculty of Medicine, University Hospital Motol in Prague, Prague, Czech Republic
| | - Jiri Drabek
- Department of Internal Medicine, Charles University in Prague, 2 Faculty of Medicine, University Hospital Motol in Prague, Prague, Czech Republic
| | - Jindra Lochmannova
- Department of Internal Medicine, Charles University in Prague, 2 Faculty of Medicine, University Hospital Motol in Prague, Prague, Czech Republic
| | - Ladislav Douda
- 2 Department of Internal Medicine–Gastroenterology, Charles University in Prague, Faculty of Medicine in Hradec Kralove, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic
| | - Stepan Hlava
- Department of Internal Medicine, Charles University in Prague, 2 Faculty of Medicine, University Hospital Motol in Prague, Prague, Czech Republic
| | - Daniela Zemkova
- Department of Pediatrics, Charles University in Prague, 2 Faculty of Medicine, University Hospital Motol in Prague, Prague, Czech Republic
| | - Vladimir Mixa
- Department of Anaesthesiology and Intensive Care Medicine, Charles University in Prague, 2 Faculty of Medicine, University Hospital in Motol in Prague, Prague, Czech Republic
| | - Martin Kyncl
- Department of Radiology, Charles University in Prague, 2 Faculty of Medicine, University Hospital Motol in Prague, Prague, Czech Republic
| | - Lubos Zeman
- Department of Pediatric Surgery, Charles University in Prague, 2 Faculty of Medicine, University Hospital Motol in Prague, Prague, Czech Republic
| | - Michal Rygl
- Department of Pediatric Surgery, Charles University in Prague, 2 Faculty of Medicine, University Hospital Motol in Prague, Prague, Czech Republic
| | - Radan Keil
- Department of Internal Medicine, Charles University in Prague, 2 Faculty of Medicine, University Hospital Motol in Prague, Prague, Czech Republic
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Keil R, Douda L. [New trends in treatment of non-variceal bleeding in the upper gastrointestinal tract]. Vnitr Lek 2015; 61:686-690. [PMID: 26375696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Acute upper gastrointestinal tract bleeding is a life-threatening incident in which a right diagnostic and therapeutic approach is necessary. Beside the standards in endoscopic hemostasis (adrenalin injection, hemostatic clips) there are some new technologies in endoscopic hemostasis.
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Koudela K, Solc J, Douda L, Pazdera M. [Relationship between locally administered Kenalog and subcutaneous ruptures of tendons (author's transl)]. Acta Chir Orthop Traumatol Cech 1980; 47:108-12. [PMID: 7386100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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