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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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Bureš J, Kohoutová D, Květina J, Radochová V, Pavlík M, Tichý A, Rejchrt S, Kopáčová M, Douda T, Vysloužil D, Pejchal J. The Effect of Lactobacillus casei on Experimental Porcine Inflammatory Bowel Disease Induced by Dextran Sodium Sulphate. Acta Medica (Hradec Kralove) 2021; 64:85-90. [PMID: 34331427 DOI: 10.14712/18059694.2021.15] [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: 10/20/2022]
Abstract
BACKGROUND Gastrointestinal injury caused by dextran sodium sulphate (DSS) is a reliable porcine experimental model of inflammatory bowel disease (IBD). The purpose of this study was to evaluate the effect of probiotic Lactobacillus casei DN 114001 (LC) on DSS-induced experimental IBD. RESULTS Eighteen female pigs (Sus scrofa f. domestica, weight 33-36 kg, age 4-5 months) were divided into 3 groups (6 animals per group): controls with no treatment, DSS, and DSS + LC. LC was administered to overnight fasting animals in a dietary bolus in the morning on days 1-7 (4.5 × 1010 live bacteria/day). DSS was applied simultaneously on days 3-7 (0.25 g/kg/day). On day 8, the pigs were sacrificed. Histopathological score and length of crypts/glands (stomach, jejunum, ileum, transverse colon), length and width of villi (jejunum, ileum), and mitotic and apoptotic indices (jejunum, ileum, transverse colon) were assessed. DSS increased the length of glands in the stomach, length of crypts and villi in the jejunum and ileum, and the histopathological score of gastrointestinal damage, length of crypts and mitotic activity in the transverse colon. Other changes did not achieve any statistical significance. Administration of LC reduced the length of villi in the jejunum and ileum to control levels and decreased the length of crypts in the jejunum. CONCLUSIONS Treatment with a probiotic strain of LC significantly accelerated regeneration of the small intestine in a DSS-induced experimental porcine model of IBD.
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Affiliation(s)
- Jan Bureš
- 2nd Department of Internal Medicine - Gastroenterology, Charles University, Faculty of Medicine in Hradec Králové, University Hospital, Hradec Králové, Czech Republic.
| | - Darina Kohoutová
- The Royal Marsden NHS Foundation Trust, London, United Kingdom.,2nd Department of Internal Medicine - Gastroenterology, Charles University, Faculty of Medicine in Hradec Králové, University Hospital, Hradec Králové, Czech Republic
| | - Jaroslav Květina
- 2nd Department of Internal Medicine - Gastroenterology, Charles University, Faculty of Medicine in Hradec Králové, University Hospital, Hradec Králové, Czech Republic
| | - Věra Radochová
- Animal Laboratory, University of Defence, Faculty of Military Health Sciences, Hradec Králové, Czech Republic
| | - Michal Pavlík
- Animal Laboratory, University of Defence, Faculty of Military Health Sciences, Hradec Králové, Czech Republic
| | - Aleš Tichý
- Department of Radiobiology, University of Defence, Faculty of Military Health Sciences, Hradec Králové, Czech Republic
| | - Stanislav Rejchrt
- 2nd Department of Internal Medicine - Gastroenterology, Charles University, Faculty of Medicine in Hradec Králové, University Hospital, Hradec Králové, Czech Republic
| | - Marcela Kopáčová
- 2nd Department of Internal Medicine - Gastroenterology, Charles University, Faculty of Medicine in Hradec Králové, University Hospital, Hradec Králové, Czech Republic
| | - Tomáš Douda
- 2nd Department of Internal Medicine - Gastroenterology, Charles University, Faculty of Medicine in Hradec Králové, University Hospital, Hradec Králové, Czech Republic
| | - David Vysloužil
- Department of Toxicology and Military Pharmacy, University of Defence, Faculty of Military Health Sciences, Hradec Králové, Czech Republic
| | - Jaroslav Pejchal
- Department of Toxicology and Military Pharmacy, University of Defence, Faculty of Military Health Sciences, Hradec Králové, Czech Republic
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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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Tachecí I, Bradna P, Douda T, Baštecká D, Kopáčová M, Rejchrt S, Lutonský M, Soukup T, Bureš J. Wireless Capsule Enteroscopy in Healthy Volunteers. Acta Med (Hradec Kralove, Czech Repub ) 2016; 59:79-83. [DOI: 10.14712/18059694.2016.93] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Introduction: The aim of our prospective study was to define endoscopy appearance of the small bowel in healthy volunteers. Method: Forty-two healthy volunteers underwent wireless capsule endoscopy, clinical investigation, laboratory tests, and completed a health-status questionnaire. All subjects were available for a 36-month clinical follow-up. Results: Eleven subjects (26%) had fully normal endoscopy findings. Remaining 31 persons (74%), being asymptomatic, with normal laboratory results, had some minor findings at wireless capsule endoscopy. Most of those heterogeneous findings were detected in the small intestine (27/31; 87%), like erosions and/or multiple red spots, diminutive polyps and tiny vascular lesions. During a 36-month clinical follow-up, all these 42 healthy volunteers remained asymptomatic, with fully normal laboratory control. Conclusions: Significant part of healthy subjects had abnormal findings at wireless capsule endoscopy. These findings had no clinical relevance, as all these persons remained fully asymptomatic during a 36-month follow-up. Such an endoscopic appearance would be previously evaluated as “pathological”. This is a principal report alerting that all findings of any control group of wireless capsule endoscopic studies must be evaluated with caution.
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Bortlík M, Ďuricová D, Kohout P, Konečný M, Koželuhová J, Novotný A, Zbořil V, Prokopová L, Douda T, Stehlík J, Shonová O, Mareš K, Hrdlička L, Matějková P, Šerclová Z, Nedbalová L, Tomanová M, Liberda M, Bronský J, Mitrová K, Drastich P, Ryska O, Falt P, Březina J, Vaňásek T, Kalvach J, Kolář M, Lukáš M. Guidelines for the administration of biological therapy in patients with Crohn´s disease and ulcerative colitis: third updated edition. ACTA ACUST UNITED AC 2016. [DOI: 10.14735/amgh201611] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Květina J, Tachecí I, Pavlík M, Kopáčová M, Rejchrt S, Douda T, Kuneš M, Bureš J. Use of electrogastrography in preclinical studies of cholinergic and anticholinergic agents in experimental pigs. Physiol Res 2015; 64:S647-52. [PMID: 26674291 DOI: 10.33549/physiolres.933227] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Electrogastrography (EGG) is a non-invasive method for the assessment of gastric myoelectrical activity. Porcine EGG is comparable with human one. The purpose of this study was to evaluate the effect of atropine and neostigmine on the EGG in experimental pigs. Adult female pigs were administrated atropine (1.5 mg i.m., n=6) and neostigmine (0.5 mg i.m., n=6) after the baseline EGG, followed by a 90-min trial recording (MMS, Enschede, the Netherlands). Running spectral analysis was used for the evaluation. The results were expressed as dominant frequency of slow waves and EGG power (areas of amplitudes). Neostigmine increased continuously the dominant frequency and decreased significantly the EGG power. Atropine did not change the dominant frequency significantly. However, atropine increased significantly the EGG power (areas of amplitudes) from basal values to the maximum at the 10-20-min interval. After that period, the areas of amplitudes decreased significantly to the lowest values at the 60-90-min interval. In conclusion, cholinergic and anticholinergic agents affect differently EGG in experimental pigs.
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Affiliation(s)
- J Květina
- Second Department of Internal Medicine - Gastroenterology, University Teaching Hospital, Hradec Králové, Czech Republic.
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Bureš J, Jun D, Hrabinová M, Tachecí I, Květina J, Pavlík M, Rejchrt S, Douda T, Kuneš M, Kuča K, Kopáčová M. Impact of tacrine and 7-methoxytacrine on gastric myoelectrical activity assessed using electrogastrography in experimental pigs. Neuro Endocrinol Lett 2015; 36 Suppl 1:150-155. [PMID: 26757120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/18/2015] [Accepted: 09/09/2015] [Indexed: 06/05/2023]
Abstract
OBJECTIVES Tacrine was the first acetylcholinesterase inhibitor approved for therapy of Alzheimer's disease. It has currently been withdrawn in some countries mostly due to the risk of hepatotoxicity and might be replaced by its derivate 7-methoxytacrine (7-MEOTA). The aim of this study was to assess the impact of these two compounds on gastric myoelectrical activity by means of surface cutaneous electrogastrography (EGG). METHODS Twelve pigs (Sus scrofa f. domestica, weighing 30-35 kg) entered the study. A single dose of tacrine (200 mg i.m., n=6) or 7-MEOTA (200 mg i.m., n=6) was administrated. All EGG recordings were performed under general anaesthesia in the morning after 24 hours of fasting. Basal (30 minutes) and study recordings (150 minutes) were accomplished using an EGG stand (MMS, Enschede, the Netherlands). Results were expressed as dominant frequency of gastric slow waves, power analysis (areas of amplitudes) and power ratio assessment (ratio of the areas of amplitudes after and before study drug administration). RESULTS Tacrine decreased EGG dominant frequency 10 minutes after its administration (from basal 3.1±0.6 to 2.8±0.6 cycles per minute; p=0.014). Tacrine induced a non-significant 60-minute increase of the power (with maximal value 493±533 μV2 at 20 minutes) and power ratio (with maximal value 2.04±3.4 at 10 minutes). Tacrine caused substantial gastric arrhythmia. 7-MEOTA did not influence dominant frequency of gastric slow waves significantly. 7-MEOTA caused a short-term late increase of the power ratio at 60 minutes (6.3±11.2; p=0.003). Blood cholinesterase activity did not correlate with any EGG parameter either after tacrine or 7-MEOTA at any time. CONCLUSIONS Tacrine and 7-MEOTA have different impacts on EGG. Tacrine decreased dominant frequency and induced long-lasting gastric arrhythmia. 7-MEOTA caused a short-term late increase of the EGG power in experimental pigs.
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Affiliation(s)
- Jan Bureš
- 2nd Department of Medicine - Gastroenterology, Charles University in Prague, Faculty of Medicine in Hradec Králové, University Teaching Hospital, Hradec Kralove, Czech Republic
| | - Daniel Jun
- Department of Toxicology and Military Pharmacy, Faculty of Military Health Sciences, University of Defence, Hradec Králové, Czech Republic
| | - Martina Hrabinová
- Department of Toxicology and Military Pharmacy, Faculty of Military Health Sciences, University of Defence, Hradec Králové, Czech Republic
| | - Ilja Tachecí
- 2nd Department of Medicine - Gastroenterology, Charles University in Prague, Faculty of Medicine in Hradec Králové, University Teaching Hospital, Hradec Kralove, Czech Republic
| | - Jaroslav Květina
- 2nd Department of Medicine - Gastroenterology, Charles University in Prague, Faculty of Medicine in Hradec Králové, University Teaching Hospital, Hradec Kralove, Czech Republic
| | - Michal Pavlík
- Department of Toxicology and Military Pharmacy, Faculty of Military Health Sciences, University of Defence, Hradec Králové, Czech Republic
| | - Stanislav Rejchrt
- 2nd Department of Medicine - Gastroenterology, Charles University in Prague, Faculty of Medicine in Hradec Králové, University Teaching Hospital, Hradec Kralove, Czech Republic
| | - Tomáš Douda
- 2nd Department of Medicine - Gastroenterology, Charles University in Prague, Faculty of Medicine in Hradec Králové, University Teaching Hospital, Hradec Kralove, Czech Republic
| | - Martin Kuneš
- Biomedical Research Centre, University Hospital, Hradec Králové, Slovakia
| | - Kamil Kuča
- Department of Toxicology and Military Pharmacy, Faculty of Military Health Sciences, University of Defence, Hradec Králové, Czech Republic
| | - Marcela Kopáčová
- 2nd Department of Medicine - Gastroenterology, Charles University in Prague, Faculty of Medicine in Hradec Králové, University Teaching Hospital, Hradec Kralove, Czech Republic
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Rejchrt S, Koupil I, Kopáčová M, Fendrichová MS, Seifert B, Voříšek V, Spirková J, Douda T, Tachecí I, Bureš J. [Epidemiology of dyspepsia]. Vnitr Lek 2014; 60:649-656. [PMID: 25130645] [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: 06/03/2023]
Abstract
Epidemiology of uninvestigated dyspepsia was studied in the Czech Republic for the first time in 2001. The aim of our current multi-centre prospective study was to evaluate dyspepsia using the same methods in a representative sample of general unselected population from the same geographical areas 10 years later. A total of 22 centres entered the study. A total of 1,836 subjects (aged 5-98 years) were enrolled. The overall prevalence of dyspepsia was 12 %; namely 3.5 % in subjects aged 5-24 years, 18 % among 25-64-year-old persons and 15 % in subjects 65 years. Despite the substantial decrease of Helicobacter pylori infection in the Czech Republic over the past 10 years, the prevalence and basic socio-demographic determinants of uninvestigated dyspepsia did not change significantly.
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Cyrany J, Repak R, Douda T, Fejfar T, Rejchrt S. Cannulotome introduced via a percutaneous endoscopic gastrostomy (PEG) tube--new technique for release of a buried bumper. Endoscopy 2013; 44 Suppl 2 UCTN:E422-3. [PMID: 23315981 DOI: 10.1055/s-0032-1310137] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- J Cyrany
- 2nd Department of Internal Medicine, Charles University in Prague, Faculty of Medicine and University Hospital, Hradec Kralove, Czech Republic.
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Tacheci I, Devière J, Kopacova M, Douda T, Bures J, Van Gossum A. The importance of upper gastrointestinal lesions detected with capsule endoscopy in patients with obscure digestive bleeding. Acta Gastroenterol Belg 2011; 74:395-399. [PMID: 22103043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
STUDY AIMS Small bowel capsule endoscopy (SBCE) is the first line procedure for detecting small bowel lesions in patients with an obscure gastrointestinal bleeding (OGIB). Missed upper gastrointestinal (UGI) lesions at the initial endoscopy may account for the so-called OGIB. This retrospective study was designed to assess the role of SBCE in detecting missed UGI lesions. METHODS All consecutive SBCE that were performed in the last year for patients with OGIB were included in our study. We evaluated the visibility of the gastric mucosa, the anatomic landmarks, the presence of UGI lesions as well as their clinical importance. The SBCE findings were compared with the reports of previous UGI endoscopies. RESULTS 118 patients (45 males, 73 females, mean age 61 +/- 19 years) were included in the analysis. The indication for SBCE was obscure overt and occult OGIB in 60 and in 58 patients, respectively. SBCE identified lesions in the small bowel in 42% of the patients. An excellent visibility of gastric mucosa was observed in 83/118 cases (703%). SBCE identified gastric lesions with potential clinical significance (high bleed potential) in 25/118 (21.2%) patients. In 12/118 (10.2%) patients the UGI lesions detected by SBCE were considered as the only potential source of bleeding. CONCLUSIONS In patients with OGIB, SBCE detected not only small bowel lesions but also significant UGI lesions that were missed or underestimated at the initial endoscopy in 21% of cases. It is therefore necessary to carefully read the gastric images when performing an SBCE.
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Affiliation(s)
- I Tacheci
- 2nd Department of Internal Medicine, University Hospital and Faculty of Medicine, Hradec Kralove, Czech Republic
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Pintér M, Pintérová Kolesárová M, Rejchrt S, Douda T, Repák R, Kopáová M, Bures J. [Inflammatory bowel disease--familial and sporadic form]. Vnitr Lek 2009; 55:1022-1029. [PMID: 20017432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
THE AIM The aim of this thesis was to elucidate more differences between a familial and sporadic inflammatory bowel disease by comparing certain clinical data. METHODS We assessed 248 patients with inflammatory bowel disease (IBD) observed in 1994-2004 in the Academic Department of Gastroenterology at the Medical Faculty in Hradec Králové. To get information about the defined characters we obtained from the questionary and the hospital data. RESULTS We did not identify any relationship between the onset of the disease and a certain age group, yet males seem to be more prone to familial Crohn's disease. The more frequent familial form of Crohn's disease was the fibro-stenotic one. There were no differences in the onset of the disease. We did not prove the differences in extraintestinal signs, alergy and comorbidities. We did not find any differences in therapy response in relation to the type of nutrition (enteral, parenteral) and the administration of immunosupresive drugs. The biological therapy in sporadic and familial Crohn's disease did not differ either. Surgical intervention was more frequent in Crohn's patients compared to the patients with ulcerative colitis; yet no difference was identified between familial and sporadic cases. Appendectomy carried out before the onset of the disease was later diagnosed as Crohn's disease in more instances than ulcerative colitis. CONCLUSION We did not prove significant differences comparing certain clinical data in familial and sporadic form of inflammatory bowel disease, yet males seem to be more prone to familial Crohn's disease. Small bowel was involved more often in familial form of Crohn's disease than in sporadic form.
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Affiliation(s)
- M Pintér
- II. interní klinika Lékarské fakulty UK a FN Hradec Králové.
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Rejchrt S, Drahošová M, Kopáčová M, Cyrany J, Douda T, Pintér M, Bureš J. Antilaminaribioside and antichitobioside antibodies in inflammatory bowel disease. Folia Microbiol (Praha) 2008; 53:373-6. [DOI: 10.1007/s12223-008-0058-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2007] [Revised: 03/25/2008] [Indexed: 11/24/2022]
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Pintérová Kolesárová M, Pintér M, Rejchrt S, Douda T, Tachecí I, Kopácová M, Bures J. [The influence of inflammatory bowel disease on the period of conceiving]. Ceska Gynekol 2008; 73:109-112. [PMID: 18567431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
INTRODUCTION Crohn's disease (CD) and ulcerative colitis (UC) influence women fertility in many ways. OBJECTIVE We tried to determine the influence of the inflammatory bowel disease on conceiving. The date of the diagnosis, localisation, form and activity at time of conception were involved. DESIGN Retrospective study. METHODS We assessed data from 81 patients with inflammatory bowel disease. 56 patients were diagnosed before conceiving (41 with CD, 15 with UC), 25 patients were diagnosed after pregnancy (14 with CD, 11 with UC). We assessed the period of conceiving (in months) depends on previous abdominal operation, localisation, form and activity of the disease at time of conception. The data were obtained from the questionnaire and hospital cards. RESULTS The previous abdominal operation, the diagnosis, localisation, and the form of the disease did not influence the period necessary to conceive in patient with inflammatory bowel disease. The anoperineal localisation and activity of Crohn's disease at the time of conception extended the period necessary to conceive. CONCLUSION Fertility of the patients with Crohn's disease depends on the activity of the disease at time of conception and anoperineal involvement. Previous abdominal operation does not influence the fertility.
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Al-Tashi M, Rejchrt S, Kopácová M, Tycová V, Siroký M, Repák R, Tachecí I, Douda T, Cyrany J, Fejfar T, Hůlek P, Bukac J, Bures J. Hiatal hernia and Barrett's oesophagus impact on symptoms occurrence and complications. Cas Lek Cesk 2008; 147:564-568. [PMID: 19097360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
UNLABELLED The aim of the study was to evaluate the influence of sliding hiatal hernia over the Barrett's oesophagus, including symptoms rate and complications. METHODS A total of 520 (4.6%) cases of Barrett's oesophagus were found out of 18.276 upper gastrointestinal endoscopies, performed in 11.276 patients at a single tertiary centre in a period from 1994 to 2004. RESULTS Sliding hiatal hernia was found in 58% of patients with Barrett's oesophagus, more frequently in men (60%). The association between hernia and some complications of Barrett's oesophagus was significant (94% of Barrett's ulcer, 77% of low-grade dysplasia with p < 0.01). However, there was no significant association with adenocarcinoma (54%; p > 0.05). The other complications of Barrett's oesophagus (i.e. bleeding, stenosis, high-grade dysplasia) were identified in small number (less than 10), so they were not evaluated statistically. Association between the presence of hiatal hernia and occurrence of symptoms (reflux symptoms, dysphagia, odynophagia, dyspeptic and other symptoms) was significant with p < 0.01. CONCLUSIONS Our study suggests that sliding hiatal hernia may play a significant role as a pathophysiologic factor in Barrett's oesophagus. Complications rate of Barrett's oesophagus were not equally frequent in particular cases with hiatal hernia. The occurrence of symptoms is getting more pronounced in those with sliding hiatal hernia.
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Pintér M, Pintérová KM, Drahosová M, Rejchrt S, Douda T, Tachecí I, Kopácová M, Bures J. [Significance of serum antibodies ANCA, ASCA, ABBA in diagnostics of idiopathic intestinal inflammations]. Cas Lek Cesk 2007; 146:863-867. [PMID: 18069213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
BACKGROUND Crohn's disease and ulcerative colitis still remain a heterogeneous group of diseases with an unclear aetiology. Serologic methods play important role in their diagnosing though there is still not an ideal marker. We tried to determine the importance of serological testing of ASCA IgA, IgG, ANCA, ABBA antibodies in patients with ulcerative colitis and Crohn's disease. METHODS AND RESULTS ASCA IgG, ASCA IgA; ANCA, ABBA antibodies and C-reactive protein were detected by indirect fluorescence assay. ASCA IgA, ASCA IgG, ABBA, ANCA were examined in 40 patients (28 Crohn's disease, 12 ulcerative colitis, 32 health controls). Specificity of ASCA IgA, IgG in CD patients was high (both 96.2%), specificity ANCA in UC 100%. ABBA antibodies had low sensitivity and specificity in both diseases. Combination of ASCA, ANCA, ABBA makes the specificity higher. CONCLUSIONS We showed the importance of combination ASCA, ANCA with ABBA antibodies to improve the serological diagnosing of IBD.
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Affiliation(s)
- M Pintér
- II. Interní klinika LF UK a FN a Subkatedra gastroenterologie, Hradec Králové.
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Douda T, Bures J, Rejchrt S, Kopácová M, Pecka M, Malý J. [Mean platelet volume (MPV) in Crohn's disease patients]. Cas Lek Cesk 2006; 145:870-3. [PMID: 17168422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
BACKGROUND Platelets are involved in the pathogenesis of chronic inflammation. Thrombocyte count and platelet volume are considered as a useful activity marker of inflammatory bowel disease. The aim of the study was to compare the yield of mean platelet volume with clinical and other laboratory markers of activity in Crohn's disease (CD). METHODS AND RESULTS A total of 56 patients with CD were investigated at time of evident clinical relapse and remission (29 males and 27 females, aged 19-68 years, mean 34.5, median 31.5 years). Complete blood count, C- reactive proteins were measured. Disease activity was assed by the Crohn's Disease Activity Index (CDAI). Patients were checked at least twice (120 analyses were carried out in total). Thrombocytosis (above 350xl09/L) was found in 32/61 (52 %) patients with clinical relapse and in 7/59 (12 %) patients with clinical remission (mean 400.7x10(9)/1; 95%CI: 361.1-440.3x10(9)/1; or as the case may be mean 278.6xl0(9)/1; 95% CI: 256.8-300.4x10(9)/1). The mean platelet volume decreased (under 7.8 fL) in 19/61 (31 %) patients with clinical relapse and in 8/59 (13.5 %) with clinical remission (mean 8.333 fl; 95% CI: 7.935-8.731 fl; or as the case may be mean 9.200 fl; 95% CI: 8.824-9.576 fl). Total platelet count, CDAI and C- reactive protein were significantly increased (p<0.0001) and mean platelet volume was statistically significantly reduced (p=0.003) during clinical relapse compared with clinical remission. CONCLUSIONS Decreased mean platelet corpuscular volume is an independent laboratory marker of clinical disease activity. However, on the basis of our study, its predictive value is inferior compared to the total platelet count, serum concentration of C- reactive protein and Crohn's disease activity index.
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Affiliation(s)
- T Douda
- II. interní klinika LF a FN, Hradec Králové.
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Kopácová M, Bures J, Vorísek V, Konstacký M, Rejchrt S, Zivný P, Douda T, Palicka V. Comparison of different protocols for 13C-urea breath test for the diagnosis of Helicobacter pylori infection in healthy volunteers. Scand J Clin Lab Invest 2005; 65:491-8. [PMID: 16179282 DOI: 10.1080/00365510500209199] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE The (13)C-urea breath test ((13)C-UBT) is the most accurate non-invasive method for diagnosis of Helicobacter pylori infection. However, several methodological issues have not been resolved yet. The aim of this study was to test different protocols of (13)C-UBT to find the optimal test drink and sampling interval. MATERIAL AND METHODS (13)C-UBT was performed at 3-day intervals in 27 healthy volunteers using citric acid (test A), orange juice (B) and still water (C) as test drinks. Breath samples were collected from time 5 to 60 min. A total number of 2106 breath samples were analysed by isotope ratio mass spectrometry (cut-off value 3.5). RESULTS Differences in delta values were greater than would be expected by chance (A versus B and A versus C at times 20, 25, 30, 35 and 40 min, p<0.05, Dunnett's method). There were no grey zone- or false-negative results among H. pylori-positive persons in test A at any time, but some were found in tests B and C. Optimal intervals for breath sampling are at times 20 or 25 min after (13)C-urea ingestion. CONCLUSIONS Citric acid solution as a test drink and 20- or 25-min breath sampling intervals are optimal for the (13)C-UBT in healthy volunteers.
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Affiliation(s)
- M Kopácová
- Second Department of Internal Medicine, Charles University, Prague, Czech Republic.
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Bures J, Kopácová M, Vorísek V, Bukac J, Neumann D, Rejchrt S, Pozler O, Douda T, Zivný P, Palicka V. [Examination of gastric emptying rate by means of 13C-octanoic acid breath test. Methods of the test for adults and results of the investigation of healthy volunteers]. Cas Lek Cesk 2005; 144 Suppl 3:18-22. [PMID: 16335258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
BACKGROUND 13C-octanoic acid breath test (13C-OABT) is a simple, safe and non-invasive technique for measuring gastric emptying. However, the method has not been standardized yet. Aim of the study was to work up, introduce and evaluate our own method of the 13C-OABT for adults. METHODS AND RESULTS Ten healthy volunteers entered the study (5 men, 5 women, mean age 32 years, 50 % Helicobacter pylori positive). Standard test meals (with 100 mg 13C-sodium octanoate) were used three times within 3 weeks. The same solid meal (1,178 kJ) for Tests 1 and 2 contained scrambled egg (+ 3 g oil), white bread (40 g), butter (10 g) and distilled water (200 ml). Semi-solid meal (1,020 kJ) for Test 3 contained milk pudding (200 g) and distilled water (200 ml). Duplicate breath samples were obtained before and every 15 minutes after eating the test meal during 255 minutes. Altogether 1,080 breath samples were analysed twice (isotope ratio mass spectrometry, AP2003 Analytical Precision, UK). To assess the half-life of elimination (t1/2 E), we modelled the process of elimination with the incomplete gamma-function, which has a convenient form for the empiric plotting of breath test data. Mean t1/2E was 136+/-10 minutes (Test 1), 134+/-14 (Test 2) and 123+/-16 minutes (Test 3). Clinical reproducibility of 13C-OABT in particular persons was 98.2% (18 breath samples series), 90.8 % (15 samples) and 87.1% (9 breath samples series). There was a significant correlation between Test 1 and Test 2 results (r=0.887, p<0.0001). Mean difference of duplicate breath sample analysis was 1.460 % (in 540 pairs), mean baseline one-day analysis difference was 0.0982 (99.9274% accuracy). In healthy volunteers, normal range of t1/2E is 110-160 minutes for solids and 91-155 minutes for semisolid test meal. Using our own computed mean time of intermediate metabolism of 13C-octanoic acid (76.5+/-7.5 minutes), gastric emptying half-time is 33.5-83.5 minutes for solids and 14.5-78.5 minutes for semisolid test meal in healthy volunteers. CONCLUSIONS The 13C-OABT is accurate non-invasive method for gastric emptying measurement.
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Affiliation(s)
- J Bures
- Katedra interních oborů LF UK, Hradec Králové.
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Rejchrt S, Douda T, Kopácová M, Siroký M, Repák R, Nozicka J, Spacek J, Bures J. Acute esophageal necrosis (black esophagus): endoscopic and histopathologic appearance. Endoscopy 2004; 36:1133. [PMID: 15578316 DOI: 10.1055/s-2004-825971] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- S Rejchrt
- Clinical Centre, Second Department of Medicine, Charles University Teaching Hospital, Hradec Králové, Czech Republic.
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