• MeSH
• Anti-Bacterial Agents therapeutic use   MeSH
• Biological Therapy methods   MeSH
• Crohn Disease * diagnosis   drug therapy   pathology   MeSH
• Enteral Nutrition methods   MeSH
• Gastrointestinal Agents administration & dosage   adverse effects   therapeutic use   MeSH
• Adrenal Cortex Hormones administration & dosage   adverse effects   therapeutic use   MeSH
• Immunosuppressive Agents administration & dosage   adverse effects   therapeutic use   MeSH
• Tumor Necrosis Factor Inhibitors administration & dosage   adverse effects   therapeutic use   MeSH
• Contraindications, Drug MeSH
• Humans MeSH
• Methotrexate administration & dosage   adverse effects   therapeutic use   MeSH
• Parenteral Nutrition methods   MeSH
• Check Tag
• Humans MeSH

Aim: To see if there is a statistically significant difference in the assessment of quality of life for Crohn's disease patients found in relapse or remission with the population norm. Methods: The quantitative research investigation was conducted using the general WHOQOL-BREF quality of life questionnaire and the Best Index for evaluating the clinical activity of the disease. The investigation was conducted from March 2017 to August 2019 in 121 Crohn's disease patients monitored in a gastroenterological ambulance or biotherapy center. Results: Based on the test hypothesis, a statistically significant difference in quality of life rating between the population norm and relapse sufferers in all domains of concern except the social relationship domain was confirmed. Furthermore, a statistically significant difference in quality of life assessment between the population norm and patients in remission in the physical health domain, the environment domain and health satisfaction was confirmed. Conclusion: The results showed that the measured values using the general questionnaire were always lower for respondents in relapse than for those in remission. Comparing patients' quality of life in relapse/remission to the population norm shows the smallest difference in quality of life assessment for those in remission. Almost identical results were found in the domain of mental health, social relationships and overall quality of life.

• MeSH
• Crohn Disease * MeSH
• Inflammatory Bowel Diseases MeSH
• Quality of Life * MeSH
• Humans MeSH
• Disease Progression MeSH
• Recurrence MeSH
• Severity of Illness Index MeSH
• Check Tag
• Humans MeSH

Cysty jater jsou častým nálezem na zobrazovacích metodách. Polycystické postižení jater popisujeme při počtu minimálně 10 cyst. Vyskytuje se nejčastěji jako součást polycystického onemocnění ledvin nebo jako izolované polycystické postižení jater. Onemocnění je obvykle asymptomatické a nevyžaduje léčbu. U pacientů s postižením ledvin bývá v popředí klinického obrazu renální selhání. Komplikace polycystózy jsou vzácné, jedná se o krvácení do cysty, vznik portální hypertenze, ikterus a jaterní selhání. Závažnou komplikací je infekce jaterní cysty, která vyžaduje jak antibiotickou terapii, tak radiologickou nebo chirurgickou intervenci z důvodu vysokého procenta selhání samotné antibiotické léčby. Z antibiotik je doporučeno podávání chinolonů. Medikamentózní léčba ať analogy somatostatinu, m-TOR inhibitory či ursodeoxycholovou kyselinou je zatím zkoušena pouze v klinických studiích. Intervenční radiologie může pomoci arteriální embolizací hepatické arterie nebo perkutánní aspirací a následnou skleroterapií cysty. Existuje několik klinických klasifikací uvedených v článku, které lze použít k rozhodnutí o nutnosti chirurgického řešení a případně transplantace jater. Prezentujeme případ 60letého muže s dědičnou polycystózou ledvin a jater, léčeného pro septický stav při infekci jaterní cysty. Parenterální antibiotická terapie sice vedla k ústupu febrilií a úpravě laboratorních hodnot, k ústupu subjektivních obtíží však došlo až po odsátí obsahu infikované cysty. Pacient byl vzhledem k pokročilosti onemocnění a riziku recidivy infekce cyst indikován k transplantaci jater.

Liver cysts are commonly identified by imaging methods. Polycystic liver disease is diagnosed when there are ten or more cysts and often develops as part of polycystic kidney disease or an isolated polycystic liver disorder. This disease is usually asymptomatic and does not require treatment. Impairment of renal function is one of the main symptoms in patients with cystic kidney disease. Complications of polycystosis, such as cyst bleeding, portal hypertension, icterus, and hepatic failure, are rare. A hepatic cyst infection that requires both antibiotic therapy and radiological or surgical intervention is a serious complication due to the high failure rate of separate antibiotic therapy. Quinolones are the recommended antibiotic therapy. Medications, such as somatostatin analogues, mTOR inhibitors, and ursodeoxycholic acid, have only been used in clinical trials. Arterial embolization of the hepatic artery or percutaneous aspiration and subsequent sclerotherapy of the cyst can aid interventional radiology. Several clinical classifications listed in this article can help clinicians decide whether to perform surgical therapy or liver transplantation. We present the case of a 60-year-old man with hereditary polycystosis of the kidneys and liver who was treated for sepsis due to hepatic cyst infection. Although parenteral antibiotic therapy reduced his fever and improved his laboratory findings, improvement of subjective problems occurred after the radiological intervention. Due to disease progression and the risk of the cyst infection recurring, the patient attended a consultation at a transplant center and liver transplantation was indicated.

• Keywords
• polycystóza jater,
• MeSH
• Anti-Bacterial Agents therapeutic use   MeSH
• Quinolones administration & dosage   pharmacology   therapeutic use   MeSH
• Cysts * diagnosis   therapy   MeSH
• Liver physiopathology   MeSH
• Clinical Laboratory Techniques MeSH
• Comorbidity MeSH
• Middle Aged MeSH
• Humans MeSH
• Tomography, X-Ray Computed methods   MeSH
• Polycystic Kidney Diseases MeSH
• Punctures methods   MeSH
• Sepsis diagnosis   therapy   MeSH
• Treatment Outcome MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Publication type
• Case Reports MeSH

BACKGROUND AND AIMS: This study assessed the efficacy of maintenance treatment with multimatrix mesalazine following achievement of complete or partial remission after induction treatment with high-dose multimatrix mesalazine. METHODS: In this phase 3b/4, open-label, multicentre, prospective, single-arm study, patients with mild-to-moderate ulcerative colitis were treated with multimatrix mesalazine 4.8g/day once daily for 8 weeks [induction phase]. At Week 8, those who achieved complete or partial remission, based on predefined clinical and endoscopic criteria, were eligible to receive 12 months of multimatrix mesalazine 2.4g/day once daily maintenance therapy. The primary endpoint was the proportion of patients in complete remission at Month 12. RESULTS: A total of 717 patients received induction treatment; 25.9% and 39.3% of patients achieved complete and partial remission, respectively, at Week 8. A total of 461 patients entered the maintenance phase. The likelihood of remaining in/achieving complete remission at Month 12 was higher for patients who entered the maintenance phase in complete remission compared with those who began maintenance in partial remission [47.8% vs 26.0%; p < 0.001]. At Month 12, mucosal healing [endoscopy score ≤ 1] was demonstrated in 76.4% [139/182] and 63.5% [176/277] of those who were in complete and partial remission, respectively, at the end of induction. CONCLUSION: Patients achieving complete remission before dose reduction were more likely to remain in remission at Month 12.

• MeSH
• Anti-Inflammatory Agents, Non-Steroidal administration & dosage   therapeutic use   MeSH
• Adult MeSH
• Induction Chemotherapy * MeSH
• Middle Aged MeSH
• Humans MeSH
• Mesalamine administration & dosage   therapeutic use   MeSH
• Adolescent MeSH
• Young Adult MeSH
• Follow-Up Studies MeSH
• Prospective Studies MeSH
• Drug Administration Schedule MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Maintenance Chemotherapy * MeSH
• Colitis, Ulcerative drug therapy   MeSH
• Treatment Outcome MeSH
• Dose-Response Relationship, Drug MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Adolescent MeSH
• Young Adult MeSH
• Male MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Clinical Trial, Phase III MeSH
• Clinical Trial, Phase IV MeSH
• Multicenter Study MeSH

OBJECTIVES: Prucalopride is effective at alleviating symptoms of chronic constipation in women. The aim of this study was to assess the efficacy of 12 weeks of prucalopride treatment compared with placebo in men with chronic constipation. METHODS: This was a multicenter, stratified, randomized, parallel-group, double-blind, placebo-controlled, phase 3 study (ClinicalTrials.gov identifier: NCT01147926). The primary end point was the proportion of patients with a mean of three or more spontaneous complete bowel movements (SCBMs) per week across the treatment period. Efficacy end points were assessed using daily electronic diaries, global assessment of the severity of constipation and efficacy of treatment, and Patient Assessment of Constipation-Symptoms (PAC-SYM) and Patient Assessment of Constipation-Quality of Life (PAC-QOL) questionnaires. RESULTS: In total, 374 patients were enrolled in the study. Significantly more patients achieved a mean of three or more SCBMs per week in the prucalopride group (37.9%) than in the placebo group (17.7%, P<0.0001). The proportion of patients rating their constipation treatment as "quite a bit" to "extremely" effective at the final on-treatment visit was 46.7 and 30.4% in the prucalopride and placebo groups, respectively. The difference between treatment groups was statistically significant (P<0.0001). The proportion of patients with an improvement of at least 1 point in PAC-QOL satisfaction subscale score was 52.7 and 38.8% in the prucalopride and placebo groups, respectively (P=0.0035). Prucalopride had a good safety profile and was well tolerated. CONCLUSIONS: Prucalopride is effective, has a good safety profile, and is well tolerated for the treatment of men with chronic constipation.

• MeSH
• Serotonin 5-HT4 Receptor Agonists adverse effects   therapeutic use   MeSH
• Benzofurans adverse effects   therapeutic use   MeSH
• Abdominal Pain chemically induced   MeSH
• Headache chemically induced   MeSH
• Medical Records MeSH
• Chronic Disease MeSH
• Defecation MeSH
• Adult MeSH
• Double-Blind Method MeSH
• Quality of Life MeSH
• Middle Aged MeSH
• Humans MeSH
• Nausea chemically induced   MeSH
• Diarrhea chemically induced   MeSH
• Surveys and Questionnaires MeSH
• Aged MeSH
• Severity of Illness Index MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged MeSH
• Publication type
• Journal Article MeSH
• Clinical Trial, Phase III MeSH
• Multicenter Study MeSH
• Research Support, Non-U.S. Gov't MeSH
• Randomized Controlled Trial MeSH

• MeSH
• Intussusception etiology   surgery   MeSH
• Middle Aged MeSH
• Humans MeSH
• Lipoma diagnosis   surgery   complications   MeSH
• Colonic Neoplasms surgery   MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Female MeSH
• Publication type
• Case Reports MeSH

Etiologie a patogeneze ulcerózní kolitidy nebyla dosud vyřešena. Je pravděpodobné, že se jedná o kombinaci faktorů genetických, imunologických a faktorů prostředí, které vedou k nekontrolovanému zánětu. Významnou roli hraje defekt vrozené imunity a střevní mikrobiální flóra. Hlavními cíly léčby ulcerózní kolitidy jsou udržení remise nemoci, slizniční hojení, vyhnutí se operaci a snížení pravděpodobnosti rozvoje kolorektální rakoviny.

Etiology and pathogenesis of ulcerative colitis is still unknown. It is a result of a combination of environmental, genetic and immunological factors in which an uncontrolled immune response within the intestinal lumen leeds to inflammation. Defect of innate immune response to microbial agents is involved in ulcerative colitis. Induction and maintenance of remission, mucosal healing, the avoidance of surgical intervention and decreasing the likelyhood of cancer developing are the primary therapeutic goals in ulcerative colitis.

• MeSH
• Remission Induction MeSH
• Colorectal Neoplasms prevention & control   MeSH
• Quality of Life MeSH
• Humans MeSH
• Mesalamine administration & dosage   MeSH
• Methylprednisolone administration & dosage   MeSH
• Antibodies, Monoclonal administration & dosage   MeSH
• Probiotics therapeutic use   MeSH
• Disease Progression MeSH
• Proctitis drug therapy   MeSH
• Antibodies, Antineutrophil Cytoplasmic diagnostic use   MeSH
• Severity of Illness Index MeSH
• Sulfasalazine administration & dosage   MeSH
• Colitis, Ulcerative diagnosis   drug therapy   complications   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Review MeSH

Východisko. Posuzování kvality života u chronických onemocnění se začíná přesouvat z oblasti klinických studií do praxe. Hlavním cílem projektu bylo zhodnocení kvality života u pacientů s Crohnovou nemocí ze dvou českých center pomocí českých verzí dotazníků kvality života: obecného World Health Organization Quality of Life – BREF a specifického Inflammatory Bowel Disease Questionnaire. Dále pak porovnání kvality života u pacientů s aktivitou a v remisi, jakož i porovnání s běžnou českou populací. Metody a výsledky. Pacienti s Crohnovou nemocí v celkovém počtu 103 osob byli podrobeni dotazníkovému šetření pomocí dvou českých verzí dotazníků zkoumajících kvalitu života. Soubor tvořilo 53 mužů a 50 žen, průměrný věk pacientů byl 42 let – 45 pacientů mělo zvýšenou aktivitu, 58 pacientů bylo v remisi. V naší skupině jsme zjistili průměrné globální skóre kvality života pomocí WHOQOL-BREF 3,5 (český standard 3,8) a spokojenost se zdravím 2,8 (český standard 3,7). Výsledky byly porovnány s českými standardy. Negativní vliv aktivity nemoci byl statisticky významný (p < 0,001) ve všech doménách obou dotazníků. Klinické faktory, jako je užití kortikosteroidů, imunosupresiv či operace, určitým způsobem ovlivnily některé domény. Závěry. Ve studii byl prokázán významný vliv aktivity nemoci na kvalitu života. Kombinace obecného a specifického dotazníku kvality života může poukazovat na faktory, které mohou být jinak nedoceněny. Kvalita života pacientů v remisi je srovnatelná s kvalitou života běžné české populace.

Background. The assessment of the quality of life in chronic diseases has started to move from clinical studies to practice. The main goal of the project was to assess the quality of life of Crohn's disease patients from two Czech centres by means of Czech versions of the general World Health Organization Quality of Life – BREF and specific Inflammatory Bowel Disease Questionnaire, to compare the quality of life of patients with an active disease and those in remission and to compare the quality of life with the general Czech population. Methods and Results. 103 patients with Crohn's disease underwent a survey performed by means of two Czech versions of quality of life questionnaire. The dataset consisted of 53 men and 50 women; the average age of patients was 42 years. Increased activity was observed in 45 patients; 58 patients were in remission. By means of WHOQOL-BREF, we found the average global score of quality of life and satisfaction with health in our group to be 3.5 (Czech standard 3.8) and 2.8 (Czech standard 3.7), respectively. The results were compared to the Czech standards. A negative influence of disease activity was statistically significant (p < 0.001) in all domains using either of the two questionnaires. Clinical factors such as the use of corticosteroids or immunosuppressives, and the history of surgery influenced some domains. Conclusions. The results from our study indicate that the disease activity may have a significant impact on the quality of life in Crohn's disease patients. A combination of the general and specific questionnaire may identify factors that would otherwise remain unappreciated properly. The quality of life of patients in remission was comparable to that of the general Czech population.

• MeSH
• Crohn Disease complications   physiopathology   psychology   MeSH
• Adult MeSH
• Data Interpretation, Statistical MeSH
• Quality of Life MeSH
• Middle Aged MeSH
• Humans MeSH
• Adolescent MeSH
• Young Adult MeSH
• Surveys and Questionnaires MeSH
• Age of Onset MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Adolescent MeSH
• Young Adult MeSH
• Male MeSH
• Female MeSH

Etiologie a patogeneze Crohnovy nemoci zůstává i přes intenzivní výzkum v této oblasti dosud nerozřešena. Vlastní etiologický faktor není znám, je však nepopiratelné, že jde o interakci mezi prostředím a geneticky vnímavým jedincem. Je popsána celá řada genů, ale funkční konsekvence genové mutace nejsou známy. Nové klasifikace Crohnovy nemoci hledají vztahy mezi fenotypem a genotypem nemoci a sérologickými markery. Kapslová endoskopie a enteroskopie zlepšila diagnostiku lézí v tenkém střevě. Časné užití imunosupresivní a biologické léčby má významný vliv na kvalitu života nemocných.

Etiology and pathogenesis of Crohn´s disease remains not completely understood. It is unquestionable interaction between the environmental and genetically susceptible individual. New genes are being describe, but the functional consequences of gene mutations are not known. New classifications of Crohn´s disease are searching interaction between fenotype and genotype of the disease and serological markers. Capsule endoscopy and enteroscopy improved detection of small intestinal

• MeSH
• Anti-Bacterial Agents administration & dosage   adverse effects   therapeutic use   MeSH
• Biological Therapy methods   utilization   MeSH
• Digestive System Surgical Procedures methods   utilization   MeSH
• Crohn Disease diagnosis   etiology   therapy   MeSH
• Diagnostic Techniques, Digestive System utilization   MeSH
• Drug Therapy methods   utilization   MeSH
• Adrenal Cortex Hormones administration & dosage   adverse effects   therapeutic use   MeSH
• Inflammatory Bowel Diseases diagnosis   etiology   therapy   MeSH
• Immunosuppressive Agents administration & dosage   adverse effects   therapeutic use   MeSH
• Disease Attributes MeSH
• Quality of Life psychology   MeSH
• Humans MeSH
• Methotrexate administration & dosage   adverse effects   therapeutic use   MeSH
• Prognosis MeSH
• Check Tag
• Humans MeSH
• Publication type
• Review MeSH

• Keywords
• Diclofenac, Meloxicam, Nimesulid,
• MeSH
• Anti-Inflammatory Agents, Non-Steroidal economics   adverse effects   therapeutic use   MeSH
• Pain drug therapy   complications   MeSH
• Economics, Pharmaceutical standards   statistics & numerical data   trends   MeSH
• Research Support as Topic MeSH
• Gastrointestinal Hemorrhage complications   mortality   therapy   MeSH
• Ibuprofen MeSH
• Humans MeSH
• Pain Management MeSH
• Osteoarthritis economics   epidemiology   drug therapy   MeSH
• Check Tag
• Humans MeSH
• Geographicals
• Czech Republic MeSH