Q2908413
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PURPOSE: To study the time course of Crohn disease and its signs. To compare the results with the world literature and draw conclusions for practice. BASIC PROCEDURES: Fifty-six patients were studied retrospectively: 31 males aged 19-48 years with disease duration 1-8 years, and 25 females aged 21-65 with disease duration 1-13 years. The disease was active (Crohn disease activity index > 150) in 25 patients and inactive in 31. Plasma levels of interleukin-6 (normal upper value 8 pg/ml) were investigated with radioimmunoassay. Bone mineral density was measured as the T-score (normal range between -1 and 0 standard deviations) in the forearm using dual-energy X-ray absorptiometry. The seasonality of births of the patients in relation to the total Slovak population and seasonality of severity of three important disease signs were examined with Halberg cosinor regression. The dependence of the signs on age and duration of disease was evaluated using quadratic regression. Results are presented as 95% confidence intervals (for means) and 95% tolerance intervals (for individuals). The level of statistical significance was set at alpha = 0.05. MAIN FINDINGS: Significant seasonality in births was found: decreased frequency in May-June and increased frequency in September-January. Significant spring elevation of interleukin-6 levels, accompanied by significant spring rise of the disease activity index and by decrease of bone density, is described. Among patients with active disease, interleukin-6 levels significantly increased up to the age of 41 years, whereas linear increase of disease activity during aging was on the borderline level of significance in the same subgroup. No significant age trend was encountered in T-score for either subgroup. The same was true for interleukin-6 and disease activity versus duration. Significant decrease in T-score paralleled disease duration up to seven years in the subgroup with active disease. PRINCIPAL CONCLUSIONS: The course of Crohn disease is influenced by time, including the seasons of the year. However, this does not find full agreement in the world literature, probably because of geographic, socioeconomic and epidemiologic differences, as well as varying approaches in method. In practice, regular monitoring of the time course is necessary in provision of appropriately timed treatment.
- MeSH
- absorpční fotometrie MeSH
- chronobiologické jevy genetika MeSH
- Crohnova nemoc diagnóza epidemiologie patofyziologie MeSH
- dospělí MeSH
- interleukin-6 MeSH
- kostní denzita fyziologie MeSH
- referenční hodnoty MeSH
- regresní analýza MeSH
- retrospektivní studie MeSH
- rizikové faktory MeSH
- roční období MeSH
- senioři MeSH
- statistika jako téma MeSH
- Check Tag
- dospělí MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Geografické názvy
- Slovenská republika MeSH
- MeSH
- amositový azbest toxicita MeSH
- buněčné jádro účinky léků MeSH
- finanční podpora výzkumu jako téma MeSH
- krysa rodu rattus MeSH
- plíce účinky léků MeSH
- silikáty toxicita MeSH
- sloučeniny vápníku toxicita MeSH
- znečištění tabákovým kouřem škodlivé účinky MeSH
- zvířata MeSH
- Check Tag
- krysa rodu rattus MeSH
- zvířata MeSH
- MeSH
- dospělí MeSH
- elektrokardiografie MeSH
- hypoxie MeSH
- lidé MeSH
- mladiství MeSH
- plicní ventilace * fyziologie MeSH
- poruchy dýchání MeSH
- regresní analýza MeSH
- statistika jako téma MeSH
- syndrom dlouhého QT * etiologie patofyziologie MeSH
- Valsalvův manévr MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- hodnotící studie MeSH
Východisko. V ostatnom období sa objavili údaje o využití probiotík, medzi nimi aj Enterococcus faecium v liečbe chronickej hepatálnej encefalopatie pri cirhóze pečene. Výsledky získané preparátom Enterococcus faecium M-74 + Selén sa zhodnotia a porovnajú s tými, ktoré uverejnila Loguercio a spol. pre preparát Enterococcus faecium SF 68. Metódy a výsledky. Celkom 15 pacientov s cirhózou pečene, portálnou hypertenziou a chronickou hepatálnou encefalopatiou dostávalo okrem bežnej terapie probiotikum ”Enterococcus faecium M-74 + Selén”, 1 kapsulu denne v troch 4-týždňových obdobiach, oddelených dvoma 2-týždňovými prestávkami. V priebehu liečby bol každý pacient 9x vyšetrený. Závažnosť hepatálnej encefalopatie sme určovali stanovením indexu portálne systémovej encefalopatie z piatich vyšetrovaných parametrov (stavu vedomia, asterixis, testu spájania čísel, amoniaku v sére a EEG). Porovnali sme index na začiatku podávania probiotika a po jeho ukončení. Časový priebeh hladín amoniaku v sére a hodnôt testu spájania čísel v oboch štúdiách sa vzájomne porovnal na základe intervalových odhadov kvadratickej regresnej funkcie. Po liečbe sme zistili významné zlepšenie indexu portálne systémovej encefalopatie: klesol v priemere o 70 % ( 55 % až 85 %, interval 95% spoľahlivosti). Zlepšil sa mentálny stav, ustúpila asterixis. Po 8 až 9 týždňoch liečby hodnoty amoniaku v sére i testu spájania čísel sa významne priblížili k norme. EEG nález sa zlepšil a často i normalizoval. Pacienti v našej štúdii mali významne nižšie počiatočné hodnoty amoniaku v sére (zvýšenie o 31 % nad normu) i testu spájania čísel (zvýšenie o 60 %) ako u Loguercio et al. (zvýšenie o 243 % a 238 %). V priebehu našej liečby sa hodnoty znížili o 20 a 30 %, v porovnávanej o 50 a 70 %. Je zaujímavé, že výrazne vyšší relatívny liečebný efekt sa dosiahol pri ťažšom stupni poruchy v porovnávanej štúdii ako pri ľahšom stupni poruchy v našej štúdii. Závery.Naše výsledky potvrdzujú predpokladaný priaznivý účinok probiotika „Enterococcus faecium M-74 + Selén” na hepatálnu encefalopatiu.
Background.. Several reports about usefulness of probiotics, including Enterococcus faecium in the treatment of chronic hepatic encephalopathy in patients with liver cirrhosis have been recently published. The results obtained by the administration of Enterococcus faecium M-74 + seleniumwill be evaluated and compared with those published by Loguercio et al. for Enterococcus faecium SF 68. Methods and Results. Fifteen patients with liver cirrhosis, portal hypertension and chronic hepatic encephalopathy were treated, beside the standard therapy, alsowith one capsule of probiotic „Enterococcus faeciumM-74 + Selenium“ per day in three four-week periods, separated by two fortnight pauses. During the treatment, every patient was examined 9-times. The severity of chronic hepatic encephalopathy was evaluated with the aid of the portal systemic encephalopathy index, calculated from5 parameters (mental stage, asterixis, number connecting test, blood ammonia, EEG). The indexes of initial and final values were compared. The time course of blood ammonia levels and that of results from number connecting test in either study were mutually compared on the basis of interval estimates of quadratic regression function. Significant improvement of the portal systemic encephalopathy index after the treatment was found: it decreased in average by 70 % (55 to 85 %, interval 95% confidence interval). The mental stage improved and the asterixis disappeared. The blood ammonia levels as well as the results from the number-connecting test after 8–9 weeks significantly approached the normal pattern. EEG findings improved and they were often normalised. Our starting blood ammonia levels (increased by 31%above norm) and results fromthe connecting test (increased by 60 %) were significantly lower accordingly the Loguercio et al. (increased by 243 and 238 %, respectively). During the treatment, the values in our study decreased by 25 % and 30 %, in the compared study by 50 % and 70 %. Conclusions. Our results proved the hypothetical favourable effect of probioticum Enterococcus faecium M-74 + Selenium on chronic hepatic encephalopathy. Interestingly, a markedly higher relative therapeutic effect has been achieved in more serious disorder in comparison with the less severe disorders in the present study.
- MeSH
- albuminurie MeSH
- diabetes mellitus 1. typu MeSH
- diabetes mellitus 2. typu MeSH
- diabetická retinopatie MeSH
- diabetické nefropatie MeSH
- klinické zkoušky jako téma MeSH
- komplikace diabetu * MeSH
- lidé středního věku MeSH
- lidé MeSH
- nemoci kloubů * metabolismus MeSH
- oftalmologie MeSH
- proteinurie MeSH
- revmatologie MeSH
- rozsah kloubních pohybů MeSH
- senioři MeSH
- statistika jako téma MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- senioři MeSH
- MeSH
- coxsackie virózy diagnóza epidemiologie komplikace MeSH
- diabetes mellitus 1. typu diagnóza epidemiologie komplikace MeSH
- dítě MeSH
- lidé MeSH
- periodicita MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- Geografické názvy
- Slovenská republika MeSH
- MeSH
- autoprotilátky krev MeSH
- diabetes mellitus epidemiologie imunologie krev MeSH
- dítě MeSH
- lidé MeSH
- mladiství MeSH
- pankreas imunologie MeSH
- tyrosinfosfatasy imunologie krev MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- mladiství MeSH
- Geografické názvy
- Slovenská republika MeSH
