- MeSH
- hospitalizace MeSH
- lidé MeSH
- mladý dospělý MeSH
- parenterální výživa MeSH
- průjem etiologie patologie MeSH
- ulcerózní kolitida * komplikace terapie MeSH
- Check Tag
- lidé MeSH
- mladý dospělý MeSH
- ženské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
Histaminová intolerance (HI, HIT) může být označena rovněž jako enterální histaminóza nebo jako hypersenzitivita na orální/potravinový histamin. Jde o neschopnost degradace exogenního histaminu z důvodu zhoršené aktivity diaminooxidázy (DAO), což vede k příznakům z histaminového nadbytku. HI bychom měli chápat jen jako variabilní soubor příznaků, nejde ani o nozologickou jednotku, ani o syndrom. O diagnostice této metabolické poruchy rozhodují výhradně klinická kritéria spolu s prokazatelným efektem nízkohistaminové diety. Biomarkery nemají pro HI dostatečnou specificitu ani senzitivitu. Funkční i absolutní deficit DAO může být způsoben faktory genetickými, farmakologickými, anebo širokou heterogenní skupinou primárních enteropatií (sekundární HI).
Histamine intolerance (HI, HIT) may also be referred to as enteral histaminosis or hypersensitivity to oral/food histamine. It is the inability to degrade exogenous histamine due to impaired diaminooxidase (DAO) activity, resulting in symptoms of histamine excess. HI should be understood as a variable set of symptoms, neither a nosological entity nor a syndrome. The diagnosis of this metabolic disorder is made solely on the basis of clinical criteria and the demonstrated effect of a low histamine diet. No biomarkers are available for HI specificity. Both functional and absolute DAO deficiency can be caused by genetic, pharmacological or a broad heterogeneous group of primary enteropathies (secondary HI).
- Klíčová slova
- histaminová intolerance,
- MeSH
- agonisté histaminu terapeutické užití MeSH
- dietoterapie MeSH
- histamin * genetika metabolismus škodlivé účinky MeSH
- lidé MeSH
- potravinová intolerance diagnóza MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
Zvyšující se prevalence obezity a komorbidity s ní spojené vedou k nutnosti intenzivní prevence a léčby tohoto závažného onemocnění již lékaři prvního kontaktu. Základem léčby obezity jsou úpravy životního stylu, založené na pohybové aktivitě a dietních opatřeních. Tato opatření budou účinná pouze při plné spolupráci motivovaného pacienta. Text podává přehled o současných možnostech dietních opatření a možnostech pohybové aktivity u obézních pacientů v ordinaci praktických lékařů. Zvláštní pozornost věnuje možnostem spolupráce praktických lékařů s nutričními terapeuty.
The increasing prevalence of obesity and its associated comorbidities have led to the need for intensive prevention and treatment of this serious disease by primary care physicians. The treatment of obesity is focused on lifestyle modifications based on physical activity and dietary measures. These interventions will be only effective with the full cooperation of a motivated patient. The text gives an overview of the current options for dietary measures and physical activity in obese patients in general practitioners' offices. Special attention is paid to the possibilities of cooperation between general practitioners and nutritional therapists.
- MeSH
- lidé MeSH
- nutriční podpora MeSH
- obezita * dietoterapie terapie MeSH
- pohybová aktivita MeSH
- primární prevence MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
Je typickým představitelem autoimunitního onemocnění. Známe trigger vyvolávající onemocnění, patofyziologickou podstatu. Dokážeme identifikovat geneticky vnímavé jedince, protilátkovou odpověď a histolopatologické změny na sliznici tenkého střeva. Jedinou možnou léčbou dosud zůstává celoživotní dodržování bezlepkové diety. V současné době pozorujeme prudký nárůst prevalence v dětské i dospělé populaci. Lze to přisuzovat jistě kvalitnější a dostupnější diagnostice, a to jak endoskopické, tak laboratorní. Široká nabídka a dostupnost bezlepkových potravin a možnosti stravování v restauračních zařízeních výrazně zvýšila kvalitu života pacientů. Přesto zůstává v ČR hlavním problémem a úkolem k řešení narovnání diskriminačního postavení pacientů ve smyslu částečného hrazení bezlepkových potravin z veřejného zdravotního pojištění, možnost stravování ve školních jídelnách MŠ i ZŠ. Výzvou do budoucna je pečlivý rodinný screening a screening u rizikových skupin, s cílem zavedení bezlepkové diety co nejdříve a redukce rizika sekundárních komplikací.
It is a typical representative of autoimmune disease. We know the triggering trigger of the disease, the pathophysiological basis. We can identify genetically susceptible individuals, antibody response and histopathological changes in the small intestinal mucosa. Lifelong adherence to a gluten-free diet remains the only possible treatment. Currently, we observe a sharp increase in prevalence in both the paediatric and adult population. This can certainly be attributed to better and more accessible diagnostics, both endoscopic and laboratory. The wide availability and accessibility of gluten-free foods and the possibility of eating in restaurants has significantly improved the quality of life of patients. Nevertheless, in the Czech Republic, the main problem and challenge to be addressed is the possibility of catering in school canteens of both primary and secondary schools, in order to correct the discriminatory position of patients in terms of partial reimbursement of gluten-free food from public health insurance. The challenge for the future is careful family screening and screening in high-risk groups with the aim of introducing a gluten-free diet as soon as possible with a reduction in the risk of secondary complications.
- MeSH
- bezlepková dieta MeSH
- celiakie * diagnóza dietoterapie farmakoterapie MeSH
- lidé MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
Parenterální nutrice je nedílnou součástí komplexní péče o novorozence nezralé, s velmi nízkou porodní hmotností, kriticky nemocné nebo neschopné přijímat stravu. Složení parenterální výživy by mělo být sestavováno individuálně pro každého pacienta na základě jeho aktuálního zdravotního stavu a s ohledem na možné komplikace. Podává se tak dlouho, dokud není pacient schopen přijímat stravu v množství dostatečném pro pokrytí nutričních potřeb. Následující série článků má za cíl představit jednotlivé komponenty parenterální nutrice a praktický význam individualizované parenterální výživy na neonatologickém nebo pediatrickém oddělení. První část cyklu je věnovaná úvodu do problematiky, vodě a elektrolytům.
Parenteral nutrition is an integral part of comprehensive care for preterm infants, very low birth weight or critically ill infants, or those unable to take oral nutrition. The composition of parenteral nutrition should be individually tailored for each patient based on their current health status and taking into account possible complications. It is administered until the patient is capable of taking oral nutrition in an amount sufficient to meet nutritional needs. The following series of articles aims to introduce the individual components of parenteral nutrition and the practical significance of individualized parenteral nutrition in neonatology or pediatric departments. The first part of the series is dedicated to an introduction to the topic, water and electrolytes.
- MeSH
- fyziologie výživy kojenců MeSH
- lidé MeSH
- minerály MeSH
- novorozenec nedonošený * MeSH
- novorozenec MeSH
- parenterální výživa * MeSH
- vodní a elektrolytová rovnováha MeSH
- Check Tag
- lidé MeSH
- novorozenec MeSH
- Publikační typ
- přehledy MeSH
(1) Objectives: Intestinal failure in home parenteral nutrition patients (HPNPs) results in oxidative stress and liver damage. This study investigated how a high dose of fish oil (FO) added to various lipid emulsions influences antioxidant status and liver function markers in HPNPs. (2) Methods: Twelve HPNPs receiving Smoflipid for at least 3 months were given FO (Omegaven) for a further 4 weeks. Then, the patients were randomized to subsequently receive Lipoplus and ClinOleic for 6 weeks or vice versa plus 4 weeks of Omegaven after each cycle in a crossover design. Twelve age- and sex-matched healthy controls (HCs) were included. (3) Results: Superoxide dismutase (SOD1) activity and oxidized-low-density lipoprotein concentration were higher in all baseline HPN regimens compared to HCs. The Omegaven lowered SOD1 compared to baseline regimens and thus normalized it toward HCs. Lower paraoxonase 1 activity and fibroblast growth factor 19 (FGF19) concentration and, on the converse, higher alkaline phosphatase activity and cholesten concentration were observed in all baseline regimens compared to HCs. A close correlation was observed between FGF19 and SOD1 in baseline regimens. (4) Conclusions: An escalated dose of FO normalized SOD1 activity in HPNPs toward that of HCs. Bile acid metabolism was altered in HPNPs without signs of significant cholestasis and not affected by Omegaven.
Caloric Restriction (CR) has established anti-cancer effects, but its clinical relevance and molecular mechanism remain largely undefined. Here, we investigate CR's impact on several mouse models of Acute Myeloid Leukemias, including Acute Promyelocytic Leukemia, a subtype strongly affected by obesity. After an initial marked anti-tumor effect, lethal disease invariably re-emerges. Initially, CR leads to cell-cycle restriction, apoptosis, and inhibition of TOR and insulin/IGF1 signaling. The relapse, instead, is associated with the non-genetic selection of Leukemia Initiating Cells and the downregulation of double-stranded RNA (dsRNA) sensing and Interferon (IFN) signaling genes. The CR-induced adaptive phenotype is highly sensitive to pharmacological or genetic ablation of LSD1, a lysine demethylase regulating both stem cells and dsRNA/ IFN signaling. CR + LSD1 inhibition leads to the re-activation of dsRNA/IFN signaling, massive RNASEL-dependent apoptosis, and complete leukemia eradication in ~90% of mice. Importantly, CR-LSD1 interaction can be modeled in vivo and in vitro by combining LSD1 ablation with pharmacological inhibitors of insulin/IGF1 or dual PI3K/MEK blockade. Mechanistically, insulin/IGF1 inhibition sensitizes blasts to LSD1-induced death by inhibiting the anti-apoptotic factor CFLAR. CR and LSD1 inhibition also synergize in patient-derived AML and triple-negative breast cancer xenografts. Our data provide a rationale for epi-metabolic pharmacologic combinations across multiple tumors.
- MeSH
- akutní myeloidní leukemie * patologie MeSH
- histondemethylasy genetika MeSH
- inzuliny * MeSH
- kalorická restrikce MeSH
- lidé MeSH
- myši MeSH
- nádorové buněčné linie MeSH
- nádorové kmenové buňky patologie MeSH
- zvířata MeSH
- Check Tag
- lidé MeSH
- myši MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
CONTEXT: Carbohydrate-restricted diets are widely used as an effective treatment tool for many chronic diseases. The impact of these diets on physical health is well known, but their impact on psychological health is less well described in the scientific literature. This is an important aspect to focus on, especially if the diets are to be sustainable in the long term. OBJECTIVE: The objective of this study was to systematically review the scientific literature describing the effect of carbohydrate-restricted diets and ketogenic diets on psychological outcomes, as observed in randomized controlled trials. Additionally, the potential synergistic effect of carbohydrate-restricted diets and exercise or social factors on these outcomes was researched. DATA SOURCES: Five databases (Web of Science, PubMed, Scopus, ScienceDirect, and MEDLINE Complete) were searched without restriction of publication date. DATA EXTRACTION: The first data extraction was made in October 2020 and the second in May 2022. Abstract screening was performed by 3 independent reviewers. The quality of studies was assessed using the Jadad scale. DATA ANALYSIS: Sixteen randomized controlled studies were included in the analysis. Five studies focused on clinical populations, 9 on obese/overweight populations, and 2 on healthy populations; all studies examined adult people. Four psychological outcomes were identified (quality of life, mental health, mood, and fatigue), and they were examined in connection with a very low-carbohydrate or ketogenic diet. CONCLUSION: Daily low-carbohydrate intake may not negatively affect psychological well-being, and low-carbohydrate diets and ketogenic diets are no worse than other diets in this respect. An intervention of 12 weeks or longer can bring benefits in psychological well-being. The synergistic effect of diet and exercise or social factors was not reviewed due to lack of evidence.
Celiac disease is a common gastroenterological illness. Current diagnostics of the disease are based on serological markers and histology of duodenal biopsies. Hitherto, a strict gluten-free diet is the only effective treatment and is necessary for good control of the disease. Serological tests in current use have very high specificity and sensitivity for diagnostics, but in follow-up they have some limitations. Their levels do not accurately reflect mucosal healing, and they are unable to detect minimal transgressions in the diet. This problem is significant in patients with IgA deficiency, and there exist no robust follow-up tools for monitoring these patients' adherence to treatment. For their follow-up, we currently use IgG-based tests, and these antibodies persist for a long time even when a patient has stopped consuming gluten. More accurate and specific biomarkers are definitely needed. Adherence to a gluten-free diet is essential not only for intestinal mucosa healing and alleviation of symptoms but also for preventing complications associated with celiac disease. Here, we summarize current evidence regarding noninvasive biomarkers potentially useful for follow-up not only of patients with IgA deficiency but for all patients with celiac disease. We describe several very promising biomarkers with potential to be part of clinical practice in the near future.
- MeSH
- bezlepková dieta MeSH
- biologické markery MeSH
- celiakie * MeSH
- deficience IgA * MeSH
- gluteny MeSH
- imunoglobulin A MeSH
- lidé MeSH
- následné studie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
- MeSH
- lidé MeSH
- nutriční podpora MeSH
- stravovací zvyklosti MeSH
- střevní mikroflóra * MeSH
- zdravá strava MeSH
- Check Tag
- lidé MeSH
