INTRODUCTION: Infections accompanying pancreatitis, particularly pancreatic necroses, represent a serious complication associated with worsening of the disease prognosis. The aim of our study was to explore whether this complication could be prevented by administering a probiotic. METHODS: The probiotic was administered to 7 patients and placebo to 15. The study was discontinued early following the release of the Propatria study results. RESULTS: There was no death in our patient sample and there was no difference between the two groups in microbial colonisation or the length of hospitalization. However, a reduction in endotoxin levels on day 7 and 10 of the hospitalization was observed in the probiotic-treated group. CONCLUSION: Based on the current knowledge, administration of probiotics in this indication is contraindicated. Nonetheless, reduction in endotoxin levels suggests a positive effect of probiotics on bacterial translocation, the importance of which should be evaluated in the future.

• MeSH
• akutní nemoc MeSH
• bakteriální infekce komplikace   prevence a kontrola   MeSH
• dvojitá slepá metoda MeSH
• endotoxiny krev   MeSH
• lidé středního věku MeSH
• lidé MeSH
• pankreatitida krev   komplikace   MeSH
• probiotika terapeutické užití   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH
• randomizované kontrolované studie MeSH
• Názvy látek
• endotoxiny MeSH

We present a case of a 46 years old female with familial adenomatous polyposis of the colon. The adenocarcinoma had been treated using all available oncology therapeutic modalities. Late post-radiation changes caused ileus that required acute surgical revision, and formation of difficult-to-define enterovesical fistula that led to recurring urosepsis. When the conservative methods, including enteral and, subsequently, home total parenteral nutrition, were unsuccessful, the patient underwent successful surgery with resection of the affected intestinal loops, part of the bladder, evacuation of an abscess in the small pelvis and terminal jejunostomy. As a result of this procedure, the patient is now able to take food per os without infectious complications. The resulting short bowel syndrome is managed by administration of additional parenteral nutrition and registration of the patient for intestinal transplantation is being considered.

• MeSH
• adenokarcinom chirurgie   MeSH
• chirurgie trávicího traktu škodlivé účinky   MeSH
• familiární adenomatózní polypóza komplikace   terapie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• nádory tračníku chirurgie   MeSH
• syndrom krátkého střeva etiologie   terapie   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH
• kazuistiky MeSH

Acute hemorrhage from esophageal varices due to portal hypertension is a frequent and serious complication of liver cirrhosis. Bacterial infection may be one of the factors influencing such hemorrhage. Endotoxins may increase portal tension and at the same time result in primary hemostasis disorder, thus becoming one of the causes of hemorrhage. The authors of the paper compared the incidence of bacterial infection in 53 patients with varicose hemorrhage due to portal hypertension with 62 patients with liver cirrhosis and portal hypertension without varicose hemorrhage. At least one pathogen was found in considerable 61.1% of the total of patients in the liver cirrhosis group, while the difference between the two groups was but insignificant. No statistically significant difference was found between the group of patients with hemorrhage and those without hemorrhage in terms of presence of bacterial infection in hemoculture, urine, throat, faeces and ascites, nor was there a difference in the etiology of the G+ bacteria, G- bacteria or fungi and yeast infectious agents in the hemoculture, urine, throat, faeces and ascites in either of the groups. No statistically significant difference was found in comparing the patients with a recurrence of hemorrhage (or with mortality) and with infection with those without recurrence of hemorrhage. Bacterial infection was more often found in patients with a recurrence of hemorrhage (75%) as compared with those without any recurrence (52%), and also in patients who died bacterial infection was proven more often than in those who survived (61.9% vs. 58.1%, respectively). There was no difference in morbidity or recurrence of hemorrhage between the patients treated with norfloxacin and ampicilin/sulbactam. No statistically significant difference was recorded between the 1st and 5th day in terms of decrease in bacterial infection. A significant difference was found in the urine etiological agent, where a significant increase in the share of fungal and yeast urine infection (p = 0.011) was recorded after the application of the therapy, as well as a drop in urine infection caused by the G- bacterial agent (p = 0.057).

• MeSH
• bakteriální infekce komplikace   MeSH
• ezofageální a žaludeční varixy mikrobiologie   MeSH
• gastrointestinální krvácení mikrobiologie   MeSH
• jaterní cirhóza mikrobiologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• portální hypertenze mikrobiologie   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH

The purpose of the study was to verify effects of Escherichia coli Nissle (Mutaflor) on intestinal colonisation, endotoxin levels, hepatic encephalopathy and liver function in patients with liver cirrhosis. The study involved 39 patients (22 taking Mutaflor and 17 taking placebo). Even though the number combination test showed extended reaction time in patients with described minimal hepatic encephalopathy the drop was not significant in the trend evaluation. However, the treated group displayed significant improvement of intestinal colonisation (p < 0.001) and a trend towards significant reduction of endotoxin levels on day 42 (p = 0.07) and improvement of liver function assessed with the Child-Pugh classification on days 42 and 84 (p = 0.06). Probiotic preparations can therefore represent a significant contribution to this group therapy.

• MeSH
• dospělí MeSH
• endotoxiny krev   MeSH
• Escherichia coli * MeSH
• jaterní cirhóza komplikace   mikrobiologie   patofyziologie   terapie   MeSH
• jaterní encefalopatie etiologie   psychologie   MeSH
• játra patofyziologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• probiotika terapeutické užití   MeSH
• senioři MeSH
• střeva mikrobiologie   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• randomizované kontrolované studie MeSH
• Názvy látek
• endotoxiny MeSH

Probiotics are live cultures of mikroorganisms which are good for human health and are used in human medicine as a treatment. Advantageous effect on a human health was proved in many studies in Europe and in the USA. On the other hand, many studies described lack of information about products containing probiotics - in particular the real bacterial strain or quantity of bacteria. We tried to evaluate thirteen products containing probiotics available in the Czech Republic. In all cases the leaflets contained information about the species and amount of bacteria (from seven products containing more than one species of bacteria were only in two cases declared the quantity of particular bacteria, in five cases was declared just the total quantity of bacteria). The declared species of bacteria were cultured in all tested products. Concluding; the information on the leaflets of probiotic products is sufficient for a clinical practice and the real species and quantity of bacteria come up to declared data.

• MeSH
• Bacteria izolace a purifikace   MeSH
• označování potravin * MeSH
• probiotika analýza   normy   MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH

An acute bleeding from oesophageal varices as a result of portal hypertension is a frequent and at the same time serious complication of cirrhosis of the liver. One of factors influencing this bleeding can be a bacterial infection. Endotoxines can increase portal pressure and so participate in development of bleeding and simultaneously deteriorate a patient's prognosis. An antibiotic treatment is a part of a treatment algorithm, however what antibiotics to administer and in what manner is unclear. A group of 46 patients who were admitted to a hospital for an acute bleeding from varices has been compared in the study to 48 cirrhosis patients hospitalised for other reasons. An infection incidence was high in both groups (63.0 % vs. 54.2 %), bleeding patients had more often positive hemoculture (17.3 % vs. 8.6 %), and statistically significantly more often positive findings in throat swab culture (36.9 % vs. 17.3 %, p = 0.04) which is an evidence of an increased pathology colonisation of these patients. Bleeding patients were randomised for peroral norfloxacin administration (n = 25) or an intravenous administration of a combination of ampicilin and sulbactam (n = 21). There was no difference in survival of both groups. Due to a high number of bacterial infections antibiotics administration has been indicated in these patients. Intravenous administration is probably of the same effect as peroral administration.

• MeSH
• ampicilin aplikace a dávkování   MeSH
• antibakteriální látky aplikace a dávkování   MeSH
• aplikace orální MeSH
• bakteriální infekce komplikace   diagnóza   farmakoterapie   MeSH
• dospělí MeSH
• ezofageální a žaludeční varixy komplikace   mikrobiologie   MeSH
• gastrointestinální krvácení etiologie   mikrobiologie   MeSH
• intravenózní infuze MeSH
• jaterní cirhóza komplikace   mikrobiologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• norfloxacin aplikace a dávkování   MeSH
• portální hypertenze komplikace   mikrobiologie   MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• sulbaktam aplikace a dávkování   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH
• klinické zkoušky MeSH
• práce podpořená grantem MeSH
• randomizované kontrolované studie MeSH
• Názvy látek
• ampicilin MeSH
• antibakteriální látky MeSH
• norfloxacin MeSH
• sulbaktam MeSH
• sultamicillin MeSH Prohlížeč