OBJECTIVE: To bring actual summary of pre and perinatal care of women with Crohn's disease and ulcerative colitis. DESIGN: Review. SETTING: Department of Gynaecology and Obstetrics, General Faculty Hospital and 1st Faculty of Medicine, Prague. METHODS: Review of articles. CONCLUSION: Care of women with inflammatory bowel diseases should be placed in a specialised centre and management of pregnancy should be discussed by a multidisciplinary team included obstetrician, gastroenterologist, surgeon and nutritional specialist. All the possibilities in treatment of these women (except a few of them) are safe during the pregnancy and in the puerperium both for mother and fetus.

• Klíčová slova
• Crohn, IBD, biological therapy, inflammatory bowel disease, pregnancy,
• MeSH
• dospělí MeSH
• idiopatické střevní záněty patofyziologie   MeSH
• komplikace těhotenství patofyziologie   MeSH
• lidé MeSH
• poporodní období MeSH
• těhotenství MeSH
• výsledek těhotenství MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

Inflammatory bowel disease (IBD) is highly prevalent. While the pathophysiological mechanisms of IBD are increasingly understood, there is a lack of knowledge concerning cognitive dysfunctions in IBD. This is all the more the case concerning the underlying neurophysiological mechanisms. In the current study we focus on possible dysfunctions of cognitive flexibility (task switching) processes in IBD patients using a system neurophysiological approach combining event-related potential (ERP) recordings with source localization analyses. We show that there are task switching deficits (i.e. increased switch costs) in IBD patients. The neurophysiological data show that even though the pathophysiology of IBD is diverse and wide-spread, only specific cognitive subprocesses are altered: There was a selective dysfunction at the response selection level (N2 ERP) associated with functional alterations in the anterior cingulate cortex and the right inferior frontal gyrus. Attentional selection processes (N1 ERP), perceptual categorization processes (P1 ERP), or mechanisms related to the flexible implementation of task sets and related working memory processes (P3 ERP) do not contribute to cognitive inflexibility in IBD patients and were unchanged. It seems that pathophysiological processes in IBD strongly compromise cognitive-neurophysiological subprocesses related to fronto-striatal networks. These circuits may become overstrained in IBD when cognitive flexibility is required.

• MeSH
• analýza rozptylu MeSH
• dospělí MeSH
• evokované potenciály MeSH
• idiopatické střevní záněty metabolismus   patofyziologie   psychologie   MeSH
• kognice * MeSH
• lidé MeSH
• mladý dospělý MeSH
• neurofyziologie * MeSH
• pozornost MeSH
• reakční čas MeSH
• TNF-alfa metabolismus   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• TNF-alfa MeSH

UNLABELLED: Low bone mineral density (BMD) and an increased fracture incidence are two extraintestinal complications associated with inflammatory bowel disease (IBD). We aimed to evaluate musculoskeletal traits and assess vertebral fracture (VF) rate in children and adolescents with IBD. Seventy patients with IBD with a median age of 13.8 years were included. The BMD and geometric parameters of the non-dominant tibia were assessed using pQCT. Dynamic muscle functions were evaluated using jumping mechanography. VFs were assessed according to the semiquantitative standardized method by Genant. The muscle functions adjusted for the patients' weight did not differ from the reference population. A low trabecular BMD (Z-score - 1.6; p < 0.001) and cortical thickness (Z-score - 0.7; p < 0.001) were found in children and adolescents with IBD. Conversely, an increased cortical BMD (Z-score 1.1; p < 0.001) was noted. No significant association was found between the 25-OHD serum levels and the bone or muscle measurements. One patient with asymptomatic VF was identified. CONCLUSION: IBD in childhood or adolescents affects bones but not muscles. Bone changes are independent of the 25-OHD serum level. A thoracolumbar spine X-ray should not be routinely recommended in children with IBD. What is Known: • Low bone mineral density and an increased fracture rate are the complications associated with IBD. • Bone strength and structural development is strongly dependent on skeletal muscle stimulation. What is New: • Children with IBD have altered bone density and geometry but normal dynamic muscle functions. • Thoracolumbar spine X-ray should be indicated on an individual basis in children with IBD.

• Klíčová slova
• Bone strength, Inflammatory bowel disease, Mechanography, Muscle functions, Peripheral quantitative computed tomography, Vitamin D,
• MeSH
• absorpční fotometrie MeSH
• dítě MeSH
• fraktury páteře diagnostické zobrazování   epidemiologie   etiologie   MeSH
• idiopatické střevní záněty komplikace   patofyziologie   MeSH
• kostní denzita * MeSH
• lidé MeSH
• logistické modely MeSH
• mladiství MeSH
• mladý dospělý MeSH
• prevalence MeSH
• průřezové studie MeSH
• rentgendiagnostika MeSH
• rizikové faktory MeSH
• svalová síla * MeSH
• trabekulární kostní tkáň patofyziologie   MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

BACKGROUND: Inflammatory bowel diseases (IBD) are associated with altered bone health and increased risk for fractures. Vitamin D deficiency is frequently found in IBD; however, the effect of vitamin D supplementation on bone health of children with IBD is poorly understood. We aimed to observe the changes in volumetric bone density and dynamic muscle functions after vitamin D substitution in a cohort of pediatric patients with IBD. METHODS: This was a prospective observational study of 55 patients (aged 5-19 years) with IBD. Bone quality was assessed using peripheral quantitative computed tomography and muscle functions by jumping mechanography at baseline and after a median of 13.8 (interquartile range, 12.0-16.0) months of daily substitution of 2000 IU of cholecalciferol. RESULTS: Median serum levels of 25-hydroxyvitamin D increased from 58 nmol/L at the baseline visit to 85 nmol/L at the last follow-up visit (P < 0.001); no signs of overdose were reported. The Z-scores of trabecular bone mineral density, cortical bone cross-sectional area, and maximal muscle power improved significantly during the follow-up period (+0.5, P = 0.001, +0.3, P = 0.002 and +0.5, P = 0.002, respectively). Cholecalciferol substitution was positively associated with trabecular bone mineral density and maximal muscle power (estimates 0.26, 95% confidence interval 0.14-0.37, P < 0.0001 and 0.60, 95% confidence interval 0.32-0.85, P < 0.0001, respectively) but not with the Strength-Strain Index or maximal muscle force (Fmax). CONCLUSIONS: We observed an improvement in bone and muscle parameters after cholecalciferol substitution in pediatric patients with IBD. Therefore, vitamin D substitution can be considered in such patients.

• MeSH
• cholekalciferol aplikace a dávkování   MeSH
• dítě MeSH
• idiopatické střevní záněty patofyziologie   terapie   MeSH
• inhibitory kostní resorpce aplikace a dávkování   MeSH
• kostní denzita účinky léků   MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• potravní doplňky * MeSH
• předškolní dítě MeSH
• prospektivní studie MeSH
• svalová síla účinky léků   MeSH
• trabekulární kostní tkáň účinky léků   MeSH
• výsledek terapie MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• předškolní dítě MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• pozorovací studie MeSH
• práce podpořená grantem MeSH
• Názvy látek
• cholekalciferol MeSH
• inhibitory kostní resorpce MeSH

OBJECTIVE: Heart rate variability (HRV) oscillations are used in the detection of autonomic instabilities in various clinical disorders. METHODS: We compared the HRV as a possible marker of chronic distress in children with inflammatory bowel disease (IBD) with HRV frequencies in the healthy controls. Participants were 29 children with IBD (19 Crohn's disease and 10 ulcerative colitis), 25 children were in remission and 4 presented mild disease activity. They were compared with the control group of 35 healthy children of the same age (13-16 years-old). RESULTS: In HRV assessment, adolescents with IBD had significantly lower levels of the spectral activity in an LF band in all three positions; lower levels of VLF in both supine positions; and the ratio of the spectral activity at LF/HF was significantly lower in the second post (standing). CONCLUSION: These results indicate children with IBD have less adaptability to stress.

• MeSH
• autonomní nervový systém patofyziologie   MeSH
• Crohnova nemoc patofyziologie   MeSH
• idiopatické střevní záněty patofyziologie   MeSH
• lidé MeSH
• mladiství MeSH
• srdeční frekvence fyziologie   MeSH
• ulcerózní kolitida patofyziologie   MeSH
• Check Tag
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

Zdenek Mařatka has been the first physician, who had brought a new information for the Czech medical community with topic of inflammatory bowel diseases, which had been systematic studied for him. He had prepared an original theory - two component hypothesis about origin of ulcerative colitis, which had been developed and innovated by him for long time. From the international point of view, Mařatka has had an extraordinary impact and significant contribution for recognition of ulcerative colitis and Crohn´s disease. Despite the fact that the true origin of ulcerative colitis and Crohn´s disease (UC) still remain elusive, basic as well as clinical research bring many new data on etiology and pathogenesis of this inflammatory condition. It seems clear that IBD originate from interaction of several intrinsic and extrinsic factors that contribute individually in a particular patient. Among internal factors the genes play an important role, because its influence on the mucosal immunity system and immunological response. Among the external factors importance are recognized the gut microbiota content, cigarette smoking and psychological stress.

• MeSH
• Crohnova nemoc patofyziologie   MeSH
• idiopatické střevní záněty patofyziologie   MeSH
• lidé MeSH
• ulcerózní kolitida patofyziologie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

Calprotectin represents an interesting peptide known to be involved in the pathophysiology of various inflammatory processes. Being secreted from activated neutrophils and monocytes under various conditions, it can also be found in the extracellular fluids and serve as a biomarker of ongoing inflammation, which property is currently used in the monitoring of inflammatory bowel diseases. Recent studies, however, suggest that calprotectin could serve as an important prognostic factor for cardiovascular and cardiometabolic diseases, since these are occurring on the basis of low-grade chronic inflammation. We assume that calprotectin may represent a useful marker in predicting the course of atherosclerotic process, coronary artery disease and acute coronary syndromes. Our review is focused on the importance of calprotectin in the diagnosis and prognostic stratification in the field of cardiometabolic risk.

• Klíčová slova
• Calprotectin, Cardiovascular diseases, Metabolic diseases, Myocardial infarction, Obesity,
• MeSH
• akutní koronární syndrom patofyziologie   MeSH
• ateroskleróza etiologie   MeSH
• biologické markery MeSH
• idiopatické střevní záněty patofyziologie   MeSH
• kardiovaskulární nemoci etiologie   patofyziologie   MeSH
• leukocytární L1-antigenní komplex fyziologie   MeSH
• lidé MeSH
• nemoci koronárních tepen patofyziologie   MeSH
• prognóza MeSH
• riziko MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• přehledy MeSH
• Názvy látek
• biologické markery MeSH
• leukocytární L1-antigenní komplex MeSH

The prevalence of chronic autoimmune and inflammatory diseases, such as inflammatory bowel disease, allergies, or rheumatic diseases, is steadily increasing in developed countries. This increase is probably accelerated by environmental factors, such as decrease in infectious burden or changes in food processing. These lifestyle changes then strongly influence the strongest stimulus for the immune system - commensal microbiota. Despite the differences in the affected organ, the immune-mediated diseases have one or more factors in common - microbe either as a trigger or as a protector, mucosal barrier dysfunction, and dysregulation of the immune system. The core questions, which microbes are involved and how these diseases can be cured or even prevented still remain unsolved. Powered by the recent progress in technology, by new insights into the function of immune system, by advances in microbiome research, and extended use of gnotobiological techniques, these mechanisms are now being unravelled and new therapeutic possibilities are emerging. To secure their niche, the microbes devised many ingenious ways, how to dampen the inflammation. Nonpathogenic microorganisms or microbial components isolated from probiotic, commensal or even pathogenic microbes could be, therefore, used to interfere with the pathogenetic mechanisms of immune-mediated diseases.

• MeSH
• alergie mikrobiologie   patofyziologie   terapie   MeSH
• autoimunitní nemoci mikrobiologie   patofyziologie   terapie   MeSH
• celiakie mikrobiologie   patofyziologie   terapie   MeSH
• gastrointestinální trakt mikrobiologie   patofyziologie   MeSH
• idiopatické střevní záněty mikrobiologie   patofyziologie   terapie   MeSH
• interakce hostitele a patogenu MeSH
• lidé MeSH
• metagenom * MeSH
• nemoci parodontu mikrobiologie   patofyziologie   terapie   MeSH
• probiotika metabolismus   MeSH
• střevní sliznice mikrobiologie   patofyziologie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• přehledy MeSH

BACKGROUND: In recent years, many achievements have been realized in the therapy of inflammatory bowel disease (IBD) although its etiology remains unknown. Thus IBD treatment is symptomatic and targets general inflammatory mechanisms. Oral formulations containing 5-aminosalicylic acid (5-ASA) have become the standard therapy for mild-to-moderate IBD. OBJECTIVE: This article is a review of recently published research dealing with new 5-ASA dosage forms. Thus promising candidates for IBD treatment evaluated in vitro are reported; systems tested in vivo in trinitrobenzene sulfonic acid (TNBS)-induced colitis in rats are mentioned; and 5-ASA formulations used in clinical studies are presented. Moreover, all oral dosage forms containing 5-ASA or its prodrugs are reviewed; their characteristics and utilization in IBD treatment are discussed. CONCLUSION: In several clinical studies, it has been shown that multiparticulates such as pellets offer more advantages as compared with single unit forms, that is, coated tablets. Prolonged presence close to the site of the action, improved drug bioavailability, and easier administration of large drug doses belong to the benefits of pellets.

• MeSH
• antiflogistika nesteroidní aplikace a dávkování   MeSH
• idiopatické střevní záněty farmakoterapie   patofyziologie   MeSH
• klinické zkoušky jako téma MeSH
• lidé MeSH
• mesalamin aplikace a dávkování   MeSH
• příprava léků metody   MeSH
• systémy cílené aplikace léků metody   MeSH
• zvířata MeSH
• Check Tag
• lidé MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• Názvy látek
• antiflogistika nesteroidní MeSH
• mesalamin MeSH

BACKGROUND: Despite holistic approach to psychosomatic medicine, gastroenterological disorders (GI) tend to be categorized broadly into "functional" and "organic". Major GI illnesses are Inflammatory bowel diseases (IBD) include ulcerative colitis and Crohn's disease. Both are chronic, with remissions and relapses over the years while irritable bowel syndrome (IBS) is a common, often disabling functional gastrointestinal disorder. METHODS: A literature review was performed using the National Library of Medicine PubMed database, including all resources within the period 1991-2008, additional references were found through bibliography reviews of relevant articles. RESULTS: Psychological problems: Higher scores of neuroticism, depression, inhibition, and emotional instability, are typical for many patients with chronic diseases and nonspecific for chronic gastroenterological disorders. Patients with chronic gastrointestinal disorders have impaired health-related quality. Psychological treatments: There have been few adequate psychological treatment trials in IBD. These achieved lower demands for health care rather than a reduction of anxiety or depression. Psychotherapy with chronic gastrointestinal disorders could lead to improve the course of the disease, changing psychological factors such as depression and dysfunctional coping and improving the patient's quality of life. CONCLUSIONS: There seem to be "risk patients" in whom psychosocial components have a bigger influence on the course of disease than in other patients; and those would probably benefit from psychotherapeutic treatment. Psychological treatments help patients manage the psychological distress which worsens bowel symptoms and quality of life.

• MeSH
• adaptace psychologická MeSH
• afektivní symptomy terapie   MeSH
• deprese terapie   MeSH
• dítě MeSH
• idiopatické střevní záněty patofyziologie   psychologie   terapie   MeSH
• kvalita života MeSH
• lidé MeSH
• neurotické poruchy terapie   MeSH
• psychoterapie * MeSH
• syndrom dráždivého tračníku patofyziologie   psychologie   terapie   MeSH
• zdravotní stav MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH