Whipple’s Disease: Our Own Experience and Review of the Literature

Whipple’s disease is a chronic infectious systemic disease caused by the bacterium Tropheryma whipplei. Nondeforming arthritis is frequently an initial complaint. Gastrointestinal and general symptoms include marked diarrhoea (with serious malabsorption), abdominal pain, prominent weight loss, and low-grade fever. Possible neurologic symptoms (up to 20%) might be associated with worse prognosis. Diagnosis is based on the clinical picture and small intestinal histology revealing foamy macrophages containing periodic-acid-Schiff- (PAS-) positive material. Long-term (up to one year) antibiotic therapy provides a favourable outcome in the vast majority of cases. This paper provides review of the literature and an analysis of our 5 patients recorded within a 20-year period at a tertiary gastroenterology centre. Patients were treated using i.v. penicillin G or amoxicillin-clavulanic acid + i.v. gentamicin for two weeks, followed by p.o. doxycycline (100 mg per day) plus p.o. salazopyrine (3 g per day) for 1 year. Full remission was achieved in all our patients

Body indices and basic vital signs in Helicobacter pylori positive and negative persons

It has been hypothesized that Helicobacter pylori (Hp) infection may contribute to reduced stature, risk of hypertension or obesity. The aim was to evaluate body indices in Hp positive and negative persons. A total of 2436 subjects (4–100 years old) were tested for Hp status by 13Curea breath test. Data on height and weight were collected for 84%, and blood pressure for 80% of the study subjects. The prevalence of Hp infection was 41.6%. The odds ratio for a 10-year increase in age was 1.21 (95% CI 1.17–1.25, p-value <0.001). Statistically significant negative association of Hp positivity with body height was most pronounced in the younger age groups, while a positive association of Hp positivity with body mass index was only seen in those aged 15+ years. There was a negative effect of Hp positivity on systolic and diastolic blood pressure in subjects below 25 and a relatively strong positive effect on blood pressure in subjects over 65 years. Residual confounding by social characteristics as a possible explanation for the associations of Hp positivity with height and blood pressure cannot be excluded. Unmeasured factors related to social and family environment may cause the apparent association between Hp positivity and children’s growth and blood pressure

Relation Helicobacter pylori infection to anthropometric and socio-economic indices

Academic Department of Internal MedicineKatedra interních oborůLékařská fakulta v Hradci KrálovéFaculty of Medicine in Hradec Králov

Wireless Capsule Enteroscopy in Healthy Volunteers

Introduction: The aim of our prospective study was to define endoscopy appearance of the small bowel in healthy volunteers. Method: Forty-two healthy volunteers underwent wireless capsule endoscopy, clinical investigation, laboratory tests, and completed a health-status questionnaire. All subjects were available for a 36-month clinical follow-up. Results: Eleven subjects (26%) had fully normal endoscopy findings. Remaining 31 persons (74%), being asymptomatic, with normal laboratory results, had some minor findings at wireless capsule endoscopy. Most of those heterogeneous findings were detected in the small intestine (27/31; 87%), like erosions and/or multiple red spots, diminutive polyps and tiny vascular lesions. During a 36-month clinical follow-up, all these 42 healthy volunteers remained asymptomatic, with fully normal laboratory control. Conclusions: Significant part of healthy subjects had abnormal findings at wireless capsule endoscopy. These findings had no clinical relevance, as all these persons remained fully asymptomatic during a 36-month follow-up. Such an endoscopic appearance would be previously evaluated as “pathological”. This is a principal report alerting that all findings of any control group of wireless capsule endoscopic studies must be evaluated with caution

The importance of upper gastrointestinal lesions detected with capsule endoscopy in patients with obscure digestive bleeding.

Study aims: Small bowel capsule endoscopy (SBCE) is the first line procedure for detecting small bowel lesions in patients with an obscure gastrointestinal bleeding (OGIB). Missed upper gastro - intestinal (UGI) lesions at the initial endoscopy may account for the so-called OGIB. This retrospective study was designed to assess the role of SBCE in detecting missed UGI lesions. Methods: All consecutive SBCE that were performed in the last year for patients with OGIB were included in our study. We evaluated the visibility of the gastric mucosa, the anatomic landmarks, the presence of UGI lesions as well as their clinical importance. The SBCE findings were compared with the reports of previous UGI endoscopies. Results: 118 patients (45 males, 73 females, mean age 61 ± 19 years) were included in the analysis. The indication for SBCE was obscure overt and occult OGIB in 60 and in 58 patients, respectively. SBCE identified lesions in the small bowel in 42% of the patients. An excellent visibility of gastric mucosa was observed in 83/118 cases (70.3%). SBCE identified gastric lesions with potential clinical significance (high bleed potential) in 25/118 (21.2%) patients. In 12/118 (10.2%) patients the UGI lesions detected by SBCE were considered as the only potential source of bleeding. Conclusions: In patients with OGIB, SBCE detected not only small bowel lesions but also significant UGI lesions that were missed or underestimated at the initial endoscopy in 21% of cases. It is therefore necessary to carefully read the gastric images when performing an SBCE.Journal ArticleMulticenter Studyinfo:eu-repo/semantics/publishe

Polystyrene Microparticles and the Functional Traits of Invertebrates: A Case Study on Freshwater Shrimp Neocardina heteropoda

The excessive worldwide production of plastic materials results in omnipresent microplastic pollution. Scientific studies dealing with the impacts of microplastics on aquatic ecosystems focus mainly on the marine environment, documenting the effect on the functional traits of various organisms. Polystyrene, one of the most commonly used plastics, has become a widely used model in this respect. In our study, freshwater shrimps (Neocardina heteropoda) were exposed to virgin polystyrene particles (size 0.5 mm; nominal concentration 8 mgL&minus;1), and their behavioral and physiological responses were compared to control shrimp. The exposed shrimps exhibited modified activity patterns (greater speeds, accelerations and distances moved), accompanied by a lowered standard metabolic rate (SMR). The observed effects differed in their progression from the 7th to 14th day of exposure, from undetectable changes (distance, SMR) to significant differences (speed, acceleration). Significant differences were also detected in the behavioral syndromes expressed by the exposed and controlled shrimps, indicating that the microplastics influence not only the particular traits, but also their functional relationships. As such, our study contributes to the integration of behavioral ecotoxicology in risk assessment, documenting the adverse performance of freshwater invertebrates exposed to microplastics with the potential to transpose the problem to higher levels of the food web

Ekologické a ekonomické hodnocení celospolečenských funkcí variantně strukturálních typů lesů

V roce 2008 byly řešeny tyto dílčí úkoly. Dílčí úkol I - Analýza funkční struktury lesního ekosystému z hlediska vazby na postup hodnocení celospolečenských funkcí lesů: Stanovení vazeb (závislostí) mezi ekosystémovými procesy a složkami a hospodářskými zásahy a postupy; Stanovení vhodného souboru kritérií a indikátorů pro hodnocení stavu lesa či výsledků hospodaření ve vztahu k funkčním otenciálům a efektům. Dílčí úkol II- Návrh kvantifikace a kvantitativní hodnocení celospolečenských funkcí variantně strukturálních typů lesů: Definice porostní struktury jako redukčního kriteria; Determinace kategorizace, stupnice, členění) lesních porostů dle prostorové, věkové a druhové struktury; Specifikace (rozšíření a doplnění) struktury postupu kvantitativního hodnocení celospolečenských funkcí variantně strukturálních typů lesů. Dílčí úkol III - Praktická verifikace návrhu adice kvantifikace a kvantitativní hodnocení celospolečenských funkcí variantně strukturálních typů lesů: Terénní inventarizace porostních struktur vybraných modelových lokalit; Popis a hodnocení redukčních kriterií a dalších taxačních charakteristik vybraných modelových lokalit; Rekognoskace zahraničních modelových lokalit. Dílčí úkol V - Provozní a praktické aplikace metody: Softwarová aplikace Hoful 1.0