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Clinical and genetic predictors of drug dependency in inflammatory bowel disease
Ďuricová, Dana ; Lukáš, Milan (advisor) ; Keil, Radan (referee) ; Špičák, Julius (referee)
IN ENGLISH Drug dependency in inflammatory bowel disease (IBD), Crohn's disease (CD) and ulcerative colitis (UC), is a specific disease phenotype which determines disease prognosis and hence may be used as a prognostic marker for treatment management. Drug dependency in IBD has been well described in corticosteroid treatment and recently also in infliximab (IFX) therapy. The aims of this thesis were: 1) to assess the occurrence of IFX dependency in paediatric and adult patients with CD; further to search for clinical and genetic predictors of IFX outcome and to evaluate the impact of IFX dependency on surgical rate; 2) to assess in CD patients the outcome of the first course of 5-ASA monotherapy with emphasis on 5-ASA dependency and to define clinical predictors of 5-ASA treatment outcome. We found that 66% of children and 29% of adults with CD became IFX dependent. The high frequency in paediatrics is in agreement with previously published studies, while the finding in adult patients indicates a lower rate of IFX dependency in the only study to date. Perianal disease and no bowel surgery prior to IFX start were predicative of IFX dependency in paediatric patients. In adult cohort, 2 genetic variants LTA c.207 A>G and CASP9 c.93 C>T were associated with IFX outcome, whereas no relevant clinical...
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Dysregulation of E3 ubiquitin ligases in inflammatory bowel diseases
Armerová, Eliška ; Petrezsélyová, Silvia (advisor) ; Červená, Klára (referee)
E3 ubiquitin ligases are a large family of enzymes involved in many cellular processes such as DNA damage repair, transport of membrane proteins, chromatin modification, cell cycle and apoptosis. E3 ubiquitin ligases have been shown to play a significant role in the maintenance of intestinal homeostasis, and their abnormal function associated with their deregulation contributes to inflammatory bowel diseases such as ulcerative colitis and Crohn's disease. In recent years, GWAS has identified approximately 200 risk loci that are susceptible to these diseases. Including those encoding E3 ubiquitin ligases.The aim of this work is to compare the already identified E3 ubiquitin ligases associated with these diseases and to give an overview of them with a focus on the regulation of intestinal homeostasis. Key words: E3, ubiquitination, inflammatory bowel diseases, intestinal homeostasis, CD, UC
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Dysregulation of E3 ubiquitin ligases in inflammatory bowel diseases
Armerová, Eliška ; Petrezsélyová, Silvia (advisor) ; Červená, Klára (referee)
E3 ubiquitin ligases are a large family of enzymes involved in many cellular processes such as repair of damaged DNA, transport of membrane proteins, chromatin modification, cell cycle and apoptosis. E3 ubiquitin ligase has been shown to play a significant role in the maintenance of intestinal homeostasis, and their abnormal function associated with their deregulation contributes to inflammatory bowel diseases such as ulcerative colitis and Crohn's disease. In recent years, approximately 200 risk loci have been identified that are susceptible to these diseases, including those encoding E3 ubiquitin ligase. 10 of them have been identified. The aim of this work is to compare the already identified E3 ubiquitin ligases associated with these diseases and to give an overview of them with a focus on the regulation of intestinal homeostasis. Key words: E3, ubiquitination, inflammatory bowel diseases, intestinal homeostasis, CD, UC
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Inflammatory Bowel Diseases in pregnancy
Kovářová, Tereza ; Krátká, Zuzana (advisor) ; Hadlová, Petra (referee)
(EN) Inflammatory bowel disease is a chronic autoimmune disease of the intestinal tract including Crohn's disease, ulcerative colitis, and other unspecified colitis. Depending on the type of disease, inflammation affects the small or large intestine or rectum. It is a multifactorial disease in which the intestinal microflora, the immune system status, and genetic predisposition are crucial. IBD is most often diagnosed in late adolescence or early adulthood. Due to the availability of quality treatment, the health status of IBD patients also improves, allowing them to consider starting a family after the disease has calmed down. Patients have fewer children than the general population, but there was no significantly higher risk of infertility. A prerequisite for successful pregnancy and childbirth is a stable condition of the disease and the use of treatment during pregnancy to prevent relapse. A specific problem of patients is voluntary childlessness because of worries about the worsening of IBD during or after pregnancy, about negative effects of treatment on a foetus, but also an occurrence of disease in offspring This work aims to summarize the issue of pregnancy in patients with IBD and to provide information on the current situation in patients with IBD in the Czech Republic. Keywords:...
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Pathophysiology of inflammatory bowel disease. Relation to primary scklerosing cholangitis, liver transplantation and carcinogenesis.
Bajer, Lukáš ; Drastich, Pavel (advisor) ; Živný, Jan (referee) ; Procházka, Vlastimil (referee)
Inflammatory bowel disease (IBD) represents a group of multifactorial illnesses with increasing incidence worldwide. Crohn's disease (CD) and ulcerative colitis (UC) are the two most thoroughly defined phenotypes of IBD. IBD associated with primary sclerosing cholangitis (PSC) - a progressive biliary disease leading to cirrhosis and liver failure - is considered as specific IBD phenotype (also referred to as 'PSC - IBD') due to its clinical and pathophysiological characteristics. The aim of the experimental part of this thesis was to define specific features of PSC - IBD in the key areas of IBD pathogenesis. These are: microbiota composition, gut - barrier failure, genetic predisposition and aberrant cellular and antibody immune response. Furthermore, the other goals were to describe relation of IBD status and activity to liver transplantation (LTx) and carcinogenesis based on thorough analysis of clinical data in patients under surveillance at the liver transplantation unit. Using the next-generation parallel sequencing technology, we discovered specific bacterial and mycobial features of gut microbiota composition in PSC - IBD which significantly differed from UC and healthy controls recruited from Czech general population. Moreover, we identified numerous seral biomarkers distinguishing CD, UC...
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Influence of targeted nutritional intervention on postoperative results in patients after intestinal resections
Hlaváčková, Iva ; Šerclová, Zuzana (advisor) ; Meisnerová, Eva (referee)
This diploma thesis is focused on patients who are undergoing surgery - intestinal resection. In a surgical patient, malnutrition is a frequent and significant negative factor that affects postoperative morbidity and lethality. Proper nutritional care has an irreplaceable role in the prevention and treatment of malnutrition. Nutritional elements are part of the perioperative care of the modern ERAS concept, which leads to reduction in the frequency of postoperative complications and a shortening of the hospitalization duration. The concept emphasizes early physical rehabilitation and shortening of the fasting period around the time of the operation, which leads to a significant saving of body protein. The theoretical part describes particular diseases that lead to surgical treatment. Special attention is paid to idiopathic intestinal inflammations and colorectal cancer. It also includes current recommendations of professional companies. The primary objective of the practical part is to compare two groups of patients who underwent intestinal resection. To find out whether targeted nutritional intervention (before, during and after surgery) has an impact on postoperative convalescence, the frequency of complications and the overall length of hospitalization. The aim was also to improve the quality of...
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Complications of tube enteral feeding in inflammatory intestine diseases
Polachová, Monika ; Meisnerová, Eva (advisor) ; Šatný, Marek (referee)
The diploma thesis is devoted to complications of enteral nutrition in patients with idiopathic inflammatory bowel diseases. The incidence of these diseases has increased in recent years. Nutritional support is an important part of the treatment and the possibility of improving the nutritional status of patients, which plays an important role in responding to other forms of treatment itself or in pre-operative preparation. All forms of artificial nutrition might also cause certain complications. The subject of this work is to observe the complications of enteral nutrition, their solutions and the possibilities of their prevention.
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The quality of life of children with Crohn's disease
Vaňková, Vendula ; Mareš, Jiří (advisor) ; Vaňková, Dana (referee)
Author: Vendula Vaňková Institution: Charles University in Prague Faculty of Medicine in Hradec Králové, Department of Social Medicine, Department of Nursing Title: The quality of life of children with Crohn's disease Supervisor: prof. PhDr. Jiří Mareš, CSc. Number of pages: 120 Number of attachments: 8 Year of defense: 2018 Keywords: Crohn's disease, children and adolescents, inflammatory bowel diseases, quality of life, mixed approach This bachelor thesis explores the quality of life of adolescents with Crohn's disease. The theoretical part deals with Crohn's disease - the incidence of diseases in adults and children and adolescents, etiology, symptoms, complications, diagnosis and treatment. The next chapter focuses on the specificities of Crohn's disease in childhood. The notion of quality of life is explained in the next chapter together with a description of previous research on this issue. Qualitative and quantitative research in adolescents with Crohn's disease is key to work. The tested set was established from five adolescents aged 14 - 17 (3 girls and 2 boys). The adolescents answered the questions in the semi-structured interview, then completed the PedsQL questionnaire, which evaluates children's quality of life. The thesis verifies the quality of life of adolescents with Crohn's...
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Needs of patients with inflammatory bowel disease.
LIDOVÁ, Michaela
This bachelor thesis focuses on the needs of patients with inflammatory bowel disease. The principal types of inflammatory bowel disease are Crohn's disease and ulcerative colitis. According to some authors, it also includes indeterminate colitis, in which the specific disease cannot be clearly identified. These two diseases are among chronic inflammatory diseases of the digestive tract. They differ in the area of the infliction of the digestive tract. Crohn's disease affects any part of the digestive tract, while ulcerative colitis affects the rectum and the large intestine. Both diseases are manifested by the frequent painful emptying of the diurnal stool with the addition of blood during an acute outburst. It is important to diagnose the disease as soon as possible and to initiate early treatment. It is also very important to follow the management of the diet and to regularly visit the doctor. In the theoretical part, we also deal with a hierarchy of needs. It is essential for a nursing team to know the patient's needs. From this knowledge, the whole nursing process may continue to develop. If a patient suffers from some of the needs, it can have a significant impact on the mental, physical and social side of the person. In the practical part of the bachelor thesis we dealt with qualitative research. The research consisted of eight respondents who suffered from one of the inflammatory bowel disease. Semi-structured interviews were conducted on the basis of a stated goal: To map the needs of patients living with inflammatory bowel disease. The research was conducted in a domestic environment. Results from data collected from patients were categorized and then processed. According to our research, it is quite clear that the most important thing for these patients is to satisfy the need for emptying. This thesis will help students to get new information about the diseases in question and could also serve as a source of information for patients with newly diagnosed inflammatory bowel disease.
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