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Microbial transplantation and its effect on the course of ulcerative colitis
Březina, Jan ; Drastich, Pavel (advisor) ; Šťovíček, Jan (referee) ; Janoštiak, Radoslav (referee)
The complex etiopathogenesis of idiopathic inflammatory bowel diseases (IBD) remains unclear, with one of the main suspected causes being the dysregulation of mucosal immunity in response to specific components of the gut microbiome. This dissertation investigates the potential of faecal microbiota transplantation (FMT) as an innovative therapeutic intervention aimed at modifying the microbiome and influencing the course of IBD. FMT, involving the transfer of stool from a healthy donor to the patient, has proven highly effective in the treatment of recurrent Clostridioides difficile colitis, where it is already considered a standard therapeutic procedure. However, in relation to IBD, FMT remains an experimental method, predominantly used in clinical studies. Current systematic reviews indicate that the effect of FMT on ulcerative colitis (UC) is variable, both in terms of achieving remission and clinical response. Recent randomized controlled trials for UC, in accordance with our presented data, show a mild to moderate effect of FMT in this indication. The effectiveness of FMT is influenced by a range of factors, particularly the correct selection of donor or donors, the diversity of their microbiome, methods of application, and frequency of administration. In the case of Crohn's disease, the data...
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Histopathological predictors of clinical course severity and development of surgical complications in children with inflammatory bowel diseases
Fabián, Ondřej ; Zámečník, Josef (advisor) ; Daum, Ondřej (referee) ; Karásková, Eva (referee)
The aim of the presented thesis is to summarize a benefit and limitations of histopathological assessment of bioptic samples for diagnostics and prediction of complicated course of the disease in children with inflammatory bowel diseases (IBD). We would also like to outline a potential benefit of more sophisticated histopathological methods in these domains. In the first phase of our research, we aimed at correlation of microscopical disease activity in children with Crohn's disease (CD) with activity assessed endoscopically and clinically. We also examined a histopathology as a possible predictor of development of complications, since previous works on adult cohorts indicate only a limited predictive value of microscopy. Our study confirmed this premise also for pediatric patients, since histopathological findings correlated weakly with endoscopy, didn't correlate with clinical activity of the disease and did predict none of the defined complications. On the other hand, endoscopy appeared to be a reliable predictor of complicated course of the disease. In the next part of our research, we were searching for other, more precise methods of assessment of histopathological disease activity that could serve as predictors of complications. We focused at immunohistochemical assessment of tissue...
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Dietary habits in inflammatory bowel disease
NÝVLTOVÁ, Natálie
This paper deals with the dietary habits of patients with inflammatory bowel disease. In the theoretical part, the anatomy of the digestive tract is described, then, for example, the epidemiology, clinical picture and therapeutic options for IBD. The first aim of the thesis was to describe the dietary habits of patients with idiopathic intestinal inflammation in the period of relapse and remission, as well as how the patients were educated about nutritional measures and in this way highlight the role of the dietitian. The second aim was to focus on the food choices of the low residue diet (Doberský, 1983) and the CDED diet, then to make comparisons for foods that might appear problematic from the CDED diet choices relative to the low residue diet of Doberský, (1983). Eight respondents diagnosed with IBD participated in the study. Data collection was conducted using a qualitative method with semi-structured interviews, and was subsequently compiled into individual case studies. A table of these selected foods was then evaluated. Finally, the menus sent by the respondents were evaluated using Nutriservis Professional software. Data analysis showed that in 7 of the 8 cases, the dietitian was not independently involved in patient education. Furthermore, in cases where adequate education was not provided, respondents tended to gravitate towards unnecessary dietary restrictions. The eating habits of the respondents during relapse and remission were highly individual. In the part of the paper where the food list was analysed, some respondents tolerated selected foods in relapse and remission, although none of them had an indicated CDED diet or were taking Modulen. This work may serve the patients with IBS themselves to better understand the nutritional issues in UC or CD. Also to students or the general public.
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Dietary habits of patients suffering from IBD
Metličková, Aneta ; Kohout, Pavel (advisor) ; Šimková, Simona (referee)
This diploma thesis titled "Dietary habits of patients suffering from IBD", deals with specifics of said diseases as well as nutrition of these patients. The theoretical part touches on Crohn's disease and ulcerative colitis, it lists characteristics, epidemiology, possible complications and treatments of these diseases. There is a detailed description of usage of medical nutrition therapy and various diets that use to be recommended to these patients. It also presents medical nutrition therapy as an indispensable element of the process of treating these diseases. The 4 main goals I set for my thesis were as follows: to map eating habits of respondents suffering from IBD; to compare eating habits of patients suffering from IBD with those of healthy respondents; to compare eating habits of patients suffering from CD with eating habits of patients suffering from UC and lastly - to find out where respondents get their information on their disease and nutrition from. The research consisted of 12 respondents in total of which half were patients suffering from IBD and the other half were healthy individuals. The group of respondents suffering from IBD consisted of 3 CD patients and 3 UC patients. To obtain the data I used a semi-structured interview as well as dietary recall. I chose to interview only...
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Calprotectin determination in patients with autoimmune disease.
ZÁZVORKOVÁ, Klára
The bachelor thesis deals with autoimmune diseases of GIT and laboratory determination of calprotectin by chemiluminescence method. In the theoretical part I focused on individual diseases, their description and treatment options. The main part of the thesis is devoted to the laboratory diagnosis of calprotectin from stool. I statistically evaluated 300 samples. And further I compared the method with other p-ANCA and ASCA methods.
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Nutrition in ulcerative colitis
PAVELKA, Filip
This bachelor thesis deals with nutrition in ulcerative colitis. The goal of the thesis was to find out how the nutrition meets nutritional and energetic needs of patients, to find out which foods most often cause problems for patients and to find out which foods are well tolerated and sought in the relapse. The thesis is divided into theoretical and practical section. The theoretical section deals with the disease of ulcerative colitis, its definition, clinical picture, treatment or nutrition. The section about nutrition deals with its most important components, important foods, nutrients, as well as recommended and mentioned diets. The practical section is divided into two parts. In the first part, data were obtained by a quantitative method using questionnare of own design. The research group consisted of 179 respondents with ulcerative colitis, who stated in the questionnaires, among other things, which foods they consume at various stages of the disease. In the second part of the research, two-week diets from 4 respondents with were evaluated. These diets were evaluated with the help of the Nutriservis application and the results were compared with the recommended values of energy and nutrient intake of individual respondents, calculated on the basis of height, weight, age and sex. The data obtained using the questionnaires show that the most common problems for patients in relapse cause e.g. legumes, poppies orfatty meats. Poppies, legumes ornuts, for example, most often cause problems in remission. On the contrary, lean meat, sea fish, eggs or potatoes are well tolerated in relapse. The evaluated diets of the respondents show that no respondent in the average values from the whole two weeks reached the calculated values of energy and essential nutrients, which i determined on the basis of calculations. The most deficient nutrient was carbohydrates of which there were 52 deficient days out of a total of 56.
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Management of multidisciplinary care in patients with inflammatory bowel disease.
KALMÁROVÁ, Diana
The diploma thesis deals with the management of multidisciplinary care for patients with inflammatory bowel diseases and is divided into a theoretical and a practical part. The theoretical part focuses on inflammatory bowel diseases, their characteristics, etiology and pathogenesis, diagnosis, treatment and psychosocial side of the disease. Another part of the theoretical part is the characteristics of management in nursing, nursing managers, the nursing profession itself, the multidisciplinary team in health care, the issue of competencies and the need for a multidisciplinary approach in the case of inflammatory bowel disease. The first aim of the thesis was to map the role of individual medical and non-medical staff involved in the care of patients with inflammatory bowel diseases, the second goal to find out how cooperation among these workers work and the third objective to identify dispensaries in patients with IBD outside hospital care. For the empirical part of the diploma thesis, a qualitative research survey was chosen, and semi-structured interviews were used as the method of data collection. Five variants of interviews were created, for nurses, doctors, nutrition therapists, psychologists and patients diagnosed with inflammatory bowel diseases. The research was conducted at the Clinical and Research Centre ISCARE in Prague and at the General University Hospital in Prague with the prior consent of the management of these facilities, except for patients who were contacted through patient groups and a psychologist who worked in his private outpatient facility. Based on interviews with nurses, doctors and a nutritional therapist, we were able to find out that as far as IBD centres are concerned, care is really interconnected and individual experts work as a multidisciplinary team led by doctors of various specialties, nurses, ostomy nurse, nutritional therapist. and a social worker. An exception is the representation of a psychologist, who unfortunately is not part of the team and there may be a problem with his / her availability, which was pointed out by some of the interviewees in the interviews. From the results of the research survey, we also managed to find out that patients have various options for better management of the disease, which are most often recommended to them by their attending physicians, but also by nurses. Nurses working in IBD centres are well versed in this issue and know the supportive options for patients with IBD. However, a problem in cooperation was found and appeared on the part of nurses, who in some cases take a passive attitude to education from an ostomy nurse, who is also an important member of a multidisciplinary team. Furthermore, based on research, we found that patients with IBD are often anxious and may have trouble trusting the nursing staff, so the main task of the nurse caring for such patients is to be more aware of these diseases, to know the supportive options, and to be able to educate clients. Respecting and understanding cooperation with other professionals are is important.
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Nutritional Particularities of Ulcerative Colitis
VÁVROVÁ, Veronika
This bachelor thesis is focused on nutrition issues in people suffering from one of the idiopathic intestinal inflammations, namely ulcerative colitis. The theoretical part deals with the characteristics of the disease, its symptoms, complications and treatment. Furthermore, it focuses more on nutrition and dietary recommendations during periods of remission, relapse and short bowel syndrome. The practical part is divided into three parts in which the method of qualitative investigation is used. The first part of the research examines how the respondents suffering from ulcerative colitis were acquainted with the residue-free diet, using semi-structured interviews. The second part of the research maps how the nutrition differs in individual respondents by considering their case history and evaluating their three-week diet. And in the third part, with the help of their nutritional history, the foods most frequently causing problems for respondents are mapped. The results of the research show that most respondents were educated by a doctor, not a nutrition therapist. Even some respondents were not answered their diet questions, so they had to search for diet information on the Internet or visit a nutritional clinic because they were already at risk of malnutrition or malnutrition. Energy and nutrient intake is sufficient for most respondents. Respondents with insufficient energy and nutrient intake supplement their energy and nutrients with sipping. As emerged from the research, almost all respondents eat rationally, only omitting meals that cause them problems. The most common meals, which bring about indigestion, are spicy dishes, fruits and vegetables with peel, grilled meat, milk and cabbage.
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Molekulární diagnostika fungálních patogenů z klinických vzorků
CIMICKÁ, Jana
This study is focused on optimization and use of molecular methods in mycological diagnostics. The patient's life often depends on early diagnosis, which current culture methods cannot provide. The solution is based on pan-fungal primers of ITS region and next generation sequencing (NGS). These methods were used for fungal detection from FFPE tissue samples from patients with ulcerative colitis (UC), Crohn disease (CD) and 10 controls without chronic inflammatory changes in the intestine. Results of this study have three levels. Firstly, the process of optimization highlights the importance of sterile DNA isolation in a laminar box which can prevent contamination by Malassezia spp. Secondly, raw data showed balanced rate of Ascomycota and Basidiomycota in CD samples similar to negative controls, while UC samples indicated higher representation of Ascomycota than other groups. Thirdly, detailed data showed fungal genera Malassezia, Cladosporium and Toninia in all groups, while genus Candida was found only in UC samples and genera Engyodontium and Ramularia were found in CD samples. In conclusion, mycobiome plays a role in inflammatory bowel diseases; however, its compartments are still questionable. The optimization of pan-fungal nested PCR and NGS helped with introduction of mycological diagnostics from FFPE samples to Bioptická laboratoř s.r.o. and is used for differential diagnostics.
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