Mastitis in a flock of milking sheep.

INTRODUCTION: Determination of somatic cell counts (SCC) becomes more and more important also for ewe's milk. SCC can be a useful indicator of milk quality for milk processors while it can be a mastitis indicator for sheep keepers and an important selection criterion for breeders. The objective of our study was to acquire basic information about factors influencing SCC variability in lambing ewes of the Tsigai (T) and Improved Valachian (IV) breeds. Somatic cell counts (SCC) were determined in 866 milk samples in 2017 and 2018, during lamb sucking and during milking period. An instrument Fossomatic 90 (Foss Electric, Hillerød, Denmark) was used for analysis. Average SCC varied from 270 to 1897 × 103 cells/ml during lamb sucking and from 268 to 2139 × 103 cells/ml during milking period. Differences between the sampling periods were statistically significant in 2017. An increase in SCC was observed at the end of both sucking and milking periods. An overall evaluation of lactation brought about the average SCC at 364 × 103 cells/ml in 2017 (log(10) SCC - 2,25) and at 1,091 × 103 cells/ml in 2018 (log(10) SCC - 2,68). The indicator log(10) was significantly influenced by breed in 2017 (T - 2,61; IV - 2,75). The effect of lactation number and number of sucking lambs did not have any significant influence on SCC.

INTRODUCTION: La détermination du nombre de cellules somatiques (CCS) devient de plus en plus importante, y compris pour le lait de brebis. Le CCS peut être un indicateur utile de la qualité du lait pour les transformateurs tandis qu'il peut être un indicateur de mammites pour les éleveurs de brebis et un critère de sélection important pour les sélectionneurs. L'objectif de notre étude était d'acquérir des informations de base sur les facteurs influençant la variabilité de la CCS chez les brebis agnelées des races Tsigai (T) et Valachian améliorée (IV). Le nombre de cellules somatiques (CCS) a été déterminé dans 866 échantillons de lait en 2017 et 2018, pendant la tétée des agneaux et pendant la période de traite. Un instrument Fossomatic 90 (Foss Electric, Hillerød, Danemark) a été utilisé pour l'analyse. Le CCS moyen a varié de 270 à 1897 × 103 cellules/ml pendant la tétée des agneaux et de 268 à 2139 × 103 cellules/ml pendant la période de traite. Les différences entre les périodes d'échantillonnage étaient statistiquement significatives en 2017. Une augmentation du CCS a été observée à la fin des périodes de tétée et de traite. Une évaluation globale de la lactation a permis d'obtenir un CCS moyen de 364 × 103 cellules/ml en 2017 (log(10) CCS ­ 2,25) et de 1 091 × 103 cellules/ml en 2018 (log(10) CCS ­ 2,68). L'indicateur log(10) a été significativement influencé par la race en 2017 (T ­ 2,61 ; IV ­ 2,75). L'effet du nombre de lactations et du nombre d'agneaux de lait n'a pas eu d'influence significative sur le CCS.

Intrapulmonary sequestration with destructive pneumonia and life-threatening hemoptysis in an adult patient: a case report.

The article reports the case of a patient with bronchopulmonary sequestration complicated by destructive actinomycotic inflammation leading to life-threatening hemoptysis. It was an adult patient with the history of repeated right-sided pneumonia the cause of which had not been investigated in detail in the past. Only hemoptysis, which appeared as a complication, led to a closer investigation of the background of repeated right-sided pneumonia. CT scan of the chest revealed a lesion of the middle lobe of the right lung with anomalous vascularization - compatible with intralobar sequestration. Initially, conservative antibiotic treatment of pneumonia was provided at a local clinic. Embolization of the afferent vessels of the sequestrum was indicated due to persistent hemoptysis; this led to a reduction of its blood supply, proven by a follow-up CT examination of the chest. Clinically, the hemoptysis subsided. Three weeks later, the hemoptysis reocurred. The patient was acutely hospitalized at a specialized thoracic surgery department where shortly after admission, hemoptysis progressed to life-threatening hemoptea. Urgent middle lobectomy of the right lung was approached via thoracotomy to treat the source of bleeding. The case describes unrecognized bronchopulmonary sequestration as a possible cause of recurrent ipsilateral pneumonia in adulthood; additionally, it emphasizes the possible risks associated with a pathologically altered tissue microenvironment of pulmonary sequestration, and the need for surgical removal in all indicated cases.

Cytokine cascade in Kawasaki disease versus Kawasaki-like syndrome.

Kawasaki disease (KD) is a medium vessel systemic vasculitis that predominantly occurs in children below five years of age. It is an acute febrile condition in which coronary artery aneurysms and myocarditis are the most common cardiovascular complications. It is most often characterized by hypercytokinemia. The etiopathogenesis of KD is not fully understood. The present review synthesizes the recent advances in the pathophysiology and treatment options of KD. According to different studies, the genetic, infections and autoimmunity factors play a major role in pathogenesis. Several susceptibility genes (e.g. caspase 3) and cytokines (e.g. IL-2, IL-4, IL-6, IL-10, IFN-gamma and TNF-alpha) have been identified in KD. Patients with high cytokine levels are predisposed to KD shock syndrome. The importance of respiratory viruses in the pathogenesis of the disease is unclear. Coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may induce in children and adults an abnormal systemic inflammatory response. This syndrome shares characteristics with KD. It has been called by many terms like MIS-C (Multisystem Inflammatory Syndrome in Children), PIMS-TS (pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2), hyperinflammatory shock syndrome, cytokine storm (cytokine release syndrome) or simply, Kawasaki-like syndrome. The cytokine's role in the development of KD or Kawasaki-like syndrome being triggered by COVID-19 is controversial. The presences of the antiendothelial cell autoantibodies (AECAs) together with the newly developed hypothesis of immunothrombosis are considered potential pathogenic mechanisms for KD. In consequence, the diagnosis and treatment of KD and Kawasaki-like syndrome, one of the most common causes of acquired heart disease in developed countries, are challenging without a clearly defined protocol.

Tissue-specific fatty acid composition, cellularity, and gene expression in diverse cattle breeds.

The nutritional quality of beef relates to the fatty acid (FA) composition of bovine adipose tissue. Those molecular mechanisms that induce the differing amounts and composition of fat in cattle breeds according to age at maturity and purpose of production remain unclear. Therefore, this study investigated the composition of total FAs, adipocyte size, and expression of some key genes involved in several adipogenesis and lipogenesis pathways measured in distinct adipose tissue depots from bulls of the genetically diverse cattle breeds Aberdeen Angus (n = 9), Gascon (n = 10), Holstein (n = 9), and Fleckvieh (n = 10). The animals were finished under identical housing and feeding conditions until slaughter at a similar age of 17 months. After slaughter, cod adipose tissue (CAT), subcutaneous adipose tissue (SAT), and M. longissimus lumborum (MLL) samples were collected. The saturated FA proportions were higher (P < .01) in CAT than in SAT across all breeds, whereas monounsaturated FA proportions were consistently higher (P < .001) in SAT compared to CAT and MLL. Aberdeen Angus bulls were distinguished from the other breeds in the proportions of mostly de novo synthesized C14:0, C16:0, C14:1n-5, C16:1n-7, and conjugated linoleic acid (P < .05). Adipocyte size decreased in the order CAT > SAT > MLL, and the largest adipocytes were observed in CAT of Holstein bulls (P < .05). Gene expression differences were more pronounced between adipose tissue depots than between breeds. The expression levels of ACACA, FASN, and SCD1 genes were related to tissue-specific, and to a lesser extent also breed-specific, differences in FA composition.

A comprehensive diagnostic approach combining phylogenetic disease bracketing and CT imaging reveals osteomyelitis in a Tyrannosaurus rex.

Traditional palaeontological techniques of disease characterisation are limited to the analysis of osseous fossils, requiring several lines of evidence to support diagnoses. This study presents a novel stepwise concept for comprehensive diagnosis of pathologies in fossils by computed tomography imaging for morphological assessment combined with likelihood estimation based on systematic phylogenetic disease bracketing. This approach was applied to characterise pathologies of the left fibula and fused caudal vertebrae of the non-avian dinosaur Tyrannosaurus rex. Initial morphological assessment narrowed the differential diagnosis to neoplasia or infection. Subsequent data review from phylogenetically closely related species at the clade level revealed neoplasia rates as low as 3.1% and 1.8%, while infectious-disease rates were 32.0% and 53.9% in extant dinosaurs (birds) and non-avian reptiles, respectively. Furthermore, the survey of literature revealed that within the phylogenetic disease bracket the oldest case of bone infection (osteomyelitis) was identified in the mandible of a 275-million-year-old captorhinid eureptile Labidosaurus. These findings demonstrate low probability of a neoplastic aetiology of the examined pathologies in the Tyrannosaurus rex and in turn, suggest that they correspond to multiple foci of osteomyelitis.

Histological aspects of skeletal muscle fibers splitting of C57BL/6NCrl mice.

The objective of the current study is to present data on the splitting of skeletal muscle fibers in C57BL/6NCrl mice. Skeletal muscles (m. rectus femoris (m. quadriceps femoris)) from 500 (250 female and 250 male) C57BL/6NCrl mice in the 16th week of life were sampled during autopsy and afterwards standardly histologically processed. Results show spontaneous skeletal muscle fiber splitting which is followed by skeletal muscle fiber regeneration. One solitary skeletal muscle fiber is split, or is in contact with few localized splitting skeletal muscle fibers. Part of the split skeletal muscular fiber is phagocytosed, but the remaining skeletal muscular fiber splits are merged into one regenerating skeletal muscle fiber. Nuclei move from the periphery to the regenerating skeletal muscle fiber center during this process. No differences were observed between female and male mice and the morphometry results document < 1 % skeletal muscle fiber splitting. If skeletal muscular fibers splitting occurs 5 % > of all skeletal muscular fibers, it is suggested to describe and calculate this in the final histopathological report.

Nerozpoznaná preeklampsie, která se rozvinula do eklamptického záchvatu s fatálním koncem.

OBJECTIVE: A fatal case of a 37 year old women in the fifth month of pregnancy, who showed no signs of life and who could not be revived is reported. DESIGN: Case report. SETTINGS: Forensic expert in healthcare, Liberec; Department of Health Care Disciplines and Population Protection, Faculty of Biomedical engineering, Czech Technical University in Prague; Department of Biology, Faculty of Education, J. Selye University, Komarno, Slovak republic; Laboratory of Veterinary Histopathology in Komarno, Slovak republic. METHODS: The forensic necropsy was done. Toxicological and histological investigation of sampled material were done. RESULTS: The autopsy revealed bleeding into the brain chambers. The toxicology results were negative. The histopathological examination showed glomerulonephritis, bloody lungs, and massive bleeding in all sampled organs. From this it was concluded that her dead was caused by unrecognized preeclampsia, which developed into eclamptic attack with fatal consequence. CONCLUSION: To avoid these fatalities we recommend that the possibility of preeclampsia is investigated early in pregnancy especially in women with high blood pressure, for whom we also recommend more frequent controls in these early stages of pregnancy. We also recommend more intensive medical care for pregnant women with preeclamptic signs, including the possibility of a shorter schedule of management in specialist care in hospital, from the first symptoms onwards.

The effect of selected feed mixtures on the duodenal morphology: comparison study.

The objective of this work was to compare the effect of selected feed mixtures on the duodenal morphology. One-hundred-four rats of the Wistar strain were divided to thirteen groups per eight rats. The experiment started in 35-day-old rats after birth and lasted for 32 days. The groups (A-M) were fed by commercial diet, 85 % wheat and 15 % oat diet, 85 % wheat and 15 % triticale, 85 % wheat and 15 % barley, 85 % wheat and 15 % amaranth, 85 % wheat and 15 % lantern, 85 % wheat and 15 % buckwheat, 100 % wheat, 100 % white lupine, 100 % flock peas - variety Garden, 100 % native peas - variety Garden, 100 % native peas - variety Zekon or 100 % extruded peas - variety Zekon diet, respectively. Samples from the duodenum were taken. The height of the villi and the depth of the crypts were measured. The tallest villi were measured in group F (474.33+/-114.36 microm) and the shortest villi were observed in group B (294.08+/-88.52 microm). The deepest crypts were measured in group K (166.41+/-35.69 microm) and the shallowest crypts were observed in group E (77.85+/-17.61 microm). The work documents that gluten-free and classical cereals combination can be a better choice for people who want to limit the gluten content of the diet.

The relationship between hepatocytes and small bowel after early and short food restriction: What the results show in morphometry.

The objective of this study was to evaluate the relationship between hepatocyte morphometry and small bowel architecture after early and short food restriction. Altogether 48 Hyplus broiler rabbits were divided into three groups. The control group was fed ad libitum (ADL) throughout the experiment (C). The first group were food-restricted between 32 and 39 days of age, when the rabbits received 50g of food per rabbit each day (R1). The second group was restricted between 32 and 39 days and the rabbits received 65g of food per rabbit each day (R2). In 39 and in 81 days eight rabbits from all three groups were euthanized. The diameter of centrilobular, midzonal and periportal hepatocytes and the height of villi, the width of villi and the crypt depth were measured. The hepatocytes grew from centrilobular to perilobular part in the C group, but in the R1 and R2 group, an opposite trend was noticed. On day 39 and daye 81 the elevations of villi were the highest. Interestingly, the nadirs of the crypts were deepest in the C group compared to the R1 and R2 groups. Early short intensive food restriction may play a role in the prevention of liver diseases (Tab. 2, Ref. 20).

Effect of turmeric on the viability, ovarian folliculogenesis, fecundity, ovarian hormones and response to luteinizing hormone of rabbits.

The present study investigated whether dietary turmeric (Curcuma longa L.) can improve rabbit reproduction, ovarian function, growth, or viability. Female New Zealand White rabbits were either fed a standard diet (n=15) or a diet enriched with 5 g (group E1) or 20 g (group E2) turmeric powder per 100 kg feed mixture (n=16 or 15, respectively). After 295 days, weight gain, conception and kindling rates, pup and mother viability, ovarian macro- and micro-morphometric indices, release of leptin in response to the addition LH, and the release of progesterone, testosterone and leptin by isolated ovarian fragments were analyzed. Dietary turmeric failed to affect ovarian length and weight but did increase the number of primary follicles (E2: 32.5% greater than control group), as well as the diameter of primary (E1: +19.4%, E2: +21.1%), secondary (E2: +41.4%), and tertiary (E1: +97.1%, E2: +205.1%) follicles. Turmeric also increased the number of liveborn (E1: +21.0%) and weaned (E1: +25.0%) pups and decreased the number of stillborn pups (E2: -87.5%) but did not affect weight gain, conception, or kindling rate. Furthermore, dietary turmeric decreased doe mortality during the first reproductive cycle (13.3% in control; 0% in E1; and 6.7% in E2) but not during the second cycle. In vitro, the ovaries of the turmeric-treated rabbits released more progesterone (E1: +85.7%, E2: +90.0%) and less testosterone (E2: -87.0%) and leptin (E2: -29.0%) than the ovaries of control rabbits. Moreover, LH decreased the leptin output of control rabbits but increased that of experimental rabbits. Therefore, it is likely that dietary turmeric improves pup viability and that it could promote rabbit fecundity by either (1) promoting the production of primary ovarian follicles or (2) stimulating the growth of follicles at all stages of folliculogenesis.

The influence of food restriction on the small bowel: Does intensive short­term food restriction lead to weight loss?

The objective of this study was to show morphological changes in the small intestine of Hyplus broiler rabbits following an eight­day food restriction programme. The control group (C) received food ad libitum (ADL) for the duration of the experiment. Group R1 received 50g of food per day, and group R2 received 65g of food per day. After the food restriction diet had been completed, groups R1 and R2 were returned to ad libitum feeding. After food restriction and at the end of the experiment, the longest small bowel measurement was recorded in the C group. In the C group, after food restriction, the villi height was significantly higher, compared to that in R1 and R2 groups and at the end of the experiment, the villi were significantly higher in R1 and R2 groups. After food restriction, the values of crypts depth were approximately similar in all groups, and the end of experiment, the depth of crypts were deepest in R1and R2 groups, as compared to that in C group. The full process is followed by weight loss to the end of the experiment. These data suggest that intensive short­term food restriction followed by ADL feeding has effect on weight loss (Fig. 3, Ref. 30).

Maternal relationship analysis of skeletal remains from Early Medieval cemetery in Slovakia.

SUMMARY: MtDNA from the skeletal remains of two bodies buried in the grave No. F44 from Nitra-Sindolka (woman and child) was analysed. Cemeteries in Sindolka belong to the Bijelo Brdo culture, where Slavs and Magyars were buried in the 10th - 11th centuries. Surprisingly, the analysis of mtDNA has shown no maternal relationship between buried persons, since the woman belongs to haplogroup T1a and the child to haplogroup J. Since both haplogroups can be found in Near Eastern and European populations at similar frequencies, the tested samples from the tomb No. F44 cannot be clearly assigned to ethnic origin.

The effect of 1-week feed restriction on performance, digestibility of nutrients and digestive system development in the growing rabbit.

A 3 to 4 week feed restriction of about 20% to 25% of the free intake is widely applied in rabbit breeding systems to reduce post-weaning digestive disorders. However, a short intensive feed restriction is described in few studies and can be beneficial for growing rabbits due to a longer re-alimentation period. The aim of this study was to evaluate the effect of ad libitum (AL) and two restriction levels of feeding (50 and 65 g/rabbit per day) applied for 1 week on performance, gastrointestinal morphology and physiological parameters during the restriction and during the re-alimentation period. Rabbits were divided into three experimental groups: AL rabbits were fed AL, R1 rabbits were restricted from 42 to 49 days of age and received 50 g daily (29% of AL) and R2 rabbits were restricted at the same age and were fed 65 g of feed daily (37% of AL). In the 1(st) week after weaning and in the weeks after restriction, all the groups were fed AL. During the restriction period, daily weight gain (DWG) in R1 significantly dropped to 11% (experiment 1) and 5% (experiment 2) compared with rabbits in the AL group, although they were fed 29% of AL, whereas in the R2 group it decreased to 20% (experiment 1) and 10% (experiment 2). In the week following feed restriction, DWG in the restricted groups increased (P<0.001) to 166% and 148% in R1 and to 128% and 145% in R2. Restricted rabbits in both the experiments reached up to 90% to 93% of the final live weight (70 days) of the AL group. Over the entire experimental period, feed restriction significantly decreased feed intake to 85% to 88% of the AL group; however, the feed conversion ratio was lower (P<0.05) only in experiment 1 (-6% in R1 and -4% in R2). Digestibilities of CP and fat were not significantly higher during the restriction period and during the 1(st) week of re-alimentation compared with the AL group. Significant interactions between feeding regime and age revealed the shortest large intestine in the AL group at 49 days of age and the longest at 70 days in the AL and R1 groups. Small intestinal villi were significantly higher and the crypts were significantly deeper in the restricted groups. It could be concluded that short intensive feed restriction increased digestible area in the small and large intestines, including the height of villi and depth of crypts, which might be involved in the compensatory growth and defence mechanism.

MutL protein homologue 1(MLH1) in colon adenocarcinomas of the dog: minireview.

The mismatch repair gene MLH1 is a gene encoding the mismatch repair protein MutL homolog 1 (MLH1), important for repairing mutations generated during DNA replication. MLH1 absence has been observed in human gastrointestinal tumours as well as tumours of the female reproductive tract. We describe the functions of MLH 1 in cell cycle regulation and DNA mismatch repair. In this sense we discuss foriegn knowledges, in which the canine colon adencarcinoma is less frequently diagnosed in Czech and Slovak regions. We briefly described a molecular mechanism of evolution of MSI+ and MSI- colorectal carcinomas in human, and this was confronted with the current opinion of canine colon adenocarcinomas. We suppose that canine colon adenocarcinomas may occur in higher frequency, but they are underdiagnosed in the clinical veterinary practice. At the end, we describe two cases of dogs diagnosed with colorectal adenocarcinoma. The authors propose the centralized collection of colon adenocarcinoma samples from dogs, in one reference veterinary histopathological laboratory, which would analyse mismatch repair proteins.

[Hyponatremia - carbamazepine medication complications]. / Hyponatrémia - komplikácia liecby karbamazepínom.

Hyponatremia can be defined like the low sodium concentration, lower that 135 mmol/l. It becomes really serious when the concentration is lower than 120 mmol/l. The most frequent causes of hyponatremia are: the extrarenal loss (GIT, skin, bleeding, sequestration), the renal loss (diuretics, nephritis with the salt loss, osmotical diuresis, the Addison disease), hypothyroidism, the lack of glucocorticoids, emotional stress, pain, pseudohyponatremia (incorrect taking, dyslipoproteinemia). There is fatigue, exhaustion, headache and vertigoes dominating in the clinical record file. By the deficit increasing a patient becomes delirious, comatose even with the shock development. It is necessary to separate sufficient supply of sodium from much more often reason, which is loss of sodium which can be caused by: excessive sweating, vomitting with the metabolical alkalosis development, diarrhoea with the metabolical acidosis development, renal losses (a phase of renal failure). Treatment of hyponatremia: intensive treatment starts at the level of plasmatic concentration of sodium under 120 mmol/l or when neurological symptoms of brain oedema are present. In the therapy it is necessary to avoid fast infusions of hypertonic saline solutions (3-5% NaCl solutions) because of the danger of the development of serious CNS complications (intracranial bleeding, etc.). It is recommended to adjust the plasmatic concentration of sodium up to 120 mmol/l during the first four hours and a subsequent correction should not be higher than 2 mmol per an hour. Treatment of the basic illness is very important. We present 2 case histories: a 74-year old female patient and a 69-year old female patient both with the hyponatremia caused by taking of carbamazepine. We want to inform and warn about not only a well known side effect during long-term treatment but about hyponatremia that arose within 48 hours after the start of taking medicine as well.

[Morbus Ormond (idiopatic retroperitoneal fibrosis)]. / Ormondova choroba (idiopatická retroperitoneálna fibróza).

Idiopathic retroperitoneal fibrosis (IRF) is a rare condition characterized by the development of fibrotic tissue around the abdominal aorta and iliac arteries and often involves structures as ureters and the inferior vena cava. The age at onset of signs and symptoms is between 40-60 years, males predominane over females. In most cases the clinical manifestation is presented as compressive syndrom of ureters, therefore the first known cases were described by urologists. In this report we present the case of 37-years old male examinated for persistent fever about 38 degrees C and high inflammatory activity in spite of empiric antibiotic therapy. Positron emission tomography (PET) showed locality of high metabolic activity of fluorodeoxyglucose with maximum paraaortal left. Microscopic examination of extracted mass showed presence of fibrous and inflammatory components. With clinical presentation, imaging and histological findings we made out the diagnosis of idiopathic retroperitoneal fibrosis--morbus Ormond.

[The importance of and options available for screening of celiac disease]. / Význam a moznosti skríningu v diagnostike celiakie.

Even though guidelines for diagnosing celiac disease have been compiled and accepted by a number of expert associations, this disease continues to be under-diagnosed in children and, particularly, in adults. This is even though numerous scientific papers, short case studies and review papers have been published highlighting this issue and consensually supporting screening methods. In addition, research results by reputable Czech and Slovak authors suggest that, at present, only a small proportion of all cases of celiac disease are correctly diagnosed. Considering this, methods to diagnose the disease in its initial stage are continuously being sought. Biopsy of the mucosa of the small intestine remains the gold standard when diagnosing celiac disease. Within the targeted diagnostic algorithm, less invasive techniques should precede biopsy. These are applied mainly in cases of atypical forms of the disease and are based on an examination of serum autoantibodies. Their application and use is advantageous from many perspectives. However, practical clinical experience showed that they are not always sufficiently specific and sensitive. Using their own experience and published literature, the authors discuss the issues of screening and diagnosing celiac disease. It is obvious that targeted screening will undoubtedly uncover new, mainly atypical forms of celiac disease, while some cases shall remain undiagnosed. The diagnosis of celiac disease can be made on the basis of clinical, laboratory and histopathological correlation, respecting possible difficulties.

What can we do to promote the recognition of celiac disease: a report on diagnostic strategies.

Searching for risk groups with celiac disease is an interdisciplinary problem, and therefore it requires the co-operation of all branches of medicine. It has been suggested that the determination of antiendomysial antibody (AEA) and tissue transglutaminase (t-TG) should be performed by doctors in the first-contact medical facilities. In diagnosed patients, and especially in paediatric practice, it the values of autoantibodies regarding the adherence to a gluten-free diet should be monitored. After reaching the adulthood, patients should be entrusted to the care of gastroenterologists. Biopsy of duodenum samples remains the golden standard for the diagnosis of celiac disease. Every histological examination of a duodenum sample must be completed by histological grading in accordance to Marsh-Oberhuber. Histochemical investigation should be an inseparable part of the malabsorption diagnostics in biopsy. In controversial biopsies, such as a biopsy with minimal or mild pathological changes, application of antibodies to the intraepithelial lymphocytes is recommended. It is also useful to perform electron-microscopy of duodenum samples as well, when repeated biopsies are negative, but the patient's troubles persist (Ref. 32).

[Serum anti-endomysium antibodies (AEA) in the diagnostic algorithm of coeliac disease]. / Sérové protilátky proti endomýziu (AEA) v diagnostickom algoritme celiakie.

The diagnostic relevance of serum anti-endomysium antibodies (AEA) in patients with celiac disease is discussed. A group of 23 newly diagnosed patients, i.e., seven patients with mild AEA positivity (+), nine patients with intermediate AEA positivity (++) and seven patients with strong AEA positivity (+++), was selected. The AEA reactivity was evaluated semiquantitatively. Celiac disease and AEA are less than 100% correlated. The final diagnosis has to be confirmed by histopathology of small intestine biopsy specimens. The available targeted screening is an alternative with a potential for the detection of atypical forms of celiac disease. Another alternative for early diagnosis is the detection of intraepithelial lymphocyte activity or of lymphocyte mediators.

[From historical data and opinions to present challenges in the field of celiac disease]. / Od historických poznatkov a názorov az po súcasné ulohy na poli celiakie.

Celiac disease is a lifelong autoimmune intestinal disorder caused by sensitivity to gluten. In clinical practice, no causal treatment is currently available and the disease can only be treated by strict adherence to a gluten-free diet. The disease that was known in ancient Greece continues to draw attention of the professional public worldwide and has been studied by many researchers. As a result, a range of theoretical and practical knowledge has been obtained and thus further aspects of the disease can be addressed. At present the discussion is open not only to doctors, pharmacists, scientists and researchers at various posts, but also to economists, lawyers and managers. In the spectrum of disease manifestations, some new forms were diagnosed, including associations with other diseases. Therefore, a higher prevalence of this disease has been reported. Multiple review articles appeared in both the local and international literature to familiarize the professional public with the symptoms and signs of the disease. Their common aim was to contribute to the detection of the disease in children and adults. Despite that, the disease remains underdiagnosed. In this context, new challenges emerge in the field of celiac disease. The current practice in diagnosing celiac disease and the available and candidate dietary interventions for effective protection and support therapy are described. The importance of early screening and advanced approaches to disease management is underlined.