[Keratin fragments as a serological indicator in patients with a liver disease]. / Keratinové fragmenty jako sérologický ukazatel u nemocných s jaterní chorobou.

INTRODUCTION: Determination of M30 antigen appears to be a sensitive method for evaluation of hepatocyte apoptosis. The aim of the present project was to implement this technique, compare M30 values in patients with a liver disease and healthy controls and to identify potential relationships between M30 values and other parameters. METHODS: M30 antigen was assessed in 25 patients with a liver disease and 30 healthy controls. These results were compared between patients with a liver disease and the controls and correlated to a range of clinical and laboratory values, including tissue polypeptide-specific antigen (TPS), in patients with a liver disease. RESULTS: We found significant differences in M30 values between controls and patients with a liver disease. The only significant correlations were the correlation between M30 and ALT, highly significant correlation between M30 and AST and highly significant correlation between M30 and TPS. CONCLUSION: The M30 antigen is a sensitive indicator of liver damage. Considering the highly significant correlation with TPS, it can be assumed that in some liver diseases, TPS could serve as a clinically useful indicator of apoptosis.

[Prophylactic antibiotics and probiotics in acute pancreatitis]. / Preventivní podání antibiotik a probiotik u tezké akutní pankreatitidy.

Severe acute pancreatitis is serious disease. High mortality is also due to infection complications. If we will be able to prevent the infection, it could diminish mortality. The role of prevention of infection with antibiotics and probiotics is discussed in the paper.

[Probiotics in acute pancreatitis--a randomised, placebo-controlled, double-blind study]. / Probiotika u akutni pankreatitidy--randomizovaná, placebem kontrolovaná, dvojite slepá studie.

INTRODUCTION: Infections accompanying pancreatitis, particularly pancreatic necroses, represent a serious complication associated with worsening of the disease prognosis. The aim of our study was to explore whether this complication could be prevented by administering a probiotic. METHODS: The probiotic was administered to 7 patients and placebo to 15. The study was discontinued early following the release of the Propatria study results. RESULTS: There was no death in our patient sample and there was no difference between the two groups in microbial colonisation or the length of hospitalization. However, a reduction in endotoxin levels on day 7 and 10 of the hospitalization was observed in the probiotic-treated group. CONCLUSION: Based on the current knowledge, administration of probiotics in this indication is contraindicated. Nonetheless, reduction in endotoxin levels suggests a positive effect of probiotics on bacterial translocation, the importance of which should be evaluated in the future.

[Liver cirrhosis and its treatment]. / Jaterní cirhóza a její lécba.

Cirrhosis is an end-stage liver disease. It is necessary to always search for the cause, attempt to initiate suitable causal treatment and assess the severity of hepatopathy by evaluating hepatic functional reserve (according to the Child-Pugh classification). It is necessary to continually monitor possible complications of cirrhosis, some can be prevented. Regular clinical and laboratory monitoring as well as ultrasound and endoscopic examinations are required. The paper discusses the treatment of the disease as well as its complications. Cure can only be achieved with a liver transplant; this option should be evaluated by a hepatologist in each patient with functional classification B or with serious complications of portal hypertension mentioned above. Treatment standards compiled by the Czech Society of Hepatology (http://www.ceska-hepatologie.cz) offer the basic algorithms of correct diagnosis and treatment.