Risk of anal incontinence in women with inflammatory bowel diseases after delivery.

AIM: The aim of our prospective study was to evaluate the development of postpartum anal incontinence in patients with inflammatory bowel disease (IBD) compared to healthy women. MATERIAL AND METHODS: Patients with IBD and healthy controls enrolled in the study from January 1st 2013 to November 30th 2016 and filled in the anal incontinence questionnaire in the beginning of pregnancy and after vaginal delivery. The results were statistically processed using suitable tests. RESULTS: A total of 57 women were enrolled, 17 (29.8 %) with ulcerative colitis, 23 (40.4 %) with Crohn's disease, and 17 (29.8 %) healthy controls. Incidence of postpartum anal incontinence is comparable across all groups; there was no statistically significant difference between the IBD and control groups (Kruskal-Wallis test by ranks with Dunn correction, non-significant). Postpartum anal incontinence was strongly correlated with the extent of perineal injury (r = 0.80; p < 0.0001; Pearson's linear correlation). CONCLUSIONS: Women with inflammatory bowel disease in remission do not exhibit higher incidence of postpartum anal incontinence (PPAI) compared to healthy controls; the key correlate of PPAI appears to be the extent of obstetric injury, consistently across all study groups. These results suggest that concerns about postpartum anal incontinence development should not be an indication for Caesarean section in IBD patients (Tab. 6, Fig. 1, Ref. 34).

Fine needle aspiration biopsy in a diagnostic workup algorithm of salivary gland tumors.

The ultrasonic diagnosis of salivary gland diseases can give a more accurate information than clinical data alone. In diagnosis of the parotid gland diseases, it is necessary to differentiate clearly tumors from other diseases. When a tumor is suspected, its presence should be confirmed, and determined if it is solitary, multiple, unilateral or bilateral, intra or extraglandular, and benign or malignant. In the period of May 1998 to January 2001 ultrasound examinations were performed in 354 patients, FNAB with ultrasound control were performed in 152 patients with a mean age of 49.7 years. The ultrasound and cytologic findings were correlated with surgical and histologic findings. Results indicate that in patients with solid mass of the salivary gland, ultrasound examination confirmed the finding of salivary gland tumor in all patients (100%). In non-solid diseases of salivary glands the diagnostic accuracy was slightly lower. The use of ultrasound techniques in the study of salivary gland pathology is well justified, due to its capacity to provide high resolution and improving clinical diagnosis. FNAB is a simple quick, accurate and virtually complications free investigative modality. The data on its ability to distinguish between lesions requiring surgery or not are encouraging.

[Noncholinergic inhibition is the cause of differences in the heart rate in well-nourished and malnourished rats]. / Necholinergní inhibice je prícinou rozdílu v srdecní frekvenci dobre zivených a podvyzivených potkanu.

The postnatal development of heart rate was compared in rats from average litters (7-10 animals) and from oversize litters (15-18 animals). Rats from oversize litters were found to have a higher heart rate between the 25th and 45th day of life compared to animals from average litters. Over the further developmental period the difference kept decreasing to disappear completely at the age of 85 days. The difference was observed also in animals which received high doses of atropine and metipranolol and is thus not attributable to difference in the tonic influence of adrenergic and cholinergic innervation. Transmural stimulation of the sinoatrial node region in isolated atria allows to demonstrate the negative chronotropic effect in young animals from average litters. This noncholinergic inhibition was not observed in animals from oversized litters and in adult animals of both groups. It was blocked by theophylline in the majority of cases. All the observed findings can be explained in the light of noncholinergic inhibition of the sinoatrial node which is tonically effective in young animals from average litters and disappears in adulthood.