Treatment of adjuvant-induced arthritis with the combination of methotrexate and probiotic bacteria Escherichia coli O83 (Colinfant).

A certain relationship was observed between the gastrointestinal system, arthritis and immune system. Patients with rheumatoid arthritis have an altered microflora composition and disturbed intestinal defensive barrier. Effect of probiotic bacteria (Colinfant; COL) with known favorable effect on intestinal microflora was determined on the methotrexate (MTX) treatment of adjuvant arthritis. Rats with adjuvant arthritis were administered methotrexate 0.5 mg/kg body mass 2-times weekly per os, COL 1 mL/kg body mass every second day per os, and a combination of MTX+COL for a period of 28 d from the immunization. Levels of serum albumin, body mass, changes in hind paw swelling, and arthrogram score were estimated in rats as variables of inflammation and destructive arthritis-associated changes. Treatment with MTX, as well as with the combination treatment with MTX+COL significantly inhibited both inflammation and destructive arthritis-associated changes. The combination treatment inhibited both the hind paw swelling and arthrogram score more remarkably than MTX alone; on the other hand, the difference between combination treatment and MTX alone was not significant. Treatment with COL alone had no effect on adjuvant arthritis in rats. Colinfant can increase the preventive effect of MTX treatment in rat adjuvant arthritis by improving its antiarthritic effects.

Small bowel ultrasound in patients with celiac disease. Retrospective study.

OBJECTIVE: Celiac disease (CD) is a common, lifelong disease with small bowel malabsorption based on genetically conditioned gluten intolerance. The clinical manifestation could be very heterogeneous. The proof of celiac disease is now based mainly on clinical and laboratory (antibodies and enterobiopsy) signs, which are in some cases problematic and inconvenient. MATERIALS AND METHODS: In our study we have examined 250 patients with suspection or with proven celiac disease and we evaluated specific ultrasound small bowel changes in this group. In the next step, we chose 59 patients with laboratory proved celiac disease and we statistically compared ultrasound, other laboratory and clinical findings in different forms and stages of the disease. RESULTS: Specific small bowel pathologies in patients with celiac disease (like changes of intestinal villi in different parts of small bowel, abnormal peristalsis and mesenterial lymphadenopathy) can be well visualized by ultrasound and in combination with clinical and laboratory signs ultrasound examination could have an important role in screening, determination of diagnosis and monitoring of patients with different forms of celiac disease.

[Large-droplet liver steatosis in celiac disease]. / Velkokapénková steatóza jater pri celiakii.

Authors monitored a case of a 25 years old woman who was admitted for swelling of lower limbs. Laboratory results showed hypoproteinemia, elevation of liver enzymes, and prolonged prothrombin time. Ultrasound examination proved hepatomegalia with diffusely hyperechogenic liver without central lesion. Computer tomography confirmed hepatomegalia with diffusely hyperechogenic liver and a suspicion of liver steatosis was expressed. Liver biopsy confirmed serious diffuse large droplet steatosis of unclear genesis. Carried out examinations excluded infectious and autoimmune liver diseases, metabolic diseases, and congenital liver diseases (Wilson's disease, porphyria, haemochromatosis etc.). Laboratory results showed gliadin, endomysin, and reticulin antibodies. An enteroscopy picture showed villi decrease. Histology examination of a biopsy specimen confirmed total villi atrophy with non-differentiated enterocytes and round-cell cellulisation of epithelium and proprium. Histology and histochemical findings were distinct proves of coeliac disease. A patient was prescribed a gluten free diet. Her metabolic parameters (normalisation of albumine levels, prothrombine time, and trace elements) and anino transferase levels gradually improved. This case documents development of a serious liver disorder as a result of malnutrition which developed in a young woman as a result of unrecognised coeliac disease.

[Accuracy in estimating decompensation in type I diabetes]. / Hranice presnosti odhadu kompenzace diabetiku I. typu.

Within the framework of a grant project the authors selected 30 patients, mean age 12.91 +/- 3.23 years with insulin dependent diabetes with a mean duration of 8 +/- 3.63 years treated so far by two doses of insulin per day: 0.49 +/- 0.21 UI/kg, ratio 3.1: 1.8 +/- 0.5: 0.3 rapid and NPH insulin, and an evening dose of 0.29 +/- 0.13 IU/kg with a ratio 2.4: 1.2 +/- 0.3: 0.2 rapid and NPH insulin, compensated on values of glycated haemoglobin HBA1c one month before assessment 6.31 +/- 1.84% and HBA1c at the time of assessment 7.52 +/- 2.13, with a residual capacity of the pancreas-C peptide values 0.70 +/- 0.20 ng/l. In this group the authors monitored, using a Biostator, the course of the 24-hour blood sugar level while the patients adhered to an individual dietary regime and insulin dosage. From the continual curve the authors selected with regard to time, typical peaks of the curve various types of profiles incl. those commonly used in practice. In those the authors compared the accuracy of calculation of compensation indexes. They found a different sensitivity of M-value, MGB a MAGE indexes, depending on the time of blood sampling used for their calculation and on the position of the selected blood sugar level in relation to the peaks of the blood sugar level. A significant finding was the marked influence on the accuracy of all indexes, but mainly of index MAGE, exerted by blood sugar levels associated with small meals and the nocturnal blood sugar level.(ABSTRACT TRUNCATED AT 250 WORDS)

Relationship between acetylator phenotype and intensity of the hypoglycaemic effect of a suplhonamide preparation in children with insulin-dependent diabetes.

The distribution of acetylator phenotypes was determined in 95 healthy children (4-15 y) and in 48 children with Type I diabetes (5-15) using the sulphadimidine test for the determination of acetylation capacity. The frequency of slow acetylators within the diabetic group (60.4%) closely resembled that in the healthy population (59.0%). There was no significant sex difference within either group. Subgrouping according to age showed a more marked preponderance of slow acetylators (65.0%) among children under six years of age on the control group but not in the diabetics (60.0%). Despite a relatively low dose of sulphadimidine used for acetylator phenotyping (20 mg/kg orally), a marked hypoglycaemic effect was observed in diabetics with slow but not with fast acetylator phenotype. The result appears to be coherent with the marked difference in the plasma concentrations of non-metabolized sulphadimidine which 6 h after the dose was 3.5-fold higher in slow acetylators than in fast ones. (Tab. 2, Fig. 1, Ref. 53.)