Celiac disease is a chronic illness of the small bowel caused by gliadin intolerance in genetically predisposed subjects. The aim of this study was to investigate serum levels of IgA and IgG antigliadin antibodies, IgA antiendomysial antibodies, and IgA anti-tissue transglutaminase antibodies in 169 patients with autoimmune thyroid diseases, i.e. chronic thyroiditis and Graves´ disease. Antiendomysial antibodies were positive in 2 out of 169 persons (1.18 %), IgA antigliadin antibodies in 15.98 %, IgG antigliadin antibodies in 51.48 %, and IgA anti-tissue transglutaminase in 14.79 %. The prevalence of positivity was higher compared to the 1312 control blood donors described in our previous study (Vančíková et al. 2002) (p<0.05). Patients with chronic thyroiditis treated with a high replacement dosage of levothyroxin (125-200 μg daily) had higher serum levels of IgA antigliadin antibodies in comparison with patients treated with a lower dosage (50-100 μg daily) (medians: 13.00 vs. 19.69, p=0.033). We found a negative correlation of IgA anti-tissue transglutaminase antibodies and total calcium serum levels (r = -0.480, p=0.0236, n=22). We can conclude that in persons with autoimmune thyropathy there is a high prevalence of positive antigliadin, anti-tissue transglutaminase and antiendomysial antibodies. Latent celiac disease may lead to impaired resorption of therapeutically administered levothyroxine, calcium, or other substances., J. Jiskra, Z. Límanová, Z. Vaníčková, P. Kocna., and Obsahuje bibliografii
Osteoporosis in chronic diseases is very frequent and pathogenetically varied. It complicates the course of the underlying disease by the occurrence of fractures, which aggravate the quality of life and increase the mortality of patients from the underlying disease. The secondary deterioration of bone quality in chronic diseases, such as diabetes of type 1 and type 2 and/or other endocrine and metabolic disorders, as well as inflammatory diseases, including rheumatoid arthritis - are mostly associated with structural changes to collagen, altered bone turnover, increased cortical porosity and damage to the trabecular and cortical microarchitecture. Mechanisms of development of osteoporosis in some inborn or acquired disorders are discussed., I. Zofkova, P. Nemcikova., and Obsahuje bibliografii
Práce se zabývá řízením péče o nemocné celiakií. Jedná se o modelový případ řízení péče o chronicky nemocné. Analytickým rámcem práce je víceúrovňový inovativní model péče o chronicky nemocné. Klíčová je interakce mezi zdravotnickým týmem, který reprezentuje systém zdravotní péče, mezi komunitními partnery a mezi pacienty a jejich rodinami. V případu celiakie je pak nutno zahrnout také roli zástupců trhu s bezlepkovými potravinami. Interakce těchto aktérů se odehrává v širším politickém kontextu, jehož stav tuto interakci zásadním způsobem ovlivňuje a odráží se tak v konečných výsledcích stavu pacientů a kvalitě jejich života. Pomocí nástroje hodnocení kvality života pod - míněné zdravím SF-36 bylo zjištěno, že kvalita života celiaků je nižší ve srovnání s evropským standardem zdravé populace a že příčiny tohoto problému je nutno hledat a systematicky odstraňovat na všech úrovních systému péče o chronicky nemocné. Zjištění tak potvrzují teoretický předpoklad, že péče o chronicky nemocné je stále značně podceňována a neodpovídá specifickým potřebám chronicky nemocných pacientů, což se odráží právě na celkové kvalitě života., This work deals with coeliac disease management. The analytical framework of this work is the multilevel Innovative Care for Chronic Conditions Framework. Crucial is the interaction between health care team that represents health care system, community partners and patients with their families. In the case of coeliac disease it is necessary to include also the role of representatives of market with gluten free products. The interaction of these participants takes place in wider political context, whose state influences this interaction fundamentally and reflects so in final results state of patients and quality of their live. Using the evaluation of the quality of life tool SF-36, it has been ascertained, that the quality of life of coealiac patients is lower in comparison with European standard of healthy population and that the causes of the problem have to be searched and systematically removed at all levels of the system of chronic health care. The findings validate the theoretic presumption, that the chronic health care is still considerably underestimated and that it does not reply to the needs of chronic ill patients, which reflects just on general quality of life., Kristýna Přibylová, and Literatura