Biomedical subjects

P Drastich

Publications and source records attributed to P Drastich.

7 recordsLinked to original sources

PubMed2006

[The diagnostics and therapy of hepatic encephalopathy. Recommendations of of the working group on portal hypertension in the Czech Hepatology Society and the J. E. Purkinje Czech Medical Society].

UNLABELLED: Hepatic encephalopathy (HE) is a set of reversible neuropsychic features which occur in connection with hepatic cirrhosis or acute hepatic failure. We distinguish manifest HE (with clinical symptoms) and minimal FE (normal clinical finding, abnormal psychometric or neurophysiologic exam). The diagnosis is clinical or laboratory one. From the auxiliary examinations in common practice the number connection test is sufficient. THERAPY: Presence of hepatic encephalopathy should lead to the consideration of the possibility to solve basic disease by hepatic transplantation. Conservative therapy lies in 1. Basic disease elimination, 2. Measures lowering the ammonia level in blood--optimalization of protein intake, administration of indigestible disaccharides (lactulose, lactitol) and fill sterilisation by antibiotics (Rifaxin, Metronidazol), ornitine-aspartate administration, 3. Influencing the changes in amino acid metabolism (administration of branched chain amino acids--BCAA). Prognosis depends on the advancement of the disease, after hepatic transplantation the clinical symptoms of HE are mostly fully reversible.

Adult↗

PubMed2006

[Laparoscopic rectopexis].

INTRODUCTION: Rektopexis is an effective treatment method of rectal prolapses. Our retrospective study assessed the laparoscopic rectopexis results. METHODOLOGY: From 01-01-2003 to 31-11-2005, 10 patients were indicated for the procedure of laparoscopic retropexis. A "Vypro" mesh (Johnson&Johnson) was used to suspend the rectum. We fix it to the sacrum and to the rectum with an anchor (Eanchr, Johnson&Johnson). The follow-up examinations were conducted 2-30 months after the procedure. We assessed mortality rates, morbidity rates, the prolaps relapses incidence rates, obstipation incidence rates. RESULTS: The laparoscopic procedure was completed in 9 patients. In one case, we converted. The mortality and serious postoperative morbidity rate was 0%. The mean duration of hospitalization was 7 days. During the follow-up, no patient relapsed. One female patient complained of mild postoperative obstipation, which, however, did not require surgical revision. CONCLUSION: Laparoscopic rectopexis is a modern, safe and effective method of the prolaps of the rectum treatment.

Female↗

PubMed2006

[Capsule endoscopy--the past, presence, and future].

Wireless capsule endoscopy is a safe non-invasive method for the examination of the small intestine and terminal oesophagus. Examination is well tolerated by most of the patients. Due to the possibility to assess mucosa of the small intestine in details, capsule endoscopy has the diagnostical yield higher than other available methods. It is effective namely for study of obscure bleeding, celiac disease and Crohn's disease. Capsule endoscopy is aimed at the longterm follow up of patients with Barrett's oesophagus, however, the costs are higher than using gastroscopy. Capsule retention represents the most serious and practically the only complication of the examination which frequently requires surgical treatment. The future of capsule endoscopy depends on the next development of the technology.

Capsules↗

PubMed2006

[Diagnostics and therapy of hepatorenal syndrome. Recommendations of of the working group on portal hypertension of the Czech Hepatology Society and the J. E. Purkinje Czech Medical Society].

Hepatorenal syndrome is a functional renal failure in patients with advanced cirrhosis and portal hypertension or acute liver failure. It is caused by extreme vasoconstriction in renal arterial bed. Type I HRS presents as an acute renal failure, while type II HRS is chronic alteration of renal function in patients with refractory ascites. Prognosis of HRS is very poor with survival reaching several weeks in patients with HRS type I. Causal treatment is liver transplantation, other treatment options include use of splanchnic vasoconstrictors (terlipressin) together with plasmaexpansion (albumin) and TIPS. It is important to exclude nephrotoxic medication (non-steroid anti inflammatory drugs, aminoglycosides) and properly treat all infective complications in prevention of HRS.

Hepatorenal Syndrome↗

PubMed2005

[Diagnostics and treatment of hepatocellular carcinoma. Recommendations of the Portal Hypertension Working Group of the Czech Hepatology Society and the J.E. Purkinje Czech Medical Society ].

Hepatocellular carcionma (HCC) is almost exclusively associated with liver cirrhosis as a significant HCC risk marker in advanced countries. Applicable therapy depends on early diagnosis, and risk patients should be screened for the presence of HCC on a regular basis. Liver ultrasound and determination of alpha-fetoprotein serum levels (AFP) are the screening methods used. Spiral CT is the most often used method for HCC staging. Non-invasive methods may under certain circumstances replace aimed biopsy. There are 3 basic curative therapies for the early stage of HCC: liver transplantation, surgical resection and different methods of local destruction of tumour (i.e., ethanolisation, thermoablation, etc.). Patients at medium stage of HCC may profit from chemoembolisation. Current available systemic chemotherapy is ineffective. Patients with advanced HCC are treated symptomatically. Patient survival prognosis after the application of one of the above treatment methods may be similar with that for HCC free cirrhosis patients, however, prognosis for advanced HCC patients is bad, with survival period from one to nine months.

Carcinoma, Hepatocellular↗

PubMed2002

[Rifaximin in the treatment of hepatic encephalopathy].

Hepatic encephalopathy is a frequent and serious complication of liver cirrhosis. Usually it is treated by non-absorbable disaccharides or antibiotics and its treatment is often difficult and associated with undesirable effects. The objective of our investigation was to evaluate the safety and effectiveness of a new antibiotic used in this indication--rifaximine. With rifaximine, 400 mg three times per day, a total of 25 patients were treated for a 10-day period. Significant improvement of the manifestations of encephalopathy occurred (evaluated by the grade of encephalopathy, test of combining numerals, the degree of flapping tremor and the arterial ammonia level). None of the patients developed undesirable effects. Rifaximine seems an effective, safe drug for hepatic encephalopathy.

Anti-Infective Agents↗

PubMed1991

[The effect of pancreas and kidney transplantation on diabetic autonomic neuropathy].

The authors examined, using cardiovascular reflex tests, nine type I diabetics 6-48 months after combined transplantation of the pancreas and kidney with satisfactory function of both grafts. The control group was formed by 10 type 1 diabetics after transplantation of the kidney and 10 subjects free from disease causing damage to the vegetative nervous system. The results of the examination during the pretransplantation period suggested in both groups of diabetics severe affection of the vegetative nervous system. Despite long-term practical normalization of the diabetic metabolic disorder, in the patients after transplantation of the pancreas no detectable improvement of findings was recorded. Changes in the tests used were not found either in the control group of patients after isolated transplantation of the kidney. Damage of the vegetative nervous system in uraemic patients is probably irreversible and intervention studies are therefore indicated in an earlier stage of the disease.

Adult↗