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Abstract: Microbes capable of metabolizing gluten are common in various parts of the intestinal tract. In this study, saliva and fecal samples were obtained from 10 adolescents (13-18 years of age), five of which had celiac disease (CD) and five of which were healthy volunteers (HV). Culture-enriched saliva and fecal samples were compared with molecular profiling, and microorganisms displaying lysis zones on gluten-containing media (i.e., gluten-degrading microorganisms; GDMs) were isolated. In total, 45 gluten-degrading strains were isolated, belonging to 13 genera and 15 species, including Candida albicans and Veillonella. GDMs were more common in HVs compared to CD patients and more diverse in saliva compared to feces. In saliva, GDMs showed partial overlap between HVs and CD patients. Bacterial communities in fecal samples determined with amplicon sequencing significantly differed between CD patients and HVs. Overall, 7-46 of all operational taxonomic units (OTUs) per sample were below the detection limit in the fecal samples but were present in the cultivated samples, and mainly included representatives from Lactobacillus and Enterococcus. Furthermore, differences in fecal short-chain fatty-acid concentrations between CD patients and HVs, as well as their correlations with bacterial taxa, were demonstrated.
Keywords: gluten-degrading microorganisms, veillonella, candida, short-chain fatty acids, celiac disease, microbiota, sequencing
Published in DKUM: 14.10.2024; Views: 0; Downloads: 17
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Abstract: Celiakija je danes pogosta beseda in tudi poznana bolezen. Od samega začetka so bolniki s celiakijo v rednem stiku z zdravstvenimi delavci, ki jih podpirajo in redno spremljajo. So pa bolniki s celiakijo prikrajšani s prehranjevanjem v restavracijah, saj so gostinski delavci premalo izobraženi in posledično gostje nezadovoljni. Simptomi, ki se pojavljajo ob dietnih prekrških, so neprijetni in jih je potrebno lajšati, zato se bolniki raje odločijo, da bodo jedli doma.
Keywords: prehrana, gluten, zdravstveni delavci
Published in DKUM: 12.05.2023; Views: 643; Downloads: 53
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Abstract: Uvod: V diplomskem delu smo opisali diagnosticiranje, zdravljenje celiakije pri otroku in pomembno vlogo medicinske sestre pri pripravi otroka s celiakijo in njihovih staršev na samo izvedbo endoskopije. Metode: Uporabili smo kvantitativno metodologijo ter kot raziskovalni instrument anketni vprašalnik. Raziskovalni vzorec je bil neslučajnostni. V anketi so sodelovali otroci, starejši od 10 let, ki so zastavljena vprašanja razumeli, in starši otrok s celiakijo. Sodelovalo je 75 anketirancev. Uporabili smo opisno statistiko. Predstavljene grafe smo tekstovno interpretirali. Za analizo odprtih anketnih vprašanj smo uporabili metodo vsebinske analize. Rezultati: V raziskavi je sodelovalo 164 anketirancev. Povprečna starost je 36,8 leta. Največ sodelujočih je bilo na endoskopski preiskavi drugič. 58 % sodelujočih je povedalo, da niso bili deležni fizične priprave, 52 % ni bilo deležnih niti psihične priprave. Tisti, ki so bili deležni tako psihične kot tudi fizične priprave, so povedali, da jih je pripravila na preiskavo v 70 % medicinska sestra. Polovica vseh sodelujočih se strinja, da so pisna navodila bila razumljiva, druga polovica si deli različna mnenja, od razumljivosti do nerazumljivosti. Razprava in sklep: Pri pripravi otroka na endoskopijo so starši, otrok, zdravnik in medicinska sestra enakovredni. Naloga medicinske sestre in zdravnika je, da si skozi pogovor pridobita zaupanje, vzpostavita dober medosebni odnos in da dovolj dobro informirata starše in otroka o pripravi na preiskavo, izvedbi te ter si pridobita soglasje. Raziskava je pokazala, da bi lahko bolje informirali otroke in starše, kot tudi, da bi se morali bolj posvetiti psihični in fizični pripravi otroka na preiskavo, da bi se strah zaradi izvedbe preiskave zmanjšal.
Keywords: psihična in fizična priprava, pediatrični pacient, preiskava
Published in DKUM: 13.04.2022; Views: 934; Downloads: 86
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Abstract: Uvod: Cistična fibroza je multisistemska bolezen, za katero so v preteklosti umirali otroci in mladostniki, v zadnjih 20 letih pa se je zaradi uporabe presejalnih orodij za prepoznavanje CF ter vse večjih možnosti terapij življenjska doba podaljšala. Multidisciplinarna obravnava in holistični pristop pozitivno vplivata na psihofizični in socialni razvoj otroka oz. mladostnika, da se laže sooči z negativnimi posledicami, ki jih pušča bolezen. Namen zaključnega dela je ugotoviti, kakšna je kvaliteta življenja otrok in mladostnikov s CF s psihofizičnega in socialnega vidika. Metode: Uporabili smo deskriptivno metodo dela. Izvedli smo sistematični pregled znanstvene in strokovne literature obravnavane teme. V tabelah smo predstavili karakteristike identificiranih relevantnih virov, ki smo jih izbrali in prikazali skozi PRISMO. Kot orodje za kritično oceno člankov smo uporabili piramido hierarhije dokazov, na raziskovalno vprašanje smo odgovorili z analizo izbranih znanstvenih spoznanj. Rezultati: Po kritični oceni 10 člankov smo ugotovili, da je zaradi presejalnih testov novorojenčkov in naprednega zdravljenja življenje bolnikov daljše, kvaliteta življenja boljša. V adolescenci lahko pride do depresije, anksioznosti in strahu pri spopadanju z boleznijo, vendar podpora družine in sovrstnikov pozitivno vpliva na obvladovanje bolezni. Še vedno pa manjkajo strategije z bolj natančnimi usmeritvami glede zdravljenja in tega, kako se lahko bolniki še laže soočijo s simptomi bolezni. Pri tem imata glavno vlogo pozitivna naravnanost in holističen pristop. Diskusija in zaključek: Pozitivno družinsko okolje, dinamika in holističen pristop pozitivno vplivajo k optimalnemu zdravljenju otrok in mladostnikov s CF. Narejenih je veliko pozitivnih premikov, ki vodijo v izboljšano kvaliteto življenja.
Keywords: cistična fibroza, psihofizično zdravje, otroci in mladostniki, kronična bolezen, pljučna funkcija
Published in DKUM: 03.02.2022; Views: 1078; Downloads: 133
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Abstract: Coeliac disease (CD) is a lifelong systemic autoimmune disorder elicited by gluten and related prolamines in genetically susceptible individuals and is one of the most common chronic diseases, affecting about 1% of the population. It has a very diverse clinical presentation, involving intestinal, extraintestinal and even asymptomatic presentations. Due to its genetic background, CD is more common among family members of affected individuals and is associated with a number of other conditions. The diagnosis of CD is traditionally based on the presence of a specific immune response and characteristic histological changes in the small intestinal mucosa. In the recently published European Society for Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) guidelines, the initial diagnostic step is determination of CD-specific IgA autoantibodies against type-2 (tissue) transglutaminase. Positive autoantibodies imply a high probability of mucosal atrophy. To confirm the diagnosis, an upper endoscopy with multiple duodenal biopsies should be performed. However, ESPGHAN guidelines for the past eight years allow paediatric gastroenterologists to diagnose the disease without intestinal biopsy when certain criteria are met. The only available treatment for CD is a lifelong strict gluten-free diet, which should only be initiated after firm confirmation of the diagnosis. Patients have to avoid all gluten-containing products, including products from wheat and wheat cultivars, rye, barley, Khorasan wheat, triticale and bulgur. Owing to the high likelihood of cross-contamination, avoidance of oats is also recommended in many regions. Despite being one of the most common lifelong disorders, CD still remains undiagnosed for a long time in many adult and paediatric patients. Diagnostic delays in some regions exceed 10 years, which can have important adverse effects on patients’ health and quality of life. The aims of our study were to analyse the clinical presentation of CD in children and adolescents in selected Central European (CE) countries, to evaluate the compliance with current ESPGHAN guidelines for diagnosing CD in children and adolescents, to assess the diagnostic delays in children and adolescents with CD in selected CE countries, to identify possible regional differences, and to determine whether the clinical presentation or the diagnostic approach influence diagnostic delays. The study was carried out as a part of the Focus IN CD project with twelve project partners from five CE countries (Croatia, Germany, Hungary, Italy, and Slovenia). Paediatric gastroenterologists from the included regions were encouraged by the regional project partners to complete a web-based questionnaire, providing anonymised medical records of children and adolescents below 19 years of age who were diagnosed with CD in 2016. The questionnaire was translated into the languages of all project partners and focused on the onset of the CD-related symptoms, clinical presentation, diagnostic approach, and the results of all performed tests. The medical records of children and adolescents were then analysed, and the results compared regionally. We found that a non-classical clinical presentation and asymptomatic disease are becoming more common, and the classical clinical presentation with malabsorption syndrome less frequent in children and adolescents with CD. Abdominal pain was found to be the most common leading symptom in children older than three years, whereas, in very young children (
Keywords: coeliac disease, children, adolescents, Central Europe, clinical presentation, management, diagnostic delays
Published in DKUM: 18.03.2021; Views: 2145; Downloads: 97
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