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vol. 85
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issue 2
58-64
EN
Acute appendicitis is one of the most common diseases requiring rapid surgical intervention. The disease occurs most often in people between 10 and 30 years of age, the risk of acute appendicitis during the whole life is 6-20%. The aim of the study was to assess the impact of BMI on the quality of life of patients operated for acute appendicitis according to the method of operation (LA- Laparoscopical Appendectomy OA - Open Appendectomy) and follow-up time after surgery. Material and methods. The study was conducted on a group of 86 randomly selected patients- 40 operated conventionally (18 women and 22 men) and from 46 patients undergoing laparoscopy (33 women and 13 men), which were operated during the period between 15 July 2007 and 27 February 2009. Each patient was assessed by BMI, recognizing the value of > 25 kg/m2 as overweight. In this study the basis of quality of life was a form Medical Outcomes Study36 -the Short Form or SF-36v.2. Results. Patients operated on in LA for 6 months observation to better assessed general health (GH) independently of BMI, while those with BMI ≤ 25 better assessed social functioning (SF) (p =0.027), an overall assessment of Physical Component Summary (PCS) (p = 0.048),Mental Component Summary (MCS) (p = 0.022) as well as an overall indicator of quality of life (p =0.025). The relationships that was not found in observations of more than 6 months after surgery (ns). Conclusions. Questionnaire SF-36v.2 facilitated an objective assessment of quality of life of patients operated on for acute appendicitis. Patients operated on by laparoscopic in observation for 6 months above assessed the quality of life regardless of BMI. The relationships that was not found in observations of more than 6 months after surgery (ns).
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52%
EN
Background: The available data on the incidence of lactose malabsorption are contradictory. Potential bias in random selection is a major drawback of studies performed to-date. Moreover, molecular analysis of polymorphism -13910 C>T upstream of the lactase (LCT) gene (NM_005915.4:c.1917+326C>T; rs4988235) has not been reported in those studies. Therefore, in this study we aimed to assess genetic predisposition and clinical manifestation of adult-type hypolactasia (ATH). Patients and methods: In two-hundred randomly chosen healthy subjects (HS) aged from 18 to 20 years, the presence of -13910 C>T polymorphic variants upstream of the LCT gene was assessed. In a subgroup of subjects with genotype predisposing to ATH, hydrogen-methane breath test (BT) with lactose loading was conducted to determine the current state of lactase activity. In addition, clinical symptoms typical for lactose malabsorption were assessed using the questionnaire method. Results: Sixty-three out of 200 (31.5 %) HS had -13910 C/C genotype. Thus, genetically determined lactase persistence is expected in the remaining 137 (68.5 %) subjects. Thirteen out of 53 (24.5 %) HS having -13910 C/C genotype were proved to be lactose intolerant. Recalculating the data for the entire studied population it implies the incidence of lactose malabsorption in 7.7 % of subjects. Only three out of 13 (23.1 %) subjects with abnormal BT results, reported clinical symptoms related to lactose consumption. Conclusions: Significantly lower than previously reported incidence of clinically detectable lactose malabsorption in young healthy adults in Poland has been documented. The -13910 C/C genotype upstream of the LCT gene indicates a predisposition to ATH, but definitely does not define the current ability to tolerate lactose.
EN
Restorative proctocolectomy is considered a surgical treatment of choice in ulcerative colitis (UC) and familial adenomatous polyposis (FAP).The aim of the study was to evaluate postoperative complications in patients who underwent surgery for familial adenomatous polyposis and ulcerative colitis, on the basis of a retrospective data analysis.Material and methods. Data of 138 patients after restorative proctocolectomy performed between 1985 and 2008 were collected at routine follow-up visits in 2004-2008. We evaluated the presence of pouchitis, the degree of ileal pouch mucosa atrophy, the presence of ileal pouch mucosal metaplasia, the presence of ileal pouch malignancies, the necessity for diverting ileostomy, the necessity for pouch resection, and severe faecal incontinence.Results. Complications were observed in 45 (32.4%) patients. Thirty-seven patients developed pouchitis (26.6%). Low-degree dysplasia, severe dysplasia or malignancies were observed in total in 20 patients (14.4%). Six (4.3%) operated patients developed other analysed complications.Conclusions. The most common complications of restorative proctocolectomy were dysplasia and pouchitis. The most common complication in patients operated for UC was pouchitis. The low observed incidence of intestinal pouchitis may be attributed to the implemented prophylaxis of inflammation. Dysplasia was the most common complication in patients undergoing proctocolectomy for FAP. Due to an increased risk of dysplastic lesions as compared with UC patients, careful endoscopic follow-up examinations are obligatory in this patient group. Other analysed complications were uncommon and were mostly a consequence of chronic pouchitis. Clinical symptoms of pouch-related problems were similar in both analysed groups.
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